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  • 1.
    Abbas, Hassan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Huzeirovic, Melisa
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    En jämförelse mellan två sjukdomsgrupper med PET/CT som undersökningsmetod: Beräkning av den totala effektiva dosen från PET- och CT-undersökning2019Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Background: Lung cancer and malignant melanoma are diseases investigated by the dual-modality positron emission tomography/computed tomography (PET/CT). There are radiation risks with the examination that can appear as stochastic effects such as cancer. The aim of this study was to compare the radiation doses between the lung cancer group (suspected or verified) and the malignant melanoma group by calculating the total effective radiation dose and to declare the risk with the PET/CT examination. Material and method: The material contained parameters regarding the examination and the sample contained 20 patients from the two groups. The method was retrospective with a quantitative approach. Results: There was a significant difference (p <0,001) between these two groups, were the lung cancer group received 11,95 milliSievert (mSv) and the malignant melanoma group 6,03 mSv and the percentage risk for lethal cancer increased by 0,06% and 0,03%, respectively. Conclusions: The lung cancer group received twice as much effective dose than the malignant melanoma group. However, the effective dose is so low that the risk increase of the lethal cancer is marginal, and the benefit of the examination outweighs the risks.

  • 2.
    Adair, Brooke
    et al.
    School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia.
    Ullenhag, Anna
    Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
    Keen, Deb
    Autism Centre of Excellence, Griffith University, Mt Gravatt, Qld, Australia.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Imms, Christine
    School of Allied Health, Australian Catholic University, Fitzroy, Vic., Australia.
    The effect of interventions aimed at improving participation outcomes for children with disabilities: a systematic review2015In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 57, no 12, p. 1093-1104Article, review/survey (Refereed)
    Abstract [en]

    Aim

    Enhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities.

    Method

    Nine databases that index literature from the fields of health, psychology, and education were searched to retrieve information on research conducted with children with disabilities aged between 5 years and 18 years. Articles were included if the author(s) reported that participation was an intended outcome of the intervention. The articles included were limited to those reporting high-level primary research, as defined by Australia's National Health and Medical Research Council evidence hierarchy guidelines. No restrictions were placed on the type of intervention being investigated.

    Results

    Seven randomized controlled or pseudo-randomized studies were included. Only three of these studies identified participation as a primary outcome. Both individualized and group-based approaches to enhancing participation outcomes appeared to be effective. Studies of interventions with a primary focus on body function or activity level outcomes did not demonstrate an effect on participation outcomes.

    Intepretation

    Few intervention studies have focused on participation as a primary outcome measure. Approaches using individually tailored education and mentoring programmes were found to enhance participation outcomes, while exercise programmes, where participation was a secondary outcome, generally demonstrated little effect.

  • 3.
    Adair, Brooke
    et al.
    Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.
    Ullenhag, Anna
    Physiotherapy Department, Mälardalens University, Västerås, Sweden.
    Rosenbaum, Peter
    McMaster University, Hamilton, ON, Canada.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Keen, Deb
    Autism Centre of Excellence, Griffith University, Mt Gravatt, Qld, Australia.
    Imms, Christine
    Centre for Disability and Development Research, Australian Catholic University, Fitzroy, Vic., Australia.
    Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review2018In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 60, no 11, p. 1101-1116Article in journal (Refereed)
    Abstract [en]

    AIM:

    We aimed to identify measures used to assess the participation of disabled children and to map the measures' content to the family of participation-related constructs (fPRC) to inform future research and practice.

    METHOD:

    Six databases were searched to identify measures used to assess participation in health, psychology, and education research. Included studies involved children aged 0 to 18 years with a permanent impairment or developmental disability and reported use of a quantitative measure of participation. A second search sought relevant literature about each identified measure (including published manuals) to allow a comprehensive understanding of the measure. Measurement constructs of frequently reported measures were then mapped to the fPRC.

    RESULTS:

    From an initial yield of 32 767 articles, 578 reported one or more of 118 participation measures. Of these, 51 measures were reported in more than one article (our criterion) and were therefore eligible for mapping to the fPRC. Twenty-one measures quantified aspects of participation attendance, 10 quantified aspects of involvement as discrete scales, and four quantified attendance and involvement in a manner that could not be separated.

    INTERPRETATION:

    Improved understanding of participation and its related constructs is developing rapidly; thoughtful selection of measures in research is critical to further our knowledge base.

    WHAT THIS PAPER ADDS:

    The fPRC can support our rapidly evolving and expanding understanding of participation. Instruments selected to measure participation do not always align with emerging concepts. Matching research aims to a chosen measure's content will improve understanding of participation. Opportunities exist to develop validated participation measures, especially self-reported measures of involvement.

  • 4.
    Adolfsson, Margareta
    Jönköping University, School of Education and Communication, HLK, CHILD.
    ICF-CY in habilitation services for children2017In: An emerging approach for education and care: Implementing a worldwide classification of functioning and disability / [ed] S. Castro & O. Palikara, London: Routledge, 2017, p. 187-203Chapter in book (Refereed)
    Abstract [en]

    Habilitation services is the name for interdisciplinary health care organisations in Sweden serving children and young people aged 0 to17 years with a wide range of disabilities categorised as mobility, behavioural, intellectual and multiple disabilities, their families and other networks. The construct of habilitation is used in childhood since it focuses on acquiring skills, whereas rehabilitation focuses on regaining lost skills. Despite this difference, the objective of services is consistent and the WHO definition of rehabilitation can apply to both: “A process aimed at enabling people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological and social functional levels. Rehabilitation provides disabled people with the tools they need to attain independence and self-determination” (WHO, 2016). Habilitation teams include social, psychological, pedagogical and medical competencies with a marked preponderance of the latter (Figure 12.1).

  • 5.
    Afsharnejad, Bahareh
    et al.
    School of Occupational Therapy, Social Works and Speech Pathology, Curtin University, Kent street, Perth, WA, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy, Social Works and Speech Pathology, Curtin University, Kent street, Perth, WA, Australia.
    Black, Melissa H.
    School of Occupational Therapy, Social Works and Speech Pathology, Curtin University, Kent street, Perth, WA, Australia.
    Alach, Tasha
    Autism Association of Western Australia, Perth, WA, Australia.
    Lenhard, Fabian
    Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet and Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
    Fridell, Anna
    Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet and Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
    Coco, Christina
    Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet and Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
    Milne, Kelly
    Autism Association of Western Australia, Perth, WA, Australia.
    Chen, Nigel T. M.
    Curtin Autism Research Group (CARG), Curtin University, Perth, WA, Australia.
    Bölte, Sven
    School of Occupational Therapy, Social Works and Speech Pathology, Curtin University, Kent street, Perth, WA, Australia.
    Girdler, Sonya
    School of Occupational Therapy, Social Works and Speech Pathology, Curtin University, Kent street, Perth, WA, Australia.
    KONTAKT© for Australian adolescents on the autism spectrum: Protocol of a randomized control trial2019In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, no 1, article id 687Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes.

    METHOD/DESIGN:

    With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs.

    DISCUSSION:

    The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.

    TRIAL REGISTRATION:

    Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.

  • 6.
    Ahacic, Kozma
    et al.
    Karolinska Institutet.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Helgason, Asgeir R
    Karolinska Institutet.
    Allebeck, Peter
    Karolinska Institutet.
    Non-response bias and hazardous alcohol use in relation to previous alcohol-related hospitalization: comparing survey responses with population data2013In: Substance Abuse Treatment, Prevention, and Policy, ISSN 1747-597X, E-ISSN 1747-597X, Vol. 8, no 10Article in journal (Refereed)
    Abstract [en]

    Background: This study examines whether alcohol-related hospitalization predicts survey non-response, and evaluates whether this missing data result in biased estimates of the prevalence of hazardous alcohol use and abstinence.

    Methods: Registry data on alcohol-related hospitalizations during the preceding ten years were linked to two representative surveys. Population data corresponding to the surveys were derived from the Stockholm County registry. The alcohol-related hospitalization rates for survey responders were compared with the population data, and corresponding rates for non-responders were based on the differences between the two estimates. The proportions with hazardous alcohol use and abstinence were calculated separately for previously hospitalized and non-hospitalized responders, and non-responders were assumed to be similar to responders in this respect.

    Results: Persons with previous alcohol-related admissions were more likely currently to abstain from alcohol (RR=1.58, p<.001) or to have hazardous alcohol use (RR=2.06, p<.001). Alternatively, they were more than twice as likely to have become non-responders. Adjusting for this skewed non-response, i.e., the underrepresentation of hazardous users and abstainers among the hospitalized, made little difference to the estimated rates of hazardous use and abstinence in total. During the ten-year period 1.7% of the population were hospitalized.

    Conclusions: Few people receive alcohol-related hospital care and it remains unclear whether this group’s underrepresentation in surveys is generalizable to other groups, such as hazardous users. While people with severe alcohol problems – i.e. a history of alcohol-related hospitalizations – are less likely to respond to population surveys, this particular bias is not likely to alter prevalence estimates of hazardous use.

  • 7.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.
    Maret, Eva
    Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.
    Brudin, Lars
    Department of Clinical Physiology, Kalmar County Hospital, Kalmar, Sweden.
    Starck, Sven-Åke
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Department of Oncology, Hospital Physics, Ryhov County Hospital, Jönköping, Sweden.
    Engvall, Jan
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion2017In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 52-61Article in journal (Refereed)
    Abstract [en]

    Background: To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference.

    Methods: Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study.

    Results: Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI).

    Conclusion: GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

  • 8.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Thyberg, Ingrid
    Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Björk, Mathilda
    Department of Rheumatology and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis2017In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 6, p. 824-834Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

    METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

    RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

    CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

  • 9.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hakansson, C.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden.
    Bjork, M.
    Linkoping Univ, Dept Rheumatol, Linkoping, Sweden.
    Occupational balance and its relation to performance of valued life activities in persons with rheumatoid arthritis in working age2018In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no Suppl. 2, p. 186-186Article in journal (Refereed)
    Abstract [en]

    Background Experience of balance in everyday activities where work is an essential part is important to health and well-being, as has also been observed in previous studies in people with rheumatoid arthritis (RA). The Valued life activity scale (VLA-swe) is a questionnaire in which patient’s first report if the separate activities are valued or not to perform and secondly difficulties to perform these activities. Occupational Balance Questionnaire (OBQ) focuses on satisfaction with the amount and variation of occupations.

    Objectives The objectives were to 1) describe the relationship between performance of valued activities and experienced occupational balance, and to 2) identify aspects associated with low occupational balance in persons with RA.

    Methods 368 persons (age 18–65 years, 77% women) with RA responded to a questionnaire measuring occupational balance (OBQ) and performance of valued life activities (VLA-swe). Other aspects of interest were activity limitations measured by Health Assessment Questionnaire (HAQ), pain (measured by VAS), continuous stress (stressed continuously for more than a month during the last 12 months), children at home, education, and living situation. The relation between OBQ and performance in VLA across genders and Workers/Non-workers were analysed using non-parametric correlation analyses. To identify the impact of different aspects on the likelihood that participants would report lower occupational balance, OBQ was analysed using workers/nonworkers, stress, gender, age, pain and difficulties performing valued activities as independent variables in logistic regressions models. The study was approved by the Regional Ethics Committee (Dnr2011/452–31).

    Results The OBQ was significantly related to difficulties to perform valued activities reported by VLA (r=-0.41, p<0.001). Having more difficulties performing valued activities was the strongest predictor of lower occupation balance and increased the risk of reporting lower occupation balance with nearly five times (OR=4.54, p 0.001). Continuous stress increased the risk of having lower occupation balance more than three times (OR=3.27, p<0.0001) than those who not reported being stressed. The other variables show no significant impact on the likelihood that the participants would report lower occupational balance.

    Conclusions The results showed support for the relationship between occupation balance and performance of valued life activities and highlights to identify what’s important for the individual and to assume that in the rehabilitation. The results also show the importance of ability to manage stress, in order to enable for retaining ability to work and achieve high occupational balance.

  • 10.
    Ahonen, Hanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Kvarnvik, Christine
    Folktandvården Region Jönköpings län.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Avdelningen för Klinisk Neurofysiologi, Linköpings Universitetssjukhus, Linköping.
    Fransson, Eleonor I.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Inspektionen för Socialförsäkringen, Göteborg.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Stensson, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Oral hälsa och obstruktiv sömnapné- protokoll för en longitudinell studie2019Conference paper (Refereed)
  • 11.
    Ahonen, Hanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Kvarnvik, Christine
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Fransson, Eleonor I.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Nygårdh, Annette
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Stensson, Malin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Norderyd, Ola
    Ulander, Martin
    Sunnergren, Ola
    Jansson, Henrik
    Sayardoust, Shariel
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    “No one seems to know”: Studieprotokoll för utvärdering av ett teoretiskt ramverk för oral hälsa avseende reliabilitet och validitet i en obstruktiv sömnapné population2019Conference paper (Other academic)
  • 12.
    Alanko, Rosanna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Oskarsson, Tina
    Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Kommunikation mellan patient och ortopedingenjör: En kvalitativ studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En studie har genomförts med syftet att undersöka diabetespatienters tolkning av informationen som ges av deras respektive ortopedingenjör under ett patientmöte samt undersöka vad ortopedingenjören anser sig ha förmedlat för information till patienten under patientmötet. Metoden i studien är kvalitativ där intervjuer med semistrukturerade öppna frågor har använts. I studien ingick två ortopedingenjörer samt två diabetespatienter. Efter avslutade intervjuer har materialet från intervjuerna analyserats och bildat kategorier. Dessa kategorier har sedan använts för att finna skillnader samt likheter mellan ortopedingenjörens och patientens tolkningar. Patientmötens har spelats in för att få möjligheten att se vart missförstånd uppstått. Genomgående i resultatet var att ortopedingenjören anser sig ha förmedlat mer information än vad patienten beskriver under intervjuerna. Några missförstånd upptäcktes men kommunikationen mellan parterna var god.  

  • 13. Aldasoki, Hanin
    et al.
    Jasseh, Awa
    Nyutexaminerade tandhygienisters upplevelse av introduktionsprogram2017Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
  • 14.
    Algurén, Beatrix
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
    Coenen, Michaela
    Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair of Public Health and Health Services Research, Research Unit for Biopsychosocial Health, LMU Munich, Munich, Germany.
    Malm, Dan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Fridlund, Bengt
    Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden.
    A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales2020In: Journal of Patient-Reported Outcomes, ISSN 2509-8020, Vol. 4, no 1, article id 7Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.

    METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.

    RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.

    CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.

  • 15.
    Algurén, Beatrix
    et al.
    Institute for Health and Rehabilitation Sciences (IHRS), Unit for Biopsychosocial Health, Ludwig-Maximilians-University, Munich, Germany.
    Lundgren Nilsson, Åsa
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sunnerhagen, Katharina S.
    Functioning of patients with first-ever stroke six weeks after admission – a report from Sweden applying the International Classification of Functioning (ICF)2007Conference paper (Refereed)
  • 16.
    Alimoradi, Zainab
    et al.
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Lin, Chung-Ying
    Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Bülow, Pia H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Bajalan, Zahra
    Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, Mark D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Ohayon, Maurice M.
    Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, United States.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Internet addiction and sleep problems: A systematic review and meta-analysis2019In: Sleep Medicine Reviews, ISSN 1087-0792, E-ISSN 1532-2955, Vol. 47, p. 51-61Article, review/survey (Refereed)
    Abstract [en]

    The pathological use of the internet – conceptualized as ‘internet addiction’ – might be crucial in initiating and increasing sleep disturbances in the community. While inconsistent evidence is reported regarding the association of internet addiction and sleep disturbances, the severity of this association remains unclear. This systematic review and meta-analysis were conducted to increase our understanding of the relationship between internet addiction and sleep disturbances. A systematic review was conducted through Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and EMBASE using keywords related to internet addiction and sleep problems. Observational studies (cohort, case-control or cross-sectional studies) focusing on association between internet addiction and sleep disturbances including sleep problems and sleep duration were selected. A meta-analysis using random-effect model was conducted to calculate the odds ratio (OR) for experiencing sleep problems and standardized mean differences (SMDs) for sleep duration. Eligible studies (N = 23) included 35,684 participants. The overall pooled OR of having sleep problems if addicted to the internet was 2.20 (95% CI: 1.77–2.74). Additionally, the overall pooled SMDs for sleep duration for the IA group compared to normal internet users was −0.24 (95% CI: −0.38, −0.10). Results of the meta-analysis revealed a significant OR for sleep problems and a significant reduced sleep duration among individuals addicted to the internet.

    The full text will be freely available from 2020-07-04 00:00
  • 17.
    Allerby, Katarina
    et al.
    Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Goulding, Anneli
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Ali, Lilas
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Gremyr, Andreas
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Waern, Margda
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Person-Centered Psychosis Care (PCPC) In An Inpatient Setting: Ward Level Data And Staff Workload2019In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 45, no Supplement 2, p. S304-S304Article in journal (Refereed)
    Abstract [en]

    Background: The person-centered care approach has been little tested in inpatient settings for persons with schizophrenia. An intervention, PersonCentered Psychosis Care (PCPC), was created to increase person-centered care through an educational intervention for staff. The education had a participatory approach where participants were involved in shaping the education and creating projects aimed at care development. The PCPC intervention focused on the patient’s narrative, the creation of a partnership between the patient and staff, and on coming to an agreement between the patient and staff concerning the care. The present study aims to compare staff experienced workload and ward level data before and after implementation of the intervention.

    Methods: The study was carried out on 4 hospital wards (43 beds) at the Psychosis Clinic, Gothenburg, Sweden. Data was collected during a 6-month pre-intervention period, followed by an implementation period of 3  years, and finally a post intervention data collection period (9 months). During both data collection periods, one nurse per ward filled out a measure of daily subjective workload (a VAS scale with 0 indicating no burden at all and 10 indicating the highest imaginable burden). Additional ward level data (length of hospital stay, involuntary interventions, rehospitalization rates) were collected via the clinic’s electronic monitoring system.

    Results: The pre-intervention ratings (n=505) showed a mean subjective workload of 5.48 (SD=1.94). The post intervention workload (n=465) showed a mean of 4.51 (SD=2.08) which represents a significant reduction of experienced workload (t (968) = p <.0005). Analyses regarding length of hospital stay, involuntary interventions, and rehospitalization rates are underway and will be presented.

    Discussion: The findings indicate an improvement in the work environment for hospital staff and provide a quantitative result in line with staff experiences previously reported in our focus group study. The before and after design has its limitations, but the positive findings motivate further testing with a more rigorous design such as a cluster randomized study.

  • 18.
    Alm, A.
    et al.
    Kärnsjukhuset, Specialistklinken Pedodonti, Dept Paediat Dent, SE-54185 Skövde, Sweden.
    Wendt, Lill-Kari
    Jönköping University, School of Health Science, HHJ. Oral health.
    Koch, G.
    Inst Postgrad Dent Educ, Dept Paediat Dent, Jönköping, Sweden.
    Birkhed, D.
    Gothenburg Univ, Dept Cardiol, Sahlgrenska Acad, Gothenburg, Sweden.
    Nilsson, M.
    Cty Hosp, Futurum Acad Healthcare, Jönköping, Sweden.
    Caries in adolescence - influence from early childhood2012In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 40, no 2, p. 125-133Article in journal (Refereed)
    Abstract [en]

    Objective: To analyse the relationship between caries determinants in early childhood and caries prevalence in proximal surfaces in adolescents at the age of 15 years. Methods: The present longitudinal study is part of a series of surveys of oral health in 671 children followed from 1 to 15 years of age. Data were selected from examinations, interviews and questionnaires at 1, 3 and 6 years and bitewing radiographs at 15 years of age. Uni- and multivariable logistic regression analyses were performed to identify caries-related determinants. The outcome variable was carious lesions and fillings (DFa) in approximal tooth surfaces at 15 years of age. Statistical comparisons were made between caries-free teenagers, DFa = 0 and teenagers with DFa > 0, DFa 4 and DFa 8, respectively. Results: In the final logistic regression analyses, caries experience at 6 years and mother's self-estimation of her oral health care as being less good to poor remained statistically significant and were related to caries in all three caries groups (i.e. DF > 0, 4 and 8) at 15 years of age. The consumption of sweets at 1 year remained statistically significant, with a caries experience of DF 4 and 8. The variables 'parents born abroad' and female gender were statistically significantly associated with DFa 4 and DFa 8, respectively. Furthermore, infrequent toothbrushing habits at 3 years of age and failure to attend the examination at 1 year were statistically significantly associated with caries at 15 years in the univariable analyses. Conclusion: Early caries experience, consumption of sweets at an early age and mother's self-estimation of her oral health care as being less good to poor are associated with approximal caries in adolescents. The study indicates that caries determinants identified during early childhood have a strong impact on approximal caries in adolescence.

  • 19. Alm, Anita
    et al.
    Fåhraeus, Christina
    Wendt, Lill-Kari
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Koch, Göran
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Birkhed, Dowen
    Body adiposity status in teenagers and snacking habits in early childhood in relation to approximal caries at 15 years of age2008In: International Journal of Paediatric Dentistry, ISSN 0960-7439, E-ISSN 1365-263X, Vol. 18, no 3, p. 189-196Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The prevalence of overweight and obesity in children is steadily increasing in many countries. Dental caries and obesity are both multifactorial diseases and are associated with dietary habits.

    OBJECTIVE: The purpose of this study was to investigate the relationship between body weight status in adolescents and snacking habits in early childhood to approximal caries prevalence at 15 years of age.

    METHODS: This study is part of a series of surveys of oral health in children followed from the ages of 1 year to 15 years. Body adiposity status was estimated at 13.5-16.4 years using the International Obesity Task Force cut-off values [age-specific body mass index (isoBMI)]. Information about snacking habits in early childhood was collected from interviews conducted at 1 year and 3 years. Approximal caries information was obtained from bitewing radiographs at 15 years. Data related to isoBMI and approximal caries were available in 402 teenagers.

    RESULT: Adolescents with isoBMI > or = 25 (n = 64) had an approximal caries prevalence that was a mean of 1.6 times higher than those with isoBMI < 25 (n = 338) (4.64 vs. 2.94; P = 0.014). Furthermore, children's snacking habits at an early age were associated with approximal caries at 15 years.

    CONCLUSION: Overweight and obese adolescents had more approximal caries than normal-weight individuals. Moreover, the frequent consumption of snacking products during early childhood appears to be a risk indicator for caries at 15 years. Future preventive programmes should therefore include, on a multidisciplinary level, strategies to prevent and reduce both obesity and dental caries at an early age.

  • 20. Alm, Anita
    et al.
    Isaksson, Helen
    Fåhraeus, Christina
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    Koch, Göran
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Nilsson, Mats
    Birkhed, Dowen
    Wendt, Lill-Kari
    Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    BMI status in Swedish children and young adults in relation to caries prevalence: BMI and caries prevalence2011In: Swedish Dental Journal, ISSN 0347-9994, Vol. 35, no 1, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Overweight and obesity are increasing as health problems at global level. Dental caries and obesity are both multifactorial diseases and are associated with dietary habits. The aim of the present study was to investigate the relationship between body weight status and caries prevalence in an unselected population followed from pre-school years to young adulthood. The present investigation was designed as a longitudinal analysis of the association between overweight/obesity and dental caries in one population at 3, 6, 15 and 20 years of age. The result shows that adolescents (15 years) and young adults (20 years) who are overweight/obese had a statistically significantly higher caries prevalence than normal-weight young people. At 6 years of age, the odds (OR) of having caries among obese children are 2.5 times higher than the odds for caries among six-year-old children of normal weight (p = 0.04). At 3 years of age, no association between overweight/obesity and caries was found. To conclude, overweight and obese adolescents and young adults had more caries than normal-weight individuals. The present study emphasises the need for multidisciplinary approaches to change the lifestyle factors causing both overweight/obesity and dental caries.

  • 21. Alm, Anita
    et al.
    Wendt, Lill-Kari
    Jönköping University, School of Health and Welfare, HHJ. Oral health.
    Koch, Göran
    Birkhed, Dowen
    Oral hygiene and parent-related factors during early childhood in relation to approximal caries at 15 years of age2008In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 42, no 1, p. 28-36Article in journal (Refereed)
  • 22.
    Almberg, Maria
    et al.
    Mobility Centre Gothenburg, Sweden.
    Selander, Helena
    Mobility Centre Gothenburg, Sweden.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Australia.
    Vaz, Sharmila
    School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Australia.
    Ciccarelli, Marina
    School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Faculty of Health Sciences, Curtin University, Perth, Australia.
    Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 2, p. 59-67Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education.

    Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learner’s permit, from the perspective of the learner drivers and their driving instructors.

    Methods: Data were collected from 33 participants with ASD or ADHD, and nine of their driving instructors.

    Results: Participants with ASD required twice as many driving lessons and more on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to “unfamiliar” driving situations to be the greatest challenges.

    Conclusion: Obtaining a driving license was associated with stressful training experience.

  • 23.
    Almqvist, Lena
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD. Mälardalens högskola.
    Sjöman, Madeleine
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Children’s behavior difficulties and staff-implemented special support in Swedish preschools: Emotional and behavioral difficultiesManuscript (preprint) (Other academic)
  • 24.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Eide, L. S. P. E.
    Bergen University College, Institute of Nursing, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Haaverstad, R. H.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Hufthammer, K. O. H.
    Haukeland University Hospital, Centre for Clinical research, Bergen, Norway.
    Kuiper, K. K. J. K.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Schjott, J. S.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Ranhoff, A. H. R.
    University of Bergen, Department of Clinical Science, Faculty of Medicine and Dentistry, Bergen, Norway.
    Norekval, T. M. N.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Factors affecting in-hospital sleep-wake pattern in octogenarians during the early postoperative phase after transcutaneous aortic valve replacement2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S53-S53Article in journal (Refereed)
    Abstract [en]

    Background: Octogenarian patients are an increasing group admitted for advanced cardiac treatment. Little is known about factors disturbing their sleep-wake pattern in the early postoperative phase after transcutaneous aortic valve replacement (TAVI), as current knowledge is based upon studies on younger age groups treated for surgical aortic valve replacement.

    Aim: To determine factors affecting the in-hospital sleep wake pattern in octogenarian patients after TAVI.

    Methods: This is a prospective cohort study in a tertiary university hospital. Inclusion criteria were age > 80 years with severe aortic stenosis accepted for TAVI. Actigraphy was used to identify sleep-wake pattern (sleep time night and sleep time day), and the Minimal Insomnia Symptom Scale (MISS) to measure self-reported insomnia daily during the first five postoperative days. Charlson`s comorbidity index was used as a measure of comorbidities and the Visual Analog Scale (VAS) to rate pain severity. Information regarding duration of anesthesia, blood transfusion and parenteral administration of morphine equivalents were derived from the patients’ medical journals. Multiple regression analysis was used to test associations between variables.

    Results: In all, 65 patients (41 women) were included. Mean age was 85 years (SD 2.8). No significant associations were found between age, comorbidities, blood transfusion and morphine equivalents and sleep. Gender was significantly associated with sleep time night and sleep efficiency as men had shortest duration of sleep from the third to the fifth postoperative night (p < .001, and adjusted R2=.230 to .283). Duration of anesthesia had a significant association with sleep time night and sleep efficiency from the third to the fifth postoperative night (p=.013 to p < .001, and adjusted R2=.230 to .283), where longer duration gave less total sleep and lower sleep efficiency. VAS score correlated with wake time night the third night, where a higher VAS score gave more wake time (p=.006 and adjusted R2 .236).

    Conclusion: Male gender, longer duration of perioperative anesthesia and postoperative pain were associated with disturbances in the postoperative sleep-wake pattern in octogenarian patients in the early postoperative phase after TAVI. This knowledge is important and relevant and should have implications in improving patient care.

  • 25.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Eide, L. S. P. E.
    Bergen University College, Institute of Nursing, Faculty of Health and Social Science, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Haaverstad, R. H.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Hufthammer, K. O. H.
    Haukeland University Hospital, Centre for Clinical research, Bergen, Norway.
    Kuiper, K. K. J. K.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Schjott, J. S.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Ranhoff, A. H. R.
    University of Bergen, Department of Clinical Science, Faculty of Medicine and Dentistry, Bergen, Norway.
    Norekval, T. M. N.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway .
    Factors associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after surgical aortic valve replacement2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S63-S64Article in journal (Refereed)
    Abstract [en]

    Background: Disturbances of the sleep-wake pattern are known phenomenon in the postoperative phase after aortic valve replacement (SAVR) that have negative impact on the morbidity, quality of life and mortality. Octogenarian patients are an increasing group admitted for cardiac surgery, however knowledge is based on younger patients.

    Aims: To determine factors associated with disturbances in postoperative sleep-wake pattern in octogenarian patients after SAVR.

    Methods: A prospective cohort study of octogenarian patients in a single center university hospital. Inclusion criteria were age > 80 years, severe aortic stenosis, accepted for SAVR. Actigraphy was used to identify the sleep-wake pattern (sleep-time, sleep efficiency and wake time night and sleep- and wake-time day) for the five first postoperative days, and the sleep questionnaires Minimal Insomnia Symptom scale (MISS) to measure the selfreported insomnia at baseline and daily for the five first postoperative days. 

    Charlsons comorbidity index was used to score comorbidities and the Visual Analog Scale (VAS), was used to rate pain severity. The patients’ medical journals were used to record duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusions and parenteral administration of morphine equivalents. Multiple regression analysis was used to test associations between variables.

    Results: In all, 78 patients were included (40 women). Mean age was 82 years (SD 2.0). For the sleep-wake pattern first to fifth postoperative night, mean sleep-time night was 330-370 minutes (SD 32-124). Mean sleep efficiency was 68-77% (SD 21-26). Mean sleep-time day was 545-712 minutes (SD 146-169). Mean insomnia score was 1,8-5,3 (SD 2,6-3,8). On the first postoperative night the pain VAS score correlated with wake time night, where a higher VAS indicated more wake time (p=.014, adjusted R2=.213). No other variable; age, gender, duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusion or morphine equivalents showed significant association with the sleep-wake pattern or insomnia.

    Conclusion: Postoperative pain was associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after SAVR. This indicates that pain management may be inadequate for patients after SAVR. More research on this issue is needed to establish data needed to improve treatment and care.

  • 26.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Haaverstad, R.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Instenes, I.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Kuiper, K. K. J.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Ranhoff, A. H.
    University of Bergen, Department of clinical science, faculty of medicine, Bergen, Norway.
    Schjott, J. D.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Norekval, T. M.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, p. 104-105Article in journal (Refereed)
    Abstract [en]

    Background: Sleep disturbance and delirium are complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve replacement (TAVI), especially in octogenarian patients. Sedatives and z-hypnotics are medications distributed to promote sleep. However, a knowledge-gap exists on patient experiences with these medications, and sleep and delirium after the cardiac treatment.

    Aim: To explore and describe how octogenarians suffering from delirium after SAVR/TAVI experience their sleep situation related to sedatives and z-hypnotics, in a long-term perspective.

    Methods An explorative and descriptive design with a longitudinal qualitative approach was applied. Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium. Information about administration of sedatives and z-hypnotics was collected from the patients journals. The Confusion Assessment Method (CAM) was used to assess delirium, the Sleep Sufficient Index (SSI) and Minimal Insomnia Symptom Scale (MISS) were used to document self-reported sleep and insomnia. All measures were performed at baseline and daily the five first postoperative days. Ten patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were re-interviewed four years later, focusing on their sleep situation.

    Findings: For the initial interview, five men and five woman, four after TAVI and six after SAVR, mean age 83 were included. One overarching theme revealed; hours in bed represented an emotional chaos. Three sub-themes described the patients experiences with sleep and delirium, a cascade of distressful experiences, the struggle between sleep and activity and elements influencing sleep. In the category physical sleep distractions, sleep medications emerged as a sleep disturbing element but also to evoke delirium. Patients described to be offered sedatives and z-hypnotics in hospital. However, they did not have a positive experience with this as the medication did not make them sleep better. Moreover, they associated the nightmares by the sedatives Four years after the cardiac treatment, the octogenarian patients described that medication did not have a sleep promoting effect, and they did not want it.

    Conclusion: Octogenarian patients are vulnerable to complications like sleep disturbances and delirium. In preventing and treating these conditions, health-care professionals should be aware of the effect and side-effect of sedatives and z-hypnotics in the octogenarian patients. Our findings show that medications should be cautiously used within this group of patients.

  • 27.
    Amofah, Hege A.
    et al.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Bjorvatn, Bjørn
    Norwegian Competence Centre for Sleep Disorders, Bergen, Norway.
    Haaverstad, Rune
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Hufthammer, Karl Ove
    Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Kuiper, Karel K. J.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Ranhoff, Anette H.
    Department of Clinical Science, University of Bergen, Norway.
    Norekvål, Tone M.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 2, p. 168-177Article in journal (Refereed)
    Abstract [en]

    Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.

    Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep–wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.

    Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep–wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days.

    Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01).

    Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep–wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.

  • 28.
    Anastassaki, Alkisti
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work.
    Öster, Anders
    Helkimo, Martti
    Magnusson, Tomas
    Jönköping University, School of Health Science, HHJ. Oral health.
    Globus pharyngeus: Litteraturöversikt och jämförande studie av två patientgrupper1996In: Tandläkartidningen, ISSN 0039-6982, Vol. 88, no 7, p. 404-409Article, review/survey (Other academic)
  • 29.
    Andersson, Amanda
    et al.
    Jönköping University, School of Health and Welfare.
    Wallenborg, Jenny
    Jönköping University, School of Health and Welfare.
    Hälsoeffekter hos MR-personal vid exponering av magnetfält: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
  • 30.
    Andersson, Bengt-Åke
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform. Jönköping University, School of Health and Welfare, HHJ. Oral health. Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Sayardoust, Shariel
    Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Löfgren, Sture
    Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Rutqvist, Lars Erik
    Scientific Affairs Group, Swedish Match AB, Stockholm, Sweden.
    Laytragoon-Lewin, Nongnit
    Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Cigarette smoking affects microRNAs and inflammatory biomarkers in healthy individuals and an association to single nucleotide polymorphisms is indicated2018In: Biomarkers, ISSN 1354-750X, E-ISSN 1366-5804, Vol. 24, no 2, p. 180-185Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cigarette smoke induces inflammation and remodels immune response. Genetic and epigenetic alterations might be involved in the pathogenesis of smoking related diseases. In this study, we investigated the effect of smoking on systemic inflammation biomarkers and epigenetic changes at microRNA (miRNA) expression level. We also examined if the levels of inflammatory biomarkers were associated with selected single nucleotide polymorphisms (SNPs).

    METHOD: From 39 smokers and 101 non-smokers, levels of total white blood cells (WBCs) and its subpopulations, plasma cytokines/chemokines/proteins and miRNAs were analysed. For three biomarkers, C-reactive protein (CRP), MCP-1 and IFN-γ that were affected by smoking, the influence of SNPs was analyzed.

    RESULT: Elevated levels of total WBCs, neutrophils, monocytes, lymphocytes, CRP, MCP-1, IFN-γ and lower levels of miR-21 were detected in smokers. The elevated levels of IFN-γ in smokers was only statistically significantly associated with rs2069705 AG/GG SNP-genotype.

    CONCLUSIONS: A lower level of oncomir miRNA-21 and a higher level of immune modelling cytokine IFN-γ detected in smokers could be a protective immune response to cigarette smoke. The higher level of IFN-γ in smokers with a specific SNP genotype also suggests that a genetic interaction with smoking might predict the pathobiology of smoking related disease.

  • 31.
    Andersson, Gunnel
    et al.
    Södertörns högskola.
    Bülow, PerJönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Psykiatriska kliniken, Länssjukhuset Ryhov, Jönköping.Denhov, AnneInstitutionen för socialt arbete, Stockholms universitet.Topor, AlainInstitutionen för socialt arbete, Stockholms universitet.
    Från patient till person: Om allvarliga psykiska problem - vardag, vård och stöd2016Collection (editor) (Other academic)
  • 32.
    Andersson, Gunnel
    et al.
    FoU-Södertörn, R&D, Stockholm, Sweden.
    Denhov, Anne
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    Bülow, Per
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Psychiatry, Ryhov County Hospital, Jönköping, Sweden.
    Topor, Alain
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    Aloneness and loneliness – persons with severe mental illness and experiences of being alone2015In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 17, no 4, p. 353-365Article in journal (Refereed)
    Abstract [en]

    People with severe mental illness (SMI) are often described as lonely and socially incapable – an inability resulting from the mental illness. The aim of this article is to explore experiences of being alone among persons with SMI. The article is based on interviews with 19 persons diagnosed with psychosis who were interviewed between four and nine times over a period of three years. The findings show that experiences of being alone can be identified by two concepts: aloneness and loneliness. The persons in the study appeared as socially able and active in relation to their social lives. However, a social agent does not operate in a void but in interaction with specific living conditions; the experiences of aloneness and loneliness may be viewed as the result of the interplay between the individual and the social and material environment.

  • 33.
    Andersson, Gunnel
    et al.
    Research and Development Center, FoU Södertörn, Haninge, Sweden.
    Ellegård, Kajsa
    Division Technology and Social Change, Department of Thematic Studies, Linköping University, Linköping, Sweden.
    Bülow, Per
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work.
    Denhov, Anne
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    Vrotsou, Katerina
    Department of Science and Technology, Linköping University, Norrköping, Sweden.
    Stefansson, Claes-Göran
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    Topor, Alain
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    A longitudinal study of men and women diagnosed with psychosis: trajectories revealing interventions in a time-geographic framework2019In: GeoJournal, ISSN 0343-2521, E-ISSN 1572-9893Article in journal (Refereed)
    Abstract [en]

    The living conditions for persons with severe mental illness have undergone substantial change in Sweden as well as in the rest of the Western world due to the downsizing of inpatient care and the development of community-based interventions. However, there is a lack of knowledge concerning the “trajectories of interventions” in this new, fragmented, institutional landscape. The aim of the study was to explore types of interventions and when they occur in a 10-year follow-up of 437 women and men diagnosed with psychosis for the first time. Based on registers and using a timegeographic visualization method, the results showed a great diversity of trajectories and differences between sexes. The aggregate picture revealed that over the 10-year period there were considerable periods with no interventions for both men and women. Furthermore, institutional interventions more commonly occurred among women but appeared for longer periods among men. Community-based interventions declined among women and increased among men during the period.

  • 34.
    Andersson, Ida
    et al.
    Jönköping University.
    Teow, Lilly
    Jönköping University.
    Oral hälsa hos barn med Downs syndrom: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 35.
    André, Ida
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Suez, Issis
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Patientupplevelser av informationsbehovet i samband med en magnetresonanstomografisk-mammografi: En intervjustudie2015Independent thesis Basic level (degree of Bachelor), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Magnetresonanstomografiska undersökningar av brösten (MRT-mammografi) har utförts i över två decennier. Undersökningen görs vid mammografiskt oklara fynd, planering inför kirurgi samt vid kontroll när det finns ökad risk för bröstcancer. Informationen inför en magnetresonanstomografisk undersökning är avgörande då information angående undersökningsprocedurer ökar patientmedverkandet vilket kan gynna bildkvalitén inför diagnostik. Syftet med studien var att undersöka patientupplevelser av informationsbehovet i samband med en MRT-mammografisk undersökning. Urvalet för studien bestod av 6 patienter som genomgick en MRT-mammografi under månaderna februari till april 2015. Studien har en kvalitativ ansats där enskilda telefonintervjuer gjorts. Insamlad data har analyserats med innehållsanalys som resulterat i 4 kategorier: Informationsmetod, Kunskap och tidigare erfarenheter, Röntgensjuksköterskans interaktion med patienter och önskat informationsinnehåll. Informationen i samband med undersökningen anses vara tillräcklig och bra enligt de flesta informanterna. Brister belyses dock i den nuvarande informationen och förbättringsutrymmen så som information på andra språk, vägbeskrivning samt information om undersökningsproceduren har angivits. En viktig kategori som synliggjorts under studiens gång är Röntgensjuksköterskans interaktion med patienter. Röntgensjuksköterskans information är ett komplement till informationen som givits i samband med en MRT-mammografi och har en betydande roll i mötet med patienter. 

  • 36. Antoniou, A. C.
    et al.
    Beesley, J.
    McGuffog, L.
    Sinilnikova, O. M.
    Healey, S.
    Neuhausen, S. L.
    Ding, Y. C.
    Rebbeck, T. R.
    Weitzel, J. N.
    Lynch, H. T.
    Isaacs, C.
    Ganz, P. A.
    Tomlinson, G.
    Olopade, O. I.
    Couch, F. J.
    Wang, X.
    Lindor, N. M.
    Pankratz, V. S.
    Radice, P.
    Manoukian, S.
    Peissel, B.
    Zaffaroni, D.
    Barile, M.
    Viel, A.
    Allavena, A.
    Dall'Olio, V.
    Peterlongo, P.
    Szabo, C. I.
    Zikan, M.
    Claes, K.
    Poppe, B.
    Foretova, L.
    Mai, P. L.
    Greene, M. H.
    Rennert, G.
    Lejbkowicz, F.
    Glendon, G.
    Ozcelik, H.
    Andrulis, I. L.
    Thomassen, M.
    Gerdes, A. -M
    Sunde, L.
    Cruger, D.
    Jensen, U. B.
    Caligo, M.
    Friedman, E.
    Kaufman, B.
    Laitman, Y.
    Milgrom, R.
    Dubrovsky, M.
    Cohen, S.
    Borg, A.
    Jernström, H.
    Lindblom, A.
    Rantala, J.
    Stenmark-Askmalm, M.
    Melin, B.
    Nathanson, K.
    Domchek, S.
    Jakubowska, A.
    Lubinski, J.
    Huzarski, T.
    Osorio, A.
    Lasa, A.
    Durán, M.
    Tejada, M. -I
    Godino, J.
    Benitez, J.
    Hamann, U.
    Kriege, M.
    Hoogerbrugge, N.
    Van Der Luijt, R. B.
    Van Asperen, C. J.
    Devilee, P.
    Meijers-Heijboer, E. J.
    Blok, M. J.
    Aalfs, C. M.
    Hogervorst, F.
    Rookus, M.
    Cook, M.
    Oliver, C.
    Frost, D.
    Conroy, D.
    Evans, D. G.
    Lalloo, F.
    Pichert, G.
    Davidson, R.
    Cole, T.
    Cook, J.
    Paterson, J.
    Hodgson, S.
    Morrison, P. J.
    Porteous, M. E.
    Walker, L.
    Kennedy, M. J.
    Dorkins, H.
    Peock, S.
    Godwin, A. K.
    Stoppa-Lyonnet, D.
    De Pauw, A.
    Mazoyer, S.
    Bonadona, V.
    Lasset, C.
    Dreyfus, H.
    Leroux, D.
    Hardouin, A.
    Berthet, P.
    Faivre, L.
    Loustalot, C.
    Noguchi, T.
    Sobol, H.
    Rouleau, E.
    Nogues, C.
    Frénay, M.
    Vénat-Bouvet, L.
    Hopper, J. L.
    Daly, M. B.
    Terry, M. B.
    John, E. M.
    Buys, S. S.
    Yassin, Y.
    Miron, A.
    Goldgar, D.
    Singer, C. F.
    Dressler, A. C.
    Gschwantler-Kaulich, D.
    Pfeiler, G.
    Hansen, T. V. O.
    Jnson, L.
    Agnarsson, B. A.
    Kirchhoff, T.
    Offit, K.
    Devlin, V.
    Dutra-Clarke, A.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E.
    Tihomirova, L.
    Blanco, I.
    Lazaro, C.
    Ramus, S. J.
    Sucheston, L.
    Karlan, B. Y.
    Gross, J.
    Schmutzler, R.
    Wappenschmidt, B.
    Engel, C.
    Meindl, A.
    Lochmann, M.
    Arnold, N.
    Heidemann, S.
    Varon-Mateeva, R.
    Niederacher, D.
    Sutter, C.
    Deissler, H.
    Gadzicki, D.
    Preisler-Adams, S.
    Kast, K.
    Schönbuchner, I.
    Caldes, T.
    De La Hoya, M.
    Aittomäki, K.
    Nevanlinna, H.
    Simard, J.
    Spurdle, A. B.
    Holland, H.
    Chen, X.
    Platte, R.
    Chenevix-Trench, G.
    Easton, D. F.
    Common breast cancer susceptibility alleles and the risk of breast cancer for BRCA1 and BRCA2 mutation carriers: Implications for risk prediction2010In: Cancer Research, ISSN 0008-5472, E-ISSN 1538-7445, Vol. 70, no 23, p. 9742-9754Article in journal (Refereed)
    Abstract [en]

    The known breast cancer susceptibility polymorphisms in FGFR2, TNRC9/TOX3, MAP3K1, LSP1, and 2q35 confer increased risks of breast cancer for BRCA1 or BRCA2 mutation carriers. We evaluated the associations of 3 additional single nucleotide polymorphisms (SNPs), rs4973768 in SLC4A7/NEK10, rs6504950 in STXBP4/COX11, and rs10941679 at 5p12, and reanalyzed the previous associations using additional carriers in a sample of 12,525 BRCA1 and 7,409 BRCA2 carriers. Additionally, we investigated potential interactions between SNPs and assessed the implications for risk prediction. The minor alleles of rs4973768 and rs10941679 were associated with increased breast cancer risk for BRCA2 carriers (per-allele HR = 1.10, 95% CI: 1.03-1.18, P = 0.006 and HR = 1.09, 95% CI: 1.01-1.19, P = 0.03, respectively). Neither SNP was associated with breast cancer risk for BRCA1 carriers, and rs6504950 was not associated with breast cancer for either BRCA1 or BRCA2 carriers. Of the 9 polymorphisms investigated, 7 were associated with breast cancer for BRCA2 carriers (FGFR2, TOX3, MAP3K1, LSP1, 2q35, SLC4A7, 5p12, P = 7 × 10-11 - 0.03), but only TOX3 and 2q35 were associated with the risk for BRCA1 carriers (P = 0.0049, 0.03, respectively). All risk-associated polymorphisms appear to interact multiplicatively on breast cancer risk for mutation carriers. Based on the joint genotype distribution of the 7 risk-associated SNPs in BRCA2 mutation carriers, the 5% of BRCA2 carriers at highest risk (i.e., between 95th and 100th percentiles) were predicted to have a probability between 80% and 96% of developing breast cancer by age 80, compared with 42% to 50% for the 5% of carriers at lowest risk. Our findings indicated that these risk differences might be sufficient to influence the clinical management of mutation carriers.

  • 37. Antoniou, A. C.
    et al.
    Sinilnikova, O. M.
    McGuffog, L.
    Healey, S.
    Nevanlinna, H.
    Heikkinen, T.
    Simard, J.
    Spurdle, A. B.
    Beesley, J.
    Chen, X.
    Neuhausen, S. L.
    Ding, Y. C.
    Couch, F. J.
    Wang, X.
    Fredericksen, Z.
    Peterlongo, P.
    Peissel, B.
    Bonanni, B.
    Viel, A.
    Bernard, L.
    Radice, P.
    Szabo, C. I.
    Foretova, L.
    Zikan, M.
    Claes, K.
    Greene, M. H.
    Mai, P. L.
    Rennert, G.
    Lejbkowicz, F.
    Andrulis, I. L.
    Ozcelik, H.
    Glendon, G.
    Gerdes, A. -M
    Thomassen, M.
    Sunde, L.
    Caligo, M. A.
    Laitman, Y.
    Kontorovich, T.
    Cohen, S.
    Kaufman, B.
    Dagan, E.
    Baruch, R. G.
    Friedman, E.
    Harbst, K.
    Barbany-Bustinza, G.
    Rantala, J.
    Ehrencrona, H.
    Karlsson, P.
    Domchek, S. M.
    Nathanson, K. L.
    Osorio, A.
    Blanco, I.
    Lasa, A.
    Benítez, J.
    Hamann, U.
    Hogervorst, F. B. L.
    Rookus, M. A.
    Collee, J. M.
    Devilee, P.
    Ligtenberg, M. J.
    van der Luijt, R. B.
    Aalfs, C. M.
    Waisfisz, Q.
    Wijnen, J.
    van Roozendaal, C. E. P.
    Peock, S.
    Cook, M.
    Frost, D.
    Oliver, C.
    Platte, R.
    Evans, D. G.
    Lalloo, F.
    Eeles, R.
    Izatt, L.
    Davidson, R.
    Chu, C.
    Eccles, D.
    Cole, T.
    Hodgson, S.
    Godwin, A. K.
    Stoppa-Lyonnet, D.
    Buecher, B.
    Léoné, M.
    Bressac-de Paillerets, B.
    Remenieras, A.
    Caron, O.
    Lenoir, G. M.
    Sevenet, N.
    Longy, M.
    Ferrer, S. F.
    Prieur, F.
    Goldgar, D.
    Miron, A.
    John, E. M.
    Buys, S. S.
    Daly, M. B.
    Hopper, J. L.
    Terry, M. B.
    Yassin, Y.
    Singer, C.
    Gschwantler-Kaulich, D.
    Staudigl, C.
    Hansen, T. V. O.
    Barkardottir, R. B.
    Kirchhoff, T.
    Pal, P.
    Kosarin, K.
    Offit, K.
    Piedmonte, M.
    Rodriguez, G. C.
    Wakeley, K.
    Boggess, J. F.
    Basil, J.
    Schwartz, P. E.
    Blank, S. V.
    Toland, A. E.
    Montagna, M.
    Casella, C.
    Imyanitov, E. N.
    Allavena, A.
    Schmutzler, R. K.
    Versmold, B.
    Engel, C.
    Meindl, A.
    Ditsch, N.
    Arnold, N.
    Niederacher, D.
    Deißler, H.
    Fiebig, B.
    Suttner, C.
    Schönbuchner, I.
    Gadzicki, D.
    Caldes, T.
    de la Hoya, M.
    Pooley, K. A.
    Easton, D. F.
    Chenevix-Trench, G.
    Common variants in LSP1, 2q35 and 8q24 and breast cancer risk for BRCA1 and BRCA2 mutation carriers2009In: Human Molecular Genetics, ISSN 0964-6906, E-ISSN 1460-2083, Vol. 18, no 22, p. 4442-4456Article in journal (Refereed)
    Abstract [en]

    Genome-wide association studies of breast cancer have identified multiple single nucleotide polymorphisms (SNPs) that are associated with increased breast cancer risks in the general population. In a previous study, we demonstrated that the minor alleles at three of these SNPs, in FGFR2, TNRC9 and MAP3K1, also confer increased risks of breast cancer for BRCA1 or BRCA2 mutation carriers. Three additional SNPs rs3817198 at LSP1, rs13387042 at 2q35 and rs13281615 at 8q24 have since been reported to be associated with breast cancer in the general population, and in this study we evaluated their association with breast cancer risk in 9442 BRCA1 and 5665 BRCA2 mutation carriers from 33 study centres. The minor allele of rs3817198 was associated with increased breast cancer risk only for BRCA2 mutation carriers [hazard ratio (HR) = 1.16, 95% CI: 1.07-1.25, P-trend = 2.8 × 10-4]. The best fit for the association of SNP rs13387042 at 2q35 with breast cancer risk was a dominant model for both BRCA1 and BRCA2 mutation carriers (BRCA1: HR = 1.14, 95% CI: 1.04-1.25, P = 0.0047; BRCA2: HR = 1.18 95% CI: 1.04-1.33, P = 0.0079). SNP rs13281615 at 8q24 was not associated with breast cancer for either BRCA1 or BRCA2 mutation carriers, but the estimated association for BRCA2 mutation carriers (per-allele HR = 1.06, 95% CI: 0.98-1.14) was consistent with odds ratio estimates derived from population-based case-control studies. The LSP1 and 2q35 SNPs appear to interact multiplicatively on breast cancer risk for BRCA2 mutation carriers. There was no evidence that the associations vary by mutation type depending on whether the mutated protein is predicted to be stable or not. 

  • 38.
    Ardila-Ardila, A.
    et al.
    University of Miami/Jackson Memorial Medical Center.
    Goodkin, K.
    University of Miami/Jackson Memorial Medical Center.
    Concha-Bartolini, M.
    University of Miami/Jackson Memorial Medical Center.
    Lecusay-Ruiz, Robert
    University of Miami/Jackson Memorial Medical Center.
    O'Mellan-Fajardo, S.
    University of Miami/Jackson Memorial Medical Center.
    Suarez-Bustamante, P.
    University of Miami/Jackson Memorial Medical Center.
    Molina-Vasquez, R.
    University of Miami/Jackson Memorial Medical Center.
    Lee, D.
    University of Miami/Jackson Memorial Medical Center.
    Chayeb, G.
    University of Miami/Jackson Memorial Medical Center.
    Wilkie, F. L.
    University of Miami/Jackson Memorial Medical Center.
    HUMANS: una batería neuropsicologica para la evaluación de pacientes infectados con VIH-1: [Humans: a neuropsychological battery for evaluating HIV-1 infected patients]2003In: Revista de neurología (Ed. impresa), ISSN 0210-0010, E-ISSN 1576-6578, Vol. 36, no 8, p. 756-762Article, review/survey (Refereed)
    Abstract [en]

    Objective. To develop a neuropsychological test battery in Spanish for the cognitive evaluation of HIV-1 infected patients. Development. Departing from the suggestions presented by the work group of the National Institute of Mental Health (USA), a neuropsychological assessment battery was developed. It was named HUMANS (HIV/University of Miami Annotated Neuropsychological test battery in Spanish). This battery includes the following domains: 1) attention and speed of processing information, 2) memory, 3) executive function, 4) language, 5) visuospacial/visuoconstructive abilities, and 6) motor abilities. Administration takes about 3-4 hours. The English parallel version of this battery has been successfully used in English for over a decade with HIV-1 infected patients. In the paper the development and adaptation to Spanish language of the HUMANS neuropsychology section is presented Conclusions. HUMANS neuropsychological test battery fulfill the recommendations presented by the workgroup of the National Institute of Mental Health for evaluating HIV-1 infected patients. Studies regarding validity and reliability are still required.

  • 39.
    Arenhall, Eva
    et al.
    Örebro Universitet, Department of Cardiology, Örebro, Sweden.
    Eriksson, Mats
    Uddevalla Hospital, Department of Pediatrics, Uddevalla, Sweden.
    Nilsson, Ulrica
    Örebro Universitet, School of Health Sciences, Örebro, Sweden.
    Steinke, Elaine E.
    Wichita State University, School of Nursing, Wichita, United States.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Decreased sexual function in partners after patients’ first-time myocardial infarction2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 6, p. 521-526Article in journal (Refereed)
    Abstract [en]

    Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.

    Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.

    Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.

    Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.

    Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction. 

  • 40. Arfwidson, Samuel
    et al.
    Berg, Stig
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Nordqvist, Persy
    Vårdbehov, sjukdomsdiagnoser och medicinkonsumtion bland äldre på ålderdomshem i Jönköpings län: en 7-årsuppföljning1976Report (Other (popular science, discussion, etc.))
  • 41.
    Arnold, Samuel R. C.
    et al.
    Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, New South Wales, Australia.
    Foley, Kitty-Rose
    Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Hwang, Ye In (Jane)
    Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, New South Wales, Australia.
    Richdale, Amanda L.
    Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Uljarevic, Mirko
    Stanford Autism Center, Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University.
    Lawson, Lauren P.
    Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Cai, Ru Ying
    Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Falkmer, Marita
    Jönköping University, School of Education and Communication, HLK, CHILD. Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Lennox, Nick
    Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Urbanowicz, Anna
    Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia.
    Trollor, Julian N.
    Department of Developmental Disability Neuropsychiatry (3DN), UNSW Sydney, New South Wales, Australia.
    Cohort profile: The Australian Longitudinal Study of Adults with Autism2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 12, article id e030798Article in journal (Refereed)
    Abstract [en]

    PURPOSE: There is a significant knowledge gap regarding the lives of adults on the autism spectrum. Some literature suggests significant health and mental health inequalities for autistic adults, yet there is a lack of comprehensive longitudinal studies exploring risk factors. Further, most research does not include the perspective of autistic adults in its conduct or design. Here, we describe the baseline characteristics and inclusive research approach of a nationwide longitudinal study. ​

    PARTICIPANTS: The Autism Cooperative Research Centre for Living with Autism's Australian Longitudinal Study of Adults with Autism (ALSAA) is a questionnaire-based longitudinal study of autistic adults (25+ years old) with follow-up at 2-year intervals. Autistic advisors were involved in each stage of research apart from data analysis. Three questionnaires were developed: self-report, informant report (ie, proxy report) and carers (ie, carer experiences and characteristics). ​

    FINDINGS TO DATE: An inclusive research protocol was developed and agreed with autistic advisors. Baseline data were collected from 295 autistic adults (M=41.8 years, SD=12.0) including 42 informant responses, 146 comparison participants and 102 carers. The majority of autistic participants (90%) had been diagnosed in adulthood (M=35.3 years, SD=15.1). When compared with controls, autistic adults scored higher on self-report measures of current depression and anxiety. Participant comments informed ongoing data gathering. Participants commented on questionnaire length, difficulty with literal interpretation of forced response items and expressed gratitude for research in this area.

    ​FUTURE PLANS: A large comprehensive dataset relating to autistic adults and their carers has been gathered, creating a good platform for longitudinal follow-up repeat surveys and collaborative research. Several outputs are in development, with focus on health service barriers and usage, caregivers, impact of diagnosis in adulthood, further scale validations, longitudinal analyses of loneliness, suicidal ideation, mental illness risk factors and other areas. Baseline data confirm poorer mental health of autistic adults. The ALSAA demonstrates a working approach to inclusive research.

  • 42. Artzi, M.
    et al.
    Shiran, S. I.
    Weinstein, M.
    Myers, V.
    Tarrasch, R.
    Schertz, M.
    Fattal-Valevski, A.
    Miller, E.
    Gordon, A. M.
    Green, Dido
    Department Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Ben Bashat, D.
    Cortical reorganization following injury early in life2016In: Neural Plasticity, ISSN 2090-5904, E-ISSN 1687-5443, article id 8615872Article in journal (Refereed)
    Abstract [en]

    The brain has a remarkable capacity for reorganization following injury, especially during the first years of life. Knowledge of structural reorganization and its consequences following perinatal injury is sparse. Here we studied changes in brain tissue volume, morphology, perfusion, and integrity in children with hemiplegia compared to typically developing children, using MRI. Children with hemiplegia demonstrated reduced total cerebral volume, with increased cerebrospinal fluid (CSF) and reduced total white matter volumes, with no differences in total gray matter volume, compared to typically developing children. An increase in cortical thickness at the hemisphere contralateral to the lesion (CLH) was detected in motor and language areas, which may reflect compensation for the gray matter loss in the lesion area or retention of ipsilateral pathways. In addition, reduced cortical thickness, perfusion, and surface area were detected in limbic areas. Increased CSF volume and precentral cortical thickness and reduced white matter volume were correlated with worse motor performance. Brain reorganization of the gray matter within the CLH, while not necessarily indicating better outcome, is suggested as a response to neuronal deficits following injury early in life.

  • 43.
    Arvidsson, Patrik
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Dada, Shakila
    Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Imms, Christine
    Centre for Disability and Development Research, Australian Catholic University, Melbourne, Australia.
    Bornman, Juan
    Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa.
    Elliott, Catherine
    School of Occupational Therapy, Speech pathology and Social Work, Curtin University, Perth, Australia.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Content validity and usefulness of Picture My Participation for measuring participation in children with and without intellectual disability in South Africa and Sweden2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014Article in journal (Refereed)
    Abstract [en]

    Background: Participation comprises attendance and involvement in everyday situations. Picture My Participation (PmP) is an instrument intended to measure participation in children with disabilities, particularly in low and middle income countries.

    Aim: To investigate content validity and usefulness of PmP for measuring participation in children with intellectual disability (ID) in South Africa and Sweden.

    Methods: A picture supported interview with 149 children, 6?18 years, with and without ID. Twenty everyday activities were provided. The three most important activities were selected by the child. Attendance was rated on all activities. Involvement was rated on the most important.

    Results: All activities were selected as important by at least one child with ID in both countries. There were similarities in perceived importance between the children with and without ID from South Africa. The children from South Africa with ID were the only subgroup that used all scale points for rating attendance and involvement.

    Conclusion: The 20 selected activities of PmP were especially relevant for children with ID in South Africa. The usefulness of the scales was higher for the children with ID in both countries. PmP is promising for assessing participation across different settings but psychometrical properties and clinical utility need further exploration.

  • 44.
    Axelsson, Anna Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    The role of the external personal assistants for children with profound intellectual and multiple disabilities working in the children's home2015In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 28, no 3, p. 201-211Article in journal (Refereed)
    Abstract [en]

    Background Children with profound intellectual and multiple disabilities need support to function in an optimal way. However, there is a limited knowledge about the role of external personal assistants working in the children's home. Materials and Methods A mixed method study was performed including qualitative data from interviews with 11 Swedish parents and nine external personal assistants and quantitative data from questionnaires answered by 60 families. Results For the child, the assistant's role was one of reinforcing, meaning supportive and empowering, and the child needed a high level of assistance. For the family, the role was one of balancing and the external personal assistant was more often found to assist in activities away from home while parents tended to assist within home and in family unit activities. Conclusion In planning and implementation of external assistance, the child's needs as well as considerations of the whole family should be regarded.

  • 45.
    Axelsson, K. F.
    et al.
    Department of Orthopaedic Surgery, Skaraborg Hospital, Skövde, Sweden.
    Wallander, M.
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Johansson, H.
    Institute for Health and Ageing, Catholic University of Australia, Melbourne, VIC, Australia.
    Lundh, Dan
    School of Bioscience, University of Skövde, Skövde, Sweden.
    Lorentzon, M.
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Hip fracture risk and safety with alendronate treatment in the oldest-old2017In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 282, no 6, p. 546-559Article in journal (Refereed)
    Abstract [en]

    Background. There is high evidence for secondary prevention of fractures, including hip fracture, with alendronate treatment, but alendronate's efficacy to prevent hip fractures in the oldest-old (80 years old), the population with the highest fracture risk, has not been studied.

    Objective. To investigate whether alendronate treatment amongst the oldest-old with prior fracture was related to decreased hip fracture rate and sustained safety.

    Methods. Using a national database of men and women undergoing a fall risk assessment at a Swedish healthcare facility, we identified 90 795 patients who were 80 years or older and had a prior fracture. Propensity score matching (four to one) was then used to identify 7844 controls to 1961 alendronate-treated patients. The risk of incident hip fracture was investigated with Cox models and the interaction between age and treatment was investigated using an interaction term.

    Results. The case and control groups were well balanced in regard to age, sex, anthropometrics and comorbidity. Alendronate treatment was associated with a decreased risk of hip fracture in crude (hazard ratio (HR) 0.62 (0.49-0.79), P < 0.001) and multivariable models (HR 0.66 (0.51-0.86), P < 0.01). Alendronate was related to reduced mortality risk (HR 0.88 (0.82-0.95) but increased risk of mild upper gastrointestinal symptoms (UGI) (HR 1.58 (1.12-2.24). The alendronate association did not change with age for hip fractures or mild UGI.

    Conclusion. In old patients with prior fracture, alendronate treatment reduces the risk of hip fracture with sustained safety, indicating that this treatment should be considered in these high-risk patients.

  • 46.
    Axelsson, Kristian F.
    et al.
    Department of Orthopaedic Surgery, Skaraborg Hospital, Skövde, Sweden.
    Nilsson, Anna G.
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Wedel, Hans
    Department of Endocrinology, Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Swede.
    Lundh, Dan
    School of Bioscience, University of Skövde, Skövde, Sweden.
    Lorentzon, Mattias
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Association between alendronate use and hip fracture risk in older patients using oral prednisolone2017In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 318, no 2, p. 146-155Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE Oral glucocorticoid treatment increases fracture risk, and evidence is lacking regarding the efficacy of alendronate to protect against hip fracture in older patients using glucocorticoids.

    OBJECTIVE To investigate whether alendronate treatment in older patients using oral prednisolone is associated with decreased hip fracture risk and adverse effects.

    DESIGN, SETTING, AND PARTICIPANTS Retrospective cohort study using a national database (N = 433 195) of patients aged 65 years or older undergoing a health evaluation (baseline) at Swedish health care facilities; 1802 patients who were prescribed alendronate after at least 3 months of oral prednisolone treatment (>= 5mg/d) were identified. Propensity score matching was used to select 1802 patients without alendronate use from 6076 patients taking prednisolone with the same dose and treatment time criteria. Follow-up occurred between January 2008 and December 2014.

    EXPOSURES Alendronate vs no alendronate use; no patients had previously taken alendronate at the time of prednisolone initiation.

    MAIN OUTCOMES AND MEASURES The primary outcome was incident hip fracture.

    RESULTS Of the 3604 included patients, the mean age was 79.9 (SD, 7.5) years, and 2524 (70%) were women. After a median follow-up of 1.32 years (interquartile range, 0.57-2.34 years), there were 27 hip fractures in the alendronate group and 73 in the no-alendronate group, corresponding to incidence rates of 9.5 (95% CI, 6.5-13.9) and 27.2 (95% CI, 21.6-34.2) fractures per 1000 person-years, with an absolute rate difference of -17.6 (95% CI, -24.8 to -10.4). The use of alendronate was associated with a lower risk of hip fracture in a multivariable-adjusted Cox model (hazard ratio, 0.35; 95% CI, 0.22-0.54). Alendronate treatment was not associated with increased risk of mild upper gastrointestinal tract symptoms (alendronate vs no alendronate, 15.6 [95% CI, 11.6-21.0] vs 12.9 [95% CI, 9.3-18.0] per 1000 person-years; P=.40) or peptic ulcers (10.9 [95% CI, 7.7-15.5] vs 11.4 [95% CI, 8.0-16.2] per 1000 person-years; P=.86). There were no cases of incident drug-induced osteonecrosis and only 1 case of femoral shaft fracture in each group.

    CONCLUSIONS AND RELEVANCE Among older patients using medium to high doses of prednisolone, alendronate treatment was associated with a significantly lower risk of hip fracture over a median of 1.32 years. Although the findings are limited by the observational study design and the small number of events, these results support the use of alendronate in this patient group.

  • 47.
    Axelsson, Kristian F.
    et al.
    Department of Orthopaedic Surgery, Skaraborg Hospital, Skövde, Sweden.
    Werling, Malin
    Department of Gastrosurgical Research & Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Eliasson, Björn
    Department of Molecular and Clinical Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Szabo, Eva
    Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Näslund, Ingmar
    Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Wedel, Hans
    Health Metrics, Sahlgrenska Academin, University of Gothenburg, Gothenburg, Sweden.
    Lundh, Dan
    School of Bioscience, University of Skövde, Skövde, Sweden.
    Lorentzon, Mattias
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Fracture Risk After Gastric Bypass Surgery: A Retrospective Cohort Study2018In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 33, no 12, p. 2122-2131Article in journal (Refereed)
    Abstract [en]

    Gastric bypass surgery constitutes the most common and effective bariatric surgery to treat obesity. Gastric bypass leads to bone loss, but fracture risk following surgery has been insufficiently studied. Furthermore, the association between gastric bypass and fracture risk has not been studied in patients with diabetes, which is a risk factor for fracture and affected by surgery. In this retrospective cohort study using Swedish national databases, 38,971 obese patients undergoing gastric bypass were identified, 7758 with diabetes and 31,213 without. An equal amount of well-balanced controls were identified through multivariable 1:1 propensity score matching. The risk of fracture and fall injury was investigated using Cox proportional hazards and flexible parameter models. Fracture risk according to weight loss and degree of calcium and vitamin D supplementation 1-year postsurgery was investigated. During a median follow-up time of 3.1 (interquartile range [IQR], 1.7 to 4.6) years, gastric bypass was associated with increased risk of any fracture, in patients with and without diabetes using a multivariable Cox model (hazard ratio [HR] 1.26; 95% CI, 1.05 to 1.53; and HR 1.32; 95% CI, 1.18 to 1.47; respectively). Using flexible parameter models, the fracture risk appeared to increase with time. The risk of fall injury without fracture was also increased after gastric bypass. Larger weight loss or poor calcium and vitamin D supplementation after surgery were not associated with increased fracture risk. In conclusion, gastric bypass surgery is associated with an increased fracture risk, which appears to be increasing with time and not associated with degree of weight loss or calcium and vitamin D supplementation following surgery. An increased risk of fall injury was seen after surgery, which could contribute to the increased fracture risk.

  • 48.
    Backman, Ellen
    et al.
    School of Health and Welfare, Halmstad University, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Documentation of everyday life and health care following gastrostomy tube placement in children: a content analysis of medical records2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Everyday routines play a vital role in child functioning and development. This study explored health professionals' documentation of everyday life and health care during the first year following gastrostomy tube placement in children and the content of intervention goals.

    METHODS: The medical records of 39 children (median age 38 months, min-max: 15-192) in one region of Sweden were analysed. A content analysis approach was used with an inductive qualitative analysis supplemented by a deductive, quantitative analysis of documented intervention goals following the ICF-CY.

    RESULTS: One overall theme, "Seeking a balance", captured the view of life with a gastrostomy and the health care provided. Two categories, "Striving for physical health" and "Depicting everyday life" with seven sub-categories, captured the key aspects of the documentation. Twenty-one children (54%) had intervention goals related to the gastrostomy, and these goals primarily focused on the ICF-CY component "Body functions".

    CONCLUSIONS: To some extent the medical records reflected different dimensions of everyday life, but the intervention goals clearly focused on bodily aspects. Understanding how health care for children using a gastrostomy is documented and planned by applying an ecocultural framework adds a valuable perspective and can contribute to family-centred interventions for children using a gastrostomy. Implications for Rehabilitation There is a need for increased awareness in healthcare professionals for a more consistent and holistic healthcare approach in the management of children with gastrostomy tube feeding. This study suggests that an expanded focus on children's participation in everyday mealtimes and in the healthcare follow-up of gastrostomy tube feeding is important in enhancing the intervention outcome. Multidisciplinary teams with a shared bio-psycho-social understanding of health would contribute to a situation in which the everyday lives of households adapt to living with gastrostomy. Routine care for children with gastrostomy should follow a checklist combining crucial physiological aspects of gastrostomy tube feeding with seemingly mundane family functions in order to achieve a successful gastrostomy tube feeding intervention.

  • 49.
    Baker, Sinan
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Alcharif, Odai
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Ekokardiografi: jämförelse av erfarenhetens betydelse vid mätningar av strain och strain rate i vänster kammare2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Echocardiography has a major role for assessment of the left ventricle. By using segmental and global longitudinal strain and strain rate both regional and global kinetics can be assessed. Segmental strain measures deformation of the myocardium as strain rate measures the velocity of the deformation. By summing the average from all segments, global longitudinal strain is obtained.

    Purpose:  To compare heart ultrasound-based segmental and global strain and strain rate in the left ventricle. Comparisons have been made between experienced biomedical laboratory scientist and less experienced biomedical laboratory scientist’s students.

    Method: Quantitative study were 10 test subjects have been examined echocardiographically. Imaging and measurements were collected with Siemens Acuson SC2000. Compilation of collected measurements were made on Microsoft Excel and Microsoft Word in charts and tables. For comparison of segmental and global strain and strain rate the analysis method Related-Samples Wilcoxon Signed Rank Test were used.

    Result: The result shows only one statistically significant difference (p <0.05) of segmental strain in the basal segments of apical projections between experienced biomedical laboratory scientist and student 1. 

    Conclusion: The data material is not enough to generalize the result to a larger population. Further studies are needed to draw a more secure conclusion.

  • 50.
    Bala, Sidona-Valentina
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Forslind, Kristina
    Section of Rheumatology, Department of Medicine, Helsingborg Hospital, Helsingborg, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hagell, Peter
    The PRO-CARE Group, School of Health & Society, Kristianstad University, Kristianstad, Sweden.
    Measuring person-centred care in nurse-led outpatient rheumatology clinics2018In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 296-304Article in journal (Refereed)
    Abstract [en]

    Background: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).

    Objective: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.

    Methods: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.

    Results: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.

    Conclusion: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.

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