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  • 66151.
    Östberg, Erland
    et al.
    Västerås & Köping Hosp, Dept Anesthesia & Intens Care, Västerås, Sweden.
    Thorisson, Arnar
    Västerås & Köping Hosp, Dept Radiol, Västerås, Sweden.
    Enlund, Mats
    Clin Res Ctr, Västerås, Sweden.
    Zetterström, Henrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hedenstierna, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Edmark, Lennart
    Västerås & Köping Hosp, Dept Anesthesia & Intens Care, Västerås, Sweden.
    Positive End-expiratory Pressure Alone Minimizes Atelectasis Formation in Nonabdominal Surgery: A Randomized Controlled Trial2018Ingår i: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 128, nr 6, s. 1117-1124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Various methods for protective ventilation are increasingly being recommended for patients undergoing general anesthesia. However, the importance of each individual component is still unclear. In particular, the perioperative use of positive end-expiratory pressure (PEEP) remains controversial. The authors tested the hypothesis that PEEP alone would be sufficient to limit atelectasis formation during nonabdominal surgery. Methods: This was a randomized controlled evaluator-blinded study. Twenty-four healthy patients undergoing general anesthesia were randomized to receive either mechanical ventilation with PEEP 7 or 9 cm H2O depending on body mass index (n = 12) or zero PEEP (n =12). No recruitment maneuvers were used. Hie primary outcome was atelectasis area as studied by computed tomography in a transverse scan near the diaphragm, at the end of surgery, before emergence. Oxygenation was evaluated by measuring blood gases and calculating the ratio of arterial oxygen partial pressure to inspired oxygen fraction (Pao(2)/Fio(2) ratio). Results: At the end of surgery, the median (range) atelectasis area, expressed as percentage of the total lung area, was 1.8 (0.3 to 9.9) in the PEEP group and 4.6 (1.0 to 10.2) in the zero PEEP group. Tire difference in medians was 2.8% (95% CI, 1.7 to 5.7%; A = 0.002). Oxygenation and carbon dioxide elimination were maintained in the PEEP group, but both deteriorated in the zero PEEP group. Conclusions: During nonabdominal surgery, adequate PEEP is sufficient to minimize atelectasis in healthy lungs and thereby maintain oxygenation. Titus, routine recruitment maneuvers seem unnecessary, and the authors suggest that they should only be utilized when clearly indicated.

  • 66152.
    Östberg, Erland
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Thorisson, Arnar
    Enlund, Mats
    Zetterström, Henrik
    Hedenstierna, Göran
    Edmark, Lennart
    Positive end-expiratory pressure and postoperative atelectasis: A randomized controlled trial2019Ingår i: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Positive end-expiratory pressure (PEEP) increases lung volume and protects against alveolar collapse during anesthesia. During emergence, safety preoxygenation preparatory to extubation makes the lung susceptible to gas absorption and alveolar collapse, especially in dependent regions being kept open by PEEP. We hypothesized that withdrawing PEEP before starting emergence preoxygenation would limit postoperative atelectasis formation.

    Methods

    This was a randomized controlled evaluator-blinded trial in 30 healthy patients undergoing non-abdominal surgery under general anesthesia and mechanical ventilation with PEEP 7 or 9 cm H2O depending on body mass index. A computed tomography scan at the end of surgery assessed baseline atelectasis. The study subjects were thereafter allocated to either maintained PEEP (n = 16) or zero PEEP (n = 14) during emergence preoxygenation. The primary outcome was change in atelectasis area as evaluated by a second computed tomography scan 30 min after extubation. Oxygenation was assessed by arterial blood gases.

    Results

    Baseline atelectasis was small and increased modestly during awakening, with no statistically significant difference between groups. With PEEP applied during awakening, the increase in atelectasis area was median (range) 1.6 (-1.1 to 12.3) cm2 and without PEEP 2.3 (-1.6 to 7.8) cm2. The difference was 0.7 cm2 (95% CI, -0.8 to 2.9 cm2; P = 0.400). Postoperative atelectasis for all patients was median 5.2 cm2 (95% CI, 4.3 to 5.7 cm2), corresponding to median 2.5% of the total lung area (95% CI, 2.0 to 3.0%). Postoperative oxygenation was unchanged in both groups when compared to oxygenation in the preoperative awake state.

    Conclusion

    Withdrawing PEEP before emergence preoxygenation does not reduce atelectasis formation after non-abdominal surgery. Despite using 100% O2 during awakening, postoperative atelectasis is small and does not affect oxygenation, possibly conditional on an open lung during anesthesia, as achieved by intraoperative PEEP.

  • 66153.
    Östberg, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten.
    Studies on macromolecules coded for by the major histocompatibility complex 1975Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
  • 66154.
    Östberg, Monica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hagekull, Berit
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Parenting stress and external stressors as predictors of maternal ratings of child adjustment2013Ingår i: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 54, nr 3, s. 213-221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study sought to disentangle the effects of different kinds of stress on maternal ratings of child externalizing and internalizing problems, social inhibition, and social competence, with a primary focus on parenting stress. The relations were explored in a sample consisting of mothers of 436 children (Mage=7years) in Sweden. Half the sample had had early clinical contacts during infancy due to child regulation problems, and the rest were mothers without known such early contacts. Demographic factors, family stressors, and parenting stress were examined in stress adjustment models. Family stressors were clinical contact during infancy, current child and parent health problems, recent negative life events, and insufficient social support. Parenting stress as a mediator of the effect of other stressors on rated child adjustment was tested as was social support as a moderator of the effect of parenting stress on adjustment. The results showed that a higher parenting stress level was associated with maternal ratings of more externalizing and internalizing behaviors, more social inhibition, and lower social competence. Other family stressors and background variables were also found to be of importance, mainly for externalizing and internalizing problems and to some extent for social competence. Social inhibition had a unique relation to parenting stress only. Parenting stress mediated effects of other stressors in twelve models, whereas social support had no moderating effect on the link between parenting stress and child adjustment. Thus, parenting stress seems to be an important overarching construct. Clinical implications are proposed.

  • 66155.
    Östberg, Monica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Hagekull, Berit
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Hagelin, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Stability and prediction of parenting stress2007Ingår i: Infant and Child Development, ISSN 1522-7227, E-ISSN 1522-7219, Vol. 16, nr 2, s. 207-223Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The study focused on stability and prediction of parenting stress experiences over a 6-year period. Mothers (N=93) who had received a clinical intervention for feeding or sleeping problems during infancy (Time 1; T 1) were followed-up when the children were 5-10 years old (Time 2; T 2). An age- and sex-of-child matched normal group was used for comparison of stress levels at T 2. Parenting stress was measured by the Swedish Parenthood Stress Questionnaire, which consists of a general parenting stress scale and sub-scales tapping different aspects of parenting stress experiences. T 1 predictors were clinical assessments of child problem load, maternal unresponsiveness, and family psychosocial problems. T 2 predictors were mother-reported concurrent child problem load and psychosocial problems. The individual stability in stress experiences was moderate. Effect sizes indicated that mothers with early clinical contacts had reduced their stress to levels close to those in the normal sample. Parenting stress at T 2 could be predicted from early and from concurrent child and family problems. The results point to the relevance of early clinical assessments and to the importance of a sub-area approach in parenting stress research, as there were differences between stress sub-areas regarding both prediction and stability.

  • 66156.
    Östberg, Monica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Hagelin, Elisabet
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Feeding and sleeping problems in infancy - a follow-up at early school age2011Ingår i: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 37, nr 1, s. 11-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Feeding and sleeping problems are common during infancy. Many regulatory problems of this kind are connected to various child and family factors. This study is a follow-up of children with early feeding and/or sleeping problems, 6 years after clinical contacts. Methods:: A total of 230 families (72%) participated in the questionnaire follow-up. Children and parents were compared with 227 (71%) reference families regarding sleeping and feeding problems, health factors in parent and child, psychosocial problems, stressful life events, social support, life satisfaction, and externalizing and internalizing behaviour in the child.Results: Six years after clinical contacts the children with early feeding and/or sleeping problems still had more problems of this kind compared with the reference children. Early child health problems were more frequent within the clinical group, but recent health problems did not separate the two groups. Mothers in the clinical sample reported more health problems than mothers in the reference group and clinical parents were less content with their social support and had more psychosocial problems, including stressful life events. Children in the clinical sample had more internalizing problems than comparison children. Recent feeding and sleeping problems were connected to more externalizing and internalizing problems.Conclusions: Early regulatory problems, concerning sleeping or feeding, are less frequent when the child grows up, but nevertheless tend to remain. A clinical recommendation for child health care is to take both child and family factors into account, to individualize contacts, work with an all-inclusive perspective and have close follow-ups.

  • 66157.
    Östberg, Monica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Rydell, Ann-Margret
    An efficacy study of a combined parent and teacher management training programme for children with ADHD2012Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 66, nr 2, s. 123-130Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD) during the last few decades. Group format has often been used for parent training but single-subject designs are more common in teacher training. More studies have focussed on pre-school children than on older children, and a minority have been conducted in public mental health settings. Aim: This study aimed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden. Method: The intervention was a modified version of Barkley's programme. Children were randomized to an Intervention or a Control group. Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms, and about behavioural problems when the study started and at a 3-month follow-up. Results: Results showed that the intervention resulted in a reduction of the number of children who met DSM-IV criteria for ADHD and/or ODD. Effects were more pronounced in the home setting than in the school setting, and were further accentuated when both parents and teachers of the same child took part in the intervention. Teachers with more problematic classroom situations benefited most from the intervention. Conclusion: The programme, "Strategies in Everyday Life", has, in a regular clinical setting, demonstrated promising effects on children's disruptive behaviour, and a clinical implication was to recommend involving both parents and teachers in the programme.

  • 66158.
    Östberg, Per
    et al.
    Karolinska Inst, Div Speech Language Pathol, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Speech Language Pathol, SE-14186 Stockholm, Sweden..
    Backlund, Charlotte
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Lindström, Emma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Convergent and diagnostic validity of STAVUX, a word and pseudoword spelling test for adults2016Ingår i: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 41, nr 3, s. 124-128Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Few comprehensive spelling tests are available in Swedish, and none have been validated in adults with reading and writing disorders. The recently developed STAVUX test includes word and pseudoword spelling subtests with high internal consistency and adult norms stratified by education. This study evaluated the convergent and diagnostic validity of STAVUX in adults with dyslexia. Forty-six adults, 23 with dyslexia and 23 controls, took STAVUX together with a standard word-decoding test and a self-rated measure of spelling skills. STAVUX subtest scores showed moderate to strong correlations with word-decoding scores and predicted self-rated spelling skills. Word and pseudoword subtest scores both predicted dyslexia status. Receiver-operating characteristic (ROC) analysis showed excellent diagnostic discriminability. Sensitivity was 91% and specificity 96%. In conclusion, the results of this study support the convergent and diagnostic validity of STAVUX.

  • 66159.
    Östberg, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Bogdanovic, Nenad
    Semantic dementia with lower motor neuron disease showing FTLD-TDP type 3 pathology (sensu Mackenzie)2011Ingår i: Neuropathology (Kyoto. 1993), ISSN 0919-6544, E-ISSN 1440-1789, Vol. 31, nr 3, s. 271-279Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We describe a case of frontotemporal lobar degeneration with semantic dementia and lower motor neuron disease. A 63-year-old man presented with the full clinical picture of semantic dementia, including semantic anomia, surface alexia, lexical agraphia, associative agnosia, prosopagnosia and phonagnosia. Flaccid dysarthria, bulbar dysphagia and fasciculations developed 7 years after onset, followed by death within a year. The neuropathological examination showed heavy neuronal loss in the anterior temporal lobe cortex, dorsal vagal and hypoglossal nuclei and anterior horns of the spinal cord. Ubiquitin- and TDP-43-positive cytoplasmic inclusions were abundant in layer II of affected cortices and in granular cells of the hippocampal dentate gyrus, whereas dystrophic neurites were sparse and intranuclear inclusions absent. It is concluded that FTLD-TDP type 3 can be associated with semantic dementia and lower motor neuron disease in combination.

  • 66160.
    Östberg, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Bogdanovic, Nenad
    Karolinska institutet.
    Wahlund, Lars-Olof
    Karolinska institutet.
    Articulatory agility in cognitive decline2009Ingår i: Folia Phoniatrica et Logopaedica, ISSN 1021-7762, E-ISSN 1421-9972, Vol. 61, nr 5, s. 269-274Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Motor speech disorders are believed to be uncommon in early Alzheimer's disease (AD). However, data from maximum performance tests of motor speech function in AD and related disorders are virtually nonexistent. The aim of this study was to make such data available. MATERIALS AND METHODS: Sequential speech motion rate was analyzed in 236 memory clinic patients with different levels of cognitive functioning. RESULTS: Sequential speech motion rate was moderately but significantly decreased in mild dementia in AD. About 10% of AD and mild cognitive impairment cases had markedly decreased rates. Rates were strongly reduced in progressive nonfluent aphasia, whereas semantic dementia did not differ from subjective cognitive impairment. Frontotemporal dementia had lower rates than AD. CONCLUSIONS: A proportion of patients with cognitive decline has markedly reduced articulatory agility. The cause of this reduction in some patients with mild cognitive impairment and mild AD is unknown. Semantic dementia is not associated with impaired articulatory agility.

  • 66161.
    Östberg, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Crinelli, Raffaella
    Danielsson, Rimma
    Wahlund, Lars-Olof
    Bogdanovic, Nenad
    Fernaeus, Sven-Erik
    A temporal lobe factor in verb fluency2007Ingår i: Cortex, ISSN 0010-9452, E-ISSN 1973-8102, Vol. 43, nr 5, s. 607-615Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Verb fluency requires self-sustained verb retrieval. The brain correlates of this task are virtually unknown. We investigated the relations between verb and noun (semantic) fluency and regional brain perfusion in subjects with varying degrees of cognitive decline, ranging from very mild subjective impairment to Alzheimer's disease (AD). Data consisted of single-photon emission computed tomography (SPECT) data and temporally resolved verb and noun fluency scores from 93 participants. Impaired verb fluency was predicted by a temporal lobe hypoperfusion factor and low education, whereas high age and low perfusion in the parietotemporal-occipital region predicted impaired noun fluency. Analysis of perfusion within the temporal region indicated primary involvement of the temporal pole and medial temporal lobe in AD. This might reflect pathology of the anterior parahippocampal region, which appears early in neurodegenerative disease. Although temporal lobe structures have not usually been implicated in verb processing, early temporal pathology thus appears to contribute to impaired verb fluency in cognitive decline.

  • 66162.
    Östberg, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Fernaeus, Sven-Erik
    Bogdanovic, Nenad
    Wahlund, Lars-Olof
    Word sequence production in cognitive decline: forward ever, backward never2008Ingår i: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 33, nr 3, s. 126-135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Backward recall of automatic word sequences involves declarative and working memory abilities known to be impaired in the early stages of cognitive decline. Yet its utility in the diagnosis of mild cognitive impairment and mild dementia has not been studied in detail. We analysed word sequence production in 234 participants drawn from three categories: subjective cognitive impairment, mild cognitive impairment, and mild dementia in Alzheimer's disease. The names of the months were used as a diagnostic target for investigating forward versus backward sequence production. Forward production remained normal across categories. In contrast, backward speed was significantly decreased in mild cognitive impairment. In dementia both speed and accuracy were impaired. Backward production had significant diagnostic classificatory power. We conclude that word sequence production yields data relevant to the diagnosis of dementia with a minimum of time and expense.

  • 66163.
    Östberg, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Fernaeus, Sven-Erik
    Hellström, Åke
    Bogdanovic, Nenad
    Wahlund, Lars-Olof
    Impaired verb fluency: a sign of mild cognitive impairment2005Ingår i: Brain and Language, ISSN 0093-934X, E-ISSN 1090-2155, Vol. 95, nr 2, s. 273-279Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We assessed verb fluency vs. noun and letter-based fluency in 199 subjects referred for cognitive complaints including Subjective Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's disease. ANCOVAs and factor analyses identified verb, noun, and letter-based fluency as distinct tasks. Verb fluency performance in Mild Cognitive Impairment differed significantly from Subjective Cognitive Impairment and Alzheimer's disease. Reduced verb fluency thus appears to be a linguistic marker for incipient dementia. One possibility is that the verb fluency deficit in Mild Cognitive Impairment results from degenerative processes known to occur in the parahippocampal region.

  • 66164.
    Östberg, Per
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Hansson, Viktoria
    Häägg, Sofia
    Adult norms and test-retest reliability for the Months Backward test: Durational and response accuracy measures2012Ingår i: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 37, nr 1, s. 11-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to present adult norms and to estimate the test-retest reliability for durational and response accuracy measures on the word sequence production test, Months Backward. A total of 216 neurologically intact adults (aged 18-88) stratified by sex, age, and education took the test at maximum speed. Errors and speech duration were recorded. A retest was conducted with 40 participants after 3 weeks. Altogether 94% of the participants completed the test without error. Errors were associated with slow performance. Duration was predicted by years of education (beta = -0.39) and self-reported dyslexia (beta = 0.19). The test-retest reliability was 0.82 for duration and 0.97 for errors. A regression formula for adjustment of logarithmically transformed duration scores is provided.

  • 66165.
    Östberg, Sara
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Functional Characterization of the Evolutionarily Conserved Adenoviral Proteins L4-22K and L4-33K2014Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Regulation of adenoviral gene expression is a complex process directed by viral proteins controlling a multitude of different activities at distinct phases of the virus life cycle. This thesis discusses adenoviral regulation of transcription and splicing by two proteins expressed at the late phase: L4-22K and L4-33K. These are closely related with a common N-terminus but unique C-terminal domains. The L4-33K protein is an alternative RNA splicing factor inducing L1-IIIa mRNA splicing, while L4-22K is stimulating transcription from the major late promoter (MLP). The L4-33K protein contains a tiny RS-repeat in its unique C-terminal end that is essential for the splicing enhancer function of the protein. Here we demonstrate that the tiny RS-repeat is required for localization of the protein to the nucleus and viral replication centers. Further, we describe an auto-regulatory loop where L4-33K enhances splicing of its own intron. The preliminary characterization of the responsive RNA-element suggests that it differs from the previously defined L4-33K-responsive element activating L1-IIIa mRNA splicing.

    L4-22K lacks the ability to enhance L1-IIIa splicing in vivo, and here we show that the protein is defective in L1-IIIa or other late pre-mRNA splicing reactions in vitro. Interestingly, we found a novel function for the L4-22K and L4-33K proteins as regulators of E1A alternative splicing. Both proteins selectively upregulated E1A-10S mRNA accumulation in transfection experiments, by a mechanism independent of the tiny RS-repeat.

    Although L4-22K is reported to be an MLP transcriptional enhancer protein, here we show that L4-22K also functions as a repressor of MLP transcription. This novel activity depends on the integrity of the major late first leader 5’ splice site. The model suggests that at low concentrations L4-22K activates MLP transcription while at high concentrations L4-22K represses transcription.

    So far, characterizations of the L4-22K and L4-33K proteins have been limited to human adenoviruses 2 or 5 (HAdV-2/5). We expanded our experiments to include HAdV-3, HAdV-4, HAdV-9, HAdV-11 and HAdV-41. The results demonstrated that the transcription- or splicing-enhancing properties of L4-22K and L4-33K, respectively, are evolutionarily conserved and non-overlapping. Thus, the sequence-based conservation is mirrored by the functions, as expected for functionally important proteins.

    Delarbeten
    1. Serine 192 in the tiny RS repeat of the adenoviral L4-33K splicing enhancer protein is essential for function and reorganization of the protein to the periphery of viral replication centers
    Öppna denna publikation i ny flik eller fönster >>Serine 192 in the tiny RS repeat of the adenoviral L4-33K splicing enhancer protein is essential for function and reorganization of the protein to the periphery of viral replication centers
    2012 (Engelska)Ingår i: Virology, ISSN 0042-6822, E-ISSN 1096-0341, Vol. 433, nr 2, s. 273-281Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    The adenovirus L4-33K protein is a key regulator involved in the temporal shift from early to late pattern of mRNA expression from the adenovirus major late transcription unit. L4-33K is a virus-encoded alternative splicing factor, which enhances processing of 3’ splice sites with a weak sequence context. Here we show that L4-33K expressed from a transfected plasmid has a diffuse nuclear localization with strong enrichment in the nuclear membrane. We further show that the highly conserved part of the carboxy-terminal end of L4-33K, which functions as the splicing enhancer domain, is sufficient for nuclear localization of the protein. Interestingly, infection of the transfected cells caused a redistribution of L4-33K from the nuclear membrane into discrete ring-like structures corresponding to the viral transcription sites. We also show that serine 192 in the tiny RS repeat, which is critical for the splicing enhancer function of L4-33K, is necessary for the nuclear localization and redistribution of L4-33K protein into viral transcription sites. Collectively, our results show a good correlation between the activity of L4-33K as a splicing enhancer protein and its localization to viral transcription sites.

    Nyckelord
    L4-33K, L4-22K, splicing, localization, adenovirus, replication centers, transcription sites, peripheral replicative zone
    Nationell ämneskategori
    Mikrobiologi inom det medicinska området
    Identifikatorer
    urn:nbn:se:uu:diva-159614 (URN)10.1016/j.virol.2012.08.021 (DOI)000310095700001 ()22944109 (PubMedID)
    Tillgänglig från: 2011-10-05 Skapad: 2011-10-05 Senast uppdaterad: 2018-01-12Bibliografiskt granskad
    2. A suppressive effect of the first leader 5’ splice site on L4-­22K-­mediated activation of major late transcription
    Öppna denna publikation i ny flik eller fönster >>A suppressive effect of the first leader 5’ splice site on L4-­22K-­mediated activation of major late transcription
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-238486 (URN)
    Tillgänglig från: 2014-12-12 Skapad: 2014-12-12 Senast uppdaterad: 2015-03-09
    3. RNA elements involved in adenovirus L4-33K regulation of alternative splicing
    Öppna denna publikation i ny flik eller fönster >>RNA elements involved in adenovirus L4-33K regulation of alternative splicing
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-237965 (URN)
    Tillgänglig från: 2014-12-12 Skapad: 2014-12-08 Senast uppdaterad: 2015-03-09
    4. Conservation of the transcriptional and post-­transcriptional activities of serotype-­specific adenovirus L4 proteins
    Öppna denna publikation i ny flik eller fönster >>Conservation of the transcriptional and post-­transcriptional activities of serotype-­specific adenovirus L4 proteins
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-238482 (URN)
    Tillgänglig från: 2014-12-12 Skapad: 2014-12-12 Senast uppdaterad: 2015-03-09
  • 66166.
    Östberg, Sara
    et al.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Backström Winquist, Ellenor
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Akusjärvi, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    RNA elements involved in adenovirus L4-33K regulation of alternative splicingManuskript (preprint) (Övrigt vetenskapligt)
  • 66167.
    Östberg, Sara
    et al.
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Biasiotto, Roberta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Akusjärvi, Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Conservation of the transcriptional and post-­transcriptional activities of serotype-­specific adenovirus L4 proteinsManuskript (preprint) (Övrigt vetenskapligt)
  • 66168.
    Östberg, Sara
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Törmänen Persson, Heidi
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi. Uppsala universitet, Science for Life Laboratory, SciLifeLab.
    Akusjärvi, Göran
    Uppsala universitet, Science for Life Laboratory, SciLifeLab. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk biokemi och mikrobiologi.
    Serine 192 in the tiny RS repeat of the adenoviral L4-33K splicing enhancer protein is essential for function and reorganization of the protein to the periphery of viral replication centers2012Ingår i: Virology, ISSN 0042-6822, E-ISSN 1096-0341, Vol. 433, nr 2, s. 273-281Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The adenovirus L4-33K protein is a key regulator involved in the temporal shift from early to late pattern of mRNA expression from the adenovirus major late transcription unit. L4-33K is a virus-encoded alternative splicing factor, which enhances processing of 3’ splice sites with a weak sequence context. Here we show that L4-33K expressed from a transfected plasmid has a diffuse nuclear localization with strong enrichment in the nuclear membrane. We further show that the highly conserved part of the carboxy-terminal end of L4-33K, which functions as the splicing enhancer domain, is sufficient for nuclear localization of the protein. Interestingly, infection of the transfected cells caused a redistribution of L4-33K from the nuclear membrane into discrete ring-like structures corresponding to the viral transcription sites. We also show that serine 192 in the tiny RS repeat, which is critical for the splicing enhancer function of L4-33K, is necessary for the nuclear localization and redistribution of L4-33K protein into viral transcription sites. Collectively, our results show a good correlation between the activity of L4-33K as a splicing enhancer protein and its localization to viral transcription sites.

  • 66169.
    Östblom, Desirée
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Sjölander, Emma
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Fysioterapi.
    Kartläggning av och skillnader i postoperativa restriktioner vid primär total höftplastik utfört med direktlateralt snitt hos utförande sjukhus i Sverige2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Primär total höftplastik utförs vanligtvis på patienter med höftledsartros när konservativ behandlings smärtlindrande effekter inte är tillräckliga. Efter ingreppet kan postoperativa rörelserestriktioner tillämpas för att minska luxationsrisken. Rörelserestriktionerna har emellertid ifrågasatts då studier visat att något samband mellan tillämpande av restriktioner och minskad risk för luxation inte föreligger.

    Syfte: Kartlägga tillämpande av postoperativa rörelserestriktioner vid svenska sjukhus som genomför primär total höftplastik med direktlateralt snitt samt undersöka skillnader mellan universitets-/regionsjukhus, länssjukhus, länsdelssjukhus och privatsjukhus avseende tillämpandet av restriktioner. Studien syftade även till att kartlägga icke-standardiserade restriktioner.

    Metod: Tvärsnittsstudie med en deskriptiv och komparativ studiedesign. Totalt svarade 42 sjukhus på en egenkonstruerad webbenkät som utgjorde underlaget för datainsamlingen.

    Resultat: Vilka postoperativa restriktioner som tillämpades för flexion över 90°, utåtrotation över 45°, inåtrotation över 45°, adduktion över neutralläge samt flexion över 90° kombinerat med samtidig rotation och adduktion varierade på de deltagande sjukhusen. Det förelåg inga signifikanta skillnader mellan sjukhusgrupperna gällande nämnda rörelser. Flera sjukhus tillämpade icke-standardiserade restriktioner baserade på patients individuella förutsättningar samt kunde variera beroende på protestyp. Även rekommendationer om att undvika extrema rörelser förekom.

    Konklusion: Det är en variation gällande vilka restriktioner som tillämpas efter primär total höftplastik. Med hänsyn till denna studies resultat samt aktuell evidens bör postoperativa restriktioner fortsatt diskuteras. 

  • 66170. Östenson, C-G
    et al.
    Abdel-Halim, S M
    Andersson, A
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinsk cellbiologi.
    Efendic, S
    Studies on the pathogenesis of NIDDM in the GK (Goto-Kakizaki) rat1996Ingår i: Lessons from Animal Diabetes IV, 1996, Vol. 17, s. 299-Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 66171.
    Östenson, Claes-Göran
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten.
    Regulation of glucagon biosynthesis and secretion in isolated mammalian pancreatic islets 1979Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
  • 66172.
    Öster, Caisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Return to Work and Health-related Quality of Life after Severe Burn2010Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    A major burn is one of the most severe traumas a person can experience, and recovery can be a protracted process. The principal aim was to increase the knowledge base regarding factors related to return to work and health-related quality of life (HRQoL) after burns. Patients treated at the Uppsala Burn Center between 2000 and 2007 were included on a consecutive basis. Assessments were made at hospitalization, and thereafter and included a home visit 2 to 7 years after injury.

    The psychometric properties of the generic HRQoL instrument EQ-5D were investigated. The results support the use of EQ-5D as an adjunct to burn-specific assessments of HRQoL. Most former patients exhibited a good HRQoL at 2 to 7 years postburn. Not working at the time of injury and having PTSD at 12 months, as well as having low scores on the EQ VAS at 12 months, were related to a worse EQ VAS score at 2 to 7 years after injury.

    The majority of former patients had returned to work 2 to 7 years postburn. Time to return to work was predicted by length of hospital stay and a personality disorder diagnosis. Predictors for not returning to work were length of stay and having any anxiety or substance use disorder prior to injury. Those who were not back at work reported lower generic and burn-specific health, and exhibited more psychiatric morbidity at follow-up than those who were working. The latter group exhibited HRQoL that was comparable to that of the general population. Participants emphasized their own psychological resources and capabilities as facilitators in the process of returning to active work.

    The findings suggest that an early and systematic approach for assessing recognized risk factors enhances the possibility of discovering patients at risk of developing problems during postburn adaptation.

    Delarbeten
    1. Validation of the EQ-5D questionnaire in burn injured adults
    Öppna denna publikation i ny flik eller fönster >>Validation of the EQ-5D questionnaire in burn injured adults
    Visa övriga...
    2009 (Engelska)Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, nr 5, s. 723-732Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BACKGROUND: Health-related quality of life (HRQoL) is an important aspect of adaptation after burn. The EQ-5D is a standardized generic instrument for assessing HRQoL. Its psychometric properties in a group of burn injured individuals are, however, not known.

    METHODS: Seventy-eight consecutive patients admitted to a burn unit were included in a prospective longitudinal study. The participants completed the EQ-5D during acute care, and at 3, 6, and 12 months after the burn. At 6 and 12 months after the burn they also completed the Short-Form 36 Health Survey (SF-36) and the Burn Specific Health Scale-Brief (BSHS-B).

    RESULTS: High feasibility of the EQ-5D was demonstrated through a high response rate and a low proportion of missing or invalid answers. The floor and ceiling effects were small. Construct validity was demonstrated through good differentiation between health states and good discrimination of health states over time. The EQ-5D was associated with burn severity and discriminated between clinical subgroups in an expected manner. Criterion validity was demonstrated through significant correlations between the EQ-5D and subscales of the SF-36 and the BSHS-B.

    CONCLUSIONS: The EQ-5D has good psychometric properties, it is short and easy to administer and thus useful in assessment of HRQoL after burn.

    Nyckelord
    Psychometrics, EQ-5D, Health-related quality of life, Burn injury, Outcome assessment
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-122802 (URN)10.1016/j.burns.2008.11.007 (DOI)000268065200016 ()19297100 (PubMedID)
    Tillgänglig från: 2010-04-20 Skapad: 2010-04-20 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
    2. Health-related quality of life 2 years to 7 years after a severe burn
    Öppna denna publikation i ny flik eller fönster >>Health-related quality of life 2 years to 7 years after a severe burn
    2011 (Engelska)Ingår i: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, nr 5, s. 1435-1441Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    BACKGROUND:

    Knowledge concerning the trajectory andpredictors of health-related quality of life (HRQoL) years after burninjury is fragmentary and these factors were therefore assessed usingthe EQ-5D questionnaire.

    METHODS:

    Consecutive adult burnpatients were included during hospitalization and assessed at 3 months, 6months, and 12 months. In addition, an interview was performed at 2years to 7 years postburn. Data concerning injury characteristics,sociodemographic variables, psychiatric disorders, and HRQoL wereobtained.

    RESULTS:

    The EQ-5D dimension Mobility improvedbetween hospitalization and 3 months, while Anxiety/Depression improvedbetween 12 months and 2 years to 7 years. Other dimensions improvedgradually. At 2 years to 7 years, only the dimensions Pain/Discomfortand Usual activities were lower than in the general population. Inaddition, overall HRQoL was lower than in the general population whenmeasured by EQ VAS but not by EQ-5D index. EQ-5D index at 2 years to 7years was predicted by EQ-5D index at 12 months and concurrent workstatus and pain. EQ VAS at 2 years to 7 years was predicted by previousassessments of work status, posttraumatic stress disorder and EQ VAS,and concurrent work status and substance abuse. Total amount ofexplained variance ranged between 17% and 57%.

    CONCLUSIONS:

    HRQoLafter burn is conveniently screened by EQ VAS. Impairment after 2 yearsto 7 years is mainly reflected in the EQ dimensions Pain/Discomfort andUsual activities and can be predicted in part by information availablebefore or at 12 months.

    Nyckelord
    Return to work, Burn injury, Health-Related Quality of Life, EQ-5D
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-132450 (URN)10.1097/TA.0b013e318208fc74 (DOI)000297118600066 ()21399545 (PubMedID)
    Tillgänglig från: 2010-10-20 Skapad: 2010-10-20 Senast uppdaterad: 2017-12-12
    3. Return to work after burn: a prospective study
    Öppna denna publikation i ny flik eller fönster >>Return to work after burn: a prospective study
    2011 (Engelska)Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, nr 7, s. 1117-1124Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Return to work (RTW) is one of the most important objectives to strive for in burn rehabilitation. Most individuals do return to work after burn but there is a subgroup that does not. Prospective long-time follow-up studies focusing on RTW after burn are scarce. Consecutive adult burn patients employed before injury (n = 58) were included in the present study during hospitalization and subsequently followed up for 12 months. In addition, a structured interview was performed at 2-7 years after burn. At that time; mean 4.5 years (SD 2.0) after burn; 67% of the participants had returned to their work. Predictive variables for time to RTW were length of stay (LOS) at the burn center and fulfilling criteria for Any personality disorder. No RTW was predicted by LOS and having Any anxiety disorder or Any substance use disorder prior to the burn. The non-working group reported lower generic (EQ-5D) and burn-specific (BSHS-B) HRQoL than the working group at every time point. Identification of risk factors associated with difficulties in RTW is required in order to execute individualized vocational rehabilitation.

    Nyckelord
    Return to work, vocational rehabilitation, Burn injury, EQ-5D, BSHS-B, HRQoL
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-132452 (URN)10.1016/j.burns.2011.05.019 (DOI)000296075600004 ()
    Tillgänglig från: 2010-10-20 Skapad: 2010-10-20 Senast uppdaterad: 2017-12-12Bibliografiskt granskad
    4. Return to Work After Burn Injury: Burn-Injured Individuals' Perception of Barriers and Facilitators
    Öppna denna publikation i ny flik eller fönster >>Return to Work After Burn Injury: Burn-Injured Individuals' Perception of Barriers and Facilitators
    2010 (Engelska)Ingår i: Journal of burn care & research : official publication of the American Burn Association, ISSN 1559-0488, Vol. 31, nr 4, s. 540-550Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    The aim of this study was to explore burn-injured individuals' perception of factors seen as facilitators or barriers in the process of returning to work after a severe burn injury. Semistructured interviews were prospectively conducted with 39 former burn injury patients, admitted to the Uppsala Burn Center between March 2000 and March 2007. The participants were employed or studying at the time of injury and were interviewed on average 4.6 years after the burn. The interview data were analyzed with qualitative content analysis. Factors acknowledged by the participants as facilitators and barriers to return to work (RTW) were identified and sorted into five categories: the Individual, Social Life, Health Care and Rehabilitation, the Workplace, and Social Welfare Agencies. Facilitators were perceived to a great extent as individual characteristics, such as own ability to take action, setting up goals in rehabilitation, having willpower, being persistent, and learning to live with impairments. The possibility of getting modified work tasks or a change of workplace, when having physical or psychological impairments, was also seen as facilitating factors. Some barriers experienced as delaying RTW were difficulties when ceasing pain medication, limited knowledge of wound care at primary health care facilities, lack of individualized rehabilitation plans, and lack of psychological support during rehabilitation. Former burn injury patients emphasized psychological resources and capabilities as facilitators in the RTW process. The need in rehabilitation for a coordinator and for assessment of work capacity, and not solely a focus on impairments, is discussed.

    Nyckelord
    Return to work, burn injury, content analysis
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:uu:diva-132449 (URN)10.1097/BCR.0b013e3181e4d692 (DOI)000279638400004 ()20616648 (PubMedID)
    Tillgänglig från: 2010-10-20 Skapad: 2010-10-20 Senast uppdaterad: 2011-11-08Bibliografiskt granskad
  • 66173.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala Univ Hosp, Uppsala, Sweden.
    Arinell, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Nehlin, Christina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset. Uppsala Univ Hosp, Uppsala, Sweden.
    The Drinking Motives Questionnaire among Swedish psychiatric patients: An exploration of the four-factor structure2017Ingår i: Drug and Alcohol Review, ISSN 0959-5236, E-ISSN 1465-3362, Vol. 36, nr 3, s. 400-407Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction and Aims: Alcohol use above hazardous limits is common among persons with psychiatric disorders, and there is limited knowledge about motives for drinking. The objective of this study was to explore the adequacy of the four-factor structure of drinking motives in an adult psychiatric outpatient population in Sweden by confirming the factor structure in the Drinking Motives Questionnaire (DMQ-R) and in alternative models.

    Design and Methods: In total, 371 patients responded to the DMQ-R along with the Alcohol Use Disorders Identification Test (AUDIT). AUDIT was used to assess frequency of alcohol consumption, number of drinks consumed on a typical occasion and binge drinking frequency. Confirmatory factor analysis was used to examine the construct validity of the DMQ-R and alternative models, including the short form, DMQ-R SF.

    Results: Fit statistics suggested that the original four-factor model had questionable fit (root mean square error of approximation [RMSEA]=0.10, comparative fit index [CFI]=0.89, standardised root mean square residual [SRMR]=0.08). The model with the best fit indices was the DMQ-R SF (RMSEA=0.07, CFI=0.97, SRMR=0.04). When using DMQ-R SF in further analyses enhancement, the most strongly endorsed motives were related to quantity and AUDIT sum score. Coping motives were most strongly related to AUDIT sum score, frequency and binge drinking. Social motives were only related to binge drinking, whereas conformity motives were not statistically associated with any motives.

    Discussion and Conclusions: The study implies that the 12-item short form, DMQ-R SF, could be more appropriate than the original DMQ-R in this group.

  • 66174.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Bäckström, Susan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Lantz, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ramklint, Mia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Psychiatric patients' perspectives of student involvement in their care2015Ingår i: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, artikel-id 69Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In the education of professionals in psychiatry, one challenge is to provide clinical placements with opportunities for students to interact and have direct contact with patients. The aim of this study was to explore Swedish psychiatric patients' perspectives on student participation in their care. Method: In a cross-sectional survey design, 655 adult psychiatric patients at a university hospital completed questionnaires. These questionnaires included statements about student involvement, student gender, attitudes towards student participation as well as two open-ended questions. Data were analyzed quantitatively and qualitatively. Results: The majority of the patients were comfortable with student participation. There were no differences between patients in wards compared to outpatients but patients who previously had students involved in their care reported higher comfort levels and a more positive attitude. Female patients were less comfortable with male students and very young students. Patients stressed the importance of being informed about the opportunity to refuse student participation. More detailed information given before the consultation as well as the importance of the student showing a professional attitude was conditions that could enable more patients to endorse student participation. Conclusion: The psychiatric patients' overall positive attitudes are in line with previous findings from other specialties and countries. The results support both altruistic motives and experience of personal gains by student involvement. More detailed information given beforehand would enable more patients to consider student participation.

  • 66175.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Return to work after burn: a prospective study2011Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, nr 7, s. 1117-1124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Return to work (RTW) is one of the most important objectives to strive for in burn rehabilitation. Most individuals do return to work after burn but there is a subgroup that does not. Prospective long-time follow-up studies focusing on RTW after burn are scarce. Consecutive adult burn patients employed before injury (n = 58) were included in the present study during hospitalization and subsequently followed up for 12 months. In addition, a structured interview was performed at 2-7 years after burn. At that time; mean 4.5 years (SD 2.0) after burn; 67% of the participants had returned to their work. Predictive variables for time to RTW were length of stay (LOS) at the burn center and fulfilling criteria for Any personality disorder. No RTW was predicted by LOS and having Any anxiety disorder or Any substance use disorder prior to the burn. The non-working group reported lower generic (EQ-5D) and burn-specific (BSHS-B) HRQoL than the working group at every time point. Identification of risk factors associated with difficulties in RTW is required in order to execute individualized vocational rehabilitation.

  • 66176.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Hensing, Ida
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Löjdström, Therese
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sjoberg, Folke
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Parents' perceptions of adaptation and family life after burn injuries in children2014Ingår i: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 29, nr 6, s. 606-613Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore parents' experiences after their child's burn injury, focusing on how the burn had influenced family life and child adjustment. Six semi-structured interviews with parents of children treated at burn centers 2 to 7years previously revealed the theme, "Feeling quite alone in striving to regain family wellbeing". Identification of difficulties perceived by the parents during rehabilitation and up until the present is useful when developing pediatric burn care and support for parents of children with burns.

  • 66177.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Return to Work After Burn Injury: Burn-Injured Individuals' Perception of Barriers and Facilitators2010Ingår i: Journal of burn care & research : official publication of the American Burn Association, ISSN 1559-0488, Vol. 31, nr 4, s. 540-550Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore burn-injured individuals' perception of factors seen as facilitators or barriers in the process of returning to work after a severe burn injury. Semistructured interviews were prospectively conducted with 39 former burn injury patients, admitted to the Uppsala Burn Center between March 2000 and March 2007. The participants were employed or studying at the time of injury and were interviewed on average 4.6 years after the burn. The interview data were analyzed with qualitative content analysis. Factors acknowledged by the participants as facilitators and barriers to return to work (RTW) were identified and sorted into five categories: the Individual, Social Life, Health Care and Rehabilitation, the Workplace, and Social Welfare Agencies. Facilitators were perceived to a great extent as individual characteristics, such as own ability to take action, setting up goals in rehabilitation, having willpower, being persistent, and learning to live with impairments. The possibility of getting modified work tasks or a change of workplace, when having physical or psychological impairments, was also seen as facilitating factors. Some barriers experienced as delaying RTW were difficulties when ceasing pain medication, limited knowledge of wound care at primary health care facilities, lack of individualized rehabilitation plans, and lack of psychological support during rehabilitation. Former burn injury patients emphasized psychological resources and capabilities as facilitators in the RTW process. The need in rehabilitation for a coordinator and for assessment of work capacity, and not solely a focus on impairments, is discussed.

  • 66178.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Dyster-Aas, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Validation of the EQ-5D questionnaire in burn injured adults2009Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, nr 5, s. 723-732Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Health-related quality of life (HRQoL) is an important aspect of adaptation after burn. The EQ-5D is a standardized generic instrument for assessing HRQoL. Its psychometric properties in a group of burn injured individuals are, however, not known.

    METHODS: Seventy-eight consecutive patients admitted to a burn unit were included in a prospective longitudinal study. The participants completed the EQ-5D during acute care, and at 3, 6, and 12 months after the burn. At 6 and 12 months after the burn they also completed the Short-Form 36 Health Survey (SF-36) and the Burn Specific Health Scale-Brief (BSHS-B).

    RESULTS: High feasibility of the EQ-5D was demonstrated through a high response rate and a low proportion of missing or invalid answers. The floor and ceiling effects were small. Construct validity was demonstrated through good differentiation between health states and good discrimination of health states over time. The EQ-5D was associated with burn severity and discriminated between clinical subgroups in an expected manner. Criterion validity was demonstrated through significant correlations between the EQ-5D and subscales of the SF-36 and the BSHS-B.

    CONCLUSIONS: The EQ-5D has good psychometric properties, it is short and easy to administer and thus useful in assessment of HRQoL after burn.

  • 66179.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap.
    Ramklint, Mia
    Meyer, Jenny
    Isaksson, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Barn- och ungdomspsykiatri.
    How do adolescents with ADHD perceive and experience stress? An interview study.2019Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, s. 1-8Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Attention-deficit/hyperactivity disorder (ADHD) is linked to high levels of perceived stress in adult populations. Thus, it is not surprising that stress managing techniques are being included in treatment protocols for adults with ADHD. There is, however, a paucity of studies on perceived stress in adolescents with ADHD. Aims: This study aims to explore how adolescents with ADHD perceive and experience stress (and stressors) using a qualitative approach. Methods: Explorative interviews were conducted with 20 adolescents (Mean age: 16.30) diagnosed with ADHD in conjunction with group treatment therapy. Data were analysed using qualitative content analysis. Results: Stress and ADHD, as well as stress, anxiety and ill-health, were described as closely intertwined. The result is presented in four categories: stress is often present, triggers of stress, stress affects daily life, and stress can be handled and prevented. A relation was found between stress and feelings of helplessness, ill-health and anxiety. Stress was viewed as being out of proportion with reality and was driven by such factors as ADHD symptoms, school demands, unpredictable situations and relational problems. Several negative consequences of stress were reported, including postponing schoolwork and the tendency to give up. Some participants also reported performing better when stressed. Accepting help from others, practising acceptance, settling down and controlling oneself, and planning in advance were seen as helpful stress managing techniques. Conclusions: Stress should be considered among other problems related to ADHD. Psychoeducation about stress, stress managing techniques and coaching should be included in the treatment of adolescents with ADHD.

  • 66180.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Is sexuality a problem?: A follow-up of patients with severe burns 6 months to 7 years after injury2015Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 41, nr 7, s. 1572-1578Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE AND AIMS:

    This is the first study investigating sexuality from 6 months up to 7 years after burn. The aim was to examine sexuality in females and males by using the BSHS-B sexuality subscale and to examine possible contributing factors with regard to sociodemographics, burn characteristics, personality traits, and previous psychiatric disorders.

    METHODS:

    A cohort of 107 patients consecutively admitted to a Swedish national burn center was followed up at 6, 12, and 24 months after burn, and 67 individuals were followed up at 2-7 years after burn. The present study utilized the BSHS-B sexuality subscale, and multiple regression analyses were used to examine possible contributing factors.

    RESULTS:

    Women were less satisfied than men, and sexuality mean scores improved over time, even up to 7 years after-burn, in both men and women. The strongest contributing factors for worse outcome regarding sexuality were a history of psychiatric morbidity, neuroticism and burn severity.

    CONCLUSIONS:

    As some patients experience sexual problems after burns, even many years later, it is important to identify these individuals. The BSHS-B sexuality subscale may be used as a screening tool, but more in-depth assessment might be needed to address all aspects of sexuality.

  • 66181.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Sveen, Josefin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    The psychiatric sequelae of burn injury2014Ingår i: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 36, nr 5, s. 516-522Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine factors predicting psychiatric morbidity, taking into account the full range of psychiatric disorders before and after burn injury. Methods: A cohort of 107 patients consecutively admitted to a Swedish national burn center was examined for lifetime psychiatric morbidity, as well as 94 patients at 1 year postinjury. Sixty-seven individuals, some from that same cohort, were interviewed at 2 to 7 years postinjury. The predictive effects of psychiatric history, personality and other risk factors for psychiatric morbidity following burn were evaluated with multiple regression analyses. Results: The prevalence of having a psychiatric disorder preburn was 57%. One year postinjury 19% had minor or major depression and 23% had subsyndromal or full posttraumatic stress disorder. At 2 to 7 years, 31% fulfilled the criteria for a psychiatric disorder. The strongest contributing factors were a history of psychiatric morbidity and neuroticism. Conclusions: Two-thirds of the patients had a lifetime psychiatric disorder, and one-third had a psychiatric diagnosis 2 to 7 years postburn. Mental health problems can have a major impact on daily life and functional abilities. Thus, identification and treatment of a range of psychiatric disorders, taking into account preburn psychiatric disorders and personality, is important for optimal adjustment after burn.

  • 66182.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Burn-specific health 2 to 7 years after burn injury2013Ingår i: Journal of Trauma and Acute Care Surgery, ISSN 2163-0755, Vol. 74, nr 4, s. 1119-1124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Knowledge concerning the pattern of recovery and predictors of burn-specific health years after burn injury is limited, and these factors were therefore assessed with a disease-specific instrument, the Burn Specific Health Scale-Brief. METHODS: Consecutive adult burn patients were prospectively included during hospitalization and assessed at 3, 6, and 12 months as well as at 2 years to 7 years (4.6 years on average) after burn. Data concerning injury characteristics, sociodemographic variables, psychiatric disorders, and burn-specific health were obtained. RESULTS: Burn-specific health improved over time, from 6 months to the final assessment after burn. At 2 years to 7 years after burn, most problems were reported in the subscales heat sensitivity, body image, and work. The regression analyses revealed that length of stay, any preburn psychiatric disorder, major depression, and posttraumatic stress disorder 12 months after burn were predictors of long-term burn-specific health in the affect and relations domain, whereas time since injury, length of stay, and major depression 12 months after burn predicted outcome in the skin involvement domain. Predictors for the subscale work were length of stay, working at the time of injury, and posttraumatic stress disorder at 12 months. CONCLUSION: This study underscores that significant improvement in postburn health can be expected even later than 2 years after injury. Furthermore, the results imply that both preburn factors and factors identified 1 year after burn have impact on burn-specific health after several years.

  • 66183.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Health-related quality of life 2 years to 7 years after a severe burn2011Ingår i: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, nr 5, s. 1435-1441Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Knowledge concerning the trajectory andpredictors of health-related quality of life (HRQoL) years after burninjury is fragmentary and these factors were therefore assessed usingthe EQ-5D questionnaire.

    METHODS:

    Consecutive adult burnpatients were included during hospitalization and assessed at 3 months, 6months, and 12 months. In addition, an interview was performed at 2years to 7 years postburn. Data concerning injury characteristics,sociodemographic variables, psychiatric disorders, and HRQoL wereobtained.

    RESULTS:

    The EQ-5D dimension Mobility improvedbetween hospitalization and 3 months, while Anxiety/Depression improvedbetween 12 months and 2 years to 7 years. Other dimensions improvedgradually. At 2 years to 7 years, only the dimensions Pain/Discomfortand Usual activities were lower than in the general population. Inaddition, overall HRQoL was lower than in the general population whenmeasured by EQ VAS but not by EQ-5D index. EQ-5D index at 2 years to 7years was predicted by EQ-5D index at 12 months and concurrent workstatus and pain. EQ VAS at 2 years to 7 years was predicted by previousassessments of work status, posttraumatic stress disorder and EQ VAS,and concurrent work status and substance abuse. Total amount ofexplained variance ranged between 17% and 57%.

    CONCLUSIONS:

    HRQoLafter burn is conveniently screened by EQ VAS. Impairment after 2 yearsto 7 years is mainly reflected in the EQ dimensions Pain/Discomfort andUsual activities and can be predicted in part by information availablebefore or at 12 months.

  • 66184.
    Öster, Caisa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Willebrand, Mimmie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Kildal, Morten
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Dyster-Aas, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Ekselius, Lisa
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Health-related quality of life after a severe burn: a prospective study2009Ingår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 35, nr Suppl 1, s. S27-S27Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Rationale:

    Health related quality of life (HRQoL) is defined as the impact an injury or illness has on quality of life, including the individual's perception of his or her injury or illness. The aim of this study was to investigate changes over time in HRQoL in burn-injured adults using the EQ-5D instrument.

    Methods:

    Participants were 88 consecutively included burn patients treated at the Uppsala University Hospital Burn Center. Their mean age was 43.3 (SD 15.5), total body surface area burned 24.4 (SD 19.8) and full-thickness burn 10.7 (SD 14.5). The participants completed the EQ-5D during hospitalisation, and at 3, 6, 12 and 24 months after injury. The EQ-5D includes five dimensions: Mobility, Self-care, Usual activities, Pain/Discomfort and Anxiety/Depression. Within each dimension there are three severity levels: no problems, moderate problems or severe problems. In addition the participants rate their health state on a VAS scale from 0 to 100. In a follow-up study the participants completed the EQ-5D in average 4.5 years after burn, with a range of 2–7 years. Pre- and post-burn psychiatric morbidity were assessed as well as burn characteristics.

    Results:

    The mean EQ utility index score improved on a group level from 0.15 at baseline to 0.72 at 24 months after the burn. In average 4.5 years after the burn the index score was 0.79. All scores were below the population norm. The VAS score improved from 48.3 at baseline to 72.5 at 24 months after burn. In spite of the fact that utility scores and VAS scores have improved more than half of the participants reported problems in the dimension Pain/Discomfort and one fifth reported problems in Usual Activities, in average 4.5 years after burn. Psychiatric morbidity pre- and post-burn as well as burn characteristics will be discussed.

    Conclusion:

    Burn injured adults have evident impairments in HRQoL even many years after burn. Most pronounced are problems in Pain/Discomfort and Usual Activities.

  • 66185.
    Österberg, A
    et al.
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Edebol Eeg-Olofsson, K
    Halldén, M
    Graf, W
    Uppsala universitet, Medicinska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper.
    Randomized clinical trial comparing conservative and surgical treatment of neurogenic faecal incontinence.2004Ingår i: Br J Surg, ISSN 0007-1323, Vol. 91, nr 9, s. 1131-7Artikel i tidskrift (Refereegranskat)
  • 66186.
    Österberg, Annika
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Kvist, Joanna
    Dahlgren, Madeleine Abrandt
    Ways of experiencing participation and factors affecting the activity level after nonreconstructed anterior cruciate ligament injury: a qualitative study2013Ingår i: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 43, nr 3, s. 17