32 research outputs found
Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity
Background/Aims Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights. Methods Data, including infants born at 24â30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6â14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions. Results ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6â14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%. Conclusions DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24â30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting
LĂ€xors vara eller inte vara? â En enkĂ€tundersökning bland lĂ€rare, elever och förĂ€ldrar.
Institution: Sociologiska institutionen, Göteborgs Universitet
Författare: Camilla Bartholdsson, Magdalena Albertsson och Marie
Henningsson
Titel: LĂ€xors vara eller inte vara? â En enkĂ€tundersökning bland lĂ€rare,
elever och förÀldrar.
Handledare: Ylva Ulfsdotter Eriksson
Typ av arbete: Examensarbete 10 poÀng, Nya LÀrarutbildningen
Antal sidor: 47 sidor
Tidpunkt: Höstterminen 2005
Syfte och Syftet med föreliggande arbete Àr att studera hur lÀxsituationen ser
frÄgestÀllningar: ut i kommunala skolor. Vi vill fÄ en uppfattning om vad lÀrare,
elever och förÀldrar tycker om lÀxor och hur de hanterar elevernas
lÀxor. VÄr förhoppning Àr att arbetet i förlÀngningen kommer att
vÀgleda oss, som pedagoger, i vÄrt sÀtt att hantera lÀxor. De
frÄgestÀllningar vi kunde besvara Àr:
âą Ăr lĂ€xorna ett anvĂ€ndbart pedagogiskt verktyg?
⹠Hur ser lÀxsituationen ut i skolorna idag?
⹠Anser lÀrare, elever och förÀldrar att lÀxor fyller en viktig
funktion för elevernas kunskapsinlÀrning?
Material och metoder: Vi har genomfört en kvantitativ studie i form av en
enkÀtundersökning. EnkÀter har lÀmnats ut till lÀrare, elever och
förÀldrar pÄ sex olika kommunala skolor. EnkÀtfrÄgorna
konstruerades sÄ att vi kunde göra jÀmförelser mellan de olika
perspektiven. SekundÀrmaterialet har varit tidigare forskning samt
relevanta kommentarer och uttalanden gjorda av personer med
koppling till skolvÀrlden.
Huvudresultat: SÄ gott som alla lÀrare, elever och förÀldrar Àr överens om att lÀxor
behövs för elevernas inlÀrning. Enligt eleverna och förÀldrarna i
vÄr undersökning har övervÀgande delen av eleverna hjÀlp att tillgÄ
i hemmet dÄ det behövs, dock Àr det svÄrt att utifrÄn vÄr
enkÀtundersökning bedöma om elever generellt har samma
möjlighet till likvÀrdig utbildning dÄ hemlÀxor ges. LÀxor Àr ett
anvÀndbart pedagogiskt verktyg under förutsÀttning att de Àr vÀl
genomtÀnkta och framförallt motiverande för eleven.
Nyckelord: LÀxa, likvÀrdig, lÀrare, elev och förÀlder
FrÄn socialbidrag till Àldreförsörjningsstöd. : En reform ur Àldre invandrares perspektiv.
In 2003 the Swedish parliament decided to incorporate maintenance support for the elderly within the framework of the state social insurance system. Maintenance support for the elderly entails that individuals who, due to too short a period of residence in Sweden, do not qualify themselves for a full guarantee pension and thus have the right to receive benefits after completion of an income test. A large proportion of these people previously received individually incometested social benefits. Maintenance support for the elderly and how it is perceived by the elderly is the focus of the study. The overall aim of the study is to gain knowledge about what it means for immigrants who moved in later life to be the subject of a transfer from a selective benefit system to one where more general principles apply. More specifically the aim concerns what it means for their possibilities for gaining access to social rights and what it means for their relationship with the Swedish welfare state. The studyâs empirical material consists of two parts. The first part contains register data from the social services register of the National Board of Health and Social Welfare and the social insurance register of the Swedish Social Insurance Board. The second consists of interviews with eleven foreign-born elderly persons who previously received social benefits and now receive maintenance support for the elderly. The analysis of the register data indicates that one-fifth of the target group actually includes people born in Sweden while the rest are immigrants arriving in Sweden in later life. For most of those in this latter group the maintenance support is their only source of financial support while it is a supplement for the Swedish-born elderly recipients. The results show that of those, who previously received social benefits and where the maintenance support is their only source of financial support, about onefifth received a smaller amount of benefit after the reform. The interview study indicates the existence of a gap between what the respondents express as needs of more individual considerations both in terms of the contact with the administrating authority and the maintenance supportâs monetary content and how the elderly perceive that these needs are provided for. In order to try to understand this gap the result was analysed by using a number of major theoretical concepts such as universalism, stigma and shame, and social citizenship, public identity and recognition. The conclusions of the study is that a comprehension of the gap can be found in the standardised design and administration of the maintenance support and in the socio-economic context that immigrants coming to Sweden in later life find themselves in
Be yourself but not too much : En studie om förÀndringen av sociala-medier och hur detta pÄverkar individens presentation av Identitet online och offline
Studiens syfte Ă€r att fĂ„ en bĂ€ttre förstĂ„else av hur utvecklingen i sociala-medier â dels en ökande del av digital interaktion i förhĂ„llande till samvaro ansikte mot ansikte och dels en förflyttning av interaktion frĂ„n text till bilder â inverkar pĂ„ individers presentation av sin identitet. Uppsatsen syftar ocksĂ„ till att undersöka hur individer upplever skillnaden mellan olika plattformar och vad utveckling betyder för interaktionen mellan individer. Detta gjordes genom kvalitativa semistrukturerade intervjuer samt en innehĂ„llsanalys av informanternas online-profiler pĂ„ Instagram. För att diskutera fenomenet ur ett socialpsykologiskt perspektiv, anvĂ€nds teorierna rörande interaktion genom Goffman, Baudrillards teori kring individernas varseblivning av realitet samt Giddens teori gĂ€llande modernitet och sjĂ€lvidentifiering.                     Resultatet av studien visar att sociala-medier Ă€r en stor del av individernas liv och förĂ€ndringen av detta upplevs tydligt. Individerna Ă€r medvetna om att det finns en skillnad mellan online och offline realitet, dock inverkar online-realiteten pĂ„ individernas liv och sjĂ€lvuppfattning med en omfattande pĂ„tryckning. Interaktionen upplevs mer passiv och indirekt, vilket gör att individerna kĂ€nner sig ensamma Ă€ven dĂ„ de har mĂ„nga vĂ€nner/följare online. Trenden mot perfektion pĂ„ sociala-medier och samhĂ€llets press pĂ„ individen skapar ett mĂ„ste att vara online och hĂ„lla sig uppdaterad. Dessutom Ă€r sociala-medier en realitet dĂ€r individer upplever en lĂ€ttnad frĂ„n offline-realiteten, dĂ„ de kan vĂ€lja vem dem vill interagera med och slipper det som kĂ€nns obekvĂ€mt i offline-realiteten. I stort sĂ€tt uppfattas sociala-medier och förĂ€ndringen frĂ„n text till bild som nĂ„got positivt, eftersom individerna kĂ€nner sig mindre angripbara och tryggare inom den enklare bildbaserade applikationen Instagram
Temporal and spatial changes in benthic invertebrate trophic networks along a taxonomic richness gradient
Species interactions underlie most ecosystem functions and are important for understanding ecosystem changes. Representing one type of species interaction, trophic networks were constructed from biodiversity monitoring data and known trophic links to assess how ecosystems have changed over time. The Baltic Sea is subject to many anthropogenic pressures, and low species diversity makes it an ideal candidate for determining how pressures change food webs. In this study, we used benthic monitoring data for 20 years (1980-1989 and 2010-2019) from the Swedish coast of the Baltic Sea and Skagerrak to investigate changes in benthic invertebrate trophic interactions. We constructed food webs and calculated fundamental food web metrics evaluating network horizontal and vertical diversity, as well as stability that were compared over space and time. Our results show that the west coast of Sweden (Skagerrak) suffered a reduction in benthic invertebrate biodiversity by 32% between the 1980s and 2010s, and that the number of links, generality of predators, and vulnerability of prey have been significantly reduced. The other basins (Bothnian Sea, Baltic Proper, and Bornholm Basin) do not show any significant changes in species richness or consistent significant trends in any food web metrics investigated, demonstrating resilience at a lower species diversity. The decreased complexity of the Skagerrak food webs indicates vulnerability to further perturbations and pressures should be limited as much as possible to ensure continued ecosystem functions
Violaxanthin accessibility and temperature dependency for de-epoxidation in spinach thylakoid membranes
Using DTT and iodoacetamide as a novel irreversible method to inhibit endogenous violaxanthin de-epoxidase, we found that violaxanthin could be converted into zeaxanthin from both sides of the thylakoid membrane provided that purified violaxanthin de-epoxidase was added. The maximum conversion was the same from both sides of the membrane. Temperature was found to have a strong influence both on the rate and degree of maximal violaxanthin to zeaxanthin conversion. Thus only 50% conversion of violaxanthin was detected at 4 degreesC, whereas at 25 degreesC and 37 degreesC the degree of conversion was 70% and 80%, respectively. These results were obtained with isolated thylakoids from non-cold acclimated leafs. Pigment analysis of sub-thylakoid membrane domains showed that violaxanthin was evenly distributed between stroma lamellae and grana partitions. This was in contrast to chlorophyll a and beta-carotene which were enriched in stroma lamellae fractions while chlorophyll b, lutein and neoxanthin were enriched in the grana membranes. In combination with added violaxanthin de-epoxidase we found almost the same degree of conversion of violaxanthin to zeaxanthin (73-78%) for different domains of the thylakoid membrane. We conclude that violaxanthin de-epoxidase converts violaxanthin in the lipid matrix and not at the proteins, that violaxanthin does not prefer one particular membrane region or one particular chlorophyll protein complex, and that the xanthophyll cycle pigments are oriented in a vertical manner in order to be accessible from both sides of the membrane when located in the lipid matrix
Normalization of puberty and adult height in girls with Turner syndrome : results of the Swedish Growth Hormone trials initiating transition into adulthood
Objective: To study the impact of GH dose and age at GH start in girls with Turner syndrome (TS), aiming for normal height and age at pubertal onset (PO) and at adult height (AH). However, age at diagnosis will limit treatment possibilities. Methods: National multicenter investigator-initiated studies (TNR 87-052-01 and TNR 88-072) in girls with TS, age 3â16 years at GH start during year 1987â1998, with AH in 2003â2011. Of the 144 prepubertal girls with TS, 132 girls were followed to AH (intention to treat), while 43 girls reduced dose or stopped treatment prematurely, making n=89 for Per Protocol population. Age at GH start was 3â9 years (young; n=79) or 9â16 years (old; n=53). Treatment given were recombinant human (rh)GH (GenotropinÂź Kabi Peptide Hormones, Sweden) 33 or 67 ”g/kg/day, oral ethinyl-estradiol (2/3) or transdermal 17ÎČ-estradiol (1/3), and, after age 11 years, mostly oxandrolone. Gain in heightSDS, AHSDS, and age at PO and at AH were evaluated. Results: At GH start, heightSDS was â2.8 (versus non-TS girls) for all subgroups and mean age for young was 5.7 years and that of old was 11.6 years. There was a clear doseâresponse in both young and old TS girls; the mean difference was (95%CI) 0.66 (â0.91 to â0.26) and 0.57 (â1.0 to â0.13), respectively. The prepubertal gainSDS (1.3â2.1) was partly lost during puberty (â0.4 to â2.1). Age/heightSDS at PO ranged from 13 years/â0.42 for GH67young to 15.2 years/â1.47 for GH33old. At AH, GH67old group became tallest (17.2 years; 159.9 cm; â1.27 SDS; total gainSDS, 1.55) compared to GH67young group being least delayed (16.1 years; 157.1 cm; â1.73 SDS; total, 1.08). The shortest was the GH33young group (17.3 years; 153.7 cm: â2.28 SDS; total gainSDS, 0.53), and the most delayed was the GH33old group, (18.5 years; 156.5 cm; â1.82 SDS; total gainSDS, 0.98). Conclusion: For both young and old TS girls, there was a GH-dose growth response, and for the young, there was less delayed age at PO and at AH. All four groups reached an AH within normal range, despite partly losing the prepubertal gain during puberty. Depending on age at diagnosis, low age at start with higher GH dose resulted in greater prepubertal height gain, permitting estrogen to start earlier at normal age and attaining normal AH at normal age, favoring physiological treatment and possibly also bone health, hearing, uterine growth and fertility, psychosocial wellbeing during adolescence, and the transition to adulthood
Continued benefit of coronary stenting versus balloon angioplasty: five-year clinical follow-up of Benestent-I trial.
OBJECTIVES: This study sought to establish whether the early favorable results in the Benestent-I randomized trial comparing elective Palmaz-Schatz stent implantation with balloon angioplasty in 516 patients with stable angina pectoris are maintained at 5 years. BACKGROUND: The size of the required sample was based on a 40% reduction in clinical events in the stent group. Seven months and one-year follow-up in this trial showed a decreased incidence of restenosis and clinical events in patients randomized to stent implantation. METHODS: Data at five years were collected by outpatient visit, via telephone and via the referring cardiologist. Three patients in the stent group and one in the percutaneous transluminal coronary angioplasty (PTCA) group were lost to follow-up at five years. Major clinical events, anginal status and use of cardiac medication were recorded according to the intention to treat principle. RESULTS: No significant differences were found in anginal status and use of cardiac medication between the two groups. In the PTCA group, 27.3% of patients underwent target lesion revascularization (TLR) versus 17.2% of patients in the stent group (p = 0.008). No significant differences in mortality (5.9% vs. 3.1%), cerebrovascular accident (0.8% vs. 1.2%), myocardial infarction (9.4% vs. 6.3%) or coronary bypass surgery (11.7% vs. 9.8%) were found between the stent and PTCA groups, respectively. At five years, the event-free survival rate (59.8% vs. 65.6%; p = 0.20) between the stent and PTCA groups no longer achieved statistical significance. CONCLUSIONS: The original 10% absolute difference in TLR in favor of the stent group has remained unchanged at five years, emphasizing the long-term stability of the stented target site
Toward âGreenâ Hybrid Materials: CoreâShell Particles with Enhanced Impact Energy Absorbing Ability
Restrained
properties of âgreenâ degradable products
drive the creation of materials with innovative structures and retained
eco-attributes. Herein, we introduce the creation of impact modifiers
in the form of coreâshell (CS) particles toward the creation
of âgreenâ composite materials. Particles with CS structure
constituted of PLA stereocomplex (PLASC) and a rubbery phase of polyÂ(Δ-caprolactone-<i>co</i>-d,l-lactide) (PÂ[CL-<i>co</i>-LA])
were successfully achieved by spray droplet atomization. A synergistic
association of the soft PÂ[CL-<i>co</i>-LA] and hard PLASC
domains in the coreâshell structure induced unique thermo-mechanical
effects on the PLA-based composites. The coreâshell particles
enhanced the crystallization of PLA matrices by acting as nucleating
agents. The coreâshell particles functioned efficiently as
impact modifiers with minimal effect on the composites stiffness and
strength. These findings provide a new platform for scalable design
of polymeric-based structures to be used in the creation of advanced
degradable materials