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  1. Article ; Online: Legalizing altruistic surrogacy in response to evasive travel? An Icelandic proposal.

    Kristinsson, Sigurður

    Reproductive biomedicine & society online

    2017  Volume 3, Page(s) 109–119

    Abstract: Surrogate motherhood has been prohibited by Icelandic law since 1996, but in recent years, Icelandic couples have sought transnational surrogacy in India and the United States despite uncertainties about legal parental status as they return to Iceland ... ...

    Abstract Surrogate motherhood has been prohibited by Icelandic law since 1996, but in recent years, Icelandic couples have sought transnational surrogacy in India and the United States despite uncertainties about legal parental status as they return to Iceland with infants born to surrogate mothers. This reflects global trends of increased reproductive tourism, which forces restrictive regimes not only to make decisions concerning the citizenship and parentage of children born to surrogate mothers abroad, but also to confront difficult moral issues concerning surrogacy, global justice, human rights and exploitation. In March 2015, a legislative proposal permitting altruistic surrogacy, subject to strict regulation and oversight, and prohibiting the solicitation of commercial surrogacy abroad, was presented in the Icelandic Parliament. The proposal aims to protect the interest of the child first, respect the autonomy of the surrogate second, and accommodate the intended parents' wishes third. After a brief overview of the development of the surrogacy issue in Iceland, this article describes the main features of this legislative proposal and evaluates it from an ethical and global justice perspective. It concludes that the proposed legislation is a response to problems generated by cross-border surrogacy in the context of evolving public attitudes toward the issue, and constitutes a valid attempt to reduce the moral hazards of surrogacy consistent with insights from current bioethical literature. Although the proposed legislation arguably represents an improvement over the current ban, however, difficult problems concerning evasive travel and global injustice are likely to persist until effective international coordination is achieved.
    Language English
    Publishing date 2017-02-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2835432-1
    ISSN 2405-6618 ; 2405-6618
    ISSN (online) 2405-6618
    ISSN 2405-6618
    DOI 10.1016/j.rbms.2016.12.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Genetics in aphasia recovery.

    Kristinsson, Sigfus / Fridriksson, Julius

    Handbook of clinical neurology

    2021  Volume 185, Page(s) 283–296

    Abstract: Considerable research efforts have been exerted toward understanding the mechanisms underlying recovery in aphasia. However, predictive models of spontaneous and treatment-induced recovery remain imprecise. Some of the hitherto unexplained variability in ...

    Abstract Considerable research efforts have been exerted toward understanding the mechanisms underlying recovery in aphasia. However, predictive models of spontaneous and treatment-induced recovery remain imprecise. Some of the hitherto unexplained variability in recovery may be accounted for with genetic data. A few studies have examined the effects of the BDNF val66met polymorphism on aphasia recovery, yielding mixed results. Advances in the study of stroke genetics and genetics of stroke recovery, including identification of several susceptibility genes through candidate-gene or genome-wide association studies, may have implications for the recovery of language function. The current chapter discusses both the direct and indirect evidence for a genetic basis of aphasia recovery, the implications of recent findings within the field, and potential future directions to advance understanding of the genetics-recovery associations.
    MeSH term(s) Aphasia/genetics ; Genome-Wide Association Study ; Humans ; Language ; Recovery of Function/genetics ; Stroke/genetics
    Language English
    Publishing date 2021-12-01
    Publishing country Netherlands
    Document type Journal Article ; Review
    ISSN 0072-9752
    ISSN 0072-9752
    DOI 10.1016/B978-0-12-823384-9.00015-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Translation, adaptation and psychometric properties of the Icelandic stroke and aphasia quality of life scale-39g.

    Kristinsson, Sigfus / Halldorsdottir, Thorunn H

    Scandinavian journal of caring sciences

    2020  Volume 35, Issue 1, Page(s) 244–251

    Abstract: Background: The overarching aim of aphasia rehabilitation is to improve people's quality of life. The most commonly used quality of life measure developed for use with individuals with aphasia is the Stroke and Aphasia Quality of Life Scale-39 (SAQOL- ... ...

    Abstract Background: The overarching aim of aphasia rehabilitation is to improve people's quality of life. The most commonly used quality of life measure developed for use with individuals with aphasia is the Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39g).
    Aims: We aimed to translate and adapt the SAQOL-39g into Icelandic, and examine its psychometric properties. Furthermore, this study aimed to gather preliminary information on the health-related quality of life (HRQOL) of stroke patients in Iceland.
    Method: A traditional back-translation approach was applied to translate the SAQOL-39g into Icelandic. We recruited 20 poststroke patients, thereof ten with aphasia, for evaluation of the psychometric properties of the translated instrument. Acceptability was based on missing data, and floor and ceiling effects, internal consistency was measured by Cronbach's α and correlation between test items and overall score, and test-retest reliability was measured by intraclass correlation coefficient (ICC) for overall and domain scores.
    Results: The back-translation led to reviewing of eight test items for the final translation. No test items required cultural adaptation. The acceptability of the translation met criteria for both proportion of missing data (0%) and floor and ceiling effects for test items and domains (<80%). Internal consistency also met criteria, both for overall score (α = 0.94) and domains: physical domain (α = 0.93), psychosocial domain (α = 0.93) and communication domain (α = 0.89). Correlation between test items and overall score ranged from 0.30 to 0.82. Test-retest reliability met criteria both for overall score (0.95) and domains: physical domain (0.94), psychosocial domain (0.95), and communication domain (0.95). The mean total score was significantly lower for participants with aphasia compared to participants without aphasia (3.73 vs. 4.20; p < 05).
    Conclusions: The Icelandic SAQOL-39g demonstrated good psychometric properties. Preliminary evidence suggests that the HRQOL of people with aphasia is significantly worse than of people without aphasia after stroke.
    MeSH term(s) Aphasia ; Humans ; Iceland ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Stroke/complications ; Surveys and Questionnaires
    Language English
    Publishing date 2020-03-22
    Publishing country Sweden
    Document type Journal Article
    ZDB-ID 639217-9
    ISSN 1471-6712 ; 0283-9318
    ISSN (online) 1471-6712
    ISSN 0283-9318
    DOI 10.1111/scs.12840
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Dissociating reading and auditory comprehension in persons with aphasia.

    Harrington, Rachael M / Kristinsson, Sigfus / Wilmskoetter, Janina / Busby, Natalie / den Ouden, Dirk / Rorden, Chris / Fridriksson, Julius / Bonilha, Leonardo

    Brain communications

    2024  Volume 6, Issue 2, Page(s) fcae102

    Abstract: Language comprehension is often affected in individuals with post-stroke aphasia. However, deficits in auditory comprehension are not fully correlated with deficits in reading comprehension and the mechanisms underlying this dissociation remain unclear. ... ...

    Abstract Language comprehension is often affected in individuals with post-stroke aphasia. However, deficits in auditory comprehension are not fully correlated with deficits in reading comprehension and the mechanisms underlying this dissociation remain unclear. This distinction is important for understanding language mechanisms, predicting long-term impairments and future development of treatment interventions. Using comprehensive auditory and reading measures from a large cohort of individuals with aphasia, we evaluated the relationship between aphasia type and reading comprehension impairments, the relationship between auditory versus reading comprehension deficits and the crucial neuroanatomy supporting the dissociation between post-stroke reading and auditory deficits. Scores from the Western Aphasia Battery-Revised from 70 participants with aphasia after a left-hemisphere stroke were utilized to evaluate both reading and auditory comprehension of linguistically equivalent stimuli. Repeated-measures and univariate ANOVA were used to assess the relationship between auditory comprehension and aphasia types and correlations were employed to test the relationship between reading and auditory comprehension deficits. Lesion-symptom mapping was used to determine the dissociation of crucial brain structures supporting reading comprehension deficits controlling for auditory deficits and vice versa. Participants with Broca's or global aphasia had the worst performance on reading comprehension. Auditory comprehension explained 26% of the variance in reading comprehension for sentence completion and 44% for following sequential commands. Controlling for auditory comprehension, worse reading comprehension performance was independently associated with damage to the inferior temporal gyrus, fusiform gyrus, posterior inferior temporal gyrus, inferior occipital gyrus, lingual gyrus and posterior thalamic radiation. Auditory and reading comprehension are only partly correlated in aphasia. Reading is an integral part of daily life and directly associated with quality of life and functional outcomes. This study demonstrated that reading performance is directly related to lesioned areas in the boundaries between visual association regions and ventral stream language areas. This behavioural and neuroanatomical dissociation provides information about the neurobiology of language and mechanisms for potential future treatment interventions.
    Language English
    Publishing date 2024-03-25
    Publishing country England
    Document type Journal Article
    ISSN 2632-1297
    ISSN (online) 2632-1297
    DOI 10.1093/braincomms/fcae102
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Review of penile reconstructive techniques.

    Kristinsson, Sverrir / Johnson, Mark / Ralph, David

    International journal of impotence research

    2020  Volume 33, Issue 3, Page(s) 243–250

    Abstract: Reconstructive surgery of the penis holds many unique challenges due to the unique physiological properties of the tissues. Much of the effort involved therefore goes to preserving as much of the native tissue as possible whilst novel and creative ... ...

    Abstract Reconstructive surgery of the penis holds many unique challenges due to the unique physiological properties of the tissues. Much of the effort involved therefore goes to preserving as much of the native tissue as possible whilst novel and creative methods have been adopted to repair defects and in creation of neophallus. A search of the PubMed database was carried out using the following keywords: 'penile trauma', 'penile cancer', 'lichen sclerosus', 'glansectomy', 'glans resurfacing', 'penile-sparing surgery', 'micropenis', 'aphallia', 'female-to-male sex reassignment surgery', 'scrotal flap' and 'genital lymphoedema'. Results for glans resurfacing in treating cancer showed low local recurrence rates at 0-10% whilst 90% of lichen sclerosus patients reported complete resolutions of pain and pruritis. For repairs of penile shaft skin defects the literature supports the use of full-thickness skin graft and pedicled scrotal flaps. The radial artery-based forearm free flap remains the best option for neophallus creation in terms of function, sensation and cosmesis but unfortunately leaves a disfiguring scar and involves multiple stages. Some novel techniques have been developed to circumvent these issues and are discussed. This article presents an update on the important developments in the field of penile reconstructive surgery.
    MeSH term(s) Female ; Humans ; Male ; Penile Diseases/surgery ; Penis/surgery ; Scrotum/surgery ; Sex Reassignment Surgery
    Language English
    Publishing date 2020-03-09
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1034295-3
    ISSN 1476-5489 ; 0955-9930
    ISSN (online) 1476-5489
    ISSN 0955-9930
    DOI 10.1038/s41443-020-0246-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The Belmont Report's Misleading Conception of Autonomy.

    Kristinsson, Sigurdur

    The virtual mentor : VM

    2009  Volume 11, Issue 8, Page(s) 611–616

    Language English
    Publishing date 2009
    Publishing country United States
    Document type Journal Article
    ISSN 1937-7010
    ISSN (online) 1937-7010
    DOI 10.1001/virtualmentor.2009.11.8.jdsc1-0908
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: How we adapted the T&O inpatient service during the COVID-19 pandemic with physician associates to support the orthopaedic team.

    Tucker, Roz / Kristinsson, Sverrir / Benny, Divya / Khan, Zainab / Oni, Tofunmi / Smith, Andrew

    Future healthcare journal

    2021  Volume 8, Issue 2, Page(s) e288–e292

    Abstract: Introduction: In March 2020, due to the COVID-19 pandemic, there were increasing demands on medical and intensive care departments in the UK. Medical staff from surgical departments were redeployed. The aim of this study was to determine whether the ... ...

    Abstract Introduction: In March 2020, due to the COVID-19 pandemic, there were increasing demands on medical and intensive care departments in the UK. Medical staff from surgical departments were redeployed. The aim of this study was to determine whether the department was able to maintain standards with the use of the physician associate / medical doctor (PA/MD) model of care.
    Methods: A mix of questionnaires and audit data was collected prospectively and compared with pre-COVID and the general surgical team which did not have PAs.
    Results: Sixty-five per cent of responses indicated an improvement compared with pre-COVID conditions and 35% indicated care was the same. The electronic discharge notification audit showed an 89% completion rate for orthopaedics compared with 73% for general surgery. Venous thromboembolism assessment compliance was better compared with general surgery.
    Conclusion: Overall, the study supports the hypothesis that a PA/MD model of care is non-inferior to a MD-only model of care and was effective.
    Language English
    Publishing date 2021-07-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 3016427-8
    ISSN 2514-6653 ; 2514-6645
    ISSN (online) 2514-6653
    ISSN 2514-6645
    DOI 10.7861/fhj.2020-0206
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Autonomy and informed consent: a mistaken association?

    Kristinsson, Sigurdur

    Medicine, health care, and philosophy

    2007  Volume 10, Issue 3, Page(s) 253–264

    Abstract: For decades, the greater part of efforts to improve regulatory frameworks for research ethics has focused on informed consent procedures; their design, codification and regulation. Why is informed consent thought to be so important? Since the publication ...

    Abstract For decades, the greater part of efforts to improve regulatory frameworks for research ethics has focused on informed consent procedures; their design, codification and regulation. Why is informed consent thought to be so important? Since the publication of the Belmont Report in 1979, the standard response has been that obtaining informed consent is a way of treating individuals as autonomous agents. Despite its political success, the philosophical validity of this Belmont view cannot be taken for granted. If the Belmont view is to be based on a conception of autonomy that generates moral justification, it will either have to be reinterpreted along Kantian lines or coupled with a something like Mill's conception of individuality. The Kantian interpretation would be a radical reinterpretation of the Belmont view, while the Millian justification is incompatible with the liberal requirement that justification for public policy should be neutral between controversial conceptions of the good. This consequence might be avoided by replacing Mill's conception of individuality with a procedural conception of autonomy, but I argue that the resulting view would in fact fail to support a non-Kantian, autonomy-based justification of informed consent. These difficulties suggest that insofar as informed consent is justified by respect for persons and considerations of autonomy, as the Belmont report maintained, the justification should be along the lines of Kantian autonomy and not individual autonomy.
    MeSH term(s) Bioethical Issues ; Choice Behavior/ethics ; Ethical Theory ; Humans ; Informed Consent/ethics ; Informed Consent/standards ; Moral Obligations ; Personal Autonomy ; Philosophy, Medical
    Language English
    Publishing date 2007-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1440052-2
    ISSN 1386-7423
    ISSN 1386-7423
    DOI 10.1007/s11019-007-9048-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article: Predictors of Therapy Response in Chronic Aphasia: Building a Foundation for Personalized Aphasia Therapy.

    Kristinsson, Sigfus / den Ouden, Dirk B / Rorden, Chris / Newman-Norlund, Roger / Neils-Strunjas, Jean / Fridriksson, Julius

    Journal of stroke

    2022  Volume 24, Issue 2, Page(s) 189–206

    Abstract: Chronic aphasia, a devastating impairment of language, affects up to a third of stroke survivors. Speech and language therapy has consistently been shown to improve language function in prior clinical trials, but few clinicially applicable predictors of ... ...

    Abstract Chronic aphasia, a devastating impairment of language, affects up to a third of stroke survivors. Speech and language therapy has consistently been shown to improve language function in prior clinical trials, but few clinicially applicable predictors of individual therapy response have been identified to date. Consequently, clinicians struggle substantially with prognostication in the clinical management of aphasia. A rising prevalence of aphasia, in particular in younger populations, has emphasized the increasing demand for a personalized approach to aphasia therapy, that is, therapy aimed at maximizing language recovery of each individual with reference to evidence-based clinical recommendations. In this narrative review, we discuss the current state of the literature with respect to commonly studied predictors of therapy response in aphasia. In particular, we focus our discussion on biographical, neuropsychological, and neurobiological predictors, and emphasize limitations of the literature, summarize consistent findings, and consider how the research field can better support the development of personalized aphasia therapy. In conclusion, a review of the literature indicates that future research efforts should aim to recruit larger samples of people with aphasia, including by establishing multisite aphasia research centers.
    Language English
    Publishing date 2022-05-31
    Publishing country Korea (South)
    Document type Journal Article ; Review
    ZDB-ID 2814366-8
    ISSN 2287-6405 ; 2287-6391
    ISSN (online) 2287-6405
    ISSN 2287-6391
    DOI 10.5853/jos.2022.01102
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Dynamic network properties of the superior temporal gyrus mediate the impact of brain age gap on chronic aphasia severity.

    Wilmskoetter, Janina / Busby, Natalie / He, Xiaosong / Caciagli, Lorenzo / Roth, Rebecca / Kristinsson, Sigfus / Davis, Kathryn A / Rorden, Chris / Bassett, Dani S / Fridriksson, Julius / Bonilha, Leonardo

    Communications biology

    2023  Volume 6, Issue 1, Page(s) 727

    Abstract: Brain structure deteriorates with aging and predisposes an individual to more severe language impairments (aphasia) after a stroke. However, the underlying mechanisms of this relation are not well understood. Here we use an approach to model brain ... ...

    Abstract Brain structure deteriorates with aging and predisposes an individual to more severe language impairments (aphasia) after a stroke. However, the underlying mechanisms of this relation are not well understood. Here we use an approach to model brain network properties outside the stroke lesion, network controllability, to investigate relations among individualized structural brain connections, brain age, and aphasia severity in 93 participants with chronic post-stroke aphasia. Controlling for the stroke lesion size, we observe that lower average controllability of the posterior superior temporal gyrus (STG) mediates the relation between advanced brain aging and aphasia severity. Lower controllability of the left posterior STG signifies that activity in the left posterior STG is less likely to yield a response in other brain regions due to the topological properties of the structural brain networks. These results indicate that advanced brain aging among individuals with post-stroke aphasia is associated with disruption of dynamic properties of a critical language-related area, the STG, which contributes to worse aphasic symptoms. Because brain aging is variable among individuals with aphasia, our results provide further insight into the mechanisms underlying the variance in clinical trajectories in post-stroke aphasia.
    MeSH term(s) Humans ; Brain Mapping ; Magnetic Resonance Imaging/methods ; Brain/diagnostic imaging ; Brain/pathology ; Aphasia/etiology ; Aphasia/diagnosis ; Aphasia/pathology ; Stroke/complications ; Temporal Lobe
    Language English
    Publishing date 2023-07-14
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ISSN 2399-3642
    ISSN (online) 2399-3642
    DOI 10.1038/s42003-023-05119-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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