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Karefylakis, C., Särnblad, S., Ariander, A., Ehlersson, G., Rask, E. & Rask, P. (2018). Effect of Vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men: a randomized controlled trial. Endocrine (Basingstoke), 61(3), 388-397
Open this publication in new window or tab >>Effect of Vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men: a randomized controlled trial
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2018 (English)In: Endocrine (Basingstoke), ISSN 1355-008X, E-ISSN 1559-0100, Vol. 61, no 3, p. 388-397Article in journal (Refereed) Published
Abstract [en]

Purpose: Several observational studies have shown an association between vitamin D deficiency and non-skeletal major health issues including impaired cardiorespiratory fitness and adiposity. Only a few studies have examined the impact of vitamin D supplementation on these conditions and the results are ambiguous. The aim of this study was to examine the effect of vitamin D supplementation on body composition and cardiorespiratory fitness in overweight/obese men with vitamin D deficiency.

Methods: This study was a prospective, placebo controlled, double blinded, randomized trial with a study period of 6 months. Forty overweight/obese men (BMI > 25 kg/m2) with vitamin D deficiency (25(OH)D ≤ 55 nmol/L) were randomized to receive either 2000 IU Cholecalciferol drops or the equivalent amount of drops of placebo. At baseline and follow up body composition and cardiorespiratory fitness were measured and blood samples were obtained. Body composition was measured using bioelectrical impedance analysis (BIA) and cardiorespiratory fitness using cardiopulmonary exercise test (CPET). The primary outcomes were changes in percentage body fat and in maximum oxygen uptake (VO2max).

Results: No statistically significant difference between the placebo and the intervention group regarding changes in percentage body fat (p = 0.54) and VO2max (p = 0.90) was observed. Moreover, there was no statistically significant difference between the groups concerning changes in BMI (p = 0.26), maximum load (p = 0.89) and oxygen uptake at anaerobic threshold (AT) (p = 0.14).

Conclusions: We conclude that treatment with 2000 IU/d vitamin D for 6 months does not impact body composition or maximum oxygen uptake in overweight/obese men with vitamin D deficiency.

Place, publisher, year, edition, pages
Humana Press, 2018
Keywords
Bioelectrical impedance analysis, Body composition, Cardiopulmonary exercise test, Cardiorespiratory fitness, Vitamin D
National Category
Nutrition and Dietetics Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-68368 (URN)10.1007/s12020-018-1665-6 (DOI)000442234600005 ()29978375 (PubMedID)2-s2.0-85049582617 (Scopus ID)
Note

Funding Agencies:

Nyckelfonden OLL-404451

Örebro University ALF 2016:1 OLL-615521

Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2018-09-06Bibliographically approved
Lemonaki, M. & Särnblad, S. (2018). Paediatric education in the Curriculum of the School of Medicine in the University of Örebro in Sweden. In: : . Paper presented at AMEE (An International Association for Medical Education), Basel, Switzerland, 25-29 August, 2018.
Open this publication in new window or tab >>Paediatric education in the Curriculum of the School of Medicine in the University of Örebro in Sweden
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: In Sweden there are seven Medical Schools. Some of them have existed in more than 50 years whereas the School of Medicine at Örebro University was established in 2011. The education is built as 5,5 year studies (330 ECTS credits) and the Curriculum is integrated according to the PBL system. The aim is to present our approach to the training in paediatrics.

Method: The poster presents the theoretical and clinical studies, as well as the examination and the assessment system concerning the paediatric education. The medical students in Örebro study paediatrics during the study of the theme of Reproduction and Growth. This is formed in three steps during their studies, particularly in terms 2, 6, 9. As an integrated medical curriculum students have both theoretical and practical studies during all the terms. The learning methods are base studies, seminars, lectures, simulation training, and clinic practice.

In the second term, the medical students study embryology, genetics, anatomy and have some clinical practice in the paediatric primary health center. In the sixth term, they study about the healthy newborn, child and adolescent as well as normal and retarded growth and normal development and nutrition. Students also start their training in taking medical history and doing clinical examination. In the ninth term students have focus on the sick newborn, child and adolescent. Seminars on child abuse and neglect are given with a specialized pediatrician, a specialized lawyer and social worker as teachers.

Conclusion: The theoretical aims of the paediatric curriculum are obtained through clinical practice, team base groups, case seminaria, other seminaria, lectures, and self studies. The clinical skills are obtained through clinical skills training in paediatric units and simulation training. The examination system includes a writing exam after each term as well as an examination of clinical skills and a OSCE examination after the ninth term. The assessment ofthe students in the end of each term is very good.

Take-home message: The training in paediatrics in the Medical school of Örebro is formed in three steps in an integrated form.

National Category
Pedagogy
Identifiers
urn:nbn:se:oru:diva-67487 (URN)
Conference
AMEE (An International Association for Medical Education), Basel, Switzerland, 25-29 August, 2018
Available from: 2018-06-25 Created: 2018-06-25 Last updated: 2018-08-31Bibliographically approved
Karefylakis, C., Pettersson-Pablo, P., Särnblad, S., Rask, E., Bitar, M., Magnusson, A. & Eriksson, C.-G. (2018). Vitamin D C3 epimer in a mid-Swedish region: Analytical measurement and epidemiology. Clinica Chimica Acta, 478, 182-187
Open this publication in new window or tab >>Vitamin D C3 epimer in a mid-Swedish region: Analytical measurement and epidemiology
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2018 (English)In: Clinica Chimica Acta, ISSN 0009-8981, E-ISSN 1873-3492, Vol. 478, p. 182-187Article in journal (Refereed) Published
Abstract [en]

Background: The discovery of an epimeric form of 25(OH)D3 may complicate the interpretation of vitamin Dstatus. The aim of this study was to examine the prevalence and determinants of 25-hydroxy-3-epi-vitamin D3 (3- epi-25(OH)D3) in a mid-Swedish region and to investigate how the measurement of 3-epi-25(OH)D3 would affect the assessment of vitamin D status using current thresholds.

Methods: We conducted a cross-sectional study of 8286 in- and outpatients in primary as well as secondary care settings. Plasma 25(OH)D, 25(OH)D2, 25(OH)D3 and 3-epi-25(OH)D3 were measured using High Pressure Liquid Chromatography – Tandem Mass Spectrometry (HPLC – MS/MS). The relative 3-epi-25(OH)D3 contribution was calculated as a percentage of the total 25(OH)D3. Blood samples were collected between March 2014 and July 2015 providing a seasonal aspect to the results.

Results: 3-epi-25(OH)D3was detected in 635 cases (7.7% of all subjects), and the mean concentration was8.4 ± 3.5 nmol/L. 3-epi-25(OH)D3correlated significantly with 25(OH)D3(r =0.38, p < 0.001).A multivariateanalysis among the detected showed that male gender and winter season were independently associatedwith higher 3-epi-25(OH)D3/25(OH)D3percentage ratio (R2=0.044). Infants and children had a significantlyhigher detection rate compared to the reference age category (18–45 years) as well as those who were testedduring the summer season.

Conclusions: We report findings from the first epidemiologic study of 3-epi-25(OH)D3 conducted in Sweden, based on a large population sample. 3-epi-25(OH)D3 was detected in 7.7% of the study population and the mean concentration was 8.4 nmol/L. The quantification of 3-epi-25(OH)D3 would not significantly influence the clinical interpretation of vitamin D levels. Additional studies are needed to understand the metabolic pathway and the possible physiological functions of this metabolite.

Place, publisher, year, edition, pages
Amsterdam, Netherlands: Elsevier, 2018
Keywords
3-epi 25(OH)D(3), 25(OH)D(3), High Pressure Liquid Chromatography – Tandem Mass Spectrometry (HPLC – MS/MS), Vitamin D
National Category
Biomedical Laboratory Science/Technology
Identifiers
urn:nbn:se:oru:diva-64072 (URN)10.1016/j.cca.2018.01.002 (DOI)000425070000028 ()29305842 (PubMedID)
Note

Funding Agency:

Örebro University  ALF 2016:1 OLL-615521

Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-03-28Bibliographically approved
Särnblad, S., Lidskog, M., Walfridsson, H., Hjelmqvist, H. & Duberg, A.-S. (2018). Will Early Clinical Training improve the professional skills?: Experience from a New Medical Education in Sweden. In: : . Paper presented at AMEE (An International Association for Medical Education), Basel, Switzerland, 25-29 August, 2018.
Open this publication in new window or tab >>Will Early Clinical Training improve the professional skills?: Experience from a New Medical Education in Sweden
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: The undergraduate medical education in Sweden is 5½ years long (11 semesters), followed by an 18 months internship before license. The university curriculum used to be 6 theoretical semesters followed by 5 “clinical” semesters. Today it is common with integrated curricula with an early introduction of clinical training.

Method: School of Medicine at Örebro University started in January 2011 and now admits 70 students every semester. The first students graduated in June 2016. The educational approach is problem-based learning and the curriculum is integrated with six themes based on physiological processes. Biomedicine, clinical medicine and professional development are integrated throughout the entire programme.

Results: In total, clinical placement constitutes 74 weeks of which 16 weeks are spread through the first six semesters. The remaining 58 weeks (semester 7-11) are divided into six longer periods related to the themes. The objective of clinical placement during the first 6 semesters is to practice general clinical skills like communication, history-taking and clinical examination, but also to understand the health care system and the tasks of other health care personnel. The clinical placement in semester 6 ends with a seminar for reflection around the professional development and the value of early clinical placement. The students appreciate the early clinical placements. They manage to acquire general professional skills at this early stage and have the possibility to reflect upon their choice of profession. This stimulates theoretical studies and makes them more comfortable when entering the long clinical placements related to the themes. This is beneficial also for the clinical tutors. The first Örebro students that graduated were satisfied with the preparation given “to work as doctors” and gave the University the highest rank in a national survey.

Conclusion: Early clinical training is beneficial for the development of professional skills; it motivates and gives the student an early understanding of their future professional role. A challenge may be to find enough placements and the need for coaching adjusted for different stages of professional development.

Take-home message: Early clinical training is beneficial for the development of professional skills.

National Category
Pedagogy
Identifiers
urn:nbn:se:oru:diva-67486 (URN)
Conference
AMEE (An International Association for Medical Education), Basel, Switzerland, 25-29 August, 2018
Available from: 2018-06-25 Created: 2018-06-25 Last updated: 2018-08-31Bibliographically approved
Särnblad, S., Ponsot, E. & Kadi, F. (2017). Acute effects on glycemia of different types of exercise in youths with type 1 diabetes. In: : . Paper presented at ISPAD 2017, Innsbruck, Austria, October 18-21, 2017.
Open this publication in new window or tab >>Acute effects on glycemia of different types of exercise in youths with type 1 diabetes
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:oru:diva-61856 (URN)
Conference
ISPAD 2017, Innsbruck, Austria, October 18-21, 2017
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-11-01Bibliographically approved
Karefylakis, C., Petterson Pablo, P., Särnblad, S., Rask, E. & Eriksson, C.-G. (2017). D-vitamin C3-epimer. Metodbeskrivning och epidemiologisk studie i en mellansvensk region.. In: : . Paper presented at Endokrindagarna 2017, Uppsala, Sweden, 1-3 februari, 2017.
Open this publication in new window or tab >>D-vitamin C3-epimer. Metodbeskrivning och epidemiologisk studie i en mellansvensk region.
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2017 (Swedish)Conference paper, Poster (with or without abstract) (Refereed)
Keywords
D-vitamin
National Category
Medical and Health Sciences Endocrinology and Diabetes
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-54020 (URN)
Conference
Endokrindagarna 2017, Uppsala, Sweden, 1-3 februari, 2017
Available from: 2016-12-16 Created: 2016-12-16 Last updated: 2018-09-03Bibliographically approved
Särnblad, S., Åkesson, K., Fernström, L., Ilvered, R. & Forsander, G. (2017). Improved diabetes management in Swedish schools: results from two national surveys. Pediatric Diabetes, 8(6), 463-469
Open this publication in new window or tab >>Improved diabetes management in Swedish schools: results from two national surveys
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2017 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 8, no 6, p. 463-469Article in journal (Refereed) Published
Abstract [en]

Background: Support in diabetes self-care in school is essential to achieve optimal school performance and metabolic control. Swedish legislation regulating support to children with chronic diseases was strengthened 2009.

Objective: To compare the results of a national survey conducted 2008 and 2015 measuring parents' and diabetes specialist teams' perceptions of support in school.

Method: All pediatric diabetes centers in Sweden were invited to participate in the 2015 study. In each center, families with a child being treated for T1DM and attending preschool class or compulsory school were eligible. The parents' and the diabetes teams' opinions were collected in two separate questionnaires.

Results: Forty-one out of 42 eligible diabetes centers participated and 568 parents answered the parental questionnaire in 2015. Metabolic control had improved since the 2008 survey (55.2 ± 10.6 mmol/mol, 7.2% ± 1.0%, in 2015 compared with 61.8 ± 12.4 mmol/mol, 7.8% ± 1.1% in 2008). The proportion of children with a designated staff member responsible for supporting the child's self-care increased from 43% to 59%, (P < .01). An action plan to treat hypoglycemia was present for 65% of the children in 2015 compared with 55% in 2008 (P < .01). More parents were satisfied with the support in 2015 (65% compared with 55%, P < .01).

Conclusions: This study shows that staff support has increased and that more parents were satisfied with the support for self-care in school in 2015 compared with 2008. More efforts are needed to implement the national legislation to achieve equal support in all Swedish schools.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2017
Keywords
adolescent; child; diabetes mellitus; type 1; schools; self-care
National Category
Pediatrics Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-51472 (URN)10.1111/pedi.12418 (DOI)000406631200008 ()27470982 (PubMedID)2-s2.0-84994417353 (Scopus ID)
Funder
Novo Nordisk
Available from: 2016-08-03 Created: 2016-08-02 Last updated: 2018-07-24Bibliographically approved
Bixo Ottosson, A., Åkesson, K., Ilvered, R., Forsander, G. & Särnblad, S. (2017). Self-care management of type 1 diabetes has improved in Swedish schools according to children and adolescents. Acta Paediatrica, 106(12), 1987-1993
Open this publication in new window or tab >>Self-care management of type 1 diabetes has improved in Swedish schools according to children and adolescents
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2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 12, p. 1987-1993Article in journal (Refereed) Published
Abstract [en]

Aim: Age-appropriate support for diabetes self-care is essential during school time, and we investigated the perceived quality of support children and adolescents received in 2015 and 2008.

Methods: This national study was based on questionnaires answered by children and adolescents aged 6-15 years of age with type 1 diabetes attending schools or preschools in 2008 (n = 317) and 2015 (n = 570) and separate parental questionnaires. The subjects were recruited by Swedish paediatric diabetes units, with 41/44 taking part in 2008 and 41/42 in 2015.

Results: Fewer participants said they were treated differently in school because of their diabetes in 2015 than 2008. The opportunity to perform insulin boluses and glucose monitoring in privacy increased (80% versus 88%; p < 0.05). Most (83%) adolescents aged 13-15 years were satisfied with the support they received, but levels were lower in girls (p < 0.05). More subjects had hypoglycaemia during school hours (84% versus 70%, p < 0.001), but hypoglycaemia support did not increase and was lower for adolescents than younger children (p < 0.001).

Conclusion: Children and adolescents received more support for type 1 diabetes in Swedish schools in 2015 than 2008, but more support is needed by girls and during hypoglycaemia.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Hypoglycaemia, Schools, Questionnaires, Self-care, Type 1 diabetes
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-59430 (URN)10.1111/apa.13949 (DOI)000414913500018 ()28608928 (PubMedID)2-s2.0-85021820368 (Scopus ID)
Available from: 2017-08-31 Created: 2017-08-31 Last updated: 2018-08-05Bibliographically approved
Pundziute Lyckå, A., Hanberger, L., Särnblad, S., Åkesson, K. & Samuelsson, U. (2016). BMI change during the course of type 1 diabetes is modified by the level of diabetes control: data from the Swedish national quality register SWEDIABKIDS. In: ISPAD 2016: . Paper presented at ISPAD 2016, Valencia, Spain, October 26-19, 2016.
Open this publication in new window or tab >>BMI change during the course of type 1 diabetes is modified by the level of diabetes control: data from the Swedish national quality register SWEDIABKIDS
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2016 (English)In: ISPAD 2016, 2016Conference paper, Poster (with or without abstract) (Refereed)
Keywords
Diabetes
National Category
Medical and Health Sciences
Research subject
Pediatrics
Identifiers
urn:nbn:se:oru:diva-52260 (URN)
Conference
ISPAD 2016, Valencia, Spain, October 26-19, 2016
Available from: 2016-09-15 Created: 2016-09-15 Last updated: 2017-10-17Bibliographically approved
Särnblad, S., Magnusson, A., Ekelund, U. & Jan, Å. (2016). Body fat measurement in adolescent girls with type 1 diabetes: a comparison of skinfold equations against dual energy X-ray absorptiometry. Acta Paediatrica, 105(10), 1211-1215
Open this publication in new window or tab >>Body fat measurement in adolescent girls with type 1 diabetes: a comparison of skinfold equations against dual energy X-ray absorptiometry
2016 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 10, p. 1211-1215Article in journal (Refereed) Published
Abstract [en]

Aim: Skinfold measurement is an inexpensive and widely used technique for assessing the percentage of body fat (%BF). This study assessed the accuracy of prediction equations for %BF based on skinfold measurements compared to dual-energy X-ray absorptiometry (DXA) in girls with type 1 diabetes and healthy age-matched controls.

Methods: We included 49 healthy girls and 44 girls with diabetes aged 12 to 19 years old, comparing the predicted %BF based on skinfold measurements and the %BF values obtained by a Lunar DPX-L scanner. The agreement between the methods was assessed by using an Bland-Altman plot.

Results: The skinfold measurements were significantly higher in girls with diabetes (p=0.003) despite a non-significant difference in total %BF (p=0.1). A significant association between bias and %BF was found for all tested equations in the Bland-Altman plots. Regression analysis showed that the association between skinfold measurements and %BF measured by DXA differed significantly (p=0.039) between the girls with diabetes and the healthy controls.

Conclusion: The accuracy of skinfold thickness equations for assessment of %BF in adolescent girls with diabetes is poor in comparison with DXA measurements as criteron. Our findings highlight the need for the development of new prediction equations for girls with type 1 diabetes.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
Adolescents, body composition, dual energy X-ray absorptiometry, skinfold measurements, type 1 diabetes
National Category
Pediatrics
Research subject
Pediatrics
Identifiers
urn:nbn:se:oru:diva-48969 (URN)10.1111/apa.13366 (DOI)000383619400030 ()26873351 (PubMedID)2-s2.0-84963533900 (Scopus ID)
Note

Funding Agencies:

Research Committee of Örebro County Council

Swedish Child Diabetes Foundation (Barndiabetes fonden)

MRC Epidemiology Unit, University of Cambridge, Cambridge, UK MC_UU_12015/3

Available from: 2016-03-04 Created: 2016-03-04 Last updated: 2018-07-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1440-9961

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