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  • 2601.
    Vanoli, Davide
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
    Quantification of atherosclerotic plaque area by vascular ultrasound: reproducibility and comparison between conventional B-mode imaging and contrast-enhanced ultrasoundManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Background: Quantification of plaque burden represents a significant challenge to clinical practices, however, innovations in technologies, techniques and methodologies play a significant role in plaque assessment and burden quantification. Plaque area determination represents a useful method for quantifying atherosclerosis but poor visualization of plaques remains an issue that may significantly restrict its use. Contrast enhanced ultrasound (CEUS) has been proposed as a technique to improve the visualization of atherosclerotic plaques, however, blooming artefacts inherent to the CEUS technique, and which are known to vary depending on the intensity of the enhancement, may lead to an underestimation of the true plaque area.

    We hypothesised that plaque area measurements using CEUS will improve reproducibility of plaque area quantification, and that this will be independent of the time at which the image is acquired post-contrast administration when compared with conventional B-mode imaging. In this study, the areas of 42 carotid plaques from 33 subjects (18 men, mean age 61.3 ± 3.02 years) were measured offline. A series of four image loops were acquired for each study: first a conventional B-mode image, then 3 separate CEUS image loops at 5, 10 and 15 seconds post-contrast administration. Also, two expert operators (A and B) performed measurements to assess for inter-observer variability.

    Results: We found a strong correlation between B-mode plaque area measurements and CEUS plaque area measurements performed at 5 (T5, ICC=0.998), 10 (T10, ICC=0.999) and 15 (T15, ICC=0.998) seconds post contrast administration. The ICC for intra-observer variability was 0.99 for operator A, and 0.98 for operator B. The ICC for inter-observer variability was 0.96 for B-mode measurements, and 0.98, 0.98 and 0.99, respectively, for CEUS measurements at T5, T10 and T15.

    Conclusion: This study showed a strong consensus between B-mode and CEUS images. Blooming artefacts, inherent to the CEUS imaging technique, do not seem to significantly affect the measurement of plaque area in comparison to conventional B-mode imaging.

  • 2602.
    Varea, Valeria
    Örebro universitet, Institutionen för hälsovetenskaper.
    Argentina, Educación Física y la producción de conocimiento: El caso de EFDeportes2010Inngår i: Lecturas: Educación Física y Deportes, ISSN 1514-3465, nr 149, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
  • 2603. Varea, Valeria
    Bodytime: Exploring body dispositions of HMS (Education) professionals2011Konferansepaper (Fagfellevurdert)
  • 2604.
    Varea, Valeria
    Örebro universitet, Institutionen för hälsovetenskaper.
    Coming to research bodies in Health and Physical Education: An autoethnographic approach2017Konferansepaper (Fagfellevurdert)
  • 2605.
    Varea, Valeria
    The University of Queensland, Brisbane, Australia.
    Exploring the origins and consequences of Health and Physical Education undergraduates’ body dispositions2013Inngår i: The International Journal of Sport and Society, ISSN 2152-7857, E-ISSN 2152-7865, Vol. 3, nr 3, s. 207-218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There is considerable literature that supports the proposition that the body is central concern for Health and Physical Education (HPE) professionals. This particular group of individuals has certain dispositions with regard to the body that can be readily conveyed to their students in intentional and unintentional ways through pedagogical encounters. This paper will discuss how a group of undergraduate HPE students think about and consider the body. Taking a poststructuralist perspective and drawing mainly on the work of Foucault, in-depth interviews were used as method to explore how these HPE undergraduates came to shape their particular dispositions across time. Three main themes emerged: the ‘normal’ body, fat bodies and the HPE teacher’s body. Findings from this study will be helpful in understanding HPE undergraduates’ body dispositions and how they shape up their idea of teaching.

  • 2606.
    Varea, Valeria
    National University of Río Cuarto, Río Cuarto, Argentina.
    La utilización de técnicas no convencionales para el estudio de representaciones del cuerpo: El caso de las estrategias proyectivas2009Inngår i: Lecturas: Educación Física y Deportes, ISSN 1514-3465, Vol. 13, nr 128, s. 1-7Artikkel i tidsskrift (Fagfellevurdert)
  • 2607.
    Varea, Valeria
    Örebro universitet, Institutionen för hälsovetenskaper.
    Mujeres en Movimiento. Deporte, cultura física y feminidades. Argentina, 1870-1980: [Women in Movement. Sport, physical culture and femininities. Argentina, 1870-1980]2018Inngår i: Sport History Review, ISSN 1087-1659, E-ISSN 1543-2947Artikkel, omtale (Fagfellevurdert)
  • 2608.
    Varea, Valeria
    School of Education, University of New England, Armidale, Australia.
    On being a non-white academic in physical education and sport pedagogy2017Inngår i: Sport, Education and Society, ISSN 1357-3322, E-ISSN 1470-1243Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Conversation regarding the challenges and pressures that Early Career Academics (ECAs) face in the current context of the neoliberal university sector has begun to grow generally, and in the field of Physical Education and Sport Pedagogy (PESP) in particular. However, the additional challenges faced by non-white PESP academics in their early careers have, as yet, been absent from the ECA conversation. In this paper, I draw upon my own experiences as a non-white, female ECA with English as an additional language (EAL), working in the field of PESP in a developed English-speaking country, to explore racialised discourses and practices in the academia. To do so, I make use of a critical whiteness lens and an autoethnographic approach. In the analysis of the narratives, I invite others to reflect on how race is socially constructed, on the ‘extra effort’ that non-white academics with EAL must expend in order to survive colour-blind academia, and on the limited options for agency among non-white ECAs. The paper concludes with reflections on how academics need to open the dialogue ‘just a bit more’ to include non-white academics in the conversation about ECAs working in neoliberal university contexts to create spaces for equitable work.

  • 2609.
    Varea, Valeria
    University of New England, Armidale, Australia.
    Percepciones sobre la grasa corporal en estudiantes de posgrado de Educación Física2016Inngår i: Ágora para la Educación Física y el Deporte, E-ISSN 1989-7200, Vol. 18, nr 2, s. 117-132Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [es]

    El objetivo de este artículo es explorar las percepciones de la (su) grasa corporal en un grupo de estudiantes de posgrado en Educación Física (EF). Un grupo de siete alumnos de posgrado de una universidad australiana participaron de la investigación. Se utilizó un marco teórico foucaultiano, particularmente sus conceptos de discurso y panóptico, y las biografías colectivas como método para la recolección de datos. Los resultados de este escrito demuestran lo significativo que pueden ser otros (por ejemplo, padres, amigos y parejas) al actuar como dispositivos panópticos sobre el cuerpo de los participantes y, más específicamente, en cuestiones relacionadas con su grasa corporal. Mientras que, en una primera instancia, son estos otros los que ejercen la vigilancia sobre el cuerpo de los estudiantes, posteriormente dicha vigilancia se transforma en auto-vigilancia y, de esta manera, los participantes aprenden a disciplinar su cuerpo para intentar lograr un prototipo de cuerpo específico. Estos resultados tienen implicaciones significativas puesto que este grupo de alumnos de posgrado en EF pronto van a trabajar con alumnos o clientes, y se ha demostrado que sus percepciones del cuerpo y de la grasa corporal pueden ser transmitidas a otros.

  • 2610.
    Varea, Valeria
    Örebro universitet, Institutionen för hälsovetenskaper.
    Shaping Body Ideas: Body Perceptions of Health and Physical Education Undergraduates2014Inngår i: Exploring Bodies in Time and Space / [ed] L. Stafford, L. McLean, & M. Weeks, Oxford: Inter-Disciplinary Press, 2014, s. 49-60Kapittel i bok, del av antologi (Fagfellevurdert)
  • 2611.
    Varea, Valeria
    et al.
    National University of Río Cuarto, Río Cuarto, Argentina; National University of La Plata, Buenos Aires, Argentina.
    Ducart, Marcelo
    National University of Río Cuarto, Río Cuarto, Argentina.
    Repensando la identidad de la Educación Física a partir de la (in)definición de Wikipedia2009Inngår i: Lecturas: Educación Física y Deportes, ISSN 1514-3465, Vol. 14, nr 136, s. 1-7Artikkel i tidsskrift (Fagfellevurdert)
  • 2612.
    Varea, Valeria
    et al.
    School of Education, University of New England, Australia.
    González-Calvo, Gustavo
    Departamento de Didáctica de la Expresión Musical, Plástica y Corporal, University of Valladolid, Spain.
    Hortigüela-Alcalá, David
    Didáctica de Expresión Corporal, University of Burgos, Spain.
    The influence of consumerism on Spanish Physical Education teachers2018Konferansepaper (Fagfellevurdert)
  • 2613.
    Varea, Valeria
    et al.
    Örebro universitet, Institutionen för hälsovetenskaper.
    Miller, Judith
    University of New England.
    Haynes, John
    University of New England.
    Learning about the body and health through social media in rural communities2016Konferansepaper (Fagfellevurdert)
  • 2614.
    Varis, Linn
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Farmakologi.
    Antibiotikas miljöpåverkan: Risken för resistens hos bakterier samt rening av vatten2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 2615.
    Varmin-Kask, Marcux
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Rättspsykiatrisk vård: En jämförelse mellan domar och medicinska bedömningar gällande kön2013Student paper other, 5 poäng / 7,5 hpOppgave
  • 2616. Vaskivuo, Laura
    et al.
    Hokkanen, Laura
    Hanninen, Tuomo
    Antikainen, Riitta
    Bäckman, Lars
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Laatikainen, Tiina
    Paajanen, Teemu
    Stigsdotter-Neely, Anna
    Strandberg, Timo
    Tuomilehto, Jaakko
    Soininen, Hilkka
    Kivipelto, Miia
    Ngandu, Tiia
    Associations between Prospective and Retrospective Subjective Memory Complaints and Neuropsychological Performance in Older Adults: The Finger Study2018Inngår i: Journal of the International Neuropsychological Society, ISSN 1355-6177, E-ISSN 1469-7661, Vol. 24, nr 10, s. 1099-1109Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Subjective memory complaints (SMCs) are among the key concerns in the elderly, but their role in detecting objective cognitive problems is unclear. The aim of this study was to clarify the association between SMCs (both prospective and retrospective memory complaints) and neuropsychological test performance in older adults at risk of cognitive decline. Methods: This investigation is part of the FINGER project, a multicenter randomized controlled trial aiming at preventing cognitive decline in high-risk individuals. The cognitive assessment of participants was conducted at baseline using a modified neuropsychological test battery (NTB). SMCs were evaluated with the Prospective and Retrospective Memory Questionnaire (PRMQ) in a sub-sample of 560 participants (mean age, 69.9 years). Results: Having more prospective SMCs was associated with slower processing speed, but not with other NTB domains. Retrospective SMCs were linked to poorer function on NTB total score, processing speed, and memory. Executive function domain was not associated with any PRMQ ratings. Depressive symptoms and poor quality of life diluted the observed associations for NTB total score and memory. However, the association between PRMQ and processing speed remained even after full adjustments. Conclusions: Our results indicate that self-reported memory problems, measured with PRMQ, are associated with objectively measured cognitive performance. Such complaints in healthy elderly people also seem to reflect reduced mental tempo, rather than memory deficits. Slowing of processing speed may thus be negatively related to memory self-efficacy. It is also important to consider affective factors among those who report memory problems.

  • 2617.
    Veenstra, Helene
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Cumulative evidence for MS as a neural network disconnection syndrome consistent with cognitive impairment mechanisms and the confounding role of fatigue and depressionoutlook from the Fourth Nordic MS symposium2016Inngår i: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 134Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    The Fourth Nordic MS symposium served as a platform to present an overview over the rise and impact of cognitive impairment in people with MS, from early stages on, impairing their quality of life. After discussing MS and cognitive impairment symptoms, a review on the pathophysiology underlying cognitive impairment was given, followed by a talk on neuroimaging highlighting cortical reorganization in MS-affected brains. As a conclusion, therapy and treatment options were discussed. The symposium presented several cutting-edge research studies providing or testing working models that appear successful in predicting and explaining cognitive impairment in MS, such as the disconnection syndrome.

  • 2618.
    Velandia, Marianne
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Matthisen, A.S.
    Karolinska Institute, Stockholm, Sweden.
    Uvnäs-Moberg, K.
    Swedish Univ Agr Sci, Dept Anim Environm & Hlth, Skara, Sweden.
    Nissen, E.
    Karolinska Institute, Stockholm, Sweden.
    Onset of vocal interaction between parents and newborns in skin-to-skin contact immediately after elective cesarean section2010Inngår i: Birth Issues, ISSN 1038-023X, Vol. 7, nr 3, s. 192-201Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Cesarean section is associated with delayed mother-infant interaction because neither the mother nor the father routinely maintains skin-to-skin contact with the infant after birth. The aim of the study was to explore and compare parent-newborn vocal interaction when the infant is placed in skin-to-skin contact either with the mother or the father immediately after a planned cesarean section.

    METHODS:

    A total of 37 healthy infants born to primiparas were randomized to 30 minutes of skin-to-skin contact either with fathers or mothers after an initial 5 minutes of skin-to-skin contact with the mothers after birth. The newborns' and parents' vocal interaction were recorded on a videotape and audiotape. The following variables were explored: newborns' and parents' soliciting, newborns' crying and whining, and parental speech directed to the other parent and to the newborn.

    RESULTS:

    Newborns' soliciting increased over time (p=0.032). Both fathers and mothers in skin-to-skin contact communicated more vocally with the newborn than did fathers (p=0.003) and mothers (p=0.009) without skin-to-skin contact. Fathers in skin-to-skin contact also communicated more with the mother (p=0.046) and performed more soliciting responses than the control fathers (p=0.010). Infants in skin-to-skin contact with their fathers cried significantly less than those in skin-to-skin contact with their mothers (p=0.002) and shifted to a relaxed state earlier than in skin-to-skin contact with mothers (p=0.029).

    CONCLUSIONS:

    Skin-to-skin contact between infants and parents immediately after planned cesarean section promotes vocal interaction. When placed in skin-to-skin contact and exposed to the parents' speech, the infants initiated communication with soliciting calls with the parents within approximately 15 minutes after birth. These findings give reason to encourage parents to keep the newborn in skin-to-skin contact after cesarean section, to support the early onset of the first vocal communication.

  • 2619. Velasquez, Ilais Moreno
    et al.
    Ärnlöv, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Molekylär epidemiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Leander, Karin
    Lind, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Kardiovaskulär epidemiologi.
    Gigante, Bruna
    Carlsson, Axel C.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Molekylär epidemiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Interleukin-8 is associated with increased total mortality in women but not in men-findings from a community-based cohort of elderly2015Inngår i: Annals of Medicine, ISSN 0785-3890, E-ISSN 1365-2060, Vol. 47, nr 1, s. 28-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective. To elucidate the association among circulating IL-8 and total mortality in a cohort of elderly, and to explore potential sex differences in the observed association. Methods. The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) is a cohort of 70-year-old men and women living in Uppsala, Sweden; baseline period: 2001-2004. IL-8 serum measurements were performed in 1003 participants. Results. In total, 61 men and 40 women died during follow-up (median 7.9 years). Baseline IL-8 concentrations were higher in women than in men (P = 0.03). In a multivariable model adjusting for age, established cardiovascular risk factors, and C-reactive protein, log-transformed standard deviation increments in IL-8 levels were weakly associated with an increased risk for total mortality (hazard ratio (HR) 1.12, 95% confidence interval (CI) 1.02 -1.23, P < 0.05) in the whole cohort. Stratified analysis revealed an association in women (HR 1.18, 95% CI 1.06-1.30, P < 0.01) but not in men (HR 0.98, 95% CI 0.76-1.26). Conclusions. A weak association between IL-8 serum levels and an increased risk for mortality was observed. The prospective data support the role of IL-8 as a biomarker of interest; yet, further studies are warranted to elucidate validity of our finding and the possibility of a sex difference.

  • 2620.
    Venkataraman, Abinaya Priya
    et al.
    KTH Royal Institute of Technology.
    Lewis, Peter
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Unsbo, Peter
    KTH Royal Institute of Technology.
    Lundström, Linda
    KTH Royal Institute of Technology.
    Peripheral resolution and contrast sensitivity: Effects of stimulus drift2017Inngår i: Vision Research, ISSN 0042-6989, E-ISSN 1878-5646, Vol. 133, s. 145-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Optimal temporal modulation of the stimulus can improve foveal contrast sensitivity. This studyevaluates the characteristics oftheperipheral spatiotemporal contrast sensitivity function in normal-sighted subjects.The purpose is to identify a temporal modulation that can potentially improve the remaining peripheral visual function in subjects with central visual field loss. High contrast resolution cut-off for grating stimuli with four temporal frequencies (0, 5, 10 and 15 Hz drift) was first evaluated in the 10° nasal visual field.Resolution contrast sensitivity for all temporal frequencies was then measured at four spatial frequencies between 0.5 cycles per degree (cpd) and the measured stationary cut-off. All measurements were performed with eccentric optical correction. Similar to foveal vision, peripheral contrast sensitivity is highest for a combination of low spatial frequency and 5 to 10 Hz drift. At higher spatial frequencies, there was a decrease in contrast sensitivity with 15 Hz drift.Despitethis decrease, the resolution cut-off did not vary largely between the different temporal frequencies tested. ​ Additional measurements of contrast sensitivity at 0.5 cpd and resolution cut-off for stationary (0 Hz) and 7.5 Hz stimuli performed at 10, 15, 20 and 25° in the nasal visual field also showed the same characteristics across eccentricities.

  • 2621.
    Ventura, F
    et al.
    Göteborgs universitet.
    Sawatzky, R
    Kanada.
    Öhlén, Joakim
    Ersta Sköndal högskola, Institutionen för vårdvetenskap, Palliativt forskningscentrum, PFC. Göteborgs universitet.
    Karlsson, P
    Göteborgs universitet.
    Koinberg, I
    Göteborgs universitet.
    Challenges of evaluating a computer-based educational programme for women diagnosed with early-stage breast cancer: A randomised controlled trial.2017Inngår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, nr 5Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In a two-group, multi-centre, randomised controlled 9 months trial, we (1) evaluated the impact of a computer-based educational programme compared to standard care and (2) examined whether different patterns of programme usage could be explained by demographic, medical and psychosocial factors. We involved 226 Swedish-speaking women diagnosed with early-stage breast cancer and scheduled for surgery. Primary outcomes were health self-efficacy and health care participation measured by the Comprehensive Health Enhancement Supportive System instrument. Secondary outcomes were anxiety and depression levels measured by the Hospital Anxiety and Depression scale. The Functional Assessment of Cancer Therapy-Breast and Sense of Coherence scales measured psychosocial factors for the study's secondary aim. Multi-level modelling revealed no statistically significant impact of the computer-based educational programme over time on the outcomes. Subsequent exploratory regression analysis revealed that older women with axillary dissection and increased physical well-being were more likely to use the programme. Furthermore, receiving post-operative chemotherapy and increased meaningfulness decreased the likelihood of use. Providing reliable and evidence-based medical and rehabilitation information via a computer-based programme might not be enough to influence multi-dimensional outcomes in women diagnosed with breast cancer. The use of these programmes should be further explored to promote adherence to e-Health supportive interventions.

  • 2622. Verrel, Julius
    et al.
    Lövdén, Martin
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Lund University, Sweden; Center for Lifespan Psychology, Germany.
    Lindenberger, Ulman
    Older Adults Show Preserved Equilibrium but Impaired Step Length Control in Motor-Equivalent Stabilization of Gait2012Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, nr 12, artikkel-id e52024Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Stable walking depends on the coordination of multiple biomechanical degrees of freedom to ensure the dynamic maintenance of whole-body equilibrium as well as continuous forward progression. We investigated adult age-related differences in whole-body coordination underlying stabilization of center of mass (CoM) position and step pattern during locomotion. Sixteen younger (20-30 years) and 16 healthy older men (65-80 years) walked on a motorized treadmill at 80%, 100% and 120% of their self-selected preferred speed. Preferred speeds did not differ between the age groups. Motor-equivalent stabilization of step parameters (step length and width) and CoM position relative to the support (back and front foot) was examined using a generalized covariation analysis. Across age groups, covariation indices were highest for CoM position relative to the front foot, the measure most directly related to body equilibrium. Compared to younger adults, older adults showed lower covariation indices with respect to step length, extending previous findings of age-related differences in motor-equivalent coordination. In contrast, no reliable age differences were found regarding stabilization of step width or any of the CoM parameters. The observed pattern of results may reflect robust prioritization of balance over step pattern regularity, which may be adaptive in the face of age-associated sensorimotor losses and decline of coordinative capacities.

  • 2623.
    Vesterlund, Liselotte
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    DNA-tekniken och dess betydelse inom rättsmedicinen: Dåtid, Nutid och FRAMTID2009Student paper other, 5 poäng / 7,5 hpOppgave
    Abstract [sv]

    DNA-baserade metoder infördes inom rättsgenetiken i mitten av 1980-talet och har snabbt ersatt äldre metoder såsom blodgruppsbestämning och HLA[1]-vävnadstypning.

    År 2001 publicerades den första versionen av det humana genomet efter flera års arbete och till en kostnad av 300 miljoner dollar (Lander et al. 2001; Venter et al. 2001). Kunskapen om den specifika genetiska koden för en individ är dock inte samma sak som att veta den genetiska sekvensen för hela mänskligheten, då vi som olika individer skiljer oss åt på DNA sekvens nivå. Denna variation mellan individer beror på dels variation i antalet kopior av våra gener, så kallade “copy number variation” (CNVs) dels på polymorfism vid enstaka nukleotider i DNA sekvensen, så kallad “single nucleotide polymorphism” (SNPs). CNVs är något besvärligare att analysera i jämförelse med SNPs, vilket har lett till att SNPs har blivit ett värdefullt redskap för att skilja olika individer från varandra och även för att identifiera genförändringar inom olika syndrom och sjukdomstillstånd. Men även om vår nyfunna kunskap om det mänskliga genomet redan har gett oss inblick i flertalet olika genetiska sjukdomar och evolutionen av Homo sapiens så är informationen kanske inte bara av godo. De nya etiska betänkanden som uppstått i och med ny kunskap och teknik inom det genetiska området behandlas i slutet av denna uppsats för att belysa behovet av kunskap för att på bästa sätt kunna använda denna kunskap för mänsklighetens bästa.

     

    [1] HLA står för “human leukocyte antigen"-antigen. HLA är en typ av antigen-presenterande molekyler som existerar på cellytan hos alla celler med cellkärna.

  • 2624.
    Vesterlund Pettersson, Mikael
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Åklagares användning av rättsmedicinsk bevisning: en analys av hur åklagare värderar rättsmedicinska slutsatser inför beslut om åtal2012Student paper other, 5 poäng / 7,5 hpOppgave
    Abstract [sv]

    SAMMANFATTNING

     

    Den 21 oktober 2011 meddelade Solna tingsrätt dom i det uppmärksammade målet med läkaren vid Astrid Lindgrens barnsjukhus, som i media kom att kalla för ”barnläkarfallet”. Mot bakgrund av det uppmärksammade rättsfallet kom det att ifrågasättas huruvida åklagarna gör någon egentlig bevisrättslig prövning av rättsmedicinska slutsatser inför åtalsbeslut. Det är i det sammanhanget som intresset för den här uppsatsens frågeställningar för min del växte fram.

     

    Det här är en rättsvetenskaplig uppsatts på det medikolegala området med tvärvetenskapliga inslag. Jag har undersökt hur åklagare inför åtalsbeslut går till väga för att kritiskt värdera rättsmedicinsk bevisning, varför uppsatsen är av deskriptiv och inte normativ karaktär. Jag har använt en rättsdogmatisk metod som kompletterats med en interaktiv rättsvetenskaplig metod genom att intervjua tre åklagare vid åklagarkammaren i Skövde. Jag har använt mig av semistrukturerade intervjuer då åklagarna haft möjlighet att svara på frågorna utifrån sin referensram.

     

    Den övergripande frågeställningen i uppsatsen är om åklagare i allmänhet har förmågan att värdera medicinsk sakkunnigbevisning på det sätt som Högsta domstolen förväntar sig att domstolar och åklagare ska göra. Av intervjuerna framgår det att åklagarna i ärenden med grövre brottslighet eller allvarligare skador gör en ingående prövning av de rättsmedicinska slutsatsernas bevisrättsliga värde, men att prövningen inte är lika ingående vid mindre allvarlig brottslighet. Åklagarna har dock uttryckt stor tilltro till de statliga myndigheter som har i uppdrag att bistå rättsväsendet med medicinsk eller annan vetenskaplig sakkunskap. Det är därför sällan som åklagare själva tar initiativ till ett second opinion i de fall som den medicinska bevisningen stärker åklagarens gärningspåstående. Det förekommer dock att åklagare begär yttrade från socialstyrelsens rättsliga råd, men då handlar det inte sällan om att en misstänkt bedömts ha begått den åtalade gärningen under påverkan av allvarlig psykisk störning vilket åklagaren ifrågasätter. Om inte förvaret agerar och begär kompletterande bevisning kommer därför domstolarna i de allra flesta fallen bara ha åklagarens bevisning i form av rättsintyg eller obduktionsprotokoll att tillgå i sin prövning. 

  • 2625.
    Vestin, Antonia
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Farmakologi.
    Vilken evidens finns för standardbehandling av hjärtsvikt till äldre?: - En litteraturstudie2018Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 2626.
    Vetrano, Davide L.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Catholic University of Rome, Italy.
    Bianchini, Elisa
    Onder, Graziano
    Cricelli, Iacopo
    Cricelli, Claudio
    Bernabei, Roberto
    Bettoncelli, Germano
    Lapi, Francesco
    Poor adherence to chronic obstructive pulmonary disease medications in primary care: Role of age, disease burden and polypharmacy2017Inngår i: Geriatrics & Gerontology International, ISSN 1444-1586, E-ISSN 1447-0594, Vol. 17, nr 12, s. 2500-2506Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    The aim of the present study was to assess the occurrence and determinants of poor adherence to pharmacological treatment in a cohort of primary care patients with chronic obstructive pulmonary disease (COPD), paying special attention to the role of age, comorbidity and polypharmacy.

    Methods

    We identified a cohort of COPD patients using the primary care Italian Health Search – IMS Longitudinal Patient Database. We assessed 1-year adherence to COPD maintenance pharmacotherapy (encompassing inhaled corticosteroids, long-acting beta agonists and long-acting anticholinergics). Poor adherence was defined as <80% of proportion of days covered by pharmacological treatment over a 1-year period.

    Results

    Of 22 505 patients (mean age 67.3 ± 13.2; 41.3% women) entering the study, 17 486 (77.7%) were poorly adherent. According to multivariate analysis, poor adherence is less likely in older adults (OR 0.51, 95% CI 0.40–0.66), in non-smokers (OR 0.77, 95% CI 0.69–0.86) and in those with a history of alcohol abuse (OR 0.74, 95% CI 0.58–0.94). Higher comorbidity (OR 1.43, 95% CI 1.13–1.80) was positively associated with poor adherence. Polypharmacy was associated with poor adherence only in patients aged ≥65 years (OR 1.34, 95% CI 1.13–1.59). Finally, COPD severity was associated with a reduced likelihood of poor adherence (OR 0.20, 95% CI 0.07–0.61 for stage IV).

    Conclusions

    The present findings show that poor medication adherence is common in patients with COPD receiving long-term treatment. The interaction between age and polypharmacy, and the role of comorbidity suggest a pivotal role of biological age as a steering determinant of poor adherence. Geriatr Gerontol Int 2017; 17: 2500–2506.

  • 2627.
    Vetrano, Davide L.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Catholic University of Rome, Italy.
    Calderón-Larrañaga, Amaia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Aragon Health Sciences Institute (IACS), Spain.
    Marengoni, Alessandra
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). University of Brescia, Italy.
    Onder, Graziano
    Bauer, Juergen M.
    Cesari, Matteo
    Ferrucci, Luigi
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Stockholm Gerontology Research Center, Sweden .
    An International Perspective on Chronic Multimorbidity: Approaching the Elephant in the Room2018Inngår i: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 73, nr 10, s. 1350-1356Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Multimorbidity is a common and burdensome condition that may affect quality of life, increase medical needs, and make people live more years of life with disability. Negative outcomes related to multimorbidity occur beyond what we would expect from the summed effect of single conditions, as chronic diseases interact with each other, mutually enhancing their negative effects, and eventually leading to new clinical phenotypes. Moreover, multimorbidity mirrors an accelerated global susceptibility and a loss of resilience, which are both hallmarks of aging. Due to the complexity of its assessment and definition, and the lack of clear evidence steering its management, multimorbidity represents one of the main current challenges for clinicians, researchers, and policymakers. The authors of this article recently reflected on these issues during two twin international symposia at the 2016 European Union Geriatric Medicine Society (EUGMS) meeting in Lisbon, Portugal, and the 2016 Gerontological Society of America (GSA) meeting in New Orleans, USA. The present work summarizes the most relevant aspects related to multimorbidity, with the ultimate goal to identify knowledge gaps and suggest future directions to approach this condition.

  • 2628.
    Vetrano, Davide L.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Catholic University of Rome, Italy.
    Collamati, Agnese
    Magnavita, Nicola
    Sowa, Agnieszka
    Topinkova, Eva
    Finne-Soveri, Harriet
    van der Roest, Henriette G.
    Tobiasz-Adamczyk, Beata
    Giovannini, Silvia
    Ricciardi, Walter
    Bernabei, Roberto
    Onder, Graziano
    Poscia, Andrea
    Health determinants and survival in nursing home residents in Europe: Results from the SHELTER study2018Inngår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 107, s. 19-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The care processes directed towards institutionalized older people needs to be tailored on goals and priorities that are relevant for this specific population. The aim of the present study was (a) to describe the distribution of selected health determinants in a sample of institutionalized older adults, and (b) to investigate the impact on survival of such measures. Design: Multicentre longitudinal cohort-study. Setting: 57 nursing homes (NH) in 7 EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and 1 non-EU country (Israel). Participants: 3036 NH residents participating in the Services and Health for Elderly in Long TERm care (SHELTER) study. Measurements: We described the distribution of 8 health determinants (smoking habit, alcohol use, body mass index [BMI], physical activity, social participation, family visits, vaccination, and preventive visits) and their impact on 1-year mortality. Results: During the one-year follow up, 611 (20%) participants died. Overweight (HR 0.79; 95% C.I. 0.64-0.97) and obesity (HR 0.64; 95% C.I. 0.48-0.87) resulted associated with lower mortality then normal weight. Similarly, physical activity (HR 0.67; 95% C.I. 0.54-0.83), social activities (HR 0.63; 95% C.I. 0.51-0.78), influenza vaccination (HR 0.66; 95% C.I. 0.55-0.80) and pneumococcal vaccination (HR 0.76 95% C.I. 0.63-0.93) were associated with lower mortality. Conversely, underweight (HR 1.28; 95% C.I. 1.03-1.60) and frequent family visits (HR 1.75; 95% C.I. 1.27-2.42) were associated with higher mortality. Conclusions: Health determinants in older NH residents depart from those usually accounted for in younger and fitter populations. Ad hoc studies are warranted in order to describe other relevant aspects of health in frail older adults, with special attention on those institutionalized, with the ultimate goal of improving the quality of care and life.

  • 2629.
    Vetrano, Davide L.
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Catholic University of Rome, Italy.
    La Carpia, Domenico
    Grande, Giulia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). University of Milan, Italy.
    Casucci, Paola
    Bacelli, Tiziana
    Bernabei, Roberto
    Onder, Graziano
    Anticholinergic Medication Burden and 5-Year Risk of Hospitalization and Death in Nursing Home Elderly Residents With Coronary Artery Disease2016Inngår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 17, nr 11, s. 1056-1059Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To assess the association of the anticholinergic medication burden with hospitalization and mortality in nursing home elderly patients and to investigate the role of coronary artery disease (CAD). Design: Longitudinal (5-year) retrospective observational study. Setting: Nursing homes in Italy. Participants: A total of 3761 nursing home older residents. Measurements: A comprehensive clinical and functional assessment was carried out through the interRAI long-term care facility instrument. The anticholinergic burden was assessed through the anticholinergic cognitive burden (ACB) scale. Occurrence of hospitalization/all-cause mortality was the primary composite outcome. First hospitalization and all-cause mortality were the secondary outcomes of the study. Hazard ratios (HRs) and subdistribution HRs were obtained through Cox and competing risk (death as competing event for hospitalization) models. Results: Within the sample (mean age 83 +/- 7 years; 72% females) the incidence rate of the primary outcome was 10/100 person-year. After adjusting for potential confounders and compared with participants with an ACB of 0, those with an ACB of 1 [HR 1.46; 95% confidence interval (CI) 1.12-1.90] and ABC of 2+ (HR 1.41; 95% CI 1.11-1.79) presented an increased risk of developing the primary outcome. After stratification, the risk for the primary outcome increased along with the anticholinergic burden, only for participants affected by CAD (HR 1.53; 95% CI 0.94-2.50 and HR 1.71; 95% CI 1.09-2.68 for the ACB of 1 and ACB of 2+ groups). An ACB score of 2+ was marginally associated with first hospitalization, considering death as a competing risk, only for those with CAD (subdistribution HR 3.47; 95% CI 0.99-12.3). Conclusions: Anticholinergic medication burden is associated to hospitalization and all-cause mortality in institutionalized older adults. CAD increases such risk. The effectiveness and safety profile of complex drug regimens should be reconsidered in this population.

  • 2630.
    Vetrano, Davide Liborio
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Catholic University of Rome, Italy.
    Villani, Emanuele Rocco
    Grande, Giulia
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Giovannini, Silvia
    Cipriani, Maria Camilla
    Manes-Gravina, Ester
    Bernabei, Roberto
    Onder, Graziano
    EAssociation of Polypharmacy With 1-Year Trajectories of Cognitive and Physical Function in Nursing Home Residents: Results From a Multicenter European Study2018Inngår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 19, nr 8, s. 710-713Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To test the association between polypharmacy and 1-year change in physical and cognitive function among nursing home (NH) residents. Design: Longitudinal multicenter cohort study based on data from the Services and Health for Elderly in Long TERm care (SHELTER) study. Setting: NH in Europe (n 1/4 50) and Israel (n 1/4 7). Participants: 3234 NH older residents. Measurements: Participants were assessed through the interRAI long-term care facility instrument. Polypharmacy was defined as the concurrent use of 5 to 9 drugs and excessive polypharmacy as the use of >= 10 drugs. Cognitive function was assessed through the Cognitive Performance Scale (CPS). Functional status was evaluated through the Activities of Daily Living (ADL) Hierarchy scale. The change in CPS and ADL score, based on repeated assessments, was the outcome, and their association with polypharmacy was modeled via linear mixed models. The interaction between polypharmacy and time was reported [ beta and 95% confidence intervals (95% CIs)]. Results: A total of 1630 (50%) residents presented with polypharmacy and 781 (24%) excessive polypharmacy. After adjusting for potential confounders, residents on polypharmacy (beta 0.10, 95% CI 0.010.20) and those on excessive polypharmacy (beta 0.13, 95% CI 0.01-0.24) had a significantly higher decline in CPS score compared to those using < 5 drugs. No statistically (P >.05) significant change according to polypharmacy status was shown for ADL score. Conclusions: Polypharmacy is highly prevalent among older NH residents and, over 1 year, it is associated with worsening cognitive function but not functional decline.

  • 2631.
    Vikberg, Sanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Sörlén, Niklas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Brandén, Lisa
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Johansson, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordström, Anna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin. School of Sports Science, UiT The Arctic University of Norway, Tromsö, Norway..
    Hult, Andreas
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Yrkes- och miljömedicin.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Effects of Resistance Training on Functional Strength and Muscle Mass in 70-Year-Old Individuals With Pre-sarcopenia: A Randomized Controlled Trial2019Inngår i: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, nr 1, s. 28-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Sarcopenia has been defined as age-related loss of muscle mass and function. The aim of this randomized controlled trial was to examine the effects of a 10-week instructor-led resistance training program on functional strength and body composition in men and women aged 70 years with pre-sarcopenia.

    DESIGN, SETTING, AND PARTICIPANTS: Participants were randomized to either 10 weeks of a physical training regimen including optional nutritional supplementation (n = 36) or to a control group (n = 34) (ClinicalTrials.gov, no. NCT03297632). The main outcome was changes in the Short Physical Performance Battery (SPPB) score. Secondary outcomes included the Timed Up and Go test, chair sit-stand time, lean body mass, and fat mass.

    RESULTS: The intervention had no significant effect on SPPB in the total cohort (P = .18), when comparing changes in the intervention group with the control group. However, those given the intervention in the male subcohort increased 0.5 ± 0.4 (mean ± standard error for the difference) points in SPPB during follow-up (P = .02) compared to male controls. With respect to secondary outcomes, the intervention group decreased 0.9 ± 0.6 seconds in chair sit-stand time compared to controls (P = .01). Furthermore, the intervention resulted in significantly greater improvements for the training group than control group in all measures of body composition (P ≤ .01 for all). For example, lean body mass increased by a mean of 1147 ± 282 g (P < .001), and total fat mass decreased by a mean of 553 ± 225 g (P = .003), favoring the intervention group.

    CONCLUSION/IMPLICATIONS: The main finding of this intervention study is that an easy-to-use, functional resistance training program was effective in maintaining functional strength and increasing muscle mass in older adults with pre-sarcopenia.

  • 2632.
    Vikstrom, Pernilla
    et al.
    Lunds universitet.
    Bjorkman, Anders
    Lunds universitet.
    Carlsson, Ingela K.
    Lunds universitet.
    Olsson, Anna-Karin
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013). NU Hlth Care, Dept Psychiat, Trollhattan.
    Rosen, Birgitta
    Lunds universitet.
    Atypical sensory processing pattern following median or ulnar nerve injury: a case-control study2018Inngår i: BMC Neurology, ISSN 1471-2377, E-ISSN 1471-2377, Vol. 18, artikkel-id 146Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Due to brain plasticity a transection of a median or ulnar nerve results in profound changes in the somatosensory areas in the brain. The permanent sensory deprivation after a peripheral nerve injury might influence the interaction between all senses. The aim of the study was to investigate if a median and/or ulnar nerve injury gives rise to a changed sensory processing pattern. In addition we examined if age at injury, injured nerve or time since injury influence the sensory processing pattern. Methods: Fifty patients (40 men and 10 women, median age 43) operated due to a median and/or ulnar nerve injury were included. The patients completed the Adolescent/Adult Sensory Profile questionnaire, which includes a comprehensive characterization on how sensory information is processed and how an individual responds to multiple sensory modalities. AASP categorizes the results into four possible Quadrants of behavioral profiles (Q1-low registration, Q2-sensory seeking, Q3-sensory sensitivity and Q4-sensory avoiding). The results were compared to 209 healthy age and gender matched controls. Anova Matched Design was used for evaluation of differences between the patient group and the control group. Atypical sensory processing behavior was determined in relation to the normative distribution of the control group. Results: Significant difference was seen in Q1, low registration. 40% in the patient group scored atypically in this Quadrant compared to 16% of the controls. No correlation between atypical sensory processing pattern and age or time since injury was seen. Conclusion: A peripheral nerve injury entails altered sensory processing pattern with increased proportion of patients with low registration to sensory stimulus overall. Our results can guide us into more client centered rehabilitation strategies.

  • 2633. Vikström, Anna
    et al.
    Hägglund, Maria
    Nyström, Mikael
    Strender, Lars-Erik
    Koch, Sabine
    Hjerpe, Per
    Lindblad, Ulf
    Nilsson, Gunnar H
    Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems.2012Inngår i: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 13, artikkel-id 2Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT.

    METHODS: Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed.

    RESULTS: 417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions.

    CONCLUSIONS: Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT.Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care.

  • 2634. Vikström, Sofia
    et al.
    Sandman, Per-Olof
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Karolinska Inst, Dept Neurobiol Caring Sci & Soc, Div Nursing, S-14183 Huddinge, Sweden.
    Stenwall, Ewa
    Boström, Anne-Marie
    Saarnio, Lotta
    Kindblom, Kristina
    Edvardsson, David
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. La Trobe Univ, Sch Nursing & Midwifery, Bundoora, Vic 3086, Australia.
    Borell, Lena
    A model for implementing guidelines for person-centered care in a nursing home setting2015Inngår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 27, nr 1, s. 49-59Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Systematic evaluations of knowledge translation interventions in nursing homes to improve practice are scarce. There is also a lack of studies focusing on creating sustainable evidence-based practice in the setting of residential dementia care. Methods: The aim of this paper is to describe a model for implementing national evidence-based guidelines for care of persons with dementia in nursing homes. The secondary aim is to outline the nursing home staff experiences during the first year of the implementation process. The intervention had a participatory action research approach. This included educational activities such as: (i) thematic seminars introducing national guidelines for dementia care, (ii) regular unit-based seminars; and (iii) later dissemination of information in reflective seminars and several days of poster-exhibitions. Areas of practice development were selected on each of the 24 units, based on unit-specific needs, and a quality improvement strategy was applied and evaluated. Each unit met ten times during a period of eight months. Data for this study were extracted from the reflective seminars and poster presentations, analyzed using a qualitative content analysis. Results: Findings showed that implementation of guidelines were perceived by staff as beneficial for both staff and the residents. However, barriers to identification of relevant sources of evidence and barriers to sustainable implementation were experienced. Conclusions: One of our assumptions was that dementia nursing homes can benefit from becoming knowledge driven, with care practices founded in evidence-based sources. Our findings show that to be partly true, even though most staff units found their efforts to pursue and utilize knowledge adversely impacted by time-logistics and practical workload challenges.

  • 2635.
    Viktor, Nilsson
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin.
    Estimates of physical activity patterns in older adults considering cardiovascular risk factors: A Comparison between the International Physical Activity Questionnaire and Actigraph GT3X+ Measurements2015Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Abstract

    Background: Physical activity has emerged as a determining factor in reducing the risk of chronic diseases. Previous studies have shown that self-reported physical activity tending to be overestimated in comparison with physical activity measured objectively. In this study we investigate the consistency between those methods and the association to cardiovascular risk factors in older adults. Methods: The study population consisted of 1403 men and women aged 70, living in Umeå, Sweden. Physical activity was objectively assessed for seven days by the Actigraph GT3X+ accelerometer in intensity levels of light, moderate and vigorous. For self-reported assessment the International physical activity questionnaire was used. Data from the survey were calculated in metabolic equivalents minutes/week for walking, moderate and vigorous activity level. Results: Self-reported activity levels of moderate and vigorous correlated significantly with light activity measured by accelerometers for both men (r=0.21, p< 0.01) and women (r=0.19 p<0.01). Self-reported walking correlated with moderate activity level from the accelerometer, for men (r=0.40 p< 0.01) and for women (r= 0.40, p< 0.01). Waist, Body Mass Index and triglycerides were significant (p<0.01) for all activity levels measured by accelerometers in women. Individuals with BMI ≥ 25 showed stronger correlations between walking METs and light activity compared to individuals with BMI <25. Conclusion: Overall individuals at the aged of 70 tend to overestimate physical activity at higher intensities in IPAQ compared to accelerometers.

    Keywords: Physical activity - Accelerometry - International Physical Activity Questionnaire - Measurement - Elderly

  • 2636. Viljonen, C.T.
    et al.
    Kirsten, T.G.J.
    Haglund, B.J.A.
    Tillgren, Per
    Mälardalens högskola, Institutionen för vård- och folkhälsovetenskap.
    Towards the Development of Indicators for Health Promoting Schools.2006Inngår i: The Health Promoting School: International Advances in Theory, Evaluation and Practice., Danmarks Pedagogiske Universtitets Forlag, Copenhagen. , 2006, s. 75-86Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 2637.
    Villegas, Fernanda
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk strålningsvetenskap.
    Tilly, Nina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk strålningsvetenskap. Elekta Instrument AB.
    Ahnesjö, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk strålningsvetenskap.
    Target size variation in microdosimetric distributions and its impact on the linear-quadratic parameterization of cell survival.2018Inngår i: Radiation Research, ISSN 0033-7587, E-ISSN 1938-5404, Vol. 190, s. 504-512Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The linear-quadratic (LQ) parameterization of survival fraction SF(D) inherently assumes that all cells in a population get the same dose D, albeit the distribution of specific energy z over the individual cells f(z,D) can be very wide. From these microdosimetric distributions, which are target size dependent, we estimate the size of the cellular sensitive volume by analysing its influence on the LQ parameterization of cell survival. A Monte Carlo track structure code was used to simulate detailed tracks from a 60Co source as well as proton and carbon ions of various energies. From these tracks, f(z,D) distributions were calculated for spherical targets with diameters ranging from 10 nm to 12 µm. A cell survival function based on f(z,D) was fitted to published experimental LQ α values, revealing an intrinsic limitation that target size imposes on the usage of f(z,D) to describe the linear term of the LQ parameterization. The results indicate that such threshold volume arises naturally from the relationship between the particle´s probability of no-hit and the probability of cell survival. Further analysis led to the proposal of a radiobiological property yf,MID, defined as the mean lineal energy corresponding to the target size that allows equivalence between the mean inactivation dose (MID) and the mean specific energy z1.  The fact that z1 is an increasing continuous function of target size within the range of biological targets of interest in radiobiology, ensures the uniqueness of yf,MID for any radiation quality, thus, its potential usefulness in modelling. In conclusion, an accurate estimation of such threshold volumes may be useful for improving modelling of cell survival curves.

  • 2638.
    Villegas, Fernanda
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk strålningsvetenskap.
    Tilly, Nina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för radiologi, onkologi och strålningsvetenskap, Enheten för medicinsk strålfysik. Elekta Instrument AB, Box7593, SE-10393 Stockholm, Sweden.
    Bäckström, Gloria
    McGill Univ, Dept Oncol, Med Phys Unit, Montreal, PQ, Canada; McGill Univ, Ctr Hlth, Res Inst, Montreal, PQ, Canada.
    Ahnesjö, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Medicinsk strålningsvetenskap.
    Corrigendum to ’Cluster pattern analysis of energy deposition sites for the brachytherapy sources 103Pd,125I,192Ir,137Cs and 60Co’, PMB 59 (2014) 5531-432016Inngår i: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 61, nr 15, s. 5883-5886Artikkel i tidsskrift (Fagfellevurdert)
  • 2639.
    Vinterflod, Charlotta
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Physicians’ perceptions on clinical pharmacy services: A qualitative study2015Independent thesis Advanced level (professional degree), 20 poäng / 30 hpOppgave
  • 2640. Virtanen, Marianna
    et al.
    Jokela, Markus
    Nyberg, Solja T.
    Madsen, Ida E. H.
    Lallukka, Tea
    Ahola, Kirsi
    Alfredsson, Lars
    Batty, G. David
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Casini, Annalisa
    Clays, Els
    De Bacquer, Dirk
    Dragano, Nico
    Erbel, Raimund
    Ferrie, Jane E.
    Fransson, Eleonor I.
    Hamer, Mark
    Heikkil, Katriina
    Joeckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Ladwig, Karl-Heinz
    Lunau, Thorsten
    Nielsen, Martin L.
    Nordin, Maria
    Oksanen, Tuula
    Pejtersen, Jan H.
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Schupp, JRgen
    Siegrist, Johannes
    Singh-Manoux, Archana
    Steptoe, Andrew
    Suominen, Sakari B.
    Theorell, Tores
    Vahtera, Jussi
    Wagner, Gert G.
    Westerholm, Peter J. M.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Westerlund, Hugo
    Kivimaki, Mika
    Long working hours and alcohol use: systematic review and meta-analysis of published studies and unpublished individual participant data2015Inngår i: BMJ-BRITISH MEDICAL JOURNAL, ISSN 1756-1833, Vol. 350, artikkel-id g7772Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objective To quantify the association between long working hours and alcohol use. Design Systematic review and meta-analysis of published studies and unpublished individual participant data. Data sources A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies. Review methods The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression. Results Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and >= 55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate. Conclusions Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.

  • 2641.
    Visuttijai, Kittichate
    Högskolan i Skövde, Institutionen för biovetenskap. Högskolan i Skövde, Forskningscentrum för Systembiologi. Department of Medical and Clinical Genetics, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Cellular, Molecular and Functional Characterization of the Tumor Suppressor Candidate MYO1C2016Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Tumor suppressor genes play a role as a growth regulator and a gatekeeper of a cell. Their inactivation is often detected in malignant tumors. Identification of novel tumor suppressor gene candidates may help to further understand tumorigenesis and aid in the discovery of a new treatment leading toward cure of cancer.

    This PhD research project aimed to understand functional significance of a novel tumor suppressor gene candidate, myosin IC (MYO1C) and to identify potential interaction(s) of the MYO1C protein with key components of the signaling pathways involving in cancer development.

    In an experimental rat model for endometrial carcinoma (EC), detailed molecular genetic analysis of a candidate tumor suppressor region located distal to the tumor protein 53 (Tp53) suggested the myosin IC gene (Myo1c) as the best potential target for deletion of the genetic material. The question arising was whether and how MYO1C could function as a tumor suppressor gene. By using qPCR, Western blot or immunohistochemistry analyses, we examined MYO1C protein level in panels of well-stratified human colorectal cancer (CRC) and EC respectively. We found that MYO1C was significantly down-regulated in these cancer materials and that for the EC panel, the observed down-regulation of MYO1C correlated with tumor stage, where tumors at more advanced stages had less expression of MYO1C. In cell transfection experiments, we found that over-expression of MYO1C significantly decreased cell proliferation, and silencing MYO1C with siRNA increased cell viability. Additionally, knockdown of MYO1C impaired the ability of cells to migrate, spread and adhere to the surface. Recent published studies suggested a potential interplay between MYO1C and the phosphoinositide 3-kinase (PI3K)/AKT pathway. To examine this hypothesis, we analyzed the expression and/or activation of components of the PI3K/AKT and RAS/ERK signaling pathways in vivo in CRC samples, and in vitro in cells transfected with the MYO1C gene expression construct or MYO1C-targeted siRNA. To identify other potential pathways/ mechanisms through which MYO1C may exert its tumor suppressor activity, we additionally performed new sets of MYO1C-siRNA knockdown experiments. At different time points post transfection, we performed microarray global gene expression experiments followed by bioinformatics analysis of the data. Altogether, the results suggested an early PI3K/AKT response to altered MYO1C expression. We additionally identified several cancer-related genes/pathways with late response to MYO1C knockdown. All things considered, the identification of MYO1C-expression impact on cell proliferation, migration, and adhesion in combination with its interplay between several cancer-related genes and signaling pathways provide further evidence for the initial hypothesis of a tumor suppressor activity of MYO1C. 

  • 2642.
    Visuttijai, Kittichate
    et al.
    Högskolan i Skövde, Institutionen för biovetenskap. Högskolan i Skövde, Forskningscentrum för Systembiologi. Department of Medical and Clinical Genetics, Sahlgrenska Academy, University of Gothenburg.
    Pettersson, Jennifer
    Department of Medical and Clinical Genetics, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Mehrbani Azar, Yashar
    Högskolan i Skövde, Institutionen för biovetenskap.
    van den Bout, Iman
    Department of physiology, Faculty of Health Sciences, University of Pretoria, South Africa.
    Örndal, Charlotte
    Department of Pathology, Sahlgrenska University Hospital, Gothenburg.
    Marcickiewicz, Janusz
    Department of Obstetrics and Gynecology, Halland Hospital Varberg, Varberg.
    Nilsson, Staffan
    Institute of Mathematical Statistics, Chalmers University of Technology, Gothenburg.
    Hörnquist, Michael
    Department of Science and Technology, University of Linköping, Norrköping.
    Olsson, Björn
    Högskolan i Skövde, Institutionen för biovetenskap. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Ejeskär, Katarina
    Högskolan i Skövde, Institutionen för biovetenskap. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Behboudi, Afrouz
    Högskolan i Skövde, Institutionen för biovetenskap. Högskolan i Skövde, Forskningscentrum för Systembiologi.
    Lowered Expression of Tumor Suppressor Candidate MYO1CStimulates Cell Proliferation, Suppresses Cell Adhesion and Activates AKT2016Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 10, artikkel-id e0164063Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Myosin-1C (MYO1C) is a tumor suppressor candidate located in a region of recurrent losses distal to TP53. Myo1c can tightly and specifically bind to PIP2, the substrate of Phosphoinositide 3-kinase (PI3K), and to Rictor, suggesting a role for MYO1C in the PI3K pathway. This study was designed to examine MYO1C expression status in a panel of well-stratified endometrial carcinomas as well as to assess the biological significance of MYO1C as a tumor suppressor in vitro. We found a significant correlation between the tumor stage and lowered expression of MYO1C in endometrial carcinoma samples. In cell transfection experiments, we found a negative correlation between MYO1C expression and cell proliferation, and MYO1C silencing resulted in diminished cell migration and adhesion. Cells expressing excess of MYO1C had low basal level of phosphorylated protein kinase B (PKB, a.k.a. AKT) and cells with knocked down MYO1C expression showed a quicker phosphorylated AKT (pAKT) response in reaction to serum stimulation. Taken together the present study gives further evidence for tumor suppressor activity of MYO1C and suggests MYO1C mediates its tumor suppressor function through inhibition of PI3K pathway and its involvement in loss of contact inhibition.

  • 2643.
    Vixner, Linda
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska Institutet.
    Manual and electroacupuncture for labour pain. Study design of a longitudinal randomized controlled trial2013Konferansepaper (Annet vitenskapelig)
    Abstract [en]

    Introduction: Results from previous acupuncture studies for labour pain are contradictory and lack important information on methodology. The sample sizes are in general small, information about the intervention such as needle placement, number of acupuncture points, type of stimulation, and duration of treatment, is often sparse or lacking However, studies indicate that acupuncture has a positive effect on women’s experiences of labour pain.

     

    Aim: The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain. Our hypothesis is that acupuncture with manual or electrical stimulation is more effective than standard care in the relief of labor pain, and that acupuncture with electrical stimulation is the most effective.

    Outcome measures: Primary outcome: Labour pain measured with visual analogue scale (VAS). Secondary outcomes are use of epidural analgesia, experience of relaxation, labour outcomes and infant outcomes. Biochemical markers of proinflammatory cytokines, memory of labour pain and overall childbirth experience.

    Methods: The study was designed as a randomized controlled trial based on Western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. VAS was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment.

    At the conference, information on the design of the study will be presented and the considerations of whether to use placebo controls or not will be discussed.

    ClinicalTrials.gov: NCT01197950

  • 2644. Vogt, Hartmut
    et al.
    Lindström, Karolina
    Bråbäck, Lennart
    Hjern, Anders
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Preterm birth and inhaled corticosteroid use in 6- to 19-year-olds:  A Swedish national cohort study2011Inngår i: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 127, nr 6, s. 1052-1069Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Preterm birth is associated with respiratory morbidity later in life, including asthma. Previous studies have mainly focused on asthma in early childhood in children born extremely preterm. In this study, we examined the risk of asthma in a national cohort of schoolchildren grouped according to degree of immaturity expressed as completed gestational weeks at birth.

    METHODS: This was a register study in a Swedish national cohort of 1 100 826 children 6 to 19 years old. Retrieval of at least 1 prescription of inhaled corticosteroids (ICS) during 2006 was used as the main indicator for asthma. Logistic regression was used to test hypotheses, with adjustment for multiple socioeconomic and perinatal indicators.

    RESULTS: Degree of immaturity, expressed as completed gestational weeks at birth, had an inverse dose-response relationship with ICS use. Compared with children born between 39 and 41 weeks' gestation, the odds ratio for ICS use increased with the degree of prematurity, from 1.10 (95% confidence interval: 1.08–1.13) for children born in weeks 37 to 38, to 2.28 (95% confidence interval: 1.96–2.64) for children born in weeks 23 to 28, after adjustment for confounders. The increase in ICS use with decreasing gestational age at delivery was similar in boys and girls, and declined with older age.

    CONCLUSION: Preterm birth increased the risk of ICS use in these 6- to 19-year-olds by degree of immaturity, from extremely preterm to early term birth.

  • 2645.
    von Heideken Wågert, Petra
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Editorial2014Inngår i: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, nr 4, s. 193-193Artikkel i tidsskrift (Annet vitenskapelig)
  • 2646.
    von Heideken Wågert, Petra
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Beteendeförändring hos individ och i organisation2012Inngår i: Äldres hälsa: Ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik, Lund: Studentlitteratur AB, 2012, s. 63-77Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 2647.
    von Holst, Hans
    et al.
    KTH, Skolan för teknik och hälsa (STH), Medicinsk teknik, Neuronik. Section of Neurosurgery, Division of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden .
    Li, Xiaogai
    Higher impact energy in traumatic brain injury interferes with noncovalent and covalent bonds resulting in cytotoxic brain tissue edema as measured with computational simulation2015Inngår i: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 157, nr 4, s. 639-648Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Cytotoxic brain tissue edema is a complicated secondary consequence of ischemic injury following cerebral diseases such as traumatic brain injury and stroke. To some extent the pathophysiological mechanisms are known, but far from completely. In this study, a hypothesis is proposed in which protein unfolding and perturbation of nucleotide structures participate in the development of cytotoxic edema following traumatic brain injury (TBI). An advanced computational simulation model of the human head was used to simulate TBI. The consequences of kinetic energy transfer following an external dynamic impact were analyzed including the intracranial pressure (ICP), strain level, and their potential influences on the noncovalent and covalent bonds in folded protein structures. The result shows that although most of the transferred kinetic energy is absorbed in the skin and three bone layers, there is a substantial amount of energy reaching the gray and white matter. The kinetic energy from an external dynamic impact has the theoretical potential to interfere not only with noncovalent but also covalent bonds when high enough. The induced mechanical strain and pressure may further interfere with the proteins, which accumulate water molecules into the interior of the hydrophobic structures of unfolded proteins. Simultaneously, the noncovalent energy-rich bonds in nucleotide adenosine-triphosphates may be perturbed as well. Based on the analysis of the numerical simulation data, the kinetic energy from an external dynamic impact has the theoretical potential to interfere not only with noncovalent, but also with covalent bonds when high enough. The subsequent attraction of increased water molecules into the unfolded protein structures and disruption of adenosine-triphosphate bonds could to some extent explain the etiology to cytotoxic edema.

  • 2648.
    von Knorring, Anne-Liis
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Psykisk ohälsa hos barn och ungdomar2012 (oppl. 1:1)Bok (Annet (populærvitenskap, debatt, mm))
  • 2649.
    von Krusenstierna, Charlotte
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Sterner, Linda
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Coachernas arbetsmetod mot unga i utanförskap, på ett Navigatorcentrum2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 2650.
    von Mentzer, Cecilia Nakeva
    et al.
    Uppsala Univ, Sweden.
    Sundstrom, Martina
    Uppsala Univ, Sweden.
    Enqvist, Karin
    Uppsala Univ, Sweden.
    Hällgren, Mathias
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Assessing speech perception in Swedish school-aged children: preliminary data on the Listen-Say test2018Inngår i: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 43, nr 3, s. 106-119Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    To meet the need for a linguistic speech perception test in Swedish, the Listen-Say test was developed. Minimal word pairs were used as speech material to assess seven phonetic contrasts in two auditory backgrounds. In the present study, childrens speech discrimination skills in quiet and in four-talker (4T) speech background were examined. Associations with lexical-access skills and academic achievement were explored. The study included 27 school children 7-9 years of age. Overall, the children discriminated phonetic contrasts well in both conditions (quiet: Mdn 95%; 4T speech; Mdn 91% correct). A significant effect of 4T speech background was evident in three of the contrasts, connected to place of articulation, voicing and syllable complexity. Reaction times for correctly identified target words were significantly longer in the quiet condition, possibly reflecting a need for further balancing of the test order. Overall speech discrimination accuracy was moderately to highly correlated with lexical-access ability. Children identified as having high concentration ability by their teacher had the highest speech discrimination scores in both conditions followed by children identified as having high reading ability. The first wave of data collection with the Listen-Say test indicates that the test appears to be sensitive to predicted perceptual difficulties of phonetic contrasts particularly in noise. The clinical benefit of using a procedure where speech discrimination, lexical-access ability and academic achievement are taken into account is discussed as well as issues for further test refinement.

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