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  • 1.
    Axelsson, Malin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Backman, Helena
    Umeå Univ, Sect Sustainable Hlth, Dept Publ Hlth & Clin Med, OLIN Unit, Umeå, Sweden..
    Nwaru, Bright I.
    Univ Gothenburg, Krefting Res Ctr, Inst Med, Gothenburg, Sweden.;Univ Gothenburg, Inst Med, Wallenberg Ctr Mol & Translat Med, Gothenburg, Sweden..
    Stridsman, Caroline
    Umeå Univ, Div Med, Dept Publ Hlth & Clin Med, OLIN unit, Umeå, Sweden..
    Vanfleteren, Lowie
    Univ Gothenburg, Krefting Res Ctr, Inst Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Resp Med & Allergol, COPD Ctr, Gothenburg, Sweden..
    Hedman, Linnea
    Piirila, Paivi
    Univ Cent Hosp, Unit Clin Physiol, HUS Med Diagnost Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland..
    Jalasto, Juuso
    Univ Cent Hosp, Unit Clin Physiol, HUS Med Diagnost Ctr, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland..
    Langhammer, Arnulf
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, HUNT Res Ctr, NTNU, Levanger, Norway..
    Kankaanranta, Hannu
    Univ Gothenburg, Krefting Res Ctr, Inst Med, Gothenburg, Sweden.;Seinajoki Cent Hosp, Dept Resp Med, Seinajoki, Finland.;Univ Tampere, Fac Med & Life Sci, Tampere, Finland..
    Radinger, Madeleine
    Univ Gothenburg, Krefting Res Ctr, Inst Med, Gothenburg, Sweden..
    Ekerljung, Linda
    Univ Gothenburg, Krefting Res Ctr, Inst Med, Gothenburg, Sweden..
    Ronmark, Eva
    Umeå Univ, Sect Sustainable Hlth, Dept Publ Hlth & Clin Med, OLIN Unit, Umeå, Sweden..
    Lindberg, Anne
    Umeå Univ, Div Med, Dept Publ Hlth & Clin Med, OLIN unit, Umeå, Sweden..
    The extent and characterization of underdiagnosis and misclassification of COPD in Sweden2023In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 62, no Suppl. 67, article id OA3167Article in journal (Other academic)
  • 2.
    Axelsson, Malin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Backman, Helena
    Vanfleteren, Lowie
    Stridsman, Caroline
    Ekerljung, Linda
    Eriksson, Berne
    Nwaru, Bright
    Ronmark, Eva
    Kankaanranta, Hannu
    Lindberg, Anne
    Lundback, Bo
    Underdiagnosis and misclassification of COPD in Sweden2020In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56, no S64, article id 1395Article in journal (Other academic)
  • 3.
    Axelsson, Malin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ilmarinen, Pinja
    Backman, Helena
    Ekerljung, Linda
    Hedman, Linnea
    Langhammer, Arnulf
    Lindberg, Anne
    Lindqvist, Ari
    Nwaru, Bright I
    Pallasaho, Paula
    Sovijärvi, Anssi
    Vähätalo, Iida
    Kankaanranta, Hannu
    Hisinger-Mölkänen, Hanna
    Piirilä, Päivi
    Rönmark, Eva
    Differences in diagnostic patterns of obstructive airway disease between areas and sex in Sweden and Finland: the Nordic EpiLung study2021In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 58, no 9, p. 1196-1207Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the current prevalence of physician-diagnosed obstructive airway diseases by respiratory symptoms and by sex in Sweden and Finland.Method: In 2016, a postal questionnaire was answered by 34,072 randomly selected adults in four study areas: Västra Götaland and Norrbotten in Sweden, and Seinäjoki-Vaasa and Helsinki in Finland.Results: The prevalence of asthma symptoms was higher in Norrbotten (13.2%), Seinäjoki-Vaasa (14.8%) and Helsinki (14.4%) than in Västra Götaland (10.7%), and physician-diagnosed asthma was highest in Norrbotten (13.0%) and least in Västra Götaland (10.1%). Chronic productive cough was most common in the Finnish areas (7.7-8.2% versus 6.3-6.7%) while the prevalence of physician-diagnosed chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) varied between 1.7 and 2.7% in the four areas. Among individuals with respiratory symptoms, the prevalence of asthma was most common in Norrbotten, while a diagnosis of COPD or CB was most common in Västra Götaland and Seinäjoki-Vaasa. More women than men with respiratory symptoms reported a diagnosis of asthma in Sweden and Seinäjoki-Vaasa but there were no sex differences in Helsinki. In Sweden, more women than men with symptoms of cough or phlegm reported a diagnosis of CB or COPD, while in Finland the opposite was found.Conclusion: The prevalence of respiratory symptoms and corresponding diagnoses varied between and within the countries. The proportion reporting a diagnosis of obstructive airway disease among individuals with respiratory symptoms varied, indicating differences in diagnostic patterns both between areas and by sex.

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  • 4.
    Bashir, Muwada Bashir Awad
    et al.
    Krefting Research Centre, Institute of Medicine, University of Gothenbur.
    Basna, Rani
    Krefting Research Centre, Institute of Medicine, University of Gothenbur.
    Zhang, Guo-Qiang
    Krefting Research Centre, Institute of Medicine, University of Gothenbur.
    Backman, Helena
    Section of Sustainable Health/the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Lindberg, Anne
    Section of Medicine/the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Ekerljung, Linda
    Krefting Research Centre, Institute of Medicine, University of Gothenburg.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hedman, Linnea
    Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
    Vanfleteren, Lowie
    COPD Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
    Lundbäck, Bo
    Krefting Research Centre, Institute of Medicine, University of Gothenburg.
    Rönmark, Eva
    Section of Sustainable Health/the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Nwaru, Bright I
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Computational phenotyping of obstructive airway diseases: protocol for a systematic review2022In: Systematic Reviews, E-ISSN 2046-4053, Vol. 11, no 1, p. 1-5, article id 216Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Over the last decade, computational sciences have contributed immensely to characterization of phenotypes of airway diseases, but it is difficult to compare derived phenotypes across studies, perhaps as a result of the different decisions that fed into these phenotyping exercises. We aim to perform a systematic review of studies using computational approaches to phenotype obstructive airway diseases in children and adults.

    METHODS AND ANALYSIS: We will search PubMed, Embase, Scopus, Web of Science, and Google Scholar for papers published between 2010 and 2020. Conferences proceedings, reference list of included papers, and experts will form additional sources of literature. We will include observational epidemiological studies that used a computational approach to derive phenotypes of chronic airway diseases, whether in a general population or in a clinical setting. Two reviewers will independently screen the retrieved studies for eligibility, extract relevant data, and perform quality appraisal of included studies. A third reviewer will arbitrate any disagreements in these processes. Quality appraisal of the studies will be undertaken using the Effective Public Health Practice Project quality assessment tool. We will use summary tables to describe the included studies. We will narratively synthesize the generated evidence, providing critical assessment of the populations, variables, and computational approaches used in deriving the phenotypes across studies CONCLUSION: As progress continues to be made in the area of computational phenotyping of chronic obstructive airway diseases, this systematic review, the first on this topic, will provide the state of the art on the field and highlight important perspectives for future works.

    ETHICS AND DISSEMINATION: No ethical approval is needed for this work is based only on the published literature and does not involve collection of any primary or human data.

    REGISTRATION AND REPORTING: SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020164898.

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  • 5.
    Genevskiy, Vladislav
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Kelly, S.
    Fisher & Paykel Healthcare, Auckland, New Zealand..
    Poeschke, L. M.
    Kliniken Essen Mitte, Essen, Germany..
    Björklund, Sebastian
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Schroeder, M.
    Kliniken Essen Mitte, Essen, Germany..
    Nillius, G.
    Univ Witten Herdecke, Kliniken Essen Mitte, Essen, Germany..
    Kocherbitov, Vitaly
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Tatkov, S.
    Fisher & Paykel Healthcare, Auckland, New Zealand..
    Water sorption properties and nanostructures of airway mucus in patients with COPD and cystic fibrosis2022In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 60, no Suppl 66Article in journal (Other academic)
    Abstract [en]

    Background: Muco-obstructive diseases lead to hypersecretion, changing the airway mucus properties, and impairing mucociliary transport, resulting in mucostasis, and increasing infection likelihood. Mucin structure may determine the water sorption properties of mucus and play a role in chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF).

    Objectives: Investigate the sorption properties and mucin nanostructures in mucus collected from healthy, COPD and CF airways.

    Methods: To investigate mucin nanostructures, small-angle X-ray scattering (SAXS) and atomic force microscopy (AFM) were used. Sorption properties were determined by quartz crystal microbalance with dissipation (QCM-D). Cell-culture (cc) samples from healthy airway mucus (HAM), COPD and CF cultures, and patient HAM from endotracheal tubes and COPD from bronchoscopy were used. Patient mucus was oven-dried at 80°C for the solids content.

    Results: SAXS and AFM revealed mucin monomers with typical dumbbell structures and varying chain lengths, CF mucins having the shortest chain lengths. Dry-weight solids reached 11wt% in COPD mucus. From QCM-D analysis, cc-COPD and COPD mucus had the highest water content (67 and 75%) during sorption at 99% humidity compared with cc-HAM and HAM (63 and 56%). The overall sorption isotherm for cc-CF mucus was notably lower than HAM and COPD. In low-humidity environments, no hydration-induced glass transition was observed, suggesting mucus remains in a rubbery state.

    Conclusions: Mucin nanostructures observed in disease could explain the sorption properties where mucin chains affect water content in high humidity environments, which may play a role in protecting the epithelium.

  • 6. Jansson, Sven-Arne
    et al.
    Hedman, Linnea
    Stridsman, Caroline
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kriit, Hedi Katre
    Lindberg, Anne
    Lundback, Bo
    Ronmark, Eva
    Backman, Helena
    Life-years lost due to asthma2019In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54, no S63, article id PA5063Article in journal (Other academic)
  • 7.
    Jansson, Sven-Arne
    et al.
    Umeå University.
    Hedman, Linnea
    Umeå University; Luleå University of Technology.
    Stridsman, Caroline
    Umeå University; Luleå University of Technology.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Lindberg, Anne
    Umeå University.
    Lundbäck, Bo
    University of Gothenburg.
    Rönmark, Eva
    Umeå University.
    Backman, Helena
    Umeå University.
    Life-years lost due to asthma and COPD2020In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56, no S64, article id 1400Article in journal (Other academic)
  • 8. Jansson, Sven-Arne
    et al.
    Leander, Mai
    Hedman, Linnea
    Umea Univ, Dept Publ Hlth & Clin Med, Occupat & Environm Med, OLIN Unit, Umea, Sweden..
    Axelsson, Malin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Stridsman, Caroline
    Rönmark, Eva
    Health-related quality of life in adults with asthma and rhinitis2015In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 46Article in journal (Other academic)
  • 9. Kaptain, Rina Juel
    et al.
    Helle, Tina
    Patomella, Ann-Helen
    Weinreich, Ulla Møller
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Association Between Everyday Technology Use, Activities of Daily Living and Health-Related Quality of Life in Chronic Obstructive Pulmonary Disease2020In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 15, p. 89-98Article in journal (Refereed)
    Abstract [en]

    Purpose: A decline in the ability to perform activities of daily living (ADL) and ability to use everyday technology can pose threats to independent living, healthcare management and quality of life (QOL) of patients suffering from chronic obstructive pulmonary disease (COPD). Evidence of the relationship between these variables remains limited. The dual aim of this study was, first, to investigate if health-related QOL (HRQOL) was associated with quality in ADL performance and everyday technology use; second, to examine whether lung function, years with COPD diagnosis, living status or educational level affected physical and mental domains of HRQOL. Methods: This cross-sectional study included (N=80) participants aged 46-87 years recruited at healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were gathered through standardized assessments and analysed using multiple regression analysis. Results: The regression model explained 50.6% (R2=0.506) of the variation in HRQOL-physical. The following four variables were statistically significantly associated with HRQOL - physical: years since COPD diagnosis (p=0.023), ability to use everyday technology (p=0.006), amount of relevant everyday technologies (p=0.015) and ADL motor ability (p<0.01). The regression model explained 22.80% (R-2=0.228) of HRQOL - mental. Only the variable ability to use everyday technology was statistically significantly associated with HRQOL - mental (p=0.009). Conclusion: Quality of ADL performance and everyday technology use seem to be associated with HRQOL in people living with COPD. The only demographic variable associated with HRQOL was years with COPD. This indicates that healthcare professionals should enhance their attention also to ADL-performance and everyday technology use when striving to increase the HRQOL of persons living with COPD.

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  • 10.
    Lavigne, Gilles
    et al.
    Faculty of Dental Medicine Universite de Montreal & CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine &amp; Stomatology CHUM Montreal QC Canada.
    Kato, Takafumi
    Department of Oral Physiology Graduate School of Dentistry Sleep Medicine Center Osaka University Hospital Osaka University Suita Japan.
    Herrero Babiloni, Alberto
    Division of Experimental Medicine McGill University Montreal QC Canada;CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine Montreal QC Canada.
    Huynh, Nelly
    Faculty of Dental Medicine Universite de Montreal and CHU Saint‐Justine Research Center Montreal QC Canada.
    Dal Fabbro, Cibele
    Faculty of Dental Medicine Universite de Montreal &amp; CIUSSS Nord Ile de Montreal, Center for Advance Research in Sleep Medicine &amp; Stomatology CHUM Montreal QC Canada.
    Svensson, Peter
    Malmö University, Faculty of Odontology (OD). Section of Orofacial Pain and Jaw Function Department of Dentistry and Oral Health Aarhus University Aarhus Denmark.
    Aarab, Ghizlane
    Department of Orofacial Pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Ahlberg, Jari
    Department of Oral and Maxillofacial Diseases University of Helsinki Helsinki Finland.
    Baba, Kazuyoshi
    Department of Prosthodontics School of Dentistry Showa University Tokyo Japan.
    Carra, Maria Clotilde
    UFR of Odontology Garanciere Université de Paris and Service of Odontology Rothschild Hospital (AP‐HP) Paris France.
    Cunha, Thays Crosara A.
    Department of Genetics and Biochemistry Federal University of Uberlandia Uberlandia Brazil.
    Gonçalves, Daniela A. G.
    Department of Dental Materials and Prosthodontics School of Dentistry São Paulo State University (Unesp) Araraquara Brazil.
    Manfredini, Daniele
    Department of Biomedical Technologies School of Dentistry University of Siena Siena Italy.
    Stuginski‐Barbosa, Juliana
    Bauru Orofacial Pain Group Bauru Brazil.
    Wieckiewicz, Mieszko
    Department of Experimental Dentistry Wroclaw Medical University Wroclaw Poland.
    Lobbezoo, Frank
    Department of Orofacial Pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands.
    Research routes on improved sleep bruxism metrics: Toward a standardised approach2021In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 30, no 5, article id e13320Article, review/survey (Refereed)
    Abstract [en]

    A recent report from the European Sleep Research Society's task force "Beyond AHI" discussed an issue that has been a long-term subject of debate - what are the best metrics for obstructive sleep apnoea (OSA) diagnosis and treatment outcome assessments? In a similar way, sleep bruxism (SB) metrics have also been a recurrent issue for >30 years and there is still uncertainty in dentistry regarding their optimisation and clinical relevance. SB can occur alone or with comorbidities such as OSA, gastroesophageal reflux disorder, insomnia, headache, orofacial pain, periodic limb movement, rapid eye movement behaviour disorder, and sleep epilepsy. Classically, the diagnosis of SB is based on the patient's dental and medical history and clinical manifestations; electromyography is used in research and for complex cases. The emergence of new technologies, such as sensors and artificial intelligence, has opened new opportunities. The main objective of the present review is to stimulate the creation of a collaborative taskforce on SB metrics. Several examples are available in sleep medicine. The development of more homogenised metrics could improve the accuracy and refinement of SB assessment, while moving forward toward a personalised approach. It is time to develop SB metrics that are relevant to clinical outcomes and benefit patients who suffer from one or more possible negative consequences of SB.

  • 11.
    Murray, Bridget
    et al.
    RCSI Univ Med & Hlth Sci, Sch Nursing & Midwifery, Dublin, Ireland..
    Smith, Sheree
    Univ Western Sydney, Sch Nursing & Midwifery, Sydney, Australia..
    Roberts, Nicola
    Edinburgh Napier Univ, Sch Hlth & Social Care, Edinburgh, Scotland..
    Padilha, Miguel Jose
    Escola Super Enfermagem Porto ESEP, Nursing Sch Porto, CINTESIS RISE, Porto, Portugal..
    Sajnic, Andreja
    Univ Hosp Ctr, Dept Resp Dis Jordanovac, Zagreb, Croatia..
    Narsavage, Georgia
    West Virginia Univ, Sch Nursing, Morgantown, WV USA..
    Christensen, Helle Marie
    Univ Southern Denmark, Odense Univ Hosp, Dept Resp Med, Odense, Denmark.;Univ Southern Denmark, Dept Clin Res, Odense, Denmark..
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carme, Hernandez
    Hosp Clin Barcelona Univ Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Med & Nursing Direct, CIBERES Barcelona, Barcelona, Spain..
    Poot, Betty
    Victoria Univ Wellington, Sch Nursing Midwifery & Hlth Practice, Wellington, New Zealand..
    Kelly, Carol
    Edge Hill Univ, Cardioresp Res Ctr, Ormskirk, England..
    Existing respiratory nursing curriculum, frameworks, and other documentation relevant to respiratory nursing education: A Scoping Review2023In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 62, no Suppl. 67, article id OA3173Article in journal (Other academic)
  • 12.
    Narsavage, G.
    et al.
    West Virginia Univ SON, Morgantown, WV USA..
    Sajnic, A.
    Univ Hosp Ctr, Zagreb, Croatia..
    Kelly, C.
    Edge Hill Univ, Ormskirk, England..
    Smith, S.
    Western Sydney Univ, Penrith, NSW, Australia..
    Roberts, N.
    Glasgow Caledonian Univ, Glasgow, Lanark, Scotland..
    Heslop-Marshall, K.
    RVI Hospita, Newcastle Upon Tyne, Tyne & Wear, England..
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Padilha, M.
    Nursing Sch Porto, Porto, Portugal..
    Hernandez, C.
    Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain..
    Murray, B.
    RCSI Univ Med & Hlth Sci, Dublin, Ireland..
    Poot, B.
    Victoria Univ Wellington, Wellington, New Zealand..
    Development of an international curriculum for respiratory nurses (ICRN): A global needs survey2022In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 60, no Suppl 66, article id 204Article in journal (Other academic)
    Abstract [en]

    Introduction: A coronavirus pandemic confirmed that respiratory nurses are critical healthcare providers. Knowledge about appropriate education for quality respiratory nursing care is limited. The ERS Nurses Chair formed the ICRN group to develop a core curriculum for respiratory nurses.

    Aims: The study surveyed the need for an international core respiratory nursing curriculum and current curricula that exist globally.

    Methods: A 39-item survey was sent to 33 respiratory nursing experts in 27 countries. Items included current roles, perception of need/expectations for a core curriculum, and respiratory content in nursing education in their countries.

    Results: Thirty responses from 25 countries were analyzed; participants worked in academia (53%)/clinical practice (40%). The need for a core respiratory nursing curriculum was confirmed (97%). Post-registration nursing programs at bachelor (63.3%) and masters (43.3%) levels included internal/medical nursing care; less than half identified separate respiratory nursing content. Consensus was that a core educational program should include knowledge (70%), skills (60%), and competencies (50%), with separate pediatric and adult content.

    Conclusion: The vast variation in formal respiratory nursing education globally confirms the need for a core respiratory curriculum. The ICRN will next use a Delphi study to identify core curricular elements for respiratory nursing education.

  • 13. Ronnebjerg, Lina
    et al.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Pascu, Adina
    Backman, Helena
    Kankaanranta, Hannu
    Lundback, Bo
    Ekerljung, Linda
    Prevalence of severe asthma: results from a population-based study2019In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54Article in journal (Other academic)
  • 14.
    Rönnebjerg, L
    et al.
    Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kankaanranta, H
    Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland.
    Ekerljung, L
    Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Health-related quality of life, anxiety, depression, beliefs of medication, and self-efficacy in individuals with severe asthma - a population-based study2024In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 61, no 2, p. 148-159Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Individuals with severe asthma often report poor Health-related quality of life (HRQoL) and more research is essential to increase understanding of how they may be helped to improve HRQoL. The main aim of the current paper is to evaluate HRQoL, and possible factors influencing HRQoL, in individuals with severe asthma. The aim is also to explore associations among anxiety, depression, beliefs of medication, self-efficacy, and HRQoL among individuals with severe and other asthma as well as those with no asthma.

    METHODS: = 902) were recruited from West Sweden Asthma Study, a population-based study, which includes both questionnaire surveys and clinical examinations.

    RESULTS: Individuals with severe asthma had worse physical HRQoL (measured with SF-8) than those with other and no asthma (median 48.4, 51.9, and 54.3, respectively). They also had worse mental HRQoL (median 46.7) and reported higher anxiety and depression scores (measured using HADS, median 5.0 and 3.5, respectively) compared to no asthma (median 4.0 and 2.0, respectively). HRQoL was particularly affected among women with severe asthma. Individuals with severe asthma believed that their asthma medication was more necessary than those with other asthma, but they reported more concern for the medication. Asthma control and packyears predicted physical HRQoL and anxiety predicted mental HRQoL among individuals with severe asthma.

    CONCLUSIONS: Efforts to improve asthma control and to reduce anxiety may improve HRQoL in individuals with severe asthma. Especially, women with severe asthma seem to need support to improve their HRQoL. Reducing concerns with asthma medication is most likely essential as high concerns may lead to poor adherence, which in turn may negatively affect asthma control and HRQoL.

  • 15.
    Rönnebjerg, Lina
    et al.
    Univ Gothenburg, Inst Med, Krefting Res Ctr, Dept Internal Med & Clin Nutr, Box 424, S-40530 Gothenburg, Sweden..
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kankaanranta, Hannu
    Univ Gothenburg, Inst Med, Krefting Res Ctr, Dept Internal Med & Clin Nutr, Box 424, S-40530 Gothenburg, Sweden.;Seinajoki Cent Hosp, Dept Resp Med, Seinajoki, Finland.;Univ Tampere, Tampere Univ Resp Res Grp, Fac Med & Hlth Technol, Tampere, Finland..
    Backman, Helena
    Umeå Univ, Dept Publ Hlth & Clin Med, Umeå, Sweden..
    Rådinger, Madeleine
    Univ Gothenburg, Inst Med, Krefting Res Ctr, Dept Internal Med & Clin Nutr, Box 424, S-40530 Gothenburg, Sweden..
    Lundbäck, Bo
    Univ Gothenburg, Inst Med, Krefting Res Ctr, Dept Internal Med & Clin Nutr, Box 424, S-40530 Gothenburg, Sweden..
    Ekerljung, Linda
    Univ Gothenburg, Inst Med, Krefting Res Ctr, Dept Internal Med & Clin Nutr, Box 424, S-40530 Gothenburg, Sweden..
    Severe Asthma in a General Population Study: Prevalence and Clinical Characteristics2021In: Journal of Asthma and Allergy, ISSN 1178-6965, Vol. 14, p. 1105-1115Article in journal (Refereed)
    Abstract [en]

    Purpose: Current guidelines primarily use medication levels to distinguish severe asthma from other types of asthma. In addition, severe asthma must also be uncontrolled at high-intensity treatment or become uncontrolled if treatment level is decreased. To date, only a few studies have used this definition to investigate the prevalence and clinical characteristics of severe asthma in population-based samples. Therefore, the aim of this study was to evaluate the prevalence and clinical characteristics of individuals with severe asthma in the population-representative West Sweden Asthma Study. Materials and Methods: In this cross-sectional population-based study, a randomly selected sample (n=1172) and a separate asthma sample (n=744) underwent clinical examinations, completed a structured interview and responded to questionnaires. Severe asthma was defined as at least one feature of uncontrolled asthma despite treatment in line with the Global Initiative for Asthma (GINA) steps 4/5. This treatment level required a minimum medium dose of inhaled corticosteroids (ICS) plus a second controller or oral corticosteroids. Results: The prevalence of severe asthma was 1.1% in the adult random sample and 9.5% within the asthma sample. Individuals with severe asthma were older and had more symptoms, activity limitations, heart disease and blood neutrophils compared to those with other asthma. They also had lower lung function and despite these impairments, 32% did not have annual contact with a healthcare provider. Conclusion: The prevalence of severe asthma was higher compared to previous studies, and many individuals with severe asthma did not have regular contact with healthcare providers. Due to the high burden of symptoms and impairments for individuals with severe asthma, it is important that the healthcare system implement strategies to improve follow-up and evaluate these patients according to existing guidelines.

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  • 16.
    Sajnic, A.
    et al.
    Univ Hosp Ctr, Zagreb, Croatia..
    Narsavage, G.
    West Virginia Univ SON, Morgantown, WV USA..
    Kelly, C.
    Edge Hill Univ, Ormskirk, England..
    Heslop-Marshall, K.
    Royal Victoria Infirm, Dept Resp Med, Newcastle Upon Tyne, Tyne & Wear, England..
    Padilha, J. M.
    CINTESIS Tech4edusim, Nursing Sch Porto, Porto, Portugal..
    Murray, B.
    RCSI Univ Med & Hlth Sci, Dublin, Ireland..
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hernandez, C.
    Univ Barcelona, Hosp Clin Barcelona, Barcelona, Spain..
    Poot, B.
    Victoria Univ Wellington, Wellington, New Zealand..
    Roberts, N.
    Glasgow Caledonian Univ, Glasgow, Lanark, Scotland..
    Christensen, H. M.
    Odense Univ Hosp, Dept Resp Med, Odense, Denmark..
    Clari, M.
    Univ Torino, Dept Publ Hlth & Pediat, Turin, Italy..
    Smith, S.
    Western Sydney Univ, Penrith, NSW, Australia..
    Steps in the development of an international curriculum for respiratory nurses (ICRN): A Delphi Process plan to standardise levels of respiratory nursing education2022In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 60, no Suppl 66, article id 515Article in journal (Other academic)
    Abstract [en]

    Introduction: The sizable population of people with respiratory conditions places a significant demand on healthcare services and a need for specialized nursing care.

    Aim: The ERS Nursing Group recognized the need for harmonized curricula for respiratory nurses. The following steps incorporate the knowledge and experience of academic and clinical experts.

    Methodology: Steps in the Delphi Process for ICRN (Cantrill, et al. Int. J Pharm. Prac, 1996):

    1) 2020 - Choose Facilitator; ERS chair & 2 researchers (Sajnic A, Narsavage G, Kelly C),

    2) 2020 - Identify Experts; ICRN Advisory Group, in 2021, a group was added to support patient involvement,

    3) 2021 - Define the Problem; ICRN Global Needs Survey (Narsavage et al.) confirmed the need for ICRN and assessed the status of respiratory nursing in 25 countries worldwide,

    4) Review the literature; scoping review in process (2022) for a starting point for survey questions,

    5) Round One Questions; country-based focus groups and literature summarized by the advisory group will form survey for global group. Common items will constitute a Round Two survey,

    6) Round Two Questions; a survey will identify ICRN items and summarize common areas,

    7) Round Three Questions; what the experts are all agreed upon will be answered,

    8) Act on Findings; a consensus document for the core curriculum will be published.

    Conclusion: Worldwide recognition of respiratory nursing as a speciality with a harmonized ICRN based on the Delphi process can be effective in improving the quality of care and patients' outcomes in active partnerships with other healthcare professionals

  • 17.
    Sajnic, Andreja
    et al.
    Univ Hosp Ctr, Dept Resp Dis Jordanovac, Zagreb, Croatia..
    Narsavage, Georgia
    West Virginia Univ, Sch Nursing, Morgantown, WV USA..
    Murphie, Phyllis
    Natl Ctr Sustainable Delivery, Modernising Patient Pathways Programme, Glasgow, Scotland..
    Hernandez, Carme
    Univ Barcelona, August Pi & Sunyer Biomed Res Inst IDIBAPS, Med & Nursing Direct, Hosp Clin Barcelona, Barcelonaupon Tyne, Spain..
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Padilha, Jose Miguel
    CINTESIS Tech4edusim, Nursing Sch Porto, Porto, Portugal..
    Rezelj, Mariana Paula
    Clin Pulm Dis Golnik, Golnik, Slovenia..
    Stonham, Carol
    Minchinhampton Surg, Stroud, England..
    Heslop-Marshall, Karen
    Newcastle Upon Tyne Hosp NHS Fdn Trust, Dept Resp Med, Royal Victoria Infirm Hosp, Newcastle Upon Tyne, Tyne & Wear, England..
    International Coalition of Respiratory Nurses supports global initiative in raising awareness of Asthma and COPD in low- and middle-income countries2023In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 62, no Suppl. 67, article id OA3174Article in journal (Other academic)
  • 18.
    Stridsman, C.
    et al.
    Umea Univ, OLIN Unit, Med Sect, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Zakrisson, A.
    Orebro Univ, Fac Med & Hlth, Dept Univ Healthcare Res Ctr, Orebro, Sweden..
    Sterner, Therese
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nurses specialized through higher education in asthma, allergy and COPD. Experiences from a Swedish perspective - A winning concept for the clinic2022In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 60, no suppl 66, article id 153Article in journal (Other academic)
    Abstract [en]

    Background: In Sweden, asthma, allergy and COPD clinics are a successful model for evidence-based care. The main criteria for the clinic is that it should be led by an educated asthma, allergy and COPD-nurse. Further, allergy consultant nurses have the main task to be a bridge between health care and the family/preschool/school/work.

    Aim: To describe the Swedish nursing education courses of an asthma, allergy and COPD nurse and an allergy consultant nurse.

    Methods/results: To become specialized, the nurse need further university studies in asthma, allergy and COPD after bachelor degree, i.e. at least 15 credits. This can also be followed up by further credits and a master’s degree. The courses are designed with a person-centered approach as a mix of nursing and medicine. It includes early detection, screening and diagnosis of asthma, allergy and COPD and skills about spirometry, allergy testing, patient education, smoking cessation support and the use of a written treatment-plan as well as assessment of risk factors, comorbidities, and symptoms i.e. both non-pharmacological and pharmacological interventions. Self-management, interprofessional collaboration and how to evaluate adherence to guidelines by using the Swedish National Airway Register are highlighted in the course. The allergy consultant nurse receives deeper education in allergy and the immunological mechanisms. The consultant often has postgraduate credits in specialist nursing or a master of science with a specialisation in paediatric and adolescent healthcare.

    Conclusion: Advanced education after bachelor’s degree has benefits both for the patient and for the society.

  • 19. Stridsman, Caroline
    et al.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Warm, Katja
    Backman, Helena
    Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health: a report from the OLIN adult asthma cohort2021In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 58, no 5, p. 586-595Article in journal (Refereed)
    Abstract [en]

    Objective: To study asthma exacerbations, healthcare utilization and health status among subjects with asthma with different treatment regimens and levels of asthma control. Methods: In 2012-2014, n = 1425 adults from a population-based asthma cohort within the OLIN studies (Obstructive Lung disease in Northern Sweden) were invited to a follow-up including spirometry and a structured interview, n = 1006 participated. Asthma Control Test (ACT) was used to detect uncontrolled asthma, and physical and mental dimensions of health were measured with SF-8. Pharmacological treatment use was classified by Global Initiative for Asthma treatment steps. Out of n = 830 with current asthma, n = 714 answered ACT (57% women, 32-92 years) and were included in the study. Results: Uncontrolled asthma increased per treatment step (no treatment 9.9%, treatment step 1-3 24.1%, and treatment steps 4-5 39.9%, p < 0.001). A higher proportion of subjects with uncontrolled asthma reported exacerbations, healthcare utilization, and worse health status than those with controlled asthma. The proportion of subjects reporting exacerbations, healthcare visits, emergency room visits and regular follow-up visits increased per treatment step. Worse health was associated with uncontrolled asthma, but not with the level of treatment. A higher proportion of women than men reported exacerbations, any healthcare visits, and lower health. Regular follow-up visits to a physician were uncommon (women 21.2% vs. men 14.6%, p = 0.022). Conclusions: Uncontrolled asthma is common in all treatment steps, and is associated with worse health status. However, health status did not differ by treatment steps. Identifying subjects with uncontrolled asthma regardless of treatment regimens should be a priority, thus follow-up visits are important.

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  • 20.
    Sundh, Josefin
    et al.
    Örebro Univ, Fac Med & Hlth, Dept Resp Med, S-70185 Örebro, Sweden..
    Tanash, Hanan
    Lund Univ, Skane Univ Hosp, Dept Resp Med, Malmö, Sweden..
    Arian, Rahi
    Publ Dent Hlth Serv, Dept Periodontol & Implantol, Örebro, Sweden..
    Neves-Guimaraes, Alessandra
    Publ Dent Hlth Serv, Dept Periodontol & Implantol, Örebro, Sweden..
    Broberg, Katrin
    Publ Dent Serv Skane, Lund, Sweden..
    Lindved, Gustav
    Clin Microbi, Copenhagen, Denmark..
    Kern, Timo
    Clin Microbi, Copenhagen, Denmark..
    Zych, Konrad
    Clin Microbi, Copenhagen, Denmark..
    Nielsen, Henrik Bjørn
    Clin Microbi, Copenhagen, Denmark..
    Halling, Anders
    Lund Univ, Ctr Primary Hlth Care Res, Dept Clin Sci Malmö, Malmö, Sweden..
    Ohlsson, Bodil
    Lund Univ, Skane Univ Hosp, Dept Internal Med, Malmö, Sweden..
    Jönsson, Daniel
    Malmö University, Faculty of Odontology (OD). Publ Dent Serv Skane, Lund, Sweden.;Lund Univ, Dept Clin Sci Malmö, Hypertens & Cardiovasc Dis, Malmö, Sweden..
    Advanced Dental Cleaning is Associated with Reduced Risk of COPD Exacerbations-A Randomized Controlled Trial2021In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 16, p. 3203-3215Article in journal (Refereed)
    Abstract [en]

    Purpose: Infections from the oral microbiome may lead to exacerbations of chronic obstructive pulmonary disease (COPD). We investigated whether advanced dental cleaning could reduce exacerbation frequency. Secondary outcomes were disease-specific health status, lung function, and whether the bacterial load and composition of plaque microbiome at baseline were associated with a difference in outcomes. Patients and Methods: One-hundred-one primary and secondary care patients with COPD were randomized to intervention with advanced dental cleaning or to dental examination only, repeated after six months. At baseline and at 12 months, data of exacerbations, lung function, COPD Assessment Test (CAT) score, and periodontal status were collected from questionnaires, record review, and periodontal examination. Student's t-test and Mann- Whitney-U (MWU) test compared changes in outcomes. The primary outcome variable was also assessed using multivariable linear regression with adjustment for potential confounders. Microbiome analyses of plaque samples taken at baseline were performed using Wilcoxon signed ranks tests for calculation of alpha diversity, per mutational multivariate analysis of variance for beta diversity, and receiver operating characteristic curves for prediction of outcomes based on machine learning models. Results: In the MWU test, the annual exacerbation frequency was significantly reduced in patients previously experiencing frequent exacerbations (p = 0.020) and in those with repeated advanced dental cleaning (p = 0.039) compared with the non-treated control group, but not in the total population including both patients with a single and repeated visits (p = 0.207). The result was confirmed in multivariable linear regression, where the risk of new exacerbations was significantly lower in patients both in the intention to treat analysis (regression coefficient 0.36 (95% CI 0.25-0.52), p < 0.0001) and in the population with repeated dental cleaning (0.16 (0.10-0.27), p < 0.0001). The composition of microbiome at baseline was moderately predictive of an increased risk of worsened health status at 12 months (AUC = 0.723). Conclusion: Advanced dental cleaning is associated with a reduced frequency of COPD exacerbations. Regular periodontal examination and dental cleaning may be of clinical importance to prevent COPD exacerbations.

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  • 21.
    Tsang, Kevin C H
    et al.
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK; Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
    Pinnock, Hilary
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK.
    Wilson, Andrew M
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK; Norwich Medical School, University of East Anglia, Norwich, UK; Norwich University Hospital Foundation Trust, Colney Lane, Norwich, UK.
    Salvi, Dario
    Malmö University, Internet of Things and People (IOTAP). Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT).
    Shah, Syed Ahmar
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK; Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
    Home monitoring with connected mobile devices for asthma attack prediction with machine learning2023In: Scientific Data, E-ISSN 2052-4463, Vol. 10, no 1, article id 370Article in journal (Refereed)
    Abstract [en]

    Monitoring asthma is essential for self-management. However, traditional monitoring methods require high levels of active engagement, and some patients may find this tedious. Passive monitoring with mobile-health devices, especially when combined with machine-learning, provides an avenue to reduce management burden. Data for developing machine-learning algorithms are scarce, and gathering new data is expensive. A few datasets, such as the Asthma Mobile Health Study, are publicly available, but they only consist of self-reported diaries and lack any objective and passively collected data. To fill this gap, we carried out a 2-phase, 7-month AAMOS-00 observational study to monitor asthma using three smart-monitoring devices (smart-peak-flow-meter/smart-inhaler/smartwatch), and daily symptom questionnaires. Combined with localised weather, pollen, and air-quality reports, we collected a rich longitudinal dataset to explore the feasibility of passive monitoring and asthma attack prediction. This valuable anonymised dataset for phase-2 of the study (device monitoring) has been made publicly available. Between June-2021 and June-2022, in the midst of UK's COVID-19 lockdowns, 22 participants across the UK provided 2,054 unique patient-days of data.

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  • 22.
    Tsang, Kevin Cheuk Him
    et al.
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK; Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
    Pinnock, Hilary
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK.
    Wilson, Andrew M
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK; Norwich Medical School, University of East Anglia, Norwich, UK; Norwich University Hospital Foundation Trust, Colney Lane, Norwich, UK.
    Salvi, Dario
    Malmö University, Internet of Things and People (IOTAP). Malmö University, Faculty of Technology and Society (TS), Department of Computer Science and Media Technology (DVMT).
    Shah, Syed Ahmar
    Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK; Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
    Predicting asthma attacks using connected mobile devices and machine learning: the AAMOS-00 observational study protocol2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 10, article id e064166Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Supported self-management empowering people with asthma to detect early deterioration and take timely action reduces the risk of asthma attacks. Smartphones and smart monitoring devices coupled with machine learning could enhance self-management by predicting asthma attacks and providing tailored feedback.We aim to develop and assess the feasibility of an asthma attack predictor system based on data collected from a range of smart devices.

    METHODS AND ANALYSIS: A two-phase, 7-month observational study to collect data about asthma status using three smart monitoring devices, and daily symptom questionnaires. We will recruit up to 100 people via social media and from a severe asthma clinic, who are at risk of attacks and who use a pressurised metered dose relief inhaler (that fits the smart inhaler device).Following a preliminary month of daily symptom questionnaires, 30 participants able to comply with regular monitoring will complete 6 months of using smart devices (smart peak flow meter, smart inhaler and smartwatch) and daily questionnaires to monitor asthma status. The feasibility of this monitoring will be measured by the percentage of task completion. The occurrence of asthma attacks (definition: American Thoracic Society/European Respiratory Society Task Force 2009) will be detected by self-reported use (or increased use) of oral corticosteroids. Monitoring data will be analysed to identify predictors of asthma attacks. At the end of the monitoring, we will assess users' perspectives on acceptability and utility of the system with an exit questionnaire.

    ETHICS AND DISSEMINATION: Ethics approval was provided by the East of England - Cambridge Central Research Ethics Committee. IRAS project ID: 285 505 with governance approval from ACCORD (Academic and Clinical Central Office for Research and Development), project number: AC20145. The study sponsor is ACCORD, the University of Edinburgh.Results will be reported through peer-reviewed publications, abstracts and conference posters. Public dissemination will be centred around blogs and social media from the Asthma UK network and shared with study participants.

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