| 61. |
- Bjereld, Ylva, 1984, et al.
(author)
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Differences in prevalence of bullying victimization between native and immigrant children in the Nordic countries: A parent-reported serial cross-sectional study
- 2015
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In: Child Care Health and Development. - : Wiley. - 0305-1862 .- 1365-2214. ; 41:4, s. 593-599
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Journal article (peer-reviewed)abstract
- Background Bullying among children is a problem with severe consequences for the victim. The present study examined parent-reported bullying victimization among children in the Nordic countries at two points in time, 1996 and 2011, and studied differences in prevalence of bullying victimization between immigrant and native children. Methods Data came from the parent-reported NordChild, carried out in the Nordic countries in 1996 and 2011. NordChild is a serial cross-sectional comparative study. A total of 7107 children aged 7–13 were included in the analyses. Results The prevalence of bullying victimization in the total Nordic countries was lower in 2011 (19.2%) than 1996 (21.7%). Difference in prevalence of bullying victimization was found both between native and immigrant children, and between countries. The largest difference in prevalence of bullying victimization was measured in Sweden 2011, where 8.6% of the native children were bullied, to be compared with the 27.8% of the immigrant children. Immigrant children had higher odds to be bullied than native children in Norway, Sweden and in the total Nordic countries at both measurements, also when adjusted for potentially confounding factors. Conclusions The higher prevalence of bullying victimization among immigrant children should be taken into consideration in the design and development of preventive work against bullying.
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| 62. |
- Bjereld, Ylva, 1984, et al.
(author)
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Do bullied children have poor relationships with their parents and teachers? A cross-sectional study of Swedish children
- 2017
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In: Children and Youth Services Review. - : Elsevier BV. - 0190-7409. ; 73, s. 347-351
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Journal article (peer-reviewed)abstract
- Parents and teachers play an important role in helping victims of bullying to prevent, cope with and end bullying. Despite that, victims' relationships with adults have often been overlooked in previous research. The aim of this study was to investigate bullied and not bullied children's perception of the quality of their relationship with teachers and parents and to examine if there were any differences in the perception associated with bullying frequency or type of victimization. Data came from the Swedish Health Behavior in School-aged Children (HBSC) survey from 2013/14, which included 7867 students aged 11,13 and 15. A multi-level multinomial logistic regression model was created to estimate association between the type of bullying victimization and the quality of relationships with parents and teachers. The result showed that bullied children had poorer relationships with parents and teachers than nonvictims. Victims had higher odds of finding it difficult to talk to parents about things bothering them, of feeling that the family was not listening to what they had to say, and of having low confidence in their teacher. Frequent cyber victims had the highest AdjOR (2.09-337) compared with non victims to have poor quality relationships with teachers and parents. (C) 2017 Elsevier Ltd. All rights reserved.
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| 63. |
- Bjereld, Ylva, 1984, et al.
(author)
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Mental health problems and social resource factors among bullied children in the Nordic Countries: A population based cross-sectional study
- 2015
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In: Child Psychiatry and Human Development. - : Springer Science and Business Media LLC. - 0009-398X .- 1573-3327. ; 46:2, s. 281-288
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Journal article (peer-reviewed)abstract
- This study estimated internalising and externalising mental health problems among bullied-, unclear if bullied- and not bullied children aged 4–16 in the Nordic countries, and identified resource factors to bullied children’s mental health. Data comes from the cross-sectional NordChild survey 2011 and the Strength and Difficulties Questionnaire, including 6,214 children in the analyses. Mental health problems were most prevalent among children parent-reported as bullied (29.2–44.3 %), followed by children with unclear status if bullied (13.0–25.6 %) and not bullied children (5.3–7.9 %). Externalising problems were more prevalent in all groups except among bullied girls aged 7–16, where internalising problems were more prevalent. Ten potential resource factors to bullied children’s mental health were analyzed, finding that (1) children with at least three close friends had higher odds to be mentally healthy than children with fewer close friends and (2) bullied boys had higher odds to be mentally healthy if they regularly practiced sport.
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| 64. |
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| 65. |
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| 66. |
- Bjurman, Christian, 1983, et al.
(author)
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Assessment of a multi-marker risk score for predicting cause-specific mortality at three years in older patients with heart failure and reduced ejection fraction.
- 2015
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In: Cardiology journal. - 1897-5593. ; 22:1, s. 31-6
-
Journal article (peer-reviewed)abstract
- Due to increasing co-morbidity associated with aging, heart failure (HF) has become more prevalent and heterogeneous in older individuals, and non-cardiovascular (CV) mortality has increased. Previously, we defined a multi-marker modality that included cystatin C (CysC), troponin T (TnT), and age. Here, we validated this multi-marker risk score by evaluating its predictions of all-cause mortality and CV mortality in an independent population of older individuals with HF and reduced ejection fraction (HFrEF).
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| 67. |
- Bjurman, Christian, 1983, et al.
(author)
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Assessment of a multimarker strategy for prediction of mortality in older heart failure patients: a cohort study
- 2013
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In: BMJ open. - : BMJ. - 2044-6055. ; 3:3
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: Primarily to develop a multimarker score for prediction of 3-year mortality in older patients with decompensated heart failure (HF). DESIGN: Prospective cohort study. SETTING: Secondary care. Single centre. PATIENTS AND BIOMARKERS: 131 patients, aged >/=65 years, with decompensated HF were included. Assessment of biomarkers was performed at discharge. PRIMARY OUTCOME MEASURE: 3-year mortality. RESULTS: Mean age was 73+/-11 years; mean left ventricular ejection fraction , 43+/-14%; 53% were male. The 3-year mortality was 53.4%. The following N-terminal brain natriuretic peptide (NTproBNP) levels could optimally stratify mortality: <2000 ng/l (n=39), 30.8% mortality; 2000-8000 ng/l (n=58), 51.7% mortality; and >8000 ng/l (n=34), 82.4% mortality. However, in the 2000-8000 ng/l range, NTproBNP levels had low-prognostic capacity, based on the area under the receiver operating characteristic curve (AUC=0.53; 95% CI 0.40 to 0.67). In this group, multivariate analysis identified age, cystatin C (CysC), and troponin T (TnT) levels as independent risk factors. A risk score based on these three risk factors separated a high-risk and low-risk groups within the NTproBNP range of 2000-8000 ng/l. The score exhibited a significantly higher AUC (0.75; 95% CI 0.62 to 0.86) than NTproBNP alone (p=0.03) in this NTproBNP group and had similar prognostic capacity as NTproBNP in patients below or above this NTproBNP range (p=0.57). Net reclassification improvement and integrated discriminatory improvement in the group with NTproBNP levels between 2000 and 8000 ng/l was 54% and 23%, respectively, and in the whole cohort 22% and 11%, respectively. CONCLUSIONS: Our results suggested that, to assess risk in HF, older patients required significantly higher levels of NTproBNP than younger patients. Furthermore, a risk score that included TnT and CysC at discharge, and age could improve risk stratification for mortality in older patients with HF in particular when NTproBNP was moderately elevated.
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| 68. |
- Bjurman, Christian, 1983, et al.
(author)
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Decreased admissions and hospital costs with a neutral effect on mortality following lowering of the troponin T cutoff point to the 99th percentile
- 2017
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In: Cardiology journal. - 1897-5593 .- 1898-018X. ; 24:6, s. 612-622
-
Journal article (peer-reviewed)abstract
- Background: The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources.Methods:Clinical and laboratory data from patients with chest pain or dyspnea at the emergency department (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012. Myocardial infarction (MI) was diagnosed at the discretion of the attending clinicians responsible for the patient.Results:Following lowering of the hs-cTnT cutoff point fewer ED patients with chest pain or dyspnea as the principal complaint were analyzed with an hs-cTnT sample (81% vs. 72%, p < 0.001). Overall 30-day mortality was unaffected but increased among patients not analyzed with an hs-cTnT sample (5.3% vs. 7.6%, p < 0.001). The MI frequency was unchanged (4.0% vs. 3.9%, p = 0.72) whereas admission rates decreased (51% vs. 45%, p < 0.001) as well as hospital costs. Coronary angiographies were used more frequently (2.8% vs. 3.3%, p = 0.004) but with no corresponding change in coronary interventions.Conclusions:At the participating hospital, lowering of the hs-cTnT cutoff point to the 99th percentile decreased admissions and hospital costs but did not result in any apparent prognostic or treatment benefits for the patients.
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| 69. |
- Bjurman, Christian, 1983, et al.
(author)
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High-sensitive cardiac troponin, NT-proBNP, hFABP and copeptin levels in relation to glomerular filtration rates and a medical record of cardiovascular disease
- 2015
-
In: Clinical Biochemistry. - : Elsevier BV. - 0009-9120 .- 1873-2933. ; 48:4-5, s. 302-307
-
Journal article (peer-reviewed)abstract
- Background: Elevation of cardiac markers in patients with renal dysfunction has not been fully assessed reducing the diagnostic usefulness of these biomarkers. Objective: To examine the effects of renal function and a medical record of cardiovascular disease on levels of cardiac biomarkers. Methods: Serum samples were collected from 489 patients referred for GFR measurement using Cr51-EDTA or iohexol plasma clearance (measured GFR). The cardiac biomaiters Troponin T (hs-cTnT), Troponin I (hsTnI), N-Terminal pro Brain Natriuretic Peptide (NTproBNP), Copeptin, Human Fatty Acid Binding Protein (hFABP), as well as the kidney function biomarkers creatinine and cystatin C, were measured. Regression was used to analyse the relationship between biomarker levels and the glomerular filtration rate (GFR) between 15 and 90 mL/min/1.73 m(2). Results: Compared with normal kidney function, the estimated increases in the studied cardiac biomarkers at a CUR of 15 mL/mM/1.73 m(2) varied from 2-fold to 15 fold but were not very different between patients with or without a medical record of cardiovascular disease and were most prominent for cardiac biomarkers with low molecular weight. hs-cTnT levels correlated more strongly to measured CUR and increased more at low CUR compared to hs-cTnI. For hFABP and NT-proBNP increases at low kidney function were more correctly predicted by a local Cystatin C-based eGFR formula compared with creatinine-based eGFR (using the MDRD or CKD-EPI equations) Conclusion: The extent of the elevation of cardiac markers at low renal function is highly variable. For hFABP and NTproBNP Cystatin C-based eGFR provides better predictions of the extent of elevation compared to the MDRD or CKD-EPI equations. (C) 2015 The Authors. The Canadian Society of Clinical Chemists. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd,40/).
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| 70. |
- Bjurman, Christian, 1983, et al.
(author)
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Small changes in Troponin T levels are common in patients with non-ST-elevation myocardial infarction and are linked to higher mortality
- 2013
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In: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 62:14, s. 1231-1238
-
Journal article (peer-reviewed)abstract
- OBJECTIVE:To examine the extent of change in Troponin T levels in patients with non-ST-elevation myocardial infarction (NSTEMI).BACKGROUND:Changes in cardiac troponin levels are required for the diagnosis of NSTEMI, according to the new universal definition of acute myocardial infarction. A relative change of 20-230 % and an absolute change of 7- 9 ng/L have been suggested as cut-off points.METHOD:In a clinical setting, where a change in cTnT was not mandatory for the diagnosis of NSTEMI, serial samples of cTnT were measured with a high-sensitive cTnT (hs-cTnT) assay, and 37 clinical parameters were evaluated in 1178 patients with a final diagnosis of NSTEMI presenting <24h after symptom onset.RESULTS:After six hours of observation, the relative change in the hs-cTnT level remained <20 % in 26 % and the absolute change <9 ng/L in 12 % of the NSTEMI patients. A relative hs-cTnT change <20% was linked to higher long-term mortality across quartiles (p=0.002) and in multivariate analyses (HR 1.61 (1.17-2.21) p=0.004), whereas 30-day mortality was similar across quartiles of relative hs-cTnT changeCONCLUSION:Because stable hs-TnT levels are common in patients with a clinical diagnosis of NSTEMI in our hospital, a small hs-cTnT change may not be useful to exclude NSTEMI, particularly as these patients show both short-term and long-term mortality at least as high as patients with large changes in hs-cTnT.
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