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  • 1. Aareleid, Tiiu
    et al.
    Leinsalu, Mall
    Rahu, Mati
    Baburin, Aleksei
    Lung cancer in Estonia in 1968-87: time trends and public health implications.1994Ingår i: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 3, nr 5, s. 419-425Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Changes in lung cancer incidence and mortality in Estonia were studied for 20 years (1968-87). A steady upward trend was observed for men and women. The 1983-87/1968-72 age-standardized incidence rate ratio was 1.22 (95% confidence interval (CI) 1.15-1.29) in men and 1.34 (95% CI 1.16-1.54) in women. The corresponding mortality rate ratio was 1.26 (95% CI 1.18-1.34) in men and 1.35 (95% CI 1.16-1.57) in women. The age-specific incidence and mortality rates increased clearly towards the younger birth cohorts. For men and women, the increase was most evident for the age group 45-64 years. In women there was a more rapid increase in incidence and mortality than in men. It may be a result of a substantial increase of tobacco smoking, particularly among women, after the World War II. The high and still rising occurrence of lung cancer is closely related to the high prevalence of smoking; in addition, high tar yields in domestic cigarettes could have been responsible for an elevated lung cancer risk during the past decades. There is not tobacco control programme in Estonia, and existing legislation and regulations do not defend the non-smoking population.

  • 2.
    Abdi Ali Ahmed, Yousra
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik, Utveckling och internationellt samarbete.
    A Study on behavioral Health Interventions for Neglected tropical diseases: What is missing in current health interventions?2017Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Aim: The aim of this paper is to provide a deeper understanding of the spread of NTDs but to also determine what is missing in the health interventions that are conducted in the countries affected by NTD.

    Method and theory: The method used in this paper is the theory testing approach which is the Social Cognitive Theory. Development in the 1970s by A. Badura, it’s based on the concept of interaction between personal, environmental and social factors.

    Results: The results showed that both the previous research and today’s health interventions lack the understanding of the roll social and personal factors play in the spread of NTD. They mainly target the environmental factors and medical. Therefore, the NTDs are still endemic despite the effort during many years.

    Ladda ner fulltext (pdf)
    fulltext
  • 3. Adamsson, I
    et al.
    Edlund, Charlotta
    Södertörns högskola, Avdelning Naturvetenskap. Karolinska Institute.
    Nord, C E
    Microbial ecology and treatment of Helicobacter pylori infections: Review2000Ingår i: Journal of chemotherapy, ISSN 1120-009X, E-ISSN 1973-9478, Vol. 12, nr 1, s. 5-16Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    The aims of the present study were to investigate the ecological disturbances caused by four different anti-H. pylori regimens, to compare different methods for diagnosing H. pylori, and to study the genetic variability of H. pylori. The patients included in the study were all treated at the Center of Gastroenterology, Huddinge University Hospital, Karolinska Institute. All patients were H. pylori-positive before entering the study, confirmed by rapid urease test, histology, culture and urea breath test or PCR. Treatment regimens included in the study were omeprazole alone (OP), in combination with amoxicillin (OA), in combination with amoxicillin and metronidazole (OAM) and in combination with clarithromycin and metronidazole (OCM). Samples from the mouth (saliva and dental plaque), stomach (biopsies from the gastric mucosa in the corpus and in the antrum) and the intestine (feces) were collected before, during and after treatment. The oral microflora was challenged by the three treatment regimens including antimicrobial agents, with the emergence of resistant streptococci and staphylococci in the OCM group. Bacterial strains in the gastric mucosa increased in numbers during treatment in all treatment groups, probably due to the pH rise, which provides a better environment for the commensal microflora. This overgrowth was especially pronounced during treatment with omeprazole alone (OP), possibly due to the fact that a concomitant suppression exerted by the antimicrobial agents occurred in the other treatment groups. H. pylori was, on the other hand, suppressed during treatment in all treatment groups, possibly due to a direct effect of omeprazole and to the colonization resistance expressed by the normal microflora, An emergence of resistant commensal strains in the gastric mucosa was seen in the OCM and the OAM groups. The intestinal microflora was most altered in the OAM and the OCM groups, with persistent disturbances in the OCM group 4 weeks after treatment. The frequency of resistant Enterococcus spp, (OCM), Enterobacteriaceae spp, (OA and OAM) and Bacteroides spp, (OCM) was increased during and after treatment. Different detection methods for H. pylori were compared and PCR was shown to have higher sensitivity than other routine diagnostic tests. The patients in the present study seemed to be colonized with a single strain of H. pylori. Treatment failures in patients treated with OAM were caused by recrudescence. These four patients with relapsing H. pylori infection, were shown to be reinfected with the original H. pylori strain, indicating that H. pylori escapes treatment by a thus far unknown mechanism.

  • 4.
    Adamsson, Inger
    et al.
    Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Nord, Carl Erik
    Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Lundquist, Per
    Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Sjöstedt, Svante
    Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Edlund, Charlotta
    Södertörns högskola, Avdelning Naturvetenskap. Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Comparative effects of omeprazole, amoxycillin plus metronidazole versus omeprazole, clarithromycin plus metronidazole on the oral, gastric and intestinal microflora in Helicobacter pylori-infected patients1999Ingår i: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 44, nr 5, s. 629-640Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Fourteen patients with Helicobacter pylori infection were treated with 20 mg omeprazole, 1 g amoxycillin and 400 mg metronidazole bd for 7 days (OAM), and 16 patients were treated with 20 mg omeprazole, 250 mg clarithromycin and 400 mg metronidazole bd for 7 days (OCM). Saliva, gastric biopsies and faecal samples were collected before, during (day 7) and 4 weeks after treatment in order to analyse alterations of the normal microflora and to determine antimicrobial susceptibility. Both treatment regimens resulted in marked quantitative and qualitative alterations. A selection of resistant streptococcal strains were noticed in both treatment groups, most apparent in the OCM group where a shift from susceptible to resistant strains was recorded. In the OAM group, six patients had overgrowth of resistant Enterobacteriaceae during treatment compared with none in the OCM group, in the gastric microflora. The MICs for Enterococcus spp. and Enterobacteriaceae in faeces increased significantly during treatment in both groups. Nine patients in the OAM group became intestinally colonized by yeasts during treatment. The total anaerobic microflora was strongly suppressed in both treatment groups, although most pronounced in the OCM group, where the frequency of clarithromycin-resistant bacteroides strains increased from 2 to 76% during treatment, and remained at 59% 4 weeks post-treatment. Even if the treatment outcome was better in the OCM group (100%) than in the OAM group (71%), the amoxycillin-based treatment might be preferable from an ecological point of view, since the qualitative alterations in terms of emergence and persistence of resistant strains seemed to be most pronounced in the clarithromycin-treated group.

  • 5. Agvald-Öhman, C
    et al.
    Lund, B
    Edlund, Charlotta
    Södertörns högskola, Institutionen för kemi, biologi, geografi och miljövetenskap.
    Multiresistant coagulase-negative staphylococci disseminate frequently between intubated patients in a multidisciplinary intensive care unit2004Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 8, nr 1, s. R42-R47Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction The intensive care unit is burdened with a high frequency of nosocomial infections often caused by multiresistant nosocomial pathogens. Coagulase-negative staphylococci (CoNS) are reported to be the third causative agent of nosocomial infections and the most frequent cause of nosocomial bloodstream infections. CoNS are a part of the normal microflora of skin but can also colonize the nasal mucosa, the lower airways and invasive devices. The main aim of the present study was to investigate colonization and the rate of cross-transmissions of CoNS between intubated patients in a multidisciplinary intensive care unit. Materials and methods Twenty consecutive patients, ventilated for at least 3 days, were included. Samples were collected from the upper and lower airways. All samples were cultured quantitatively and CoNS were identified by morphology and biochemical tests. A total of 199 CoNS isolates from 17 patients were genetically fingerprinted by pulsed-field gel electrophoresis in order to identify clones and to monitor dissemination within and between patients. Results An unexpected high number of transmission events were detected. Five genotypes were each isolated from two or more patients, and 14/20 patients were involved in at least one and up to eight probable transmission events. Conclusions A frequent transmission of CoNS was found between patients in the intensive care unit. Although transmission of bacteria does not necessarily lead to infection, it is nevertheless an indication that infection control measures can be improved.

  • 6.
    Ahmed, Iqra Shahzadi
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    Preventing the spread of Tuberculosis via refugees, asylum seekers and immigrants entering Sweden: A study of health communication, prevention strategies, policies and recommendations2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Sverige har under många decennier sett en minskning av tuberkulos (TBC), men infektionen har kontinuerligt ökat från 2003. Majoriteten av TBC-fallen är personer som är födda utanför Sverige. Hälsotillståndet har förbättrats i Sverige men det finns fortfarande problem. Kommunikationen mellan flyktingar och sjukvårdsspecialister är bristande idag, vilket resulterar att endast ett fåtal genomgår hälsokontroller. Detta kan leda till en ökning av infektioner och sjukdomar i Sverige.

    Denna studie undersöker hur hälsokommunikationen idag fungerar mellan den svenska sjukvården, nyanlända immigranter, asylsökande och flyktingar, samt vilken typ av vård som finns tillgänglig för flyktingar med hög risk för att utveckla TBC. Specifikt syftar studien till att förstå på vilket sätt kommunikation brister på samt analysera vilka sätt det finns för att en reducering av TBC i Sverige ska kunna ske och hur kommunikationen kan förbättras. Studien har genomförts med hjälp av både primära källor i form av intervjuer och sekundära källor.

    Baserat på de intervjuer och sekundära källor som genomförts i studien dras slutsatsen att trots att den svenska sjukvården utvecklas positivt så finns det en hel del brister - hälsokommunikation är bristande idag mellan nyanlända flyktingar, sjukvårdspersonal och myndigheter. En av huvudorsakerna som informanterna i studien nämnt är språket, mycket av det som skrivs och sägs är på svenska. Det är viktigt att en mer välfungerad hälsokommunikation utvecklas mellan de nyanlända flyktingarna, sjukvårdspersonal och myndigheterna för att det ska kunna underlättas för flyktingar att söka vård och samarbeta med sjukvårdspersonal med deras arbete för att kunna förhindra spridning av TBC och andra sjukdomar och infektioner i Sverige. 

    Ladda ner fulltext (pdf)
    fulltext
  • 7. Akre, O
    et al.
    Ekbom, A
    Sparén, Pär
    Södertörns högskola, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Tretli, S
    Body size and testicular cancer2000Ingår i: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 92, nr 13, s. 1093-1096Artikel i tidskrift (Refereegranskat)
  • 8.
    Alam, Sadaf Sakina
    Södertörns högskola, Institutionen för livsvetenskaper.
    Determination of gp120 & Trx80 dependent production of hydrogen peroxide in cell free & cell-dependent systems2009Självständigt arbete på avancerad nivå (masterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Hydrogen peroxide (H2O2), a reactive oxygen specie (ROS), is most commonly associated with oxidative stress causing cytotoxic effects on living cells. Oxidative stress has been implicated in various conditions including neurodegenerative diseases, autoimmune diseases and cancer. In addition H2O2 is produced as a defense mechanism against pathogens, as being released by activated phagocytes. In recent years, H2O2 has become established as an important regulator of signal transduction in eukaryotic cells. Hydrogen peroxide is generated both intracellularly and extracellularly in response to various stimuli including cytokines and growth factors. There are different mechanisms by which H2O2 is generated, facilitating signal transduction in cells; through NOX-system in miyochondria, via singlet oxygen, receptor/ligand interaction or by redox active metal ions. The HIV glycoprotein 120 (gp120) is associated with HIV dementia and it is known as a neurotoxin that causes neuronal damage. It has been proposed that free radicals may be involved in the pathogenesis caused by gp120. In addition the truncated form of thioredoxin (Trx80) is known to stimulate HIV replication in HIV infected cells, however, the exact mechanism is not known. A possible way both proteins may mediate their activity is by inducing H2O2 production. The aim of this study was to investigate H2O2 production induced by the proteins gp120 and Trx80. In order to detect H2O2 production an assay based on the fluorescent compound Amplex Red, was established. The assay was used to detect H2O2 released by gp120 and Trx80 in a cell-free environment, in a cell-system and in the presence of metal ions (copper ions) with a physiological reductant (ascorbate). We did not detect H2O2 production induced by gp120 and Trx80 respectively, using our assay, however, other ROS such as hydroxyl radicals may have been generated although they were not detectable with our method. Hence, further studies are needed in order to fully understand how gp120 and Trx80 mediate their activity.

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 9.
    Alkemar, Gunnar
    Södertörns högskola, Institutionen för livsvetenskaper. Stockholms universitet, Wenner-Grens institut.
    Ribosome and ribosomal RNA Structure: An experimental and computational analysis of expansion segments in eukaryotic ribosomal RNA2008Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Ribosomes are large ribonucleoprotein complexes which incorporate amino acids into peptide chains during translational process in all types of living cells. The eukaryotic ribosome is larger compared to its prokaryotic counterpart. The size differences are due to a larger protein part and that the rRNA contains eukaryote specific expansion segments (ES). Cryo-EM reconstruction has visualized many ES on the ribosomal surface which have given clues about function and structural features. However, the secondary structures of most ES are unknown or ill defined. In this thesis, the secondary and also to a certain extent the tertiary structures of several ES are determined by using computational methods and biochemical experimental techniques. The juxtaposition of ES6 close to ES3 in the Cryo-EM image of the yeast ribosome suggested that ES3 and ES6 might interact. A computational analysis of more than 2900 sequences shows that a complementary helical region of seven to nine contiguous base pairs can form between ES3 and ES6 in almost all analyzed sequences. Biochemical in situ experiments support the proposed interaction. Secondary structure models are presented for ES3 and ES6 in 18S rRNA and ES39 in 28S rRNA, where homologous structural elements could be modeled in the experimentally analyzed ribosomes from fungi, plants and mammals. The structure models were further supported by computational methods where the ES6 structure and the ES39 structure could be formed in more than 6000 and 900 sequences respectively. A tertiary structure model of ES3 and ES6 including the helical interaction is presented. An in vitro transcribed and folded ES6 sequence differed from that observed in situ, suggesting that chaperones, ribosomal proteins, and/or the tertiary rRNA interaction could be involved in the in vivo folding of ES6. An analysis of the similarities between ES39 structures suggests that it might be under selective constraint to preserve its secondary structure.

  • 10.
    Alshareef, Hanouf
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    The Effect of Water, Sewage and Hand Hygiene on Waterborne Diseases in Saudi Arabia2021Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Waterborne diseases are illnesses caused by microscopic organisms, like viruses, bacteria and  parasites, that transmitted via the fecal-oral route through ingestion of contaminated water or food or by direct person to person contact. The transmission cycle can be broken through safe water supplies, maintaining standards of sanitation and proper handwashing practices. Two waterborne diseases are considered in this study: hepatitis A and amebic dysentery. The study aimed to understand the important factors for preventing waterborne diseases in order to improve public health. A descriptive cross-sectional study was conducted to assess the effect of different drinking water sources, sewage systems and different active practices of soap use for hand washing on incidence of waterborne diseases in different regions in Saudi Arabia. Data was obtained from Ministry of Health and Household Environment Survey provided by General Authority for Statistics. Statistical analysis performed by using general linear model and type II Analysis of Variance. In comparison of different drinking water sources, this study showed borderline rise in incidence of waterborne diseases with the use of private well water. Whereas different sewage systems had no clear effect on the incidence of waterborne diseases. The study also revealed that not using soap for hand washing would increase the risk for hepatitis A infection. Moreover, the study showed significant decline in waterborne diseases incidence when access to filtered water combined with regular soap use in the same linear model.

    Ladda ner fulltext (pdf)
    The Effect of Water, Sewage and Hand Hygiene on Waterborne Diseases in Saudi Arabia Hanouf Alshareef
  • 11.
    Alsterdal, Lotte
    Södertörns högskola, Institutionen för kultur och kommunikation, Centrum för praktisk kunskap.
    Dilemman i omsorgsarbete: att stödja personer med funktionsnedsättningar i deras boende2010Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
  • 12. Aluoja, Anu
    et al.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhälle och historia, Sociologi. Södertörns högskola, Institutionen för samhälle och historia, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Symptoms of depression in the Estonian population: prevalence, sociodemographic correlates and social adjustment2004Ingår i: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 78, nr 1, s. 27-35Artikel i tidskrift (Refereegranskat)
  • 13. Aluoja, Anu
    et al.
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Leinsalu, Mall
    Development and psychometric properties of the Emotional State Questionnaire: a self-report questionnaire for depression and anxiety1999Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 53, nr 6, s. 443-449Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Anxiety and depression are dimensions of emotional state that can be validly assessed with self-report measures. This article introduces a new self-report questionnaire for depression and anxiety (Emotional State Questionnaire (EST-Q)) and presents data on its reliability and validity. The items of the EST-Q were derived from diagnostic criteria of DSM-IV and ICD-10. Thirty-three items were rated on a five-point frequency scale. The questionnaire was administered to 194 inpatients with depressive and anxiety disorders and to a population sample of 479 subjects. According to the results of factor analysis, five subscales were formed: Depression, Anxiety, Agoraphobia-Panic, Fatigue, and Insomnia. EST-Q and subscales showed acceptable internal consistency (alpha = 0.69-0.88). Significant differences in subscales between patients and population and across diagnostic groups confirmed the discriminant validity of the instrument. Depression, Anxiety, and Agoraphobia-Panic subscales distinguished corresponding diagnostic groups. Fatigue and Insomnia appeared to assess nonspecific psychopathology dimensions characteristic of several psychiatric disorders.

  • 14. Alvarez, J. L.
    et al.
    Kunst, A. E.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Bopp, M.
    Strand, B. H.
    Menvielle, G.
    Lundberg, O.
    Martikainen, P.
    Deboosere, P.
    Kalediene, R.
    Artnik, B.
    Mackenbach, J. P.
    Richardus, J. H.
    Educational inequalities in tuberculosis mortality in sixteen European populations2011Ingår i: The International Journal of Tuberculosis and Lung Disease, ISSN 1027-3719, E-ISSN 1815-7920, Vol. 15, nr 11, s. 1461-1467Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban and rural populations in several European countries. DESIGN: Data were obtained from the Eurothine Project, covering 16 populations between 1990 and 2003. Age- and sex-standardised mortality rates, the relative index of inequality and the slope index of inequality were used to assess educational inequalities. RESULTS: The number of TB deaths reported was 8530, with a death rate of 3 per 100000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were greater than in total mortality. Relative and absolute inequalities were large in Eastern European and Baltic countries but relatively small in Southern European countries and in Norway, Finland and Sweden. Inequalities in mortality were observed among both men and women, and in both rural and urban populations. CONCLUSIONS: Socio-economic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve access to treatment of vulnerable groups and thereby reduce TB mortality.

  • 15.
    Ambagtsheer, Frederike
    et al.
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Gunnarson, Martin
    Södertörns högskola, Institutionen för kultur och lärande, Centrum för praktisk kunskap.
    de Jong, Jessica
    Central Division of the National Police, the Netherlands.
    Lundin, Susanne
    Lund University.
    van Balen, Linde
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Orr, Zvika
    The Hebrew University of Jerusalem, Israel.
    Byström, Ingela
    Lund University.
    Weimar, Willem
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Trafficking in Human Beings for the Purpose of Organ Removal: A Case Study Report2016Ingår i: Trafficking in Human Beings for the Purpose of Organ Removal: Results and Recommendations / [ed] Frederike Ambagtsheer & Willem Weimar, Lengerich: Pabst Science Publishers, 2016Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 16.
    Ambagtsheer, Frederike
    et al.
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Gunnarson, Martin
    Södertörns högskola, Institutionen för kultur och lärande, Centrum för praktisk kunskap.
    van Balen, Linde
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Ivanovski, Ninoslav
    University of St. Cyril and Methodius, Macedonia.
    Lundin, Susanne
    Lund University.
    Byström, Ingela
    Lund University.
    Weimar, Willem
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Organ Recipients who Paid for Kidney Transplantation abroad: A Report2016Ingår i: Trafficking in Human Beings for the Purpose of Organ Removal: Results and Recommendations / [ed] Frederike Ambagtsheer & Willem Weimar, Lengerich: Pabst Science Publishers, 2016Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 17. Andersen, Ronald
    et al.
    Smedby, Björn
    Vågerö, Denny
    Cost containment, solidarity and cautious experimentation: Swedish dilemmas2001Ingår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 52, s. 1195-1204Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints on health services spending and service delivery — a policy emphasizing “cost containment?” It examines recent policies and longer term trends including: changes in health personnel and facilities; integration of health and social services for older persons; introduction of competition among providers; cost sharing for patients; dismantling of dental insurance; decentralization of government responsibility; priority settings for treatment; and encouragement of the private sector. It is apparent that the Swedes have had considerable success in attaining cost containment — not primarily through “market mechanisms” but through government budget controls and service reduction. Further, it appears that equal access to care, or solidarity, may be adversely affected by some of the system changes.

  • 18.
    Andersson, Gustaf
    Södertörns högskola, Institutionen för svenska, retorik och journalistik.
    Ungdomsdiabetes: ett livslångt kontrollbehov2006Självständigt arbete på grundnivå (kandidatexamen), 20 poäng / 30 hpStudentuppsats
    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 19.
    Andrén, Victoria
    et al.
    Stockholm University, Sweden; Region Västmanland, Sweden.
    Öjemyr, Torun Lindholm
    Region Västmanland, Sweden.
    Yourstone, Jenny
    Södertörns högskola, Institutionen för samhällsvetenskaper, Psykologi.
    Damberg, Mattias
    Uppsala University, Uppsala, Sweden; Västmanland County Hospital, Sweden.
    Gender and arson: psychosocial, psychological, and somatic offender characteristics at the time of the crime2023Ingår i: Journal of Forensic Psychiatry & Psychology, ISSN 1478-9949, E-ISSN 1478-9957, Vol. 34, nr 1, s. 113-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Deliberate fire-setting, such as the crime of arson, can have devastating, even lethal, consequences. This study compared factors at the time of arson by female and male offenders in Sweden between 2000–2010. The women (n = 100), and men (n = 100) included in this study were randomly chosen from among all individuals who had been convicted for arson during this period and who underwent forensic psychiatric investigations. Information regarding psychiatric and somatic characteristics, their psychosocial situation, and whether they were in contact with health or social services before the arsons were examined. The results showed that both women and men have complex psychiatric and somatic characteristics, as well as psychosocial situations. Women showed more self-destructive behaviour, lower Global Assessment of Functioning scores, and had been in contact with psychiatric health services to a greater extent than men. More women than men had children. These findings suggest that specific actions may be needed for preventing and treating women compared with men at risk for committing arson. 

  • 20.
    Ardila-Ardila, A.
    et al.
    University of Miami/Jackson Memorial Medical Center, USA.
    Goodkin, K.
    University of Miami/Jackson Memorial Medical Center, USA.
    Concha-Bartolini, M.
    University of Miami/Jackson Memorial Medical Center, USA.
    Lecusay-Ruiz, Robert
    University of Miami/Jackson Memorial Medical Center, USA.
    O'Mellan-Fajardo, S.
    University of Miami/Jackson Memorial Medical Center, USA.
    Suarez-Bustamante, P.
    University of Miami/Jackson Memorial Medical Center, USA.
    Molina-Vasquez, R.
    University of Miami/Jackson Memorial Medical Center, USA.
    Lee, D.
    University of Miami/Jackson Memorial Medical Center, USA.
    Chayeb, G.
    University of Miami/Jackson Memorial Medical Center, USA.
    Wilkie, F. L.
    University of Miami/Jackson Memorial Medical Center, USA.
    HUMANS: una batería neuropsicologica para la evaluación de pacientes infectados con VIH-1: [Humans: a neuropsychological battery for evaluating HIV-1 infected patients]2003Ingår i: Revista de Neurocirugía, ISSN 1514-3716, Vol. 36, nr 8, s. 756-762Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

  • 21.
    Arillo, Maria-Isabel
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    Cutting the cord: a study on maternal mortality and obstetric care in disaster settings2012Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    This study examines global incentives to reduce maternal mortality, namely the fifth Millenium Developmnet Goal to reduce maternal mortality with 75% by 2015. More specifically it examines maternal mortality and obstetric care in situations of emergency. When exposed to extreme situations the risks of negative pregnancy- and delivey outcomes are increased. Data was collected from seconday sources and from interviews with health staff with experiences from humanitarian work in the field. The findings were analyzed using a theoretical framework explaining maternal mortality be referring to both direct and indirect causes. The two theoretical models used in the study are similar and reminds of each other when explaining maternal mortality. One is based on the assumption that an obstetric complication has occurred and differnt delays in recieving care is the main cause maternal mortality, whilst the other theory is more in depth and elaborates the underlying causes. The first theory is used a base tto analyze the data after which the other theory is applied in order to introdue a deeper dimension to the analysis. The findings suggest that direct causes accounts for 80 per cent of all maternal deaths, homorrhage being the largest, including in disasters. Further causes are infections, unsafe abortions, eclampsia and obstructed labor. Also, underlying socail factors such as gender inequality indirectly has a negative impact on maternal mortality. Moreover, findings suggest that obstetric care is prioritized in disaster relief response.

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  • 22.
    Azad, Azadé
    et al.
    Stockholm University, Sweden.
    Sernbo, Elisabet
    University of Gothenburg, Sweden.
    Svärd, Veronica
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete. Karolinska Institutet, Sweden.
    Holmlund, Lisa
    Karolinska Institutet, Sweden.
    Björk Brämberg, Elisabeth
    Karolinska Institutet, Sweden.
    Conducting In-Depth Interviews via Mobile Phone with Persons with Common Mental Disorders and Multimorbidity: The Challenges and Advantages as Experienced by Participants and Researchers2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 22, s. 11828-11828Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Qualitative interviews are generally conducted in person. As the coronavirus pandemic (COVID-19) prevents in-person interviews, methodological studies which investigate the use of the telephone for persons with different illness experiences are needed. The aim was to explore experiences of the use of telephone during semi-structured research interviews, from the perspective of participants and researchers. Data were collected from mobile phone interviews with 32 individuals who had common mental disorders or multimorbidity which were analyzed thematically, as well as field notes reflecting researchers’ experiences. The findings reveal several advantages of conducting interviews using mobile phones: flexibility, balanced anonymity and power relations, as well as a positive effect on self-disclosure and emotional display (leading to less emotional work and social responsibility). Challenges included the loss of human encounter, intense listening, and worries about technology, as well as sounds or disturbances in the environment. However, the positive aspects of not seeing each other were regarded as more important. In addition, we present some strategies before, during, and after conducting telephone interviews. Telephone interviews can be a valuable first option for data collection, allowing more individuals to be given a fair opportunity to share their experiences.

  • 23.
    Azad, Azadé
    et al.
    Karolinska Institutet, Sweden; Stockholm University, Sweden.
    Svärd, Veronica
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete. Karolinska Institutet, Sweden.
    Patients’ with Multimorbidity and Psychosocial Difficulties and Their Views on Important Professional Competence for Rehabilitation Coordinators in the Return-to-Work Process2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, nr 19, artikel-id 10280Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Coordinators may play a key role during the return-to-work (RTW) process for people on sickness absence. There are still few studies on the newly implemented rehabilitation coordinators (RECO) within Swedish healthcare, and none focus on their competence. The aim of this study was to explore how persons with multimorbidity and psychosocial difficulties describe the professional competence of the RECO they encountered during their RTW process. The study takes a relational and practical approach in defining professional competence, including both what professionals do and what they possess. Interviews with 12 people with multimorbidity and psychosocial difficulties who had encountered a RECO during their RTW process were analysed using thematic analysis. Six different themes were found: communicative and coordinating skills; advisory and guidance skills; engagement and advocacy skills; being persistent and flexible; being empathic and therapeutic; being professional and trustworthy. Most of these are found in research on RTW coordinators, but being persistent, and having advisory, guidance, advocacy and therapeutic skills have not been recognised as important competences previously. This study adds patients’ views on important professional competence that support the RTW process, which should be regarded in further developments of RECOs’ functions and their competence descriptions.

  • 24.
    Baars, Adája E
    et al.
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Rubio-Valverde, Jose R
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Hu, Yannan
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Bopp, Matthias
    University of Zürich, Zurich, Switzerland.
    Brønnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Regidor, Enrique
    Universidad Complutense de Madrid, and CIBER Epidemiología y Salud Pública, Madrid, Spain.
    White, Chris
    Office for National Statistics, London, United Kingdom.
    Wojtyniak, Bogdan
    National Institute of Public Health, Warsaw, Poland.
    Mackenbach, Johan P
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Nusselder, Wilma J
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Fruit and vegetable consumption and its contribution to inequalities in life expectancy and disability-free life expectancy in ten European countries2019Ingår i: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 64, nr 6, s. 861-872Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To assess to what extent educational differences in total life expectancy (TLE) and disability-free life expectancy (DFLE) could be reduced by improving fruit and vegetable consumption in ten European countries.

    METHODS: Data from national census or registries with mortality follow-up, EU-SILC, and ESS were used in two scenarios to calculate the impact: the upward levelling scenario (exposure in low educated equals exposure in high educated) and the elimination scenario (no exposure in both groups). Results are estimated for men and women between ages 35 and 79 years.

    RESULTS: Varying by country, upward levelling reduced inequalities in DFLE by 0.1-1.1 years (1-10%) in males, and by 0.0-1.3 years (0-18%) in females. Eliminating exposure reduced inequalities in DFLE between 0.6 and 1.7 years for males (6-15%), and between 0.1 years and 1.8 years for females (3-20%).

    CONCLUSIONS: Upward levelling of fruit and vegetable consumption would have a small, positive effect on both TLE and DFLE, and could potentially reduce inequalities in TLE and DFLE.

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  • 25.
    Baburin, Aleksei
    et al.
    National Institute for Health Development, Tallinn, Estonia / University of Tampere, Tampere, Finland.
    Lai, Taavi
    University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre on Health of Societies in Transition). Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Avoidable mortality in Estonia: Exploring the differences in life expectancy between Estonians and non-Estonians in 2005-2007.2011Ingår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, nr 11, s. 754-762Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia.

    STUDY DESIGN: Descriptive study.

    METHODS: Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable).

    RESULTS: The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death.

    CONCLUSIONS: Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures.

  • 26.
    Baburin, Aleksei
    et al.
    National Institute for Health Development, Tallinn, Estonia.
    Reile, Rainer
    National Institute for Health Development, Tallinn, Estonia; University of Tartu, Tartu, Estonia.
    Veideman, Tatjana
    National Institute for Health Development, Tallinn, Estonia.
    Leinsalu, Mall
    Södertörns högskola, Institutionen för samhällsvetenskaper, Sociologi. Södertörns högskola, Institutionen för samhällsvetenskaper, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Age, Period and Cohort Effects On Alcohol Consumption In Estonia, 1996-20182021Ingår i: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 56, nr 4, s. 451-459Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To analyse the independent effects of age, period and cohort on estimated daily alcohol consumption in Estonia.

    METHODS: This study used data from nationally representative repeated cross-sectional surveys from 1996 to 2018 and included 11,717 men and 16,513 women aged 16-64 years in total. The dependent variables were consumption of total alcohol and consumption by types of beverages (beer, wine and strong liquor) presented as average daily consumption in grams of absolute alcohol. Mixed-effects negative binomial models stratified by sex were used for age-period-cohort analysis.

    RESULTS: Alcohol consumption was highest at ages 20-29 years for both men and women and declined in older ages. Significant period effects were found indicating that total alcohol consumption and consumption of different types of beverages had increased significantly since the 1990s for both men and women. Cohort trends differed for men and women. Men born in the 1990-2000s had significantly lower daily consumption compared to earlier cohorts, whereas the opposite was found for women.

    CONCLUSION: While age-related patterns of alcohol consumption are aligned with life course stages, alcohol use has increased over the study period. Although the total daily consumption among men is nearly four times higher than among women, the cohort trends suggest convergence of alcohol consumption patterns for men and women.

  • 27.
    Bangah, Ramesh
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik, Miljövetenskap.
    The State of Needle Exchange Programs in Sweden and Hepatitis C Virus Incidence2020Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Hepatitis C virus (HCV) affects up to 45,000 people in Sweden today. Although it is a very treatable disease, the prevalence of HCV is extremely high within the population of people who inject drugs (PWID). This study examines the direct effect of needle exchange programs (NEPs) on HCV rates in Sweden. Previous research has shown that NEPs reduce the transmission of other blood-borne diseases among PWID. Using an interrupted time series (ITS) analysis, this study investigates if there are statistically significant differences between HCV rates in Swedish counties before and after the implementation of NEPs. The study also investigates via linear regression to see if there is a relationship between sterile injecting equipment (needles and syringes) dispensed and HCV rates in the counties where NEPs exist. While there has been a steady decrease in HCV rates across the country as a whole, the ITS analyses show no statistically significant differences in HCV rates due to the opening of NEPs. Because of the relatively recent introduction of NEPs in Sweden, more data points post-intervention may be needed before we can truly see the effect they have on regional HCV rates. There is also no relationship between the number of needles and syringes dispensed and county HCV rates. However, Sweden falls far short of the 300 syringes/needles per user per year recommendation of the World Health Organization at this time. Standardized data collection and further research can help answer these questions more clearly. 

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  • 28.
    Bellander, Theres
    et al.
    Stockholms universitet, Sverige.
    Karlsson, Anna-Malin
    Stockholms universitet, Sverige.
    Landqvist, Mats
    Södertörns högskola, Institutionen för kultur och lärande, Svenska.
    Melander Marttala, Ulla
    Uppsala univrsitet, Sverige.
    Nikolaidou, Zoe
    Södertörns högskola, Institutionen för kultur och lärande, Svenska.
    Att bygga hälsokunskap från konsultationsrum till onlineforum2021Ingår i: Tala om kroppen: språkliga perspektiv på hälsa och sjukdom i den digitala eran / [ed] Inga-Lill Grahn; Camilla Lindholm, Stockholm: Morfem , 2021, s. 109-137Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 29. Bergander, L
    et al.
    Wahlström, Niklas
    Södertörns högskola, Avdelning Naturvetenskap. Karolinska Institutet.
    Alsberg, T
    Bergman, Jan
    Södertörns högskola, Avdelning Naturvetenskap. Karolinska Institutet.
    Rannug, A
    Rannug, U
    Characterization of in vitro metabolites of the aryl hydrocarbon receptor ligand 6-formylindolo[3,2-b] carbazole by liquid chromatography-mass spectrometry and NMR.2003Ingår i: Drug Metabolism And Disposition, ISSN 0090-9556, E-ISSN 1521-009X, Vol. 31, nr 2, s. 233-241Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The tryptophan photoproduct 6-formylindolo[3,2-b] carbazole (FICZ) exhibits the highest aryl hydrocarbon receptor (AhR) binding affinity reported so far. In different cells, in vitro, both extracts of UV-irradiated tryptophan and the synthesized pure compound FICZ induce a rapid and transient expression of AhR-regulated genes. The transient induction suggests that the biotransformation gene battery induced by AhR activation takes part in a metabolic degradation of the ligand, whereby a low steady-state level is regained. The down-regulation of AhR-regulated gene expression was previously shown to be dependent on cytochrome P450 1A1 (CYP1A1). Metabolism of FICZ generates five major metabolites, which appeared as three peaks (M1-M3) in the high performance liquid chromatography. The aim of the present study was to use rat liver S9 from Aroclor-pretreated rats to produce large enough quantities of FICZ metabolites for structure characterization and to determine their product precursor relationship. NMR analysis of large combined fractions of the metabolites indicated that M3 and M2 contained 2 isomers, respectively. By means of liquid chromatography-mass spectrometry (negative ion electrospray mode) and NMR spectroscopy (by H-1-NMR, correlation spectroscopy, and nuclear Overhauser effect spectroscopy techniques) five metabolites of FICZ were identified, and their structures were elucidated. The molecular weights of the two M3 isomers were 300 and both M2 and M1 compounds demonstrated molecular weights of 316, corresponding to addition of one (M3) and of two oxygen (M2 and M1), respectively. The structures were assigned as 2- and 8-hydroxy (M3), 2,10- and 4,8-dihydroxy (M2) and 2,8-dihydroxy derivatives of indolo[3,2-b] carbazole-6-carboxaldehyde (6-formylindolo[ 3,2-b] carbazole).

  • 30.
    Bergfeldt, Vendela
    Södertörns högskola, Institutionen för naturvetenskap, miljö och teknik.
    Microbes that never sleep: A multidisciplinary study of the antibiotic resistance management in Sweden2016Självständigt arbete på avancerad nivå (masterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    The hypotheses of this study are that reduction and rational usage of antibiotics reduces development of antibiotic resistance. In Sweden, the trends do not follow this pattern. Despite a decrease in prescriptions of antibiotics, there is an increase in the number of patients infected with Methicillin-resistant Staphylococcus Aureus (MRSA), Extended Spectrum Beta-Lactamases (ESBL) and ESBL selecting for carbapenem-resistance (ESBLCARBA). This study aims to study factors affecting antibiotic resistance management. An additional aim is to use a multidisciplinary approach for a subject that has mostly been studied with quantitative methods. First, linear regressions investigated any possible significant changes of prescription rates in outpatient care, hospital usage of antibiotic groups and antibiotic resistance. After this, nine interviews were conducted with physicians in outpatient care, hospital care and with representatives from the Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance (Strama), a network working for Swedish prevention against antibiotics resistance. There was a significant decrease in the number of prescriptions of antibiotics in outpatient care among all Swedish counties and a small, but significant increase of antibiotics used in hospitals. The number of patients infected with multidrug resistant bacteria also show a significant increase. The interviews revealed that health care workers in all counties follow the same guidelines and try to be as specific as possible in choosing antibiotics to hit specific bacteria. The respondents suggested migration and extended travelling as explanations to the growing number of cases of multidrug resistant bacteria. Further, two major factors emerged as important for an efficient antibiotic resistance management; Education/knowledge and Discussion. The results indicate a need for further research on rational usage of antibiotics and the use of broad-spectrum antibiotics in hospital care, rather than the reduction through prescriptions. The results indicate that rational usage has a bigger impact than reduction. Using a multidisciplinary approach gave a broader perspective on the issue and future studies should see the possibilities of mixing quantitative and qualitative studies.

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  • 31.
    Berglund, Erik
    et al.
    Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Friberg, Emilie
    Karolinska Institutet, Sweden.
    Engblom, Monika
    Karolinska Institutet, Sweden.
    Andersén, Åsa
    Uppsala University, Sweden.
    Svärd, Veronica
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete. Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Coordination and Perceived Support for Return to Work: A Cross-Sectional Study among Patients in Swedish Healthcare2022Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, nr 7, artikel-id 4040Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Receiving support from a return-to-work (RTW) coordinator (RTWC) may be beneficial for people on long-term sick leave. The aim of this study was to investigate whether the number of contacts with an RTWC and their involvement in designing rehabilitation plans for the patients were associated with perceiving support for RTW, emotional response to the RTWC, and healthcare utilization. Methods: In this cross-sectional study, 274 patients who had recently been in contact with an RTWC in Swedish primary or psychiatric care answered questions regarding their interaction with an RTWC, perceived support for RTW, and emotional response to the RTWC. Results: Having more contact with an RTWC was associated with perceiving more support in the RTW process (adjusted OR 4.14, 95% CI 1.49–11.47). RTWC involvement in designing a rehabilitation plan for the patient was associated with perceiving more support in the RTW process from an RTWC and having a more positive emotional response to the RTWC. Conclusions: From the patient’s perspective, this study indicates that the involvement of an RTWC and receiving a rehabilitation plan that an RTWC has helped to design might be perceived as important in the RTW process.

  • 32.
    Berglund, Erik
    et al.
    Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Friberg, Emilie
    Karolinska Institutet, Sweden.
    Engblom, Monika
    Karolinska Institutet, Sweden.
    Svärd, Veronica
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete. Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Physicians’ experience of and collaboration with return-to-work coordinators in healthcare: a cross-sectional study in Sweden2023Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians.  The aim of this study was to explore physicians’ experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics.

    Materials and methods: Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs.

    Results: Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RtWcs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification.

    Conclusions: Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs’ facilitation of contacts with RtW stakeholders and improvements in the sickness certification process may be of importance for physicians.

  • 33. Bergström, R.
    et al.
    Sparén, Pär
    Södertörns högskola, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition). Karolinska Institute.
    Adami, H. -O
    Trends in cancer of the cervix uteri in Sweden following cytological screening1999Ingår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 81, nr 1, s. 159-166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Trends in cervical cancer incidence following the introduction of screening have mostly been studied using cross-sectional data and not analysed separately for squamous cell cancer and adenocarcinomas. Using Swedish nationwide data on incidence and mortality, we analysed trends during more than 3 decades and fitted Poisson-based age-period-cohort models, and also investigated whether screening has reduced the incidence of adenocarcinomas of the cervix. The incidence of reported cancer in situ increased rapidly during 1958-1967. Incidence rates of squamous cell cancer, fairly stable before 1968, decreased thereafter by 4-6% yearly in women aged 40-64, with a much smaller magnitude in younger and older women. An age-cohort model indicated a stable 70-75% reduction in incidence for women born 1940 and later compared with those born around 1923. The incidence of adenocarcinomas doubled during the 35-year study period. The mortality rate increased by 3.6% before 1968 and decreased by 4.0% yearly thereafter. Although a combination of organized and opportunistic screening can reduce the incidence of squamous cell cancer substantially, the incidence of adenocarcinomas appears uninfluenced by screening.

  • 34.
    Björk, Ragnar
    Södertörns högskola, Institutionen för genus, kultur och historia, Historia.
    Nobelsystemet: Karolinska institutet och Nobelpriset i medicin till Hugo Theorell 19552007Ingår i: Lychnos, ISSN 0076-1648, s. 43-62Artikel i tidskrift (Refereegranskat)
  • 35.
    Björkehag, Jonathan
    et al.
    Södertörns högskola, Institutionen för ekonomi och företagande.
    Seglare, Kristin
    Södertörns högskola, Institutionen för ekonomi och företagande.
    Innovationssystem för medicinsk teknik i Stockholm: En undersökning av centrala omständigheter för organisatorisk samverkan2009Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund För att främja medicinteknisk innovation inom vården har ett utvecklingsprojekt för samverkan mellan Stockholms landstingsstyrda sjukhus påbörjats, under namnet PUSH (Produktutveckling inom Stockholms hälso- och sjukvård). Syftet med samverkan är att ta vara på landstingspersonalens idéer och utveckla s.k. high-practice-produkter samt att underlätta för medicintekniska företag att testa produkter i vårdmiljö. Liknande innovationssatsningar finns på olika håll i Sverige och utomlands, men det har varit problematiskt att få flera av dessa att överleva, då olika omständigheter påverkar utvecklingen av satsningarna. Samverkansprojektet mellan sjukhusen står således inför en rad utmaningar om de inte ska gå samma öde till mötes.

    Syfte Syftet är att undersöka omständigheter som är centrala för organisatorisk samverkan inom innovationssystem för utveckling av medicinteknik. Utgångspunkten är utveckling av ”high-practice-produkter” inom projektet PUSH.

    Teoretisk ansats För att belysa innovationspåverkande omständigheter i studien, har teorier om innovationssystem, kluster och nätverk studerats, utifrån att de behandlar organisatorisk samverkan.

    Metod Studiens kvalitativa upplägg bygger på ett semideduktivt tillvägagångssätt. Utifrån ett deduktivt synsätt utgår analysen från befintliga teorier medan empirin på ett induktivt sätt ligger till grund för att framhålla och vidga delar av teorierna. Insamlad data utgörs till stor del av semistrukturerade intervjuer och tidigare undersökningar och utvärderingar.

    Resultat och analys Erfarenheter från samverkansprojekt för innovationer visar att projekten påverkas delvis av omständigheter som ligger utanför projektens kontroll, som innovationspolitiska beslut och medicintekniskt regelverk. Påverkningsbara omständigheter är exempelvis att innovationsprojekt är beroende av ett välutvecklat kontaktnät som sträcker sig över hela innovationsprocessen, från utveckling av idén till kommersialisering. För långsiktig överlevnad är ett uttalat kommersialiseringsfokus av största vikt för projekten. En central orsak till att innovationsprojekt inte överlever på lång sikt är att det saknas finansiering, dels för kommersialisering av enskilda produkter och dels för att behålla och utveckla befintliga innovationsstrukturer.

    Slutdiskussion För samverkansprojekt bör befintliga strukturer utnyttjas och kompletteras med en utvidgning av nätverket för att involvera en bredare kompetens. Beslutsfattare måste ta ställning till om huruvida innovationssatsningar ingår i landstingets uppdrag. En gemensam policy för ägarförhållanden och risktagande, finansiering och fördelning av eventuella vinster måste utarbetas om samverkansprojektets visioner ska kunna uppnås.

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    FULLTEXT01
  • 36.
    Björkehag, Jonathan
    et al.
    Södertörns högskola, Institutionen för ekonomi och företagande.
    Seglare, Kristin
    Södertörns högskola, Institutionen för ekonomi och företagande.
    Karolinska Testbädd för Telemedicin och eHälsa: En analys av medicintekniska företags behov och krav på en samverkansmiljö för produktutveckling på Karolinska Universitetssjukhuset2010Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med uppsatsen är att kartlägga behovet av en testbädd för telemedicinska produkter och att analysera krav som medicintekniska företag ställer på en testbäddsmiljö för samverkan med sjukvården. Målet har varit att konkretisera resultatet i en kommersialiseringsplan för Karolinska Testbädd för Telemedicin och eHälsa, vid Medicinsk Teknik på Karolinska Universitetssjukhuset. Vid genomförandet av undersökningen har totalt 19 intervjuer och ytterligare 6 telefonintervjuer genomförts med dels representanter från medicintekniska företag och sjukvården och dels med samarbetsstrukturer för medicinsk teknik och möjliga finansiärer. En enkätundersökning har genomförts för att kvantifiera resultatet från intervjuerna. Webbutskick har gjorts till 279 företag med verksamhet inom områdena medicinsk teknik, IT och telekom.

    Uppsatsen beskriver hur den kliniska forskningen inom området medicinsk teknik har förändrats de senaste decennierna och hur situationen ser ut idag. Utmaningar som den svenska hälso- och sjukvården står inför presenteras, som demografiska förändringar, ökade sjukvårdskostnader, dyrare behandlingsmetoder och färre kommersialiserade innovationer inom medicinsk teknik.  Omständigheter som påverkar produktutveckling för hälso- och sjukvården belyses, dels genom den regulatoriska gränsdragningen mellan IT-produkter och medicintekniska produkter och dels utifrån en genomgång av forskning inom produkt- och tjänsteutveckling och utifrån de frågor kring hur företag bedriver produktutveckling som ställts i intervjuerna och i webbenkäten.

    Resultatet visar att företagen i högsta grad är beroende av samarbete med sjukvården i olika faser av sin produktutvecklingsprocess och att flera företag uttrycker ett behov av en testbäddsstruktur. Företagen samarbetar med vården framförallt för att det möjliggör att utveckla mer vårdanpassade produkter. Samarbete med vården ger kortare utvecklingstider och därmed minskade utvecklingskostnader. Det förenklar även arbetet med validering av produkters funktionalitet. Flera företag har utarbetade samarbeten direkt in på vårdavdelningar, medan andra i dagsläget saknar nödvändiga samarbetsstrukturer. Studien har identifierat ett flertal företag som visat intresse för ett samarbete med Testbädden och ytterligare ett antal som har önskat att få mer information om vad Testbädden kan erbjuda. I kommersialiseringsplanen föreslås Karolinska Testbädd för Telemedicin och eHälsa fokusera på sin nisch samt vidareutveckla den kompetens som företagen saknar. Testbädden bör arbeta vidare med att utveckla både externa kontakter och den interna samverkansorganisationen på Karolinska för att möjliggöra effektiva, smidiga och kvalitativa samarbeten mellan företag och sjukhusets avdelningar.

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    Karolinska Testbädd för Telemedicin och eHälsa : J Björkehag, K Seglare
  • 37.
    Blomqvist Mickelsson, Tony
    Södertörns högskola, Institutionen för polisiärt arbete.
    Sports clubs’ role in community capacity development: illustrations from the Swedish sports movement2024Ingår i: Community Development Journal, ISSN 0010-3802, E-ISSN 1468-2656Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Strong political neoliberal currents in Sweden are directing attention toward communities’ responsibility to address local issues, particularly in disadvantaged areas. In parallel, community sports clubs in Sweden have gained strong traction as being sites where social issues can be addressed. In Swedish disadvantaged areas, where infrastructure is of poor quality, these clubs can be an important addition to statutory interventions, but they need to be further explored in terms of strategic pathways and conditions. Community sports have only recently been conceptualized with Chaskin’s capacity-building concept. In this paper, I seek to further stimulate this line of inquiry. By using material from two interrelated projects with informants in the sports movement, I show how sports clubs use multiple strategies according to three of Chaskin’s proposed strategies: leadership development, organizational development, and inter-organizational collaboration. By outlining an empirically dense illustration, this paper contributes to the research on sports clubs and their role in the community and provides suggestions on how strategical assessments must include how associations develop strategies online.

  • 38.
    Blomqvist Mickelsson, Tony
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete.
    Towards Understanding Post-Socialist Migrants’ Access to Physical Activity in the Nordic Region: A Critical Realist Integrative Review2021Ingår i: Social Sciences, E-ISSN 2076-0760, Vol. 10, nr 12, artikel-id 452Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Experiences of, and access and barriers to, physical activity (PA) differ between individuals. This becomes perpetuated in a migration context. Although there is super-diversity between migrant groups, health research rarely accounts for this cultural diversity. More concerningly, the matter of context is rarely scrutinized or juxtaposed with the specifics of certain ethnic groups. This integrative review assessed the evidence on post-socialist migrants’ PA levels, constraints, and enablers for PA in the Nordic region. The results show that post-socialist female migrants have an especially high risk of being physically inactive. The qualitative work elucidates socio-cultural factors that impose specific constraints on females when attempting to engage in PA. Furthermore, in scrutinizing the context, Nordic nature (Friluftsliv) is a viable way for migrants to access PA with additional health benefits (e.g., mental). However, the Nordic environment also poses specific PA challenges, such as harsh winters. This can be understood by considering post-socialist migrants’ prior use of, and attitude to, nature. The review highlights the importance of understanding specifics about both migrant groups and contexts through a critical-realist lens in the pursuit of providing PA opportunities. Future PA programs need to understand the contextual, sociohistorical, and cultural settings in which they and migrants are embedded.

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  • 39.
    Blomqvist Mickelsson, Tony
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete.
    Ukrainian refugees and the Swedish sports movement: new opportunities and challenges2024Ingår i: European Sport Management Quarterly, ISSN 1618-4742, E-ISSN 1746-031X, Vol. 24, nr 3, s. 661-680Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Research Question: The war in Ukraine has forced approximately eight million people into neighboring European countries. As part of sports clubs’ societal commitment, many have received Ukrainian refugees. However, compared to previous so-called ‘refugee waves’, forced migration from Ukraine is different in terms of demographics, culture, and (sports) traditions. This paper aimed to assess these ‘new’ nuances and their implications for the European sports movement. Research Methods: Data were gathered through 17 semi-structured interviews with Swedish sports club representatives, analyzed with a critical realist-inspired thematic analysis, and interpreted with Bronfenbrenner’s process-person-context-time framework. Results and Findings: The representatives expressed that Ukrainian refugees are more in-tune with organized sports compared to other refugee populations; however, there are also culturally discrepant ideas about sports. Specifically, there seems to be an influx of skilled (youth) refugees, who approach sports in ways incompatible with Swedish conventions about youth sports. While the sporting capital often enables easier inclusion, it also presents challenges in extreme cases. Implications: The findings show that the European sports movement must be attentive to new challenges and opportunities associated with the current humanitarian crisis. Sports representatives need to balance culturally sensitive approaches with ethical considerations regarding youth sports. 

  • 40.
    Blomqvist Mickelsson, Tony
    et al.
    Södertörns högskola, Institutionen för samhällsvetenskaper, Socialt arbete.
    Stylin, Pilo
    Swedish Budo and Martial Arts Confederation, Stockholm, Sweden.
    Integrating Rough-and-Tumble Play in Martial Arts: A Practitioner's Model2021Ingår i: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, artikel-id 731000Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper introduces a model that explains psychosocial development by embedding the developmental concept of rough-and-tumble play (RTP) into the contextual settings of martial arts (MA). Current sport-for-change literature relies on theories that address contextual factors surrounding sport but agrees that sport in itself does not facilitate developmental outcomes. In contemporary times where western societies invest substantial resources in sport programs for their psychosocial contribution, this becomes problematic. If the contextual factors surrounding sport are exclusively what produce developmental outcomes, what is the rationale for investing resources in sport specifically? We challenge this idea and argue that although contextual factors are important to any social phenomena, the developmental outcomes from sport can also be traced to the corporeal domain in sport. To date, we have lacked the theoretical lenses to articulate this. The developmental concept of RTP emphasizes how "play fighting" between consenting parties stimulates psychosocial growth through its demand for self-regulation and control when "play fighting" with peers. In short, RTP demands that individuals maintain a self-regulated mode of fighting and is contingent on a give-and-take relationship to maintain enjoyment. RTP can thus foster empathy and prosocial behavior and has strong social bonding implications. However, such play can also escalate. A fitting setting to be considered as moderated RTP is MA because of its resemblance to RTP, and its inherent philosophical features, which emphasizes self-regulation, empathy, and prosocial behavior. This paper outlines what constitutes high-quality RTP in a MA context and how this relates to developmental outcomes. By doing so, we present a practitioner's framework in which practitioners, social workers, and physical educators can explain how MA, and not merely contextual factors, contributes toward developmental outcomes. In a time where sport is becoming increasingly politicized and used as a social intervention, it too becomes imperative to account for why sport, and in this case, MA, is suitable to such ends.

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  • 41.
    Bonds, Olivia
    Södertörns högskola, Institutionen för svenska, retorik och journalistik.
    Mobbning: ur flera perspektiv2007Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats
    Abstract [en]

    Det finns elever som trycker ner andra i sin omgivning. När det är dags för rast finns det de som säger ”vad äcklig du är” och skrattar åt sin jämnåriga skolkamrat. Samtidigt sprider sig nya tekniker som gör skolan ännu mer försvarslös mot mobbning än tidigare. Inte ens i det egna hemmet kan ett barn vara garanterad att få slippa sin plågoande. Vad är egentligen mobbning? Hur tänker en mobbare? Och hur ser en vanlig skolmiljö ut år 2007?

    Ladda ner fulltext (pdf)
    FULLTEXT01
  • 42.
    Brindsjö, Matilda
    et al.
    Södertörns högskola, Institutionen för samhällsvetenskaper, Företagsekonomi.
    Krutova, Alexandra
    Södertörns högskola, Institutionen för samhällsvetenskaper, Företagsekonomi.
    I kollisionen mellan marknadslogik och trygghet: En studie om hur idrottsföreningar hanterar barnidrottens kommersialisering2024Självständigt arbete på grundnivå (kandidatexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    The purpose of this study is to examine how the effects of commercialisation impact the management of sports organizations. Additionally, the study aims to investigate how sports organizations handle commercialisation to ensure a sustainable balance between the market logic and safe sports for children. Neo -institutional theory, and its various components, have been used as a theoretical lens to answer these research questions. The study was conducted using a deductive, qualitative method, and the questions for the semi-structured interviews were designed and analysed with the help of neo-institutional theory.

    The results and analysis show that commercialisation primarily affects the management of sports organizations through increased professionalisation. To manage commercialisation and maintain a sustainable balance between market logic and safe sports for children, sports organizations work on educating employees, coaches, and parents. They establish guidelines and ensure compliance, focusing on a proactive approach to prevent infringement. Within the organizations, there is an ongoing dialogue to integrate these guidelines into the organization. The results also highlight the importance of understanding the individual needs of athletes so that sports activities can be conducted on their terms. A long-term perspective on sports participation is also emphasised as important for sustainability.

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    fulltext
  • 43. Brooks, Andrew J
    et al.
    Johansson, Magnus
    Södertörns högskola, Avdelning Naturvetenskap.
    Criswell, Erin
    Jans, David A
    Vasudevan, Subhash G
    The Interdomain Region of Dengue NS5 ProteinInteracts with NS3 and Host Proteins2002Ingår i: Dengue Bulletin, ISSN 1020-895X, Vol. 26, s. 155-161Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Although dengue virus genome replication occurs in the cytoplasm of infected cells, it has been shown that the NS5 protein (RNA-dependent RNA polymerase) is hyperphosphorylated at a late stage in infection and localized to the cell nucleus. A 37 amino acid sequence of NS5 (residues 369-405) was shown to contain a functional nuclear localization signal (NLS) that interacted with the cellular nuclear transport factor, importin α/β heterodimer. Further studies using the yeast two-hybrid system revealed that the NS5 region (residues 320-368) immediately adjacent to the NLS contained an importin β-binding site that abuts or overlaps the binding site for the NS3 protein (protease/helicase). The importin β-binding site has also been shown to be a functional NLS (bNLS). Intriguingly, when both bNLS and NLS (residues 320-405) were present, the fused β -galactosidase protein did not accumulate in the nucleus. Here we provide a review of our studies on the NS5 interdomain region and compare it to other members of the Flavivirus genus in order to highlight the importance of this region as a possible target for developing broad-acting antiviral agent against dengue and other mechanistically-related viruses.

  • 44. Brooks, Andrew J
    et al.
    Johansson, Magnus
    James Cook University.
    John, Anna V
    Xu, Yibin
    Jans, David A
    Vasudevan, Subhash G
    The interdomain region of dengue NS5 protein that binds to the viral helicase NS3 contains independently functional importin beta 1 and importin alpha/beta-recognized nuclear localization signals.2002Ingår i: Journal of Biological Chemistry, ISSN 0021-9258, E-ISSN 1083-351X, Vol. 277, nr 39, s. 36399-36407Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dengue virus NS5 protein is a multifunctional RNA-dependent RNA polymerase that is essential for virus replication. We have shown previously that the 37- amino acid interdomain spacer sequence (residues (369)X(2)KKX(14)KKKX(11)RKX(3)405) of Dengue2 NS5 contains a functional nuclear localization signal (NLS). In this study, beta-galactosidase fusion proteins carrying point mutations of the positively charged residues or truncations of the interdomain linker region (residues 369-389 or residues 386-405) were analyzed for nuclear import and importin binding activities to show that the N-terminal part of the linker region (residues 369-389, a/bNLS) is critical for nuclear localization and is recognized with high affinity by the conventional NLS-binding importin alpha/beta heterodimeric nuclear import receptor. We also show that the importin beta-binding site (residues 320-368, bNLS) adjacent to the a/bNLS, previously identified by yeast two-hybrid analysis, is functional as an NLS, recognized with high affinity by importin beta, and able to target beta-galactosidase to the nucleus. Intriguingly, the bNLS is highly conserved among Dengue and related flaviviruses, implying a general role for the region and importin beta in the infectious cycle.

  • 45.
    Bräutigam, Lars
    et al.
    Södertörns högskola, Institutionen för livsvetenskaper, Molekylärbiologi.
    Hillmer, Janine M.
    Södertörns högskola, Institutionen för livsvetenskaper, Molekylärbiologi.
    Söll, Iris
    Södertörns högskola, Institutionen för livsvetenskaper, Molekylärbiologi.
    Hauptmann, Giselbert
    Södertörns högskola, Institutionen för livsvetenskaper, Molekylärbiologi.
    Localized Expression of Urocortin Genes in the Developing Zebrafish rain2010Ingår i: Journal of Comparative Neurology, ISSN 0021-9967, E-ISSN 1096-9861, Vol. 518, nr 15, s. 2978-2995Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The corticotropin-releasing hormone (CRH) family consists of four aralogous genes, CRH and urocortins (UCNs) 1, 2, and 3. In a previous tudy, we analyzed CRH in the teleost model organism zebrafish and its ranscript distribution in the embryonic brain. Here, we describe ull-length cDNAs encoding urotensin 1 (UTS1), the teleost UCN1 rtholog, and UCN3 of zebrafish. Major expression sites of uts1 in adult ebrafish are the caudal neurosecretory system and brain. By using T-PCR analysis, we show that uts1 mRNA is also present in ovary, aternally contributed to the embryo, and expressed throughout embryonic evelopment. Expression of ucn3 mRNA was detected in a range of adult issues and during developmental stages from 24 hours post fertilization nward. Analysis of spatial transcript distributions by whole-mount in itu hybridization revealed limited forebrain expression of uts1 and cn3 during early development. Small numbers of uts1-synthesizing eurons were found in subpallium, hypothalamus, and posterior iencephalon, whereas ucn3-positive cells were restricted to elencephalon and retina. The brainstem was the main site of uts1 and cn3 synthesis in the embryonic brain. uts1 Expression was confined to he midbrain tegmentum; distinct hindbrain cell groups, including locus oeruleus and Mauthner neurons; and the spinal cord. ucn3 Expression was ocalized to the optic tectum, serotonergic raphe, and distinct hombomeric cell clusters. The prominent expression of uts1 and ucn3 in rainstem is consistent with proposed roles of CRH-related peptides in tress-induced modulation of locomotor activity through monoaminergic rainstem neuromodulatory systems. J. Comp. Neurol. 518:2978-2995, 2010.

  • 46.
    Burbano, X.
    et al.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Miguez, M. J.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Lecusay, Robert
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Rodriguez, A.
    University of Miami School of Medicine, Department of Medicine, Miami, FL, United States.
    Ruiz, P.
    University of Miami School of Medicine, Department of Medicine, Miami, FL, United States.
    Morales, G.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Castillo, G.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Baum, M.
    Florida International University, College of Health Dietetics and Nutrition, Miami, FL, United States.
    Shor-Posner, G.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Thrombocytopenia in HIV-infected drug users in the HAART era2001Ingår i: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 12, nr 8, s. 456-461Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present case-control study compared 26 HIV+ drug users having persistent thrombocytopenia (TCP< 150 000/mm(3)) with 54 available age, gender and HIV CDC classification matched controls with normal platelet counts. Participants were followed longitudinally over a 2-year period (1998-2000), and hematological alterations evaluated in relationship to antiretroviral treatment, drug use and nutritional (selenium) status. Demographic information and medical history, including antiretroviral treatment were obtained. Blood was drawn for complete cell blood count, T lymphocytes and viral load. Sixty-nine percent of the individuals with persistent TCP and 49% of the controls were receiving antiretrovirals. At baseline, no significant differences in CD4 existed between the two groups. Over time, CD4 cell count declined in the cases (P = 0.05) and a significantly higher proportion of the cases (38%) developed AIDS (CD4< 200 cell/mm(3)), as compared to the controls (18%, P = 0.004). A high risk for development of thrombocytopenia was observed with specific drug use (heroin 2.96 times, P = 0.0007), selenium levels below 145 mug/l (6 times, P = 0.008), and abnormal liver enzyme (SGOT) levels (2 times, P = 0.002). Together, these results indicate a number of factors that may be sensitive predictors of thrombocytopenia, which, despite antiretroviral treatment, appears to be related to more rapid disease progression in drug users.

  • 47. Burström, Bo
    et al.
    Macassa, Gloria
    Öberg, Lisa
    Södertörns högskola, Avdelning 1, Centrum för praktisk kunskap.
    Bernhardt, Eva
    Smedman, Lars
    Barnadödlighet, fattigdom och sanitära reformer: Stockholm 1878-19252003Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 80, nr 3, s. 209-215Artikel i tidskrift (Refereegranskat)
  • 48. Burström, Bo
    et al.
    Macassa, Gloria
    Öberg, Lisa
    Södertörns högskola, Institutionen för medier, konst och filosofi.
    Bernhardt, Eva
    Smedman, Lars
    Equitable child health interventions: the impact of improved water and sanitation on inequalities in child mortality in Stockholm, 1878 to 1925.2005Ingår i: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 95, nr 2, s. 208-216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Today, many of the 10 million childhood deaths each year are caused by diseases of poverty--diarrhea and pneumonia, for example, which were previously major causes of childhood death in many European countries. Specific analyses of the historical decline of child mortality may shed light on the potential equity impact of interventions to reduce child mortality. In our study of the impact of improved water and sanitation in Stockholm from 1878 to 1925, we examined the decline in overall and diarrhea mortality among children, both in general and by socioeconomic group. We report a decline in overall mortality and of diarrhea mortality and a leveling out of socioeconomic differences in child mortality due to diarrheal diseases, but not of overall mortality. The contribution of general and targeted policies is discussed.

  • 49. Burström, Bo
    et al.
    Öberg, Lisa
    Södertörns högskola, Institutionen för kultur och kommunikation.
    The dialectics of childhood diarrhea mortality2006Ingår i: International Journal of Health Services, ISSN 0020-7314, E-ISSN 1541-4469, Vol. 36, nr 3, s. 481-501Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As in European countries a century ago, diarrhea is a major cause of child mortality in poor countries today. In Stockholm at the turn of the 19th century, political commitment, infrastructural investments in water and sanitation, and enforcement of sanitary improvements by a strong implementing organization helped eliminate diarrhea as a principal cause of death among children. These interventions also had an equitable impact on social class differences in diarrhea mortality, but not on overall mortality; overall mortality declined, but class differences remained. General infrastructural improvement and health education coupled with targeted interventions to vulnerable children may be successful in improving child health and reducing social differentials in mortality. Specific health care interventions may need to be complemented by infrastructural investments to improve water and sanitation if diarrhea mortality is to be further reduced in poor countries today.

  • 50. Burström, Bo
    et al.
    Öberg, Lisa
    Södertörns högskola, Lärarutbildningen.
    Smedman, Lars
    Policy measures and the survival of foster infants in Stockholm 1878-19252012Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, nr 1, s. 56-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: At the end of the 19th century, infant mortality was high in urban and rural areas in Sweden. In Stockholm, the mortality rate was particularly high among foster children. This study addresses the importance for health of targeted public policies and their local implementation in the reduction of excess mortality among foster children in Stockholm at the turn of the 19th century. In response to public concern, a law was passed in 1902 on inspections of foster homes. Stockholm city employed a handful of inspectors who visited foster homes and advised parents on child care and feeding. METHODS: Analysis of historical records from the City of Stockholm was combined with epidemiological analysis of mortality rates and hazard ratios on individual-level data for 112 746 children aged <1 year residing in one part of Stockholm between 1878 and 1925. Hazard ratios of mortality were calculated using Cox' regression analysis. RESULTS: Mortality rates of foster infants exceeded 300/1000 before 1903. Ten years later the mortality rates among foster children had declined and were similar to other children born in and out of wedlock. Historical accounts and epidemiological analysis of individual-level data over a longer time period showed similar results. CONCLUSIONS: Targeted policy measures to foster children may have potentiated the positive health effects of other universal policies, such as improved living conditions, clean water and sanitation for the whole population in the city, contributing to an equalization of mortality rates between different groups.

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