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Dusing GJ, Kim C, Nielsen A, Chum A. Disparities in alcohol- and substance-related hospitalizations and deaths across sexual orientations in Canada: a longitudinal study. Public Health 2024; 226:32-38. [PMID: 37995410 DOI: 10.1016/j.puhe.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES We aim to quantify disparities in substance-related acute events (i.e. hospitalizations and deaths for substances, including alcohol, cannabis, opioids, narcotics, and/or illicit drugs) across sexual orientations based on health administrative data. STUDY DESIGN This was a longitudinal analysis from six waves of the Canadian Community Health Survey (2009-2014) linked to hospitalization/mortality data in Ontario, Canada. METHODS The study sample consisted of survey respondents aged ≥15 (weighted n = 15,406,000) who provided a valid response to the question about sexual orientation. The primary outcome was substance-related acute events, including hospitalizations and deaths due to alcohol, cannabis, opioids, narcotics, and/or illicit drugs. Disparities in substance-related acute events across sexual orientation and gender were examined using flexible parametric survival analysis. RESULTS Bisexual women had hazard ratios of 2.46 (95% confidence interval: 1.46-4.15) for any substance-related acute event and 2.67 (95% confidence interval: 1.42-5.00) for non-alcohol substance acute events compared to heterosexual women. Lesbian women did not exhibit significant differences in acute event risk compared to heterosexual women. Gay and bisexual men demonstrated elevated but not statistically significant risks compared to heterosexual men. CONCLUSIONS Bisexual women face higher risks of substance-related acute events, potentially due to self-medication of unique stressors brought on by discrimination and isolation. Enhanced education and training for healthcare professionals are essential to increase awareness and sensitivity toward the heightened substance use risk among lesbian, gay, and bisexual individuals. Targeted interventions aimed at reducing substance use problems among bisexual individuals warrant increased funding and research.
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Affiliation(s)
- G J Dusing
- York University, School of Kinesiology and Health Sciences, Canada
| | - C Kim
- York University, School of Kinesiology and Health Sciences, Canada
| | - A Nielsen
- Canadian Institute of Health Information, Canada
| | - A Chum
- York University, School of Kinesiology and Health Sciences, Canada; University of Toronto, Dalla Lana School of Public Health, Canada.
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Canabarro APF, Eriksson M, Nielsen A, Salazar M. Social capital and STIs testing among young men in Stockholm, Sweden: A cross-sectional study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Testing for sexually transmitted infections (STIs) is highly accessible in Sweden, but young men's testing rate is considerably lower than young women's. Social capital (SC) might shape people's STIs testing patterns. However, such association has not been studied among young men before. This study assessed the prevalence of different forms of SC and if they increase STIs testing among young men in Stockholm, Sweden.
Methods
This population-based cross-sectional study was conducted in 2018 and included 523 men aged 20-29 years living in Stockholm. Bonding SC (having helped someone; having received help; having someone to share inner feelings with), institutionalized trust SC (in school; healthcare; media) and STIs testing behavior (never tested, tested only in the last 12 months, only more than 12 months ago, or both before and after the last 12 months) were assessed. Weighted adjusted multinomial logistic regression tested the associations between SC and STIs testing.
Results
High levels of bonding SC (range: 86.5 - 95.5%), as well as trust in healthcare (76.7%) and school (64.8%) were reported. Having helped someone (aRRR 6.1, 95% CI 1.7 - 21.6), having received help (aRRR 8.1, 95% CI 2.6 - 24.7) and having someone to share feelings (aRRR 4.0, 95% CI 1.7 - 9.2) were associated with being tested for STIs more than 12 months ago. Trust in media was the only institutional trust significantly associated with STIs testing (tested in the last 12 months: aRRR 2.5, 95% CI 1.1 - 5.4; both before and after: aRRR 3.8, 95% CI 1.6 - 8.9).
Conclusions
Peer-to-peer interventions using bonding SC should be used to promote STIs testing. More studies are needed to understand how trust in media increases testing for STIs. Although trust in healthcare and school were not statistically associated with testing, the high overall trust in these institutions reported in our study could be harnessed to implement sexual education programs promoting STIs testing among young men.
Key messages
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Affiliation(s)
- APF Canabarro
- Department of Global Public Health, Karolinska Institutet , Stockholm, Sweden
| | - M Eriksson
- Department of Social Work, Umeå University , Umeå, Sweden
| | - A Nielsen
- Department of Global Public Health, Karolinska Institutet , Stockholm, Sweden
| | - M Salazar
- Department of Global Public Health, Karolinska Institutet , Stockholm, Sweden
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Nielsen A, Skaarup K, Hauser R, Johansen N, Lassen M, Inciardi R, Jensen G, Schnohr P, Moegelvang R, Biering-Soerensen T. Left atrial strain predicts heart failure in the general population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left atrial (LA) function has shown to be a significant predictor of cardiovascular outcomes. We sought to determine the prognostic value of LA strain in relation to incident heart failure (HF) in the general population.
Methods
The present study includes 3,540 participants from the general population without prevalent atrial fibrillation or HF. All participants underwent health examinations and echocardiography including measures of LA function by means of peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and LA strain during the conduit phase (LACS). Cox proportional hazards regressions were utilised to access the association between incident HF and LA strain parameters.
Results
Median age of the study population was 57 years (interquartile range: 40, 69) and 2,015 (57%) were female. During follow-up (median 5.4 years), 66 (2%) participants were diagnosed with HF. Participants who developed HF had lower PALS (26.4% vs. 36.6%, p<0.001), PACS (15.6% vs. 16.5%, p=0.016), and LACS (11.4% vs. 19.3%, p<0.001) at baseline. Lower values of all three LA strain parameters were associated with a higher risk of developing HF in univariable analysis (Figure 1 & 2). After multivariable adjustments for Framingham Risk Score and global longitudinal strain, PALS (HR=1.06, 95% CI [1.03; 1.09], p<0.001, per 1% decrease), PACS (HR=1.07, 95% CI [1.02; 1.12], p=0.003, per 1% decrease), and LACS (HR=1.05, 95% CI [1.01; 1.10], p=0.016, per 1% decrease) remained significantly associated with incident HF. However, in participants with normal-sized LA (LA volume index <34 ml/m2) and no ischemic heart disease (n=3,046), only PALS and PACS remained independent predictors of HF (Figure 2).
Conclusion
LA strain provides independent prognostic value regarding the risk of incident HF in the general population.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): The Danish Heart Foundation and The Metropolitan Region of Denmark
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Affiliation(s)
- A Nielsen
- Gentofte University Hospital , Copenhagen , Denmark
| | - K Skaarup
- Gentofte University Hospital , Copenhagen , Denmark
| | - R Hauser
- Gentofte University Hospital , Copenhagen , Denmark
| | - N Johansen
- Gentofte University Hospital , Copenhagen , Denmark
| | - M Lassen
- Gentofte University Hospital , Copenhagen , Denmark
| | - R Inciardi
- Civil Hospital of Brescia , Brescia , Italy
| | - G Jensen
- Bispebjerg and Frederiksberg Hospital , Frederiksberg , Denmark
| | - P Schnohr
- Bispebjerg and Frederiksberg Hospital , Frederiksberg , Denmark
| | - R Moegelvang
- Bispebjerg and Frederiksberg Hospital , Frederiksberg , Denmark
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Schøler P, Søndergaard J, Nielsen A. Danish Feasibility Study of a New Innovation for Screening and Brief Intervention for Alcohol Problems in Primary Care: The 15-method. Eur Psychiatry 2022. [PMCID: PMC9567853 DOI: 10.1192/j.eurpsy.2022.2103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
The 15-method: a new brief intervention tool for alcohol problems in primary care, has shown promising results in Sweden for mild to moderate alcohol use disorders.
Objectives
To evaluate the 15-method’s usability, organizational integration, and overall implementation feasibility in Danish general practice (GP) in preparation for a large-scale evaluation of the method’s effectiveness in identifying and treating alcohol problems in GP.
Methods
In the Central and Southern Region of Denmark, five general practices participated: seven doctors and eight nurses. Participants received half a day of training in the 15-method. Testing of implementation strategies and overall applicability ran for two months. A focus group interview, two individual interviews with the participating doctors, and five individual patient interviews concluded the study phase.
Results
indicate that implementation of the 15-method is feasible in Danish general practice. The healthcare professionals and patients were optimistic about the method and its possibilities. The method was considered a new patient-centred treatment offer and provided structure to a challenging topic. An interdisciplinary approach was much welcomed. Results indicate that the method is ready for large-scale assessment.
Conclusions
Implementation of the 15-method is considered feasible in Danish general practice, and large-scale evaluation is currently being planned. The results from the present feasibility study, and an overview of the large-scale evaluation, will be presented at the conference.
Disclosure
No significant relationships.
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Tryggedsson J, Andersen K, Bogenschutz M, Nielsen A. Gender differences in a clinical sample of 60+ year old patients receiving treatment for alcohol use disorder. Eur Psychiatry 2022. [PMCID: PMC9568114 DOI: 10.1192/j.eurpsy.2022.2138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Gender differences have been found in treatment-seeking older adults with AUD, concerning areas such as quality of life, drinking patterns, and prevalence of AUD. However, little is known about how these gender differences may relate to treatment.
Objectives
To investigate gender differences in quality of life, problematic areas at treatment start, and subsequent choice of treatment, in a clinical sample of 60+ year old patients receiving treatment for AUD.
Methods
We will utilize data from the Elderly Study; a multi-national (USA, Germany, and Denmark), single-blind randomized controlled trial. Participants (n=693) were randomized to brief, outpatient treatment based on motivational enhancement therapy alone (4 sessions) or motivational enhancement therapy followed by a community reinforcement approach age-adapted to older adults (up to 8 sessions). The latter was a module-based treatment where participants chose which module(s) they deemed most relevant. Modules focused on coping with aging, building sober networks, mood management, etc. The gender differences at baseline will be described by means of descriptive statistics (e.g. one-way analysis of variance, χ2 statistics, etc.). Gender differences, including choice of modules, will be investigated by means of multivariate statistics, e.g. generalized linear models. Analyses will be controlled for relevant confounders such as age, country, education, work situation, marital status, family and friends, type of housing, etc.
Results
Will be presented at the EPA Congress.
Conclusions
Will be presented at the EPA Congress.
Disclosure
No significant relationships.
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Benini E, Politis SN, Nielsen A, Sørensen SR, Tomkiewicz J, Engrola S. Type of hormonal treatment administered to induce vitellogenesis in European eel influences biochemical composition of eggs and yolk-sac larvae. Fish Physiol Biochem 2022; 48:185-200. [PMID: 35044583 PMCID: PMC8844165 DOI: 10.1007/s10695-021-01042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Egg biochemical composition is among the main factors affecting offspring quality and survival during the yolk-sac stage, when larvae depend exclusively on yolk nutrients. These nutrients are primarily embedded in the developing oocytes during vitellogenesis. In aquaculture, assisted reproduction procedures may be applied enabling gamete production. For the European eel (Anguilla anguilla), reproductive treatment involves administration of pituitary extracts from carp (CPE) or salmon (SPE) to induce and sustain vitellogenesis. In the present study, we compared the influence of CPE and SPE treatments on offspring quality and composition as well as nutrient utilization during the yolk-sac stage. Thus, dry weight, proximal composition (total lipid, total protein), free amino acids, and fatty acids were assessed in eggs and larvae throughout the yolk-sac stage, where body and oil-droplet area were measured to estimate growth rate, oil-droplet utilization, and oil-droplet utilization efficiency. The results showed that CPE females spawned eggs with higher lipid and free amino acid contents. However, SPE females produced more buoyant eggs with higher fertilization rate as well as larger larvae with more energy reserves (estimated as oil-droplet area). Overall, general patterns of nutrient utilization were detected, such as the amount of total lipid and monounsaturated fatty acids decreasing from the egg stage and throughout the yolk-sac larval stage. On the contrary, essential fatty acids and free amino acids were retained. Notably, towards the end of the yolk-sac stage, the proximal composition and biometry of surviving larvae, from both treatments, were similar.
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Affiliation(s)
- E Benini
- Technical University of Denmark, National Institute of Aquatic Resources, Kgs. Lyngby, Denmark.
| | - S N Politis
- Technical University of Denmark, National Institute of Aquatic Resources, Kgs. Lyngby, Denmark
| | - A Nielsen
- Technical University of Denmark, National Institute of Aquatic Resources, Kgs. Lyngby, Denmark
| | - S R Sørensen
- Technical University of Denmark, National Institute of Aquatic Resources, Kgs. Lyngby, Denmark
| | - J Tomkiewicz
- Technical University of Denmark, National Institute of Aquatic Resources, Kgs. Lyngby, Denmark
| | - S Engrola
- Centre of Marine Sciences, Universidade Do Algarve, Faro, Portugal
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Christensen MW, Keefe D, Wang F, Hansen C, Chamani I, Sommer C, Nyegaard M, Rohde P, Nielsen A, Bybjerg-Grauholm J, Kesmodel U, Knudsen U, Kirkegaard K, Ingerslev J. P–617 Idiopathic early ovarian aging: Do biomarkers of ageing indicate premenopausal accelerated biological ageing in young women with diminished response to ART? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Do young women with idiopathic early ovarian ageing have changes in telomere length and epigenetic age indicating accelerated biological aging?
Summary answer
The telomere length and epigenetic age were comparable to those in young women with normal ovarian ageing.
What is known already
Increased risk of several health events usually considered to be age-related such as cardiovascular disease, osteoporosis, over-all morbidity and mortality have been associated with premature and early menopause when compared to the risk in women with normal menopausal age suggesting an accelerated general ageing process associated to early ovarian ageing. It is unclear whether the onset of this process may start before menopause.
Study design, size, duration
A prospective cohort study. Young women (≤ 37 years) having ART at two Danish Public fertility clinics during the period 2016 to 2018 were divided into two groups dependent on their ovarian reserve status: early ovarian ageing (EOA) (N = 55) and normal ovarian ageing (NOA)( N = 52). Number of oocytes harvested in first and subsequent cycles was used as a marker of ovarian reserve. Blood samples was drawn at time of oocyte retrieval to assess biological age.
Participants/materials, setting, methods
EOA was defined as ≥ 2 IVF cycles with ≤ 5 harvested oocytes despite sufficient stimulation with FSH and NOA as ≥ 8 oocytes harvested in minimum 1 cycle. Known causes influencing the ovarian reserve (endometriosis, ovarian surgery, etc.) was reason for exclusion. Relative telomere length (qPCR) and epigenetic age acceleration (DNA methylation levels) were measured in white blood cells as markers of accelerated biological ageing.
Main results and the role of chance
Relative telomere length was comparable with a mean of 0.46 (± sd 0.12) in the EOA group and 0.47 (0.14) in the normal ovarian ageing group (p = 0.64). The difference of predicted mean epigenetic age and mean chronological age (i.e. epigenetic age acceleration) was, insignificantly, 0.5 years older in the EOA group when compared to the NOA group( (–1.02 years (2.62) and –1.57 years (2.56), respectively, p = 0.27)), but this difference disappeared when adjusting for chronological age.
Limitations, reasons for caution
Discrete changes in epigenetic age acceleration may not have been captured as the study only had power to detect an age acceleration of ≥ 2 years.
Wider implications of the findings: By analysis of biomarkers for ageing in whole blood, we did not find any indications of a premenopausal accelerated aging in young women with idiopathic EOA. Further investigations in a similar cohort of premenopausal women is needed to fully elucidate the potential relationship between premenopausal accelerated biological ageing and EOA.
Trial registration number
The study was approved by the Danish Data protection Agency (nr 1–16–02–320–14) and the Regional committee on health research ethics of Central Region Denmark (jr.no 1–10–72–142–14).
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Affiliation(s)
- M W Christensen
- Horsens Regional Hospital, Fertility Clinic- Obstetrics and Gyneacology, Horsens, Denmark
- Aarhus University, Clinical Medicine, Aarhus, Denmark
| | - D Keefe
- New York University Langone Medical Center, Department of Obstetrics and Gynecology, New York, USA
| | - F Wang
- New York University Langone Medical Center, Department of Obstetrics and Gynecology, New York, USA
| | - C Hansen
- Statens Serum Institut, Center for Neonatal Screening- Department of Congenital Disorders, Copenhagen, Denmark
| | - I Chamani
- New York University Langone Medical Center, Department of Obstetrics and Gynecology, New York, USA
| | - C Sommer
- New York University Langone Medical Center, Department of Obstetrics and Gynecology, New York, USA
| | - M Nyegaard
- Aarhus University, Department of Biomedicine, Aarhus, Denmark
| | - P Rohde
- Aalborg University, Department of Chemistry and Bioscience, Aalborg, Denmark
| | - A Nielsen
- Aarhus University, Department of Biomedicine, Aarhus, Denmark
| | - J Bybjerg-Grauholm
- Statens Serum Institut, Center for Neonatal Screening- Department of Congenital Disorders, Copenhagen, Denmark
| | - U Kesmodel
- Aalborg University Hospital, Fertility Unit, Aalborg, Denmark
- Aalborg University, Clinical Medicine, Aalborg, Denmark
| | - U Knudsen
- Horsens Regional Hospital, Fertility Clinic- Obstetrics and Gyneacology, Horsens, Denmark
- Aarhus University, Clinical Medicine, Aarhus, Denmark
| | - K Kirkegaard
- Aarhus University Hospital, Obstetrics and Gynecology, Aarhus, Denmark
| | - J Ingerslev
- Aarhus University, Clinical Medicine, Aarhus, Denmark
- Aalborg University Hospital, Fertility Unit, Aalborg, Denmark
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Nielsen A, Lundgaard K, Jacobsen K, Hansen K, Søltoft K, Sten L, Gullander L, Sibolt P, Calmels L, Andersson L, Geertsen P. PO-1988 Designing a radiation therapy technologist training program for online adaptive Radiation Therapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08439-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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Gledhill W, Huddleston R, Kravetz L, Nielsen A, Sedlak R, Vashon R. Treatability of Surfactants at a Wastewater Ireatment Plant. TENSIDE SURFACT DET 2021. [DOI: 10.1515/tsd-1989-260409] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Nielsen A, Soerensen S, Skaarup K, Djernaes K, Estepar R, Hansen M, Worck R, Johannesen A, Hansen J, Biering-Soerensen T. Left atrial function assessed by speckle tracking echocardiography predicts atrial fibrillation burden after catheter ablation independently of reconduction: a RACE-AF echocardiographic sub-study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Left atrial (LA) function assessed by 2D speckle tracking echocardiography (STE) has demonstrated to be a useful predictor of recurrence of atrial fibrillation (AF) following catheter ablation (CA). Pulmonary vein reconduction (PVR) is one of the most important causes of recurrent paroxysmal AF (PAF) after ablation. The purpose of this study was to evaluate the association between AF burden (% of time in AF) following CA and LA strain measurements independently of PVR.
Methods
This prospective study included 66 patients with PAF who underwent CA (mean age 60 ± 8 years, 65% male). STE was performed during sinus rhythm prior to CA. AF burden was recorded by continuous rhythm monitoring using implantable loop recorders during a follow-up period of 4-6 months, excluding a blanking period of 3 months. After follow-up, all patients underwent an invasive assessment of pulmonary vein isolation to test for PVR. Multivariable linear regression analysis was used to assess the association between AF burden and peak atrial longitudinal reservoir strain (PALS), peak atrial contraction strain (PACS) and peak atrial conduit strain (PCS).
Results
Prior to CA, median AF burden was 3.8% (IQR: 0.5, 17). During follow-up, 37 patients (56%) were free of AF while median AF burden was 0.7% (IQR: 0.2, 1.6) in patients with an AF burden of more than 0%. A total of 35 patients (54%) were found to have PVR after ablation. Patients with AF recurrence had significantly lower PACS compared to patients with no AF during follow-up (10% ± 6% vs. 14% ± 5%, p = 0.004). No differences in PALS and PCS were observed. Increased PACS remained independently associated with low AF burden following CA after multivariable adjustments for clinical characteristics, comorbidities, and PVR (β=-0.262, p = 0.049) (Figure 1). PALS and PCS did not remain significantly associated with AF burden.
Conclusion
Increased PACS is strongly associated with low AF burden after CA even after adjusting for PVR. This suggests that an analysis of LA function could be useful to stratify patients prior to CA and improve treatment strategies.
Abstract Figure.
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Affiliation(s)
- A Nielsen
- Gentofte University Hospital, Copenhagen, Denmark
| | - S Soerensen
- Gentofte University Hospital, Copenhagen, Denmark
| | - K Skaarup
- Gentofte University Hospital, Copenhagen, Denmark
| | - K Djernaes
- Gentofte University Hospital, Copenhagen, Denmark
| | - R Estepar
- Brigham and Women"s Hospital, Boston, United States of America
| | - M Hansen
- Gentofte University Hospital, Copenhagen, Denmark
| | - R Worck
- Gentofte University Hospital, Copenhagen, Denmark
| | - A Johannesen
- Gentofte University Hospital, Copenhagen, Denmark
| | - J Hansen
- Gentofte University Hospital, Copenhagen, Denmark
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Moonaz S, Whitehead AM, Lawrence L, Natividad D, Kindred D, Nielsen A, Teets R. Yoga therapy DYADS: A novel approach to chronic pain management in underserved populations. Explore (NY) 2020; 18:195-199. [PMID: 33342752 DOI: 10.1016/j.explore.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/04/2020] [Accepted: 12/05/2020] [Indexed: 02/07/2023]
Abstract
Yoga therapy is an emerging integrative health approach that applies the practices and teachings of yoga for individuals with clinical concerns. It is generally offered as individual sessions between a yoga therapist and client or in a small group setting with several clients who share a clinical concern. Here we describe a third model for consideration- the yoga therapy dyad. A dyad includes two clients working simultaneously with a single yoga therapist and differs from both individual and small group sessions in the potential benefits and challenges. The yoga therapy dyad model that is detailed here was implemented as part of a feasibility trial along with group acupuncture therapy for chronic pain in an underserved population. Underserved populations are at risk for pain and reduced access to care. This pilot may inform future research, policy, education, and clinical practice.
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Affiliation(s)
- S Moonaz
- Maryland University of Integrative Health, 7750 Montpelier Road, Laurel, MD 20723, USA.
| | - A M Whitehead
- Integrative Health Coordinating Center, VHA Office of Patient Centered Care & Cultural Transformation, 810 Vermont Ave NW, Washington, DC 20420, USA
| | | | | | | | - A Nielsen
- Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health, 1425 Madison Avenue, L5-40, New York, NY 10029, USA
| | - R Teets
- Icahn School of Medicine at Mount Sinai, Department of Family Medicine & Community Health, 1425 Madison Avenue, L5-40, New York, NY 10029, USA; Institute for Family Health, 230W 17th St, New York, NY 10011, USA.
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12
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Nielsen A, Andersen M. PO-1938: Implementation of Stereotactic Radiosurgery (SRS) for brain metastases. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01955-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Chao Y, Yang S, Zhang Y, Shen Z, Wu X, Wang J, Quiroz M, Nielsen A, Liu C, Desai J. 154P Investigation of PD-L1 expression and tislelizumab efficacy in gastroesophageal adenocarcinoma using a novel tumor and immune cell score with VENTANA PD-L1 (SP263) assay and Combined Positive Score (CPS). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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14
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Briones-Vozmediano E, Stjärnfeldt J, Larson F, Nielsen A, Eriksson M, Salazar M. Young men’s discourses of health service utilization for Chlamydia infection testing in Stockholm. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chlamydia Trachomatis (CT) infection is the most commonly reported sexually transmitted bacterial disease in Sweden, other European countries, as well as globally. CT is often asymptomatic and if it goes untreated it can cause severe reproductive health issues. In Sweden, men test for CT in a much lesser extent than women. The aim of this study is to identify factors influencing Swedish young men to use Health care for CT detection.
Methods
Qualitative study based on 18 semi-structured interviews with young men (18-30 years old) in Stockholm during 2018. A Situational Analysis was conducted (a development of Constructivist Grounded Theory) of the interviews' transcriptions, using Open Code as the software for qualitative analysis in order to code and organize the information obtained. We constructed a situational map to illustrate the positions taken by Swedish young men according to their discourses.
Results
Three ideal types of Swedish young men with different discourses and behaviors towards CT testing were identified: unconcerned men are indifferent about CT and other sexual transmitted infections (STI) and therefore not testing; ambivalent men only test when suspect suffering from an STI and/or are influenced by their social network; Whereas, proactive men test regularly as a way to know they are healthy. The differences between the ideal types are explained by their risk perception, the role of health services, and the positive or negative influence of their social network.
Conclusions
The ideal types of young men identified in this study show a range of discourses linked to their risk perception, the role of health services, and the influence of their social network, which in practice is translated into different behaviours adopted for CT testing. Testing should be encouraged as an important part of CT prevention by educating groups of unconcerned young men about both the consequences of untreated CT and the free testing options available in Sweden.
Key messages
Swedish young men have different discourses towards CT testing depending on their risk perception, the strategies adopted to test and the positive or negative role of their social network. The role of health services and the social support emerged as key factors to promoting testing among Swedish Young men.
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Affiliation(s)
- E Briones-Vozmediano
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Department of Global Public Health, Karolinska Institut, Stockholm, Sweden
| | - J Stjärnfeldt
- Department of Global Public Health, Karolinska Institut, Stockholm, Sweden
| | - F Larson
- Department of Global Public Health, Karolinska Institut, Stockholm, Sweden
| | - A Nielsen
- Department of Global Public Health, Karolinska Institut, Stockholm, Sweden
| | - M Eriksson
- Department of Social Work, University of Umeå, Umeå, Sweden
| | - M Salazar
- Department of Global Public Health, Karolinska Institut, Stockholm, Sweden
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Møller-Bisgaard S, Georgiadis S, Hørslev-Petersen K, Ejbjerg B, Hetland ML, Ørnbjerg L, Glinatsi D, Møllenbach Møller J, Boesen M, Stengaard-Pedersen K, Rintek Madsen O, Jensen B, Villadsen J, Hauge EM, Bennett P, Hendricks O, Asmussen K, Kowalski M, Lindegaard HM, Bliddal H, Steen Krogh N, Ellingsen T, Nielsen A, Balding L, Jurik AG, Thomsen H, Ǿstergaard M. AB0209 PREDICTORS OF ACHIEVING STRINGENT REMISSION IN PATIENTS WITH ESTABLISHED RHEUMATOID ARTHRITIS IN CLINICAL REMISSION FOLLOWING A TREAT-TO-TARGET STRATEGY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Achieving remission according to stringent criteria such as Simplified Disease Activity Index (SDAI) and ACR/EULAR Boolean remission is associated with a better long-term outcome in patients with RA1. Possible predictors of achieving stringent remission in patients in clinical remission, following targeted treatment strategies, have not been investigated.Objectives:To investigate the predictive value of clinical, radiographic and MRI variables on achieving more stringent remission in RA patients in clinical remission, following MRI and conventional treat-to-target (T2T) strategies.Methods:In this post-hoc study, data were used from 171 RA patients in clinical remission (DAS28-CRP< 3.2 and no swollen joints) on conventional synthetic DMARDs, included in the IMAGINE-RA randomized clinical trial2, where they followed an MRI T2T strategy (targeting absence of osteitis) combined with clinical remission (DAS28-CRP≤3.2 and no swollen joints) or a conventional T2T strategy (targeting clinical remission only). Baseline contrast-enhanced MRIs of the dominant wrist and 2nd-5thMCP joints and radiographs of hands and feet were evaluated according to the OMERACT RAMRIS scoring system and Sharp/van der Heijde method, respectively, by two experienced readers. Potential clinical, radiographic and MRI baseline predictors of remission were first tested in univariate logistic regression analyses with achievement of Clinical Disease Activity Index (CDAI), SDAI, and ACR/EULAR Boolean remission at 24 months as dependent variables. Variables with p<0.25 were subsequently tested in multivariate logistic regression analyses with backward selection, adjusted for age, gender and strategy group. Missing values of covariates were imputed using chained equations.Results:Based on the univariate analyses, tender joint count, patient VAS global, VAS pain, VAS fatigue, physician VAS global, HAQ, MRI osteitis, radiographic and MRI erosion and joint space narrowing scores were included in multivariate analyses (Table).Following the MRI T2T strategy was a positive predictor and high patient VAS global a negative predictor of achieving all definitions of remission. Furthermore, high patient VAS pain was negatively associated with achieving SDAI and ACR/EULAR Boolean remission and high tender joint count negatively associated with achieving CDAI and SDAI remission.Multivariate logistic regression analyses with backward selection, final modelsDependent variables, remission at 24 monthsCDAISDAIACR/EULAR BooleanOR95% CIp-valueOR95% CIp-valueOR95% CIp-valueCovariatesMRI T2T strategy group2.941.25-7.520.0132.461.03-6.350.0435.472.33-14.11<0.001Female0.900.36-2.250.820.800.31-2.050.640.800.32-1.970.63Age1.020.98-1.070.321.020.98-1.070.331.030.99-1.070.15Tender joint count (0-28)0.330.12-0.860.0230.290.10-0.780.013Patient VAS global0.910.88-0.94<0.0010.930.88-0.97<0.0010.930.88-0.980.003Patient VAS pain0.950.91-1.000.0490.920.87-0.980.004Conclusion:In RA patients in clinical remission, poor patient reported outcomes and tender joint count were associated with decreased chance of achieving stringent remission, while following an MRI T2T strategy predicted stringent remission across all definitions thereof.References:[1]Smolen et al. Ann Rheum Dis 2017[2]Møller-Bisgaard et al. JAMA 2019Disclosure of Interests:Signe Møller-Bisgaard Grant/research support from: AbbVie, Consultant of: BMS, Speakers bureau: BMS, Celgene, Pfizer, Stylianos Georgiadis Grant/research support from: Novartis, Kim Hørslev-Petersen: None declared, Bo Ejbjerg: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis, Lykke Ørnbjerg: None declared, Daniel Glinatsi: None declared, Jakob Møllenbach Møller: None declared, Mikael Boesen Consultant of: AbbVie, AstraZeneca, Eli Lilly, Esaote, Glenmark, Novartis, Pfizer, UCB, Paid instructor for: IAG, Image Analysis Group, AbbVie, Eli Lilly, AstraZeneca, esaote, Glenmark, Novartis, Pfizer, UCB (scientific advisor)., Speakers bureau: Eli Lilly, Esaote, Novartis, Pfizer, UCB, Kristian Stengaard-Pedersen: None declared, Ole Rintek Madsen: None declared, Bente Jensen: None declared, Jan Villadsen: None declared, Ellen Margrethe Hauge: None declared, Philip Bennett: None declared, Oliver Hendricks: None declared, Karsten Asmussen: None declared, Marcin Kowalski: None declared, Hanne Merete Lindegaard: None declared, Henning Bliddal Grant/research support from: received research grant fra NOVO Nordic, Consultant of: consultant fee fra NOVO Nordic, Niels Steen Krogh: None declared, Torkell Ellingsen: None declared, Agnete Nielsen: None declared, Lone Balding: None declared, Anne Grethe Jurik: None declared, Henrik Thomsen: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB
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Møller-Bisgaard S, Hørslev-Petersen K, Ejbjerg B, Hetland ML, Christensen R, Ørnbjerg L, Glinatsi D, Møllenbach Møller J, Boesen M, Stengaard-Pedersen K, Rintek Madsen O, Jensen B, Villadsen J, Hauge EM, Bennett P, Hendricks O, Asmussen K, Kowalski M, Lindegaard HM, Bliddal H, Steen Krogh N, Ellingsen T, Nielsen A, Jurik AG, Balding L, Thomsen H, Ǿstergaard M. FRI0019 MRI INFLAMMATION, DISEASE ACTIVITY AND FUNCTIONAL IMPAIRMENT ARE MORE EFFECTIVELY REDUCED BY ESCALATION TO BIOLOGICS COMPARED TO CSDMARD-ESCALATION IN RHEUMATOID ARTHRITIS PATIENTS IN CLINICAL REMISSION FOLLOWING A TREAT-TO-TARGET STRATEGY: SECONDARY ANALYSES OF THE IMAGINE-RA TRIAL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The effect of different treatment escalations on MRI inflammation in rheumatoid arthritis (RA) patients following an MRI treat-to-target (T2T) strategy has not previously been investigated.Objectives:To compare the effect of different treatment escalations on MRI inflammation, physical function and disease activity in RA patients in clinical remission, following an MRI T2T strategy.Methods:One hundred RA patients in clinical remission (DAS28-CRP<3.2 and no swollen joints), on conventional synthetic (cs) DMARDs following an MRI T2T strategy targeting DAS28-CRP≤3.2, no swollen joints plus absence of MRI osteitis, were followed for 2 years with clinical and MRI (wrist and 2nd-5thMCP joints) evaluation every 4 months1. If target was not met, a predefined treatment escalation algorithm dictated: First: increase in csDMARDs (A), second: adding a TNF inhibitor (TNFi) (B), third and onwards: switch between biologics (C). If target was met, no change in baseline csDMARDs was done (D). Outcomes were assessed 4 months after treatment change. MRIs were evaluated with known chronology by one experienced reader. Repeated measures mixed linear models were used to express estimates of group differences on predefined co-primary outcomes (MRI osteitis, HAQ) and key secondary outcomes (MRI combined inflammation, Simplified Disease Activity Index (SDAI)).Results:Escalation to first TNFi (B) or to 2ndor later biologic (C) compared to csDMARDs (A) was consistently more effective on all outcomes (e.g. in group B osteitis was reduced with 1.8 units more than A) (Table). Unchanged (D) compared to escalation in csDMARD (A) treatment did not differ, except for HAQ-score. Escalation to a 2ndor later biologics (C) compared to the first TNFi (B) was more effective suppressing MRI inflammation. Escalation to TNFi treatment (B) or to 2ndor later biologic (C) compared to unchanged treatment (D) was more effective on all outcomes except from HAQ-score (no difference between groups).Comparisons of treatment escalations1A: Increment in csDMARD mono/combination therapy (n=73)); B: Switch from csDMARD combination therapy to TNFi (n=39); C: Switch from TNFi to 2ndbiologic/switch between biologics (n=21); D: No change in csDMARDs from baseline (n=58)A vs BA vs CA vs DB vs CB vs DC vs DOutcomesPrimaryMRIOsteitis1.8 (1.0; 2.6) p<.00013.6 (2.3; 4.8) p<.00010.3 (−0.3; 1.0)p=.321.8 (0.8; 2.9) p=.0006−1.4 (−2.4; −0.5) p=.0045−3.3 (−4.6; −1.9) p<.0001HAQ0.081(0.033; 0.13) p=.00110.091(0.031; 0.15) p=.00320.054(0.014; 0.095) p=.00910.0092(−0.051; 0.070) p=.77−0.027(−0.082; 0.028) p=.33−0.037(−0.10; 0.031) p=.29Key secondaryMRI combined inflammationa2.5 (0.9; 4.1) p=.00185.4 (3.1; 7.7) p<.00010.4 (−0.9; 1.8)p=.522.9 (0.8; 4.9) p=.0064−2.1 (−4.0; −0.2) p=.032−5.0 (−7.5; −2.4) p=.0002SDAI2.7 (1.9; 3.5) p<.00012.4 (1.4; 3.4) p<.00010.5 (−0.2; 1.2)p=.14−0.3 (−1.3; 0.7)p=.60−2.2 (−3.1; −1.3) p<.0001−1.9 (−3.0; 0.8) p=.00061Estimates of group differences (least squares means (95% CI)).aSum score of synovitis, osteitis and tenosynovitisConclusion:T2T-based treatment escalations to biologics compared to csDMARD-escalations more effectively improved MRI inflammation, physical function and disease activity. Further optimization of the treatment in RA patients in clinical remission may improve long-term outcomes.References:[1]Møller-Bisgaard et al. JAMA 2019Disclosure of Interests:Signe Møller-Bisgaard Grant/research support from: AbbVie, Consultant of: BMS, Speakers bureau: BMS, Celgene, Pfizer, Kim Hørslev-Petersen: None declared, Bo Ejbjerg: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis, Robin Christensen: None declared, Lykke Ørnbjerg: None declared, Daniel Glinatsi: None declared, Jakob Møllenbach Møller: None declared, Mikael Boesen Consultant of: AbbVie, AstraZeneca, Eli Lilly, Esaote, Glenmark, Novartis, Pfizer, UCB, Paid instructor for: IAG, Image Analysis Group, AbbVie, Eli Lilly, AstraZeneca, esaote, Glenmark, Novartis, Pfizer, UCB (scientific advisor)., Speakers bureau: Eli Lilly, Esaote, Novartis, Pfizer, UCB, Kristian Stengaard-Pedersen: None declared, Ole Rintek Madsen: None declared, Bente Jensen: None declared, Jan Villadsen: None declared, Ellen Margrethe Hauge: None declared, Philip Bennett: None declared, Oliver Hendricks: None declared, Karsten Asmussen: None declared, Marcin Kowalski: None declared, Hanne Merete Lindegaard: None declared, Henning Bliddal Grant/research support from: received research grant fra NOVO Nordic, Consultant of: consultant fee fra NOVO Nordic, Niels Steen Krogh: None declared, Torkell Ellingsen: None declared, Agnete Nielsen: None declared, Anne Grethe Jurik: None declared, Lone Balding: None declared, Henrik Thomsen: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB
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Nielsen A. The MOSEXY – Trial: Mobile Phone for Sexual Health in Youth. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Nielsen
- Department of Womens and Childrens Health, Karolinska Institute, Stockholm, Sweden
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Abstract
Five cases of primary malignant lymphomas of the salivary glands are reported. Four lymphomas arose in the parotid gland and one in the submandibular gland. All were non-Hodgkin lymphomas. In 4 cases the lymphomas were of low-grade malignancy, viz. 2 immunocytomas and 2 centroblastic/centrocytic malignant lymphomas, and 1 was a T-immunoblastic malignant lymphoma of high-grade malignancy. Four patients with localized disease were treated with radiotherapy and 1 patient with disseminated disease was treated with chemotherapy. One patient died from a disease unrelated to the malignant lymphoma, and 4 patients were alive at 66-136 months after treatment.
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Salazar M, De Costa A, Danielsson KG, Nielsen A. Testing for Chlamydia trachomatis - a “safe approach” to “unsafe sex”. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Salazar
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - A De Costa
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - K Gemzell Danielsson
- Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden
| | - A Nielsen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Zajac M, Boothman AM, Ben Y, Gupta A, Antal J, Jin X, Nielsen A, Manriquez G, Barker C, Wang P, Patil P, Schechter N, Rebelatto M, Walker J. Abstract 664: Analytical validation and clinical utility of an immunohistochemical PD-L1 diagnostic assay for treatment with durvalumab in urothelial carcinoma patients. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: A high quality programmed cell death ligand-1 (PD-L1) diagnostic may help to identify patients (pts) most likely to respond to anti-PD-L1/programmed cell death-1 (PD-1) therapy. Here we describe a PD-L1 immunohistochemical (IHC) diagnostic test developed for urothelial carcinoma (UC) pts treated with durvalumab.
Methods: The IHC assay uses an anti-human PD-L1 rabbit mAb optimized for detection of both tumor cell (TC) and tumor-associated immune cell (IC) PD-L1 expression with the OptiView DAB IHC Detection Kit on the automated VENTANA BenchMark ULTRA platform. The assay was validated for intended use in UC formalin-fixed, paraffin-embedded samples in a series of studies that addressed sensitivity, specificity, robustness and precision and implemented in Study CD-ON-MEDI4736-1108 (NCT01693562). Pts were evaluated using the VENTANA PD-L1 (SP263) Assay at a prespecified PD-L1 expression cut-off. Efficacy was analyzed in pts with PD-L1 low/negative (defined as TC <25% and IC <25%) UC and in pts with PD-L1 high (defined as TC ≥25% or IC ≥25%) UC.
Results: The VENTANA PD-L1 (SP263) Assay met all the predefined acceptance criteria (average positive agreement and average negative agreement >85%), showing analytical specificity, sensitivity and precision. It demonstrated ≥97% and ≥85% inter-reader precision agreement for TC and IC respectively. For intra-reader precision, it demonstrated >96% and >87% agreement for TC and IC respectively. For intra-day performance, the assay demonstrated ≥96% agreement for TC and IC and for inter-day performance, it demonstrated ≥98% and 100% agreement for TC and IC respectively. Precision studies for inter-antibody lot, inter-detection kit lot and intra-platform demonstrated >97% agreement for both TC and IC. Inter-laboratory testing was performed at 3 external laboratories and demonstrated an overall agreement rate of 92.3%. The VENTANA PD-L1 (SP263) Assay was implemented in Study CD-ON-MEDI4736-1108 and durvalumab demonstrated clinical activity and durability of response in both PD-L1 high and PD-L1 low/negative subgroups, yet with different response rates. In addition, given the high negative predictive value of the assay, it is especially helpful in evaluating the likelihood of response to durvalumab; pts who were classified as PD-L1 high with the VENTANA PD-L1 (SP263) Assay tended to have a higher objective response rate per RECIST v1.1 than pts who were PD-L1 low/negative.
Conclusions: These data show that determination of PD-L1 expression in TC and IC in UC pts using the VENTANA PD-L1 (SP263) Assay is precise and highly reproducible and highlight the utility of the assay in a clinical setting. The VENTANA SP263 Assay is especially helpful in informing pts and physicians on the likelihood of response to durvalumab, but not for the purpose of restricting treatment to only PD-L1 high pts.
Citation Format: M Zajac, A M. Boothman, Y Ben, A Gupta, J Antal, X Jin, A Nielsen, G Manriquez, C Barker, P Wang, P Patil, N Schechter, M Rebelatto, J Walker. Analytical validation and clinical utility of an immunohistochemical PD-L1 diagnostic assay for treatment with durvalumab in urothelial carcinoma patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 664. doi:10.1158/1538-7445.AM2017-664
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Affiliation(s)
- M Zajac
- 1AstraZeneca, Cambridge, United Kingdom
| | | | - Y Ben
- 2AstraZeneca, Gaithersburg, MD
| | - A Gupta
- 3MedImmune, Gaithersburg, MD
| | - J Antal
- 3MedImmune, Gaithersburg, MD
| | - X Jin
- 3MedImmune, Gaithersburg, MD
| | - A Nielsen
- 4Ventana Medical Systems Inc., Tucson, AZ
| | | | - C Barker
- 1AstraZeneca, Cambridge, United Kingdom
| | - P Wang
- 4Ventana Medical Systems Inc., Tucson, AZ
| | - P Patil
- 4Ventana Medical Systems Inc., Tucson, AZ
| | | | | | - J Walker
- 1AstraZeneca, Cambridge, United Kingdom
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Zajac M, Boothman A, Nielsen A, Manriques G, Barker C, Wang P, Patil P, Schechter N, Rebelatto M, Walker J. An immunohistochemical PD-L1 diagnostic assay for treatment with durvalumab in urothelial cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw525.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vangsted A, Jensen P, Madsen M, Gimsing P, Jensen T, Hansen A, Rasmussen A, Nielsen A, Buhl U, Jandu H, Brunner N, Pratt B, Frølund U, Helleberg C, Abildgaard N, Knudsen S. APO010 sensitivity in relapsed multiple myeloma patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hodges P, Nielsen A, French S. Key messages for patients with low back pain: expert and consumer opinion. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nielsen A, Lind V, Steinheim G, Holand Ø. Variations in lamb growth on coastal and mountain pastures, will climate change make a difference? ACTA AGR SCAND A-AN 2015. [DOI: 10.1080/09064702.2015.1029515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Clemmesen J, Busk T, Nielsen A. The Topographical Distribution of Leukemia and Hodgkin's Disease in Denmark 1942-46. Acta Radiol 2013. [DOI: 10.1177/028418515203700310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Clemmesen J, Busk T, Nielsen A. Age Distribution Figures for Malignant Diseases in Denmark 1942-1944. Acta Radiol 2013. [DOI: 10.1177/028418514903100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Nielsen A, Michaelsen KF, Holm L. Parental concerns about complementary feeding: differences according to interviews with mothers with children of 7 and 13 months of age. Eur J Clin Nutr 2013; 67:1157-62. [PMID: 24045795 DOI: 10.1038/ejcn.2013.165] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 07/30/2013] [Accepted: 08/12/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES To investigate and analyze differences in parental concerns during earlier and later phases of complementary feeding. SUBJECT/METHODS Eight focus group interviews were conducted with 45 mothers of children aged 7 or 13 months. Deductive and inductive coding procedures were applied in the analysis. RESULTS There were marked differences in mothers' health concerns in early and in later phases of complementary feeding. In the early phase, feeding a child healthy food was an unquestioned and self-evident practice. The child's food was a specific category, separated from the rest of the family's food, and the mother's focus was on the immediate well-being and safety of the child. In the later phase, health concerns shifted towards a longer-term perspective, and the aim of integrating the child into the family's social world became as important as concerns about well-being and safety. Contested and partly contradictory practices resulted, including conscious acceptance of some intake of sugar and unhealthy fats. Perceived relevance of nutritional guidelines on complementary feeding was high in the early phase but declined later. CONCLUSION Mothers' concerns and practices in the feeding of a young child vary considerably across the early and later phases of complementary feeding. This should be explored further and taken into consideration in the targeting and timing of dietary guideline communications.
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Affiliation(s)
- A Nielsen
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
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Medrud L, Nielsen A, Boesen M, Fredberg U, Ellingsen T. AB0731 Does dynamic contrast-enhanced magnetic resonance (dce-mri) aid the diagnosis of early rheumatoid arthritis in the wrist? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.3053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nielsen A, Munk C, Jørgensen HO, Winther JF, van den Brule AJC, Kjaer SK. Multiple-type human papillomavirus infection in younger uncircumcised men. Int J STD AIDS 2013; 24:128-33. [PMID: 23512509 DOI: 10.1177/0956462412472294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A cohort of 388 young men enrolled for military service in the Danish army was established and the participants underwent a clinical examination with human papillomavirus (HPV) testing. In addition, a questionnaire containing questions regarding sociodemographic variables, sexual habits and lifestyle factors was completed. The prevalence of HPV was 33.4% in this cohort of uncircumcised men aged 18-29 years. Multiple HPV types were prevalent with one-third of the HPV-positive men being positive for more than one HPV type. Number of recent sexual partners and infrequent condom use were strong risk factors, particularly in men having multiple HPV types. Our findings re-emphasize the importance of sexual transmission and also point to a role of factors that may be related to individual susceptibility as genital warts, alcohol intake and, to a lesser extent, smoking were strongly associated with having multiple HPV types.
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Affiliation(s)
- A Nielsen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen
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Anderson B, Nielsen A, Kligler B, McKee D. P04.32. Acupuncture and heart rate variability: a systems level approach to understanding mechanism. Altern Ther Health Med 2012. [PMCID: PMC3373763 DOI: 10.1186/1472-6882-12-s1-p302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Verma A, Nielsen A, Bronk JM, McGrath JE, Riffle JS. Synthesis of new, functionalized poly(butyl vinyl ether) oligomers and novel copolymers containing these materials. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/masy.19910470119] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Buttmann N, Nielsen A, Munk C, Liaw KL, Kjaer S. High-risk sexual behaviour in a random sample of >22,000 men from the general population in Denmark. Contraception 2010. [DOI: 10.1016/j.contraception.2010.04.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Nielsen A, Munk C, Kjaer S. O675 Increased incidence of anal cancer in Danish women from 1978-2006. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61048-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hjortebjerg U, Mark K, Nielsen A, Tofte J, Ringer D, Mikkelsen TB. 4268 Side effects at the time of rehabilitation as reported by 329 breast cancer patients' in response to an open question and a structured, closed questionnaire. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70885-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Atkinson SF, Johnson DR, Venables BJ, Slye JL, Kennedy JR, Dyer SD, Price BB, Ciarlo M, Stanton K, Sanderson H, Nielsen A. Use of watershed factors to predict consumer surfactant risk, water quality, and habitat quality in the upper Trinity River, Texas. Sci Total Environ 2009; 407:4028-4037. [PMID: 19339037 DOI: 10.1016/j.scitotenv.2009.02.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Revised: 02/16/2009] [Accepted: 02/20/2009] [Indexed: 05/27/2023]
Abstract
Surfactants are high production volume chemicals that are used in a wide assortment of "down-the-drain" consumer products. Wastewater treatment plants (WWTPs) generally remove 85 to more than 99% of all surfactants from influents, but residual concentrations are discharged into receiving waters via wastewater treatment plant effluents. The Trinity River that flows through the Dallas-Fort Worth metropolitan area, Texas, is an ideal study site for surfactants due to the high ratio of wastewater treatment plant effluent to river flow (>95%) during late summer months, providing an interesting scenario for surfactant loading into the environment. The objective of this project was to determine whether surfactant concentrations, expressed as toxic units, in-stream water quality, and aquatic habitat in the upper Trinity River could be predicted based on easily accessible watershed characteristics. Surface water and pore water samples were collected in late summer 2005 at 11 sites on the Trinity River in and around the Dallas-Fort Worth metropolitan area. Effluents of 4 major waste water treatment plants that discharge effluents into the Trinity River were also sampled. General chemistries and individual surfactant concentrations were determined, and total surfactant toxic units were calculated. GIS models of geospatial, anthropogenic factors (e.g., population density) and natural factors (e.g., soil organic matter) were collected and analyzed according to subwatersheds. Multiple regression analyses using the stepwise maximum R(2) improvement method were performed to develop prediction models of surfactant risk, water quality, and aquatic habitat (dependent variables) using the geospatial parameters (independent variables) that characterized the upper Trinity River watershed. We show that GIS modeling has the potential to be a reliable and inexpensive method of predicting water and habitat quality in the upper Trinity River watershed and perhaps other highly urbanized watersheds in semi-arid regions.
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Affiliation(s)
- S F Atkinson
- Institute of Applied Science, Department of Biological Sciences, University of North Texas, Denton, TX 76203-0559, USA.
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Paaby P, Nielsen A, Møller-Petersen J, Raffn K. Cyclical changes in endogenous overnight creatinine clearance during the third trimester of pregnancy. Acta Med Scand 2009; 223:459-68. [PMID: 3376774 DOI: 10.1111/j.0954-6820.1988.tb15898.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To investigate the pattern of change in endogenous overnight creatinine clearance during the third trimester, 12 healthy women with uncomplicated pregnancies were examined three times a week. Urine was collected overnight from 22.00 to 08.00 hours and analysed for creatinine. Serum was sampled in the morning and analysed for creatinine, beta 2-microglobulin, progesterone and estradiol. The general trend of creatinine clearance was parabolic with a declining level during the last month before term. A sinusoid pattern with minimum values around the time when the women would have had menstruation had they not become pregnant was superimposed on the parabolic trend. A mathematical model (parabolas overlaid with a cosine curve) was constructed and fitted to the data. The cyclical pattern was significant. Serum creatinine showed a pattern with increasing values during the last 4-6 weeks before term and cyclical changes which were also significant. In the individual case the monthly and preterm clearance decrement sometimes was over 50%. Monthly and preterm decreases in creatinine clearance may be quite normal and serial measurements of creatinine clearance are therefore necessary to determine if declining values indicate pathological falls in the glomerular filtration rate.
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Affiliation(s)
- P Paaby
- Department of Clinical Chemistry, Aalborg Hospital, Denmark
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Swimmer Y, McNaughton L, Foley D, Moxey L, Nielsen A. Movements of olive ridley sea turtles Lepidochelys olivacea and associated oceanographic features as determined by improved light-based geolocation. ENDANGER SPECIES RES 2009. [DOI: 10.3354/esr00164] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Phillips CR, Bacon K, Pinney J, Nielsen A, LeTourneau JL. Pulmonary permeability index predicts progression to acute lung injury in patients with increased risk. Crit Care 2009. [PMCID: PMC4083935 DOI: 10.1186/cc7213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Hjortebjerg U, Bruun Pister C, Larsen S, Mark K, Munch Nielsen M, Nielsen A, Tofte J, Kristensen T. 8175 POSTER Side effects at the time of rehabilitation as reported by more than 600 cancer patients in response to an open question and a structered, closed questionaire. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71677-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Nielsen A, Mizuno M, Ratkevicius A, Mohr T, Rohde M, Mortensen S, Quistorff B. No Effect of Antioxidant Supplementation in Triathletes on Maximal Oxygen Uptake,31P-NMRS Detected Muscle Energy Metabolism and Muscle Fatigue. Int J Sports Med 2007. [DOI: 10.1055/s-1999-970282] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
BACKGROUND Bullying has been shown to be a serious problem amongst school children, but few studies have been population-based and included pre-school children. METHODS The study is part of a cross-sectional comparative study in 1984 and 1996, focusing on children's and their families' health and welfare in the Nordic countries. At each point of time parents of 3000 randomly selected children aged 2-17 years in each of five Nordic countries received a postal questionnaire. Altogether approximately 20,000 questionnaires were completed. The prevalence of bullying, risk factors for bullying and possible effect factors were analysed. RESULTS Parents reported bullying of their child in 15.1% of the cases. Bullying varied from 7.2% in Sweden to about 20% in Denmark and Finland. There was a small increase in bullying from 13.7% in 1984 to 16.4% in 1996. Bullying was most frequent in boys (OR: 1.4) and in children 2-6 and 7-12 years old (OR: 2.0 and 2.2 compared with older children). Children of single parents and of parents with low education had increased risks (OR: 1.4 and 1.4). Children with chronic conditions had higher risks for being bullied (OR: 2.3). In 1996 children with psychiatric/nervous problems and hyperactivity had high risks for being bullied (OR: 8.8 and 10.5) and for bullying others (3.9 and 3.5). Being bullied was associated with poor thriving and psychosomatic and psychological problems. No countries had national interventions before 1984, but Sweden had early focused on the problem and implemented a strong national policy before 1996. After 1996 national anti-bullying policies were strengthened in the Nordic countries, most in Sweden and Norway. CONCLUSION Bullying is common among Nordic children, including pre-school children. Bullying is a threat to children's health, and augments problems in children with chronic conditions. The low prevalence of bullying in Sweden may be a result from sustained, strong anti-bullying policies. There is still a need for continuing interventions.
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Affiliation(s)
- R Nordhagen
- Norwegian Institute of Public Health, Nydalen, Oslo, Norway.
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Nielsen A. Accuracy of US in Major Pelvic Injury. Acad Emerg Med 2004. [DOI: 10.1197/j.aem.2004.02.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
OBJECTIVE In order to prevent suicidal behaviour among adolescents and young adults it would be valuable to know if altering the conditions of their upbringing could reduce their suicidal behaviour. The study surveys possible risk factors. METHOD Population-based registers covering children born in Denmark in 1966 at the age span of 14-27 years and their parents for: health, education, family dissolution, suicidal behaviour, substance abuse, criminality and unemployment. A discrete-time proportional hazard modelling was used to analyse the longitudinal observations. RESULTS First-time suicide attempts were associated with parental psychiatric disorder, suicidal behaviour, violence, child abuse and neglect. Increased risks were also found among adolescents and young adults who suffered from psychiatric disorder or physical handicap, had been legally imprisoned, were addicted to drugs, or without graduation, vocational training or employment. CONCLUSION Stigmatization, social exclusion, and mental disorders in the adolescents or young adults and parents increased risks for attempted suicide.
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Affiliation(s)
- M N Christoffersen
- The Danish National Institute of Social Research, Copenhagen K, Denmark.
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Ipsen R, Otte J, Sharma R, Nielsen A, Gram Hansen L, Bruun Qvist K. Effect of limited hydrolysis on the interfacial rheology and foaming properties of β-lactoglobulin A. Colloids Surf B Biointerfaces 2001; 21:173-178. [PMID: 11377946 DOI: 10.1016/s0927-7765(01)00170-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hydrolysis of beta-lactoglobulin (beta-Lg), genetic variant A, using a serine protease specific for glutamic and aspartic acid residues from Bacillus licheniformis (BLP), resulted in improved foam overrun and foam stability. Limited hydrolysis (19-26% hydrolysed beta-Lg) led to a more rapid increase in the viscoelastic properties of air/water interfacial films and a concomitant increase in foam overrun compared with intact beta-Lg, presumably due to increased exposure of hydrophobic areas. The increased exposure did not, however, cause formation of an interfacial layer with increased viscoelastic properties. More extended hydrolysis (86% hydrolysed beta-Lg) resulted in a higher initial overrun than the unhydrolysed sample and the best foam stability. The interfacial elasticity and viscosity, though, was the lowest observed. Thus, high maximum values of these interfacial properties are not necessary prerequisites for formation of a voluminous and stable foam.
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Affiliation(s)
- R Ipsen
- Department of Dairy and Food Science, The Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 C, Frederiksberg, Denmark
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Bornehag CG, Blomquist G, Gyntelberg F, Järvholm B, Malmberg P, Nordvall L, Nielsen A, Pershagen G, Sundell J. Dampness in buildings and health. Nordic interdisciplinary review of the scientific evidence on associations between exposure to "dampness" in buildings and health effects (NORDDAMP). Indoor Air 2001; 11:72-86. [PMID: 11394014 DOI: 10.1034/j.1600-0668.2001.110202.x] [Citation(s) in RCA: 211] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Several epidemiological investigations concerning indoor environments have indicated that "dampness" in buildings is associated to health effects such as respiratory symptoms, asthma and allergy. The aim of the present interdisciplinary review is to evaluate this association as shown in the epidemiological literature. A literature search identified 590 peer-reviewed articles of which 61 have been the foundation for this review. The review shows that "dampness" in buildings appears to increase the risk for health effects in the airways, such as cough, wheeze and asthma. Relative risks are in the range of OR 1.4-2.2. There also seems to be an association between "dampness" and other symptoms such as tiredness, headache and airways infections. It is concluded that the evidence for a causal association between "dampness" and health effects is strong. However, the mechanisms are unknown. Several definitions of dampness have been used in the studies, but all seems to be associated with health problems. Sensitisation to mites may be one but obviously not the only mechanism. Even if the mechanisms are unknown, there is sufficient evidence to take preventive measures against dampness in buildings.
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Affiliation(s)
- C G Bornehag
- National Testing and Research Institute, Karlstad, Sweden
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Graller J, Nielsen A, Garber B, Davison LG, Gable L, Seidenberg H. Concurrent therapies: a model for collaboration between psychoanalysts and other therapists. J Am Psychoanal Assoc 2001; 49:587-606. [PMID: 11508378 DOI: 10.1177/00030651010490020701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Many psychoanalysts treat individuals who are simultaneously in couples therapy or whose partners are in individual therapy. If such cases stall, some analysts may seek consultation from a colleague, though most have accepted the tacit historical prohibition against communication between therapists treating members of the same family. Experience, however, suggests that a certain form of communication between such therapists can have a powerfully enhancing effect on the concurrent therapies. After a review of the literature, the advantages, disadvantages, and impediments to collaborative cross-communication are examined. A model is then presented for use in ongoing discussion between therapists, and is illustrated with two clinical examples. The proposed model centers on the transference-countertransference configurations within the therapeutic field, and serves as an organizer highlighting areas for discussion.
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Affiliation(s)
- J Graller
- Chicago Institute for Psychoanalysis, USA
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Marker P, Nielsen A, Bastian HL. Fractures of the mandibular condyle. Part 1: patterns of distribution of types and causes of fractures in 348 patients. Br J Oral Maxillofac Surg 2000; 38:417-21. [PMID: 11010766 DOI: 10.1054/bjom.2000.0317] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This prospective study was designed to record relevant characteristics of mandibular condyle fractures and to evaluate the relationship between these. Data were recorded on sex, age, cause of trauma, level of fracture, dislocation of the mandibular head, dental state and associated fractures of all patients diagnosed in our hospital during the period 1984-1996 with mandibular condyle fractures. Data were analysed in our Computer Department. The sample comprised 348 patients with 444 fractures, and a male:female ratio of 2:1. Traffic accidents were the most common cause: 103 (41%) of the unilateral and 54 (56%) of the bilateral fractures, followed by alleged assault and falls. Low fractures were the most common -n = 314 of 444 (71%). The causes that involved considerable force (traffic accidents and falls) resulted in more dislocations of the mandibular head, more bilateral fractures, a tendency to fractures higher on the condyle and significantly more intracapsular fractures. Absence of molar occlusion also gave more high and fewer low fractures, but played no part in dislocation of the mandibular head from the glenoid fossa.
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Affiliation(s)
- P Marker
- Department of Oral and Maxillofacial Surgery, Odense University Hospital, Odense, Denmark
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