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Predictors of specialist somatic healthcare utilization among older people with intellectual disability and their age-peers in the general population : a national register study

OBJECTIVES: To compare somatic healthcare usage among older people with intellectual disabilities (ID) to that of their age-peers in the general population, taking into account health and demographic factors, and to identify predictors for somatic healthcare usage among older people with ID.PARTICIPANTS: Equally sized cohorts, one with people with ID and one referent cohort, one-to-one-matched by

A Retrospective Evaluation of the Benefit of Referring Pediatric Cancer Patients to an External Proton Therapy Center

Background: Pediatric cancer patients requiring radiation therapy (RT) have been routinely assessed and referred to proton therapy (PT) at an external institution. The benefit of the delivered PT compared to the state-of-the-art intensity modulated x-ray RT (XT) at the home institution was evaluated. Procedure: Twenty-four consecutive children referred for PT during 2010–2013 for craniospinal (CSI

Opportunities and challenges of delivering digital clinical trials : lessons learned from a randomised controlled trial of an online behavioural intervention for children and young people

Background: Despite being the gold standard of research to determine effectiveness, randomised controlled trials (RCTs) often struggle with participant recruitment, engagement and retention. These issues may be exacerbated when recruiting vulnerable populations, such as participants with mental health issues. We aimed to update understanding of the scope of these problems in trials of health techn

Therapist-supported online remote behavioural intervention for tics in children and adolescents in England (ORBIT) : a multicentre, parallel group, single-blind, randomised controlled trial

Background: Exposure and Response Prevention (ERP) is a form of behavioural therapy for tics; however, its effectiveness remains uncertain. We aimed to evaluate the effectiveness of internet-delivered, therapist-supported, and parent-assisted ERP for treatment of tics in children and young people with Tourette syndrome or chronic tic disorder. Methods: This multicentre, parallel group, single-blin

Therapist-supported online interventions for children and young people with tic disorders : Lessons learned from a randomized controlled trial and considerations for future practice

In recent years, research into internet-based cognitive behavioral therapy (iCBT) has suggested that therapist-guided digital interventions have greater engagement, adherence, and effectiveness than self-directed digital therapies. While research has focused on the effectiveness of, and adherence to, these interventions, less attention has been paid to their implementation in practice and what asp

Restoring tumor immunogenicity with dendritic cell reprogramming

Decreased antigen presentation contributes to the ability of cancer cells to evade the immune system. We used the minimal gene regulatory network of type 1 conventional dendritic cells (cDC1) to reprogram cancer cells into professional antigen-presenting cells (tumor-APCs). Enforced expression of the transcription factors PU.1, IRF8, and BATF3 (PIB) was sufficient to induce the cDC1 phenotype in 3

The prognostic value of FET PET at radiotherapy planning in newly diagnosed glioblastoma

Background: Glioblastoma patients show a great variability in progression free survival (PFS) and overall survival (OS). To gain additional pretherapeutic information, we explored the potential of O-(2-18F-fluoroethyl)-L-tyrosine (FET) PET as an independent prognostic biomarker. Methods: We retrospectively analyzed 146 consecutively treated, newly diagnosed glioblastoma patients. All patients were

Patient QA systems for rotational radiation therapy : A comparative experimental study with intentional errors

Purpose: The purpose of the present study was to investigate the ability of commercial patient quality assurance (QA) systems to detect linear accelerator-related errors. Methods: Four measuring systems (Delta 4®, OCTAVIUS®, COMPASS, and Epiqa™) designed for patient specific quality assurance for rotational radiation therapy were compared by measuring four clinical rotational intensity modulated r

Destination Gö

Mitt i naturen i Blekinges skärgård, på kanten mellan skog och hav är mitt destinationsprojekt lokaliserat. Intentionen med arbetet är att visa upp Blekinges kvaliteter, att skapa en plats för återhämtning, kreativt skapande och möten mellan människor. Platsen jag valt för mitt projekt ligger i Ronneby, där jag kommer från, och har givit mig mycket energi och andrum genom åren. Naturens variation

A Heavy Burden - Coloniality and Exploitation of the Subaltern in Nepal’s Mountain Tourism Industry

This thesis analyzes the effects of mountain tourism on local people and communities in Nepal with a focus on three main questions: the equity of mountain jobs, the impacts of Western mountaineering’s dominance on local cultures, and the respect and lack of respect for local workers' lives. Despite repeated accounts of precarious and dangerous working conditions the adventure and mountain tour

Conserving whose world? A critical discourse analysis of the "30x30" target from a decolonial perspective

Building on the substantial research that critically analyzes the social implications that conservation policy has on indigenous peoples, this thesis analyzes how colonial legacies may influence the way conservation knows and sees nature and subsequently help shape the strategies aiming to protect it. The thesis has two objectives. The first is to examine how the “30x30” target may challenge and/o

Use of PET/CT instead of CT-only when planning for radiation therapy does not notably increase life years lost in children being treated for cancer

Background: PET/CT may be more helpful than CT alone for radiation therapy planning, but the added risk due to higher doses of ionizing radiation is unknown. Objective: To estimate the risk of cancer induction and mortality attributable to the [F-18]2-fluoro-2-deoxyglucose (FDG) PET and CT scans used for radiation therapy planning in children with cancer, and compare to the risks attributable to t

Modeling positioning uncertainties of prostate cancer external beam radiation therapy using pre-treatment data

Purpose To investigate the influence of treatment plan data and image guidance (IG) on positioning uncertainty during prostate cancer (PCa) radiotherapy (RT). Methods Body mass index (BMI), planning target volume (PTV), bladder volume (BV), and rectal cross section area (RCS) were collected for 267 consecutive PCa patients undergoing daily IGRT. Radiographic isocenter corrections to intra-prostati

The impact of leaf width and plan complexity on DMLC tracking of prostate intensity modulated arc therapy

Purpose: Intensity modulated arc therapy (IMAT) is commonly used to treat prostate cancer. The purpose of this study was to evaluate the impact of leaf width and plan complexity on dynamic multileaf collimator (DMLC) tracking for prostate motion management during IMAT treatments. Methods: Prostate IMAT plans were delivered with either a high-definition MLC (HDMLC) or a Millennium MLC (M-MLC) (0.25

Identifying Non-Steroidal Anti-Inflammatory Drug (NSAID) Users Among People with Osteoarthritis Through Administrative and Clinician-Reported Data - A Validation Study of 116,162 Patients

PURPOSE: (i) To report the prevalence of participants to a first-line intervention for OA in Sweden using over-the-counter (OTC) and/or prescribed NSAIDs; (ii) To estimate the accuracy of dispensed prescriptions of NSAIDs recorded in a Swedish health-care register to capture the use of NSAID considering clinician-report as reference standard.METHODS: Register-based study. We used data from OA indi

Effectiveness of Multimodal Treatment for Young People With Body Dysmorphic Disorder in Two Specialist Clinics

Body dysmorphic disorder (BDD) typically originates in adolescence and is associated with considerable adversity. Evidence-based treatments exist but research on clinical outcomes in naturalistic settings is extremely scarce. We evaluated the short- and long-term outcomes of a large cohort of adolescents with BDD receiving specialist multimodal treatment and examined predictors of symptom improvem

Effectiveness of Behaviour Therapy for Children and Adolescents with Tourette Syndrome and Chronic Tic Disorder in a Naturalistic Setting

It is unclear if the results of randomised controlled trials (RCTs) of behaviour therapy (BT) for Tourette syndrome (TS) and chronic tic disorder (CTD) can be generalised to naturalistic clinical settings and are durable long-term. In this naturalistic study, 74 young people with TS/CTD received BT at a specialist clinic. Data were collected at baseline, post-treatment, and at 3-, 6-, and 12-month

The role of salmon fishing in the adoption of pottery technology in subarctic Alaska

Ceramic technology makes an abrupt appearance in the New World Arctic at circa 2800 cal BP. While there is general consensus that the ultimate source of these Alaskan pottery traditions lay in continental NE Asia, the motivations for the adoption of pottery in Alaska have remained unclear. Through organic residue analysis we investigated the function of Norton pottery in Southwest Alaska, and the

Lung tissue bioengineering for transplantation and modelling of development, disease and regeneration

The lung is a vital and dynamic organ that serves as a critical first barrier to environmental stimuli and facilitates gas exchange from birth until death. Developmental or genetic defects that impair lung function severely impact quality of life. Minor defects present in early life increase the likelihood that patients will develop chronic lung diseases in adulthood that have no cure. Current the

Insomnia in pediatric obsessive–compulsive disorder : prevalence and association with multimodal treatment outcomes in a naturalistic clinical setting

Objective: Little is known about the prevalence and impact of insomnia on clinical outcomes in youth with obsessive–compulsive disorder (OCD). This study aimed to investigate this subject. Patients/methods: A total of 193 patients from a specialist pediatric OCD clinic completed a range of diagnostic and clinical measures, including the Insomnia Severity Index (ISI). Patients scoring above a previ