| 1. |
- Karjalainen, Suvi, et al.
(författare)
-
Teachers’ descriptions of classroom communication after an SLP-led in-service training
- 2022
-
Ingår i: Logopedics, Phoniatrics, Vocology. - : Taylor & Francis Group. - 1401-5439 .- 1651-2022.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study is to explore teachers’ experience and understanding of classroom communication after participating in a speech-language pathologist (SLP) led in-service training on classroom communication.Method: This qualitative study used a focus group approach to explore how teachers describe their classroom communication. Twenty primary-school teachers participated. Thematic analysis was used to analyze the teachers’ responses about their classroom communication practices 6 months after in-service training.Results: Three core themes on teachers’ understanding of their communication in the classroom were identified in the analysis: (1) awareness of voice use; (2) the use of body communication; (3) setting the stage for learning. The teachers gave many examples of voice use reflecting an increased awareness of audibility and vocal health. They reported on moving around more and using more body communication to enhance their message. Further, they expressed an increased awareness about how body posture affects voice and communication. The third theme reflects how the teachers “sets the stage for learning” i.e. how they use the prerequisites in the physical environment for successful classroom communication, including the classroom’s sound environment as well as seating and furniture.Conclusions: The findings in this study indicate that teachers increased their awareness, implemented new practices in their classroom communication and reflected on prerequisites for classroom communication as a result of the in-service training. Teachers’ classroom communication developed when provided practical training and strategies to increase their awareness on communication. We conclude that this type of SLP-led training can be recommended as in-service training.
|
|
| 2. |
- Yli-Hukka, Julia, et al.
(författare)
-
Dysphagia terminology for texture modified fluid and food: a national survey of speech-language pathologists’ practice
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022.
-
Tidskriftsartikel (refereegranskat)abstract
- Texture modified consistencies (TMC) is a common compensatory strategy in dysphagia management. Lack of consensus regarding TMC terminology places a person at risk of poor oral intake, malnutrition, dehydration, and aspiration. Purpose: To investigate: (a) Swedish Speech-Language Pathologists (SLPs) dysphagia management with TMC, including terminology, inter-professional collaboration, and knowledge of standard TMC guides; and (b) the current TMC terminology/guides used within university hospitals, in Sweden. Method: Part One surveyed SLPs from 19/21 regions. Recruitment occurred via regional SLP/department managers, the national SLP association and email lists. Non-parametric statistics were employed. Part Two explored TMC guides within the seven university hospitals. Result: The initial survey identified 78 Swedish TMC terms. Overlap of both TMC terms and descriptions occurred. Different terms to describe same/similar textures were used by 70% of the SLPs. Knowledge of established guides was high (>90%), though TMC was often (60%) based on locally developed documents. Collaboration with other professions was reported by 97% of SLPs, however almost half perceived collaboration to be inadequate, citing difficulties with transfer of TMC recommendations. Variance in TMC terms/guides within/across the university hospitals occurred. Conclusion: Variable TMC terminology is used in Sweden, impacting optimal dysphagia management. Future research should focus upon implementation of standardised TMC terminology. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
|
|
| 3. |
- Baker, C. P., et al.
(författare)
-
Female adolescent singing voice characteristics : an exploratory study using LTAS and inverse filtering
- 2022
-
Ingår i: Logopedics, Phoniatrics, Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; , s. 1-13
-
Tidskriftsartikel (refereegranskat)abstract
- Background and Aim: To date, little research is available that objectively quantifies female adolescent singing-voice characteristics in light of the physiological and functional developments that occur from puberty to adulthood. This exploratory study sought to augment the pool of data available that offers objective voice analysis of female singers in late adolescence. Methods: Using long-term average spectra (LTAS) and inverse filtering techniques, dynamic range and voice-source characteristics were determined in a cohort of vocally healthy cis-gender female adolescent singers (17 to 19 years) from high-school choirs in Aotearoa New Zealand. Non-parametric statistics were used to determine associations and significant differences. Results: Wide intersubject variation was seen between dynamic range, spectral measures of harmonic organisation (formant cluster prominence, FCP), noise components in the spectrum (high-frequency energy ratio, HFER), and the normalised amplitude quotient (NAQ) suggesting great variability in ability to control phonatory mechanisms such as subglottal pressure (Psub), glottal configuration and adduction, and vocal tract shaping. A strong association between the HFER and NAQ suggest that these non-invasive measures may offer complimentary insights into vocal function, specifically with regard to glottal adduction and turbulent noise in the voice signal. Conclusion: Knowledge of the range of variation within healthy adolescent singers is necessary for the development of effective and inclusive pedagogical practices, and for vocal-health professionals working with singers of this age. LTAS and inverse filtering are useful non-invasive tools for determining such characteristics.
|
|
| 4. |
- Hallin, Anna Eva, et al.
(författare)
-
Factors affecting speech-language pathologists’ language assessment procedures and tools–challenges and future directions in Sweden
- 2022
-
Ingår i: Logopedics, Phoniatrics, Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: National surveys of speech-language pathologists’ (SLP) practices play an important role in professional development, and previous research show that many challenges faced by the profession are similar across the globe. This study aims to describe Swedish SLP assessment practices, examine factors that may affect this practice, and discuss the results in the light of international studies. Methods: Data from 584 SLPs were collected through an online questionnaire with multiple choice and open-ended questions. A mixed-method design was deployed where a deductive qualitative analysis of free-text responses complemented quantitative data. Results: In line with previous results from English-speaking countries, both standardized discrete skill tests and contextualized assessments were used by the respondents but fewer used language sample analysis and dynamic assessment procedures, despite international recommendations. There were few differences based on experience, work setting, proportion of multilingual assessments and socio-economic status of the health catchment area. Main challenges reported were lack of time and difficulty prioritizing, and assessment and/or diagnosis of multilingual/L2 children, which is similar to challenges faced by SLPs in other countries. Swedish SLPs also reported lack of national clinical guidelines as a main challenge. Factors contributing to better assessments included experience, and the combination of many sources of information, including professional and interprofessional discussions. Conclusions: The accumulated evidence from this and previous studies show that to address challenges and build on strengths, changes on a systemic level are needed. This includes more time and resources for continuing education and implementation of recommended assessment methods, as well as professional and interprofessional collaborations.
|
|
| 5. |
- Socher, Michaela, et al.
(författare)
-
The relationship between reasoning and language ability : comparing children with cochlear implants and children with typical hearing
- 2022
-
Ingår i: Logopedics, Phoniatrics, Vocology. - : Taylor & Francis. - 1401-5439 .- 1651-2022. ; 47:2, s. 73-83
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeLanguage has been suggested to play a facilitating role for analogical reasoning tasks, especially for those with high complexity. This study aims to evaluate if differences in analogical reasoning ability between children with cochlear implants (CI) and children with typical hearing (TH) might be explained by differences in language ability.MethodsThe analogical reasoning ability (verbal; non-verbal; complex non-verbal: high relational integration demand) of children with CI (N = 15, mean age = 6;7) was compared to two groups of children with TH: age and language matched (TH-A+L, N = 23, mean age = 6;5), and age matched (TH-A, N = 23, mean age = 6;5).ResultsChildren with CI were found to perform comparable to Group TH-A+L on non-verbal reasoning tasks but significantly more poorly on a verbal analogical reasoning task. Children with CI were found to perform significantly more poorly on both the non-verbal analogical reasoning task with high relational integration demand and on the verbal analogical reasoning task compared to Group TH-A. For the non-verbal analogical reasoning task with lower relational integration demand only a tendency for a difference between group CI and Group TH-A was found.ConclusionsThe results suggest that verbal strategies are influencing the performance on the non-verbal analogical reasoning tasks with a higher relational integration demand. The possible reasons for this are discussed. The verbal analogical reasoning task used in the current study partly measured lexical access. Differences between the children with CI and both groups of children with TH might therefore be explained by differences in expressive vocabulary skills.
|
|
| 6. |
- Andersson, Ketty, et al.
(författare)
-
Does the narrative ability during retelling differ in 5-year-olds born with and without unilateral cleft lip and palate?
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:1, s. 18-24
-
Tidskriftsartikel (refereegranskat)abstract
- Background: A previous study has indicated poorer narrative ability during retelling in 5-year-olds with unilateral cleft lip and palate (UCLP) as a group, compared to peers without UCLP. Aim: To investigate if there are any differences between 5-year-olds with and without UCLP in narrative ability during retelling. Methods: A total of 83 children participated, 51 with UCLP and 32 without. They had no known additional malformations or syndromes. The children were audio recorded while performing the Bus Story Test (BST). The recordings were orthographically transcribed. From the transcriptions the BST information score was calculated. The macrostructure of the narratives was assessed with the Narrative Scoring Scheme (NSS), and the microstructure with mean length of utterance in words, grammaticality, grammatical complexity and lexical diversity. Results for children with and without UCLP were compared. Results: The group with UCLP performed better than the group without UCLP in the NSS sub-category Conclusion. No other significant differences were seen between the groups. The UCLP group had a larger standard deviation for the information score than the group without UCLP. Conclusions: The group with UCLP displayed at least as good results as the group without UCLP, but the information score was more varied for the UCLP group than for the group without UCLP.
|
|
| 7. |
- Brännström, K. Jonas, et al.
(författare)
-
Perceived listening effort in children with hearing loss : listening to a dysphonic voice in quiet and in noise
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:1, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The present study investigates the effect of signal degradation on perceived listening effort in children with hearing loss listening in a simulated class-room context. It also examines the associations between perceived listening effort, passage comprehension performance and executive functioning. Methods: Twenty-four children (aged 06:03–13:00 years) with hearing impairment using cochlear implant (CI) and/or hearing aids (HA) participated. The children made ratings of perceived listening effort after completing an auditory passage comprehension task. All children performed the task in four different listening conditions: listening to a typical (i.e. normal) voice in quiet, to a dysphonic voice in quiet, to a typical voice in background noise and to a dysphonic voice in background noise. In addition, the children completed a task assessing executive function. Results: Both voice quality and background noise increased perceived listening effort in children with CI/HA, but no interaction with executive function was seen. Conclusion: Since increased listening effort seems to be a consequence of increased cognitive resource spending, it is likely that less resources will be available for these children not only to comprehend but also to learn in challenging listening environments such as classrooms.
|
|
| 8. |
- Kalnak, Nelli, et al.
(författare)
-
Description and prediction of reading decoding skills in Swedish children with Developmental Language Disorder
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:2, s. 84-91
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: Research is lacking in terms of reading decoding skills among clinical samples of Swedish-speaking children with Developmental Language Disorder (DLD). Method: The present cross-sectional study included a sample of 61 children (8-12 years) with DLD attending school language units, years 1 to 5. Our purpose was to study reading decoding skills and predictors for decoding, such as a phonological processing skill (nonword repetition), working memory, and a family history of literacy problems. Results: The results on a combined measure of the word and nonword decoding indicated that only 18% of the children had age-adequate decoding skills. The proportion of age-adequate decoders did not change noticeably with the school year. The participants’ decoding skills showed larger deviations to test norm means with higher school years. Hierarchical regression analysis showed that the best predictors of decoding skills were measures of working memory and nonword repetition, followed by school year. These factors significantly contributed to the variance in decoding among our sample of children with DLD. A family history of literacy problems made no contribution to the variance. Conclusions: The findings emphasize the necessity of assessing and following up on literacy development in children with DLD.
|
|
| 9. |
- Kalnak, Nelli, et al.
(författare)
-
Past-tense inflection of non-verbs : a potential clinical marker of developmental language disorder in Swedish children
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:1, s. 10-17
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: In this paper, we explore the performance of past-tense inflection of non-verbs (NVI) in children with developmental language disorder (DLD) and in typically developing controls, to investigate its accuracy as a clinical marker for Swedish-speaking children with DLD. Further, we investigate the relationship between NVI, nonword-repetition, and family history. Methods: The sample consists of 36 children with DLD (mean age 9;5 years) and 60 controls (mean age 9;2 years). Results: The DLD group performed significantly lower than the controls on the NVI task, with a large effect size of the difference (d = 1.52). Analysis of the clinical accuracy of NVI resulted in 80.6% sensitivity and 76.6% specificity. NVI was significantly and moderately associated with nonword-repetition in the controls, but not in the DLD group. A positive family history, 80.6% in the DLD group and 6.9% in the controls, was associated with lower performance on NVI. When controlling for group (DLD and controls), a non-significant association between family history and performance on the NVI task was found. Conclusions: NVI is a potential clinical marker of DLD in Swedish school-aged children, but the current NVI task does not reach the level of being acceptable. Further development of the NVI task is warranted to improve its accuracy.
|
|
| 10. |
|
|
| 11. |
- Rex, Susanne, et al.
(författare)
-
A preliminary validation of a dynamic speech motor assessment for Swedish-speaking children with childhood apraxia of speech
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:4, s. 230-238
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Children with speech sound disorders (SSDs) have difficulties affecting different levels of speech production. For treatment to be beneficial, it is important to differentiate between Childhood Apraxia of Speech (CAS)–a motor speech disorder with deficits in speech praxis–and other SSDs (nonCAS-SSD). We have previously developed a motor speech examination Dynamisk motorisk talbedömning (DYMTA). We aimed to evaluate DYMTAs reliability and validity in a small-scale sample to estimate DYMTAs usability in diagnostic settings. Methods: Speech, language, and oral motor abilities were assessed in 45 children between 40 and 106 months. Intra- and inter-rater reliability of DYMTA were analyzed. Further, DYMTAs ability to validly discriminate between children with CAS and nonCAS-SSD was assessed. Results: The intra-rater reliability for the scores of DYMTA was strong, with ICCs ranging from 0.97 to 1.0. DYMTA total score had strong inter-rater reliability as evidenced both by the agreement estimates (DYMTA-A: 0.91 and DYMTA-B: 0.87) and the ICCs (0.97 and 0.96). Inter-rater reliability was also strong for the separate subscores on agreement estimates and for all subscores on ICCs, except for the Prosody subscores. DYMTA accurately discriminated between children with CAS and nonCAS-SSD in this small sample with an AUC of 0.92 for DYMTA-A and 0.94 for DYMTA-B. Conclusions: With its focus on speech movements, DYMTA could serve as a valuable addition to other tests when assessing children’s speech motor performance. This first examination suggests that DYMTA may be both a reliable and valid tool in the diagnostic process of SSD.
|
|
| 12. |
- Sahlén, Birgitta, et al.
(författare)
-
Best ear hearing level, time factors and language outcome in Swedish children with mild and moderate hearing loss with hearing aids
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:4, s. 239-248
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The risk for language disorder is high in children with all levels of hearing loss (HL). Early identification and intervention should be as important for children with mild HL as for those with more severe HL. Despite new-born hearing screening, a recent survey of speech language therapist services in southern Sweden indicates that children with mild and moderate HL are severely neglected when it comes to language assessment and language intervention. In this study we explore associations between Best Ear Hearing Level (BEHL), time factors and language skills in Swedish children with HL with hearing aids (HA). Method: Participants were 19 children with mild HL (BEHL 23–39) and 22 children with moderate HL (BEHL 40–70) aged 5–15 years. Information on age at diagnosis and at HA fitting were collected. The children performed a nonword repetition and a sentence comprehension task. Results: The time elapsed between diagnosis and fitting with HA was longer for the children with mild HL.Participants with mild HL received their HA significantly later than children with moderate HL. No association between BEHL and the two language measures was found, and language skills were not better in children with mild than moderate HL. 17% of participants performed below cut-off for language disorder on both language measures. Conclusion: Given the risk for long-term academic and social consequences of even mild HL delayed HA intervention for children with HLleads to serious concerns by families, clinicians, and pedagogues.
|
|
| 13. |
- Wiberg, S., et al.
(författare)
-
Tracheostomy management by speech-language pathologists in Sweden
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:3, s. 146-156
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Speech-language pathologists' (SLPs) role in tracheostomy management is well described internationally. Surveys from Australia and the United Kingdom show high clinical consistency in SLP tracheostomy management, and that practice follows guidelines, research evidence and protocols. Swedish SLPs work with tracheostomised patients, however, the content and extent of this practice, and how it compares to international research is unknown. This study reports how SLPs in Sweden work with tracheostomised patients, investigating (a) the differences and similarities in SLPs tracheostomy management and (b) the facilitators and barriers to tracheostomy management, as reported by SLPs. Methods: A study-specific, online questionnaire was completed by 28 SLPs who had managed tracheostomised patients during the previous year. This study was conducted in 2018, pre Covid-19 pandemic. The answers were analysed for exploratory descriptive comparison of data. Content analyses were made on answers from open-ended questions. Results: Swedish SLPs manage tracheostomised patients, both for dysphagia and communication. During this study, the use of protocols and guidelines were limited and SLPs were often not part of a tracheostomy team. Speech-language pathologists reported that the biggest challenges in tracheostomy management were in (a) collaboration with other professionals, (b) unclear roles and (c) self-perceived inexperience. Improved collaboration with other professionals and clearer roles was suggested to facilitate team tracheostomy management. Conclusions: This study provides insight into SLP tracheostomy management in Sweden, previously uncharted. Results suggest improved collaboration, further education and clinical training as beneficial for a clearer and more involved SLP role in tracheostomy management.
|
|
| 14. |
- Åsberg Johnels, Jakob, 1978, et al.
(författare)
-
Language/cognitive predictors of literacy skills in 12-year-old children on the autism spectrum
- 2022
-
Ingår i: Logopedics Phoniatrics Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 47:3, s. 166-170
-
Tidskriftsartikel (refereegranskat)abstract
- Aim Some school age children with autism spectrum disorder (ASD) struggle with literacy development, yet, the individual differences are major and not well understood. Moreover, literacy attainment is multi-faceted and literacy skills and difficulties manifest in more than one way. The aim of this study was to describe this variability and to identify language/cognitive predictors of different literacy skills. Methods We assessed different literacy skills (word reading accuracy, reading fluency, reading comprehension, and spelling), along with a set of language/cognitive predictor skills (listening comprehension, rapid automatized naming, phonological awareness and nonverbal cognitive ability), in 12-year-old children with ASD without intellectual disability recruited from a longitudinal study in Sweden. Results There was great heterogeneity (from floor to ceiling levels) in literacy skills, with a statistically increased prevalence of poor reading comprehension and reading fluency compared with population norms. In regression analyses, it was shown that concurrent language/cognitive predictor skills (e.g. phonological awareness) were differentially associated with literacy subskills. Moreover, a longitudinal analysis showed that preschool language problems were associated with poor word reading accuracy and spelling in middle school. Conclusions The results confirm previous findings as well as provide new knowledge regarding profiles of literacy (difficulties) in children with ASD; interestingly, the identified predictors of literacy skills in ASD resembled those identified as important in general reading (and dyslexia) research, which might indicate that similar kinds of support and training would be beneficial.
|
|
| 15. |
|
|
| 16. |
- Asp, Mihaela, et al.
(författare)
-
Ovarian tumor frozen section, a multidisciplinary affair
- 2022
-
Ingår i: Acta Oncologica. - 1651-226X. ; 61:7, s. 785-792
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundOvarian Cancer (OC) constitute the eighth most common cancers among women worldwide. Surgery remains the cornerstone in the management of OC. Intraoperative frozen section (FS) diagnosis is widely used to decide the surgery course. We aimed to assess the reliability of intraoperative FS diagnosis for treatment planning of patients with suspected OC from a multidisciplinary perspective. The clinical consequences of reclassification and the multidisciplinary management of the therapy plan, is the secondary aim of this study. To our knowledge, this information is sparely investigated.MethodsA single-center, retrospective population-based study of patients who underwent surgery for suspected OC between 2018 and 2020. Histopathological outcomes were classified as benign, borderline, or malignant. The FS diagnosis was the diagnostic test, and the final histopathology report was the gold standard. Diagnostic capability for treatment planning was assessed, and modifications made possible by overall clinical knowledge were discussed.ResultsA total of 358 patients were identified, of whom 187 were included in the FS group. Overall accuracy was 89.8%, and 19 patients were reclassified; the malignancy grade of 15 tumors was underestimated. Prevalence, sensitivity, specificity, positive predictive value, and negative predictive value for invasive malignancies on FS were 54.0% (CI 46.6–61.3%), 88.1% (CI 80.2–93.7%), 98.8% (CI 93.7–99.9%), 98.9% (CI 92.7–99.8%), and 87.6% (CI 80.6–92.4%), respectively. Tumors incorrectly graded by FS tended to be of borderline-related.ConclusionsThe reliability of the FS methodology was an accurate test to help perform appropriate surgery and plan swift oncological treatment. FS is a reliable method to diagnose invasive malignancies and benign pathology. The communication between the pathologist, surgeon, and medical oncologist is highly important for both intraoperative decision-making and postoperative patient care.
|
|
| 17. |
- Blom, Katarina Y., et al.
(författare)
-
Early intervention with compression garments prevents progression in mild breast cancer-related arm lymphedema : a randomized controlled trial
- 2022
-
Ingår i: Acta Oncologica. - 0284-186X. ; 61:7, s. 897-905
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Early diagnosis and compression treatment are important to prevent progression in breast cancer-related arm lymphedema (BCRAL). However, some mild BCRAL can be reversible, and therefore, compression treatment may not be needed. The aim of this study was to investigate the proportion of women with mild BCRAL showing progression/no progression of lymphedema after treatment with or without compression garments, differences in changes of lymphedema relative volume (LRV), local tissue water and subjective symptoms during 6 months. Also, adherence to self-care was examined. Material and methods: Seventy-five women diagnosed with mild BCRAL were randomized to a compression group (CG) or noncompression group (NCG). Both groups received self-care instructions, and the CG were treated with a standard compression garment (ccl 1). Women in the NCG who progressed in LRV ≥2%, or exceeded 10% dropped out, and received appropriate treatment. The proportion showing progression/no progression of LRV, and changes in LRV was measured by Water Displacement Method. Changes in local tissue water were measured by Tissue Dielectric Constant (TDC), subjective symptoms by Visual Analogue Scale, and self-care by a questionnaire. Results: A smaller proportion of LRV progression was found in the CG compared to the NCG at 1, 2 and 6 months follow-up (p ≤ 0.013). At 6 months, 16% had progression of LRV in the CG, compared to 57% in the NCG, (p = 0.001). Thus, 43% in the NCG showed no progression and could manage without compression. Also, CG had a larger reduction in LRV, at all time-points (p ≤ 0.005), and in the highest TDC ratio, when same site followed, at 6 months (p = 0.025). Subjective symptoms did not differ between the groups, except at 1 month, where the CG experienced more reduced tension (p = 0.008). There were no differences in adherence to self-care. Conclusion: Early treatment with compression garment can prevent progression in mild BCRAL. Trial registration: ISRCT nr ISRCTN51918431.
|
|
| 18. |
- Borgquist, Rasmus, et al.
(författare)
-
Diagnosis and treatment of the rare procedural complication of malpositioned pacing leads in the left heart: a single center experience
- 2022
-
Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 56:1, s. 302-309
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives. This study assessed the management approach and outcome of the pacemaker or implantable cardioverter-defibrillator (ICD) leads malpositioned in the left heart. Malpositioned leads (MPLs) may have deleterious consequences, and appropriate management remains uncertain. Methods. The study population included all patients referred to a single institution for MPL in the left side of the heart after pacemaker or ICD implantation during the period from 2015 to 2021. The approach and outcome of lead management were retrospectively assessed. Results. During the study period, 6887 patients underwent device implantation. MPL was diagnosed in five patients (0.07%). In four cases, the pacing lead was placed in a coronary sinus (CS) branch, while the pacing lead was inside the left ventricle (LV) in one case. Symptoms suggestive of lead malposition were reported by 2 patients (40%). One of the patients presented with recurrent TIAs. Another presented with inappropriate ICD shocks. In one asymptomatic case, an ICD lead changed position from the right ventricle to the CS, suggesting idiopathic lead migration. In 4/5 patients, the leads were removed or repositioned by percutaneous approach, with no major periprocedural complications. Conclusions. In this series of MPL in the left heart, two patients presented with thromboembolic events or inappropriate ICD shocks. These serious complications highlight the critical need for early correct diagnosis and proper management of MPL.
|
|
| 19. |
- Ferrannini, Giulia, et al.
(författare)
-
Long-term prognosis after a first myocardial infarction : eight years follow up of the case-control study PAROKRANK
- 2022
-
Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 56:1, s. 337-342
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To explore long-term cardiovascular outcomes and mortality in patients after a first myocardial infarction (MI) compared with matched controls in a contemporary setting. Methods. During 2010-2014 the Swedish study PAROKRANK recruited 805 patients <75 years with a first MI and 805 age-, gender-, and area-matched controls. All study participants were followed until 31 December 2018, through linkage with the National Patient Registry and the Cause of Death Registry. The primary endpoint was the first of a composite of all-cause death, non-fatal MI, non-fatal stroke, and heart failure hospitalization. Event rates in cases and controls were calculated using a Cox regression model, subsequently adjusted for baseline smoking, education level, and marital status. Kaplan-Meier curves were computed and compared by log-rank test. Results. A total of 804 patients and 800 controls (mean age 62 years; women 19%) were followed for a mean of 6.2 (0.2-8.5) years. The total number of primary events was 211. Patients had a higher event rate than controls (log-rank test p < .0001). Adjusted hazard ratio (HR) for the primary outcome was 2.04 (95% CI 1.52-2.73). Mortality did not differ between patients (n = 38; 4.7%) and controls (n = 35; 4.4%). A total of 82.5% patients and 91.3% controls were event-free during the follow up. Conclusions. In this long-term follow up of a contemporary, case-control study, the risk for cardiovascular events was higher in patients with a previous first MI compared with their matched controls, while mortality did not differ. The access to high quality of care and cardiac rehabilitation might partly explain the low rates of adverse outcomes.
|
|
| 20. |
- Fürst, Per, et al.
(författare)
-
Advanced cancer and concomitant dementia : access to specialized palliative care, emergency room, hospital care, and place of death
- 2022
-
Ingår i: Acta Oncologica. - 0284-186X. ; 61:7, s. 874-880
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Dementia and advanced cancer are complex, life-limiting conditions that benefit from specialized palliative care (SPC) interventions at the end of life. The objective was to study possible differences in care for patients with concomitant advanced cancer and dementia (CA-DEM) or cancer only (CA) regarding access to SPC, acute hospital care, and place of death. Materials and methods: A retrospective observational registry study on health care consumption data from the Stockholm Regional Council involving logistic regression analyses of age, sex, living arrangements, comorbidities, dementia diagnosis, and socio-economic status. Results: Of the 12,667 persons aged ≥65 years who died from advanced cancer between 2015 and 2019, 605 had concomitant dementia. Of these, 76% of patients with CA and 42% of patients with CA-DEM had access to SPC (p<.0001). There were more admissions to palliative care for persons not living in nursing homes (p<.0001), women (p<.0001), socioeconomically privileged patients (p<.05), those with fewer comorbidities (p<.0001), and younger patients (<85 years) (p<.0001). Access to SPC reduced ER visits, hospitalizations, and acute hospital deaths for CA, whereas access to SPC only reduced hospital deaths in the CA-DEM group. Conclusions: The probability of being admitted to SPC was lower in cancer patients with known dementia. Access to SPC reduced emergency room visits and acute admissions to hospitals for the whole group, and hospital deaths both for CA and CA-DEM.
|
|
| 21. |
|
|
| 22. |
- Högmo, Anders, et al.
(författare)
-
Base of tongue squamous cell carcinomas, outcome depending on treatment strategy and p16 status. A population-based study from the Swedish Head and Neck Cancer Register
- 2022
-
Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 61:4, s. 433-440
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The base of tongue squamous cell carcinoma (BOTSCC) is mainly an HPV-related tumor. Radiotherapy (EBRT) ± concomitant chemotherapy (CT) is the backbone of the curatively intended treatment, with brachytherapy (BT) boost as an option. With four different treatment strategies in Sweden, a retrospective study based on the population-based Swedish Head and Neck Cancer Register (SweHNCR) was initiated.Material and methods: Data on tumors, treatment and outcomes in patients with BOTSCC treated between 2008 and 2014 were validated through medical records and updated as needed. Data on p16 status were updated or completed with immunohistochemical analysis of archived tumor material. Tumors were reclassified according to the UICC 8th edition.Results: Treatment was EBRT, EBRT + CT, EBRT + BT or EBRT + CT + BT in 151, 145, 82 and 167 patients respectively (n = 545). A p16 analysis was available in 414 cases; 338 were p16+ and 76 p16−. 5-year overall survival (OS) was 68% (95% CI: 64–72%), with76% and 37% for p16+ patients and p16− patients, respectively. An increase in OS was found with the addition of CT to EBRT for patients with p16+ tumors, stages II–III, but for patients with tumor stage I, p16+ (UICC 8) none of the treatment strategies was superior to EBRT alone.Conclusion: In the present retrospective population-based study of BOTSCC brachytherapy was found to be of no beneficial value in curatively intended treatment. An increase in survival was found for EBRT + CT compared to EBRT alone in patients with advanced cases, stages II and III (UICC 8), but none of the regimes was significantly superior to EBRT as a single treatment modality for stage I (UICC 8), provided there was p16 positivity in the tumor. In the small group of patients with p16− tumors, a poorer prognosis was found, but the small sample size did not allow any comparisons between different treatment strategies.
|
|
| 23. |
|
|
| 24. |
- Rydelius, Anna, et al.
(författare)
-
Diffusion tensor imaging in glioblastoma patients treated with volumetric modulated arc radiotherapy : a longitudinal study
- 2022
-
Ingår i: Acta oncologica (Stockholm, Sweden). - 1651-226X. ; 61:6, s. 680-687
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Chemo- and radiotherapy (RT) is standard treatment for patients with high-grade glioma, but may cause side-effects on the patient's cognitive function.AIM: Use of diffusion tensor imaging (DTI) to investigate the longitudinal changes in normal-appearing brain tissue in glioblastoma patients undergoing modern arc-based RT with volumetric modulated arc therapy (VMAT) or helical tomotherapy.MATERIALS AND METHODS: The study included 27 patients newly diagnosed with glioblastoma and planned for VMAT or tomotherapy. All subjects underwent magnetic resonance imaging at the start of RT and at week 3, 6, 15, and 26. Fourteen subjects were additionally imaged at week 52. The DTI data were co-registered to the dose distribution maps. Longitudinal changes in fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were assessed in the corpus callosum, the centrum semiovale, the hippocampus, and the amygdala.RESULTS: Significant longitudinal changes in FA, MD, and RD were mainly found in the corpus callosum. In the other examined brain structures, only sparse and transient changes were seen. No consistent correlations were found between biodose, age, or gender and changes in DTI parameters.CONCLUSION: Longitudinal changes in MD, FA, and RD were observed but only in a limited number of brain structures and the changes were smaller than expected from literature. The results suggest that modern, arc-based RT may have less negative effect on normal-appearing parts of the brain tissue up to 12 months after radiotherapy.
|
|
| 25. |
- Siddhuraj, Premkumar, et al.
(författare)
-
Histology-based blood leukocyte profiling reveals parallel Th2 and Th17 signatures in seasonal allergic rhinitis
- 2022
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 1651-2251 .- 0001-6489. ; 142:9-12, s. 696-704
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Allergic rhinitis (AR), a common condition in the westernized world, is suggested to be more immunologically complex than the archetypical 'Th2' inflammation. New approaches are needed to decode this complexity.AIMS/OBJECTIVES: In this study, we explored a novel histology-based analysis for circulating blood leukocyte profiling in 16 patients with seasonal AR outside and during the pollen season.MATERIAL AND METHODS: Leukocytes were purified with minimal ex-vivo artefacts, embedded into agarose-paraffin pellets for immunohistochemistry-based immune cell profiling. Blood leukocyte mapping was performed.RESULTS: Samples collected during the pollen season had statistically increased eosinophils, neutrophils, monocytes, and CD8+ T-lymphocytes compared to the off-season baseline. In contrast, no change was observed for CD20+ B-lymphocytes and CD3+ T-lymphocytes. Subclassification of CD4+ T-helper cells demonstrated a parallel and significant expansion of Th2 and Th17-cells during the pollen season, while Th1-cells remained unchanged. Whereas absolute basophils numbers were unaltered, the basophil markers GATA2 and CPA3 increased during the pollen season.CONCLUSIONS AND SIGNIFICANCE: This study introduces a novel and applicable method for systemic immune cell screening and provides further evidence of complex and parallel Th2 and Th17-immune signatures in seasonal AR. It also forwards GATA2 and CPA3 as potential biomarkers for ongoing allergic inflammation.
|
|
| 26. |
- Wettergren, Lena, et al.
(författare)
-
Prevalence and risk factors for sexual dysfunction in young women following a cancer diagnosis : a population-based study
- 2022
-
Ingår i: Acta Oncologica. - : Taylor & Francis Group. - 0284-186X .- 1651-226X. ; 61:10, s. 1165-1172
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Self-reported sex problems among women diagnosed with reproductive and nonreproductive cancers before the age of 40 are not fully understood. This study aimed to determine sexual dysfunction in young women following a cancer diagnosis in relation to women of the general population. Furthermore, to identify factors associated with sexual dysfunction in women diagnosed with cancer.Materials and Methods: A population-based cross-sectional study with 694 young women was conducted 1.5 years after being diagnosed with cancer (response rate 72%). Potential participants were identified in national quality registries covering breast and gynecological cancer, lymphoma and brain tumors. The women with cancer were compared to a group of women drawn from the general population (N = 493). Sexual activity and function were assessed with the PROMIS® SexFS. Logistic regression was used to assess differences between women with cancer and the comparison group, and to identify factors associated with sexual dysfunction.Results: The majority of the women with cancer (83%) as well as the women from the comparison group (87%) reported having had sex the last month (partner sex and/or masturbation). More than 60% of the women with cancer (all diagnoses) reported sexual dysfunction in at least one of the measured domains. The women with cancer reported statistically significantly more problems than women of the comparison group across domains such as decreased interest in having sex, and vaginal and vulvar discomfort. Women with gynecological or breast cancer and those receiving more intense treatment were at particular high risk of sexual dysfunction (≥2 domains). Concurrent emotional distress and body image disturbance were associated with more dysfunction.Conclusion: The results underscore the need to routinely assess sexual health in clinical care and follow-up. Based on the results, development of interventions to support women to cope with cancer-related sexual dysfunction is recommended.
|
|
| 27. |
- Wändell, Per, et al.
(författare)
-
Valvular heart diseases in immigrants and Swedish-born individuals : a national cohort study
- 2022
-
Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 56:1, s. 217-223
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives. The aim of this study was to analyse the risk of valvular heart diseases among foreign-born individuals in Sweden. Design. This was a nationwide study of individuals aged 18 years of age and older (N = 6,118,649; 2,970,055 men and 3,148,594 women). Valvular heart diseases were defined as at least one registered diagnosis in the National Patient Register between 1 January 1998 and 31 December 2012. Cox regression analysis was used to estimate hazard ratios (HR) with 99% confidence intervals (CI) of incident valvular heart diseases in foreign-born individuals compared to Swedish natives. The Cox regression models were adjusted for age, co-morbidities, and sociodemographic factors. Sub-categories were chronic rheumatic valvular heart diseases and non-rheumatic valvular heart diseases. Results. There were 64,979 male cases and 59,075 female cases. Fully adjusted HRs (99% CI) were among immigrant men 0.86 (0.82–0.89) and immigrant women 0.96 (0.92–1.00). For chronic rheumatic valvular disease among immigrant men and women, the HRs were 1.62 (1.37–1.92) and 1.75 (1.52–2.00), respectively, and, for non-rheumatic valvular disease among immigrant men 0.83 (0.80–0.87) and immigrant women 0.92 (0.88–0.96). Increased risks for chronic rheumatic valvular disease were found among men from Southern, Eastern and Central Europe, Africa and Asia and among women from Western, Eastern and Central Europe and Africa, Latin America and Asia. Conclusions. We observed lower risks in general of valvular heart disease, but higher risks of chronic rheumatic valvular heart disease in immigrants, which is important in the clinical situation.
|
|
| 28. |
|
|
| 29. |
- Lindsköld, Linnéa, 1985-
(författare)
-
Läsandets politiska historia
- 2022
-
Ingår i: Biblioteksbladet. - 1651-5447. ; :3, s. 42-49
-
Tidskriftsartikel (populärvet., debatt m.m.)
|
|
| 30. |
- Brunström, Mattias, et al.
(författare)
-
Association of education and feedback on hypertension management with risk for stroke and cardiovascular disease
- 2022
-
Ingår i: Blood Pressure. - : Informa UK Limited. - 0803-7051 .- 1651-1999. ; 31:1, s. 31-39
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose Education and feedback on hypertension management has been associated with improved hypertension control. This study aimed to assess the effectiveness of such interventions to reduce the risk of stroke and cardiovascular events. Materials and Methods Individuals >= 18 years with a blood pressure (BP) recording in Vasterbotten or Sodermanland County during the study period 2001 to 2009 were included in 108 serial cohort studies, each with 24 months follow-up. The primary outcome was risk of first-ever stroke in Vasterbotten County (intervention) compared with Sodermanland County (control). Secondary outcomes were first-ever major adverse cardiovascular event (MACE), myocardial infarction, and heart failure, as well as all-cause and cardiovascular mortality. All outcomes were analysed using time-to-event data included in a Cox proportional hazards model adjusted for age, sex, hypertension, diabetes, coronary artery disease, atrial fibrillation, systolic BP at inclusion, marital status, and disposable income. Results A total of 121 365 individuals (mean [SD] age at inclusion 61.7 [16.3] years; 59.9% female; mean inclusion BP 142.3/82.6 mmHg) in the intervention county were compared to 131 924 individuals (63.6 [16.2] years; 61.2% female; 144.1/81.1 mmHg) in the control county. A first-ever stroke occurred in 2 823 (2.3%) individuals in the intervention county, and 3 584 (2.7%) individuals in the control county (adjusted hazard ratio 0.96, 95% CI 0.90 to 1.03). No differences were observed for MACE, myocardial infarction or heart failure, whereas all-cause mortality (HR 0.91, 95% CI 0.87 to 0.95) and cardiovascular mortality (HR 0.91, 95% CI 0.85 to 0.98) were lower in the intervention county. Conclusions This study does not support an association between education and feedback on hypertension management to primary care physicians and the risk for stroke or cardiovascular outcomes. The observed differences for mortality outcomes should be interpreted with caution.
|
|
| 31. |
- Carlbring, Per
(författare)
-
Signing off after two decades
- 2022
-
Ingår i: Cognitive Behaviour Therapy. - : Taylor & Francis Group. - 1650-6073 .- 1651-2316. ; 51:1, s. 1-2
-
Tidskriftsartikel (refereegranskat)
|
|
| 32. |
- Fagerberg, Nils, 1972-, et al.
(författare)
-
Evaluation of individual-tree growth models for Picea abies based on a case study of an uneven-sized stand in southern Sweden
- 2022
-
Ingår i: Scandinavian Journal of Forest Research. - : Taylor & Francis Group. - 0282-7581 .- 1651-1891. ; 37:1, s. 45-58
-
Tidskriftsartikel (refereegranskat)abstract
- To develop recommendations for tree selection in Continuous Cover Forestry (CCF), access to valid tools for simulating growth at individual tree-level is necessary. To assist efforts to develop such tools, in this study, long-term observation data from two uneven-sized Norway spruce plots in southern Sweden are used to evaluate old and new individual-tree growth models (two established Swedish models, two new preliminary models and included as a reference, a Finnish model). The plots' historical management records and site conditions are the same, but their last thinning treatment differs. Observed diameter increment at tree-level is investigated in relation to treatment. Individual tree growth residuals of tested models are evaluated in relation to tree diameter, treatment, projection length and sensitivity to the predictor mean stand age. Furthermore, the relations between displayed residuals and basal area local competition are analysed. The analyses indicate that active thinning made annual diameter increment independent of tree diameter above a threshold level, while the absence of thinning supported a concave relationship. All tested models displayed a significant linear bias leading to overestimation of small trees' growth and increasing underestimations of larger trees' growth with tree diameter. All distance-independent models displayed residual trends related to local competition.
|
|
| 33. |
- Goude, Martin, et al.
(författare)
-
Using hybrid modelling to predict basal area and evaluate effects of climate change on growth of Norway spruce and Scots nine stands
- 2022
-
Ingår i: Scandinavian Journal of Forest Research. - : Informa UK Limited. - 0282-7581 .- 1651-1891. ; 37, s. 59-73
-
Tidskriftsartikel (refereegranskat)abstract
- When modelling forest growth, capturing the effects of climate change is needed for reliable longterm predictions and management choices. This remains a challenge because commonly used mensurational forest growth and yield models, relying on inventory data, cannot account for climate change effects. We developed hybrid physiological/mensurational basal area growth and yield models, which combine physiological response to climatic conditions and empirical relations. We included climate and site effects by replacing time with light sums of photosynthetically active radiation and modifying the latter with monthly soil water, vapour pressure deficit, temperature, and frost days. When parameterised with permanent sample plot data for Scots pine and Norway spruce across Sweden, the hybrid models could reproduce observations well, although with no increase in precision compared with time-based mensurational models. When considering different climate scenarios, a significant impact on productivity from climate change emerged. For example, a 2 degrees C warming enhanced Scots pine production by up to 14% in regions where temperatures were originally cooler and soil water deficit was low (i.e. northwest Sweden), but depressed it, up to 9%, elsewhere. Hence, climate-sensitive models that take local variations into account are necessary for accurate predictions and sustainable forest management.
|
|
| 34. |
- Johansson, Benny, et al.
(författare)
-
The a' velocity by tissue-Doppler echocardiography correlates to invasive mean left atrial pressure in patients with normal ejection fraction
- 2022
-
Ingår i: Scandinavian Cardiovascular Journal. - : Taylor & Francis. - 1401-7431 .- 1651-2006. ; 56:1, s. 6-12
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the correlation of a' velocity by tissue-Doppler measurements with invasively measured mean left atrial pressure in patients with normal ejection fraction.Design: In this retrospective study, we evaluated the septal a', lateral a' and average a' velocity by tissue-Doppler echocardiography, in 125 in-hospital patients, 1-12 h before an elective pulmonary vein isolation due to intermittent atrial fibrillation, and compared to invasively measured mean left atrial pressure (LAP) during the invasive procedure. The patients, aged 35-81 years, had to be in sinus rhythm at both examinations, no atrial fibrillation during two procedures, no or mild valve disease and normal ejection fraction (>50%).Results: Invasively measured mean LAP correlated well to septal a' (r = -0.435), lateral a' (r = -0.473) and average a' velocity (r = -0.491). Normal mean LAP (<= 12 mmHg) was found in 95 patients and elevated mean LAP (>12 mmHg) in 30 patients. The patients with elevated mean LAP had a lower septal a' velocity (6.5 +/- 2.7 vs 8.6 +/- 2.3 cm/s; p < .01), lateral a' velocity (5.9 +/- 2.3 vs 8.6 +/- 2.1 cm/s; p < .01) and average a' velocity (6.2 +/- 2.4 vs 8.8 +/- 2.1 cm/s; p < .01) compared to patients with normal mean LAP. Septal a', lateral a' and average a' velocity were good predictors of elevated mean LAP with AUC of 0.78, 0.83 and 0.82. Average a' velocity with cut-off < 7.25 cm/s had a sensitivity of 83% and a specificity of 77% to predict elevated mean LAP.Conclusion: The a' velocity is a good indicator of mean LAP and might be considered in the evaluation of left ventricle filling pressure in patients with normal ejection fraction.
|
|
| 35. |
- Nordin, Per, et al.
(författare)
-
Successful spruce regenerations : impact of site preparation and the use of variables from digital elevation models in decision-making
- 2022
-
Ingår i: Scandinavian Journal of Forest Research. - : Taylor & Francis. - 0282-7581 .- 1651-1891. ; 37:1, s. 33-44
-
Tidskriftsartikel (refereegranskat)abstract
- Various site preparation methods are used in Swedish forestry. However, some methods can lead to unnecessary disturbance, which could be avoided by using variables from digital elevation models in management decisions. The current study aimed to investigate how different site preparation methods, and their intensities, affect Norway spruce (Picea abies (L.) Karst.) regeneration. Additional aims were to clarify how these methods affect soil disturbance and vegetation development, along with how variables from digital elevation models could be used in silvicultural decision-making. Experimental sites were established in southern Sweden to assess five different site preparation treatments with different planting densities: (1) conventional disc trenching 2500 seedlings/ha (DT2500); (2) low intensity disc trenching 1250 seedlings/ha (LDT1250); (3) low intensity disc trenching 2500 seedlings/ha (LDT2500); (4) low-intensity patch-wise 1250 seedlings/ha (PW1250); and (5) patch-wise 2500 seedlings/ha (PW2500). Site preparation intensity had no effect on seedling growth and, survival or vegetation development; the tested treatments differed in terms of soil disturbance. Planting spot properties and weather conditions influenced the seedling performance. DTW and slope could not substantially explain either seedling growth or survival. The results indicate that the choice of site preparation method should consider flexibility when planting while adapting the level of disturbance accordingly.
|
|
| 36. |
- Rönnberg Wästljung, Ann-Christin, et al.
(författare)
-
Phenotypic plasticity in Populus trichocarpa clones across environments in the Nordic-Baltic region
- 2022
-
Ingår i: Scandinavian Journal of Forest Research. - : Informa UK Limited. - 0282-7581 .- 1651-1891. ; 37, s. 1-5
-
Tidskriftsartikel (refereegranskat)abstract
- Transition towards a bio-based society requires large amounts of woody biomass to be converted into biofuels and biomaterials. Populus species are good candidates for growth in short rotations, but there is a lack of climate-adapted plant material suitable for growth at the high latitudes of the Nordic-Baltic region. Here we studied the growth and phenology traits in 63 Populus trichocarpa clones earlier preliminary selected for growth at northern latitudes, in three different field sites; i.e. in central Sweden, eastern and western Latvia. The material showed moderate broad sense heritabilities, with high values for phenology traits, indicating opportunities for selection. Genotype x environment (g x e) interaction was identified for all traits, but the phenotypic correlation between pairs of sites provided more detailed information indicating the strength of the g x e interaction. The between-clone variation in plasticity was high, and we identified some clones showing a high and stable performance across the three sites. These clones are of particular interest for the commercial deployment and future breeding of Populus material for the Nordic-Baltic region.
|
|
| 37. |
|
|
| 38. |
- Ax, Anna-Karin, 1980-, et al.
(författare)
-
Long-term resource utilisation and associated costs of exercise during (neo)adjuvant oncological treatment : the Phys-Can project
- 2022
-
Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 61:7, s. 888-896
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exercise during oncological treatment is beneficial to patient health and can counteract the side effects of treatment. Knowledge of the societal costs associated with an exercise intervention, however, is limited. The aims of the present study were to evaluate the long-term resource utilisation and societal costs of an exercise intervention conducted during (neo)adjuvant oncological treatment in a randomised control trial (RCT) versus usual care (UC), and to compare high-intensity (HI) versus low-to-moderate intensity (LMI) exercise in the RCT.METHODS: We used data from the Physical Training and Cancer (Phys-Can) project. In the RCT, 577 participants were randomised to HI or to LMI of combined endurance and resistance training for 6 months, during oncological treatment. The project also included 89 participants with UC in a longitudinal observational study. We measured at baseline and after 18 months. Resource utilisation and costs of the exercise intervention, health care, and productivity loss were compared using analyses of covariance (RCT vs. UC) and t test (HI vs. LMI).RESULTS: Complete data were available for 619 participants (RCT HI: n = 269, LMI: n = 265, and UC: n = 85). We found no difference in total societal costs between the exercise intervention groups in the RCT and UC. However, participants in the RCT had lower rates of disability pension days (p < .001), corresponding costs (p = .001), and pharmacy costs (p = .018) than the UC group. Nor did we find differences in resource utilisation or costs between HI and LMI exercise int the RCT.CONCLUSION: Our study showed no difference in total societal costs between the comprehensive exercise intervention and UC or between the exercise intensities. This suggests that exercise, with its well-documented health benefits during oncological treatment, produces neither additional costs nor savings.
|
|
| 39. |
- Bergström, Aileen, et al.
(författare)
-
The jigsaw puzzle of activities for mastering daily life; service recipients and professionals’ perceptions of gains and changes attributed to reablement : A qualitative meta-synthesis
- 2022
-
Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor and Francis Ltd.. - 1103-8128 .- 1651-2014. ; , s. 1-12
-
Forskningsöversikt (refereegranskat)abstract
- Background: Reablement services are intended to make a difference in the daily lives of older adults. Outcomes are often described in terms of independence, improving quality of life, improving ADL functioning, or reducing services. However, little is known if the older adults or next-of-kin experience these outcomes when talking about participating in reablement services. Aim: This study aims to explore how older adults, next-of-kin, and professionals narrate the reablement recipients’ possible outcomes as gains and changes in everyday life during and after the reablement period. Materials and methods : This meta-synthesis included 13 studies. Data were analyzed with a meta-ethnographic approach, searching for overarching metaphors, in three stages. Results: The metaphor ‘the jigsaw puzzle of activities for mastering daily life again’ illustrates that re-assembling everyday life after reablement is not a straightforward process of gains and changes but includes several daily activities that must be organized and fit together. To obtain a deeper understanding of the participants’ gains, and changes after reablement, we use the theoretical framework of ‘doing, being, becoming, and belonging’. Conclusion: The findings indicate the complexity of reablement services as well as the need for a holistic approach. Significance: Outcome measures should be meaningful for reablement recipients.
|
|
| 40. |
|
|
| 41. |
|
|
| 42. |
|
|
| 43. |
|
|
| 44. |
- Aghajanzadeh, Susan, et al.
(författare)
-
A prospective 5-year study of trismus prevalence and fluctuation in irradiated head and neck cancer patients
- 2022
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 142:7-8, s. 620-626
-
Tidskriftsartikel (refereegranskat)abstract
- Background Trismus is a complication post-radiotherapy for head and neck cancer (HNC), which causes pain, eating limitations and reduced quality-of-life. However, little is known about the condition long-term or how trismus fluctuates within an irradiated population. Aim/Objective To prospectively map trismus prevalence in irradiated HNC patients up to 5-years following treatment completion including describing intra-group fluctuation of maximum interincisal opening (MIO). Materials and Methods 211 patients receiving curatively intended radiotherapy for HNC were included in this prospective study. Patients were followed pre-radiotherapy (baseline), 3-, 6-, 12-, 24-, 36- and 60-months post-radiotherapy completion using MIO. Results Mean MIO at baseline, 12-months and 5-years following radiotherapy were 51.5 mm, 41.7 mm and 41.3 mm respectively. A total of 28% (n = 36) fulfilled the trismus criterion at 5-years post-radiotherapy. Eighty percent of patients (n = 24) with trismus at 5 years post-radiotherapy also suffered from trismus at 12 months post-radiotherapy, whilst 88-92% of all patients reported reduced MIO at any given timepoint compared to baseline. 15% of patients never exceeded an MIO of >35 mm at any time-point. Conclusion Trismus is a prevalent long-term complication of HNC and its treatment, which does not appear to heal spontaneously. The majority of fluctuations in MIO occur during the first 12 months post-radiotherapy completion.
|
|
| 45. |
- Aronsson, Helena, et al.
(författare)
-
Losses of phosphorus, potassium and nitrogen from horse manure left on the ground
- 2022
-
Ingår i: Acta Agriculturae Scandinavica - Section B. - : Informa UK Limited. - 0906-4710 .- 1651-1913. ; 72:1, s. 893-901
-
Tidskriftsartikel (refereegranskat)abstract
- In this five-month Swedish field study, we examined losses of nutrients from horse manure over time, in order to examine how regularly manure should be cleared from paddocks in order to minimise the risk of nutrient leaching. Small heaps of manure (400 g) were placed in open cylinders outdoors and samples (five replicates) were taken on 12 occasions from December 2020 to May 2021. The samples were analysed for weight, dry matter content and concentrations of total nitrogen (N), ammonium N, total phosphorus (P), water-extractable P (WEP), potassium (K) and carbon (C). There was a fast decline in P and K concentrations and a strong correlation between accumulated precipitation and losses from the manure into the soil. The mean reduction in total-P was 11 mg P kg−1 manure dry weight per mm accumulated precipitation. Manure N was retained in the manure over the five-month period. In conclusion, this study demonstrated high mobility of P and K, indicating a need for strategies for rapid removal of manure from paddocks. Daily removal of manure from paddocks used year-round would, approximately, save 1.7 kg P and 5.5 kg K per horse per year, which could be recycled to replace non-renewable mineral fertilisers.
|
|
| 46. |
|
|
| 47. |
- Berg, Matilda, 1989-, et al.
(författare)
-
Internet-based CBT for adolescents with low self-esteem : a pilot randomized controlled trial
- 2022
-
Ingår i: Cognitive Behaviour Therapy. - : Routledge. - 1650-6073 .- 1651-2316. ; 51:5, s. 388-407
-
Tidskriftsartikel (refereegranskat)abstract
- Low self-esteem is a common problem among adolescents and is related to psychiatric problems such as depression and anxiety. However, effective and available interventions primarily targeting low self-esteem are scarce, in particular for youths. To address this gap, the aim of this pilot study was to evaluate a novel internet-based Cognitive Behavioral Therapy (ICBT) program for low self-esteem in adolescents using a randomized controlled design. Fifty-two participants (15-19 years) were recruited and randomly allocated to seven weeks of therapist-supported ICBT (n=26) or to a waitlist control condition (n=26). The primary outcome was the Rosenberg Self-Esteem Scale (RSES). Secondary outcomes measured domain-specific aspects of self-esteem, self-compassion, quality of life, depression and anxiety. The treatment group showed significantly higher levels of self-rated self-esteem compared to the control group at post-treatment, with a large between-group effect-size (RSES, d = 1.18). Further, the treatment had significant positive impact on secondary measures of self-esteem, self-compassion, quality of life, depression and anxiety. The results of this pilot-RCT suggest that ICBT can be effective for treating low self-esteem in adolescents, decrease depression and anxiety levels, and increasing quality of life. Replication of the results in larger samples is needed.
|
|
| 48. |
- Bergsten, Urban
(författare)
-
Effects of site preparation and reindeer grazing on the early-stage success of Scots pine regeneration from seeds in northern Finland and Sweden
- 2022
-
Ingår i: Scandinavian Journal of Forest Research. - : Informa UK Limited. - 0282-7581 .- 1651-1891. ; 37, s. 338-351
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- The importance of sufficient soil scarification to ensure the regeneration of Scots pine on sub-dry and more fertile sites has been emphasized in many studies. Here we aimed to study, how site preparation intensity affects the early success of natural regeneration and sowing (bare seeds and seed pellets) of Scots pine with or without the reindeer grazing. The study area was located in northern Finland and Sweden where five site preparation methods were compared: unprepared control, logging machine tracks, Huminmix (mixing the mineral soil and organic layer), disc trenching and intensive disc trenching. In each of these we used direct seeding, seed pellets and natural regeneration. Results revealed that even the lightest site preparation methods can provide sufficient regeneration results while the reindeer grazing limits the optimal regeneration result. Huminmix and even the track of the logging machine could provide satisfactory regeneration results both in direct seeding and natural regeneration. This could facilitate the coexistence of forest management, reindeer herding and other land use forms in the same stands and area. The use of seed pellets needs further research, but it may have potential due to lower consumption of seeds and less need for site preparation.
|
|
| 49. |
- Bidarian-Moniri, Armin, et al.
(författare)
-
Autoinflation compared to ventilation tubes for treating chronic otitis media with effusion
- 2022
-
Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 142:6, s. 476-483
-
Tidskriftsartikel (refereegranskat)abstract
- Background Otitis media with effusion (OME) is the most common cause of acquired hearing loss and surgery in children. Autoinflation has been suggested as an alternative treatment for OME. Objectives The aim of the study was to compare treatment outcome with a new autoinflation device versus ventilation tube (VT) surgery or watchful waiting in children with chronic bilateral OME from the waiting list for surgery. Methods Forty-five children performed autoinflation during four weeks, forty-five were submitted to VT surgery, and twenty-three were enrolled as control group. Tympanometry was performed in the autoinflation and the control groups and audiometry in all groups. Results An equivalent hearing improvement was achieved in the autoinflation and the VT group at one (p=.19), six (p=.23) and twelve (p=.31) months with no significant alteration in the control group. In the autoinflation group 80% of the children avoided surgery and no complications were reported compared to 34% complication rate in the VT group. Conclusion Autoinflation achieved an equivalent improvement in hearing thresholds compared to VT surgery for treating OME. Significance Autoinflation may be a reasonable first-line treatment for children with OME to potentially avoid surgery. Article Summary: The Moniri autoinflation device is well tolerated and an effective alternative to ventilation tubes for treatment of chronic otitis media with effusion in young children. What's known on this subject: Previous studies have shown that autoinflation may reduce effusion in children with otitis media with effusion; however limited compliance to treatment, lack of adequate hearing evaluation, short follow-up time and also lack of comparative data to ventilation tube surgery have been reported. What this study adds: A new device was developed to allow for the performance of autoinflation in young children. The effect is compared to ventilation tube surgery and equivalent improvement in hearing is achieved in the short and the long-term follow-up.
|
|
| 50. |
|
|
