Academic literature on the topic 'Riskgrupp'

Introduction: Maternal nutrition plays an important role in maternal and fetal outcomes. The lowmaternal BMI or Obesity are both associated with adverse outcomes. Objectives: To evaluate theimpact of the maternal body mass index on the pregnancy outcome and neonatal outcomes.Materials and Methods: This is a prospective cohort study in which a total of 200 patients meetingthe inclusion criteria were enrolled in the study after informed consent of which 100 patientsenrolled after 18 weeks of gestation had a low BMI and 100 patients with a higher BMI than normal.Results: Pregnant females having low BMI as baseline had more risk of IUGR, fetal distress and lowbirth weight in newborns while those having high maternal BMI had more incidence of PIH inmothers, oligohydramnios, increased birth weight, increased risk of LSCS and NICU admissions anddelayed maternal wound healing. Conclusion: The health of women, throughout their childbearingages, should be cared, to improve their obstetrical and perinatal outcomes. Also, the high-riskgroups should be managed properly.

Thus, the index of dental plaque was reliably low in patients undergoing the treatment by aligners as compared with the patients with fixed bracket-systems. Non-removable orthodontic equipment affects marginal periodontal tissues and mouth hygienic condition more than removable one. In spite of observed considerable data spread, when comparing the initial level of antimicrobial peptide measured before the placing the bracket systems, statistically significant differences were obtained. In mixed saliva in patients of basic group the content level of alpha-defensin was higher than in the control group. 3 months after carrying bracket systems value index significantly changed: in the group with inflammatory processes the content of alpha defensin decreases in periodontal tissues whilst in comparison group it increases. The changes in basic group after three months was significant. Thus data evaluation suggests that orthopedic problems are accompanied by blood rheological changes that lead to the increase in plasma viscosity red blood cells aggregability and decrease in red blood cells deformation. That is, (blood rheology) and coagulation changes are notable while dysfunction of vascular endothelium is present. These patients might be considered as riskgroups for cardiovascular problems.

Introduction: We sought to assess the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on final pathological outcome.Methods: A retrospective review of RARP patient records operated between 2006 and 2015 was conducted. SWT was defined as period from prostate biopsy to surgery. Primary outcome was the impact on postoperative Cancer of the Prostate Risk Assessment (CAPRA-S) score. Patients were stratified according to D’Amico risk categories. Univariate analysis (UVA) and multivariable (MVA) analysis with a generalized linear model was used to evaluate the effect of SWT and other predictive factors on pathological outcome in individual risk group and on the overall sample.Results: A total of 835 patients were eligible for analysis. Mean SWT was significantly different between the three D’Amico groups, with mean SWT of 180.22 days (95% confidence interval [CI] 169.03; 191.41), 159.14 days (95% CI 152.38; 165.90), and 138.96 days (95% CI 124.60; 153.33) for low-, intermediate-, and high-risk groups, respectively (p<0.001). After stratification by D’Amico riskgroup, no significant association was observed between SWT and CAPRA-S score in the three risk categories on UVA and MVA. Predictors of higher CAPRA-S score in the multivariable model in the overall cohort were: older age (p=0.014), biopsy Gleason score (p<0.001), percentage of positive cores (p<0.001), and clinical stage (p<0.001).Conclusions: In the present study evaluating SWT for RARP in a Canadian socialized system, increased delay for surgery does not appear to impact the pathological outcome. Further studies are required to evaluate the impact of wait time on biochemical recurrence-free survival, cancer-specific survival, and overall survival.

Background It has been claimed that around 70% of childhoodacute lymphoblastic leukemia (ALL) can be cured. One of theimportant role is high dose methotrexate (HDMTX) administrationduring the consolidation therapy.Objective To determine the safety and effectiveness of HDMTXin children with ALL.Methods We reviewed patients with ALL in Pantai Indah KapukHospital, Jakarta during the period August 2000 through July 2005with observation time run through September 2006. Only patientswith normal kidney function were allowed to have HDMTX. Besidesgood hydration and alkalinization, patients were supported with goodhygiene (mouth, skin and anal area). MTX was given in loadingdose of 10% from the total dose in ½ hour and the rest 23½ hours for90%. Leucovorin rescue was started 12 hours after discontinuationof 24 hour MTX IV infusion. Leucovorin was given until the MTXconcentration reached 0.1 uM/L. Patients were stratified to low,intermediate and high risk groups; 2 gram/m 2 was given to low riskgroup and 5 gram/m2 to intermediate and high risk groups.Results There were 20 patients eligible for study. All methotrexatesteady-state plasma concentrations (MTX Cp ss ) were above 16 uM/L, and steady state concentration in CSF was always below 0.5 uM/L for 2 gram/m 2 and above 0.5 uM/L for 5 gram/m 2 doses. All 20cases went through the procedure with only mild side effects i. e,mild mucositis, anal furuncle and diarrhea, which recovered 2 weekslater. Only 1 high risk case with initial WBC 612X10 9 /L, succumbedafter he went through the HDMTX program smoothly and relapsedsubsequently during reinduction phase.Conclusion HDMTX can be given safely to ALL patients with normalkidney function with good supportive care. Five gram/m 2 HDMTXeffectively treat the minor disease and/or prevent CNS and testicularleukemia. This study has also given an impression that HDMTXmay increase event-free survival.

Abstract In myelodysplastic syndromes (MDS) cytogenetic analysis has a major role to assess the individual risk of patients. According to the International Prognostic Scoring System (IPSS) three cytogenetic subgroups can be distinguished: favorable [-y,del(5)(q),del(20)(q)], poor [chr. 7 abnormalities, complex] and intermediate [other abnormalities]. In a multicenter analysis the prognostic impact of karyotypic patterns in a series of 1159 primary MDS patients with cytogenetic data was investigated. Aim of the presented analysis was to study the influence of age and gender on this prognostic model. Median age was 66 years, median survival 37 months, 654 patients (56,4%) were male and 505 (43,6%) female. According to the three cytogenetic riskgroups defined by the IPSS the distribution and the median survival duration were as follows: favorable 739 pts. (63,8%), 53 months; intermediate 206 pts. (17,8%), 31 months; poor 214 pts. (18,4%), 11 months. These results are concordant with other published data, especially the original publication of the IPSS. Focussing on age and gender we divided the whole patient cohort in 4 subgroups:male, female, age at time of diagnosis <66 years (579 pts.) and ≥ 66 years (580 pts.) The distribution and survival data are shown in table 1. Risk distribution was comparable among all different subgroups. Analysis of the influence of gender showed significant shorter survival for men in the low risk group, in the other two subgroups median survival duration was not significantly different in favor of the male cohort (interaction p=0.0057). In the two different age groups the younger subgroup with favorable or intermediate cytogenetics lived significantly longer, in the high risk group survival difference was not significant, but substantially the same as in the other risk groups. The observed difference in the low risk subgroup between men and women could be due to a considerable higher frequency of del(5)(q) in female patients (60 females of 83 cases). The shorter survival of the older patient cohorts with favorable or intermediate cytogenetics could be due to non-hematological comorbidity, which has more impact on survival in the lower risk subgroups, while the disease itself is the predominant factor limiting lifetime in the elderly high risk group as defined by cytogenetics. Table 1 Female Male P (sex) <66 years ≥66 years P(age) Favorab. n(%), survival 314(62,2%) 70mo 425(65%) 40mo <0.00001 348(60,1%) 58mo 391(67,4%) 48mo 0.001 Intermed. n(%), survival 86(17%) 30mo 120(18,3%) 33mo 0.70 117(20,2%), 40mo 89(15,3%) 27mo 0.008 Poor n(%), survival 105(20,8%) 10mo 109(16,7%) 13mo 0.81 114(19,7%) 15mo 100(17,3%) 8mo 0.11 P (risk groups) <0.00001 <0.00001 <0.00001 <0.00001

Abstract Objective: We applied next generation sequencing (NGS) with a panel of 206-MPN-relevant genes, in order to identify non-driver mutation profile and prognostic value of non-driver mutations in PMF and Post-PV/ET myelofibrosis. Methods: Targeted capture sequencing assays were carried out on bone marrow DNA specimens obtained at time of referral. Gene list was shown in Figure 1. DNA libraries were prepared using Illumina standard protocol. The amplified DNA was captured by using biotinylated oligo-probes (MyGenosticsGenCap Enrichment technologies). Illumina utilizes a unique "bridged" amplification reaction that occurs on the surface of the flow cell. A flow cell containing millions of unique clusters is loaded into theHiSeq 2000 for automated cycles of extension and imaging. TheSolexa QA package, thecutadapt program, theSOAPaligner program, the Picard software, the GATK program, the Exome-assistant program, theMagicViewer, thePolyphen, the SIFT, the PANTHER and thePmut were used to bioinformatics analysis. Results: 54 PMF patients (median age 55 [21-77]yrs; 69% males) and 17 post-PV/ET patients (median age 59[46-83]yrs; 59% males) were tested. In PMF patients, 6 (13%) subjects were categorized as DIPPS low-risk group, 25 (56%) intermediate-1-riskgroup and 14 (31%) intermediate-2-risk group. JAK2 mutations were detected in 21 subjects (47%), CALR mutations in 4 (9%) , MPL mutation in 1(2%) and Tri-negative (no detectable mutation in JAK2, CALR or MPL) in 19 (42%). In post-PV/ET MF patients, JAK2 mutations were detected in 16 (94%) and CALR mutations in 1 (6%). In PMF patients, mutations other than JAK2, CALR or MPL, referred as non-driver mutation, were detected in 43 (96%) patients including 89% of "Tri-negative" subjects. 12 (27%) subjects harbored one, 9 (20%) two, 12 (26.7%) three and 10 (22%) four or more. Mutational frequencies were: ASXL1 33%, U2AF1 22%, TET2 16%, FAT1 16%, SETBP1 13%, CUX1 9%, EP300 9%, SRSF2 9%, FAT 2 6.7%, NOTCH3 6.7%, EZH2 6.7%, GATA3 6.7% and <5% (at least 2 subjects) for KRAS, SF3B1, CEBPA, DNMT3A, PPARGC1B, SH2B3, PTPRB, AKTIS1, PTPRT and SHROOM2 (Figure 2).We searched for pairwise gene associations, recognizing that pairs of genes could show a tendency to eithercooccurrenceor mutually exclusivity.JAK2 shows a clear proclivity forcomutationwith TET2 (OR, 7.7, q=0.04), whereas JAK2 is mutually exclusive with CALR (OR 0.09, q=0.02).ASXL1 shows a clear proclivity forcomutationwith FAT2 (OR, 7.9, q=0.05). EP300 shows a clear proclivity forcomutationwith SRSF2 (OR, 62.2, q=0.001). In post PV/ET MF patients, non-driver mutations were detected in 15 (88%) patients. ASXL1 was the most frequently mutated in the cohort (41%), followed by TET2 (29%) and NOTCH3 (18%) (Figure 2).Compared to patients with PMF, no splicing factor gene (U2AF1, U2AF2, SRSF2 and SF3B1) mutation was detected in patients with post-PV/ET MF. In PMF patients, subjects classified as higher-risk (Int-2 or High risk) DIPSS group were more likely to have U2AF1 mutation (P=0.03). Patients with ASXL1 mutations were more likely to have higher WBC level (P=0.018). Patients with TET2 mutations were more likely to have higher platelet level (P=0.03), but patients with FAT1 mutations were more likely to have lower platelet level (P=0.035). In post PV/ET MF patients, subjects with ASXL1 mutations were more likely to have larger spleen size from LCM (P=0.006). In PMF patients, follow-up data were available for 38 subjects. Date of last follow-up was June, 2016 or last contact. Median follow-up of survivors was 36 months. 8 (18%) deaths were documented. In univariate analysis, the number of non-driver mutations was considered as three categories (zero, 1-2 and more than 3). The 5-yrs PS was 100%, 81.6% and 24.4% in three categories respectively. In addition, survival was adversely affected by presence of mutant U2AF1 (P=0.009). Conclusions: Non-driver mutations occur in about 90% of patients with PMF or Post-PV/ET MF. Mutant epigenetic genes and splicing factor genes are the most common non-driver mutations. Survival was adversely affected by the number of non-driver mutations and presence of U2AF1 mutation. Figure 1 The NGS panel of 206-MPN-relevant genes Figure 1. The NGS panel of 206-MPN-relevant genes Figure 2 Gene mutation profile in PMF and Post-PV/ET MF. Figure 2. Gene mutation profile in PMF and Post-PV/ET MF. Disclosures No relevant conflicts of interest to declare.

Abstract INTRODUCTION Acute myeloid leukemia (AML) is a hematopoietic malignancy that comprises almost 25% of pediatricleukemiasand is characterized by genetic and epigenetic alterations that lead to impairment of differentiation and clonal expansion. Despite intensive chemotherapy, more than half of children with AML either fail to achieve a complete remission (CR) or relapse after initial response.As such, the availability of a predictor of treatment failure at diagnosis may allow early institution of alternative therapies to improve outcome. MicroRNAs (miRNAs), a class of small non-coding RNAs that regulate the translation of their target mRNAs, are frequentlydysregulatedin cancers, and thus may serve as robust biomarkers of patient outcome. METHODS To identifymiRNAbiomarkers associated with treatment failure and candidate therapeutic targets, we performed a comprehensive sequence-based characterization of the pediatric AMLmiRNAexpression landscape usingmiRNA-seqdata from 637 primary samples. AmiRNAexpression-based model for EFS separating patients into low, intermediate, andhigh riskgroups was produced using penalized Cox regression. The model was designed usingmiRNAexpression data obtained from a training cohort, which consisted of two-thirds of our study cohort (n=425), and then tested on the remaining one-third of our study cohort (n=212). The training and test cohorts were derived by random selection. RESULTS A 36-miRNA EFS predictive model was generated. This model was comprised of16miRNAsthat were over-expressed and 20 that were under-expressed in patients who experienced an event (death, relapse or IF). Among the 36miRNAtranscripts were miR-155, miR-335, miR-139 and miR-375, which have been previously individually associated with survival in pediatric AML. To demonstrate the potential clinical utility of the model, we determined 2 miRNAmodel score thresholds in the training cohort to separate patients into low, intermediate and high miRNAmodel score risk groups. The miRNAmodel score groupings were significantly associated with EFS in both the training cohort and test cohort (Figure 1A; P<0.001). Specifically, within the training cohort, the model identified 108 (25%) patients as high risk (5-year EFS: 7.36%; HR: 2.83, P<0.001), and 106 (25%) patients as low risk (5-year EFS: 81.4%; HR: 0.32, P<0.001). The training and test cohorts were combined for further subclass evaluation. In the combined cohort, multi-variate Cox regression analysis, which includedmiRNA expression risk status and conventional cytogenetic and molecular (CM) risk groups, demonstrated that themiRNA risk classification remains an independent predictor of high risk (HR: 2.44, P<0.001) and low risk (HR: 0.34, P<0.001). Furthermore, to demonstrate the strength of our predictive model, we evaluated the clinical significance of the model in each of the low, standard and high CM risk cohorts. In this analysis, our model was capable of further stratifying patients in each of the 3 CM risk cohorts into 3 distinct miRNAmodel score-based risk categories (Figure 1B, P<0.001). Of particular interest is the ability of the model to identify patients with poorer outcomes in the CM low risk cohort and those with more favorable outcomes in the CMhigh risk cohort. CONCLUSIONS We present amiRNAexpression-based predictor of outcome in pediatric AML, comprised of 36miRNAtranscripts. Our predictive model was developed and tested on a large cohort of primary patient samples (n=637), and demonstrated that diagnosticmiRNAexpression profiles can identify risk groups in patients independent of other CM risk factors. Moreover, this model is applicable to RNA from samples that are routinely obtained for diagnosis, and thus has the potential to impact clinical practice. Figure 1. Stratifying patients using the miRNA-based EFS predictive model. A)Kaplan-Meier plots displaying EFS differences between patients in variousmiRNA model score groups. Patients with highmiRNA model scores had the poorest outcomes, while patients with the lowmiRNA model scores had superior outcomes. B)Kaplan-Meier curves depicting EFS of patients when classified using ourmiRNA model score groupings. ThemiRNA model score groupings were effective in further stratifying patients within the low, standard and high conventional CM risk group classifications. Figure 1. Stratifying patients using the miRNA-based EFS predictive model. A)Kaplan-Meier plots displaying EFS differences between patients in variousmiRNA model score groups. Patients with highmiRNA model scores had the poorest outcomes, while patients with the lowmiRNA model scores had superior outcomes. B)Kaplan-Meier curves depicting EFS of patients when classified using ourmiRNA model score groupings. ThemiRNA model score groupings were effective in further stratifying patients within the low, standard and high conventional CM risk group classifications. Disclosures No relevant conflicts of interest to declare.

Abstract Issue Since 2002, the Netherlands started a hepatitis B-vaccination program targeted at high behavioral risk groups in absence of a universal vaccination policy (implemented from 2011 onwards). The Public Health Services (PHS) offer free HBV-vaccination to sexworkers (SW) and men who have sex with men (MSM). In order to increase vaccination coverage and adherence a combination of offline and online strategies was used. Description In 2002 the HBV-program started to reach risk groups by offline outreach activities like visiting sauna’s, brothels, festivals etc. In addition targeted campaigns were developed: posters and incentives were used at outreach locations. Gradually, reaching the riskgroups at location became less effective and more costly, therefore online outreach became more important: targeted campaigns are conducted via social media, online dating platforms and commercial sex websites. These campaigns refer to websites with sexual health information, tailored advice and an online module to schedule vaccination appointments. Results In 16 years’ time, the program reached over 62,000 MSM and 23,000 SW with a combination of offline and online strategies. Nowadays, PHS nurses organize each year around 70-80 regional (online and offline) outreach actions for MSM and around 30-35 for SW. in 2017-2018 9-13% of the first vaccinations among MSM and SW was facilitated by the online appointment module. In addition, each year PHS are motivated to develop innovative plans in order to increase vaccination coverage such as informative meetings for MSM migrants with a festive touch, and in-depth research in how to reach male and female SW at home. Lessons Combining targeted online and offline strategies in order to reach the risk groups for vaccination has been successful over the past 16 years. Each year about 4,000 MSM and 1,000 SW receive their first HBV-vaccination thanks to constant commitment and creativity of enthusiastic health professionals for new approaches. Key messages Combining targeted online and offline strategies in order to reach the risk groups for vaccination has been successful. Encouraging innovative plans is succesful in reaching high behavioral risk groups for vaccinations.

Objectives. This study aims to (1) determine the cardiovascular risk of persons with hypertension and diabetesattending hypertension/diabetic clinics or hypertension/health club meetings in the AMIGA (Alfonso, Mendez,Indang, General Emilio Aguinaldo and Amadeo) municipalities of Cavite; (2) suggest measures to improve thecardiovascular disease (CVD) program in these municipalities using the results of the study.
 Methods. A cross-sectional study was performed on patients diagnosed with hypertension and/or diabetes whoare attending clinics or club meetings in the barangays of the five AMIGA municipalities of Cavite. Participantswere interviewed using an abbreviated version of the World Health Organization (WHO) STEPS questionnaireon risk factors. The participants’ anthropometric measurements were obtained and their total blood cholesterollevels determined. CVD risk was then estimated using the WHO / International Society of Hypertension (ISH) riskprediction chart for the Western Pacific Region B.
 Results. 1,032 participants from 27 barangays qualified for the study. Participants were predominantly female(74%); over-all mean age was 58.43 years. Majority of the participants (79.17%) were found to be in the low-riskgroup; 11.34% were in the moderate risk group; 4.46% were in the high-risk group; while 5.05% were in the veryhigh-risk group. Majority of the participants were also found to be obese. Mean total cholesterol was 207.02 mg/dl.
 Conclusion. Majority of participants were stratified in the low-risk category (<10% chance to have cardiovascularevents in the next 10 years), while 9.5% were in the high-risk category (≥20% risk). Obesity is a major risk factorthat could be addressed in this population.

<p><p>In our study we examined recurrent patterns and changes in the representation of</p><p>homosexual persons in Swedish daily newspapers 1987, 1997 and 2007.</p><p>We analysed articles about HIV-infected persons and articles with a view to portray the</p><p>life conditions of gay and lesbian persons from the three different years. We chose to</p><p>only analyze news articles that intend to represent real human beings, which mean that</p><p>we did not analyze reports that only reproduce abstract knowledge from authorities.</p><p>With analytical tools from semiotics and discourse analysis we identified some recurrent</p><p>patterns in the representation of homosexual people. We found that a recurrent pattern in</p><p>that when homosexual people are seen as groups, they are described as deviant,</p><p>discriminated and some times as a threat. When portrayed as individuals the nonanonymous</p><p>persons appear in articles and pictures as normal, strong and healthy. Lesbian</p><p>women are not represented in the articles from 1987, but in articles from 1997 and 2007</p><p>they appear as unhappy when single and happy in a relationship.</p><p>The results also showed some interesting differences in news representation of</p><p>homosexual persons between the three investigated years. One example of this is that the</p><p>media stopped referring to homosexual men as a ‘hazard group’ in terms of HIV at some</p><p>point after the year 1987. We recognize this as an important change in the news medias</p><p>perspective on both HIV and love between men.</p></p>

Studien undersöker arbetsmarknadens förändrade förutsättning utifrån en riskgrupp vilket i studiens kontext är ungdomar (med eller utan utbildning), lågutbildade, arbetslösa samt nyexaminerade. Syftet är att undersöka riskgruppens förutsättning att med hjälp av en utbildningsinvestering uppnå en etablering på arbetsmarknaden. Arbetsmarknaden upplever en inkomstojämnlikhet samt inkomstosäkerhet vilket har orsakat ett ökat behöv för anställningsbarhet bland riskgruppen. Denna studie avgränsar sig endast till utbildning på tertiär nivå. Således studeras övergången mellan studier och arbetsmarknad utifrån utbildningsformerna: folkhögskolan, vuxenutbildning, kompletterande utbildning, yrkeshögskolan och folkhögskolan. Övergången studeras främst i relation till riskgruppens förutsättning. Metoden som använts är en trianguleringsmetod där både kvalitativ och kvantitativ metod trianguleras för att nå fram till ett resultat. I den kvalitativa metoden används en narrativ litteraturgenomgång och i den kvantitativa metoden används en systematisk litteraturgenomgång genom en metaanalys. Det sistnämnda använder sig av en etableringsmått efter avslutad studier från tertiär utbildningsnivå.

RSV är en luftvägsinfektion som anses drabba alla barn innan de fyllt två år och kan orsaka stora problem för en del barn, särskilt underburna och barn med hjärt- och lungsjukdomar. Syftet med föreliggande arbete var att belysa: dels vilka RSV-incidensrisker och andra risker som föreligger för barn i riskgrupper som har en större benägenhet att drabbas av RSV-infektion än andra barn; dels på vilka sätt smittspridning kan förebyggas. Fjorton relevanta artiklar har påträffats via databaserna PubMed och Cinahl. De har analyserats med innehållsanalys. Utifrån analysen skapades två kategorier: incidensrisk i riskgrupper och profylax samt fem underkategorier: tre rörande incidensrisk och andra risker för kända riskgrupper och två rörande olika typer av profylax. Det framkom, förutom att det fanns en större risk att drabbas av RSV om barnen tillhörde någon riskgrupp, att barn i dessa grupper även blev sjukare än andra barn. Profylaxbehandling mot RSV ansågs vara effektiv med väldigt dyr och det rådde oenighet om vilka kriterier som skulle avgöra vilka barn som skulle få viss profylax. Vårdpersonal behöver mer fortlöpande utbildning om hygien och smittspridning. Fortsatta studier inom ämnet, med inriktning på omvårdnad, vore intressant.

<p>I media talas det ofta om att antalet ungdomar vilka provar och använder sig av drogen Ecstasy i samband med dans- och ravepartyn ökar drastiskt runt om i vår värld. Målet med denna forskningsöversikt är därför att med hjälp av forskningsstudier från 2003 och framåt, söka få en bild av viken grupp av ungdomar som befinner sig i riskzonen för att hamna i ett missbruk av Ecstasy, samt vilka riskfaktorer och risker som berör dessa ungdomar.</p><p>Metoden som använts för att besvara dessa frågor är en forskningsöversikt som bygger på elva forskningsartiklar i ämnet. Studien berör i huvudsak tre olika länder i var sina världsdelar. Den teori som används i analysen av studien är ett globalt, socialt och kulturellt perspektiv, som inkluderar såväl sociala som kulturella teorier. Sammanfattningen av studien visar att såväl de psykiska, fysiska och sociala riskfaktorerna i stort sett är likartade för de berörda ungdomsgrupperna i samtliga av dessa länder. Det vill säga att ungdomar som brukar Ecstasy, eller ligger i riskzonen för ett missbruk av drogen, möter ungefär samma sociala problematik och att de psykiska och fysiska biverkningarna av drogen är de samma oavsett vilket land de bor i.</p><p>Då det gäller sociala riskgrupper på global nivå, har det i översikten visat sig att den övervägande delen är de ungdomar som deltar i dans- och ravepartyn, oavsett etnisk bakgrund och kön, vilka under barndomen uppvisat symptom på ångest och/eller depression och kommer från medel- eller övre medelklass, löper störst risk att komma i kontakt med Ecstasy. Av dessa anledningar ökar även risken för dessa ungdomar att hamna i ett missbruk av drogen. En annan orsak till denna utsatthet beror på att ungdomar från denna samhällsklass i högre utsträckning deltar i så kallade ravepartyn och liknande tillställningar, än ungdomar från andra samhällsklasser.</p>

I spåren av de globala klimatförändringarna förväntas värmeböljor öka i både frekvens och intensitet, inte bara på sydliga breddgrader utan även på de norra vilket kommer att leda till en ökad incidens av sjukliga tillstånd relaterade till överhettning. Omedelbar och snabb nedkylning av överhettade personer är av största vikt för att minimera morbiditet och mortalitet. Inom svensk sjukvård finns inga riktlinjer för det initiala omhändertagandet av personer drabbade av överhettning. Syftet med studien var att erhålla fördjupad inblick i människans termoreglering med fokus på: hudens cirkulatoriska respons vid nedkylning, effekter av olika metoder för kylning och identifiera när det föreligger ökad risk för överhettning. Metoder som användes var litteraturstudie, värmebalansberäkning och enkät. Resultatet visade att människans termoreglering är av komplex natur som till största del styrs via reglering av hudens genomblödning men de fysiologiska mekanismerna är ännu inte helt klarlagda. Effektiva metoder för kylning är helkroppsimmersion i cirkulerande kallt vatten eller fuktning av huden med kallt vatten och fläktning. Vattentemperatur för optimal kyleffekt är ännu inte fastställt. Värmebalansberäkningarna illustrerade att bästa kyleffekt, via evaporation och konvektion uppnås med att så stor yta som möjligt fuktas med vatten (etanol vid hög luftfuktighet), fläkthastighet 3 m/s, vindriktning tvärs kroppens längdriktning och hudblodflöde 90 l/m2h. Riskgrupper för ansträngningsutlöst värmeslag är t.ex. idrottare, militärer och räddningsarbetare.  Det klassiska värmeslaget drabbar främst äldre och småbarn, kroniskt sjuka, fysiskt och psykiskt funktionshindrade. Riskfaktorer är bl.a. hög luftfuktighet, infektion, vissa läkemedel, social isolering, institutionsboende och avsaknad av luftkonditionering. Telefonintervjuer bekräftade att det initiala medicinska omhändertagandet variera stort på regionsjukhusens akutmottagningar. Sammanfattningsvis behövs en större sammanställning av forskningsresultat kring överhettning och effekter av olika kylmetoder för skapande av riktlinjer. Utifrån denna studie rekommenderas, beroende på personens allmäntillstånd nedsänkning i kar med cirkulerande kallt vatten alternativt placering i näthängmatta eller sidoläge med kontinuerlig sprayning av vatten över hela kroppen samtidigt som fläktar blåser tvärs kroppens längdriktning.

Introduktion: Spelberoende är idag ett folkhälsoproblem som både drabbar den spelberoende själv och dennes anhöriga. Riskfaktorer kopplade till spelberoende är många, men det saknas samstämmighet. Dessutom är skyddsfaktorerna få. Trots att det finns en åldersgräns för pengaspel är många unga drabbade där samsjuklighet är vanligt. Kostnaden för att behandla spelberoende beräknas vara låg även om det idag finns liten evidens kring effektiva behandlingsmetoden. Få personer söker dessutom vård för spelberoende. Syfte: Syftet med denna litteraturstudie var att beskriva vilka riskfaktorer och hälsokonsekvenser som är kopplade till spelberoende, samt att beskriva utsatta grupper i befolkningen. Metod: En strukturerad litteraturstudie utfördes med 13 inkluderade artiklar. Analysen genomfördes med hjälp av tematisk analys. Resultat: Resultaten visar att genetiska, biologiska, sociala, kognitiva, geografiska faktorer tillsammans personliga beteenden samt livsstils- och miljöfaktorer är avgörande för risken att utveckla spelberoende, vilket också kan leda till samsjuklighet och hälsokonsekvenser. Främsta samsjukligheten är substansberoende tillsammans med psykisk ohälsa och ökad risk för självmord. Utsatta grupper i befolkningen är unga män med familjeproblematik och migrationsbakgrund. Slutsats: Spelberoende är ett komplex beroende med många negativa hälsokonsekvenser. Ur ett folkhälsoperspektiv är det viktigt att förstå hur faktorer samverkar för att tidigt kunna förebygga spelproblem.<br>Introduction: Gambling is a growing public health issue that affects both the person with gambling disorder and relatives. There are many risk factors associated with gambling disorder, but there is a lack of agreement. In addition, there are few protective factors. Although there is an age limit for gambling, many adolescents are affected where comorbidity is common. The cost of treating gambling disorder is estimated to be low, although today there is little evidence of effective methods. Few people also seek care for gambling disorder. Aim: The aim of this literature study was to describe the risk factors and the health consequences that are linked to gambling disorder, and to describe vulnerable groups in the population. Method: A structured literature study was conducted with 13 included articles. The analysis was implemented using thematic analysis. Results: The results show that genetic, biological, social, cognitive, geographical factors together personal behaviors as well as lifestyle and environmental factors are crucial for the risk of developing gambling disorder, which can also lead to comorbidity and health consequences. The main comorbidity is substance addiction together with poor mental health and increased risk of suicide. Vulnerable groups in the population are young men with family issues and migration backgrounds. Conclusion: Gambling disorder is a complex addiction with many negative health consequences. In a public health perspective, it is important to understand how factors interact in order to prevent gambling problems at an early stage.

Fokuset i denna studie är e-tjänster för riskgruppen äldre personer i samband med framförallt pandemier. Undersökningen handlar om att kartlägga målgruppens bild av, och användning av, de offentliga och kommunala e-tjänster som erbjuds. Tidigare forskning visar att äldre personer i större utsträckning upplever ett utanförskap när det gäller tillgänglighet och digitala tjänster men däremot att det finns väldigt lite forskning kring riskgrupper och tillgänglighet kopplat till krislägen, som pandemier. Användarvänlighet, användbarhet och tillgänglighet används i studien för att förklara UX (User experience). Det finns fundamentala riktlinjer för att implementera god UX design vilket vi vidare förklarar i stycket “2.6 User Experience (UX) och Informationsarkitektur” (Chesnut &amp; Nichols 2015, s.9). Studien undersöker den upplevda tillgängligheten hos e-tjänster samt vilka typer av e-tjänster som den äldre riskgruppen upplever har behov av, och som därmed är en hjälp, vid en pandemi. Studien undersöker tillgänglighet och dess ramverk (WCAG 2.1) d.v.s. synlig, manövrerbar, begriplig och robust (W3C, 2018). Vår studie baseras på en metodkombination där en enkät och intervjuer utförts för att undersöka hur riskgruppen, den äldre målgruppen upplever e-tjänster vid en pågående pandemi. De e-tjänster som intervjupersonerna använder såsom exempelvis skatteverkets e-tjänst för skatteåterbetalning uppfyller fortfarande inte tillgänglighetens krav och kan därmed förbättras. Både enkätsvar och intervjuer visade att de viktigaste e-tjänsterna för äldre under pandemin är de som berör vården och dess olika e-tjänster på exempelvis 1177 eller olika vårdcentraler.