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  • 1.
    Collin, Angelica
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Hammarberg, Matilda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Röstfaktorer som avslöjar ironi: Akustiska likheter och skillnader mellan sinnesstämningar2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The word irony is defined as an utterance where the meaning is the opposite of the words. This report is a continuing study of Peder Palmér's study What is ironic speech: to find the auditory clues (2013). The basis for this follow-up study consists of recordings with three different talkers with five sentences in five different moods: happiness, anger, seriousness, irony and sarcasm. Thirty men and women aged 18 to 60 years have been listening to the sentences and categorized them based on interpreted mood. The authors have measured fundamental frequency and intensity, and used these measurements as a basis to elucidate the perception of irony and the ability to perceive mood based on changes in fundamental frequency and intensity. The fundamental frequency has also been compared between the three talkers. An acoustic comparison between the different moods forms the basis for the analysis, which can provide information about the importance of acoustic parameters, as well as other factors such as context, when identifying different moods. The aim is to examine whether the moods that are most similar from an acoustic perspective are the ones that the test subjects most often fail to distinguish. The results show that it is difficult to solely from acoustic parameters interpret mood. Fundamental frequency and intensity appear to be of some importance when confusing irony with other moods. No differences were found between men and women's ability to detect irony and sarcasm based solely on acoustic parameters.

  • 2.
    Larsson, Lina
    Linköping University, Department of Science and Technology. Linköping University, The Institute of Technology.
    Kliniskt datainsamlingssystem med beslutsstöd - Användarutredning och gränssnitt för Sahlgrenskas akutintag2005Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

     Extra high requirements are made on all systems in health care that they are functional and usable,´something, however, that is not always the case. At Emergency Admissions at Sahlgrenska University´Hospital many systems are in use at the same time and it happens that much overhead is caused by having to fill in the same information in different places. In addition, data that is gathered is to a large extent saved in free text format, which means that it cannot be used in a larger context such as research, quality control or for decision support. Data is saved in the patient file only for the treatment process of the individual patient.

    A data collecting system with decision support functionality could be a first step towards reducing Emergency Admissions’ costs and patients’ waiting times by providing a structured method of data collection. It is also possible that it could contribute to safer care for patients as the system could warn the staff on occasions where there may be a risk of a patient suffering from a serious, acute illness that might be difficult to diagnose.

    An analysis has been performed at Emergency Admissions at Sahlgrenska to distinguish possible users of a new system for collecting data with decision support. The results showed that the nurses in reception were the most suitable target group.

    A prototype of a user interface for gathering initial patient data at reception has been made at Emergency Admissions at Sahlgrenska. This prototype has decision support functionality for ranking the most probable diagnoses as well as providing advice on suitable tests and examinations to perform. The focus has been on usability and on adapting the system to the needs of the users.

    It is highly important that future users, the staff at Emergency Admissions, continue to participate in the future further development of the data gathering system so that their needs and requirements are not overshadowed by the new technology.

  • 3.
    Jaque, Cassandra
    et al.
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, The Institute of Technology.
    Johansson, Anders
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, The Institute of Technology.
    Kromatografi av polära läkemedel och metaboliter med HILIC-teknik2013Independent thesis Basic level (degree of Bachelor), 10,5 credits / 16 HE creditsStudent thesis
    Abstract [en]

    The purpose of this project was to investigate if retention of polar compounds that are given to treat tuberculosis, diabetes, inflammatory bowel disease and childhood leukemia could be obtained with HILIC separation. By varying different parameters for different types of columns the compounds were analyzed with the aim of finding guidelines for future method optimizations. To perform these analyzes three different columns were tested – ZIC-HILIC (silica-based with zwitterions), ZIC-pHILIC (polymer-based with zwitterions) and XBridge Amide (amide functions). The results were evaluated with selected quality measures. The parameters being varied were pH, temperature, flow rate, type of buffer and ionic strength. In addition, comparisons between isocratic and gradient separations were performed.

     

    Over 1 000 analyzes were conducted in which retention of 16 of total 18 substances were successfully obtained with HILIC. The columns that generated the best results in terms of greatest number of identified compounds were ZIC-HILIC and XBridge Amide. ZIC-pHILIC offered a wide pH range but generally gave inferior chromatography. The influence of the different parameters on the results has not been investigated in sufficient scope. This means that no specific methods for the different drug groups can be reported.

  • 4.
    Engström, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Radiology.
    Karlsson, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Landtblom, Anne-Marie
    Linköping University, Department of Clinical and Experimental Medicine, Neurology.
    Craig, A. D. (Bud)
    Atkinson Research Laboratory, Barrow Neurological Institute, Phoenix, AZ.
    Mental energy: graded co-activation of the anterior insular and anterior cingulate cortices during challenging working memory,  visual perception and motor speed tasks.Manuscript (preprint) (Other academic)
  • 5.
    Weström, Sarah
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Örneholm, Isabelle
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Interaktion och intervention: En undersökning av kommunikativa behov hos personer med afasi och dysartri i vardagliga och kliniska samtal2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In speech and language intervention, the ability to interact is seldom evaluated; rather intervention is evaluated in terms of improved testresults.  If goal-setting in intervention also is based on everyday communicative needs, the relevance of the treatment may be increased and intervention outcome may be implemented in the patient’s natural environment.

    The present study, as part of a research-project, is based on analyses of interaction and interviews to examine everyday conversations and speech and language intervention. The aim was to explore if there is a relation between everyday communication needs and goal-setting in speech and language intervention for people with aphasia. A further aim was to investigate if there are everyday communicative needs that may form goals for speech and language intervention.

    Two individuals with aphasia and one individual with both dysarhtria and aphasia participated in the study. Three speech and language pathologists and two relatives also participated in the study. Everyday interaction and intervention sessions were recorded and transcribed according to Conversation Analysis principles and analysed from an interactional perspective. Interviews regarding intervention and everyday communication were carried out with all participants. Recordings were presented and discussed with all participants, in so called retrospections.

    Four phenomena that illustrate communication needs of the participating patients were identified: repair, alternative and augmentative communication, co-construction and feedback. Analysis, interviews and retrospections have revealed that communication needs can form the basis of goal-setting in speech and language intervention. It is also demonstrated that intervention mainly is based on the everyday communication needs of the patient. Retrospections were also shown to be useful in order to observe communication needs in everyday life and in order to evaluate speech and language intervention. The retrospections were found to be beneficial to an open dialogue between speech and language pathologist, patient and relatives regarding the content and aim of the intervention.

     

  • 6.
    Andersson, Marie
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Nordin, Elin
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Voice Onset Time among Children with Phonological Impairment.2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Speech production requires cooperation between cognitive, linguistic and motor processes. It also requires spatial and temporal control of muscles, as well as simultaneous and coordinated activity of respiration, phonation and articulation (Cheng, Murdoch, Goozée & Scott, 2007; Yorkston, Beukelman, Strand & Bell, 1999; Raphael, Borden & Harris, 2011). Voice Onset Time (VOT) reflects the timing between phonation and articulation (Hoit-Dalgaard, Murry & Kopp, 1983). VOT is the most reliable acoustic cue for distinguishing between voiceless or voiced plosives (Auzou et al. 2000). Studies of English-speaking children with phonological impairment have shown atypical VOT-patterns (Bond & Wilson, 1980). The aim of the present study was to investigate Voice Onset Time (VOT) among Swedish children with phonological impairment and to examine if their VOT-values differ from typically developed Swedish children. Participants were 38 children aged 4;2−11;6 distributed over eight age- groups and five developmental stages of phonology. Audio recordings of minimal pairs were made at preschools, schools or at speech pathology clinics. The results indicated that children with phonological impairment produced VOT with deviant values and with a great variability. A marked acoustic difference between voiceless and voiced stop consonants was present, but not in all cases. Since the VOT-values were distributed over the group of children with phonological impairment, no developmental trend toward adult-like values that could be related to increasing age was found for either the acquisition of producing VOT or the acquisition of producing voicing lead. No differences in VOT were seen between the children in different phonological developmental stages or ages. No correlation between the degree of deviance of VOT and the proportion of Procent Phonemes Correct (PPC), age or phonological processes were found. From the results the conclusion can be drawn that children with phonological impairment have deviant VOT-values that could be caused by lack of phonological knowledge, but in particular since the variability did not decrease with increased age, have difficulties with motor execution. 

  • 7.
    Björck, S
    et al.
    Department of Surgery, Sahlgrenska Hospital, Gothenburg.
    Enochsson, L
    Department of Surgery, Sahlgrenska Hospital, Gothenburg.
    Svanvik, Joar
    Department of Surgery, Sahlgrenska Hospital, Gothenburg.
    Commentary: the rising tide of cholecystectomy for biliary dyskinesia2013In: Alimentary Pharmacology and Therapeutics, ISSN 0269-2813, E-ISSN 1365-2036, Vol. 37, no 4, 493-494 p.Article in journal (Other academic)
  • 8.
    Ronquist, Gunnar
    et al.
    Avdelningen för klinisk kemi, institutionen för medicinska vetenskaper, Uppsala universitet, Uppsala, Sverige.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet, Göteborg, Sverige.
    Gabrielsson, Susanne
    Enheten för translationell immunologi, medicinkliniken, Karolinska universitetssjukhuset; Karolinska institutet, Stockholm, Sverige.
    Mincheva-Nilsson, Lucia
    Avdelningen för klinisk immunologi, institutionen för klinisk mikrobiologi, Umeå universitet, Umeå, Sverige.
    Svanvik, Joar
    Transplantationscentrum Sahlgrenska universitetssjukhuset, Göteborg, Sverige.
    Telemo, Esbjörn
    Avdelningen för reumatologi och inflammationsforskning, Göteborgs universitet, Göteborg, Sverige.
    Waldenström, Anders
    Institutionen för folkhälsa och klinisk medicin, Umeå universitet, Umeå, Sverige.
    Exosomen – intercellulär signalbärare med framtids­potential [Exosomes - intercellular signal carriers with a future potential]: Kan ge nya diagnostiska och terapeutiska möjligheter [May provide new diagnostic and therapeutic opportunities]2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 46, no 110, 2050-2052 p.Article in journal (Other academic)
    Abstract [en]

    Small vesicles were first described in prostatic and seminal fluids more than 30 years ago [5]. They were called prostasomes and are members of the same family now called exosomes. All cells in the body can release extracellular vesicles that function as intercellular messengers. The smallest of these, exosomes, are produced by almost all types of cells in the body and exist in all body fluids. Exosomal signalling takes place in two different ways: either with a cargo of functional proteins and/or by transfection of functional RNA molecules from one cell to the cytoplasm of another, or by ligand-receptor mediated interactions between molecules of the exosome membrane and the cellular membrane of the target cell. The importance of exosomes both in health and disease is rapidly acknowledged and clinical applications in diagnosticts and therapy are under development. The content of proteins and nucleic acids of exosomes will soon be used as bio markers for different diseases such as cancer and cardiac disease. Clinical tests are ongoing where exosomes are used as natural vectors for cancer specific peptides in the treatment of cancer. Exosomes will most probably soon be used in therapy by using them as natural vectors for new  RNA based therapies and also for follow up of therapy.

  • 9.
    Zaigham, Mehreen
    et al.
    Department of Obstetrics and Gynecology Skåne University Hospital, Institution of Clinical Sciences, Lund University, Malmö, Sweden.
    Lundberg, Fredrik
    Department of Neonatology, Skåne University Hospital, Institution of Clinical Sciences, Lund University, Malmö, Sweden.
    Hayes, Ronald
    Banyan Biomarkers Inc., Alachua, FL, USA.
    Undén, Johan
    Department of Intensive Care and Perioperative Medicine, Skåne University Hospital, Institution of Clinical Sciences, Lund University, Malmö, Sweden.
    Olofsson, Per
    Department of Obstetrics and Gynecology Skåne University Hospital, Institution of Clinical Sciences, Lund University, Malmö, Sweden.
    Umbilical cord blood concentrations of ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) in neonates developing hypoxic-ischemic encephalopathy.2015In: The Journal of Maternal-Fetal & Neonatal Medicine, ISSN 1476-7058, E-ISSN 1476-4954, Vol. 29, no 11, 1822-1828 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) concentrations in umbilical cord blood of neonates who develop Sarnat stage II-III hypoxic-ischemic encephalopathy (HIE) to healthy controls, and to relate the concentrations to the severity of neurology and long-time outcomes.

    MATERIAL AND METHODS: Cord sera of 15 neonates with HIE II-III and 31 matched controls were analyzed for UCH-L1 and GFAP. Comparisons were performed for cord artery pH, amplitude-integrated electroencephalography (aEEG), stage of HIE, and death or sequelae up to an age of 6 years. Parametric and non-parametric statistics were used with a two-sided p < 0.05 considered significant.

    RESULTS: Among controls no associations between biomarker concentrations and gestational age, birthweight, length of storage of cord sera and degree of hemolysis were found. No significant differences in biomarker concentrations were found between HIE neonates and controls, and no differences were found with regard to HIE stage, cord acidemia, severity of aEEG changes, or persistent sequelae or death.

    CONCLUSIONS: No differences in cord blood UCH-L1 and GFAP concentrations were found between HIE neonates and controls, and no associations were found between the biomarker concentrations and the severity of disease, or whether the condition developed into a permanent or fatal injury.

  • 10.
    Kufver, Karin
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Sandra, Karlsson
    Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Premenstruellt syndrom: Symptom och coping2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Studien har undersökt symptom samt hantering av PMS genom en enkätstudie där 72 kvinnor i åldrarna 18-49 deltagit. Syftet med studien var att beskriva symptombild och kvinnors sätt att hantera PMS. Fokus riktades mot vad kvinnorna gör för att hantera upplevda symptom och vi har tittat på olika samband. Resultaten visade att de allra flesta kvinnor upplever något PMS-symptom och förekomsten är hög (98,5%) med en spridd symptombild. Mest förekommande symptom när det gäller svåra besvär var ilska/lättretlighet, gråtmildhet och fysiska symptom. Det vanligaste sättet att hantera och förhålla sig till sin PMS i vår studie är ett medvetet och accepterande förhållningssätt. Att äta sötsaker, undvika sociala aktiviteter samt träna mindre har ett signifikant negativt samband med känslan av att kunna hantera sin PMS. Studien har även belyst att ökad medvetenhet hos kvinnor kan gynna deras förmåga att hantera PMS och föreslår fortsatt forskning inom området med fokus på behandlings metoder.

  • 11.
    Neggers, Sebastian J C M M
    et al.
    Department of Endocrinology Erasmus Medical Center, Rotterdam, Netherlands et al .
    Pronin, Vyacheslav
    1Department of Endocrinology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
    Balcere, Inga
    Department of Endocrinology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
    Lee, Moon-Kyu
    Division of Endocrinology and Metabolism, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.
    Rozhinskaya, Liudmila
    Department of Neuroendocrinology and Bone Diseases, National Endocrinology Research Centre, Moscow, Russian Federation.
    Bronstein, Marcello D
    Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.
    Gadelha, Mônica R
    Endocrine Section, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
    Maisonobe, Pascal
    Boulogne-Billancourt, Ipsen, Boulogne-Billancourt, France.
    Sert, Caroline
    Boulogne-Billancourt, Ipsen, Boulogne-Billancourt, France.
    van der Lely, Aart Jan
    Department of Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands.
    Lanreotide Autogel 120 mg at extended dosing intervals in patients with acromegaly biochemically controlled with octreotide LAR: the LEAD study2015In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 173, no 3Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate extended dosing intervals (EDIs) with lanreotide Autogel 120 mg in patients with acromegaly previously biochemically controlled with octreotide LAR 10 or 20 mg.

    DESIGN AND METHODS: Patients with acromegaly had received octreotide LAR 10 or 20 mg/4 weeks for ≥ 6 months and had normal IGF1 levels. Lanreotide Autogel 120 mg was administered every 6 weeks for 24 weeks (phase 1); depending on week-24 IGF1 levels, treatment was then administered every 4, 6 or 8 weeks for a further 24 weeks (phase 2). Hormone levels, patient-reported outcomes and adverse events were assessed.

    PRIMARY ENDPOINT: proportion of patients on 6- or 8-week EDIs with normal IGF1 levels at week 48 (study end).

    RESULTS: 107/124 patients completed the study (15 withdrew from phase 1 and two from phase 2). Of 124 patients enrolled, 77.4% were allocated to 6- or 8-week EDIs in phase 2 and 75.8% (95% CI: 68.3-83.3) had normal IGF1 levels at week 48 with the EDI (primary analysis). A total of 88.7% (83.1-94.3) had normal IGF1 levels after 24 weeks with 6-weekly dosing. GH levels were ≤ 2.5 μg/l in > 90% of patients after 24 and 48 weeks. Patient preferences for lanreotide Autogel 120 mg every 4, 6 or 8 weeks over octreotide LAR every 4 weeks were high.

    CONCLUSIONS: Patients with acromegaly achieving biochemical control with octreotide LAR 10 or 20 mg/4 weeks are possible candidates for lanreotide Autogel 120 mg EDIs. EDIs are effective and well received among such patients.

  • 12.
    Strid, Linette
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Lundgren, Anna
    Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    ”Man är ju i ett tillstånd som inte går att beskriva”: att uppleva en närståendes självmord2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Målet med studien är att med kvalitativ metod undersöka efterlevandes upplevelse av en närståendes självmord. Med semi-strukturerade intervjuer har sex deltagare i Mellansverige skildrat sin upplevelse och materialet har bearbetats i enlighet med metoden Interpretative Phenomenological Analysis (IPA). Genom analysen synliggjordes tre områden nämligen 1) att uppleva en närståendes självmord, 2) att hantera en närståendes självmord och 3) att skapa mening kring en närståendes självmord. Dessa består i sin tur av ett antal teman som detaljerat beskriver varje del av den totala upplevelsen. Något som är särskilt värt att nämna är hur viktig omgivningens förståelse varit för att de efterlevande ska kunna bearbeta sitt trauma. Deltagande i stödgrupp för efterlevande har varit till hjälp samt den inre styrka som samtliga deltagare upplever sig ha anammat för att orka och utvärderat studiens begränsningar samt givit förslag på fortsatt forskning.

  • 13.
    Gheorghiade, Mihai
    et al.
    Northwestern University Feinberg School of Medicine, Chicago, USA.
    Greene, Stephen J
    Duke University Medical Center, Durham, North Carolina, USA.
    Butler, Javed
    Stony Brook University, Stony Brook, New York, USA.
    Filippatos, Gerasimos
    Athens University Hospital Attikon and Kapodistrian University of Athens, Athens, Greece.
    Lam, Carolyn S P
    National Health Center, Singapore and Duke, National University of Singapore, Singapore.
    Maggioni, Aldo P
    Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy.
    Ponikowski, Piotr
    Medical University, Wroclaw, Poland.
    Shah, Sanjiv J
    Northwestern University Feinberg School of Medicine, Chicago, USA.
    Solomon, Scott D
    Brigham and Women's Hospital Boston, Massachusetts, USA.
    Kraigher-Krainer, Elisabeth
    Charite University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany.
    Samano, Eliana T
    Bayer, Sao Paulo, Brazil.
    Müller, Katharina
    Bauer Pharma, Wuppertal, Germany.
    Roessig, Lothar
    Bauer Pharma, Wuppertal, Germany.
    Burkert, Pieske
    Charité University Medicine Berlin–Campus Virchow Klinikum and German Heart Center Berlin, Germany.
    Effect of Vericiguat, a Soluble Guanylate Cyclase Stimulator, on Natriuretic Peptide Levels in Patients With Worsening Chronic Heart Failure and Reduced Ejection Fraction: The SOCRATES-REDUCED Randomized Trial.2015In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 314, no 21, 2251-2262 p.Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: Worsening chronic heart failure (HF) is a major public health problem.

    OBJECTIVE: To determine the optimal dose and tolerability of vericiguat, a soluble guanylate cyclase stimulator, in patients with worsening chronic HF and reduced left ventricular ejection fraction (LVEF).

    DESIGN, SETTING, AND PARTICIPANTS: Dose-finding phase 2 study that randomized 456 patients across Europe, North America, and Asia between November 2013 and January 2015, with follow-up ending June 2015. Patients were clinically stable with LVEF less than 45% within 4 weeks of a worsening chronic HF event, defined as worsening signs and symptoms of congestion and elevated natriuretic peptide level requiring hospitalization or outpatient intravenous diuretic.

    INTERVENTIONS: Placebo (n = 92) or 1 of 4 daily target doses of oral vericiguat (1.25 mg [n = 91], 2.5 mg [n = 91], 5 mg [n = 91], 10 mg [n = 91]) for 12 weeks.

    MAIN OUTCOMES AND MEASURES: The primary end point was change from baseline to week 12 in log-transformed level of N-terminal pro-B-type natriuretic peptide (NT-proBNP). The primary analysis specified pooled comparison of the 3 highest-dose vericiguat groups with placebo, and secondary analysis evaluated a dose-response relationship with vericiguat and the primary end point.

    RESULTS: Overall, 351 patients (77.0%) completed treatment with the study drug with valid 12-week NT-proBNP levels and no major protocol deviation and were eligible for primary end point evaluation. In primary analysis, change in log-transformed NT-proBNP levels from baseline to week 12 was not significantly different between the pooled vericiguat group (log-transformed: baseline, 7.969; 12 weeks, 7.567; difference, -0.402; geometric means: baseline, 2890 pg/mL; 12 weeks, 1932 pg/mL) and placebo (log-transformed: baseline, 8.283; 12 weeks, 8.002; difference, -0.280; geometric means: baseline, 3955 pg/mL; 12 weeks, 2988 pg/mL) (difference of means, -0.122; 90% CI, -0.32 to 0.07; ratio of geometric means, 0.885, 90% CI, 0.73-1.08; P = .15). The exploratory secondary analysis suggested a dose-response relationship whereby higher vericiguat doses were associated with greater reductions in NT-proBNP level (P < .02). Rates of any adverse event were 77.2% and 71.4% among the placebo and 10-mg vericiguat groups, respectively.

    CONCLUSIONS AND RELEVANCE: Among patients with worsening chronic HF and reduced LVEF, compared with placebo, vericiguat did not have a statistically significant effect on change in NT-proBNP level at 12 weeks but was well-tolerated. Further clinical trials of vericiguat based on the dose-response relationship in this study are needed to determine the potential role of this drug for patients with worsening chronic HF.

    TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01951625.

  • 14.
    Galiè, Nazzareno
    et al.
    University of Bologna, Italy.
    Barberà, Joan A
    University of Barcelona and Biomedical Research Networking Center on Respiratory Diseases, Madrid, Spain.
    Frost, Adaani E
    Baylor College of Medicine, Houston, USA.
    Ghofrani, Hossein-Ardeschir
    University of Giessen and Marbury Lung Center, Giessen, Germany.
    Hoeper, Marius M
    Hanover Medical School and German Center of Lung Research, Hanover, Germany.
    McLaughlin, Vallerie V
    University of Michigan, USA.
    Peacock, Andrew J
    Regional Heart and Lung Center, Glasgow, Scotland.
    Simonneau, Gérald
    University Paris-Sud, Paris, France.
    Vachiery, Jean-Luc
    Hospital Erasme, Brussels, Belgium.
    Grünig, Ekkehard
    University Hospital Heidelberg, Heidelberg, Germany.
    Oudiz, Ronald J
    UCLA Medical Center, Torrance,USA.
    Vonk-Noordegraaf, Anton
    University Medical Center, Amsterdam, Netherlands.
    White, R James
    University of Rochester, NY, USA.
    Blair, Christiana
    Gilead Sciences, Foster City.
    Gillies, Hunter
    Gilead Sciences, Foster City.
    Miller, Karen L
    Gilead Sciences, Foster City.
    Harris, Julia H N
    GlaxoSmith Kline, Uxbridge, UK.
    Langley, Jonathan
    GlaxoSmith Kline, Uxbridge, UK.
    Rubin, Lewis J
    University of California at San Diego, USA.
    Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension2015In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 373, no 9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Data on the effect of initial combination therapy with ambrisentan and tadalafil on long-term outcomes in patients with pulmonary arterial hypertension are scarce.

    METHODS: In this event-driven, double-blind study, we randomly assigned, in a 2:1:1 ratio, participants with World Health Organization functional class II or III symptoms of pulmonary arterial hypertension who had not previously received treatment to receive initial combination therapy with 10 mg of ambrisentan plus 40 mg of tadalafil (combination-therapy group), 10 mg of ambrisentan plus placebo (ambrisentan-monotherapy group), or 40 mg of tadalafil plus placebo (tadalafil-monotherapy group), all administered once daily. The primary end point in a time-to-event analysis was the first event of clinical failure, which was defined as the first occurrence of a composite of death, hospitalization for worsening pulmonary arterial hypertension, disease progression, or unsatisfactory long-term clinical response.

    RESULTS: The primary analysis included 500 participants; 253 were assigned to the combination-therapy group, 126 to the ambrisentan-monotherapy group, and 121 to the tadalafil-monotherapy group. A primary end-point event occurred in 18%, 34%, and 28% of the participants in these groups, respectively, and in 31% of the pooled-monotherapy group (the two monotherapy groups combined). The hazard ratio for the primary end point in the combination-therapy group versus the pooled-monotherapy group was 0.50 (95% confidence interval [CI], 0.35 to 0.72; P<0.001). At week 24, the combination-therapy group had greater reductions from baseline in N-terminal pro-brain natriuretic peptide levels than did the pooled-monotherapy group (mean change, -67.2% vs. -50.4%; P<0.001), as well as a higher percentage of patients with a satisfactory clinical response (39% vs. 29%; odds ratio, 1.56 [95% CI, 1.05 to 2.32]; P=0.03) and a greater improvement in the 6-minute walk distance (median change from baseline, 48.98 m vs. 23.80 m; P<0.001). The adverse events that occurred more frequently in the combination-therapy group than in either monotherapy group included peripheral edema, headache, nasal congestion, and anemia.

    CONCLUSIONS: Among participants with pulmonary arterial hypertension who had not received previous treatment, initial combination therapy with ambrisentan and tadalafil resulted in a significantly lower risk of clinical-failure events than the risk with ambrisentan or tadalafil monotherapy. (Funded by Gilead Sciences and GlaxoSmithKline; AMBITION ClinicalTrials.gov number, NCT01178073.).

  • 15.
    Mounagurusamy, Purani
    Linköping University, Department of Computer and Information Science, Database and information techniques.
    Parsing AQL Queries into SQL Queries using ANTLR2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    An Electronic Health Record is a collection of each patient’s health information which is stored electronically or in digital format. openEHR is an open standard specification for electronic health record data. openEHR has a method for querying a set of clinical data using the Archetype Query Language (AQL). 

    The EHR data is in XML format and this format is a tree like structure. Since XML databases were considerably slower, AQL needs to be translated to another query language. Researchers have already investigated translating AQL to XQuery and tested the performance. Since the performance was not satisfactory, we now investigate translating AQL to SQL.

    AQL queries are translated to SQL queries using the ANTLR tool. The translation is implemented in Java language. The AQL queries which are translated into SQL queries are also tested in this thesis work. Finally, the result is to get the corresponding SQL query for any given AQL query.

  • 16.
    Müller-Wieland, Dirk
    et al.
    Asklepios Clinic St Georg, Hamburg, Germany .
    Assmann, Gerd
    Assmann-Foundation for Prevention, Münster, Germany.
    Carmena, Rafael
    University, Valencia, Spain .
    Davignon, Jean
    Faculty of Medicine at the Université de Montréal, Canada.
    von Eckardstein, Arnold
    University Hospital of Zurich, Switzerland.
    Farinaro, Eduardo
    Medical School University of Naples Federico II, Italy.
    Greten, Heiner
    Asklepios Clinic St Georg, Hamburg, Germany.
    Olsson, Anders G
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology. Stockholm Heart Centre, Sweden.
    Riesen, Walter F
    Institute for Laboratory Medicine, St Gallen, Switzerland.
    Shlyakhto, Evgenyi
    Russian Federation Agency of Health and Social Development, Saint Petersburg, Russia.
    Treat-to-target versus dose-adapted statin treatment of cholesterol to reduce cardiovascular risk.2016In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, no 3, 275-281 p.Article in journal (Refereed)
    Abstract [en]

    Clinical guidelines should be based on the best available evidence and are of great importance for patient care and disease prevention. In this respect, the 2013 American College of Cardiology/American Heart Association report is highly appreciated and well-recognized. The report included critical questions concerning hypercholesterolaemia, but its translation into a clinical guideline initiated intense debate worldwide because of the recommendation to switch from a treat-to-target approach for low-density-lipoprotein-cholesterol to a statin dose-based strategy.

  • 17.
    Tardif, Jean-Claude
    et al.
    Université de Montréal Beaulieu-Saucier Pharmacogenomics, Centre Montreal, Quebec, Canada.
    Rhéaume, Eric
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Lemieux Perreault, Louis-Philippe
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Grégoire, Jean C
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Feroz Zada, Yassamin
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Asselin, Géraldine
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Provost, Sylvie
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Barhdadi, Amina
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Rhainds, David
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    L'Allier, Philippe L
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Ibrahim, Reda
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Upmanyu, Ruchi
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Niesor, Eric J
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Benghozi, Renée
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Suchankova, Gabriela
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Laghrissi-Thode, Fouzia
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Guertin, Marie-Claude
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Olsson, Anders G
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Mongrain, Ian
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Schwartz, Gregory G
    University of Colorado, Denver, USA and F. Hoffmann-La Roche, Basel, Switzerland.
    Dubé, Marie-Pierre
    Université de Montréal Beaulieu-Saucier Pharmacogenomics, Centre Montreal, Quebec, Canada.
    Pharmacogenomic determinants of the cardiovascular effects of dalcetrapib.2015In: Circulation: Cardiovascular Genetics, ISSN 1942-325X, E-ISSN 1942-3268, Vol. 8, no 2, 372-382 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dalcetrapib did not improve clinical outcomes, despite increasing high-density lipoprotein cholesterol by 30%. These results differ from other evidence supporting high-density lipoprotein as a therapeutic target. Responses to dalcetrapib may vary according to patients' genetic profile.

    METHODS AND RESULTS: We conducted a pharmacogenomic evaluation using a genome-wide approach in the dal-OUTCOMES study (discovery cohort, n=5749) and a targeted genotyping panel in the dal-PLAQUE-2 imaging trial (support cohort, n=386). The primary endpoint for the discovery cohort was a composite of cardiovascular events. The change from baseline in carotid intima-media thickness on ultrasonography at 6 and 12 months was evaluated as supporting evidence. A single-nucleotide polymorphism was found to be associated with cardiovascular events in the dalcetrapib arm, identifying the ADCY9 gene on chromosome 16 (rs1967309; P=2.41×10(-8)), with 8 polymorphisms providing P<10(-6) in this gene. Considering patients with genotype AA at rs1967309, there was a 39% reduction in the composite cardiovascular endpoint with dalcetrapib compared with placebo (hazard ratio, 0.61; 95% confidence interval, 0.41-0.92). In patients with genotype GG, there was a 27% increase in events with dalcetrapib versus placebo. Ten single-nucleotide polymorphism in the ADCY9 gene, the majority in linkage disequilibrium with rs1967309, were associated with the effect of dalcetrapib on intima-media thickness (P<0.05). Marker rs2238448 in ADCY9, in linkage disequilibrium with rs1967309 (r(2)=0.8), was associated with both the effects of dalcetrapib on intima-media thickness in dal-PLAQUE-2 (P=0.009) and events in dal-OUTCOMES (P=8.88×10(-8); hazard ratio, 0.67; 95% confidence interval, 0.58-0.78).

    CONCLUSIONS: The effects of dalcetrapib on atherosclerotic outcomes are determined by correlated polymorphisms in the ADCY9 gene.

    CLINICAL TRIAL INFORMATION: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00658515 and NCT01059682.

  • 18.
    Stefani, Emanuela
    Linköping University, The Tema Institute, Centre for Gender Studies.
    De-constructing the psychological family: Investigation of gender bias in psychological practice with clients2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    As sometimes happens, research questions arise from spontaneous conversations, daily meetings. This is the case too, where an informal chat between psychologists stimulated my attention on the use of categories of meaning that usually are both familiar and taken for granted in their use: from my experience as a psychologist working in social work, when it comes to "taking up the maternal and paternal role" (or "using maternal and paternal code") professionals of social and clinical works understand nearly immediatly. But what about if these categories of meanings unwittingly bring with them gender stereotypes? Do clinical professionals, in particular, conduct their practice being careful not to convey or reinforce sexist or stereotypical messages?

    My research starts from a doubt, and passes through the sieve of papers, both scientific and not scientific, looking for backup references about interconnections between therapeutic practice and gender awareness, zooming attention on "maternal and paternal function" taken up by professionals when working with clients. While I have found considerable amounts of material on the first area, I didn’t find nearly anything on the second. In order to emphasize the importance of having gender awareness in thought and conduct of psychological practice, I documented some connections between Gender and Feminist Studies, Psychology and Politics.

    The research is developed within a post-structuralist framework, conducting semi-structured interviews with 4 psychotherapists, half of whom are specialized in the field of gender violence. By using the Feminist Critical Discourse Analysis I investigated the statements obtained by stimuli ranging from a) the ways in which gender is manifested in clinical practice, b) the use of "maternal and paternal function", and c) if their clinical practice contributes to the reduction of gender discrimination. The research seems to show that only one person is gender aware within her clinical practice: the same only one with a scientific and cultural background and on Gender Studies.

    What research urges is the need for a deepening of both focus analyzed here: on one hand, understanding the level of gender awereness of Italian professionals and this use in their clinical practice; and, on the other hand, the need to investigate the meaning, use, theoretical foundations and outcome of the use of ''maternal and paternal function" in clinical work with clients.

  • 19.
    Hägg, Mary
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Hudiksvall, Uppsala University/County Council of Gävleborg, Gävle, Uppsala, Sweden.
    Tibbling, Lita
    Hudiksvall, Uppsala University/County Council of Gävleborg, Gävle, Uppsala, Sweden.
    Effect of oral IQoro(R) and palatal plate training in post-stroke, four-quadrant facial dysfunction and dysphagia: A comparison study2015In: Acta Oto-Laryngologica, ISSN 0001-6489, E-ISSN 1651-2251, Vol. 135, no 9, 962-968 p.Article in journal (Refereed)
    Abstract [en]

    Conclusion: Training with either a palatal plate (PP) or an oral IQoro(R) screen (IQS) in patients with longstanding facial dysfunction and dysphagia after stroke can significantly improve facial activity (FA) in all four facial quadrants as well as swallowing capacity (SC). Improvements remained at late follow-up. The training modalities did not significantly differ in ameliorating facial dysfunction and dysphagia in these patients. However, IQS training has practical and economic advantages over PP training. Objectives: This study compared PP and oral IQS training in terms of (i) effect on four-quadrant facial dysfunction and dysphagia after a first-ever stroke, and (ii) whether the training effect persisted at late follow-up. Methods: Patients were included during two periods; 13 patients in 2005-2008 trained with a PP, while 18 patients in 2009-2012 trained with an IQS. Four-quadrant facial dysfunction was assessed with an FA test and swallowing dysfunction with a SC test: before and after a 3-month training period and at late follow-up. FA and SC significantly improved (p less than 0.001) in both groups. FA test scores after training and at late follow-up did not differ significantly between the groups, irrespective of whether the interval between stroke incidence and the start of training was long or short.

  • 20. Klompstra, Leonie
    et al.
    Jaarsma, TinyStrömberg, Anna
    Playing exergames by heart failure patients.2013Conference proceedings (editor) (Refereed)
    Abstract [en]

    Purpose: Regular daily exercise is recognized as important in patients with heart failure (HF), but adherence to exercise recommendations is low. It is important to search for alternative approaches to motivate patients with HF to be more active. The use of exergames (games to improve physical exercise) might be an encouragement for HF patients, especially for people who may be reluctant to engage in more traditional forms of exercise, such as going to the gym or take a walk outside. The aim of this study is to assess the self-reported time playing on the Wii exergame platform when patients get access to the Wii at home for 12 weeks and the factors related to the time playing.

    Methods: As part of a feasibility study, the Wii was installed in the home of HF patients for a period of 12 weeks and patients were instructed to exergame 20 minutes a day (e.g. virtual bowling or tennis). Patients completed a diary which contained questions about the amount of minutes exergaming, heart failure symptoms and perceived exertion. At baseline and 12 weeks the physical capacity was assessed by 6minute walking test. We compared patients who played more than the median amount of minutes on the Wii with patients who played less than the median time.

    Results:  Thirty-two HF patients (age 64 ± 14, 10 female) were included. The mean time exergaming was 28 (±13) minutes a day (median of 27 minutes). Two patients stopped exergaming during the study. Men played more minutes a day on the Wii (31 minutes) than women (20 minutes), (t =2.243, p <.033) which could not be explained by age. Both male and female patients decreased in time exergaming, comparing the first 6 weeks access to the Wii with the last 6 weeks, but no differences were found in the amount of minutes decrease in exergaming (-5±9) between man and women. Patients who played more than the median time were significant lower educated, had a lower NYHA class and had more often grandchildren than patients who exergamed less than the median time.  No association could be found between the groups in exercise capacity, motivation, self-efficacy, symptoms experience, perceived exertion with time exergaming.

    Conclusion: Patients with HF played a considerable time active games on the Wii during 12 months of access to the Wii. Although women exergamed less than men, they did not decrease more in playing then men during the study. Patients who increased more than the median amount of minutes exergaming had a lower educational level, lower NYHA class, and more patients had grandchildren than patients who exergamed less. Access to exergames seem to be a promising to keep HF patients motivated to be active and to provide social facilitation with grandchildren. 

  • 21.
    Karlsson, Louise
    et al.
    Linköping University, Faculty of Medicine and Health Sciences, Faculty of Health Sciences, Medical Programme.
    Olofsson, John
    Linköping University, Faculty of Medicine and Health Sciences, Faculty of Health Sciences, Medical Programme.
    Tidseffektivitet vid ljumskbråcksoperationer: - Jämförelse mellan privat- och offentlig vårdgivare2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background:

    Inguinal hernia surgery is one of the most common surgeries within general surgery, with approximately 20 000 surgeries per year in Sweden. There are three places in Östergötland County where inguinal hernias are executed within outpatient surgery; at Aleris Specialistvård in Motala (ASM), Närsjukvården in Finspång (NiF) and at Medicinskt Centrum in Linköping (MCL).

    There is a theory that private health care providers are more time-efficient than public health care providers. The private health care providers are considered to perform more operations over a given time though no studies has been done on time efficiency.

    This study was performed to detect if there is a difference in time in the various steps during the surgery between the clinics, what causes these differences and if the patients differ.

     

    Methods:

    The study includes 70 patients distributed on three outpatient surgery clinics; ASM, MCL and NiF. The inguinal hernia operations were divided into shorter steps measured with a digital watch.  Furthermore, data were noted about the patients’ age, ASA-score, BMI and who were present in the operating room. Statistical analyses were performed with the Kruskal-Wallis one-way analysis of variance. The software used was SPSS version 22.

     

    Results:

    The study found no significant difference in BMI, ASA-score and age between the health care providers (p > 0,05). However, regarding the time efficiency, there were significant differences between the clinics.

     

    Conclusions:

    The study concludes that there are big differences in time, within the various steps in the inguinal hernia surgeries, between the clinics. The private health care providers were always faster than the public health care provider. Since no earlier studies have been made in this area, it would be interesting to see if there are similar differences in other types of surgeries.

  • 22.
    Hahn, Camilla (Editor)
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Årsberättelse disciplinnämnden vid LiU 20142014Other (Other academic)
    Abstract [sv]

    Den statistik som redovisas i årsberättelsen är vald för att ge en bild av de ärenden som hanteras av nämnden och skall i första hand jämföras med föregående år. Ambitionen är inte att redogöra för statistiska skillnader eller samband. Med tanke på det antal ärenden som hanteras och att förändringar som kan förekomma mellan olika år ofta handlar om enstaka fall är det svårt att göra alltför långtgående analyser.

  • 23.
    Hahn, Camilla (Editor)
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Årsberättelse disciplinnämnden vid LiU 20132013Other (Other academic)
  • 24.
    Onengut-Gumuscu, Suna
    et al.
    Center for Public Health Genomics, Univ Department of Medicine, Division of Endocrinology, University of Virginia, Charlottesville, Virginia, USA.
    Chen, Wei-Min
    Center for Public Health Genomics, Department of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, Virginia, USA.
    Burren, Oliver
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Cooper, Nick J
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Quinlan, Aaron R
    Center for Public Health Genomics, Department of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, Virginia, USA.
    Mychaleckyj, Josyf C
    Center for Public Health Genomics, Department of Public Health Sciences, Division of Biostatistics and Epidemiology, University of Virginia, Charlottesville, Virginia, USA.
    Farber, Emily
    Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA.
    Bonnie, Jessica K
    Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA.
    Szpak, Michal
    Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA.
    Schofield, Ellen
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Achuthan, Premanand
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Guo, Hui
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Fortune, Mary D
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Stevens, Helen
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Walker, Neil M
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Ward, Lucas D
    Department of Computer Science, Massachusetts Institute of Technology (MIT), Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
    Kundaje, Anshul
    Department of Computer Science, Massachusetts Institute of Technology (MIT), Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA / Department of Genetics, Stanford University, Stanford, California, USA / Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA.
    Kellis, Manolis
    Department of Computer Science, Massachusetts Institute of Technology (MIT), Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
    Daly, Mark J
    Broad Institute of MIT and Harvard, Cambridge, Center for Human Genetic Research, Massachusetts General Hospital, Boston, Massachusetts, USA.
    Barrett, Jeffrey C
    Wellcome Trust Sanger Institute, Hinxton, UK.
    Cooper, Jason D
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Deloukas, Panos
    Wellcome Trust Sanger Institute, Hinxton, UK.
    Todd, John A
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
    Wallace, Chris
    Juvenile Diabetes Research Foundation (JDRF)/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, National Institute for Health Research (NIHR) Biomedical Research Centre, University of Cambridge, Addenbrooke's Hospital, Medical Research Council (MRC) Biostatistics Unit, Institute of Public Health, University Forvie Site, Cambridge, UK.
    Concannon, Patrick
    Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia, USA.
    Rich, Stephen S
    Center for Public Health Genomics, University of Virginia, Department of Public Health Sciences, Division of Biostatistics and Epidemiology, Charlottesville, Virginia, USA.
    Fine mapping of type 1 diabetes susceptibility loci and evidence for colocalization of causal variants with lymphoid gene enhancers.2015In: Nature Genetics, ISSN 1061-4036, E-ISSN 1546-1718, Vol. 47, no 4, 381-386 p.Article in journal (Refereed)
    Abstract [en]

    Genetic studies of type 1 diabetes (T1D) have identified 50 susceptibility regions, finding major pathways contributing to risk, with some loci shared across immune disorders. To make genetic comparisons across autoimmune disorders as informative as possible, a dense genotyping array, the Immunochip, was developed, from which we identified four new T1D-associated regions (P < 5 × 10(-8)). A comparative analysis with 15 immune diseases showed that T1D is more similar genetically to other autoantibody-positive diseases, significantly most similar to juvenile idiopathic arthritis and significantly least similar to ulcerative colitis, and provided support for three additional new T1D risk loci. Using a Bayesian approach, we defined credible sets for the T1D-associated SNPs. The associated SNPs localized to enhancer sequences active in thymus, T and B cells, and CD34(+) stem cells. Enhancer-promoter interactions can now be analyzed in these cell types to identify which particular genes and regulatory sequences are causal.

  • 25.
    Fernlund, Eva
    et al.
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Lund University, Sweden.
    Schlegel, Todd T.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Platonov, Pyotr G.
    Lund University, Sweden.
    Carlson, Jonas
    Lund University, Sweden.
    Carlsson, Marcus
    Lund University, Sweden.
    Liuba, Petru
    Lund University, Sweden.
    Peripheral microvascular function is altered in young individuals at risk for hypertrophic cardiomyopathy and correlates with myocardial diastolic function2015In: American Journal of Physiology. Heart and Circulatory Physiology, ISSN 0363-6135, E-ISSN 1522-1539, Vol. 308, no 11, H1351-H1358 p.Article in journal (Refereed)
    Abstract [en]

    Hypertrophic cardiomyopathy (HCM) is a major cause of sudden cardiac death in the young. Based on previous reports of functional abnormalities in not only coronary but also peripheral vessels in adults with HCM, we aimed to assess both peripheral vascular and myocardial diastolic function in young individuals with an early stage of HCM and in individuals at risk for HCM. Children, adolescents, and young adults (mean age: 12 yr) with a family history of HCM who either had (HCM group; n = 36) or did not have (HCM-risk group; n = 30) echocardiography-documented left ventricular (LV) hypertrophy as well as healthy matched controls (n = 85) and healthy young athletes (n = 12) were included in the study. All underwent assessment with 12-lead electrocardiography, two-dimensional echocardiography, tissue Doppler imaging and laser Doppler with transdermal iontophoresis of ACh and sodium nitroprusside. LV thickness and mass were increased in HCM and athlete groups compared with control and HCM-risk groups. The mitral E-to-e ratio, measured via tissue Doppler, was increased in HCM (P less than 0.0001) and HCM-risk (P less than 0.01) groups compared with control and athlete groups, as were microvascular responses to ACh (HCM group: P less than 0.045 and HCM- risk group: P less than 0.02). Responses to ACh correlated with the E-to-e ratio (r = 0.5, P = 0.001). Microvascular responses to sodium nitroprusside were similar in all groups (P = 0.2). HCM-causing mutations or its familial history are associated with changes in cardiac diastolic function and peripheral microvascular function even before the onset of myocardial hypertrophy. Tissue Doppler can be used to differentiate HCM from physiological LV hypertrophy in young athletes.

  • 26.
    Ermstål, Isabella
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Perfektionism och self-compassion - En experimentell studie om hur perfektionism och self-compassion påverkar uppsatsskrivande och korrekturläsning i olika affektiva situationer.2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna experimentella studie var att öka kunskapen om perfektionism genom att undersöka huruvida perfektionism går att påverka, hur perfektionism påverkar prestation samt hur olika perfektionismdimensioner tar sig uttryck i olika situationer. För att undersöka detta skapades ett internetexperiment innehållande en kort version av Pennebaker’s essay writing procedure (uppsatsskrivande-uppgift), en korrekturläsningsuppgift samt självskattningsformulär för olika perfektionismdimensioner och self-compassion. Deltagarna i studien randomiserades till två olika betingelsegrupper som fick skriva om en gång då de lyckats (pos. betingelsegrupp) eller en gång då de misslyckats (neg. betingelsegrupp). Resultatet visade på ett signifikant samband mellan perfektionismdimensionen perfectionist strivings och antalet ändringar i texten hos den negativa betingelsegruppen samt ett signifikant samband mellan self-compassion och antal skrivna ord i uppsatsskrivande-uppgiften före ändring i den positiva betingelsegruppen. Resultaten visade även på signifikanta korrelationsskillnader både mellan perfektionismdimensionen perfectionist strivings och antalet ändringar i texten samt mellan self-compassion och antalet skrivna ord i uppsatsskrivande-uppgiften. Resultaten tyder på att olika perfektionismdimensioner och self-compassion blir mer framträdande samt påverkar prestation på olika sätt beroende på om situationen är positiv eller negativ.

  • 27.
    John, M. T.
    et al.
    University of Minnesota, USA.
    Feuerstahler, L.
    University of Minnesota, USA.
    Waller, N.
    University of Minnesota, MN 55455 USA.
    Baba, K.
    Showa University, Japan.
    Larsson, Pernilla
    Centre of Oral Rehabilitation, Prosthetic Dentistry,Norrköping .
    Celebic, A.
    University of Zagreb, Croatia.
    Kende, D.
    University of Pecs, Hungary.
    Rener-Sitar, K.
    University of Ljubljana, Slovenia.
    Reissmann, D. R.
    University of Medical Centre Hamburg Eppendorf, Germany.
    Confirmatory factor analysis of the Oral Health Impact Profile2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 9, 644-652 p.Article in journal (Refereed)
    Abstract [en]

    Previous exploratory analyses suggest that the Oral Health Impact Profile (OHIP) consists of four correlated dimensions and that individual differences in OHIP total scores reflect an underlying higher-order factor. The aim of this report is to corroborate these findings in the Dimensions of Oral Health-Related Quality of Life (DOQ) Project, an international study of general population subjects and prosthodontic patients. Using the projects Validation Sample (n = 5022), we conducted confirmatory factor analyses in a sample of 4993 subjects with sufficiently complete data. In particular, we compared the psychometric performance of three models: a unidimensional model, a four-factor model and a bifactor model that included one general factor and four group factors. Using model-fit criteria and factor interpretability as guides, the four-factor model was deemed best in terms of strong item loadings, model fit (RMSEA = 0.05, CFI = 0.99) and interpretability. These results corroborate our previous findings that four highly correlated factors - which we have named Oral Function, Orofacial Pain, Oro-facial Appearance and Psychosocial Impact - can be reliably extracted from the OHIP item pool. However, the good fit of the unidimensional model and the high interfactor correlations in the four-factor solution suggest that OHRQoL can also be sufficiently described with one score.

  • 28.
    Stevenson, Jean E
    et al.
    University of Sheffield, UK, Linnéuniversitetet, Sverige.
    Israelsson, Johan
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Kalmar Länssjukhus, Kalmar.
    Nilsson, Gunilla C
    Linnéuniversitetet.
    Petersson, Göran I
    Linnéuniversitetet.
    Bath, Peter A
    University of Sheffield, UK.
    Recording signs of deterioration in acute patients: The documentation of vital signs within electronic healthrecords in patients who suffered inhospital cardiac arrest2014In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811Article in journal (Refereed)
    Abstract [en]

    Vital sign documentation is crucial to detecting patient deterioration. Little is known about the documentation of vital signs in electronic health records. This study aimed to examine documentation of vital signs in electronic health records. We examined the vital signs documented in the electronic health records of patients who had suffered an in-hospital cardiac arrest and on whom cardiopulmonary resuscitation was attempted between 2007 and 2011 (n = 228), in a 372-bed district general hospital. We assessed the completeness of vital sign data compared to VitalPAC™ Early Warning Score and the location of vital signs within the electronic health records. There was a noticeable lack of completeness of vital signs. Vital signs were fragmented through various sections of the electronic health records. The study identified serious shortfalls in the representation of vital signs in the electronic health records, with consequential threats to patient safety.

  • 29.
    Ordell, Sven
    et al.
    ötdl/samhällsodontolog,odont dr, Tandvårdsgruppen,Landstinget i Östergötland.
    Ekbäck, Gunnar
    Tandvårdsenheten, Örebro läns landsting.
    Så kommer behovet av tandläkare förändras2014In: Tandläkartidningen, ISSN 0039-6982, Vol. 106, no 5, 72-76 p.Article in journal (Refereed)
    Abstract [sv]

    Behovet av tandläkare med kompetens för en alltmer komplex vård kommer sannolikt att öka inom den närmaste framtiden. Men mer detaljerade analyser krävs för att landstingen och regionerna i tid ska kunna anpassa sin planering efter de behov inom tandvården som kommer att uppstå.

  • 30.
    John, Mike T.
    et al.
    University of Minnesota, USA.
    Reissmann, Daniel R.
    University of Medical Centre Hamburg Eppendorf, Germany.
    Feuerstahler, Leah
    University of Minnesota, USA.
    Waller, Niels
    University of Minnesota, USA.
    Baba, Kazuyoshi
    Showa University, Japan.
    Larsson, Pernilla
    Centre of Oral Rehabilitation, Prosthetic Dentistry, Norrköping, Sweden.
    Celebic, Asja
    University of Zagreb, Croatia.
    Szabo, Gyula
    University of Pecs, Hungary.
    Rener-Sitar, Ksenija
    University of Ljubljana, Slovenia.
    Factor analyses of the Oral Health Impact Profile - Overview and studied population2014In: Journal of Prosthodontic Research, ISSN 1883-1958, Vol. 58, no 1, 26-34 p.Article in journal (Refereed)
    Abstract [en]

    Purpose: A desideratum of oral health-related quality of life (OHRQoL) instruments such as the Oral Health Impact Profile (OHIP) is that they accurately reflect the structure of the measured construct(s). With this goal in mind, the Dimensions of Oral Health-Related Quality of Life (DOQ) Project was proposed to investigate the number and nature of OHRQoL dimensions measured by OHIP. In this report, we describe our aggregate data set for the factor analyses in the project, which consists of responses to the 49-item OHIP from general population subjects and prosthodontics patients from 6 countries, including a large age range of adult subjects and both genders. Materials and methods: The DOQ Projects aggregate data set combines data from 35 individual studies conducted in Croatia, Germany, Hungary, Japan, Slovenia, and Sweden. Results: The combined data set includes 10778 OHIPs from 9348 individuals (N = 6349 general population subjects, N = 2999 prosthodontic patients). To elucidate the OHIP latent structure, the aggregated data were split into a Learning Sample (N = 5173) for exploratory analyses and a Validation Sample (N = 5022) for confirmatory analyses. Additional data (N = 583) were assigned to a third data set. Conclusion: The Dimensions of Oral Health-Related Quality of Life Project contains a large amount of international data and is representative of populations where OHIP is intended to be used. It is well-suited to assess the dimensionality of the questionnaire. (C) 2013 Japan Prosthodontic Society. Published by Elsevier Ireland. All rights reserved.

  • 31.
    Åstrom, Anne N.
    et al.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekback, Gunnar
    Department of Dentistry, Örebro County Council, Örebro, Sweden.
    Ordell, Sven
    Dental Commissioning Unit,Ostergotland County Council.
    Nasir, Elwalid
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Long-term routine dental attendance: influence on tooth loss and oral health-related quality of life in Swedish older adults2014In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 42, no 5, 460-469 p.Article in journal (Refereed)
    Abstract [en]

    ObjectivesFew studies have investigated the effect of long-term routine dental attendance on oral health between middle-aged and older adults, using a prospective cohort design. This study aimed to assess routine dental attendance (attending dentist in the previous 12months for dental checkups) from age 50 to 65years. Moreover, this study examined whether long-term routine dental attendance contributes to oral health-related quality of life, OHRQoL, and major tooth loss independent of social factors and the type of treatment sector utilized. Whether oral health impacts of long-term routine attendance varied with type of treatment sector utilized was also investigated. MethodIn 1992, a census of the 1942 cohort in two counties of Sweden participated in a longitudinal questionnaire survey conducted at age 50 and again after 5, 10, and 15years. Information was collected on a wide range of health- and oral health-related aspects. Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow-ups in 1997, 2002, and 2007. ResultsRoutine dental attendance decreased from 69.1% at age 50-64.2% at age 65. Adjusted logistic regression analyses revealed that individuals reporting long-term routine attendance (routine attendance in both 1992 and 2007) were 0.3 (95% CI 0.2-0.5) times less likely than their counterparts who were nonroutine attenders to report oral impacts. According to generalized estimating equations (GEE), individuals who reported long-term routine attendance were 0.6 (95% CI 0.4-0.7) times less likely than nonroutine attenders to have major tooth loss across the survey years. The effect of long-term routine attendance on OHRQoL was stronger in public than in private dental healthcare attenders. ConclusionRoutine attendance decreased from age 50-65years. Long-term routine attendance had positive impact on major tooth loss and OHRQoL supporting the principle of encouraging annual dental attendance for preventive checkups among older people.

  • 32.
    Larsson, Pernilla
    et al.
    Department of Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    John, M. T.
    Division of Epidemiology and Community Health and Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, USA.
    Nilner, K.
    Department of Prosthetic Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.
    List, T.
    Division of Epidemiology and Community Health and Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, USA.
    Normative values for the oro-facial Esthetic Scale in Sweden2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 2, 148-154 p.Article in journal (Refereed)
    Abstract [en]

    This study reports the findings and challenges of the assessment of oro-facial aesthetics in the Swedish general population and the development of normative values for the self-reporting Orofacial Esthetic Scale (OES). In a Swedish national sample of 1406 adult subjects (response rate: 47%), OES decile norms were established. The influence of sociodemographics (gender, age, and education), oral health status and general health status on OES scores was analysed. Mean +/- standard deviation of OES scores was 503 +/- 156 units (0, worst score; 70, best score); less than1% of the subjects had the minimum score of 0, and 11% had the maximum score of 70 OES units. Orofacial Esthetic Scale score differences were (i) substantial (greater than5 OES units) for subjects with excellent/very good versus good to poor oral or general health status; ii) small (2 units), but statistically significant for gender (P=0.01) and two age groups (P=0.02), and (iii) absent for subjects with college versus no college education (P=0.31) or with and without dentures (P=0.90). To estimate normative values for a self-reporting health status, instrument is considered an important step in standardisation, and the developed norms provide a frame of reference in the general population to interpret the Orofacial Esthetic Scale scores.

  • 33.
    Magnusson, Karolina
    Linköping University, Department of Biomedical Engineering. Linköping University, Faculty of Science & Engineering.
    Mechanical heart rate detection using cardiogenic impedance - a morphology approach2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The objective of this thesis is to examine the possibility to determine the mechanical heart rate using intracardiac impedance in the time domain. Deducing the mechanical heartrate from the impedance could help improve the performance of implanted devices that today depend on the measurement of the heart’s electrical activity. Cardiogenic – also known as intracardiac – impedance is based on the difference in conductivity between heart muscle tissue and blood, making the impedance vary as the heart is filled and emptied. The data used in this thesis was acquired from three previous studies performed by St Jude Medical, two clinical and one preclinical. Two impedance measurement configurations were chosen from these studies, one bipolar and one quadropolar. To deduce the heart rate from the intracardiac impedance six algorithms were evaluated. Three using continuous peak detection and three evaluating small frames of the impedance signal.The peak detection algorithms were peak detection on the impedance signal itself, on its derivative  and on its integral. The three others were an Auto Correlation Function (ACF), an Average Magnutide Difference Function (AMDF) and an Average Wave Comparison Function (AWCF). In order to assess the heart rates deduced from the intracardiac impedance by the algorithms, these rates were compared to both the IEGM or the ECG (depending on which study was at hand) and the blood pressure.

    Several issues affected the performance of the algorithms. Impedance morphology can vary between patients. Some display so called “double peaks”, making it hard to decide whether a patient has for example a pulse of 80 bpm or of 160 bpm. The impedance morphology was also affected by amplitude modulation with the respiration frequency which in some patients cause difficulties to analyze the impedance signal. The results show that the two impedance measurement configurations perform equally well and that the ACF method was the overall best performing algorithm. They also show that individual patient impedance morphology has a large influence on the results and for future studies it should therefore be interesting to calibrate the algorithms for each patient, as this should improve performance.

  • 34.
    Hongxing, Li
    et al.
    Department of Clinical Dentistry – Prosthodontics, University of Bergen, Bergen, Norway.
    List, Thomas
    Orofacial pain and Jaw Function, Malmö University, Malmö, Sweden.
    Nilsson, Ing-Marie
    Specialist Center for Oral Rehabilitation, Norrköping, Sweden .
    Johansson, Anders
    Department of Clinical Dentistry – Prosthodontics, University of Bergen, Bergen, Norway.
    Nordrehaug Astrom, Anne
    Department of Clinical Dentistry – Community Dentistry, University of Bergen, Bergen, Norway.
    Validity and reliability of OIDP and OHIP-14: a survey of Chinese high school students2014In: BMC Oral Health, ISSN 1472-6831, Vol. 14, no 158, 1-10 p.Article in journal (Refereed)
    Abstract [en]

    Background: To determine the impact of oral diseases on everyday life, measures of oral quality of life are needed. In complementing traditional disease-based measures, they assess the need for oral care to evaluate oral health care programs and management of treatment. To assess the reliability and validity of the Oral Impact of Daily Performance (OIDP) and the short-form Oral Health Impact Profile (OHIP-14) among high school students in Xian, the capital of Shanxi province, China. Methods: Cross-sectional one-stage stratified random cluster sample using high schools as the primary sampling unit. Students completed self-administered questionnaires at school. The survey included the OHIP-14 and OIDP inventories, translated and culturally adapted for China, and global oral health and socio-behavioral measures. Results: A total of 5,608 students participated in the study, with a 93% response rate (mean age 17.2, SD 0.8, 52% females, 45.3% urban residents). The proportion experiencing at least one impact (at any frequency) during the previous six months was 62.9% for the OHIP-14 and 45.8% for the OIDP. Cronbachs alpha measured internal consistency at 0.85 for OHIP-14 and 0.75 for OIDP while Cohens kappa varied between 0.27 and 0.58 for OHIP-14 items and between 0.23 and 0.65 for OIDP items. Kappa scores for the OHIP-14 and OIDP additive scores were 0.52 and 0.66, respectively. Both measures varied systematically and in the expected direction, with global oral health measures showing criterion validity. The correlation between OIDP and OHIP-14 was r(s) + 0.65. That both measures varied systematically with socio-behavioral factors indicates construct validity. Conclusion: Both the OIDP and OHIP-14 inventories had reasonable reliability and construct validity in relation to subjective global oral health indicators among adolescents attending high schools in China and thus appear to be useful oral health -related quality of life measures in this context. Overall, the OHIP-14 and OIDP performed equally well, although OHIP-14 had superior content validity due to its sensitivity towards less severe impacts.

  • 35.
    Backlund, Lisa
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Luuk, Liisa
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    DAY: Allians, komorbiditet och kunskap i KBT-behandling bestående av fyra behandlingsträffar och tio veckors internetbehandling för depression2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    I studien utvärderades en KBT-behandling för depression bestående av fyra behandlingsträffar i kombination med ett internetprogram under tio veckor. Syftet var att undersöka om behandlingen ledde till ökad kunskap om behandlingsinnehållet samt om kunskap, allians och komorbiditet kunde predicera symptomförbättring. Kunskapsökning undersöktes med ett kunskapstest som analyserades med ANCOVA och resultatet visade på en trend mot att behandlingen ledde till ökad kunskap. När skattningar av deltagarnas säkerhet på svaren på frågorna i kunskapstestet inkluderades i analysen var resultatet signifikant bättre för behandlingsgruppen jämfört med kontrollgruppen. Huruvida kunskap, allians och komorbiditet kunde predicera förbättring i behandlingsgruppen undersöktes med Pearsons produktmomentkorrelationskoefficient. Allians och kunskap kunde inte predicera symptomförbättring. Däremot fanns ett negativt samband mellan antalet komorbida tillstånd och symptomförbättring på ett av utfallsmåtten, vilket kan indikera att formatet fungerar sämre för personer med en generellt hög symptombörda. Forskningsområdet är nytt, varför det behövs fler studier om faktorer som påverkar behandlingsresultatet när sedvanlig KBT-behandling kombineras med internetbehandling.

  • 36.
    Larsson, Pernilla
    et al.
    Department for Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    John, M. T.
    Division of Epidemiology and Community Health, Department of Diagnostic and Biological Sciences, University of Minnesota, Minneapolis, USA.
    Hakeberg, M.
    Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg,.
    Nilner, K.
    Department of Oral Prosthetics, Faculty of Odontology, Malmö University, Malmö, Sweden.
    List, T.
    Department for Orofacial Pain and Jawfunction, Faculty of Odontology, Malmö University, Malmö, Sweden.
    General population norms of the Swedish short forms of Oral Health Impact Profile2014In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842, Vol. 41, no 4, 275-281 p.Article in journal (Refereed)
    Abstract [en]

    We reported the development and psychometric evaluation of a Swedish 14-item and a five-item short form of the Oral Health Impact Profile. The 14-item version was derived from the English-language short form developed by Slade in1997. The five-item version was derived from the German-language short form developed by John etal. in 2006. Validity, reliability and normative values for the two short form summary scores were determined in a random sample of the adult Swedish population (response rate: 46%, N=1366 subjects). Subjects with sufficient OHRQoL information to calculate a summary score (N=1309) were on average 50 center dot 1 +/- 17 center dot 4years old, and 54% were women. Short form summary scores correlated highly with the 49-item OHIP-S (r greater than= 0 center dot 97 for OHIP-S14, r greater than= 0 center dot 92 for OHIP-S5) and with self-report of oral health (r greater than= 0 center dot 41). Reliability, measured with Cronbachs alpha (0 center dot 91 for OHIP-S14, 0 center dot 77 for OHIP-S5), was sufficient. In the general population, 50% of the subjects had greater than= 2 OHIP-S14 score points and 10% had greater than= 11 points, respectively. Among subjects with their own teeth only and/or fixed dental prostheses and with partial removable dental prostheses, 50% of the population had greater than= 2 OHIP-S14 score points, and 10% had greater than= 11 points. For subjects with complete dentures, the corresponding figures were 3 and 24 points. OHIP-S5 medians for subjects in the three population groups were 1, 1 and 2 points. Swedish 14-item and 5-item short forms of the OHIP have sufficient psychometric properties and provide a detailed overview about impaired OHRQoL in Sweden. The norms will serve as reference values for future studies.

  • 37.
    Karlsson, Therése
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Lawrence, Hanna
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    English as a Second Language for Kenyan Children in Primary School: A Trial of the Spoken Language Assessment Profile – Revised Edition2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Sub-Saharan Africa is a multilingual environment and there is a lack of materials available for speech and language assessment in this area (Hartley & Krämer, 2013). The norms for assessment material cannot be used for both monolinguals and bilinguals, since bilinguals may have different levels of knowledge in their languages (Kohnert, 2010). The Spoken Language Assessment Profile – Revised edition (SLAP-R) is an assessment that can be used to evaluate English as a second language (ESL) in Sub-Saharan Africa. The purpose of this instrument is an attempt to fill the gap of suitable speech and language assessment tools that can be used for all those involved in setting up clinics, schools or speech and language assessment tools (Hartley & Krämer, 2013). The aim of the present study was to assess English as a second language for Kenyan children in primary school based on their result on the SLAP-R. The present study consisted of 68 participants with reported typically developed language and hearing that attended first or second grade in a public school in western Kenya. All participants were between six and nine years old, had a Bantu language as their first language and had been exposed to English for less than one year up to eight years. They had also attended preschool at their current school. The independent variables in the present study were grade, age and exposure to English. SLAP-R consists of six subtests that test expressive and receptive phonology, semantics and grammar. These parts constituted the dependent variables. In addition there is a part called ultimate expressive language skill (UELS) that consists of picture sequences where the participant should tell a story of what is happening in the pictures. The result indicated that grade had the largest effect on the participant’s performance in English as a second language. Grade two had significantly higher results regarding receptive phonology as well as expressive and receptive semantics and grammar than the participants in grade one. Most of the incorrect answers were made in the subtest expressive grammar. These answers were mainly incorrect due to other reasons than an answer in Kiswahili.

  • 38.
    Gulcan, Ferda
    et al.
    University of Bergen, Norway.
    Nasir, Elwalid
    University of Bergen, Norway.
    Ekback, Gunnar
    Örebro County Council, Sweden; University of Örebro, Sweden.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Nordrehaug Astrom, Anne
    University of Bergen, Norway.
    Correction: Change in Oral Impacts on Daily Performances (OIDP) with increasing age: testing the evaluative properties of the OIDP frequency inventory using prospective data from Norway and Sweden (vol 14, 59, 2014)2015In: BMC Oral Health, ISSN 1472-6831, E-ISSN 1472-6831, Vol. 15, no 58Article in journal (Other academic)
    Abstract [en]

    n/a

  • 39.
    Neffati, Hammadi
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Översättning och anpassning av Kortfattad Afasiprövning till arabiska: Jämförelse med arabiska Bilingual Aphasia Test och självskattad språkförmåga2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    With the growing amount of citizens with another mother tongue than Swedish, the need for assessment instruments in other languages than Swedish within the Swedish health care increases. To enable this, the knowledge of multilingualism and adequate assessments are required. The aim is to develop a modern Arabic version of a screening material that is comparable to what is used in the Swedish clinic in the assessment of people diagnosed with aphasia. In the present study, Short Aphasia Examination (Kortfattad Afasiprövning), which is one of the few screening material is available in Swedish and among the ten most frequently used assessment materials (Blom Johansson, Carlsson & Sonnander, 2011). Translation and adaptation was made to the Standard Arabic (KAPARABISKA) and Arabic dialect of Hadari (KAPHADARI). The results were also compared with the participants' self-rated language abilities. The study is also implementing a comparison between KAP and the Hadari Arabic screening version of the Bilingual Aphasia Test (BAT). The translated assessment materials were tested on six participants, where five had Arabic as their mother tongue and one participant had Arabic and Swedish as mother tongues. The result indicates that the Arabic versions of KAP and BAT are assessing the language ability of the participants almost equally, but that KAP is assessing reading and writing abilities on a higher difficulty. The KAP assessments were conducted during half as long time as BAT. Both the KAP assessments and the BAT assessment identified participants with limited literacy skills, which indicates the importance of inquiring the patient’s education level to avoid false interpretation of the results.

  • 40.
    Jansson, Lisa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Höglund, Emelie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Logopeders samtal med närstående till en person med afasi: En samtalsanalys2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In institutional interactions such as conversations between a speech and language therapist, a person closely related to a person with aphasia and the individual with aphasia there is an asymmetry considering the power. The asymmetry arising in institutional interactions may mean that the participant with the least power will experience a face threatening act. Understanding is seen as a dynamic process and when understanding is a problem in the conversation the ongoing activity is disturbed. The receiver can solve the problem by giving the speaker a candidate understanding. How these strategies are used in conversations between a speech and language therapist with a person closely related to a person with aphasia is a relatively unexplored field and an important area which is a common for speech therapists. The aim of the present study was to investigate a number of communication strategies in the conversation with a person closely related to a person with aphasia; how understanding was reached and how face threatening acts were reduced when the speech therapists delivered test results and gave counseling. Three conversations between speech and language therapists, persons closely related to a person with aphasia and in two of the recordings the person with aphasia were recorded, transcribed and analyzed according to principles of Conversation Analysis (CA). Two speech and language therapists, three persons closely related to a person with aphasia and two persons with aphasia participated in the study. In total, the recorded material is one hour and 37 minutes. Participating speech and language therapists also filled in a questionnaire. Strategies for mitigation and understanding were identified. The strategies were divided into two categories; strategies to mitigate FTA:s when delivering the test results and counseling, the other categorie was the use of candidate understandings for gaining an mutual understanding. The study revealed that candidate understandings were often initiated by the person closely related to a person with aphasia. The study also revealed that the test results with positive outcome where not mitigated and often emphasized and test results that could be perceived as negative were mitigated with hedging.

  • 41.
    Larsson, Elias
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Isaksson, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Avgörande faktorer för talnaturlighet hos personer med Parkinsons sjukdom: Korrelationsstudie mellan naiva lyssnares bedömning och akustisk analys2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Speech and voice changes are common in Parkinson’s disease. These changes can affect the speaker’s intelligibility but can also have a negative impact on the perceived naturalness of speech. The research available regarding the different factors that affect speech naturalness is scarce, which was the motivation behind this study.

    The aim of the present study was to investigate whether the level of perceived speech naturalness could derive from any specific aspects of speech. This was accomplished by recording speech samples from eight people with Parkinson’s disease using a test battery with various speech tasks. These samples were presented to a group of 27 naive listeners whose task was to judge the level of intelligibility as well as the level of speech naturalness. Correlations were then made between their assessments and various acoustic measurements.

    The main finding of the present study was that speech and articulation rate seemed to have the greatest impact on the perceived level of naturalness, where the people who had the slowest rate were judged to be the least natural sounding. Furthermore there were strong indications that the level of intelligibility correlated with the level of speech naturalness. In this study there were no other acoustic correlates found with statistical significance.

  • 42.
    Birchwood, Aina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Hammarberg, Matilda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Högteknologiskt samtalsstöd vid demens: En analys av samtal med och utan surfplatta med applikationen Book Creator2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The number of people who are affected by dementia is expected to increase, from 25 million in the year 2000 to approximately 63 million in the year 2030. Dementia can be described as a global disorder of intellectual functions, where the cognitive ability including communication is affected. High technological communication aids that support people with dementia in their communication are currently an underexplored area with limited evidence. The aim of the present study was to identify interactional phenomena occurring in interaction involving one person with dementia with and without a tablet with the application Book Creator. A further aim was to examine how the conversation partner experienced the communication of the person with dementia. The study was conducted in a residential care facility for people with dementia where a total of nine conversations were recorded, six conversations without the application and three conversations with the application. The material comprised 2 hours and 25 minutes and was transcribed according to Conversation Analytic principles. Five phenomena were identified: initiative, common ground, coherence, incomplete common ground and non-coherence. The frequency of occurrence of these phenomena was calculated in percentage of their occurrence in relation to total number of turns.The result in the present study indicated that the interactional phenomena involving incomplete common ground and non-coherence occurred in a reduced frequency in conversations with the application Book Creator. The person with dementia took the initiative to the same extent in interactions with and without the application. There appeared to be no differences regarding common ground and coherence between the participants in the conversation with and without the application. The analysis also revealed that the person with dementia could handle the tablet with the application Book Creator on her own with some support. The results are in accordance with research regarding communicative difficulties in people with dementia, strategies to address these difficulties and the need of increased training in communicative treatment in dementia.

  • 43.
    Netin, Rebecka
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Pehrson, Fanny
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Logopedisk gruppbehandling för barn med språkstörning2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The study objective was to investigate interaction in speech and language therapy groups for children with language impairment and to investigate whether treatment was implemented in the home environment. The material was collected from a speech and language therapy center in the south of Sweden and from the participants’ home environment. In total, seven video recordings were made of speech and language therapy sessions in two different groups. Five sessions were recorded in one of the groups, and the remaining two were recorded in the second group. Three SLPs, eight children and eleven parents participated in the study. Interviews with two of the participating SLPs and two of the participating parents were conducted. Video recordings from a home setting were collected from two of the participating children. All of the collected video recorded material was transcribed and analyzed according to principles of Conversation Analysis. The results show that the SLPs in therapy use imitation-based and modelling strategies to elicitate language production. Manual signs and recasts were found to be used as treatment strategies. Other phenomena in treatment were repairs, feedback and face-saving strategies. The study highlights the asymmetry in the interaction between children and SLPs, but also shows that the interaction sometimes departs from interaction of an institutional kind. The results indicate that one of the participating parents has implemented manual signs in the interaction during treatment as well as in the home environment. The study shows that two parents use recasts in the interaction with their children.  

  • 44.
    Johansson, Louise
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    En vit kvinna som har ett svart hembiträde kan inte vara rasist: En diskursanalytisk studie av afrobrasilianska kvinnors tal om ras och kön2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Brasilien är ett land som historiskt och kulturellt har präglats av kolonialisering och slaveri, vilket har bidragit till en befolkning som kännetecknas av mångfald när det kommer till ras och kultur. Andra konsekvenser av det historiska arvet är att den patriarkala familjen kommit att få central betydelse i samhället samt att vithet kommit att idealiseras när det gäller ras och hudfärg. Mot denna bakgrund utgör afrobrasilianska kvinnor en utsatt grupp då de riskerar att drabbas av både sexism och rasism i sin vardag.     Syftet med den här studien var att med en socialkonstruktionistisk ansats och utifrån ett intersektionellt perspektiv undersöka hur afrobrasilianska kvinnor talar om ras och kön utifrån upplevelser och erfarenheter av fördomar och diskriminering. Intervjuer har gjorts med tio deltagare uppdelade i två fokusgrupper. Den ena gruppen bestod av kvinnor i åldrarna 50 till 77 år och den andra gruppen utgjordes av tonårstjejer mellan 14 och 15 år. Intervjuerna har analyserats med hjälp av diskursiv psykologi, vilket är en kvalitativ analysmetod inom det diskursanalytiska fältet.     Mest framträdande i deltagarnas tal var upplevelser och erfarenheter av fördomar och diskriminering på grund av ras, medan motsvarande för kön förekom i begränsad utsträckning. En övergripande och till synes dominerande diskurs identifierades i hur deltagarna pratade om ras och hudfärg. De använde sig av ett språkbruk där ras och hudfärg syftade till att beskriva, definiera och värdera. Vidare tydliggjordes att benämningen negro kan användas både på ett neutralt sätt och i syfte att nedvärdera och förolämpa. Intervjudeltagarna pratade om upplevelser och erfarenheter av fördomar och diskriminering på grund av ras på i huvudsak två olika sätt. Dessa sätt kan ses som konflikterande tolkande repertoarer under benämningarna det harmoniska samhället och det rasistiska samhället. Dessutom identifierades retoriska strategier för att hantera den utsatthet som det rasistiska samhället medför.     Tal om upplevelser och erfarenheter av fördomar och diskriminering på grund av kön framstod som mindre tillgängligt för deltagarna. Dock framträdde vad som beskrivs som en dominerande diskurs där traditionella könsroller ses som självklara. Utifrån ett mer uttalat intersektionellt perspektiv riktades avslutningsvis fokus mot de skärningspunkter och överlappningar som synliggjordes mellan ras och kön. Som ytterligare en viktig social kategorisering i deltagarnas tal identifierades klass, varför även denna kategori inkluderades i analysen. Den bild som framträdde var den av den afrobrasilianska kvinnan som unik i sin utsatthet i förhållande till både kvinnor av annan ras och hudfärg samt män av samma ras och hudfärg. 

  • 45.
    Collin, Angelica
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Tollander, Sofie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Att leva med autismspektrumtillstånd: Innehållsanalys och samtalsanalys av en fokusgruppsdiskussion2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Autism Spectrum Disorders (ASD) is a neuropsychiatric impairment that may affect an individual's everyday life. Life areas that may be problematic include work, family, relationships and areas that require social interaction. The aim of the present study was to investigate communication in everyday life amongst adults with ASD as well as, by listening to the participants' personal narratives, explore how AST can affect an individual's life. The study was based on a video recorded focus group discussion with four participants who in adulthood have been diagnosed with ASD. Conversation Analysis and Content analysis were used for analysis of the material. The results showed that the participants have skills for social interaction and empathy. Some of the participants were perceived as using their gaze in a deviant way, and unexpected changes in topics and attempted interruptions were observed during the discussion. The majority of the participants described periods of psychiatric problems during their lives, and that the diagnosis has been important for their quality of life as it enables them to create relationships with people with similar difficulties. This appears to be important to them since they have difficulties building relationships. The results contribute to a better understanding of how a neuropsychiatric diagnosis can affect an individual's life.

  • 46.
    Neuhaus, V.
    et al.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Bot, A.G.J.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Guitton, T.G.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Ring, D.C.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Scapula fractures: Interobserver reliability of classification and treatment2014In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 28, no 3, 124-129 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. Copyright © 2013 by Lippincott Williams and Wilkins.

  • 47.
    Mellema, J.J.
    et al.
    Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, United States.
    Doornberg, J.N.
    University of of Amsterdam Orthopaedic Residency Program (PGY 4), Academic Medical CenterAmsterdam, Netherlands.
    Guitton, T.G.
    University of of Amsterdam Orthopaedic Residency Program (PGY 4), Academic Medical CenterAmsterdam, Netherlands.
    Ring, D.
    Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical SchoolBoston, MA, United States.
    Biomechanical studies: Science (f)or common sense?2014In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 45, no 12, 2035-2039 p.Article in journal (Refereed)
    Abstract [en]

    Introduction: It is our impression that many biomechanical studies invest substantial resources studying the obvious: that more and larger metal is stronger. The purpose of this study is to evaluate if a subset of biomechanical studies comparing fixation constructs just document common sense. Methods: Using a web-based survey, 274 orthopaedic surgeons and 81 medical students predicted the results of 11 biomechanical studies comparing fracture fixation constructs (selected based on the authors sense that the answer was obvious prior to performing the study). Sensitivity, specificity, and accuracy were calculated according to standard formulas. The agreement among the observers was calculated by using a multirater kappa, described by Siegel and Castellan. Results: The accuracy of predicting outcomes was 80% or greater for 10 of 11 studies. Accuracy was not influenced by level of experience (i.e., time in practice and medical students vs. surgeons). There were substantial differences in accuracy between observers from different regions. The overall categorical rating of inter-observer reliability according to Landis and Koch was moderate (k = 0.55; standard error (SE) = 0.01). Conclusion: The results of a subset of biomechanical studies comparing fracture fixation constructs can be predicted prior to doing the study. As these studies are time and resource intensive, one criterion for proceeding with a biomechanical study should be that the answer is not simply a matter of common sense. © 2014 Elsevier Ltd. All rights reserved.

  • 48.
    Romanos, J.
    et al.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, PO Box 30001, Groningen 9700 RB, Netherlands; School of Medicine, Lebanese American University, Beirut, Lebanon.
    Rosen, A.
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden; Department of Medical Biosciences, Medical and Clinical Genetics, Umeå University, Umeå, Sweden.
    Kumar, V.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Trynka, G.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, PO Box 30001, Groningen 9700 RB, Netherlands; Division of Genetics and Division of Rheumatology, Harvard Medical School, Brigham and Womens Hospital, Boston, MA, United States.
    Franke, L.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Szperl, A.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Gutierrez-Achury, J.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Van, Diemen C.C.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Kanninga, R.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Jankipersadsing, S.A.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, Netherlands.
    Steck, A.
    Barbara Davis Centre for Childhood Diabetes, University of of Colorado Denver, Aurora, CO, United States.
    Eisenbarth, G.
    Barbara Davis Centre for Childhood Diabetes, University of of Colorado Denver, Aurora, CO, United States.
    Van, Heel D.A.
    Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, London, United Kingdom.
    Cukrowska, B.
    Department of Pathology, Childrens Memorial Health Institute, Warsaw, Poland.
    Bruno, V.
    European Laboratory for Food-Induced Disease, University of of Naples Federico II, Naples, Italy.
    Mazzilli, M.C.
    Department of Molecular Medicine, Sapienza University of of Rome, Rome, Italy.
    Nunez, C.
    Clinical Immunology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos IdISSC, Madrid, Spain.
    Bilbao, J.R.
    Immunogenetics Research Laboratory, Hospital de Cruces, Bizkaia, Spain.
    Mearin, M.L.
    Department of Paediatrics, Leiden University of Medical Centre, Leiden, Netherlands.
    Barisani, D.
    Department of Experimental Medicine, Faculty of Medicine, University of of Milano- Bicocca, Monza, Italy.
    Rewers, M.
    Barbara Davis Centre for Childhood Diabetes, University of of Colorado Denver, Aurora, CO, United States.
    Norris, J.M.
    Epidemiology Department, Colorado School of Public Health, Aurora, United States.
    Ivarsson, A.
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
    Boezen, H.M.
    Department of Epidemiology, University of of Groningen, University of Medical Centre Groningen, Groningen, Netherlands.
    Liu, E.
    Barbara Davis Centre for Childhood Diabetes, University of of Colorado Denver, Aurora, CO, United States.
    Wijmenga, C.
    Department of Genetics, University of of Groningen, University of Medical Centre Groningen, PO Box 30001, Groningen 9700 RB, Netherlands.
    Improving coeliac disease risk prediction by testing non-HLA variants additional to HLA variants2014In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 63, no 3, 415-422 p.Article in journal (Refereed)
    Abstract [en]

    Background The majority of coeliac disease (CD) patients are not being properly diagnosed and therefore remain untreated, leading to a greater risk of developing CD-associated complications. The major genetic risk heterodimer, HLA-DQ2 and DQ8, is already used clinically to help exclude disease. However, approximately 40% of the population carry these alleles and the majority never develop CD. Objective We explored whether CD risk prediction can be improved by adding non-HLA-susceptible variants to common HLA testing. Design We developed an average weighted genetic risk score with 10, 26 and 57 single nucleotide polymorphisms (SNP) in 2675 cases and 2815 controls and assessed the improvement in risk prediction provided by the non-HLA SNP. Moreover, we assessed the transferability of the genetic risk model with 26 non-HLA variants to a nested case-control population (n=1709) and a prospective cohort (n=1245) and then tested how well this model predicted CD outcome for 985 independent individuals. Results Adding 57 non-HLA variants to HLA testing showed a statistically significant improvement compared to scores from models based on HLA only, HLA plus 10 SNP and HLA plus 26 SNP. With 57 non-HLA variants, the area under the receiver operator characteristic curve reached 0.854 compared to 0.823 for HLA only, and 11.1% of individuals were reclassified to a more accurate risk group. We show that the risk model with HLA plus 26 SNP is useful in independent populations. Conclusions Predicting risk with 57 additional non-HLA variants improved the identification of potential CD patients. This demonstrates a possible role for combined HLA and non-HLA genetic testing in diagnostic work for CD.

  • 49.
    Birkehag, Emma
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Ansvariga mammor, valbara pappor och ojämställda "andra": Psykologers konstruktioner av kön samt etnicitet och ras relaterat till föräldraskap inom barn- och ungdomspsykiatrin2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Psykologer och barn- och ungdomspsykiatrin kan förstås som delar av de professioner och institutioner som i Sverige är med och formar föräldraskapets innehåll och utformning. Syftet med studien var att undersöka hur psykologer inom barn- och ungdomspsykiatrin i Sverige konstruerar kön och etnicitet/ras i relation till föräldraskap samt att undersöka vilken funktion konstruktionerna har för att upprätthålla eller utmana hegemoniska konstruktioner av kön och etnicitet/ras. Tio psykologer verksamma inom barn- och ungdomspsykiatrin intervjuades och materialet analyserades med metoden kritisk diskurspsykologi.

    Resultatet visade att psykologer konstruerar kön som att moderskap består av självklar och nödvändig närvaro och faderskap av valbar, positiv och kompletterande närvaro. Moderskap konstrueras vidare som tillgänglighet och omsorgsfullhet, och som en möjlig orsak till barnets problem eller psykiska ohälsa. Psykologerna konstruerar även föräldrarnas kön heteronormativt samt konstruerar kön relaterat till föräldraskap som könsneutralt. Psykologerna konstruerar etnicitet/ras relaterat till föräldraskap som att etnicitet inte har någon betydelse, varvat med en konstruktion av ”vi mot dem”, där svenskar ställs mot icke-europeiska föräldrar, och där ”de andras” familjerelationer konstrueras som präglade av könsmakt. Konstruktionernas funktion diskuteras och värdera slutligen.

  • 50.
    Odeskog, Sanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Stenberg, Noomi
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Validering av föräldraskattningsformuläret SCDI-III för svenska barn i tre års ålder2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The Swedish Communicative Development Inventory (SCDI-III), a parent report instrument, is a modified form of the third version of the MacArthur-Bates Communicative Development Inventory, and has been developed as a research tool for the investigation of the language ability of children aged 2;6 - 4;0 years.

    It is of great importance that children who are most at risk of developing a language impairment are identified in time in order to increase the possibility to stimulate their language in favourable developmental phases. Clinicians have expressed a need for a material that can provide an overview of a child’s language ability, prior to carrying out further language assessment. The need of such material has contributed to the need for an investigation of the validity of SCDI-III, which has formed the basis for the present study. The purpose was to validate the already standardized parent estimation form SCDI-III with established language assessments to investigate whether it can be used to identify children who are at risk for language impairment.

    Forty-one children (21 girls and 20 boys) aged 3;0 - 3;11 years, with Swedish as their mother tongue, and 41 guardians participated in the study. The grammatical abilities of the children were examined using the validation tools SIT (Språkligt Impressivt Test) and Gramba (Grammatiktest för barn) and the lexical abilities were examined using BNT (Boston Naming Test) and PPVT-III (Peabody Picture Vocabulary Test). The testing was performed at their respective daycare center, and the guardians filled in SCDI-III, after which the results were compared.  

    Moderate significant correlations were found between estimations in SCDI’s word production section and the children’s production on the BNT and the result of the PPVT-III, and between parents’ evaluations in the sentence construction section of the questionnaire and the test results on Gramba. No significant or strong correlations in the sentence complexity section of the SCDI-III were found on any of the four SLP assessments. In addition to these results, girls performed significantly better than boys on Gramba and the oldest children had significantly better results than the youngest on the BNT. The results of the present study suggest a need for different methods and perspectives for the assessment of children’s language abilities. SCDI-III could therefore be a complementary tool in providing a basis for discussion between practicing speech-language pathologists and guardians, but cannot be used as an assessment tool by itself. 

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