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  • 1.
    Abdullahi Mohamed, Mohamed
    Mälardalen University, School of Sustainable Development of Society and Technology.
     GLP-1 REGULATES PROLIFERATION OF GLP-1 SECRETING CELLS THROUGH A FEEDBACK MECHANISM2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background and aim:

    Diabetes mellitus (DM) is a chronic and progressive illness that affects all type of populations and ages. According to World health organization (WHO) by 2030 it will be 366 million people effected world wild. Many new drugs are Glucagon-like peptide-1 (GLP-1) based therapy for treatment of type 2diabetes. GLP-1 is released from the intestinal L-cells, and is a potent stimulator of glucose-dependent insulin secretion. The aim of this study was to investigate the effect of GLP-1 and its stable analogs on cell proliferation of GLP-1 secreting GLUTag cells.

    Material and methods:

    GluTag cells were incubated for 48h in DMEM medium containing (0.5% fetal bovine serum and 100 IU/ml penicillin and 100 μg/ml streptomycin and 3mM glucose concentration) in the present or absence of the agents. DNA synthesis was measured using 3H- thymidine incorporation and Ki67 antigen staining. Western blot were performed to investigate the present of GLP-1 receptor in GLUTag cells.

    Results/conclusions:

    These results suggest that GLP-1 regulates proliferation of the GLP-1-secreting cell through a feedback mechanism via its receptor. Since serum GLP-1 levels are decreased in type 2 diabetic patients, the effect of GLP-1 on the GLP-1-secreting cell proliferation suggested here provides a novel beneficial long-term effect of the incretin-based drugs in clinical practice i.e. through increase of the GLP-1-secreting cell mass, augmenting the incretin effect. In addition, the feedback mechanism action of GLP-1 reveals a new insight in regulation manner of the L-cell proliferation.

    GLP-1(7-36) increased cell proliferation in GLUTag cells, an effect which was blocked by the GLP-1 receptor antagonist exendin(9-39). The GLP-1 receptor was expressed in GluTag cells.

    Keywords:

    Incretin hormone, GLP-1, GLP-1 receptor, Exendin-4, Diabetes

  • 2.
    Agnew, L.
    et al.
    University of Queensland, Brisbane, Australia .
    Johnston, V.
    University of Queensland, Brisbane, Australia .
    Ludvigsson, M. L.
    Linköping University, Linköping, Sweden; Rehab Väst, County Council of Östergötland, Sweden.
    Peterson, G.
    Linköping University, Linköping, Sweden; Linköping University, Linköping, Sweden.
    Overmeer, Thomas
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Johansson, G.
    Karolinska Institutet, Stockholm, Sweden.
    Peolsson, A.
    University of Queensland, Brisbane, Australia; Linköping University, Linköping, Sweden.
    Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III: A cross-sectional analysis2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 546-551Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III. Design: Cross-sectional analysis. Patients: A total of 166 working age patients with chronic whiplash-associated disorder. Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability. Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R2= 0.65, p < 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress. Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder.

  • 3.
    Andersson, Per
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Sjöberg, Rickard L
    Öhrvik, John
    Leppert, Jerzy
    Effects of family history and personal experience of illness on inclination to change health related behavior2009In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 17, no 1, p. 3-7Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to examine how personal experience of illness and family history of cardiovascular disease (CVD), adjusted for gender, education and nationality, affects risk behaviour. Subjects were 2054 men and women of age 50 from two countries, Sweden (n=1011) and Poland (n=1043), who were recruited from screening program in primary health care. Family history, personal experience and risk behaviours (smoking habits, exercise habits, BMI-level) were self-reported. The results show that smoking behaviour is affected by personal experience of illness but not by family history of CVD. No effects of these variables were found on the remaining risk related variables that were tested in this study.  These results suggest that individuals with a personal experience of illness may be inclined to change smoking behaviour more than the average person. Smoking prevention strategies may thus benefit from targeting this group in particular.

     

  • 4.
    Andersson, Per
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Sjöberg, RL.
    Uppsala University, Västerås, Sweden .
    Öhrvik, J.
    Uppsala University, Västerås, Sweden .
    Leppert, J.
    Uppsala University, Västerås, Sweden .
    Knowledge about cardiovascular risk factors among obese individuals2006In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, Vol. 5, no 4, p. 275-279Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Obesity is an important biological risk factor for cardiovascular disease (CVD). AIMS: The main aim of this study was to answer the question whether obese individuals differ from individuals with normal weight with regard to knowledge about risk factors for CVD. A further aim was to replicate previous findings that obese individuals are at higher risk of developing other biological risk factors for CVD. METHOD: Normal weights, BMI<25 kg/m(2) (n=385), and obese, BMI> or =30 kg/m(2) (n=159), individuals were identified from a screening program conducted among 50-year-old inhabitants of the County of Västmanland, Sweden. Participants answered questions regarding their gender, level of education, and items relating to knowledge about cardiovascular risk factors. Total cholesterol and blood glucose levels, height, weight and blood pressure were measured. RESULTS: Obese individuals did not differ significantly from individuals with a normal weight regarding knowledge of cardiovascular risk factors when education was controlled for. Obesity and low level of education are associated with other risk factors for CVD such as high blood pressure and high serum cholesterol. CONCLUSION: Obese individuals are at an increased risk of developing other risk factors for CVD but are just as knowledgeable about risk factors for CVD as normal weighting individuals.

  • 5.
    Arvidsson, Malin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Jakobsson, Tobias
    Mälardalen University, School of Health, Care and Social Welfare.
    Patientens upplevelser av intensivvårdsdelirium: En litteraturstudie2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
  • 6.
    Asp, Margareta
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Simonsson, B.
    Competence Ctr Hlth Reg Västmanland, Västerås, Sweden.
    Peter, Larm
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala Univ, Sweden.
    Molarius, A.
    Karlstad Univ, Sweden.
    Physical mobility, physical activity, and obesity among elderly: findings from a large population-based Swedish survey2017In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 147, p. 84-91Article in journal (Refereed)
    Abstract [en]

    Objective: To examine how physical activity and physical mobility are related to obesity in the elderly. Study design: A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods: Obesity (body mass index >= 30 kg/m(2)) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results: The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14-3.75) than for physical inactivity (OR 1.63, 95% CI 1.28-2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion: It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.

  • 7.
    Bechtouli, Nadia
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Oldrati, Satu
    Mälardalen University, School of Health, Care and Social Welfare.
    Den vårdande relationen inom psykiatrisk vård.: En litteraturstudie ur sjuksköterskeperspektiv.2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund Den vårdande relationen är kärnan i omvårdnaden. Patienterna beskriver att de behöver känna trygghet innan den vårdande relationen skapas. Psykiatrisjuksköterskan är skyldig att ansvara för att patienternas behov tillgodoses. Syfte Syftet är att synliggöra hur sjuksköterskor inom psykiatrisk vård beskriver den vårdande relationen. Vidare syftar studien till att synliggöra likheter och skillnader jämfört med hur den vårdande relationen gestaltas i den teoretiska referensramen. Den metod som ansågs vara mest lämplig för att besvara studien var en kvalitativ innehållsanalys. Med en deduktiv ansats, vilket beskrivs utifrån Elo och Kyngäs, (2008). Den teoretiska referensramen som valdes till studien utgår från Kaséns (2002) fyra aspekter av den vårdande relationen. I resultatet framkommer sjuksköterskors beskrivningar av den vårdande relationer och hur den kan gestaltas utifrån Kaséns fyra aspekter. Det framkom likheter och skillnader i resultatets analys del, vad sjuksköterskor beskrev som vårdande relationer. Slutsatser som kan tas utifrån studien är att den vårdande relationen har flera liknelser med patienternas beskrivning av den vårdande relationen. Även skillnader i deras beskrivningar av den vårdande relationen visades. Den vårdande relationen berörde sjuksköterskan lika väl som den berörde patienten.  Nyckelord: 

  • 8.
    Bergdahl, E.
    et al.
    Umeå University, Umeå, Sweden .
    Gustavsson, J.M.C
    Umeå University, Umeå, Sweden .
    Kallin, K.
    Umeå University, Umeå, Sweden .
    von Heideken Wågert, Petra
    Umeå University, Umeå, Sweden .
    Lundman, B.
    Umeå University, Umeå, Sweden .
    Bucht, G.
    Umeå University, Umeå, Sweden .
    Gustafson, Y.
    Umeå University, Umeå, Sweden .
    Depression among the oldest old: The Umeå 85+ study2005In: International Psychogeriatrics, Vol. 17, no 4, p. 557-575Article in journal (Refereed)
    Abstract [en]

    objectives: To investigate the prevalence of depression among the oldest old and to analyze factors associated with depression. Methods: A cross-sectional, population-based study was undertaken in Umea, Sweden. Out of 319 eligible participants aged 85, 90 and 95 years and older, it was possible to evaluate 242 people (75.9%) for depression. Data were collected from structured interviews and assessments in the participants' homes, and from medical charts, relatives and caregivers. Depression was screened for using the Geriatric Depression Scale-15 and further assessed with the Montgomery-Asberg Depression Rating Scale. Cognition was assessed using the Mini-mental State Examination, activities of daily living (ADL) using the Barthel ADL Index, nutrition using the Mini Nutritional Assessment and well-being using the Philadelphia Geriatric Center Morale Scale. Results: The 85-year-olds had a significantly lower prevalence of depression than the 90- and 95-year-olds (16.8% vs. 34.1% and 32.3%). No sex differences were found. One-third of those with depression had no treatment and among those with ongoing treatment 59% were still depressed. Persons diagnosed with depression had a poorer well-being and a higher 1-year mortality. Logistic regression analyses showed that depression was independently associated with living in institutions and number of medications. Conclusion: Depression among the oldest old is common, underdiagnosed and inadequately treated, and causes poor well-being and increased mortality. More knowledge about depression is essential to improve the assessment and treatment of depression among the oldest old.

  • 9.
    Blix- Lindström, S.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Stockholm, Sweden.
    Johansson, E.
    Karolinska Institutet, Stockholm, Sweden.
    Women's satisfaction with decision-making related to augmentation of labour2004In: Midwifery, ISSN 0266-6138, Vol. 20, no 1, p. 104-112Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVE: to describe women's experiences of participating in decision-making related to augmentation of labour. DESIGN: a qualitative approach using modified grounded theory technique. Open-ended interviews were conducted 1-3 days after childbirth. SETTING: the interviews were performed in the postnatal wards in five hospitals (tertiary level) in Stockholm, Sweden. PARTICIPANTS: 20 newly delivered women who had received oxytocin infusion for augmentation of labour during childbirth. FINDINGS AND KEY CONCLUSIONS: support and guidance from midwives in combination with knowledge and expectations about the intervention seemed to be important for women's satisfaction with decision-making concerning augmentation of labour. Four patterns of decision-making were found. One group of women participated in the decision-making regarding augmentation of labour while a second group was invited, but refrained from participation. These women were satisfied with the decisions made. A third group of women did not participate, but wanted to and they were dissatisfied with the decisions made. The fourth group did not participate in the decision-making-and did not want to. These women accepted the decisions made. The desire for information exceeded the desire for involvement in decision-making and the majority of women had confidence in the midwives' assessment.

  • 10.
    Blomgren, KB.
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Sundström, A.
    Medical Products Agency, Uppsala, Sweden .
    Steineck, G.
    Karolinska Institutet, Stockholm, Sweden.
    Wiholm, B-E.
    Medical Products Agency, Uppsala, Sweden.
    Interviewer Variability: Quality aspects in a case-control study.2006In: European Journal of Epidemiology, ISSN 0393-2990, Vol. 21, no 4, p. 267-277Article in journal (Refereed)
    Abstract [en]

    Quality assurance and quality control are important for the reliability of case-control studies. Here we describe the procedures used in a previously published study, with emphasis on interviewer variability. To evaluate risk factors for acute pancreatitis, information including previous diagnoses and medication was collected from medical records and by telephone interviews from 462 cases and 1781 controls. Quality assurance procedures included education and training of interviewers and data validity checks. Quality control included a classification test, annual test interviews, expert case validation, and database validation. We found pronounced variations between interviewers. The maximal number of interviews per day varied from 3 to 9. The adjusted average (95% CI) number of diagnoses captured per interview of cases was 4.1 (3.8-4.3) and of controls 3.5 (3.4-3.7) (excluding one deviating interviewer). For drugs, the average (95% CI) number per interview was 3.9 (3.7-4.1) for cases and 3.3 (3.2-3.4) for controls (excluding one deviating interviewer). One of the fourteen interviewers deviated significantly from the others, and more so for controls than for cases. This interviewer's data ;were excluded. Nonetheless, data concerning controls more frequently needed correction and supplementation than for cases. Erroneous coding of diagnoses and medication was also more frequent among controls. Thus, a system for quality control of coding practices is crucial. Variability in interviewers' ability to ascertain information is a possible source of bias in interview-based case-control studies when "blinding" cannot be achieved.

  • 11.
    Börjesson, Mats
    Mälardalen University, Department of Social Sciences.
    Psykiatrins förändringar: En vårdares berättelse1997In: Hur ska själen läkas?: Den psykiatriska vårdens förändringar, Stockholm: Natur och Kultur , 1997Chapter in book (Refereed)
  • 12. Böttiger, Margareta
    et al.
    CERNERUD, LARS
    Resultatet av vaccination med två monovalenta parotitvacciner givna till svenska skolbarn1982In: Hygiea, Vol. 91, p. 239-239Article in journal (Refereed)
  • 13. CERNERUD, LARS
    A look at the Seiing-Sun in Baby's Eyes1976In: Modern Medicine, Vol. 1, p. 126-Article in journal (Refereed)
  • 14.
    CERNERUD, LARS
    The Nordic School of Public Health, Göteborg, Sweden.
    Are there still Social Inequalities in Height and Body Mass Index of Stockholm Children1994In: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 22, no 3, p. 161-165Article in journal (Refereed)
    Abstract [en]

    Height and body mass index (BMI) of all non-immigrant schoolchildren in Stockholm in the age interval 10.0-10.9 years born in 1981 were related to the mother's educational level and the number of siblings. The two social variables were dichotomized and two extreme groups of socially more and less privileged children were formed. Socially less privileged boys were 1.1 cm shorter than their more privileged peers, whereas there was no difference as regards girls. Socially less privileged children were expected to show higher BMI, but the finding was contrary. More privileged boys were heavier. The findings were compared to a previous study of Stockholm children born in 1933-1963. Major social inequalities in height were levelled out for Stockholm children in the 1950s, a social gap reappeared in the 1960s and small disparities still exist for boys today.

  • 15.
    CERNERUD, LARS
    Nordic School of Public Health, Goteborg, Sweden .
    Height and Body mass index of 7-year-old Stockholm School Children 1940-19901993In: Acta Paediatrica, ISSN 0803-5253, Vol. 82, no 3, p. 304-305Article in journal (Refereed)
  • 16. CERNERUD, LARS
    Secular Growth Changes in relation to Changing Socioeconomic Conditions1985In: Annals of Human Biology, ISSN 0301-4460, E-ISSN 1464-5033, Vol. 8, p. 50-53Article in journal (Refereed)
  • 17.
    CERNERUD, LARS
    Nordic School of Public Health, Göteborg, Sweden .
    The Association between Height and some Structural Social Variables: A study of 10-year-old children in Stockholm during 40 years1993In: Annals of Human Biology, ISSN 0301-4460, Vol. 20, no 5, p. 469-476Article in journal (Refereed)
    Abstract [en]

    The associations between height of 10-year old children and mother's age, family size, number of inhabitants per room and father's occupational level were investigated over a period of 40 years. The analyses were based on samples of 10-year-old Stockholm schoolchildren born in 1933, 1943, 1953 and 1963. Family size consistently associated with height. Father's occupational level showed a statistically significant association only for children growing up in the 1930s and 1940s, and the number of inhabitants per room only during the 1930s. Mother's age was significantly associated with height only in the cohort of children born in 1963, taller children having older mothers. The influence of the structural social factors taken together on height variation was lowest in the 1953 cohort; its magnitude in the 1963 cohort was the same as in the 1943 cohort. 

  • 18.
    CERNERUD, LARS
    et al.
    The Nordic School of Public Health, Goteborg, Sweden.
    Edding, Elisabeth
    The Nordic School of Public Health, Goteborg, Sweden.
    The Value of Measuring Height and Weight of Schoolchildren1994In: Pediatric and Perinatal Epidemiology, ISSN 0269-5022, Vol. 8, no 4, p. 365-372Article in journal (Refereed)
    Abstract [en]

    The measurements of height and weight in the Stockholm school health service was appraised in relation to the screening value, the costs and benefits. The concept of a doubtful screening value of growth surveillances at school age was supported. Investment costs and running expenses were very low. The measurement procedure used only 2% of the total time spent by the nurses in the school health service. The growth data were an appropriate prerequisite for the reassurance of adolescents about their developing identity and body image. The growth data also constituted an appropriate indicator for public health research. The benefits and low costs may justify maintenance of the measurements in the school health service despite a low screening value.

  • 19.
    CERNERUD, LARS
    et al.
    The Nordic School of Public Health, Goteborg, Sweden .
    Elfving, Jörn
    The Nordic School of Public Health, Goteborg, Sweden .
    Social Inequality in Height: A comparison between 10-year-old helsinki and Stockholm Children1995In: Scandinavian Journal of Social medicine, ISSN 0300-8037, Vol. 23, no 1, p. 23-27Article in journal (Refereed)
    Abstract [en]

    The height of children may be used to indicate social inequality. The aim of this study was to analyze the difference in height of the socially more and less privileged 10-year-old Helsinki children in 1963 and 1991 and to compare the social gap to the corresponding gap in 1943, 1963 and 1991 in previous studies of Stockholm children. The difference in mean height of the Helsinki boys in 1963 was 4.5 cm (p<0.001) and for girls 4.4 cm (p<0.001). In Stockholm the corresponding differences in 1963 were negligible. Twenty years earlier (in 1943) it was 3.2 cm (p<0.001) in Stockholm. In 1991 the difference was 1.4 cm (p <0.05) for boys and 0.6 cm (n.s.) for girls in Helsinki, equivalent to the findings of the Stockholm children at the same time. The well-off Helsinki children already in 1963 were as tall as the Stockholm children. Thus, the decrease of the social gap in height from 1963 to 1991 in Helsinki seems to be mainly due to an increase in height of the socially less privileged children, exactly what was previously found for the Stockholm children between 1943 and 1963. Would the time for the equalization of height mirror the time for the development of the welfare stares in Finland and Sweden respectively?

  • 20.
    CERNERUD, LARS
    et al.
    Nordic School of Public Health, Göteborg, Sweden.
    Eriksson, Margareta
    Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden.
    Jonsson, B.
    Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden.
    Steneroth, G.
    Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden.
    Zetterström, Rolf
    Karolinska Institute, St. Göran's Children's Hospital, Stockholm, Sweden.
    Amphetamine addiction during pregnancy. 14 year follow-up of growth and school performance1996In: Acta Paediatrica, ISSN 0803-5253, Vol. 85, no 2, p. 204-208Article in journal (Refereed)
    Abstract [en]

    Sixty-five children born to women who all abused amphetamine during pregnancy have been followed prospectively since their birth in 1976-77. At the age of 14-15 years, information about growth and school achievement was collected from school records. For comparison of school achievements the means of schoolmates were used, and for growth a group of Stockholm children born in the same year. By the age of 14 years only 14 children (22%) had stayed with their biological mothers for the whole period since birth. In the eighth grade, 10 (15%) were one grade lower than indicated by their biological age. The norm for Sweden is less than 5%. The means of the points in mathematics, Swedish language and sports were statistically below those of their classmates. At the age of 10 years the girls were significantly shorter and lighter than their peers born in 1976. At the age of 14 years the boys were statistically taller and heavier than their peers. It can be concluded that maternal amphetamine abuse during pregnancy will influence children at least up to the age of 14-15 years even though many of them have been living in foster homes since a young age.

  • 21. CERNERUD, LARS
    et al.
    GARMÉN, ANNIKA
    The Accuracy of the Routine School Health Anthropometry1989In: Acta Orthopaedica Scandinavica (Supplementum), ISSN 0300-8827, Acta Paediatrica Scandinavica, Vol. suppl 359, p. 6-10Article in journal (Refereed)
  • 22.
    CERNERUD, LARS
    et al.
    The Nordic School of Public Health, Göteborg, Sweden .
    Lindgren, Gunilla
    Stockholm Institute of Education, Sweden .
    Secular Changes in Height and Weight of Stockholm Schoolchildren born in 1933, 1943, 1953 and 19631991In: Annals of Human Biology, ISSN 0301-4460, Vol. 18, no 6, p. 497-505Article in journal (Refereed)
    Abstract [en]

    Secular growth changes of Stockholm schoolchildren born in 1933, 1943, 1953 and 1963 were studied through samples of about 2500 children in each year. Heights and weights at the ages 7, 10 and 13 years were obtained from school health records stored in the Stockholm city archives. The increase in height and weight at these ages was more marked between the children born in 1933 and 1943 than later, except for the girls aged 7, who had no increase in height. The increase in height between the later samples was at age 7 years practically none, at age 10 years about 1 cm/decade and at age 13 years 1-2 cm/decade. The body mass index (BMI) indicated a continuous trend towards a slimmer body build for Stockholm schoolchildren at the age of 7 years. At the ages of 10 and 13 years the BMI remained fairly stable for the cohorts born from 1943 to 1963. 

  • 23.
    CERNERUD, LARSD
    The Nordic School of Public Health, Goteborg, Sweden.
    Differences in Height between Socially more and less privileged 10 year old Stockholm Children born in 1933-19631992In: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 20, no 1, p. 5-10Article in journal (Refereed)
    Abstract [en]

    The change of the difference in height between two socially extreme groups of 10 year old Stockholm children born in 1933, 1943, 1953 and 1963 was analysed. Data on height and social conditions were taken from the school health records. The two groups were established on the basis of the father's occupation and the number of children in the family. The height of the 10 year old children in the more privileged group born in 1933, 1943 and 1953 was virtually unchanged, but the height in the less privileged group increased gradually. The difference between the two groups was levelled out in the 1953 cohort. However, it reappeared in the 1963 cohort, mainly as a result of increasing height in the more privileged group and fairly unchanged height in the less privileged group.

  • 24.
    Chabo, Ablahad
    Mälardalen University, School of Sustainable Development of Society and Technology. Mälardalen University, Department of Biology and Chemical Engineering.
    Treatment of a mantle cell lymphoma cell line with cannabinoids and cytostatics: - effects on DNA synthesis and ceramide metabolism2009Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Mantle cell lymphoma (MCL) is an aggressive B-cell malignancy with bad prognosis, which predominates in males with advanced age. However, studies of the endocannabinoid system and how it affects tumour behaviour provides the basis for designing innovative therapeutic strategies that could open new opportunities for treatment of patient with MCL. It has earlier been shown that the cannabinoid receptor ligand (R)-(+)-methanandamide (R-MA) induce cell death in MCL by accumulation of ceramide. Ceramide has a pro-apoptotic effect on the cell but could be metabolized by the enzymes glucosylceramide synthase (GCS) and sphingosine kinase 1 (SphK1) to molecules with pro-proliferative effect. Therefore, treatments with R-MA on Jeko-1 MCL cell line were performed in this study to determine interference in the proliferative behaviour as well as in the gene expression of the enzymes GCS and SphK1. In addition, treatments with chemotherapeutic substances, such as doxorubicin or cytarabine (Ara-C), and combinations of R-MA and chemotherapeutic substance, were performed for the same reason. Results showed that the proliferation behaviour of Jeko cells remained unaffected when treated with R-MA, in contrast to the decreased proliferative effects shown when treated with cytostatics or combinations of R-MA and cytostatics. Furthermore, a tendency for up-regulation of GCS and SphK1 expression was recognized when cells were treated with cytostatics or combination of cytostatics and R-MA, in contrast to cells treated with R-MA alone. Although, R-MA alone had a tendency for a small down-regulation of GCS expression, it contributed to a potential elevation of GCS expression when combined with Ara-C or doxorubicin. It is believed that the effect from upregulated levels of the metabolizing enzymes GCS and SphK1 is balanced by, earlier observed, up-regulations of the ceramide synthesis enzymes.

  • 25.
    Dsilna, Ann
    et al.
    Karolinska Institutet, Sweden.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Sweden.
    Alfredsson, Lars
    Karolinska Institutet, Sweden.
    Lagercrantz, Hugo
    Karolinska Institutet, Sweden.
    Blennow, Mats
    Karolinska Institutet, Sweden.
    Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants2005In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 147, no 1, p. 43-49Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight (VLBW) infants. STUDY DESIGN: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods: continuous nasogastric feeding, intermittent nasogastric feeding, or intermittent orogastric feeding. Feeding was initiated within 30 hours of birth. Daily enteral and parenteral volumes, caloric and protein intakes, growth, enteral intolerance, and clinical complications were recorded. Cox regression analysis was used to determine primary outcome, the time to achieve full enteral feeding. RESULTS: The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants (hazard ratio [HR] = 1.86; 95% confidence interval [CI] = 1.07 to 3.22). In stratified analysis according to birth weight, the improvement was even more pronounced in the smallest infants, those with birth weight < or = 850 g (adjusted HR = 4.13; 95% CI = 1.48 to 11.53). Growth rate was significantly faster in the continuously fed infants ( P = .002). CONCLUSION: In VLBW infants, continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth.

  • 26.
    Eklund Lundgren, Sara
    Mälardalen University, School of Health, Care and Social Welfare.
    Jag önskar att någon såg mig i ögonen och såg hela mig: Hur patienter med självskadebeteende erfar bemötandet från vårdpersonal då de söker hjälp för sina skador inom den akutsomatiska vården.2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 27.
    Ekéus, Cecilia
    et al.
    Karolinska Institute, Sweden.
    Christensson, Kyllike
    Karolinska Institute, Sweden.
    Hjern, Anders
    Uppsala University, Sweden.
    Unintentional and violent injuries among pre-school children of teenage mothers in Sweden: a national cohort study.2004In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 58, no 8, p. 680-685Article in journal (Refereed)
    Abstract [en]

    STUDY OBJECTIVE: This study investigates the risk and mediating mechanisms of unintentional and violent injuries in pre-school children of teenage mothers. DESIGN: Cohort study based on Swedish national registers. Cox analyses of proportional hazard were used to estimate the relative risk of hospital admission and death attributable to injuries in analyses of data from national registers. PARTICIPANTS: The study population was a national cohort of 800,192 children born in Sweden during 1987-93 who were followed up prospectively from birth to their 7th birthday. MAIN RESULTS: Children of teenage mothers had higher relative risks (RRs) of hospital admissions for violent as well as unintentional injuries; age adjusted RRs of 2.7 (95% CI 1.2 to 6.1) and 1.6 (1.4 to 1.8), respectively, for children of mothers under 18 years of age and 2.5 (1.6 to 3.8) and 1.5 (1.4 to 1.6) of mothers aged 18-19 are compared with those with mothers aged at least 32 at the birth of the child. When the models were adjusted to socioeconomic variables and indicators of parental substance misuse and psychiatric illness the risk decreased slightly but remained well above that of children with older mothers. In addition, children of teenage mothers had an increased risk of death attributable to violent injuries (RR 6.7 (2.6 to 16.0), as well as to unintentional injuries (RR 3.5 (2.0 to 6.1). CONCLUSIONS: Maternal age is an important determinant of injuries in pre-school children in Sweden and the children of teenage mothers are at particular risk. Young parents should be given priority in injury prevention programmes.

  • 28.
    Elinge, E.
    et al.
    Umeå University, Sweden.
    Stenvall, M.
    Umeå University, Sweden.
    von Heideken Wågert, Petra
    Umeå University, Sweden.
    Löfgren, B.
    Umeå University, Sweden.
    Gustafson, Y.
    Umeå University, Sweden.
    Nyberg, L.
    Umeå University, Sweden.
    Daily life among the oldest old with and without previous hip fractures2005In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, Vol. 12, no 2, p. 51-58Article in journal (Refereed)
    Abstract [en]

    The aim of this cross-sectional study was to describe the oldest old, with and without previous hip fracture with regard to their ability to perform personal and instrumental activities of daily living (ADL); home adaptations received; possession of assistive devices; perceived health and morale. A random sample drawn from the population of 85-year-olds, all 90-year-olds and all ≥95-year-olds (n = 253) in Umeå, a city in northern Sweden, were examined. Data obtained from assessments and interviews carried out in the participants' homes, as well as data from medical charts, were analysed. Those with an earlier hip fracture (n = 58) had more difficulties in performing both personal and instrumental ADLs than those without (n = 195) but regarding individual home adaptations and the possession of assistive devices for personal care, no differences were detected betweenthe groups. Self-perceived health and morale were equally good in both groups. The conclusion drawn is that lifelong consequences, in the form of reduced abilities to perform ADLs and wheelchair dependency are common among the oldest old after a hip fracture. Therefore, trials concerningthe effects of more extensive and prolonged rehabilitation following hip fracture would be of great interest.

  • 29.
    Engquist, Markus
    et al.
    Ryhov Hospital, Jönköping, Sweden.
    Löfgren, Håkan
    Ryhov Hospital, Jönköping, Sweden.
    Öberg, Birgitta
    Linkoping University, Linköping, Sweden.
    Holtz, Anders
    Uppsala University Hospital, Uppsala, Sweden.
    Peolsson, Anneli
    Linkoping University, Linköping, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vavruch, Ludek
    Spine Center Goteborg, Gothenburg, Sweden.
    Lind, Bengt
    Spine Center Goteborg, Gothenburg, Sweden.
    Factors affecting the outcome of surgical versus nonsurgical treatment of cervical radiculopathy: A randomized, controlled study2015In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, no 20, p. 1553-1563Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Prospective randomized controlled trial.

    OBJECTIVE: To analyze factors that may influence the outcome of anterior cervical decompression and fusion (ACDF) followed by physiotherapy versus physiotherapy alone for treatment of patients with cervical radiculopathy.

    SUMMARY OF BACKGROUND DATA: An understanding of patient-related factors affecting the outcome of ACDF is important for preoperative patient selection. No previous prospective, randomized study of treatment effect modifiers relating to outcome of ACDF compared with physiotherapy has been carried out.

    METHODS: Sixty patients with cervical radiculopathy were randomized to ACDF followed by physiotherapy or physiotherapy alone. Data for possible modifiers of treatment outcome at one year, such as sex, age, duration of pain, pain intensity, disability (Neck Disability Index, NDI), patient expectations of treatment, anxiety due to neck/arm pain, distress (Distress And Risk Assessment Method, DRAM), self efficacy (Self Efficacy Scale, SES) health status (EQ-5D) and MRI findings were collected. A multivariate analysis was performed to find treatment effect modifiers affecting the outcome regarding arm/ neck pain intensity and NDI.

    RESULTS: Factors that significantly altered the treatment effect between treatment groups in favor of surgery were: duration of neck pain < 12 months (p = 0.007), duration of arm pain < 12 months (p = 0.01) and female sex (p = 0.007) (outcome: arm pain), low EQ-5D index (outcome: neck pain, p = 0.02), high levels of anxiety due to neck/arm pain (outcome: neck pain, p = 0.02 and NDI, p = 0.02), low SES score (p = 0.05) and high DRAM score (p = 0.04). (outcome: NDI). No factors were found to be associated with better outcome with physiotherapy alone.

    CONCLUSIONS: In this prospective, randomized study of patients with cervical radiculopathy, short duration of pain, female sex, low health quality, high levels of anxiety due to neck/arm pain, low self efficacy and a high level of distress before treatment were associated with better outcome from surgery. No factors were found to be associated with better outcome from physiotherapy alone.

  • 30.
    Eriksson, Margareta
    et al.
    Karolinska Institute, St Goran's Hospital, Stockholm, Sweden.
    CERNERUD, LARS
    Karolinska Institute, St Goran's Hospital, Stockholm, Sweden.
    Johnson, Björn
    Karolinska Institute, St Goran's Hospital, Stockholm, Sweden.
    Steneroth, Gun
    Karolinska Institute, St Goran's Hospital, Stockholm, Sweden.
    Zetterström, Rolf
    Karolinska Institute, St Goran's Hospital, Stockholm, Sweden.
    Amphetamine abuse during pregnancy: Follow-up of children after 14 years1994In: Pediatric Research, no 36, p. 13-13Article in journal (Refereed)
    Abstract [en]

    Sixtyfive children born to women who all used amphetamine during pregnancy have been followed prospectively since birth 1976-77. The children have been tested and examined regularly, demonstrating that social environmental factors influence the child's growth and somatic status while exposure for amphetamine during fetal life seem to influence the child's test results and behaviour up to the age of 8 years.

    After 14 years information was collected about school achievement, health, somatic growth and psycosocial environment. Only 20 children (30%) were still in the custody of their biological mothers. Ten children (15%) were one class below that for their biological age. Corresponding figure in Sweden is < 5 %. Grades in language, mathematics and sports were significantly lower than the mean of their schoolmates. The difference was most pronounced in boys. Weight and length were decreased in girls and increased in boys in comparison with Swedish school children born in the same year. Socioenvironmental risk factors correlated with poor outcome.

    Amphetamine abuse during pregnancy will influence the development of exposed children up to the age of 14 years.

  • 31.
    Fabian, Helena
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Institutet, Stockholm, Sweden .
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Waldenström, U.
    Karolinska Institutet, Stockholm, Sweden .
    Characteristics of primiparous women who are not reached by parental education classes after childbirth in Sweden2006In: Acta Paediatrica, ISSN 0803-5253, Vol. 95, no 11, p. 1360-1369Article in journal (Refereed)
    Abstract [en]

    Background: Parental education classes are part of the national child health promotion programme of the Swedish Child Health Clinics (CHC). Aim: To investigate attendance at parental education classes during the infant's first year, and to identify factors associated with non-attendance in primiparous women. Methods: Swedish-speaking women were recruited from 97% of all antenatal clinics in Sweden during 3 wk, evenly spread over 1 y from 1999 to 2000. Questionnaires were mailed in early pregnancy, and at 2 mo and 1 y after the birth. Two thousand, four hundred and forty women answered the main outcome question about class attendance asked in the third questionnaire, and 1076 of these were first-time mothers. Results: Seventy-eight per cent of the primiparas attended classes and 31% of the multiparas. Factors associated with non-attendance in primiparas were: native language other than Swedish, a low level of education, smoking during pregnancy, inconvenient timing of pregnancy, maternal hospital admission, and infant health problems. Three per cent of the primiparas did not attend classes either during pregnancy or after the birth, and this group seemed to constitute an even less privileged group.

  • 32.
    Fabian, Helena
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Karolinska Institutet, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    Waldenström, U.
    Karolinska Institutet, Stockholm, Sweden .
    Characteristics of Swedish women who do not attend childbirth and parenthood education classes during pregnancy2004In: Midwifery, ISSN 0266-6138, Vol. 20, no 3, p. 226-235Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: to investigate the attendance rate at childbirth and parenthood education classes during pregnancy in a national Swedish sample and describe the characteristics of women who did not attend. DESIGN: a cohort study utilising a postal questionnaire in early pregnancy and at 2 months after birth. SETTING: women were recruited from 97% of all antenatal clinics in Sweden at their first 'booking' visit during three different weeks spread over 1 year in 1999-2000. PARTICIPANTS: 2546 women, who were 77% of those who consented to participate in the study and 55% of all women eligible for the study. MEASUREMENT AND FINDINGS: most primiparous women (93%) attended classes and the majority of the multiparae (81%) did not. Having a native language other than Swedish was associated with non-attendance in both primiparae and multiparae (OR 2.7, 95% CI 1.3-5.4; OR 2.1, 95% CI 1.4-3.1). In addition, the following factors were associated with non-attendance in the primiparae: unemployment (OR 2.0, 95% CI 1.1-3.8), smoking during pregnancy (OR 2.7, 95% CI 1.2-5.8), having considered abortion (OR 4.3, 95% CI 1.2-16.1), and having had few antenatal check-ups (OR 2.0, 95% CI 1.1-3.7). The following factors were associated with non-attendance in the multiparae: age older than 35 years (OR 1.6, 95% CI 1.1-2.3), low level of education (OR 3.6, 95% CI 2.3-5.7), and pregnancy unplanned but welcome (OR 1.5, 95% CI 1.1-2.0), having had counselling because of fear of childbirth (OR 1.6, 95% CI 1.1-2.4), and expressing a need of such counselling (OR 1.9, 95% CI 1.1-3.1). KEY CONCLUSIONS: the childbirth and parenthood education programme reached the majority of pregnant women, and that non-attendees were more disadvantaged in terms of socio-demographic background and feelings about the approaching birth. These women should be given special attention during the antenatal check-ups so that childbirth and parenthood education could be adapted to their specific needs.

  • 33.
    Fabian, Helena
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Karolinska Institutet, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    Waldenström, U.
    Karolinska Institutet, Stockholm, Sweden.
    Childbirth and parenthood education classes in Sweden. Women's opinion and possible outcomes2005In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, Vol. 84, no 5, p. 436-443Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate first-time mothers' views about antenatal childbirth and parenthood education and their contact with other class participants after birth, and to compare participants and non-participants with respect to the use of pain relief, experience of pain, mode of delivery, childbirth overall, duration of breastfeeding, and assessment of parental skills. METHODS: A national cohort of 1197 Swedish-speaking women completed three questionnaires: during early pregnancy, 2 months, and 1 year after giving birth. RESULTS: Seventy-four percent of first-time mothers stated that antenatal education helped prepare them for childbirth, and 40% for early parenthood. One year after giving birth, 58% of the mothers had met with other class participants. These outcomes were associated with the number of class sessions. When controlling for the selection of women into participants and non-participants, no statistical differences were found concerning memory of labor pain, mode of delivery, overall birth experience, duration of breastfeeding, and assessment of parental skills. However, participants had a higher rate of epidural analgesia. Mothers who were young, single, with low level of education, living in a small city, and smokers were less likely to find the classes helpful. CONCLUSION: Participation in childbirth and parenthood education classes did not seem to affect first-time mothers' experience of childbirth and assessment of parental skills, but expanded their social network of new parents. The higher epidural rate suggests that participation in classes made women more aware of pain relief techniques available, rather than improving their own coping with pain. More research should focus on current forms of antenatal education, with special focus on women of low socioeconomic status.

  • 34.
    Faresjö, Å
    et al.
    Linköping University, Linköping, Sweden.
    Grodzinsky, E
    County Council of Östergötland, Linköping, Sweden.
    Johansson, S
    University of Gothenburg, Gothenburg, Sweden .
    Wallander, MA
    Uppsala University, Uppsala, Sweden.
    Timpka, T
    Linköping University, Linköping, Sweden.
    Åkerlind, Ingemar
    Linköping University, Sweden.
    A population based case control study of work and psychosocial problems in patients with irritable bowel syndrome - women are more seriously affected than men.2007In: American Journal of Gastroenterology, ISSN 0002-9270, Vol. 102, no 2, p. 371-379Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Everyday psychosocial functioning and quality of life are known to be reduced for patients with irritable bowel syndrome (IBS), but few previous studies have analyzed associations with functioning in working life. Accordingly, we examined perceptions of working conditions, functioning in the workplace, quality of life, and psychological complaints among IBS patients compared with age- and sex-matched controls. METHODS: A case-control study design was used based on 347 IBS patients from Swedish general practice who were compared with age- and sex-matched controls (N = 1,041) randomly selected from the general population. A survey was performed including validated questions concerning job strain, quality of life (SF-36 [Short Form 36]), absence because of illness, depression, anxiety, and sleeping habits. RESULTS: The IBS patients reported considerably more often that their daily performance in working life was affected by their gastrointestinal problems (OR [odds ratio] 7.14, 95% CI 5.45-9.36). Male IBS cases only reported less authority regarding decisions on their working pace (OR 5.44, 95% CI 1.28-23.18), while female IBS patients reported less decision authority regarding planning their work (OR 2.29, 95% CI 1.13-4.64), fewer learning opportunities at work (OR 2.12, 95% CI 1.26-3.57), and more long-term sick leave than their controls (OR 3.70, 95% CI 1.94-7.07). The female IBS cases also reported lower quality of life in all dimensions than their controls. CONCLUSION: In particular, female IBS patients reported lower authority over decisions at work and problems in their daily functioning in the workplace. These associations persisted after adjustments for possible confounders such as mood, sleeping problems, and perceived health.

  • 35.
    Gelberg, Jan
    et al.
    Lund Univ, Sweden.
    Strömsöe, Anneli
    University of Dalarna, Falun, Sweden.
    Hollenberg, Jacob
    Södersjukhuset, Sweden.
    Radell, Peter
    Karolinska Univ Hosp, Sweden.
    Claesson, Andreas
    University College of Boras, Borås, Sweden.
    Svensson, Leif
    Sahlgrenska University Hospital, Sweden.
    Herlitz, Johan
    Lund University, Lund, Sweden.
    Improving survival and neurologic function for younger age groups after out-of-hospital cardiac arrest in Sweden: a 20-year comparison2015In: Pediatric Critical Care Medicine, ISSN 1529-7535, E-ISSN 1947-3893, Vol. 16, no 8, p. 750-757Article in journal (Refereed)
    Abstract [en]

    Objective: To describe changes in the epidemiology of out-of-hospital cardiac arrest in Sweden with the emphasis on the younger age groups.

    Design: Prospective observational study. Setting: Sweden.

    Patients: Patients were recruited from the Swedish Registry of Cardiopulmonary Resuscitation from 1990 to 2012. Only non-crew-witnessed cases were included.

    Intervention: Cardiopulmonary resuscitation.

    Measurement and Main Results: The endpoint was 30-day survival. Cerebral function among survivors was estimated according to the cerebral performance category scores. In all, 50,879 patients in the survey had an out-of-hospital cardiac arrest, of which 1,321 (2.6%) were 21 years old or younger and 1,543 (3.0%) were 22-35 years old. On the basis of results from 2011 and 2012, we estimated that there are 4.9 cases per 100,000 person-years in the age group 0-21 years. The highest survival was found in the 13- to 21-year age group (12.6%). Among patients 21 years old or younger, the following were associated with an increased chance of survival: increasing age, male gender, witnessed out-of-hospital cardiac arrest, ventricular-fibrillation, and a short emergency medical service response time. Among patients 21 years old or younger, there was an increase in survival from 6.2% in 1992-1998 to 14.0% in 2007-2012. Among 30-day survivors, 91% had a cerebral performance category score of 1 or 2 (good cerebral performance or moderate cerebral disability) at hospital discharge.

    Conclusions: In Sweden, among patients 21 years old or younger, five out-of-hospital cardiac arrests per 100,000 person-years occur and survival in this patient group has more than doubled during the past two decades. The majority of survivors have good or relatively good cerebral function.

  • 36.
    Hadrovic, Banina
    Mälardalen University, School of Sustainable Development of Society and Technology.
    A study of TRPV1 and TRPV4 ion channels in the beta cells by using fura-2 based microfluorometry.2009Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The calcium ion (Ca2+) is an important ion that regulates many cellular functions including exocytosis, contraction of muscles, neural functions, fertilization and cell division. In the plasma membrane of cells there are different Ca2+ channels, including the transient receptor potential (TRP) family of cation channels. The TRP channels are activated by physical stimuli like temperature, stretch, osmolality, and also various ligands. These channels are divided into seven subfamilies, namely TRPC, TRPV, TRPM, TRPML, TRPA, TRPP, and TRPN.

     

    TRP channels can regulate the cytoplasmic free Ca2+ concentration ([Ca2+]i)  and are therefore important for research of insulin secretion from beta (β) cells. With TRP research new and more effective treatment methods for people with diabetes can be developed. People with type 2 diabetes have a decreased insulin secretion from beta (β) cells, in response to glucose. Cytoplasmic free Ca2+ concentration ([Ca2+]i)  is important for insulin secretion. It is therefore desirable to find compounds that can increase [Ca2+]i in pancreatic β cells and thereby increase insulin secretion.

     

     

    The aim of this project was to investigate whether pancreatic β cells express TRPV1 and TRPV4 ion channels. If the channels are expressed in β cells the [Ca2+]i can be increased by identifying substances that stimulate TRPV1 and TRPV4 channels. The results can then be used for providing better treatment for patients with diabetes type 2. Insulinoma cells from rat (S5 cells) were used as a model for β cells. [Ca2+]i was measured from single fura-2 loaded S5 cells by ratiometric microfluorometry. To test whether TRPV1 is expressed,

    N-(4-hydroxyphenyl)-Arachidonoylamide (AM404) and [5-hydroxyl-1-(4-hydroxy-3-methoxyphenyl)decan-3-one] ([6]-gingerol) were used. To test whether TRPV4 was expressed, a TRPV4-selective agonist 4alpha-Phorbol 12,13-Didecanoate namely 4α–PDD was used.

     

    The two agonist of TRPV1, AM404 and [6]-gingerol increased [Ca2+]i . Capsaicin a classical activator of TRPV1 used as a control also increased [Ca2+]i . These increases were inhibited by capsazepine, a specific blocker of TRPV1. 4α–PDD, a specific agonist of TRPV4 also increased [Ca2+]i. These results suggest that S5 cells express both TRPV1 and TRPV4 channels and that AM404, [6]-gingerol and 4α–PDD are potential substances for increasing the insulin secretion from β cells.

  • 37. Harlid, R.
    et al.
    Enlund, Mats
    Mälardalen University, Department of Caring and Public Health Sciences.
    Handbok i intravenös anestesi2006Book (Other academic)
  • 38.
    Hellgren, K
    et al.
    Karolinska Institutet, Sweden.
    Hellström, A
    Göteborg University, Göteborg, Sweden.
    Jacobson, L
    Karolinska Institutet, Sweden.
    Flodmark, O
    Karolinska Institutet, Sweden.
    Wadsby, M
    Linköping University, Linköping, Sweden.
    Martin, Lene
    Karolinska Institutet, Sweden.
    Visual and cerebral sequelae of very low birth weight in adolescents.2007In: Archives of Disease in Childhood: Fetal and Neonatal Edition, ISSN 1359-2998, E-ISSN 1468-2052, Vol. 92, no 4, p. F259-F264Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the visual functions and relate them to MRI findings and the intellectual level in adolescents born with very low birth weight (VLBW). DESIGN: Population-based case-control study. PATIENTS: 59 15-year-old VLBW adolescents and 55 sex and age-matched controls with normal birth weight. MAIN OUTCOME MEASURES: Objective clinical findings (visual acuity, stereo acuity and cycloplegic refraction) were recorded. Structured history taking was used to identify visual difficulties. The intellectual level was assessed with the Wechsler Intelligence Scale for Children (WISC). All VLBW adolescents underwent MRI of the brain. RESULTS: Significant differences were found between the VLBW adolescents and controls regarding visual acuity (median -0.11 and -0.2, respectively; p=0.004), stereo acuity (median 60'' and 30'', respectively; p<0.001), prevalence of astigmatism (11/58 and 0/55, respectively; p<0.001) and in full-scale IQ (mean IQ 85 and 97, respectively; p<0.001) and performance IQ (mean 87 and 99, respectively; p=0.002). The structured history also revealed a borderline significant difference between the groups (mean problems 0.46 and 0.15 respectively; p=0.051). 30% (17/57) of the VLBW adolescents had abnormal MRI findings and performed worse in all tests, compared with both the VLBW adolescents without MRI pathology and the normal controls. CONCLUSION: This study confirms previous observations that VLBW adolescents are at a disadvantage regarding visual outcome compared with those with normal birth weight. In 47%, visual dysfunction was associated with abnormal MRI findings and in 33% with learning disabilities. The adolescents with abnormal MRI findings had more pronounced visual and cognitive dysfunction. The findings indicate a cerebral causative component for the visual dysfunction seen in the present study.

  • 39.
    Helmersson, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Nordvall, Maria
    Mälardalen University, School of Health, Care and Social Welfare.
    Utvärdering av en KOL-skola: - effekter på hälsa, välbefinnande och fysisk kapacitet2011Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The background of this study is based on a cooperation between the physiotherapy program at Mälardalen University and a hospital in the county of Södermanland. The aim of the study was to evaluate whether a four week treatment of COPD-school have had an impact on patient health, well being and physical capacity. The COPD-school consisted of four occasions in which different health care professionals gave patients information on subjects including; symptom impact, emotional experiences and the importance of physical activity. There were ten patients with chronic obstructive pulmonary disease (COPD) in stage two to four who participated in the intervention. The instruments for evaluation that were used were The St. George's Respiratory Questionnaire and six minute walk test. The results showed no significant difference in the survey or six minute walk test for the group after the intervention. Previous research has shown that psychosocial factors have a profound effect on patients with COPD and their wellbeing. The authors therefore believe that future research should focus on designing treatment for patients with COPD based on the biopsychosocial model.

  • 40.
    Herlitz, Johan
    et al.
    Sahlgrenska akademin vid Göteborgs universitet - Göteborg, Sweden.
    Svensson, Leif
    Karolinska Institutet, Stockholm, Sweden.
    Strömsöe, Anneli
    Högskolan Dalarna, Sweden.
    Several factors affect the prognosis2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112Article in journal (Other academic)
  • 41.
    Hildingsson, Ingegerd
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Mid Sweden University, Sundsvall, Sweden.
    Lindgren, Helena
    Mälardalen University, Department of Caring and Public Health Sciences.
    Haglund, B
    National Board of Health and Welfare, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    Characteristics of women giving birth at home in Sweden: a national register study2006In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, Vol. 195, no 5, p. 1366-1372Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of the study was to estimate the proportion of planned home births in Sweden and to identify maternal characteristics of women giving birth at home. Study design: This case-control study included register data of births from 1992 to 2001 in 352 women giving birth at home and 1760 women giving birth in a hospital. Results: Four hundred thirty-nine out-of-hospital births were found during the study period, and the proportion of planned home births was less than 0.5/1000. Women with home birth were more likely to have 4 children or more (odds ratio 3.7 [1.4 to 9.9]), be born in a European country outside Sweden (odds ratio 3.5 [1.8 to 6.8]), have a family income below the median (odds ratio 2.9 [2.0 to 4.1% not work outside the home (odds ratio 2.4 [1.7 to 3.5]), have a high level of education (odds ratio 2.1 [1.5 to 3.0]), and be older than 35 years (odds ratio 1.7 [1.1 to 2.5]). Conclusion: Women with planned home births appear to be a group having a different lifestyle, compared with Swedish women in general.

  • 42.
    Hildingsson, Ingegerd
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institute, Stockholm, Sweden.
    Rubertsson, Christine
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institute, Stockholm, Sweden.
    Waldenström, Ulla
    Karolinska Institute, Stockholm, Sweden.
    Few women wish to be delivered by caesarean section2002In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 109, no 6, p. 618-623Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate how many women wish to have a caesarean section when asked in early pregnancy, and to identify background variables associated with such a wish. DESIGN: National survey. SETTING: Swedish antenatal clinics. POPULATION: 3,283 Swedish-speaking women booked for antenatal care, at approximately 600 Swedish antenatal clinics, during three weeks spread over one year (1999-2000). METHODS: A questionnaire was mailed shortly after the first antenatal visit. MAIN OUTCOME MEASURES: Women's preferences for mode of delivery. RESULTS: 3,061 women completed the first questionnaire, corresponding to 94% of those who consented to participate after exclusion of reported miscarriages. The background characteristics of the study sample were very similar to a one-year cohort of women giving birth in Sweden during 1999. The result showed that 8.2% of the women would prefer to have a caesarean section. A wish for caesarean section was associated with parity, age, civil status, residential area and obstetric history. Women preferring caesarean section were more depressed and worried, not only about giving birth, but also about other things in life. A multivariate logistic regression model showed three factors being statistically associated with a wish for caesarean section: a previous caesarean section, fear of giving birth and a previous negative birth experience. CONCLUSIONS: Relatively few women wish to have a caesarean section when asked in early pregnancy, and these women seem to be a vulnerable group.

  • 43.
    Hildningsson, Ingegerd
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Karolinska Institutet, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    Waldenström, U.
    Karolinska Institutet, Stockholm, Sweden.
    Number of antenatal visits and women´s opinion2005In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, Vol. 84, no 3, p. 248-254Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The national recommendation in Sweden regarding number of antenatal care visits was reduced in 1996. The aim of this study was to explore the factors associated with number of visits made and with women's own opinions about these visits. Another aim was to study associations between the number of visits and satisfaction with antenatal care overall. METHODS: All Swedish-speaking women who came for their first visit to the midwife in 593 participating clinics during 3 weeks evenly spread over 1 year in 1999-2000 were invited to participate in the study. Information was collected by postal questionnaires after the booking visit and 2 months after childbirth. Cases of preterm delivery and intrauterine death were excluded. RESULTS: After excluding miscarriages, non-Swedish-speaking women, and women booked at non-participating clinics, about 69% of all women booked in antenatal care were recruited. Of these, 2421 (83%) completed the two questionnaires. About 25% followed the standard visiting schedule for a normal pregnancy, 57% made more visits, and 17% fewer visits. The number of visits made was associated with parity, medical diagnosis, depressive symptoms, level of education, and women's preferences in early pregnancy. Women's own opinion that they made too few visits was associated with a preference for more visits in early pregnancy and actually receiving fewer visits than the standard schedule. The view that they made too many visits was associated with a previous negative birth experience, a wish for fewer visits, having a medical diagnosis, many children, and major worries. The vast majority of women (87.6%) were satisfied with antenatal care overall but less with emotional (76.9%) than with medical (82.3%) aspects. No association was found between number of visits made and satisfaction, but women's own opinion that they had too few visits was associated with dissatisfaction with medical as well as emotional aspects of care and the opinion that they made too many visits with the emotional aspects of care. CONCLUSION: Two-thirds of the women did not follow the standard visiting schedule, the majority of women made more visits. The number of antenatal visits seemed to be fairly well adapted to women's individual needs and, to some extent, to their own wishes. Very few women were dissatisfied with the number of visits made as well as the antenatal care overall.

  • 44.
    Jacobson, Lena
    et al.
    Karolinska University Hospital, Stockholm, Sweden .
    Flodmark, Olof
    Karolinska Institute, Stockholm, Sweden .
    Martin, Lene
    Karolinska Institute, Stockholm, Sweden .
    Visual field defects in prematurely born patients with white matter damage of immaturity: a multiple-case study.2006In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, no 3, p. 357-362Article in journal (Refereed)
    Abstract [en]

    PURPOSE: White matter damage of immaturity may affect visual, motor and cognitive functions. This multiple-case study presents standardized perimetry results in six teenagers and young adults born prematurely with visual dysfunction due to white matter damage of immaturity of pre- or perinatal origin. METHODS: Six subjects, aged 13-25 years, born at a gestational age of 28-34 weeks, with white matter damage of immaturity documented by MRI, and optic disc appearances documented by fundus photography, were examined with manual and computerized quantitative perimetry. RESULTS: All subjects had subnormal visual field (VF) function, although the depth and extension of the VF defects differed between subjects. The inferior VF function was more deviant than the superior in all cases. The concordance between the VF defects detected with the different techniques was good, although the static computerized techniques revealed slightly more abnormality. CONCLUSION: White matter damage of immaturity may affect the VF. The lower VF is often more affected than the upper. The abnormalities can be demonstrated by both manual and computerized perimetry.

  • 45.
    Johansson, Ann-Christin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Centrum för klinisk forskning LTV.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Öhrvik, John
    Karolinska Institutet, Sweden.
    Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery.2016In: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 25, no 1, p. 296-203Article in journal (Refereed)
    Abstract [en]

    Abstract

    PURPOSE:

    The aim of this study was to describe the associations among pain, disability and psychosocial factors preoperatively as well as 3 and 24 months later for patients who undergo first time discectomy and to analyse the predictive value of psychosocial factors on the outcome 24 months after surgery.

    METHODS:

    Fifty-nine patients, 41 % women, with a mean age of 40 years and without comorbidities were included, of whom 56 responded to the 24-month follow-up; at that point, they were divided into patients with complaints (C, n = 36) and patients without complaints (NC, n = 20). Correlations among the pain intensity, disability and psychosocial factors were analysed preoperatively, 3 and 24 months after discectomy, and regression analyses of psychosocial factors on the outcome at 24 months were performed.

    RESULTS:

    Psychosocial variables were weakly correlated with the pain intensity and disability preoperatively. High expectations on the return to work were predictive of both pain intensity (β = 8.0, p = 0.03) and disability (β = 9.1, p < 0.001) at 24 months. Associations between psychosocial variables and outcome variables were strengthened at the 3-month follow-up in the C group, and this association remained 24 months after surgery. Fear of movement was most strongly correlated with leg pain intensity (r s 0.64, p < 0.001) and the ability to decrease pain was the most correlated with disability (r s 0.78, p < 0.001).

    CONCLUSION:

    Having high expectations on the return to work after surgery was the strongest predictor for a favourable outcome. Therefore, low preoperative expectations on return to work convey an important prognostic signal.

  • 46.
    Johansson, K.
    et al.
    Linköping University, Linköping, Sweden.
    Bendtsen, P.
    Linköping University, Linköping, Sweden.
    Åkerlind, Ingemar
    Linköping University, Linköping, Sweden.
    Advice to patients in Swedish primary care regarding alcohol and other life style habits: How patients report the actions of GPs in relation to their own expectations and satisfaction with the consultation2005In: European Journal of Public Health, ISSN 1101-1262, Vol. 15, no 6, p. 615-620Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Lifestyle advice given by general practitioners (GPs) may be a cost-effective means of health promotion; however, it is not fully put into routine practice. The aim of this study was to explore to what extent GPs' patients expect and receive advice concerning alcohol, tobacco, exercise and diet in relation to sociodemographic characteristics, type of visit and patient satisfaction. METHODS: A postal questionnaire was sent to a representative sample (n = 9750) of patients who had consulted GPs in a county in Sweden. The response rate was 69% (n = 6734). RESULTS: Exercise was the most (16%) and alcohol the least (5%) common type of advice. The patients received advice more often than they expected in all areas except alcohol. The patients reported the highest rate of unfulfilled advice expectation and the lowest rate of unexpected advice in the case of alcohol. Male gender, poorer self-rated health and scheduled appointment were independent predictors of all types of advice. Continuity of GP contact was only favourable for exercise and diet advice. The patients who received advice were more satisfied with their visit to the doctor. CONCLUSIONS: A tertiary preventive perspective guides GPs' practice of giving advice. Male patients with advanced illnesses are given priority. Women and patients with long-term risk habits are more neglected. The GPs tend to misjudge the expectations and needs of their patients and are too restrained in their counselling practice. Alcohol is the most disregarded area of advice in proportion to the patients' expectations and needs.

  • 47.
    Kumpula, Esa
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ekstrand, Per
    Red Cross Univ Coll, Stockholm, Sweden.
    Challenges and Possibilities for Understanding Men's Health in Twenty-First Century Forensic Psychiatric Care2014In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, no 8, p. 613-619Article in journal (Refereed)
    Abstract [en]

    Forensic psychiatric care in Sweden constitutes a specific institutional environment in health care in terms of gender and power relationships. This context emphasizes safety and protection in an environment where men constitute a majority of the patients and staff. It involves relationships among men's health, constructions of masculinities, and issues regarding equality between women's and men's caring work. The aim of this theoretical article is to problematize men's health in relation to constructions of masculinities. Our analysis shows how the perception of health is involved in the construction of masculinities and how this plays out in daily interactions between caregivers and patients.

  • 48.
    Kyhlbäck, Maria
    et al.
    Akademiska Sjukhuset Uppsala.
    Kjellby-Wendt, Gunilla
    Sahlgrenaka Akademin.
    Abbott, Allan
    Karolinska Institutet.
    Millisdotter, Monica
    Lunds Universitetssjukhus.
    Grönlund, Per
    Östersunds sjukgymnastik.
    Johansson, Mia
    Umeå Universitetssjukhus.
    Johansson, Ann-Christin
    Mälardalen University, School of Health, Care and Social Welfare.
    Postoperativ rehabilitering vid ländryggsdiskbråck2011In: Fysioterapi, ISSN 1653-5804, no 1, p. 32-37Article in journal (Other academic)
    Abstract [sv]

    Bakgrund och syfte:Under 2008 har en grupp sjukgymnaster tagit fram nationella behandlingsriktlinjer för patienter som genomgått diskbråcksoperation. Syftet var att dessa skulle baseras på vetenskaplig evidens och klinisk erfarenhet.Metoder:Litteratursökning gjordes i sju olika databaser, sökningen omfattade randomiserade, kontrollerade studier under tidsperioden 1990-2008. Inkluderade studier granskades utifrån ett modifierat kvalitetsindex enligt SBU (Statens Beredning för medicinsk Utvärdering). För bevisvärdering av studieresultat användes SBU:s gradering högt, medelhögt och lågt bevisvärde. Evidensgrad för olika sjukgymnastiska metoder som förekom i de inkluderade studierna kategoriserades i enlighet med SBU:s nivåer för vetenskaplig evidens; starkt vetenskapligt underlag, måttligt starkt vetenskapligt underlag, begränsat vetenskapligt underlag och otillräckligt vetenskapligt underlag. Resultat:Sexton artiklar som uppfyllde kriterierna för granskning inkluderades i granskningen.Baserat på dessa studier finns måttligt stark evidens för att aktiv träning som inkluderar ett mer aktivt förhållningssätt är mer effektiv på kort sikt än mer försiktig/passiv träning och förhållningssätt (< 6 månader efter operation). Det finns ett starkt vetenskapligt stöd för att den aktiva träningen inte påverkar smärta och funktion på lång sikt (ett år efter operation), liksom att tidig, aktiv träning inte ökar komplikationsrisken efter operation. Det vetenskapliga stödet är begränsat vad gäller de positiva effekterna av enbart råd om fysisk aktivitet, motsägande beträffande effekten av övervakad träning jämfört med hemträning och otillräckligt beträffande effekten av beteendemedicinskt inriktad träning.Konklusion:Sjukgymnastiken efter diskbråcksoperation bör ha ett aktivt förhållningssätt inkluderande tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation.

  • 49.
    Larsson, Eva
    et al.
    Uppsala University Hospital, Uppsala, Sweden.
    Martin, Lene
    Karolinska Institute, Stockholm, Sweden.
    Holmström, Gerd
    Uppsala University Hospital, Uppsala, Sweden .
    Peripheral and central visual fields in 11-year-old children who had been born prematurely and at term2004In: Journal of pediatric ophthalmology and strabismus, ISSN 0191-3913, E-ISSN 1938-2405, Vol. 41, no 1, p. 39-45Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To examine the peripheral and central visual fields in children who had been born prematurely and at term. METHODS: Four groups of 11-year-old children were examined: group 1 included 24 children who had been born at term (control group); group 2 included 20 children who had been born prematurely without ROP; group 3 included 22 children who had been born prematurely with untreated ROP (stages 2 and 3); and group 4 included 21 children who had been born prematurely and underwent cryotreatment for severe ROP. Their peripheral visual fields were examined with Goldmann perimetry. Static high-pass resolution perimetry was used to evaluate their central visual fields within 30 degrees. RESULTS: The peripheral visual fields were constricted in children who had undergone cryotreatment (group 4), as compared with the other groups (1 to 3). We found no difference between the groups of children who had been born prematurely with or without ROP (groups 2 and 3) and the control group. The function of the central visual fields, expressed as neural capacity, was reduced in the children who had been born prematurely compared with the controls, significantly in their left eyes only. The children who underwent cryotreament did not differ from the other children who had been born prematurely in this respect. CONCLUSIONS: The peripheral visual fields were constricted in children who had undergone cryotreatment. It is uncertain whether this was caused by the treatment or by severe ROP. The central visual fields showed a tendency of reduced neural capacity in the children who had been born prematurely, reflecting a reduced density of retinocortical neural channels. However, this was not related to ROP or cryotreatment.

  • 50.
    Libungan, Berglind
    et al.
    Sahlgrens university hospital, Sweden.
    Lindqvist, Jonny
    Sahlgrens university hospital, Sweden.
    Strömsöe, Anneli
    Univ Dalarna, Sweden.
    Nordberg, Per
    Karolinska institutet, Sweden.
    Hollenberg, Jacob
    Karolinska institutet, Sweden.
    Albertsson, Per
    Sahlgrens university hospital, Sweden.
    Karlsson, Thomas
    Univ Gothenburg, Sweden.
    Herlitz, Johan
    Western Sweden Univ Boras, Sweden.
    Out-of-hospital cardiac arrest in the elderly: a large-scale population-based study2015In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 94, p. 28-32Article in journal (Refereed)
    Abstract [en]

    Background: There is little information on elderly people who suffer from out-of-hospital cardiac arrest (OHCA). Aim: To determine 30-day mortality and neurological outcome in elderly patients with OHCA.

    Methods: OHCA patients >= 70 years of age who were registered in the Swedish Cardiopulmonary Resuscitation Register between 1990 and 2013 were included and divided into three age categories (70-79, 80-89, and >= 90 years). Multiple logistic regression analyses were performed to identify independent predictors of 30-day survival.

    Results: Altogether, 36,605 cases were included in the study. Thirty-day survival was 6.7% in patients aged 70-79 years, 4.4% in patients aged 80-89 years, and 2.4% in those over 90 years. For patients with witnessed OHCA of cardiac aetiology found in a shockable rhythm, survival was higher: 20%, 15%, and 11%, respectively. In 30-day survivors, the distribution according to the cerebral performance categories (CPC) score at discharge from hospital was similar in the three age groups. In multivariate analysis, in patients over 70 years of age, the following factors were associated with increased chance of 30-day survival: younger age, OHCA outside the home, witnessed OHCA, CPR before arrival of EMS, shockable first-recorded rhythm, and short emergency response time.

    Conclusions: Advanced age is an independent predictor of mortality in OHCA patients over 70 years of age. However, even in patients above 90 years of age, defined subsets with a survival rate of more than 10% exist. In survivors, the neurological outcome remains similar regardless of age. 

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