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  • 2601. Zarkada, Georgia
    et al.
    Heinolainen, Krista
    Mäkinen, Taija
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för immunologi, genetik och patologi, Vaskulärbiologi.
    Kubota, Yoshiaki
    Alitalo, Kari
    VEGFR3 does not sustain retinal angiogenesis without VEGFR22015Inngår i: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 112, nr 3, s. 761-766Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Angiogenesis, the formation of new blood vessels, is regulated by vascular endothelial growth factors (VEGFs) and their receptors (VEGFRs). VEGFR2 is abundant in the tip cells of angiogenic sprouts, where VEGF/VEGFR2 functions upstream of the delta-like ligand 4 (DLL4)/Notch signal transduction pathway. VEGFR3 is expressed in all endothelia and is indispensable for angiogenesis during early embryonic development. In adults, VEGFR3 is expressed in angiogenic blood vessels and some fenestrated endothelia. VEGFR3 is abundant in endothelial tip cells, where it activates Notch signaling, facilitating the conversion of tip cells to stalk cells during the stabilization of vascular branches. Subsequently, Notch activation suppresses VEGFR3 expression in a negative feedback loop. Here we used conditional deletions and a Notch pathway inhibitor to investigate the cross-talk between VEGFR2, VEGFR3, and Notch in vivo. We show that postnatal angiogenesis requires VEGFR2 signaling also in the absence of Notch or VEGFR3, and that even small amounts of VEGFR2 are able to sustain angiogenesis to some extent. We found that VEGFR2 is required independently of VEGFR3 for endothelial DLL4 up-regulation and angiogenic sprouting, and for VEGFR3 functions in angiogenesis. In contrast, VEGFR2 deletion had no effect, whereas VEGFR3 was essential for postnatal lymphangiogenesis, and even for lymphatic vessel maintenance in adult skin. Knowledge of these interactions and the signaling functions of VEGFRs in blood vessels and lymphatic vessels is essential for the therapeutic manipulation of the vascular system, especially when considering multitargeted antiangiogenic treatments.

  • 2602.
    Zebari, Akhtiar
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Modernization of drug distribution in Kurdistan: Is it possible to implement the Swedish drug distribution system in Kurdistan?2013Independent thesis Advanced level (degree of Master (Two Years)), 20 poäng / 30 hpOppgave
  • 2603.
    Zejnilovic, Nermina
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Stratum corneums betydelse för upptag och verkan av mediciner och kosmetiska preparat2013Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 2604. Zhang, Wei
    et al.
    Dourado, Daniel F. A. R.
    Fernandes, Pedro Alexandrino
    Ramos, Maria Joao
    Mannervik, Bengt
    Stockholms universitet, Naturvetenskapliga fakulteten, Institutionen för neurokemi.
    Multidimensional epistasis and fitness landscapes in enzyme evolution2012Inngår i: Biochemical Journal, ISSN 0264-6021, E-ISSN 1470-8728, Vol. 445, s. 39-46Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The conventional analysis of enzyme evolution is to regard one single salient feature as a measure of fitness, expressed in a milieu exposing the possible selective advantage at a given time and location. Given that a single protein may serve more than one function, fitness should be assessed in several dimensions. In the present study we have explored individual mutational steps leading to a triple-point-mutated human GST (glutathione transferase) A2-2 displaying enhanced activity with azathioprine. A total of eight alternative substrates were used to monitor the diverse evolutionary trajectories. The epistatic effects of the imitations on catalytic activity were variable in sign and magnitude and depended on the substrate used, showing that epistasis is a multidimensional quality. Evidently, the multidimensional fitness landscape can lead to alternative trajectories resulting in enzymes optimized for features other than the selectable markers relevant at the origin of the evolutionary process. In this manner the evolutionary response is robust and can adapt to changing environmental conditions.

  • 2605. Zhong, Yaqin
    et al.
    Schön, Pär
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI). Karolinska Institutet, Sweden.
    Burström, Bo
    Burström, Kristina
    Association between social capital and health-related quality of life among left behind and not left behind older people in rural China2017Inngår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, artikkel-id 287Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The association between social capital and health-related quality of life (HRQoL) has not been thoroughly studied among older persons in rural China, especially among those who were left behind or not. This study investigates the association between social capital and HRQoL and examines possible differences of this association between being left behind or not in rural China.

    Methods: A cross-sectional survey of 825 people aged 60 years and older, residing in three rural counties in Jiangsu Province in China, was conducted in 2013. Factor analysis was performed to measure social capital. EQ-5D was used to measure HRQoL. Tobit regression analysis with upper censoring was conducted to explore the association between social capital and EQ-5D index.

    Results: After controlling for individual characteristics, low social capital and being left behind were significantly associated with low HRQoL. Old people with low social capital had 0.055 lower EQ-5D index compared to those with high social capital. Old people being left behind had 0.040 lower EQ-5D index compared to those who were not left behind. For different dimensions of social capital, the main effects came from the domain of trust and reciprocity. There was a significant interaction between low social capital and being left behind on HRQoL, suggesting that low social capital was associated with low HRQoL among persons left behind.

    Conclusions: Our findings indicate that the left behind old people with low social capital were a potentially vulnerable group in rural China. Formulating and implementing initiatives and strategies which increase social capital may foster better HRQoL, especially for old people who were left behind.

  • 2606.
    Zilg, B.
    et al.
    Karolinska Institute, Sweden.
    Alkass, K.
    Karolinska Institute, Sweden.
    Berg, Sören
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Druid, H.
    Karolinska Institute, Sweden.
    Interpretation of postmortem vitreous concentrations of sodium and chloride2016Inngår i: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 263, s. 107-113Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Vitreous fluid can be used to analyze sodium and chloride levels in deceased persons, but it remains unclear to what extent such results can be used to diagnose antemortem sodium or chloride imbalances. In this study we present vitreous sodium and chloride levels from more than 3000 cases. We show that vitreous sodium and chloride levels both decrease with approximately 2.2 mmol/L per day after death. Since potassium is a well-established marker for postmortem interval (PMI) and easily can be analyzed along with sodium and chloride, we have correlated sodium and chloride levels with the potassium levels and present postmortem reference ranges relative the potassium levels. We found that virtually all cases outside the reference range show signs of antemortem hypo- or hypernatremia. Vitreous sodium or chloride levels can be the only means to diagnose cases of water or salt intoxication, beer potomania or dehydration. We further show that postmortem vitreous sodium and chloride strongly correlate and in practice can be used interchangeably if analysis of one of the ions fails. It has been suggested that vitreous sodium and chloride levels can be used to diagnose drowning or to distinguish saltwater from freshwater drowning. Our results show that in cases of freshwater drowning, vitreous sodium levels are decreased, but that this mainly is an effect of postmortem diffusion between the eye and surrounding water rather than due to the drowning process, since the decrease in sodium levels correlates with immersion time. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

  • 2607. Zwoinska, Martyna K.
    et al.
    Kolm, Niclas
    Stockholms universitet, Naturvetenskapliga fakulteten, Zoologiska institutionen.
    Maklakov, Alexei A.
    Sex differences in cognitive ageing: Testing predictions derived from life-history theory in a dioecious nematode2013Inngår i: Experimental Gerontology, ISSN 0531-5565, E-ISSN 1873-6815, Vol. 48, nr 12, s. 1469-1472Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Life-history theory maintains that organisms allocate limited resources to different traits to maximize fitness. Learning ability and memory are costly and known to trade-off with longevity in invertebrates. However, since the relationship between longevity and fitness often differs between the sexes, it is likely that sexes will differentially resolve the trade-off between learning and longevity. We used an established associative learning paradigm in the dioecious nematode Caenorhabditis remanei, which is sexually dimorphic for lifespan, to study age-related learning ability in males and females. In particular, we tested the hypothesis that females (the shorter-lived sex) show higher learning ability than males early in life but senesce faster. Indeed, young females outperformed young males in learning a novel association between an odour (butanone) and food (bacteria). However, while learning ability and offspring production declined rapidly with age in females, males maintained high levels of these traits until mid-age. These results not only demonstrate sexual dimorphismin age-related learning ability but also suggest that it conforms to predictions derived from the life-history theory.

  • 2608. Äng, Björn
    Impaired neck motor function and pronounced pain-related fear in helicopter pilots with neck pain - a clinical approach2008Inngår i: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 18, nr 4, s. 538-49Artikkel i tidsskrift (Fagfellevurdert)
  • 2609. Äng, Björn
    et al.
    Harms-Ringdahl, K.
    Neck pain and related disability in helicopter pilots: A survey of prevalence and risk factors2006Inngår i: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 77, nr 7, s. 713-9Artikkel i tidsskrift (Fagfellevurdert)
  • 2610. Äng, Björn
    et al.
    Kristoffersson, M.
    Neck muscle activity in fighter pilots wearing night-vision equipment during simulated flight2013Inngår i: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, nr 2, s. 125-33Artikkel i tidsskrift (Fagfellevurdert)
  • 2611. Äng, Björn
    et al.
    Linder, J.
    Harms-Ringdahl, K.
    Neck strength and myoelectric fatigue in fighter and helicopter pilots with a history of neck pain2005Inngår i: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 76, nr 4, s. 375-80Artikkel i tidsskrift (Fagfellevurdert)
  • 2612. Äng, Björn
    et al.
    Monnier, A.
    Harms-Ringdahl, K.
    Neck/shoulder exercise for neck pain in air force helicopter pilots: a randomized controlled trial2009Inngår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 34, nr 16, s. E544-51Artikkel i tidsskrift (Fagfellevurdert)
  • 2613.
    Åberg-Holm, Charlotte Margareta
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Bemästring och livserfarenheter hos 100-åriga finlandssvenskar: - en studie av livsberättelser2017Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Studiens syfte är att ur ett livsloppsperspektiv belysa vilka bemästringsstrategier finlandssvenskar i åldern 100-103 år har använt från barndomen till ålderdomen. Fokus läggs främst på bemästring av svårigheter, men studien tar även fasta på hur man som 100-åring ser på livet idag och på framtiden.

    För studien intervjuades tre kvinnor och två män i Finland. En kvalitativ innehållsanalys användes för att tolka intervjumaterialet.

    Studiens resultat visar att de intervjuade som barn i Finland i början av 1900-talet fick bemästra genom att acceptera och vara i ödets händer. I vuxenlivet tog de däremot kontroll över sina liv och vägde ofta fördelar mot nackdelar. Idag som 100-åringar vill de behålla kontrollen trots behov av hjälp, men ser också tillbaka på och accepterar livet som helhet. Vissa strategier syns även över längre perioder i livet. Behovet av socialt stöd är en viktig aspekt, men även individens inställning till livet har stor roll.

    Resultatet visar hur viktigt det är att låta till och med 100-åringar behålla sin självbestämmanderätt för att själva kunna bemästra svårigheter.

  • 2614.
    Ådén, Emma
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Sammanställning och utvärdering av läkemedelsgenomgångar inom Västerbottens läns landsting under 20112012Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 2615.
    Ågren, Helena
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Jönköpings kommun.
    Självbestämmande och inflytande i vardagen: Äldre personers uppfattningar om självbestämmande och inflytande relaterat till rambeslut i hemtjänsten2016Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Syftet var att undersöka äldre personers uppfattningar om självbestämmande och inflytande relaterat till rambeslut i hemtjänsten. Att respektera individens rätt till självbestämmande och inflytande är grundläggande värden och förhållningssätt i svensk äldreomsorg. Rambeslut i hemtjänsten är ett salutogent arbetssätt som syftar till att i högre utsträckning stärka individens möjlighet till självbestämmande och att utöva inflytande över insatsernas utformning avseende hur och när de ska utföras. Uppsatsen tar sin utgångspunkt i den salutogena teorin.

     

    Studien genomfördes med kvalitativ metod. Åtta äldre personer deltog i semistrukturerade intervjuer. Intervjuerna bandades och transkriberades ordagrant och analyserades med kvalitativ innehållsanalys. Deltagarna ingick i ett pilotprojekt där rambeslut skulle utvecklas för att därefter införas för alla hemtjänstkunder i den aktuella kommunen.

     

    Analysen resulterade i tre kategorier som beskriver äldres uppfattningar om självbestämmande och inflytande relaterat till rambeslut i hemtjänsten. Kategorierna inkluderade 1) de äldres vaga uppfattningar om innebörden av begreppen, 2) vad de äldre tycker är viktigt att ha inflytande över och 3) att de äldre uppfattar sig ha inflytande i stunden men inte i planeringen. De äldre uttryckte bland annat att det är viktigt att ha inflytande över när man ska få sin hemtjänst, hur städningen utförs och att det finns flexibilitet utifrån dagsform. En slutsats som kan dras utifrån detta är att det som de äldre tycker är viktigt att ha självbestämmande och inflytande över stämmer väl överens med intentionerna för införandet av rambeslut. En annan slutsats är att de äldre uppfattar att de har självbestämmande och inflytande i stunden, i den faktiska vardagen, men inte i själva planeringen av insatserna. En tredje slutsats är att samtliga tre salutogena faktorer, begriplighet, hanterbarhet och meningsfullhet, är essentiella för att rambeslutets intentioner om ökat självbestämmande och inflytande ska uppnås.

  • 2616.
    Ågren, Sara
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    Elfving, Helena
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Självmedkänsla och hälsa: Psykoterapeutstudenter och legitimerade psykoterapeuter2016Independent thesis Advanced level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Självmedkänsla anses vara betydelsefull för vår fysiska och psykiska hälsa och ökar förutsättningarna för vår inre trygghet vid motgångar och svårigheter. Självmedkänsla motverkar nedstämdhet, stress och ökar förmågan till känslomässig självreglering och ger ökad kontakt med adaptiva aktiverande affekter med ökad förmåga till läkande och helande hos människan. Blivande psykoterapeuter och andra inom människovårdande yrken anses speciellt utsatta och självomsorg blir en viktig komponent. Självmedkänsla utvecklas i den trygga anknytningen och kan övas upp som vuxen, via meditation, mindfulness, affektfokuserade psykoterapier och i en trygg terapeutisk relation. Studiens syfte var att undersöka självskattad självmedkänsla och fysisk/psykisk hälsa bland psykoterapeutstudenter och göra en jämförelse med legitimerade psykoterapeuter. En enkät (Self-Compassion Scale, SF-36) som mäter självmedkänsla respektive fysisk/psykisk hälsa, distribuerades till studenterna i en klassrumssituation och till legitimerade psykoterapeuter via post. Totalt kom 33 psykoterapistudenter och 34 legitimerade psykoterapeuter att ingå i studien. Resultatet visar att psykoterapeutstudenterna, enligt självskattning, hade en signifikant bättre självmedkänsla men signifikant sämre fysisk och psykisk hälsa än de legitimerade psykoterapeuterna. Båda grupperna hade en medel nivå avseende självskattad självmedkänsla. Mindfulnessträning och meditation kan vara verktyg att stärka upp självmedkänslan och minska självkritiken.

  • 2617.
    Åhman, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Pregnancy Ultrasound Detecting Soft Markers – the Challenge of Communicating Risk Figures2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    This thesis focuses on expectant parents’ experiences and needs when soft makers are detected at mid-trimester ultrasound, resulting in an unexpected assessment of risk for fetal anomalies. The thesis also describes the prevalence of ultrasonographic fetal soft markers and the incidence of Down syndrome in a low-risk population of 10,535 pregnant women with a total of 10,710 fetuses, as well as the risk of invasive prenatal diagnostics in conjunction with the detection of soft markers. Finally, the thesis aims to explore the value of a web-based patient decision aid (DA) in facilitating informed decision making regarding routine fetal screening for anomalies and the fathers’ role in decision making regarding prenatal screening.

    A prospective observational study was conducted between 2008–2011 to investigate the prevalence of ultrasonographic fetal soft markers at second trimester screening. During this time period, 12 women and 17 men were interviewed about their experience when soft markers were detected. Based on the results of these interviews, a web-based decision aid (DA) to enhance expectant parents’ decision-making concerning fetal screening was developed and a trial initiated to test its utility. Interviews were conducted with 17 women who received access to the DA, 11 who had chosen to use the DA and six who had not used it. All interview studies were analysed using systematic text condensation (STC) developed by Malterud.

    Soft markers were detected in 5.9% of the fetuses at mid-trimester ultrasound, whereof 5.1% were isolated. All soft markers showed a positive likelihood ratio (LR+) for DS; however, the association was only statistically significant for the collapsed category ‘any marker’ (isolated, multiple or combined with anomaly), not for isolated markers. An almost 24-fold increase of invasive diagnostic testing was shown in all women, including those with a low estimated risk for aneuploidy, i.e. < 1/200 (paper III).

    The results from interviews showed that the finding of soft markers created much anxiety and indicated that both women and men lacked awareness of the potential of the ultrasound examination (papers I and II). The results also showed that the men were actively engaged in decision making not only by supporting their partners, but also considered their own values and needs regarding these issues (paper II). It was also evident that women wanted their partners to be engaged in decisions regarding fetal diagnostics (papers I and IV).

    The web-based patient DA was able to initiate a process of conscious decision making in pregnant women, as a result of their interaction with the tool. The DA allowed for clarification of women’s thoughts and priorities and helped them to understand the significance of the screening result and providing a basis for making informed decisions regarding fetal screening (paper IV).

  • 2618.
    Åhnby, Ulla
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Forskningsplattformen socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. Äldres livsvillkor och omsorg. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete.
    Henning, Cecilia
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Forskningsplattformen socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. Äldres livsvillkor och omsorg. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete.
    Future Workshop for Empowerment in Eldercare: Examples from Sweden2009Inngår i: Perspectives on Empowerment, Social Cohesion and Democracy / [ed] Cecilia Henning & Karin Renblad, Jönköping: School of Health Sciences, Jönköping University , 2009, s. 161-184Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 2619.
    Åkerberg, Maria
    et al.
    Växjö universitet, Fakulteten för humaniora och samhällsvetenskap, Institutionen för vårdvetenskap och socialt arbete.
    Thelander, Ann-Sofie
    Växjö universitet, Fakulteten för humaniora och samhällsvetenskap, Institutionen för vårdvetenskap och socialt arbete.
    Anhörigas informationsbehov inom den palliativa vården.: En litteraturstudie2006Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Den palliativa vården innefattar inte bara patienten utan i många fall också de anhöriga. Syftet med studien var att undersöka anhörigas informationsbehov inom den palliativa vården. För att besvara syftet gjordes en litteraturstudie där vetenskapliga artiklar användes. Genom databas- och manuellsökning valdes elva kvalitativa och kvantitativa artiklar ut. En innehållsanalys av artiklarna gjordes utifrån en kvalitativ ansats. Resultatet visar att anhörigas informationsbehov främst består av medicinsk-, omvårdnads- och organisationsinformation. De två viktigaste fynden när det gäller upplevelser av information var att de individuella behoven måste bejakas och att källan till informationen ansågs viktig. Resultatet visar dessutom att god information minskar ovisshet och stress hos anhöriga. Genom att få sitt informationsbehov tillfredsställt skapas förutsättningar till mental förberedelse. Författarna kan utifrån studien se att god information kan kopplas samman med välbefinnande hos anhöriga i den palliativa vården.

  • 2620. Åkerborg, Örjan
    et al.
    Lang, Andrea
    Wimo, Anders
    Sköldunger, Anders
    Fratiglioni, Laura
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Centrum för forskning om äldre och åldrande (ARC), (tills m KI).
    Gaudig, Maren
    Rosenlund, Mats
    Cost of Dementia and Its Correlation With Dependence2016Inngår i: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 28, nr 8, s. 1448-1464Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was Euro43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.

  • 2621.
    Åkerstedt, Torbjorn
    et al.
    Stockholms Universitet, Karolinska Institutet.
    Anund, Anna
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Axelsson, John
    Karolinska Institutet.
    Kecklund, Goran
    Stockholms Universitet.
    Subjective sleepiness is a sensitive indicator of insufficient sleep and impaired waking function2014Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 23, nr 3, s. 240-252Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The main consequence of insufficient sleep is sleepiness. While measures of sleep latency, continuous encephalographical/electro-oculographical (EEG/EOG) recording and performance tests are useful indicators of sleepiness in the laboratory and clinic, they are not easily implemented in large, real-life field studies. Subjective ratings of sleepiness, which are easily applied and unobtrusive, are an alternative, but whether they measure sleepiness sensitively, reliably and validly remains uncertain. This review brings together research relevant to these issues. It is focused on the Karolinska Sleepiness Scale (KSS), which is a nine-point Likert-type scale.

    The diurnal pattern of sleepiness is U-shaped, with high KSS values in the morning and late evening, and with great stability across years. KSS values increase sensitively during acute total and repeated partial sleep deprivation and night work, including night driving. The effect sizes range between 1.5 and 3. The relation to driving performance or EEG/EOG indicators of sleepiness is highly significant, strongly curvilinear and consistent across individuals. High (>6) KSS values are associated particularly with impaired driving performance and sleep intrusions in the EEG. KSS values are also increased in many clinical conditions such as sleep apnea, depression and burnout. The context has a strong influence on KSS ratings. Thus, physical activity, social interaction and light exposure will reduce KSS values by 1–2 units. In contrast, time-on-task in a monotonous context will increase KSS values by 1–2 units. In summary, subjective ratings of sleepiness as described here is as sensitive and valid an indicator of sleepiness as objective measures, and particularly suitable for field studies.

  • 2622.
    Åkerstedt, Torbjorn
    et al.
    Stockholms Universitet, Karolinska Institutet.
    Hallvig, David
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Anund, Anna
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Fors, Carina
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Schwarz, Johanna
    Stockholms Universitet.
    Kecklund, Göran
    Stockholms Universitet.
    Having to stop driving at night because of dangerous sleepiness: awareness, physiology and behaviour2013Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 22, nr 4, s. 380-388Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A large number of accidents are due to the driver falling asleep at the wheel, but details of this link have not been studied on a real road. The purpose of the present study was to describe the development of sleepiness indicators, leading to the drive being terminated prematurely by the onboard expert driving instructor because of imminent danger. Eighteen individuals participated during a day drive and a night drive on a motorway (both 90 min). Eight drivers terminated (N) prematurely (after 43 min) because of sleep-related imminent danger [according to the driving instructor or their own judgement (two cases)].

    The results showed very high sleepiness ratings (8.5 units on the Karolinska Sleepiness Scale) immediately before termination (<7 at a similar time interval for those 10 who completed the drive). Group N also showed significantly higher levels of sleep intrusions on the electroencephalography/electro-oculography (EEG/EOG) than those who completed the drive (group C). The sleep intrusions were increased in group N during the first 40 min of the night drive. During the day drive, sleep intrusions were increased significantly in group N. The night drive showed significant increases of all sleepiness indicators compared to the day drive, but also reduced speed and driving to the left in the lane. It was concluded that 44% of drivers during late-night driving became dangerously sleepy, and that this group showed higher perceived sleepiness and more sleep intrusions in the EEG/EOG.

  • 2623.
    Åkerstedt, Torbjörn
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Sömnen2012Inngår i: Hjärnan / [ed] Lars Olson och Anna Josephson, Solna: Karolinska Institutet University Press , 2012, 2, s. 145-161Kapittel i bok, del av antologi (Fagfellevurdert)
  • 2624.
    Åkerstedt, Torbjörn
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Axelsson, John
    Lekander, Mats
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Orsini, Nicola
    Kecklund, Göran
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    The daily variation in sleepiness and its relation to the preceding sleep episode - a prospective study across 42days of normal living2013Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 22, nr 3, s. 258-265Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Sleepiness is linked to accidents and reduced performance, and is usually attributed to short/poor prior sleep and sleepiness. However, while the link between reduced sleep and subsequent sleepiness is well established in laboratory experiments of sleep reduction, very little is known about the day-to-day variation of sleepiness in everyday life and its relation to the immediately preceding sleep episode. The purpose of the present study was to investigate the characteristics of this relation across 42 consecutive days. Fifty volunteers participated. Self-reports of sleep were given in the morning and recorded with actigraphy; health was rated in the evening; and sleepiness was rated at eight points during the day (on a scale of 1-9). Results from mixed-model regression analyses showed that, on average, total sleep time predicted sleepiness during the rest of the day across the 42 days, with sleepiness increasing with shorter preceding sleep (β = -0.15 units h(-1) , P < 0.001). Sleepiness also increased with earlier time of rising and lower-rated sleep quality. Days off reduced sleepiness, but was accounted for by sleep. Self-rated health improved when sleepiness was low during the same day (β = -0.36 unit unit(-1) of rated health, P < 0.001), but the two were measured simultaneously. Napping was related to high sleepiness during the same day. Actigraphy measures of sleep duration showed similar, but somewhat weaker, effects than diary measures. It was concluded that the main determinants of daytime sleepiness in a real-life day-to-day context were short sleep, poor sleep and early rising, and that days with high sleepiness ended with ratings of poorer health.

  • 2625.
    Åkerstedt, Torbjörn
    et al.
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet. Karolinska Institute, Sweden.
    Discacciati, Andrea
    Miley-Åkerstedt, Anna
    Westerlund, Hugo
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Stressforskningsinstitutet.
    Aging and the Change in Fatigue and Sleep - A Longitudinal Study Across 8 Years in Three Age Groups2018Inngår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 9, artikkel-id 234Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Fatigue is prevalent in the population and usually linked to sleep problems, and both are related to age. However, previous studies have been cross-sectional. The purpose of the present study was to investigate the trajectories of sleep and fatigue across 8 years of aging in a large group (N > 8.000) of individuals. A second purpose was to investigate whether fatigue trajectories would differ between age groups, and whether different trajectories of fatigue would be reflected in a corresponding difference in trajectories for sleep variables. Results from mixed model analyses showed that fatigue decreased across 8 years in all age groups, while sleep problems increased, non-restorative sleep decreased, weekend sleep duration decreased, and weekday sleep duration showed different patterns depending on age. Furthermore, the larger the decrease in fatigue, the larger was the increase in sleep duration across years, the lower was the increase of sleep problems, and the larger was the decrease of non-restorative sleep. The results suggest that aging has positive effects on fatigue and sleep and that these changes are linked.

  • 2626.
    Åkerstedt, Torbjörn
    et al.
    Stockholms Universitet, Karolinska Institutet.
    Ingre, Michael
    Stockholms Universitet.
    Kecklund, Göran
    Stockholms Universitet, Karolinska Institutet.
    Anund, Anna
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Sandberg, David
    Chalmers Tekniska Högskola.
    Wahde, Mattias
    Chalmers Tekniska Högskola.
    Philip, Pierre
    CNRS .
    Kronberg, Peter
    Volvo Technology.
    Reaction of sleepiness indicators to partial sleep deprivation, time of day and time on task in a driving simulator: the DROWSI project2010Inngår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 19, nr 2, s. 298-309Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Studies of driving and sleepiness indicators have mainly focused on prior sleep reduction. The present study sought to identify sleepiness indicators responsive to several potential regulators of sleepiness: sleep loss, time of day (TOD) and time on task (TOT) during simulator driving. Thirteen subjects drove a high-fidelity moving base simulator in six 1-h sessions across a 24-h period, after normal sleep duration (8 h) and after partial sleep deprivation (PSD; 4 h).

    The results showed clear main effects of TOD (night) and TOT but not for PSD, although the latter strongly interacted with TOD. The most sensitive variable was subjective sleepiness, the standard deviation of lateral position (SDLAT) and measures of eye closure [duration, speed (slow), amplitude (low)]. Measures of electroencephalography and line crossings (LCs) showed only modest responses. For most variables individual differences vastly exceeded those of the fixed effects, except for subjective sleepiness and SDLAT.

    In a multiple regression analysis, SDLAT, amplitude/peak eye-lid closing velocity and blink duration predicted subjective sleepiness bouts with a sensitivity and specificity of about 70%, but were mutually redundant. The prediction of LCs gave considerably weaker, but similar results. In summary, SDLAT and eye closure variables could be candidates for use in sleepiness-monitoring devices. However, individual differences are considerable and there is need for research on how to identify and predict individual differences in susceptibility to sleepiness.

  • 2627.
    Åkesson, Christoffer
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Bergström, Thomas
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Personcentrerad  omvårdnad relaterat till personer med demenssjukdom2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Syfte: Att beskriva personcentrerad vård utifrån vårdpersonalens perspektiv i omvårdnaden av personer som lever med demens. Metod: Litteraturöversikt med 11 vetenskapliga artiklar varav 6 stycken kvantitativa och 5 stycken kvalitativa vilka sammanställdes och ledde fram till resultatet. Resultat: Resultatet visar att i personcentrerad omvårdnad ska vårdpersonalen se människan framför sjukdomen, se personens individuella behov, önskemål och intressen. Vårdpersonalen är med och skapar meningsfulla aktiviteter efter förmåga med hjälp av personernas delaktighet eller genom ta tillvara på livshistorien. Personer som lever med demens är delaktiga i sin omvårdnad och vårdpersonalen stödjer deras självständighet. En personcentrerad miljö är anpassad efter personens unika behov med personliga tillhörigheter som gör att personen känner igen sig och därmed stärker dennes identitet.  Slutsats: Den personcentrerade omvårdnaden kan med sitt förhållningssätt öka livskvaliteten och välbefinnande för personer som lever med demens genom att se hela människan och individanpassa omvårdnaden. Andra aspekter som kan öka livskvalitén är ta tillvara personens resurser, livshistorien från individen och att vårdpersonalen kan söka information från anhöriga för att få en mer rättvis och nyanserad bild av personens intressen, smak och vad denne gillar samt inte gillar. Den personcentrerade vården betonar att meningsfulla aktiviteter och miljön spelar en viktig roll för individens upplevelse av välmående och livskvalitet. 

  • 2628.
    Ålander, Ture
    et al.
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Scandurra, Isabella
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Experiences of Healthcare Professionals to the Introduction in Sweden of a Public eHealth Service: Patients' Online Access to their Electronic Health Records2015Inngår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 216, s. 153-157Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Patients' increasing demands for medical information, the digitization of health records and the fast spread of Internet access form a basis of introducing new eHealth services. An international trend is to provide access for patients to health information of various kind. In Sweden, access by patients to their proper electronic health record (EHR) has been provided in a pilot county since November 2012. This eHealth service is controversial and criticism has arised from the clinical professions, mainly physicians. Two web surveys were conducted to discover whether the opinions of healthcare professionals differ; between staff that have had experience with patients accessing their own EHR and those who have no such expericence. Experienced nurses found the EHR more important for the patients and a better reform, compared to unexperienced nurses in the rest of the country. Similarly, physicians with their own experience had a more positive attitude compared to non-experienced physicians. The conclusion of this study is that healthcare professionals must be involved in the implementation of public eHealth services such as EHRs and that real experiences of the professionals should be better disseminated to their inexperienced peers.

  • 2629.
    Ålander, Åsa
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    En Kvalitativ studie om hemtjänstpersonalens upplevelser i Vanguardmetoden.: - I jämförelse med tidigare arbetssätt.2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 2630.
    Åmodt, Kristine
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Illegal handel av legemidler på internettUtviklingen i Norge og tollvesenets analysemetoder2014Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 2631.
    Årneby, Henrik
    Högskolan i Halmstad, Sektionen för ekonomi och teknik (SET), Bio- och miljösystemforskning (BLESS).
    The acute effect of a foam rolling and a dynamic stretch warm-up routine on jumping performance2014Independent thesis Advanced level (degree of Master (One Year)), 20 poäng / 30 hpOppgave
    Abstract [en]

    Background: Self-myofascial release is widely used by athletes but the scientific evidence of its supposedly positive effects is limited. This study was conducted to investigate the effects of foam rolling as a warm-up routine in comparison with a dynamic stretching routine and how it may affect the jumping performance among subjects familiar with weight training. Aim: The aim of this study was to investigate the acute effect of foam rolling vs. a standardized dynamic stretch warm-up routine on jumping performance. Method: Twelve subjects, mean (SD) age 25.1 (± 3.0) years, participated in a randomized, controlled, crossover study. All subjects completed a standardized foam rolling (FR) and a dynamic stretch (DS) warm-up routine on separate days of testing. Squat jump (SJ), counter movement jump (CMJ) and loaded counter movement jump (L-CMJ) all performed bilaterally and unilaterally were conducted to investigate the acute effect of the two warm-up routines. A dependent T-test was used to investigate differences between the warm-up routines. Results: A statistical significant difference in favor of the DS was found for SJ performed bilaterally among males (p = 0.009). The mean (SD) jumping height for SJ FR was 35.6 (± 4.7) cm and for SJ DS 37.9 (± 5.2) cm. The male group also improved more in L-CMJ performed on the right leg with an external load of 54kg after DS compared to FR. No other statistical significant differences were found between the two interventions. A near statistical significant difference was found for SJ performed bilaterally for the total sample (p = 0.057) also in favor of the DS. The mean (SD) jumping height for SJ FR was 29.3 (± 8.7) cm and for SJ DS 30.5 (± 9.9) cm. Conclusion: Findings from this study supports a dynamic stretch warm-up routine prior to performing high intensity bilateral plyometrics instead of a foam rolling warm-up routine. However the data was inconsistent and more research with larger sample sizes is needed to further investigate the possible effects of foam rolling as a warm-up routine on jumping performance performed both bilaterally and unilaterally.

  • 2632.
    Åsgård, Rikard
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Haghdoost, Siamak
    Stockholm University.
    Osterman Golkar, Siv
    Stockholm University.
    Hellman, Björn
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaceutisk biovetenskap.
    Czene, Stefan
    Stockholm University.
    Evidence for different mechanisms of action behind the mutagenic effects of 4-NOPD and OPD: the role of DNA damage, oxidative stress and an imbalanced nucleotide pool2013Inngår i: Mutagenesis, ISSN 0267-8357, E-ISSN 1464-3804, Vol. 28, nr 6, s. 637-644Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The mutagenicity of 4-nitro-o-phenylenediamine (4-NOPD) and o-phenylenediamine (OPD) was compared using the Mouse Lymphoma Assay (MLA) with or without metabolic activation (S9). As expected, OPD was found to be a more potent mutagen than 4-NOPD. To evaluate possible mechanisms behind their mutagenic effects, the following end points were also monitored in cells that had been exposed to similar concentrations of the compounds as in the MLA: general DNA damage (using a standard protocol for the Comet assay); oxidative DNA damage (using a modified procedure for the Comet assay in combination with the enzyme hOGG1); reactive oxygen species (ROS; using the CM-H(2)DCFDA assay); and the balance of the nucleotide pool (measured after conversion to the corresponding nucleosides dC, dT, dG and dA using high-performance liquid chromatography). Both compounds increased the level of general DNA damage. Again, OPD was found to be more potent than 4-NOPD (which only increased the level of general DNA damage in the presence of S9). Although less obvious for OPD, both compounds increased the level of oxidative DNA damage. However, an increase in intracellular ROS was only observed in cells exposed to 4-NOPD, both with and without S9 (which in itself induced oxidative stress). Both compounds decreased the concentrations of dA, dT and dC. A striking effect of OPD was the sharp reduction of dA observed already at very low concentration, both with and without S9 (which in itself affected the precursor pool). Taken together, our results indicate that indirect effects on DNA, possibly related to an unbalanced nucleotide pool, mediate the mutagenicity and DNA-damaging effects of 4-NOPD and OPD to a large extent. Although induction of intracellular oxidative stress seems to be a possible mechanism behind the genotoxicity of 4-NOPD, this pathway seems to be of less importance for the more potent mutagen OPD.

  • 2633.
    Åstrand, Elaine
    University of Melbourne, Melbourne, VIC, Australia.
    Mapping retinal degeneration and loss-of-function in Rd-FTL mice2009Inngår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 50, nr 12, s. 5955-5964Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE. Retinitis pigmentosa (RP) is a blinding disease caused by the degeneration of photoreceptors. To further understand the process of degeneration in RP, the authors have traced activation patterns associated with rod and cone photoreceptor degeneration in a mouse model of RP METHODS. The authors used a double-mutant mouse, Rd-FTL, which contains a natural mutation, rd1, affecting the rod photoreceptors and an axon-targeted beta-galactosidase reporter system, which is under the regulation of the promoter of the c-fos gene. These mice allowed the authors to trace degeneration-related activity that corresponded to rod and cone death RESULTS. The authors traced cell death-associated activation in both rods and cones, allowing them to accurately determine the time course of cone degeneration in these mice. In the analysis of downstream activation patterns in the inner retina, they found that amacrine and ganglion cells maintain their photopic light-related activation until at least the initiation of cone degeneration. These cell populations then show increased activity during the peak time of cone cell degeneration. The authors also examined light-regulated functional activation of a subclass of amacrine cells, the dopaminergic amacrine cells. These cells showed light-induced functional activation after rod photoreceptor death and until the period of cone photoreceptor death, suggesting that they can be regulated by cone photoreceptors alone CONCLUSIONS. These findings have helped to accurately trace the periods of photoreceptor degeneration in this model of RP and show that correct light-regulated inner retinal activation is maintained until the time of cone degeneration. (Invest Ophthalmol Vis Sci. 2009;50:5955-5964) DOI: 10.1167/iovs.09-3916

  • 2634.
    Åstrand, Elaine
    et al.
    Université Claude Bernard Lyon, France .
    Enel, P.
    Université Claude Bernard Lyon, France .
    Ibos, G.
    Université Claude Bernard Lyon, France .
    Dominey, P.F.
    Université Claude Bernard Lyon, France .
    Baraduc, P.
    Université Claude Bernard Lyon, France .
    Hamed, S.B
    Université Claude Bernard Lyon, France .
    Comparison of Classifiers for Decoding Sensory and Cognitive Information from Prefrontal Neuronal Populations.2014Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, nr 1, s. 1-14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Decoding neuronal information is important in neuroscience, both as a basic means to understand how neuronal activity is related to cerebral function and as a processing stage in driving neuroprosthetic effectors. Here, we compare the readout performance of six commonly usedclassifiers at decoding two different variables encoded by the spiking activity of the non-human primate frontal eye fields (FEF): the spatial position of a visual cue, and the instructed orientation of the animal's attention. While the first variable is exogenously driven by the environment, the second variable corresponds to the interpretation of the instruction conveyed by the cue; it is endogenously driven and corresponds to the output of internalcognitive operations performed on the visual attributes of the cue. These two variables were decoded using either a regularized optimal linear estimator in its explicit formulation, an optimal linear artificial neural network estimator, a non-linear artificial neural network estimator, a non-linear naïve Bayesian estimator, a non-linear Reservoir recurrent network classifier or a non-linear Support Vector Machine classifier. Our results suggest that endogenous information such as the orientation of attention can be decoded from the FEF with the same accuracy as exogenous visualinformation. All classifiers did not behave equally in the face of population size and heterogeneity, the available training and testing trials, the subject's behavior and the temporal structure of the variable of interest. In most situations, the regularized optimal linear estimator and the non-linear Support Vector Machine classifiers outperformed the other tested decoders.

  • 2635.
    Åstrand, Elaine
    et al.
    Université Claude Bernard Lyon, France .
    Ibos, Guilhem
    Université Claude Bernard Lyon, France .
    Duhamel, Jean-René
    Université Claude Bernard Lyon, France .
    Hamed, S.B
    Université Claude Bernard Lyon, France .
    Differential dynamics of spatial attention, position, and color coding within the parietofrontal network2015Inngår i: Journal of Neuroscience, ISSN 0270-6474, E-ISSN 1529-2401, Vol. 35, nr 7, s. 3174-3189Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Despite an ever growing knowledge on howparietal and prefrontal neurons encode low-level spatial and color information or higher-level information, such as spatial attention, an understanding of how these cortical regions process neuronal information at the population level is still missing. A simple assumption would be that the function and temporal response profiles of these neuronal populations match that of its constituting individual cells. However, several recent studies suggest that this is not necessarily the case and that the single-cell approach overlooks dynamic changes in how information is distributed over the neuronal population. Here, we use a time-resolved population pattern analysis to explore how spatialposition, spatial attention and color information are differentially encoded and maintained in the macaque monkey prefrontal (frontal eye fields) and parietal cortex (lateral intraparietal area). Overall, our work brings about three novel observations. First, we show that parietal and prefrontal populations operate in two distinct population regimens for the encoding of sensory and cognitive information: a stationary mode and a dynamic mode. Second, we show that the temporal dynamics of a heterogeneous neuronal population brings about complementary information to that of its functional subpopulations. Thus, both need to be investigated in parallel. Last, we show that identifying the neuronal configuration in which a neuronal population encodes given information can serve to reveal this same information in a different context. All together, this work challenges common views on neural coding in the parietofrontal network. 

  • 2636.
    Åstrand, Elaine
    et al.
    University of Lyon, France.
    Wardak, C.
    University of Lyon, France.
    Hamed, S.B.
    University of Lyon, France.
    Selective visual attention to drive cognitive brain-machine interfaces: from concepts to neurofeedback and rehabilitation applications2014Inngår i: Frontiers in Systems Neuroscience, ISSN 1662-5137, E-ISSN 1662-5137, Vol. 8, nr 144, s. 144-160Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Brain-machine interfaces (BMIs) using motor cortical activity to drive an external effector like a screen cursor or a robotic arm have seen enormous success and proven their great rehabilitation potential. An emerging parallel effort is now directed to BMIs controlled by endogenouscognitive activity, also called cognitive BMIs. While more challenging, this approach opens new dimensions to the rehabilitation of cognitivedisorders. In the present work, we focus on BMIs driven by visuospatial attention signals and we provide a critical review of these studies in the light of the accumulated knowledge about the psychophysics, anatomy, and neurophysiology of visual spatial attention. Importantly, we provide a unique comparative overview of the several studies, ranging from non-invasive to invasive human and non-human primates studies, that decodeattention-related information from ongoing neuronal activity. We discuss these studies in the light of the challenges attention-driven cognitive BMIs have to face. In a second part of the review, we discuss past and current attention-based neurofeedback studies, describing both the covert effects of neurofeedback onto neuronal activity and its overt behavioral effects. Importantly, we compare neurofeedback studies based on the amplitude of cortical activity to studies based on the enhancement of cortical information content. Last, we discuss several lines of future research and applications for attention-driven cognitive brain-computer interfaces (BCIs), including the rehabilitation of cognitive deficits, restored communication in locked in patients, and open-field applications for enhanced cognition in normal subjects. The core motivation of this work is the key idea that the improvement of current cognitive BMIs for therapeutic and open field applications needs to be grounded in a proper interdisciplinary understanding of the physiology of the cognitive function of interest, be it spatial attention, working memory or any other cognitive signal.

  • 2637.
    Åström, Helena
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Liposomalt vinkristin: Ett etablerat cytostatikum i ny beredningsform2013Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
  • 2638.
    Öberg, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    A multicentre study evaluating the effects of the Swedish ACE programme2017Inngår i: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, nr 11, s. 876-886Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: This study investigated the effects of a modified Swedish version of an interactive group education programme, the Active Communication Education (ACE) programme, in five Swedish regions. This study also explored whether the pre- and post-programme outcomes differed with regard to region, age, gender, hearing loss (HL) or the attendance of significant others (SOs). Design: An intervention study with between- and within-group measurements was applied. Study sample: Seventy-seven individuals with hearing impairments and a mean age of 73.9 years (SD = 9.8) from five different regions in Sweden participated in this study. Results: Statistically significant short- and long-term effects on communication strategy use, activity and participation were observed. The ACE programme was most effective for older individuals, women and participants with more severe HL. Individuals who attended with an SO tended to use better communication strategies. No regional differences were observed. The qualitative results indicated that the programme increased individuals ability to cope and restored their social identities. Conclusions: The ACE programme is effective, is recommended for implementation in clinical settings and is considered an alternative or additional treatment to hearing aid rehabilitation. Additional studies that include younger individuals and a control group are recommended.

  • 2639.
    Öberg, Marie
    Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Amulticenter study evaluating the effects of the Swedish ACE programme2017Konferansepaper (Annet vitenskapelig)
  • 2640.
    Öberg, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Nationell utvärdering av Aktiv Kommunikation2017Konferansepaper (Annet vitenskapelig)
  • 2641.
    Öberg, Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US. Linköpings universitet, Medicinska fakulteten.
    Arlinger, Stig
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Nordqvist, Peter
    3. Dept. of Speech, Music and Hearing School of Computer Science and Communication KTH - Royal Institute of.
    Swedish quality register of hearing aid rehabilitation – Results from a large data set2016Inngår i: Swedish quality register of hearing aid rehabilitation – Results from a large data set, 2016Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Abstract:

    Purpose

    The aim of the study is to present normative data of hearing aid rehabilitation for a Swedish population with regard to gender, age, return

    clients/first time user and bilateral/unilateral hearing aid use.

    Method

    Questionnaires with 19 items were sent by mail to clients 3-6 months after completed hearing aid rehabilitation. In addition to the seven IOI-HA

    items there were five items concerning satisfaction with reception, information and participation and seven items concerning functionality with the

    hearing aids.

    Results

    Approximately 60 000 hearing aid users returned the questionnaire during the period 2011-2014 (response rate 52.5%). Differences were found

    with regard to hearing aid experiences, gender and unilateral versus bilateral hearing aid fitting. Women compared to men and bilaterally fitted

    compared to unilaterally fitted, reported significantly higher scores for all seven items in IOI-HA. The largest differences in mean score were found

    for the item hearing aid use between experienced and first-time user where experienced users used the aids more. No correlation was found

    between mean IOI-HA score and average hearing threshold level.

    Conclusion

    When evaluating hearing aid rehabilitation differences between groups need to be considered.

  • 2642.
    Öberg, Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Elisabet, Sundewall Thorén
    Eriksholm Reserach Centre, Denmark.
    Hagejärd, Lena
    Avdelningen för logopedi, foniatri och audiologi, Lunds universitet, Lund Sverige.
    Teodorescu, Ina
    Avdelningen för logopedi, foniatri och audiologi, Lunds universitet, Lund Sverige.
    Online Individualized Active Communication Education- a Swedish pilot study2015Konferansepaper (Annet vitenskapelig)
  • 2643.
    Öberg, Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US. Linköpings universitet, Medicinska fakulteten.
    Elisabet, Sundewall Thorén
    Eriksholm Reserach Centre, Denmark.
    Teodorescu, Ina
    Logopedics, Phoniatrics and Audiology, Clinical Sciences Lund University, Sweden.
    Hagejärd, Lena
    Logopedics, Phoniatrics and Audiology, Clinical Sciences Lund University, Sweden.
    Online Individualized Active Communication Education- -a Swedish pilot study2015Inngår i: Online Individualized Active Communication Education- -a Swedish pilot study, 2015Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction

    The group rehabilitation program Active Communication Education program (ACE), has been translated and evaluated in two Swedish studies. Statistically significant effects were found for activity and participation and communication strategies. The qualitative analyze showed that the participants found the structure and the content of the program to be beneficial and “learning from the group” was found to be the most pronounced advantage of the program. All individuals do not want to or do not have the possibility to participate in group activities and therefore are individual education programs requested. Could an individual educational program, administered via the internet, be beneficial even without the possibility to learn from the peers in a group? The aim with this study was to translate and, in a pilot study, evaluate the Individual Active Communication Education program (I-ACE) for a Swedish population.

    Method                                                                                                                                                                      

    The originally I-ACE program, developed in Australian, was translated and mixed with contents from the Swedish ACE program to a five week, online education program. Participants were recruited by advertisements in hearing health care centers and at social medium forums. Twenty-four individuals participated and received I-ACE material by mail every week. The effects were evaluated with standardized questionnaires and open ended items.

    Result

    Statistically significant effects were found for activity and participation and for communication strategies. The qualitative analyze showed that the participants were satisfied with the content of the program. Learning about communication strategies and own reflections about the hearing problems were the most pronounced advantages.

    Conclusion

    The Swedish version of the I-ACE with material administered by mail worked well and was found to increase participants’ activity and participation and communication strategies. Further research, including a control group, is needed to draw conclusions about the effectiveness of the I-ACE program.

  • 2644.
    Öberg, Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Ingo, Elisabet
    Linköpings universitet, Institutionen för beteendevetenskap och lärande.
    On-line supportsystem för audionomer och förstagångsbrukare2017Konferansepaper (Annet vitenskapelig)
  • 2645.
    Öberg, Marie
    et al.
    Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US. Linköpings universitet, Medicinska fakulteten.
    Ingo, Elisabet
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    On-line supportsystem för audionomer och förstagångsbrukare2017Konferansepaper (Annet vitenskapelig)
  • 2646.
    Öberg, Marie
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Wänström, Gunilla
    Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Lunner, Thomas
    Eriksholm Research Centre, Denmark.
    Behandlingsprocessens betydelse vid hörapparatanpassning2015Konferansepaper (Annet vitenskapelig)
  • 2647.
    Öberg, Peter
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete. Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Bildtgård, Torbjörn
    Social Work, Stockholm University.
    The impact of new intimate relationships in later life on life satisfaction2013Inngår i: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 53, nr Supplement 1, s. 61-61Artikkel i tidsskrift (Annet vitenskapelig)
  • 2648.
    Öhlen, Joakim
    Ersta Sköndal högskola, Palliativt forskningscentrum, PFC.
    Do inequalities in end of life care matter?2014Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, nr 2, s. 105-107Artikkel i tidsskrift (Fagfellevurdert)
  • 2649.
    Öhlen, Joakim
    et al.
    Ersta Sköndal högskola, Palliativt forskningscentrum, PFC.
    Ekman, Inger
    Zingmark, Karin
    Bolmsjö, Ingrid
    Benzein, Eva
    Conceptual development of "at-homeness" despite illness and disease: a review.2014Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, s. 23677-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness." The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness" was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness" are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.

  • 2650.
    Öhlund, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rättsmedicin.
    Otillräknelig, psykiskt störd eller både och?2012Student paper other, 5 poäng / 7,5 hpOppgave
    Abstract [sv]

    Vård kontra fängelse. Frågan om hur man bör se på straffansvar och påföljd för personer som begår brott under inflytande av en allvarlig psykisk störning är en omdebatterad och dessutom en mycket känslig fråga. Hur ska man bedöma och bestraffa de personer som inte kan hållas till ansvar för sina handlingar?

    Det är allmänt accepterat att personer som inte kan ta ansvar för sig själv eller sina handlingar inte ska dömas enligt samma straffrättsliga principer som människor med full psykisk förmåga. I det svenska rättssystemet har denna uppfattning rättfärdigat principen om fängelseförbud för personer med en allvarlig psykisk sjukdom. Det svenska rättssystemet kunde tidigare döma en person till straffrättsligt ansvar men utan påföljd. Efter en lagändring 2008[1] har domstolarna numera möjligheten att döma en person som begått ett brott under påverkan av en allvarlig psykisk störning till fängelse om det finns synnerliga skäl.

    Presumtionen för att annan påföljd än fängelse ska användas gäller endast för allvarligt psykiskt störda lagöverträdare. Det räcker således inte med att den tilltalade bedöms som psykiskt störd utan måste bedömas som allvarligt psykiskt störd för att få straffrättslig särbehandling. Den psykiska bedömningen får därför en stor inverkan på påföljdsvalet och kan resultera i skillnaden mellan långvarig vård eller livstids fängelse. Klassificeringen av det psykiska tillståndet är därmed helt avgörande för påföljdsfrågan.

    I de flesta rättsstater finns krav på tillräknelighet för att döma någon till ansvar för en brottslig gärning. Enligt denna syn kan endast de personer som kan ta ansvar kan också begå brott, en svensk rätt skulle följden bli att barn under 15 år och psykiskt sjuka inte kan begå brott och därför inte dömas till ansvar i domstol. Sverige hade ett tillräknelighetskrav fram till 1965 men numera har en gärningsmans psykiska tillstånd endast betydelse vid påföljdsbestämningen.[2]

    [1] SFS 2008:320.

    [2] Asp, s. 399-400

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