| 1. |
- Beeres, Dorien Tecla, et al.
(author)
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Child–adult contract for prevention of tobacco use : "as-treated" analysis of a cluster randomized controlled trial (the TOPAS study) at 3-year follow-up
- 2024
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In: Prevention Science. - : Springer Nature. - 1389-4986 .- 1573-6695. ; 25, s. 175-192
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Journal article (peer-reviewed)abstract
- To estimate the effect of a 3-year commitment to remain tobacco free on tobacco uptake among high school students in Sweden. The commitment is developed in the form of a contract between a child and a significant adult, constituting the core component of Tobacco-free Duo (T-Duo), a Swedish school-based tobacco prevention program. Secondary analysis of data from a cluster randomized controlled trial. Participants were 586 students in high schools assigned to the intervention arm of T-Duo. At inception, participants attended grade 7 (i.e., age 12–13). Only students who were tobacco naïve at baseline for the respective outcome and participated in all follow-ups were included. The exposure was defined as signing a 3-year contract with a significant adult, categorized as “stable contract” (3 years contract with the same contract partner), “unstable” (signed a contract sometime during follow-up but this was not sustained over time and/or with the same partner), and “no contract” at all during the intervention period. The primary outcome was having never tried cigarette smoking at the end of grade 9. Exposure and outcomes were self-reported in yearly questionnaires. Of 586 students, 321 (55%) held a stable contract, 204 (35%) an unstable contract, and 61 (10%) did not sign a contract at all. At the end of grade 9 (age 15–16), the relative risk (RR) to remain cigarette free was 1.11 (95% CI 1.00–1.22) (Number Needed to Treat = 10) among students in any type of contract compared to students that did not write a contract at all. The RRs for remaining tobacco free (secondary outcomes) ranged from 1.07 (0.98–1.16) for regular snus use to 1.16 (1.00–1.35) for any type of tobacco use. A commitment to remain tobacco free through a child–adult contract seems to exert a preventive effect on the uptake of tobacco use among Swedish adolescents over 3 school years. The current findings apply to a selected sample of both schools and students.Registration: Current Controlled Trials ISRCTN52858080 Date: January 4, 2019, retrospectively registered.
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| 2. |
- Galanti, Maria Rosaria, et al.
(author)
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Tobacco-Free Duo Adult-Child Contract for Prevention of Tobacco Use Among Adolescents and Parents : Protocol for a Mixed-Design Evaluation
- 2020
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In: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 9:10
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Journal article (peer-reviewed)abstract
- BACKGROUND: Universal tobacco-prevention programs targeting youths usually involve significant adults, who are assumed to be important social influences. Commitment not to use tobacco, or to quit use, as a formal contract between an adolescent and a significant adult is a preventive model that has not been widely practiced or explored and has been formally evaluated even less. In this paper, we present the rationale and protocol for the evaluation of the Swedish Tobacco-free Duo program, a multicomponent school-based program the core of which rests on a formal agreement between an adolescent and an adult. The adolescent's commitment mainly concerns avoiding the onset of any tobacco use while the adult commits to support the adolescent in staying tobacco free, being a role model by not using tobacco themselves.OBJECTIVE: To assess (1) whether Tobacco-free Duo is superior to an education-only program in preventing smoking onset among adolescents and promoting cessation among their parents, (2) whether exposure to core components (adult-child agreement) entails more positive effects than exposure to other components, (3) the impact of the program on whole school tobacco use, (4) potential negative side effects, and (5) school-level factors related to fidelity of the program's implementation.METHODS: A mixed-design approach was developed. First, a cluster randomized controlled trial was designed with schools randomly assigned to either the comprehensive multicomponent program or its educational component only. Primary outcome at the adolescent level was identified as not having tried tobacco during the 3-year junior high school compulsory grades (12-15 years of age). An intention-to-treat cohort-wise approach and an as-treated approach complemented with a whole school repeated cross-sectional approach was devised as analytical methods of the trial data. Second, an observational study was added in order to compare smoking incidence in the schools participating in the experiment with that of a convenience sample of schools that were not part of the experimental study. Diverse secondary outcomes at both adolescent and adult levels were also included.RESULTS: The study was approved by the Umeå Regional Ethics Review Board (registration number 2017/255-31) in 2017. Recruitment of schools started in fall 2017 and continued until June 2018. In total, 43 schools were recruited to the experimental study, and 16 schools were recruited to the observational study. Data collection started in the fall 2018, is ongoing, and is planned to be finished in spring 2021.CONCLUSIONS: Methodological, ethical, and practical implications of the evaluation protocol were discussed, especially the advantage of combining several sources of data, to triangulate the study questions. The results of these studies will help revise the agenda of this program as well as those of similar programs.TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) 52858080; https://doi.org/10.1186/ISRCTN52858080.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/21100.
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| 3. |
- Pulkki-Brännström, Anni-Maria, et al.
(author)
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Protocol for the evaluation of cost-effectiveness and health equity impact of a school-based tobacco prevention programme in a cluster randomised controlled trial (the TOPAS study)
- 2021
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:8
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Journal article (peer-reviewed)abstract
- Introduction: Despite a long-term downward trend in smoking prevalence, tobacco remains the number one risk factor for death and disability in Sweden. Globally, tobacco use generates a substantial economic burden for health systems and is also a major driver of socioeconomic inequalities in health. This article describes the planned cost-effectiveness and health equity impact evaluation of a multicomponent school-based programme to prevent the onset of tobacco use in adolescents.Methods and analysis: Cost-effectiveness of the multicomponent Tobacco-Free Duo programme will be evaluated against the educational component of the same programme only. An incremental cost-effectiveness ratio (ICER) will be calculated in terms of the cost per case prevented using the trial primary outcome and within-trial payer costs. If the ICER is negative, an incremental net benefit ratio will be calculated. Robustness of the results will be assessed through one-way sensitivity analyses. The slope index of inequality will be computed to assess the potential impact of the Tobacco-free Duo programme on education-related inequalities in the onset of smoking and in adult smoking cessation, comparing the two trial arms.Ethics and dissemination: Ethical approval was obtained from the Regional Ethics Review Board, Umeå (registration number 2017/255-31). The Public Health Agency of Sweden commissioned the study. The findings will be disseminated internationally within academia and to national and local policy-makers.Trial registration number: ISRCTN52858080; Pre-results.
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| 4. |
- Andersson, Maria, 1976, et al.
(author)
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Mild renal ischemia-reperfusion reduces charge and size selectivity of the glomerular barrier
- 2007
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In: American Journal of Physiology Renal Physiology. - : American Physiological Society. - 0363-6127 .- 1931-857X .- 1522-1466. ; 292:6
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Journal article (peer-reviewed)abstract
- Despite recent discoveries of molecules in podocytes, the mechanisms behind most conditions of proteinuria are still poorly understood. To understand more about this delicate barrier, we studied the functional and morphological effects of mild (15 min) renal ischemia-reperfusion injury (IRI). Renal function was studied in rats in vivo, followed by a more detailed analysis of the glomerular barrier in cooled (8 degrees C) isolated perfused kidneys (cIPK). Renal blood flow was quickly restored, whereas the glomerular filtration rate remained halved 30 min after IRI. Tubular cell activity was intact as judged from the unaffected Cr-EDTA U/P concentration ratio. In vivo, the fractional clearance (theta) for albumin increased 16 times. In rats subjected to cIPK starting 30 min after in vivo IRI, theta(albumin) was 15 times and theta(Ficoll_36angstroms) 1.8 times higher than in control cIPKs. According to the heterogeneous charged fiber model, IRI reduced the fiber charge density to 38% of control (P < 0.01, n = 7). Morphometric analysis with electron microscopy did not reveal any changes in the podocytes or the glomerular basement membrane (GBM) after IRI, suggesting more subtle changes of the GBM and/or the endothelial glycocalyx. We conclude that mild renal IRI induces formation of reactive oxygen species, massive proteinuria, and loss of charged fibers with no apparent change in morphology. These novel findings stress the importance of other components of the barrier, such as proteoglycans produced by the glomerular cells, and provide a tentative explanation for the mechanisms behind proteinuria in glomerulonephritis, for example.
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| 5. |
- Beeres, D., et al.
(author)
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Evaluation of the Swedish school-based program “tobacco-free DUO” in a cluster randomized controlled trial (TOPAS study). Results at 2-year follow-up
- 2022
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In: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 155
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Journal article (peer-reviewed)abstract
- Friends' and parents' tobacco use are strong predictors of tobacco uptake among adolescents, however the effectiveness of interventions based on public commitments and agreements to remain tobacco-free are not established. Here, we evaluated the effectiveness of the school-based Swedish program Tobacco-Free Duo (T-Duo) in preventing adolescents from initiating tobacco use (TOPAS study). T-Duo is a multi-component intervention witha formal agreement between a student and an adult partner to remain tobacco-free during the entire 3-year study period as core component. The standardized educational component of the same program was used as comparator (control). Primary outcome was the probability to “remain a non-user” of i) cigarettes and secondary outcomes ii) other types of tobacco at second (21-month) follow-up. Analysis was conducted according to Intention To Treat. In total 1776 adolescents (51% female) aged 12–13 in grade 7 from 34 participating high schools in Sweden were included at baseline in 2018, of which 1489 were retained after 21 months. The Risk Ratio (RR) of not having tried cigarettes 21-months after initiation of the intervention was 1.03(CI 0.98–1.08), Bayes Factor(BF) = 0.93, Absolute Risk Difference(ARD) = 3.1%. Similar associations were found for never smoked a whole cigarette and never use of other tobacco/nicotine products. There was a minimal reduction of tobacco use initiation among Swedish adolescents assigned to a multi-component intervention (T-Duo) compared to those assigned to standardized classroom education after 2 schoolyears. However, for most outcomes' findings were inconclusive and not reliably different from zero. Trial registration: ISRCTN5285808 (doi:https://doi.org/10.1186/ISRCTN52858080); Study protocol: DERR1-https://doi.org/10.2196/21100. Registration: Current Controlled Trials ISRCTN52858080 Date: January 4, 2019, retrospectively registered. Protocol: Galanti, M.R., Pulkki-Brännström, A.-M., Nilsson, M., 2020. Tobacco-free duo adult-child contract for prevention of tobacco use among adolescents and parents: protocol for a mixed-design evaluation. JMIR Res. Protoc. 9, e21100. doi:10.2196/21100. © 2021
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| 6. |
- Borg, Sabina, et al.
(author)
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The Added Value of a Behavioral Medicine Intervention in Physiotherapy on Adherence and Physical Fitness in Exercise-Based Cardiac Rehabilitation (ECRA): A Randomised, Controlled Trial
- 2020
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In: Patient Preference and Adherence. - : DOVE MEDICAL PRESS LTD. - 1177-889X. ; 14, s. 2517-2529
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Journal article (peer-reviewed)abstract
- Purpose: Despite beneficial effects, adherence to exercise-based cardiac rehabilitation (exCR) is low in patients with coronary artery disease (CAD). The aim of this study was to investigate adherence to and the effects of a behavioral medicine intervention in physiotherapy (BMW) added to routine exCR care on the primary outcome of physical fitness compared with routine exCR care. Patients and Methods: In a randomized, controlled trial, 170 patients with CAD (136 men), mean age 62.3 (7.9) years, were included at a Swedish university hospital. Patients were randomized 1:1 to routine exCR care (RC) or to a BMIP added to routine exCR care for four months, with a long-term follow-up at 12 months. The outcome assessment included submaximal aerobic exercise capacity, muscle endurance and self-reported physical activity and physical capacity. Results: The four-month follow-up showed improvements in all outcomes for both groups, but changes did not differ significantly between the groups. Patients in the BMIP group were more adherent to exCR recommendations compared with the RC group (31% vs 19%) and a non-significant tendency towards the maintenance of submaximal aerobic exercise capacity over time was seen in the BMIP group, whereas patients in the RC group appeared to deteriorate. Conclusion: Both groups improved significantly at the four-month follow-up, while the 12-month follow-up showed a non-significant tendency towards better long-term effects on submaximal aerobic exercise capacity and exercise adherence for a BMIP compared with RC. In spite of this, a better understanding of the role of a BMIP in enhancing adherence is needed.
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| 7. |
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| 8. |
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| 9. |
- Furberg, Maria, 1970-, et al.
(author)
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Facing the limit of resilience : perceptions of climate change among reindeer herding Sami in Sweden
- 2011
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In: Global Health Action. - Häggeby : Co-Action publishing. - 1654-9716 .- 1654-9880. ; 4:8417, s. 11-
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Arctic area is a part of the globe where the increase in global temperature has had the earliest noticeable effect and indigenous peoples, including the Swedish reindeer herding Sami, are amongst the first to be affected by these changes.OBJECTIVE: To explore the experiences and perceptions of climate change among Swedish reindeer herding Sami.STUDY DESIGN: In-depth interviews with 14 Swedish reindeer herding Sami were performed, with purposive sampling. The interviews focused on the herders experiences of climate change, observed consequences and thoughts about this. The interviews were analysed using content analysis.RESULTS: ONE CORE THEME EMERGED FROM THE INTERVIEWS: facing the limit of resilience. Swedish reindeer-herding Sami perceive climate change as yet another stressor in their daily struggle. They have experienced severe and more rapidly shifting, unstable weather with associated changes in vegetation and alterations in the freeze-thaw cycle, all of which affect reindeer herding. The forecasts about climate change from authorities and scientists have contributed to stress and anxiety. Other societal developments have lead to decreased flexibility that obstructs adaptation. Some adaptive strategies are discordant with the traditional life of reindeer herding, and there is a fear among the Sami of being the last generation practising traditional reindeer herding.CONCLUSIONS: The study illustrates the vulnerable situation of the reindeer herders and that climate change impact may have serious consequences for the trade and their overall way of life. Decision makers on all levels, both in Sweden and internationally, need improved insights into these complex issues to be able to make adequate decisions about adaptive climate change strategies.
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| 10. |
- Nilsson, Maria, 1957-, et al.
(author)
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"Immortal but frightened" : smoking adolescents´ perceptions on smoking uptake and prevention
- 2010
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10, s. 776-
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Journal article (peer-reviewed)abstract
- Young smokers described starting to smoke as a means of gaining control of feelings and situations during early adolescence. Smoking adolescents expect adults to intervene against smoking. Close relations with concerned adults could be a reason for less frequent smoking or trying to quit smoking. Interventions aimed at normative changes, with consistent messages from both schools and parents about the negative aspects of tobacco seem to be a feasible approach for preventing youth from using tobacco.
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| 11. |
- Nilsson, Maria, 1957-, et al.
(author)
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Topas - tobakspreventivt arbete i skolan. Slutrapport : en utvärdering av det ANDT-förebyggande programmet Tobaksfri duo
- 2022
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Reports (other academic/artistic)abstract
- I Sverige har tobaksförebyggande program med ungdomar som målgrupp under många år initierats, utvecklats och drivits av kommuner, regioner, och den ideella sektorn. Antalet vetenskapliga studier om tobaksförebyggande arbete i landet som publicerats i vetenskapliga tidskrifter är mycket få och har främst genomförts med en kvasiexperimentell design. Tobaksfri duo (T-Duo) har spridits i landet och önskemål har uttryckts om en utvärdering med metodik som ger högre evidensgrad jämfört med de studier som genomförts tidigare. Genom Topasprojektet har en sådan utvärdering av användningen av programmets kärnkomponenter möjliggjorts. Studien har genomförts av Umeå universitet och Karolinska Institutet på uppdrag av Folkhälsomyndigheten. Den hade en blandad design: 1) en klusterrandomiserad kontrollerad studie (CRCT) där skolor tilldelades programmet T-Duos sex kärnkomponenter eller en minimal komponent i form av Strukturerad undervisning, 2) en observationsstudie där programskolor jämfördes med skolor i en extern referensgrupp samt 3) en hälsoekonomisk utvärdering av programmets kostnadseffekt.Studiens övergripande syfte var att utvärdera effekterna och kostnaderna av programmet T-Duos sex kärnkomponenter genom att besvara följande specifika frågeställningar:Påverkas ungas tobaksdebut och tobaksanvändning av programmet? - d.v.s. är den förebyggande effekten större om man arbetar med programmet jämfört med en minimal komponent, alternativt ordinarie ANDT-undervisning i skolan?Påverkar deltagande i programmet vårdnadshavares tobaksbruk?Har graden av implementering av programmet betydelse för effekten?Är effekterna sådana att programkostnaderna är motiverade?Resultaten från studien visar att det fullständiga programmet T-Duo förknippas med en måttlig förebyggande effekt på högstadieelevers tobaksdebut (cirka 8 % större sannolikhet att förbli rökfria efter tre år), jämfört med om man enbart bedrev undervisning om tobak enligt programmet som ingick i Topas kontrollgrupp Undervisningsskolor (U-skolor). Resultaten kan dock ha påverkats av vissa systematiska fel, dels bortfall, dels beroende på självrapportering.Kontraktet som skrevs mellan ett barn och en vuxen 18 år eller äldre som barnet själv valde som vuxenpartner i T-Duo visade sig vara en effektiv komponent om kontraktet kunde upprätthållas under samtliga år. Komponenten innehåller tre delar kopplat till kontraktet, i) dels en möjlighet till stöd från en vuxen som barnet själv valt, att barnet ii) vid kontraktsskrivning gör ett åtagande inför andra om att man inte ska använda tobak under de kommande tre åren och slutligen iii) möjligheten för barnet att delta i utlottning av mindre priser och till rabatter (på till exempel skolfiket).Resultaten indikerade också att T-Duo kan påverka tobaksbruk på gruppnivå, det vill säga på skolnivå, på ett positivt sätt över tid. Med andra ord att alla elever på en skola som jobbade med T-Duo påverkades av programmet och inte bara de som deltog.Vad gällde vårdnadshavare (VH) i T-skolor sågs en möjlig effekt avseende tobaksstopp, det vill säga att de få deltagare som använde tobak i början av studien och som var kvar i slutet slutade använda tobak i större utsträckning än föräldrar i skolor lottade till enbart undervisningskomponenten. Dock måste resultaten tolkas med stor försiktighet på grund av det låga antalet VH som svarade på enkäten. Av denna anledning är det inte möjligt att säga om VH som tecknade kontrakt med sina barn hade större sannolikhet att förbli tobaksfria eller inte, eftersom andelen tobaksbrukare i gruppen som tecknade kontraktet med sina barn redan från början var mycket låg och betydligt lägre än bland resterande VH.Mycket få skolor hade implementerat programmet T-Duo helt enligt manualen för studien. Implementeringen var oftast måttlig, dvs att man hade genomfört mer än två kärnkomponenter enligt manualen, dock inte alla. Graden av implementering påverkade dock inte resultaten.I beräkningen av kostnadseffektivitet relaterades skillnaden i kostnader mellan T-skolor och U-skolor till den beräknade effekten i termer av hur många fler barn som förblev rökfria på grund av programmet. Det treåriga programmet kostade 785 kr per exponerat barn på T-skolorna och endast strukturerad undervisning kostade 491 kr per barn på U-skolorna. T-Duo kostade därmed 294 kr mer per barn jämfört med endast Strukturerad undervisning och kostnadseffektiviteten uppskattades till 5 066 kr för varje ytterligare barn som var rökfri i slutet på årskurs nio. Om effekten kvarstår fram till vuxen ålder representerar T-duo en mycket bra användning av resurserna i förhållande till framtida konsekvenser på hälsan som vuxen. Osäkerheten rörande programeffekten och om effekten kommer att bestå är avgörande för denna slutsats.
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| 12. |
- Rafsten, Lena, et al.
(author)
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Gothenburg Very Early Supported Discharge study (GOTVED) : a randomised controlled trial investigating anxiety and overall disability in the first year after stroke
- 2019
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In: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 19, s. 1-10
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Journal article (peer-reviewed)abstract
- BACKGROUND AND PURPOSE: Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine.METHODS: A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients' degree of overall disability, measured by the modified Rankin Scale (mRS).RESULTS: No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke.CONCLUSIONS: The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit.TRIAL REGISTRATION: Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).
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| 13. |
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| 14. |
- van Daalen, Kim R., et al.
(author)
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The 2024 Europe report of the lancet countdown on health and climate change : unprecedented warming demands unprecedented action
- 2024
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In: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 9:7, s. e495-e522
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Research review (peer-reviewed)abstract
- Record-breaking temperatures were recorded across the globe in 2023. Without climate action, adverse climate-related health impacts are expected to worsen worldwide, affecting billions of people. Temperatures in Europe are warming at twice the rate of the global average, threatening the health of populations across the continent and leading to unnecessary loss of life. The Lancet Countdown in Europe was established in 2021, to assess the health profile of climate change aiming to stimulate European social and political will to implement rapid health-responsive climate mitigation and adaptation actions. In 2022, the collaboration published its indicator report, tracking progress on health and climate change via 33 indicators and across five domains.This new report tracks 42 indicators highlighting the negative impacts of climate change on human health, the delayed climate action of European countries, and the missed opportunities to protect or improve health with health-responsive climate action. The methods behind indicators presented in the 2022 report have been improved, and nine new indicators have been added, covering leishmaniasis, ticks, food security, health-care emissions, production and consumption-based emissions, clean energy investment, and scientific, political, and media engagement with climate and health. Considering that negative climate-related health impacts and the responsibility for climate change are not equal at the regional and global levels, this report also endeavours to reflect on aspects of inequality and justice by highlighting at-risk groups within Europe and Europe's responsibility for the climate crisis.
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| 15. |
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| 16. |
- Ahrentorp, Fredrik, et al.
(author)
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Sensitive magnetic biodetection using magnetic multi-core nanoparticles and RCA coils
- 2017
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In: Journal of Magnetism and Magnetic Materials. - : Elsevier BV. - 0304-8853 .- 1873-4766. ; 427, s. 14-18
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Journal article (peer-reviewed)abstract
- We use functionalized iron oxide magnetic multi-core particles of 100 nm in size (hydrodynamic particle diameter) and AC susceptometry (ACS) methods to measure the binding reactions between the magnetic nanoparticles (MNPs) and bio-analyte products produced from DNA segments using the rolling circle amplification (RCA) method. We use sensitive induction detection techniques in order to measure the ACS response. The DNA is amplified via RCA to generate RCA coils with a specific size that is dependent on the amplification time. After about 75 min of amplification we obtain an average RCA coil diameter of about 1 mu m. We determine a theoretical limit of detection (LOD) in the range of 11 attomole (corresponding to an analyte concentration of 55 fM for a sample volume of 200 mu L) from the ACS dynamic response after the MNPs have bound to the RCA coils and the measured ACS readout noise. We also discuss further possible improvements of the LOD.
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| 17. |
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| 18. |
- Alcorta, M., et al.
(author)
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Nuclear Structure of C-12 from Break-up Studies in Complete Kinematics
- 2009
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In: AIP Conference Proceedings. - : AIP. - 1551-7616 .- 0094-243X. - 9780735407022 ; 1165, s. 27-30 461
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Conference paper (peer-reviewed)abstract
- A complete kinematics study of the B-10(He-3,p alpha alpha alpha) and B-11(He-3,d alpha alpha alpha) reactions has been performed to study the multi-particle break-up of C-12 resonances above the triple-alpha threshold. Four-particle coincidence detection gives us complete information on the direction and energy of the individual alpha particles from the decay of C-12, allowing us to extract new information on the structure of C-12 which we shall present in this contribution. We have observed gamma de-excitation of the T=1 15.11 MeV resonance using charged particle detectors, and have constructed Dalitz plots of the individual resonances in C-12 using the complete kinematics information of the alpha particles which come from their break-up.
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| 19. |
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| 20. |
- Alm Rosenblad, Magnus, 1957, et al.
(author)
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Detection of signal recognition particle (SRP) RNAs in the nuclear ribosomal internal transcribed spacer 1 (ITS1) of three lineages of ectomycorrhizal fungi (Agaricomycetes, Basidiomycota)
- 2016
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In: MycoKeys. - : Pensoft Publishers. - 1314-4057 .- 1314-4049. ; 13, s. 21-33
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Journal article (peer-reviewed)abstract
- During a routine scan for Signal Recognition Particle (SRP) RNAs in eukaryotic sequences, we surprisingly found in silico evidence in GenBank for a 265-base long SRP RNA sequence in the ITS1 region of a total of 11 fully identified species in three ectomycorrhizal genera of the Basidiomycota (Fungi): Astraeus, Russula, and Lactarius. To rule out sequence artifacts, one specimen from a species indicated to have the SRP RNA-containing ITS region in each of these genera was ordered and re-sequenced. Sequences identical to the corresponding GenBank entries were recovered, or in the case of a non-original but conspecific specimen differed by three bases, showing that these species indeed have an SRP RNA sequence incorporated into their ITS1 region. Other than the ribosomal genes, this is the first known case of non-coding RNAs in the eukaryotic ITS region, and it may assist in the examination of other types of insertions in fungal genomes.
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| 21. |
- Atusingwize, Edwinah, et al.
(author)
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Social media use and alcohol consumption among students in Uganda : a cross sectional study
- 2022
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In: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 15:1
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Journal article (peer-reviewed)abstract
- Background Globally, alcohol use significantly contributes to the disease burden. Alcohol consumption in Uganda is related to several health consequences among young people, including university students. Social media is commonly used by students to share academic information and create social networks. Among young people in high-income countries, previous studies have also shown that social media use can have negative health outcomes related to alcohol use, and associated problems. To date, similar studies conducted in low- and middle-income countries are largely missing. Objective To assess the prevalence of and associations between social media use and alcohol consumption among university students in Uganda. Method This was a cross-sectional study among 996 undergraduate students at Makerere University. Data were collected using a questionnaire. Alcohol use in the previous 12 months was the dependent variable. The independent variable was social media use categorised as general use, alcohol-related use, and social media lurking/passive participation. Multinomial logistic regression was used to assess associations. Crude and adjusted odds ratios were reported. Results Nearly all students (97%) used social media and 39% reported alcohol use. Regular alcohol use was significantly associated with moderate (OR = 2.22, CI: 1.35-3.66) and high level general social media use (OR = 2.45, CI: 1.43-4.20). Regular alcohol use was also associated with alcohol-related social media (OR = 6.46, CI: 4.04-10.30), and alcohol-related lurking (OR = 4.59, CI: 2.84-7.39). Similar, although weaker associations were identified for occasional alcohol use. Conclusions Approximately four in ten students reported alcohol use in the past year, and almost all students used social media. Alcohol-related social media use was associated with occasional and regular alcohol use, with stronger associations for regular use. These findings may guide further research and present an opportunity for potential alcohol control interventions to improve health among young populations in low- and middle-income countries.
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| 22. |
- Becker, K., et al.
(author)
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Antibacterial activity of apramycin at acidic pH warrants wide therapeutic window in the treatment of complicated urinary tract infections and acute pyelonephritis
- 2021
-
In: EBioMedicine. - : Elsevier B.V.. - 2352-3964. ; 73
-
Journal article (peer-reviewed)abstract
- Background: The clinical-stage drug candidate EBL-1003 (apramycin) represents a distinct new subclass of aminoglycoside antibiotics for the treatment of drug-resistant infections. It has demonstrated best-in-class coverage of resistant isolates, and preclinical efficacy in lung infection models. However, preclinical evidence for its utility in other disease indications has yet to be provided. Here we studied the therapeutic potential of EBL-1003 in the treatment of complicated urinary tract infection and acute pyelonephritis (cUTI/AP). Methods: A combination of data-base mining, antimicrobial susceptibility testing, time-kill experiments, and four murine infection models was used in a comprehensive assessment of the microbiological coverage and efficacy of EBL-1003 against Gram-negative uropathogens. The pharmacokinetics and renal toxicology of EBL-1003 in rats was studied to assess the therapeutic window of EBL-1003 in the treatment of cUTI/AP. Findings: EBL-1003 demonstrated broad-spectrum activity and rapid multi-log CFU reduction against a phenotypic variety of bacterial uropathogens including aminoglycoside-resistant clinical isolates. The basicity of amines in the apramycin molecule suggested a higher increase in positive charge at urinary pH when compared to gentamicin or amikacin, resulting in sustained drug uptake and bactericidal activity, and consequently in potent efficacy in mouse infection models. Renal pharmacokinetics, biomarkers for toxicity, and kidney histopathology in adult rats all indicated a significantly lower nephrotoxicity of EBL-1003 than of gentamicin. Interpretation: This study provides preclinical proof-of-concept for the efficacy of EBL-1003 in cUTI/AP. Similar efficacy but lower nephrotoxicity of EBL-1003 in comparison to gentamicin may thus translate into a higher safety margin and a wider therapeutic window in the treatment of cUTI/API. Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section. © 2021 The Author(s)
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| 23. |
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| 24. |
- Boij, A, et al.
(author)
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Kunskapsbaserat tobaksförebyggande arbete i skolan : A Non Smoking Generations (NSG) flerkomponentsprogram
- 2018
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In: Socialmedicinsk Tidskrift. - : Socialmedicinsk tidskrift. - 0037-833X. ; 95:4, s. 421-433
-
Journal article (peer-reviewed)abstract
- Den idéburna organisationen A Non Smoking Generation utvecklade under 2010–2017 ett kunskaps- och teoribaserat tobaksförebyggande flerkomponentsprogram för grund- och gymnasieskola tillsammans med en tvärvetenskaplig rådgivande forskargrupp. Här beskrivs programutvecklingsarbetet och genomförandet i fyra svenska kommuner, graden av engagemang och stöd för genomförandet samt elevernas syn på policy och lagar rörande tobak. Programmets teoretiska ramverk utgick från teorier och kunskap om förändringsberedskap, risk- och skyddsfaktorer, implementering, samt den processmodell som utvecklades och tillämpades i projektet. Alla skolor i kommunerna gick under projekttiden från att ha en lägre förändringsberedskap att arbeta tobaksförebyggande till en högre. I slutet av projektet var de tobaksspecifika skyddsfaktorerna inkluderade i tobakspolicys som tillämpades och andelen elever som kände till tobakspolicyn hade ökat. Resultaten visade också att kommunernas skolor hade kunnat tillämpa och kommit långt i arbetet med processmodellen. Av intervjuerna framkom att de var mycket nöjda med modellen och ansåg att den var lätt att arbeta utifrån och hålla fast vid i framtida arbete.
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| 25. |
- Borg, Sabina, et al.
(author)
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Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation : a randomized, controlled trial
- 2023
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In: BMC Sports Science, Medicine and Rehabilitation. - : BioMed Central Ltd. - 2052-1847. ; 15:1
-
Journal article (peer-reviewed)abstract
- Background: Interventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC). Methods: A total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed. Results: No significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up. Conclusion: A BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed. Trial registration number NCT02895451, 09/09/2016, retrospectively registered.
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| 26. |
- Borg, Sabina, et al.
(author)
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The role of a behavioural medicine intervention in physiotherapy for the effects of rehabilitation outcomes in exercise-based cardiac rehabilitation (ECRA) - the study protocol of a randomised, controlled trial
- 2017
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In: BMC Cardiovascular Disorders. - : BIOMED CENTRAL LTD. - 1471-2261 .- 1471-2261. ; 17
-
Journal article (peer-reviewed)abstract
- Background: To help patients with coronary artery disease (CAD) benefit from the positive health effects attained by exercise-based cardiac rehabilitation (CR), adherence to these programmes according to international guidelines is important. Strategies to increase adherence to exercise-based CR are mainly an unexplored area. The objective of this study is to investigate the effects of a behavioural medicine intervention in physiotherapy, containing goal-setting, self-monitoring and feedback, with the aim of improving rehabilitation outcomes for exercise-based CR, compared with usual care. Methods: This is a randomised, controlled trial. A total of 160 patients with CAD will be included consecutively at the Coronary Care Unit at a university hospital in Sweden. Patients are randomised 1:1 using sealed envelopes to usual care or a behavioural medicine intervention in physiotherapy, in addition to usual care for 4 months. Outcome assessment at baseline, 4 and 12 months includes submaximal aerobic capacity (primary outcome), exercise adherence, muscle endurance, level of physical activity, biomarkers, anxiety and depression, health-related quality of life, patient enablement and self-efficacy (secondary outcomes). Discussion: This is the first study to evaluate the role of an integrated behavioural medicine intervention in exercise-based CR in the effects of rehabilitation outcomes. The results of this study will provide valuable information about the effect of these interventions in exercise-based CR and it has the potential to inform and assist in further treatment in secondary prevention for patients with CAD.
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| 27. |
- Bott, Lukas Thomas, et al.
(author)
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Coulomb dissociation of O-16 into He-4 and C-12
- 2023
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In: NUCLEAR PHYSICS IN ASTROPHYSICS - X, NPA-X 2022. - : EDP Sciences. - 2100-014X. ; 279
-
Conference paper (peer-reviewed)abstract
- We measured the Coulomb dissociation of O-16 into He-4 and C-12 within the FAIR Phase-0 program at GSI Helmholtzzentrum fur Schwerionenforschung Darmstadt, Germany. From this we will extract the photon dissociation cross section O-16(alpha,gamma)C-12, which is the time reversed reaction to C-12(alpha,gamma)O-16. With this indirect method, we aim to improve on the accuracy of the experimental data at lower energies than measured so far. The expected low cross section for the Coulomb dissociation reaction and close magnetic rigidity of beam and fragments demand a high precision measurement. Hence, new detector systems were built and radical changes to the (RB)-B-3 setup were necessary to cope with the high-intensity O-16 beam. All tracking detectors were designed to let the unreacted O-16 ions pass, while detecting the C-12 and He-4.
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| 28. |
- Bromley Milton, Maria, et al.
(author)
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Is Pain Intensity Really That Important to Assess in Chronic Pain Patients? A Study Based on the Swedish Quality Registry for Pain Rehabilitation (SQRP)
- 2013
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In: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 8:6
-
Journal article (peer-reviewed)abstract
- BackgroundIncorporating the patient's view on care and treatment has become increasingly important for health care. Patients describe the variety of consequences of their chronic pain conditions as significant pain intensity, depression, and anxiety. We hypothesised that intensities of common symptoms in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups. This study has three aims: 1) to determine the importance of different symptoms with respect to participation and ill-health; 2) to identify subgroups based on data concerning important symptoms; and 3) to determine the secondary consequences for the identified subgroups with respect to participation and health factors.Methods and SubjectsThis study is based on a cohort of patients referred to a multidisciplinary pain centre at a university hospital (n = 4645, participation rate 88%) in Sweden. The patients answered a number of questionnaires concerning symptoms, participation, and health aspects as a part of the Swedish Quality Registry for Pain Rehabilitation (SQRP).ResultsCommon symptoms (such as pain intensity, depression, and anxiety) in patients with chronic pain showed great variability across subjects and 60% of the cohort had normal values with respect to depressive and anxiety symptoms. Pain intensity more than psychological symptoms showed stronger relationships with participation and health. It was possible to identify subgroups based on pain intensity, depression, and anxiety. With respect to participation and health, high depressive symptomatology had greater negative consequences than high anxiety.ConclusionsCommon symptoms (such as pain intensity and depressive and anxiety symptoms) in chronic pain conditions carry important information that can be used to identify clinically relevant subgroups.
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| 29. |
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Dalmo, Johanna, et al.
(author)
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Priming increases the anti-tumor effect and therapeutic window of 177Lu-octreotate in nude mice bearing human small intestine neuroendocrine tumor GOT1.
- 2017
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In: EJNMMI Research. - : Springer Science and Business Media LLC. - 2191-219X. ; 7:1
-
Journal article (peer-reviewed)abstract
- BACKGROUND: 177Lu-[DOTA0, Tyr3]-octreotate (177Lu-octreotate) is used for treatment of patients with somatostatin receptor (SSTR) expressing neuroendocrine tumors. However, complete tumor remission is rarely seen, and optimization of treatment protocols is needed. In vitro studies have shown that irradiation can up-regulate the expression of SSTR1, 2 and 5, and increase 177Lu-octreotate uptake. The aim of the present study was to examine the anti-tumor effect of a 177Lu-octreotate priming dose followed 24 h later by a second injection of 177Lu-octreotate compared to a single administration of 177Lu-octreotate, performed on the human small intestine neuroendocrine tumor cell line, GOT1, transplanted to nude mice. RESULTS: Priming resulted in a 1.9 times higher mean absorbed dose to the tumor tissue per administered activity, together with a reduced mean absorbed dose for kidneys. Priming gave the best overall anti-tumor effects. Magnetic resonance imaging showed no statistically significant difference in tumor response between treatment with and without priming. Gene expression analysis demonstrated effects on cell cycle regulation. Biological processes associated with apoptotic cell death were highly affected in the biodistribution and dosimetry study, via differential regulation of, e.g., APOE, BAX, CDKN1A, and GADD45A. CONCLUSIONS: Priming had the best overall anti-tumor effects and also resulted in an increased therapeutic window. Results indicate that potential biomarkers for tumor regrowth may be found in the p53 or JNK signaling pathways. Priming administration is an interesting optimization strategy for 177Lu-octreotate therapy of neuroendocrine tumors, and further studies should be performed to determine the mechanisms responsible for the reported effects.
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| 34. |
- Dasandi, N., et al.
(author)
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The inclusion of health in major global reports on climate change and biodiversity
- 2022
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In: Bmj Global Health. - : BMJ. - 2059-7908. ; 7:6
-
Journal article (peer-reviewed)abstract
- This article argues that human health has become a key consideration in recent global reports on climate change and biodiversity produced by various international organisations; however, greater attention must be given to the unequal health impacts of climate change and biodiversity loss around the world and the different health adaptation measures that are urgently required.
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| 35. |
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| 36. |
- Demakopoulou, Katie, et al.
(author)
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Excavations in Midea 2008-2009
- 2010
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In: Opuscula Atheniensia : Annual of the Swedish Institute at Athens. - 0078-5520. ; 3, s. 7-32
-
Journal article (peer-reviewed)
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| 37. |
- Dubouis, Ghislain, et al.
(author)
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It starts at home? Climate policies targeting household consumption and behavioral decisions are key to low-carbon futures
- 2019
-
In: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 52, s. 144-158
-
Journal article (peer-reviewed)abstract
- Through their consumption behavior, households are responsible for 72% of global greenhouse gas emissions. Thus, they are key actors in reaching the 1.5°C goal under the Paris Agreement. However, the possible contribution and position of households in climate policies is neither well understood, nor do households receive sufficiently high priority in current climate policy strategies. This paper investigates how behavioral change can achieve a substantial reduction in greenhouse gas emissions in European high-income countries. It uses theoretical thinking and some core results from the HOPE research project, which investigated household preferences for reducing emissions in four European cities in France, Germany, Norway and Sweden. The paper makes five major points: First, car and plane mobility, meat and dairy consumption, as well as heating are the most dominant components of household footprints. Second, household living situations (demographics, size of home) greatly influence the household potential to reduce their footprint, even more than country or city location. Third, household decisions can be sequential and temporally dynamic, shifting through different phases such as childhood, adulthood, and illness. Fourth, short term voluntary efforts will not be sufficient by themselves to achieve the drastic reductions needed to achieve the 1.5°C goal; instead, households need a regulatory framework supporting their behavioral changes. Fifth, there is a mismatch between the roles and responsibilities conveyed by current climate policies and household perceptions of responsibility. We then conclude with further recommendations for research and policy.
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| 38. |
- Elvén, Maria, 1973-
(author)
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Clinical reasoning focused on clients’ behaviour change in physiotherapy : Development and evaluation of the Reasoning 4 Change instrument
- 2019
-
Doctoral thesis (other academic/artistic)abstract
- With the recognition of the impact of lifestyle behaviours on health and the evidence of incorporating behavioural considerations in physiotherapy, there is a need to advance the clinical reasoning of physiotherapists. Clinical reasoning encompasses the thinking and decision-making processes guiding client management and is a core competency of physiotherapists. Enabling clinical reasoning advancements requires investigations in practice and education, which in turn require robust assessments. The overall aim of this thesis was to develop and evaluate an instrument to study physiotherapy students’ clinical reasoning focused on clients’ activity-related behaviour and behaviour change.In study I, a conceptual model was developed based on exploration of existing research, theory and views of physiotherapists and students. The data resulted in the clinical reasoning model focused on clients’ behaviour change with reference to physiotherapists (CRBC-PT). Studies II and III included instrument development and evaluation in four phases. Phase 1 included determination of the instrument structure and item generation based on the CRBC-PT model, evidence in clinical reasoning assessment and existing measures. Phase 2 included cognitive interviews with students to assess item understanding and resulted in revisions of item problems and approval of feasibility. Phase 3 included a Delphi study with physiotherapists with expertise in behavioural medicine to evaluate item relevance. The findings demonstrated a high level of consensus regarding content relevance. The final version of the Reasoning 4 Change (R4C) instrument included four domains, namely, Physiotherapist, Input from client, Functional behavioural analysis, and Strategies for behaviour change. In phase 4, the reliability and validity of the instrument were evaluated. Physiotherapists with expertise in behavioural medicine and students responded to the web-based R4C instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists. The analyses showed excellent inter-rater reliability, satisfactory construct validity, internal consistency and test-retest reliability. In study IV, final-semester students (n=151) from all physiotherapy programmes in Sweden completed the R4C instrument. Hierarchical multiple regression analyses were conducted with three dependent variables, namely, input from client, functional behavioural analysis, and strategies for behaviour change. All included independent variables explained 37% of the variance in input from client. Cognitive and metacognitive skills explained 22%, attitudes 15% and curriculum with behavioural medicine competencies 3%. Only the variable curriculum with behavioural medicine competencies explained the variance in functional behavioural analysis (4%) and strategies for behaviour change (5%).In conclusion, the in-depth description of clinical reasoning focused on clients’ behaviour change may contribute to expanded understanding of the complexity and multidimensionality in reasoning processes that incorporate factors related to human behaviours, analyses of what factors motivate or hinder behaviours, and interventions to support behaviour change. Such knowledge is valuable for the teaching of and learning clinical reasoning. The R4C instrument helps fill the need for well-tested instruments and can support investigations and evaluations in physiotherapy education and research. To develop students’ clinical reasoning competence, cognitive and metacognitive skills, positive attitudes and the incorporation of behavioural medicine competencies into physiotherapy curricula should be targeted. Further attention to complex reasoning, including analysis and intervention, is warranted.
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| 39. |
- Fagerberg, Björn, et al.
(author)
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Klimat och hälsa : En kunskapssammanställning
- 2020
-
Reports (other academic/artistic)abstract
- Effekterna av klimatförändringarna blir allt tydligare. Påverkan på människors hälsa av klimatförändringarna är betydande; tillgång på mat och rent vatten påverkas, infektionspanoramat förändras, och förekomsten av extrema väderhändelser ökar. Indirekt kan detta leda till dramatiska samhälleliga förändringar, t ex genom ökande flyktingströmmar. Scenarierna är alarmerande. Det finns fortfarande en möjlighet att påverka denna utveckling, men det är bråttom!De viktigaste åtgärderna för att minska klimatpåverkan bidrar också till bättre hälsa, på så sätt en ”win-win situation”. Målet med den aktuella rapporten är därför att lyfta fram åtgärder som väsentligt kan minska risken för allvarliga klimatförändringar men också sådana som samtidigt förbättrar människors hälsa. Den belyser därför speciellt hälsoeffekter av förbränning av fossila bränslen och hälsovinster med minskad köttkonsumtion. Vi beskriver översiktligt vad som orsakar klimatförändringarna och sammanfattar den aktuella vetenskapliga litteraturen om hur ett förändrat klimat kommer att påverka folkhälsan om inte kraftfulla åtgärder sätts in, först och främst för att minska temperaturökningarna, men också om vi inte förbereder oss för ett varmare klimat. Vi vill också presentera möjligheter för vad man inom sjukvården kan göra för att minska klimatpåverkan.Åtgärder som bidrar till att minska klimatpåverkan, dvs primärprevention, framstår tydligt som det klokaste och mest ekonomiska alternativet, och har som rapporten visar också andra positiva effekter på folkhälsan. Detta hindrar inte att vi redan nu samtidigt måste förbereda oss för högre temperaturer, för att undvika eller åtminstone begränsa de alarmerande hälso-scenarier som är att vänta om temperaturen tillåts stiga 1.5°C eller mer, som tagit fram av ledande forskare i Europa.Rapporten bygger huvudsakligen på IPPCs senaste rapporter [1, 2], slutsatser från ”Lancet Commission on Health and Climate Change” [3, 4], rapporten ”The imperative of climate action to protect human health in Europe”, från European Academies' Science Advisory Council [5], samt en sammanställning över prioriteringar för begränsa hälsoeffekter av klimatförändringar från WHO Europa [6] med tillägg av vissa referenser som nyligen publicerats.
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| 40. |
- Forsman, Henrietta, et al.
(author)
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Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students
- 2020
-
In: Journal of Advanced Nursing. - Hoboken, NJ : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 76:1, s. 199-208
-
Journal article (peer-reviewed)abstract
- AimsTo identify clusters based on graduating nursing students’ self‐reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students’ perceptions of overall quality of the nursing programme and students’ general self‐efficacy.DesignA cross‐sectional study combining survey data and results from a national examination.MethodsData were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self‐Efficacy scale and results from the National Clinical Final Examination. A Two‐Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.ResultsThree clusters were identified illustrating students’ different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self‐assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.ConclusionThe study illustrates how nursing students’ self‐assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self‐evaluation is a key learning outcome and is, in the long run, essential to patient safety.ImpactThe study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self‐efficacy lower than other students. The findings illuminate the need for student‐centered strategies in nursing education, including elements of self‐assessment in relation to examination to make the students more aware of their clinical competence.
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| 41. |
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| 42. |
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| 43. |
- Glerup, Mia, et al.
(author)
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Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis : 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort
- 2020
-
In: Journal of Rheumatology. - : J RHEUMATOL PUBL CO. - 0315-162X .- 1499-2752. ; 47:5, s. 730-738
-
Journal article (peer-reviewed)abstract
- Objective: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.Methods: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.Results: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 +/- 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.Conclusion: This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.
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| 44. |
- Helldeen, D., et al.
(author)
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Climate change and child health: a scoping review and an expanded conceptual framework
- 2021
-
In: Lancet Planetary Health. - : Elsevier. - 2542-5196. ; 26, s. 9-9
-
Journal article (peer-reviewed)abstract
- Climate change can have detrimental effects on child health and wellbeing. Despite the imperative for a fuller understanding of how climate change affects child health and wellbeing, a systematic approach and focus solely on children (aged <18 years) has been lacking. In this Scoping Review, we did a literature search on the impacts of climate change on child health from January, 2000, to June, 2019. The included studies explicitly linked an alteration of an exposure to a risk factor for child health to climate change or climate variability. In total, 2970 original articles, reviews, and other documents were identified, of which 371 were analysed. Employing an expanded framework, our analysis showed that the effects of climate change on child health act through direct and indirect pathways, with implications for determinants of child health as well as morbidity and mortality from a range of diseases. This understanding can be further enhanced by using a broader range of research methods, studying overlooked populations and geographical regions, investigating the costs and benefits of mitigation and adaptation for child health, and considering the position of climate change and child health within the UN Sustainable Development Goals. Present and future generations of children bear and will continue to bear an unacceptably high disease burden from climate change.
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| 45. |
- Helldén, Daniel, et al.
(author)
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Climate change adaptation across the life-course - from pregnancy to adolescence – it’s time to advance the field of climate change and child health
- 2023
-
In: Environmental Research. Health. - : Institute of Physics (IOP). - 2752-5309. ; 1:2
-
Journal article (other academic/artistic)abstract
- Children are bearing and will continue to bear a high burden from climate change, through directand indirect pathways. Climate change adaptation interventions are essential to limit the currentand projected impacts of climate change on child health. However, the perspective of children andtheir health with regards to adaptation in research and policy is limited. Ensuring that adaptationinterventions are context specific, consider interrelated barriers to implementation and leverageexisting structures including multisectoral collaboration is vital. Further, a life-course perspectiveon child health and well-being could serve as a template for tailoring adaptation interventions tothe specific vulnerabilities and needs of specific development periods of the child. A meaningfulengagement of children and young persons in the design and implementation of adaptationinterventions is essential to increase effectiveness and uptake. With climate change effectingmillions of children worldwide, it is high time to put child health at the center of adaptation.
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| 46. |
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| 47. |
- Herrmann, Alina, et al.
(author)
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The Role of Health in Households' Balancing Act for Lifestyles Compatible with the Paris Agreement : Qualitative Results from Mannheim, Germany
- 2020
-
In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:4
-
Journal article (peer-reviewed)abstract
- Household lifestyles are the main drivers of climate change. Climate change mitigation measures directed to households often have substantial health co-benefits. The European mixed-methods study HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) investigates households' preferences for reducing greenhouse gas emissions and particularly researches the role of information on health co-benefits in households' decision making. The results presented in this study are derived from 18 qualitative interviews, conducted with a subsample of households from Mannheim, Germany. The in-depth interviews were transcribed verbatim, analyzed with a qualitative content analysis, supported by NVivo software. They showed that, in order to reduce their greenhouse gas emission in a way compatible with the 1.5 °C goal, households have to undertake a difficult balancing act, considering factors from the individual sphere, such as health co-benefits, as well as from the public sphere, such as (climate) policies. Shared responsibility and equity are important aspects of households. In conclusion, health is an important factor in households' decision making. However, information policies about health co-benefits need to go along with structural policy measures, in order to support households effectively in the implementation of healthy and climate-friendly lifestyles, especially in sectors where behavior change is difficult, like the mobility sector.
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| 48. |
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| 49. |
- Jaensson, Maria, 1967-, et al.
(author)
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Evaluation of postoperative recovery in day surgery patients using a mobile phone application : a multicentre randomized trial
- 2017
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In: British Journal of Anaesthesia. - : Oxford University Press. - 0007-0912 .- 1471-6771. ; 119:5, s. 1030-1038
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Journal article (peer-reviewed)abstract
- Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores.Methods: The study was a single-blind, multicentre randomized controlled trial. A total of 997 patients were randomly allocated to either RAPP or standard care. The Swedish web version of a quality of recovery (SwQoR) questionnaire was used to evaluate the patients' postoperative recovery, either on paper or using an application (RAPP) on postoperative days seven and 14.Results: On postoperative day seven the RAPP group reported significantly better values in seven out of 24 items of the SwQoR: sleeping difficulties; not having a general feeling of wellbeing; having difficulty feeling relaxed/comfortable; and dizziness; headache; pain in the surgical wound; and a swollen surgical wound compared with the control group, implying a good postoperative recovery. Both men and women in the RAPP group reported significantly better values (and, hence good postoperative recovery) compared with the control group in the items sleeping difficulties; not having a general feeling of wellbeing and pain in the surgical wound.Conclusions: Measurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients' quality of recovery and identify key areas for improvement in perioperative care.
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- Jaensson, Maria, 1967-, et al.
(author)
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Gender differences in risk factors for airway symptoms following tracheal intubation
- 2012
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In: Acta Anaesthesiologica Scandinavica. - Hoboken, USA : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 56:10, s. 1306-1313
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Journal article (peer-reviewed)abstract
- Background: A common complaint after endotracheal intubation is sore throat and hoarseness. The aim of this study was to describe gender differences and independent risk factors in the development of post-operative sore throat and hoarseness after endotracheal intubation in adults.Methods: This prospective cross-sectional observational study was conducted at a university hospital in Sweden. A total of 495 patients were included (203 men and 292 women) and enrolled from a total of eight different surgical departments. Outcome variables were post-operative sore throat and hoarseness evaluated post-operatively in the post-anaesthesia care unit. A total of 31 variables were recorded which described the intubation process, intraoperative factors as well as the extubation process. Bivariate and multivariate analyses were performed.Results: The overall incidence of post-operative sore throat was 35% and hoarseness 59%. The results show different predictors for men and women in the development of airway symptoms. The main risk factor for developing sore throat in men was intubation by personnel with Conclusion: Post-operative sore throat and hoarseness result from several factors, and the cause of these symptoms are multifactorial and differs by gender. Identification of these factors pre-operatively may increase awareness among anaesthesia personnel and possibly reduce the incidence of these minor but distressing symptoms.
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