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Article ; Online: Vitamins C, E, and β-Carotene and Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis.

Lampousi, Anna-Maria / Lundberg, Therese / Löfvenborg, Josefin E / Carlsson, Sofia

2024 Volume 15, Issue 5, Page(s) 100211

Abstract: ... dietary antioxidants vitamin C, vitamin E, and β-carotene and type 2 diabetes (T2D) and related traits ... of vitamin E (RR: 0.72; CI: 0.61, 0.86), and 4 mg/d of β-carotene (RR: 0.78; CI: 0.65, 0.94). Supplementation ... with vitamin E (RR: 1.01; CI: 0.93, 1.10) or β-carotene (RR: 0.98; CI: 0.90, 1.07) did not have ...

Abstract	A systematic review and meta-analysis was conducted to assess the relationship between the common dietary antioxidants vitamin C, vitamin E, and β-carotene and type 2 diabetes (T2D) and related traits. MEDLINE, Embase, and the Cochrane Library were searched for relevant publications up until May 2023. Studies were eligible if they had a cohort, case-control, or randomized controlled trial (RCT) design and examined dietary intake, supplementation, or circulating levels of these antioxidants as exposure, and insulin resistance, β-cell function, or T2D incidence as outcomes. Summary relative risks (RR) or mean differences (MD) with 95% confidence intervals (CI) were estimated using random-effects models. The certainty of the evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluations framework. Among 6190 screened records, 25 prospective observational studies and 15 RCTs were eligible. Inverse associations were found between dietary and circulating antioxidants and T2D (observational studies). The lowest risk was seen at intakes of 70 mg/d of vitamin C (RR: 0.76; CI: 0.61, 0.95), 12 mg/d of vitamin E (RR: 0.72; CI: 0.61, 0.86), and 4 mg/d of β-carotene (RR: 0.78; CI: 0.65, 0.94). Supplementation with vitamin E (RR: 1.01; CI: 0.93, 1.10) or β-carotene (RR: 0.98; CI: 0.90, 1.07) did not have a protective effect on T2D (RCTs), and data on vitamin C supplementation was limited. Regarding insulin resistance, higher dietary vitamin C (RR: 0.85; CI: 0.74, 0.98) and vitamin E supplementation (MD: -0.35; CI: -0.65, -0.06) were associated with a reduced risk. The certainty of evidence was high for the associations between T2D and dietary vitamin E and β-carotene, and low to moderate for other associations. In conclusion, moderate intakes of vitamins C, E, and β-carotene may lower risk of T2D by reducing insulin resistance. Lack of protection with supplementation in RCTs suggests that adequate rather than high intakes may play a role in T2D prevention. This systematic review and meta-analysis was registered in PROSPERO with registration number CRD42022343482.
Language	English
Publishing date	2024-03-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2583634-1
ISSN	2156-5376 ; 2156-5376
ISSN (online)	2156-5376
ISSN	2156-5376
DOI	10.1016/j.advnut.2024.100211
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Article ; Online: Correction: Lung cancer prediction using machine learning on data from a symptom e-questionnaire for never smokers, formers smokers and current smokers.

Nemlander, Elinor / Rosenblad, Andreas / Abedi, Eliya / Ekman, Simon / Hasselström, Jan / Eriksson, Lars E / Carlsson, Axel C

PloS one

2023 Volume 18, Issue 12, Page(s) e0295780

Abstract: This corrects the article DOI: 10.1371/journal.pone.0276703.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0276703.].
Language	English
Publishing date	2023-12-07
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0295780
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Article ; Online: Plasma apolipoprotein E levels in longitudinally followed patients with mild cognitive impairment and Alzheimer's disease.

Giannisis, Andreas / Al-Grety, Asma / Carlsson, Henrik / Patra, Kalicharan / Twohig, Daniel / Sando, Sigrid Botne / Lauridsen, Camilla / Berge, Guro / Grøntvedt, Gøril Rolfseng / Bråthen, Geir / White, Linda R / Kultima, Kim / Nielsen, Henrietta M

Alzheimer's research & therapy

2022 Volume 14, Issue 1, Page(s) 115

Abstract: Background: Low levels of plasma apolipoprotein E (apoE) and presence of the APOE ε4 allele are ...

Abstract	Background: Low levels of plasma apolipoprotein E (apoE) and presence of the APOE ε4 allele are associated with an increased risk of Alzheimer's disease (AD). Although the increased risk of AD in APOE ε4-carriers is well-established, the protein levels have received limited attention. Methods: We here report the total plasma apoE and apoE isoform levels at baseline from a longitudinally (24 months) followed cohort including controls (n = 39), patients with stable amnestic mild cognitive impairment during 24 months follow up (MCI-MCI, n = 30), patients with amnestic MCI (aMCI) that during follow-up were clinically diagnosed with AD with dementia (ADD) (MCI-ADD, n = 28), and patients with AD with dementia (ADD) at baseline (ADD, n = 28). We furthermore assessed associations between plasma apoE levels with cerebrospinal fluid (CSF) AD biomarkers and α-synuclein, as well as both CSF and plasma neurofilament light chain (NfL), YKL-40 and kallikrein 6. Results: Irrespective of clinical diagnosis, the highest versus the lowest apoE levels were found in APOE ε2/ε3 versus APOE ε4/ε4 subjects, with the most prominent differences exhibited in females. Total plasma apoE levels were 32% and 21% higher in the controls versus MCI-ADD and ADD patients, respectively. Interestingly, MCI-ADD patients exhibited a 30% reduction in plasma apoE compared to MCI-MCI patients. This decrease appeared to be associated with brain amyloid-β (Aβ Conclusions: Our results demonstrate important associations between low plasma apoE levels, Aβ pathology, and progression from aMCI to a clinical ADD diagnosis.
MeSH term(s)	Alzheimer Disease/cerebrospinal fluid ; Alzheimer Disease/diagnosis ; Amyloid beta-Peptides/cerebrospinal fluid ; Apolipoprotein E3/cerebrospinal fluid ; Apolipoprotein E3/genetics ; Apolipoprotein E4/cerebrospinal fluid ; Apolipoprotein E4/genetics ; Apolipoproteins E/cerebrospinal fluid ; Apolipoproteins E/genetics ; Biomarkers/cerebrospinal fluid ; Cognitive Dysfunction/cerebrospinal fluid ; Cognitive Dysfunction/diagnosis ; Female ; Humans ; Kallikreins ; Peptide Fragments/cerebrospinal fluid ; alpha-Synuclein ; tau Proteins/cerebrospinal fluid
Chemical Substances	Amyloid beta-Peptides ; Apolipoprotein E3 ; Apolipoprotein E4 ; Apolipoproteins E ; Biomarkers ; Peptide Fragments ; alpha-Synuclein ; tau Proteins ; Kallikreins (EC 3.4.21.-)
Language	English
Publishing date	2022-08-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2506521-X
ISSN	1758-9193 ; 1758-9193
ISSN (online)	1758-9193
ISSN	1758-9193
DOI	10.1186/s13195-022-01058-9
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Article ; Online: Correction: Plasma apolipoprotein E levels, isoform composition, and dimer profile in relation to plasma lipids in racially diverse patients with Alzheimer's disease and mild cognitive impairment.

Giannisis, Andreas / Al-Grety, Asma / Carlsson, Henrik / Howell, Jennifer C / Hu, William T / Kultima, Kim / Nielsen, Henrietta M

Alzheimer's research & therapy

2023 Volume 15, Issue 1, Page(s) 160

Language	English
Publishing date	2023-09-27
Publishing country	England
Document type	Published Erratum
ZDB-ID	2506521-X
ISSN	1758-9193 ; 1758-9193
ISSN (online)	1758-9193
ISSN	1758-9193
DOI	10.1186/s13195-023-01306-6
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Article ; Online: Plasma apolipoprotein E levels, isoform composition, and dimer profile in relation to plasma lipids in racially diverse patients with Alzheimer's disease and mild cognitive impairment.

Giannisis, Andreas / Al-Grety, Asma / Carlsson, Henrik / Howell, Jennifer C / Hu, William T / Kultima, Kim / Nielsen, Henrietta M

Alzheimer's research & therapy

2023 Volume 15, Issue 1, Page(s) 119

Abstract: ... apolipoprotein E (apoE) levels in NHW APOEε4-carriers compared to non-carriers, and low plasma apoE levels were ...

Abstract	Background: The APOEε4-promoted risk of Alzheimer's disease (AD) is lower in Black/African-Americans (B/AAs), compared to non-Hispanic whites (NHWs). Previous studies reported lower plasma apolipoprotein E (apoE) levels in NHW APOEε4-carriers compared to non-carriers, and low plasma apoE levels were directly associated with an increased risk of AD and all dementia. We further showed that APOEε3/ε3 AD patients exhibited reduced plasma apoE dimers compared to corresponding control subjects. Whether plasma apoE levels and apoE dimer formation differ between races/ethnicities and therefore may help explain AD risk racial disparity remains to be elucidated. Methods: Using mass spectrometry, we determined total plasma apoE and apoE isoform levels in a cohort of B/AAs (n = 58) and NHWs (n = 67) including subjects with normal cognition (B/AA: n = 25, NHW: n = 28), mild cognitive impairment (MCI) (B/AA: n = 24, NHW: n = 24), or AD dementia (B/AA: n = 9, NHW: n = 15). Additionally, we used non-reducing western blot analysis to assess the distribution of plasma apoE into monomers/disulfide-linked dimers. Plasma total apoE, apoE isoform levels, and % apoE monomers/dimers were assessed for correlations with cognition, cerebrospinal fluid (CSF) AD biomarkers, sTREM2, neurofilament light protein (NfL), and plasma lipids. Results: Plasma apoE was predominantly monomeric in both racial groups and the monomer/dimer distribution was not affected by disease status, or correlated with CSF AD biomarkers, but associated with plasma lipids. Plasma total apoE levels were not related to disease status and only in the NHW subjects we observed lower plasma apoE levels in the APOEε4/ε4-carriers. Total plasma apoE levels were 13% higher in B/AA compared to NHW APOEε4/ε4 subjects and associated with plasma high-density lipoprotein (HDL) in NHW subjects but with low-density lipoprotein levels (LDL) in the B/AA subjects. Higher plasma apoE4 levels, exclusively in APOEε3/ε4 B/AA subjects, were linked to higher plasma total cholesterol and LDL levels. In the controls, NHWs and B/AAs exhibited opposite associations between plasma apoE and CSF t-tau. Conclusions: The previously reported lower APOEε4-promoted risk of AD in B/AA subjects may be associated with differences in plasma apoE levels and lipoprotein association. Whether differences in plasma apoE levels between races/ethnicities result from altered APOEε4 expression or turnover, needs further elucidation.
MeSH term(s)	Humans ; Alzheimer Disease/cerebrospinal fluid ; Amyloid beta-Peptides/cerebrospinal fluid ; Apolipoprotein E4/cerebrospinal fluid ; Apolipoproteins E/genetics ; Biomarkers/cerebrospinal fluid ; Cognitive Dysfunction/cerebrospinal fluid ; Neurofilament Proteins ; Protein Isoforms ; tau Proteins/cerebrospinal fluid ; Black or African American ; White
Chemical Substances	Amyloid beta-Peptides ; Apolipoprotein E4 ; Apolipoproteins E ; Biomarkers ; Neurofilament Proteins ; Protein Isoforms ; tau Proteins
Language	English
Publishing date	2023-07-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2506521-X
ISSN	1758-9193 ; 1758-9193
ISSN (online)	1758-9193
ISSN	1758-9193
DOI	10.1186/s13195-023-01262-1
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Article ; Online: Lung cancer prediction using machine learning on data from a symptom e-questionnaire for never smokers, formers smokers and current smokers.

Nemlander, Elinor / Rosenblad, Andreas / Abedi, Eliya / Ekman, Simon / Hasselström, Jan / Eriksson, Lars E / Carlsson, Axel C

PloS one

2022 Volume 17, Issue 10, Page(s) e0276703

Abstract: ... of symptoms reported in an adaptive e-questionnaire, separately for never smokers, former smokers, and current ... 194). All participants answered an adaptive e-questionnaire with a maximum of 342 items, covering ...

Abstract	Purpose: The aim of the present study was to investigate the predictive ability for lung cancer of symptoms reported in an adaptive e-questionnaire, separately for never smokers, former smokers, and current smokers. Patients and methods: Consecutive patients referred for suspected lung cancer were recruited between September 2014 and November 2015 from the lung clinic at the Karolinska University Hospital, Stockholm, Sweden. A total of 504 patients were later diagnosed with lung cancer (n = 310) or no cancer (n = 194). All participants answered an adaptive e-questionnaire with a maximum of 342 items, covering background variables and symptoms/sensations suspected to be associated with lung cancer. Stochastic gradient boosting, stratified on smoking status, was used to train and test a model for predicting the presence of lung cancer. Results: Among never smokers, 17 predictors contributed to predicting lung cancer with 82% of the patients being correctly classified, compared with 26 predictors with an accuracy of 77% among current smokers and 36 predictors with an accuracy of 63% among former smokers. Age, sex, and education level were the most important predictors in all models. Conclusion: Methods or tools to assess the likelihood of lung cancer based on smoking status and to prioritize investigative and treatment measures among all patients seeking care with diffuse symptoms are much needed. Our study presents risk assessment models for patients with different smoking status that may be developed into clinical risk assessment tools that can help clinicians in assessing a patient's risk of having lung cancer.
MeSH term(s)	Humans ; Smokers ; Smoking/adverse effects ; Lung Neoplasms/diagnosis ; Lung Neoplasms/epidemiology ; Lung Neoplasms/etiology ; Surveys and Questionnaires ; Machine Learning
Language	English
Publishing date	2022-10-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0276703
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Article ; Online: Parents' experiences of an e-health intervention implemented in pediatric healthcare: a qualitative study.

Larsson, Ingrid / Svedberg, Petra / Arvidsson, Susann / Nygren, Jens M / Carlsson, Ing-Marie

BMC health services research

2019 Volume 19, Issue 1, Page(s) 800

Abstract: ... on parents' ability to communicate and include children. E-health solutions can remove barriers to children's ... communication with healthcare professionals. The aim of this study was to explore parents' perspectives on the outcomes of an e ...

Abstract	Background: The growing field of participation in healthcare has the potential to provide a number of benefits for children, patients, healthcare professionals and also the healthcare systems. According to the Convention on the Rights of the Child (UNCRC), children have the right to participate in their own healthcare and make their voice heard. Children's opportunities for understanding their conditions, sharing their views and participating in decisions regarding their care depend on healthcare professionals but also on parents' ability to communicate and include children. E-health solutions can remove barriers to children's communication with healthcare professionals. The aim of this study was to explore parents' perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments. Methods: The empirical data is based on interviews with 16 parents. In the present study constructivist, grounded theory was chosen as the method. Results: The theory of enhancing participation, by orientating communication about healthcare towards the voice of the child instead of the parents, summarizes the process of how the outcome of Sisom for children lead to enhanced participation, by making the child the main actor and an agent in his/her own healthcare. The facilitators for achieving participation in Sisom were four interrelated outcomes; engaging, voice-guarding, raising awareness and integrity preserving. In addition to generating increased participation, it emerged that the use of Sisom also initiated a process, which was evident in all four subcategories that facilitated the child in coping with the experience of having an illness. Conclusions: We conclude, that Sisom orientated communication about healthcare towards the voice of the child instead of the parents as well as including the child in the dialogue with the healthcare professional and thus increasing the child's participation and human rights.
MeSH term(s)	Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Outcome Assessment, Health Care ; Parents/psychology ; Pediatrics/organization & administration ; Qualitative Research ; Telemedicine/organization & administration
Language	English
Publishing date	2019-11-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-019-4643-7
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Article: Population structure and phylogeography of Elymus mutabilis and its genetic relationships with E. transbaicalensis (Poaceae)

Leo, Jonatan / Bengtsson, Therése / Carlsson, Anders S. / Brassac, Jonathan / von Bothmer, Roland

Nordic journal of botany. 2022 Apr., v. 2022, no. 4

2022

Abstract: ... habitats and is considered closely related to E. mutabilis and sometimes even referred to as a subspecies ... to establish whether E. mutabilis and E. transbaicalensis can be considered as two distinct species ... structure of E. mutabilis and E. transbaicalensis using genotyping‐by‐sequencing (GBS). In total 68 ...

Abstract	Elymus mutabilis is a morphologically diverse species in the Poaceae family growing in Eurasia from northern Europe to far east Russia and southwards to central Asia. Elymus transbaicalensis occurs in similar habitats and is considered closely related to E. mutabilis and sometimes even referred to as a subspecies or synonym. Based on high similarity in morphology and habitat, molecular studies are needed to establish whether E. mutabilis and E. transbaicalensis can be considered as two distinct species. Thus, the objective of this study was to study diversity, relationships among populations and the phylogeographical structure of E. mutabilis and E. transbaicalensis using genotyping‐by‐sequencing (GBS). In total 68 individuals of E. mutabilis were sampled from 18 populations collected from northern Europe, central Asia and far east Russia, representing the central and two peripheral parts of the natural distribution of the species. The results reveal a clear distinction between E. mutabilis and E. transbaicalensis and no introgression. The phylogeographic structure of E. mutabilis follows the geographical distribution of the species. Populations from northern Europe, southern Siberia and far east Russia together form a clade separated from the peripheral populations in central Asia, indicating a common ancestry of the latter. Phylogenetic analyses revealed a radiation pattern among populations in northern Europe indicating a founding followed by rapid dispersal.
Keywords	Elymus mutabilis ; Elymus transbaicalensis ; Siberia ; ancestry ; botany ; genotyping by sequencing ; geographical distribution ; habitats ; introgression ; phylogeny ; phylogeography ; population structure ; Central Asia ; Eurasia ; Northern European region
Language	English
Dates of publication	2022-04
Publishing place	Blackwell Publishing Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	2406507-9
ISSN	1756-1051 ; 0107-055X
ISSN (online)	1756-1051
ISSN	0107-055X
DOI	10.1111/njb.03520
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Parents’ experiences of an e-health intervention implemented in pediatric healthcare

Ingrid Larsson / Petra Svedberg / Susann Arvidsson / Jens M. Nygren / Ing-Marie Carlsson

BMC Health Services Research, Vol 19, Iss 1, Pp 1-

a qualitative study

2019 Volume 9

Abstract: ... but also on parents’ ability to communicate and include children. E-health solutions can remove barriers ... perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments ...

Abstract	Abstract Background The growing field of participation in healthcare has the potential to provide a number of benefits for children, patients, healthcare professionals and also the healthcare systems. According to the Convention on the Rights of the Child (UNCRC), children have the right to participate in their own healthcare and make their voice heard. Children’s opportunities for understanding their conditions, sharing their views and participating in decisions regarding their care depend on healthcare professionals but also on parents’ ability to communicate and include children. E-health solutions can remove barriers to children’s communication with healthcare professionals. The aim of this study was to explore parents’ perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments. Methods The empirical data is based on interviews with 16 parents. In the present study constructivist, grounded theory was chosen as the method. Results The theory of enhancing participation, by orientating communication about healthcare towards the voice of the child instead of the parents, summarizes the process of how the outcome of Sisom for children lead to enhanced participation, by making the child the main actor and an agent in his/her own healthcare. The facilitators for achieving participation in Sisom were four interrelated outcomes; engaging, voice-guarding, raising awareness and integrity preserving. In addition to generating increased participation, it emerged that the use of Sisom also initiated a process, which was evident in all four subcategories that facilitated the child in coping with the experience of having an illness. Conclusions We conclude, that Sisom orientated communication about healthcare towards the voice of the child instead of the parents as well as including the child in the dialogue with the healthcare professional and thus increasing the child’s participation and human rights.
Keywords	Children ; E-health intervention ; Grounded theory ; Parents ; Participation ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2019-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Measuring quality of life in life-threatening illness - content validity and response processes of MQOL-E and QOLLTI-F in Swedish patients and family carers.

Axelsson, Lena / Alvariza, Anette / Carlsson, Nina / Cohen, S Robin / Sawatzky, Richard / Årestedt, Kristofer

BMC palliative care

2020 Volume 19, Issue 1, Page(s) 40

Abstract: Background: The McGill Quality of Life Questionnaire - Expanded (MQOL-E) and the Quality of Life ... as companion instruments. Contemporary measurement validity theory places emphasis on response processes, i.e ... and examine content validity and response processes during completion of MQOL-E and QOLLTI-F version 2 ...

Abstract	Background: The McGill Quality of Life Questionnaire - Expanded (MQOL-E) and the Quality of Life in Life-Threatening Illness-Family Carer/Caregiver version (QOLLTI-F) are developed for use with patients facing the end of life and their family carers, respectively. They are also developed for possible use as companion instruments. Contemporary measurement validity theory places emphasis on response processes, i.e. what people feel and think when responding to items. Response processes may be affected when measurement instruments are translated and adapted for use in different cultures. The aim of this study was to translate and examine content validity and response processes during completion of MQOL-E and QOLLTI-F version 2 (v2) among Swedish patients with life-threatening illness and their family carers. Methods: The study was conducted in two stages (I) translation and adaptation (II) examination of content validity and response processes using cognitive interviews with 15 patients and 9 family carers. Participants were recruited from the hemodialysis unit, heart clinic, lung clinic and specialized palliative care of a Swedish county hospital. Patients had life-threatening illness such as advanced heart failure, advanced chronic obstructive pulmonary disease, end-stage kidney disease or advanced cancer. Patients were outpatients, inpatients or receiving home care. Results: Patients and family carers respectively believed that the items of the MQOL-E and QOLLTI-F v2 reflect relevant and important areas of their quality of life. Although some items needed more time for reflection, both instruments were considered easy to understand. Some changes were made to resolve issues of translation. Participants expressed that reflecting on their situation while answering questions was valuable and meaningful to them, and that responding was an opportunity to express feelings. Conclusions: The results of response processes pertaining to the Swedish translations of both MQOL-E and QOLLTI-F v2 contribute evidence regarding content validity, linguistic equivalence and cultural appropriateness of the translated instruments. In addition, results show that the instruments may support conversations on matters of importance for quality of life between patients and/or family carers and health care professionals. Further research is needed to study the psychometric properties of Swedish translations.
MeSH term(s)	Adult ; Caregivers/psychology ; Caregivers/statistics & numerical data ; Female ; Humans ; Interviews as Topic/methods ; Male ; Middle Aged ; Patients/psychology ; Patients/statistics & numerical data ; Psychometrics/instrumentation ; Psychometrics/methods ; Psychometrics/statistics & numerical data ; Quality of Life/psychology ; Reproducibility of Results ; Surveys and Questionnaires ; Sweden ; Translating
Language	English
Publishing date	2020-03-25
Publishing country	England
Document type	Journal Article
ISSN	1472-684X
ISSN (online)	1472-684X
DOI	10.1186/s12904-020-00549-6
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