| 1. |
- Johansson, Therese
(författare)
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Leveraging genetic and population-level data to improve women’s health
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hormonal contraception (HC) and menopausal hormone therapy (MHT) are commonly used medicines, but their safety profiles are uncertain due to conflicting research. This thesis aims to examine the potential risks associated with HC and MHT by utilizing large-scale population-based cohorts.In Paper I, we prospectively examined the link between oral contraceptives (OCs) and MHT use with the risk of stroke in the UK Biobank (UKB). Cox regression with time-varying exposures was used to investigate if treatment effects vary with time and to avoid immortal time bias. We included time-varying covariates to account for potential confounding factors that change over time and might affect the exposure level. Our research showed higher stroke risk during the initial period after initiating both treatments and increased stroke risk with MHT use regardless of menopause timing.In Paper II, we calculated the hazard rate of the first incidence of depression following OC use. To avoid the influence of healthy-user bias, we estimated the risk in first-time users and excluded previous users in the reference group. A unique aspect of our study was the sibling analysis, which explored the causal relationship between OC use and depression by examining female sibling pairs in the UKB. Our findings showed that initiating OC was associated with a higher risk of depression, especially among adolescents and during the initial phase of treatment.Paper III explored the genetic predisposition to venous thromboembolism (VTE) among OC users in the UKB. Using polygenic risk scores, we demonstrated that women with a high genetic liability for VTE have a significantly increased risk when initiating OC. This suggests that genetic screening may be beneficial in personalising contraceptive advice and mitigating the risk of thrombotic events.In Paper IV, we investigated the association between different types of contemporary MHT and the risk of cardiovascular disease, building upon our findings from Paper I. We emulated a target trial using the Swedish nationwide registers to estimate the intention-to-treat and per-protocol effect. We showed that specific MHT treatments, particularly those that combine estrogen and progestin, are linked to an increased risk of ischemic heart disease (IHD) and venous thromboembolism (VTE). Tibolone was positively associated with IHD and cerebral infarction but not VTE. In Paper V, we examined the risk of depression following HC initiation using the Swedish nationwide registers. Our research expanded upon the findings of Paper II by including various types of modern HCs and employing an emulated target trial study design. We observed an increased risk of depression among various HCs and found that the risk of depression is influenced by different dosages and types of progestins rather than the route of administration.Using advanced analytical methods, we identified critical risk periods, variations in risk between different treatments and the interplay between treatment and genetics. While HC and MHT offer significant benefits, their potential side effects warrant careful consideration. Therefore, prescribing HCs and MHT should be approached with nuance, emphasising individual risk assessments and ongoing monitoring to optimise safety.
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| 2. |
- Backlund, Åsa, 1970-
(författare)
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Elevvård i grundskolan : Resurser, organisering och praktik
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis is to describe and analyse the organization, resources and practice of pupil welfare work in municipal compulsory schools. In one study, telephone interviews with head masters from a random sample of 100 municipal compulsory schools have been carried out. A second study is based on material from two case studies, where the work of the pupil welfare team members and the everyday organizing of pupil welfare, are scrutinized.The distribution of special pupil welfare resources varied considerably. Almost one-third of the variation could be explained by organizational and structural variables included in a regression analysis. Practically all schools in the sample had a school nurse, while school social workers and in particular school psychologists, were available to a lesser extent. Regarding the latter two professions, the results indicate that these resources are allocated to pupils of different age groups. The involvement of different kinds of municipal service in pupil welfare work is becoming a common form of organization. The case studies show that these service units can become influential actors in the organizing of local pupil welfare work.School nurses appear to be an institutionalized resource, with regard to their presence in schools and the content of their work. The school social worker lacks a specific technology of her own that distinguishes her work from other professions. School social work is performed by several professions and for some tasks domain conflicts can arouse. These conflicts can to a certain degree be rooted in the enhanced consultative role of the pupil welfare specialists, which affects the division of labour between the actors. The pupil welfare meetings studied in the case studies where characterized by asymmetrical relationships, where little space were given for pupils and their parents to be actively involved in the decision-making process.
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| 3. |
- Carlson, Åsa
(författare)
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Kön, kropp och konstruktion : en undersökning av den filosofiska grunden för distinktionen mellan kön och genus
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The distinction between sex and gender has become widely accepted in society and it is a basic assumption in many feminist theories. But in the 90s, this distinction has been severly criticised. Many thinkers have felt that gender has been emphasised at the expense of sex and that the body's significance for what it means to be a woman or a man socially has been lost. Also, it has been felt that sex and body have to be described in a new way, a way that suits feminist purposes without resulting in sex being seen as the passive material, or worse, the physical cause of what we have come to name gender.My question is therefore whether there exists any motive - apart from strategic, political ones - that nevertheless justifies a division between sex and gender, but also how one such new, poststructuralist description of the body can be understood. The description that I engage with suggests that the body is materialized. The theory of the body as materialized is meant to substitute the idea that we are beings with a non-constructed or given sex and a constructed gender. In my investigation I reach the conclusion that given and constructed provide no better ground for the sex/gender distinction than the fuzzy distinction between biological and social. I find that the theory of materialization constitutes a more nuanced and therefore more correct ontological understanding than a simple division between a given sex and a constructed gender. Even a complex concept of construction is problematic: it demands the problematic division into causal and intentional relations, a division the theory of the materialized body avoids. Instead it gets the problem to explain why the body doesn't seem to materialize in just any direction.
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| 4. |
- Davidsson, Åsa
(författare)
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Natural Hazards as Windows of Opportunity for Change : Character and Time Perspectives on Environmental Opportunities and Preparedness
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the aftermath of natural hazards, opportunities often arise for society to make changes that prevent future losses. These changes can also have environmental impacts, increase preparedness, and contribute to sustainable development. Due to the loss of biodiversity and land degradation, there is an urgent need for actions promoting positive environmental changes. Reversing the trend of land degradation and biodiversity loss is motivated by various reasons, such as preserving ecosystem functions and services that offer protection against natural hazards and reducing drivers of climate change. However, due to land degradation, loss of ecosystems, and human settlements in hazard-prone areas, it is also necessary to take actions that reduce the risk of tsunamis by improving preparedness. Improved preparedness from a people-centered perspective is a crucial aspect of sustainable development.The four papers that make up this thesis present and apply two new frameworks— one to assess the environmental effect of human-made societal changes, and one to evaluate the maintenance of a TEWS (Tsunami Early Warning System) over time. The two frameworks capture two aspects of change after a natural hazard: i) environmental impacts and ii) Disaster Risk Reduction (DRR). The thesis focuses particularly on time, a common aspect in both frameworks.The results indicate that changes triggered by natural hazards have a dual nature in that their impact on the environment can be both positive and negative. The thesis also provides evidence that past natural hazards can create a delayed window, which can be used as an argument for nature conservation during the establishment of national parks.The framework for evaluating the maintenance of a TEWS shows how difficult it is to operate all parts of the warning chain over time, from tsunami detection to evacuation. If parts of the chain are not maintained, the warning system may not be reliable.
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| 5. |
- Höglund, Julia
(författare)
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The effect of common and rare variants on inflammatory traits and diseases
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Genome wide association studies (GWAS) have identified thousands of loci associated to an immense number of traits and diseases. Most associations have been to common variants, but rare variant associations are progressively being reported. Common genetic variants often have a small effect individually but can contribute to disease risk when being several, whereas rare genetic variants often have a large effect individually. In so-called complex diseases, a number of variants together contribute to alterations in disease risk. However, to what extent common and rare variants contribute in combination or separately, still needs to be characterized for many types of diseases.In Paper I, we performed a GWAS on whole-genome sequence (WGS) data from a Swedish cohort (NSPHS, Northern Swedish Population Health Study). The same cohort have previously been genotyped, and our aim was to assess the differences and possible gains of analysing WGS data instead of genotyped data. We demonstrated that we were able to gain both power and precision in increasing the support for previous associations as well as detecting novel ones.In Paper II, we assessed the ABO blood grouping system by analysing the ABO genotypes in UK Biobank. We genetically determined the ABO genotypes of all participates and investigated whether individuals with different ABO genotypes pose different risks for cardiovascular and inflammatory disease. We were able to fine-map previous associations between the ABO blood groups and cardiovascular disease, including proteins involved in coagulation. We confirmed that non-O individuals have a higher risk of blood clots, even heterozygous carriers of A and B. These results show the potential importance of implementing ABO genotypes in the clinic.In Paper III, we used whole-exome sequence (WES) data from UK Biobank to assess the genetic contribution to changes in eosinophil count. We performed gene-based analyses with five different analysis models and found novel associations to eosinophil count. We further found associations that appears to be mainly driven by rare variants in previously known eosinophil loci. Even if WES analysis is limited to coding variation, these are promising results for further validation.In Paper IV, we built upon Paper I and performed gene-based tests in relation to more than 400 protein levels measured in NSPHS. We utilised several different models, including only coding variation, only regulatory and others and used these variant-sets in different models. By taking common GWAS variants into account, we demonstrated that novel findings could still be found. We further demonstrated that the majority of all variants in NSPHS are rare but the majority of variants carried by each individual are common.This thesis has highlighted the utilisation of different kinds of genetic data, and how it can aid in both improving, fine-mapping and increasing associations to complex diseases. This work had aided in the advancements in genetic epidemiology and medical genetics. It has explored both genotyped, WGS and WES variants, highlighting how rare and common variants can be detected and characterise in relation to inflammatory disease, both as single variants and in aggregate.
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| 6. |
- Jeansson, Åsa, 1966-
(författare)
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Vad, hur och varför i slöjdämnet : textillärares uppfattningar om innehåll och undervisning i relation till kursplanen
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis deals with questions of how the purpose and content in the Swedish school subject Sloyd can be understood in the present, some years after a new curriculum came into effect in 2011. Through sloyd teachers’ stories of their knowledge and the historical traces that have left a mark on their teaching, such as older syllabuses and mediated experiences, the intention is to examine the pedagogical thinking that forms the classroom’s activities. The overall purpose is to develop knowledge of what shapes the design of sloyd, based on how the subject is expressed in the syllabus and in teachers' understandings of teaching and the subject. Based on previous knowledge and interviews, a hermeneutic research process has been designed and developed over time. Seventeen semi-structured interviews with textiles teachers where conducted, recorded and transcribed for the study. The hermeneutic interpretation process involved repeatedly reading and listening, and the material was coded using the digital analysis tool ATLAS.ti. Through repeated reading of the codes, three overarching themes were found: Textiles teachers' perceptions of Sloyd’s purpose and content, Textiles teachers’ teaching, and Manual and intellectual work in unity. The perspective of curriculum theory using a frame factor model is intended to highlight how Sloyd manifests itself at different levels of interpretation, which may impact how sloyd takes shape in the classroom. For a functional perspective on the study's data, didactic theory is used with a focus on subject didactics. The transformation phase is central to the shaping of Sloyd, where teachers’ beliefs and perceptions about the subject will influence their interpretation of the syllabus. Shulman's model of pedagogical thinking and action linked to pedagogical content knowledge, PCK, form the basis for the analysis together with theoretical perspectives on teachers’ pedagogical thinking as Kansanen and Hansén describes it. In summary, two levels of pedagogical thinking are distinguished by analysis. Firstly, based on those teachers who transform and implement teaching in sloyd based on an interpretation that follows the syllabus closely, and secondly, based on those who proceed from an interpretation that is closer to sloyd’s field of knowledge, based on handicraft. This results in two subject conceptions relating to sloyd. Teachers can ascribe to one of these, or move between them in the different phases of pedagogical planning and reflection. The conclusions also include an understanding of why the knowledge requirements in the syllabus largely relate to the students expressing themselves in words regarding their learning and their choices during the process. The curriculum is results-oriented and the knowledge that is evaluated must therefore be measurable and comparable, and be made possible to learn through the subject content. It can also be interpreted as an approximation of a practical knowledge culture to a theoretical knowledge culture, and therefore a legitimation of a practical subject in the school context that elementary school constitutes.
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| 7. |
- Johansson, Gunilla
(författare)
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Nature-based interventions to promote health in people with stress-related illness
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stress-related illness is increasing and is a common cause of sick leave in Sweden. Spending time in nature reduces stress and promotes health and well-being. Consequently, nature-based interventions (NBI) for people with stress-related illness have been developed, implemented and studied in southern Scandinavia. However, such interventions are uncommon in the Circumpolar North with a different climate which affect conditions for outdoor activities. The overall aim of this doctoral thesis was to explore NBIs to promote health in people with stress-related illness from the perspectives of previous research, people with stress-related illness, healthcare professionals and entrepreneurs offering NBIs with a specific focus on northern natural conditions.The thesis includes four studies. An integrative literature review (I) identified and summarised scientific studies of NBIs for people with stress-related illness. Studies using both qualitative and quantitative designs were included. Study II explored key stakeholders’ perceptions of the value of NBIs in promoting health in people with stress-related illness. Semi-structured interviews were conducted with people with stress-related illness experience, healthcare professionals, and entrepreneurs offering NBI and data were analysed through qualitative content analysis. In study III people with stress-related illness experiences of participating in an NBI program in a northern natural setting were explored. A longitudinal case study design was used, and data were collected through repeated semi-structured interviews, diary entries and self-assessment questionnaires. Qualitative content analysis was used to analyse interviews and reflections from diaries and data from self-assessing questionnaires were presented descriptively. Study IV explored people with stress-related illness experiences of nature prescription. Data were collected through interviews with open-ended questions and analysed with a phenomenological-hermeneutic method.Findings show that natural environments offer unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. In NBI people with stress-related illness find a source for recovery, joy, and well-being. Spending time in nature is perceived as calming and facilitates being in the present. NBIs improve health and strengthen self-efficacy and work ability. Time in nature provides new perspectives, supports existential reflections, and empowers people with stress-related illness to find opportunities for change to achieve balance in everyday life. NBIs can be helpful for people with stress-related illness to overcome barriers to going out in nature or to find their way back to nature. In conclusion, NBIs seem to be beneficial in promoting health in people with stress-related illness. Different stakeholders have similar perceptions of the value of NBIs, indicating that it could be a valuable complement to health care. NBIs in a northern natural setting seems to have similar health promoting qualities as those seen in studies of NBIs in other natural settings.
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| 8. |
- Johansson Palmkvist, Åsa, 1980-
(författare)
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Tekniker i människans tjänst : En feministisk analys av återskapande och förändring inom forskning på inflytelserik teknik
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis takes its starting point in the massive attention paid to artificial intelligence (AI) in recent years, especially the reporting on how AI maintains and reinforces power imbalances linked to gender and other categories. The aim is to examine and problematize relations between influential technology and gender from a feminist perspective. More specifically, the focus is on how co-productions of technology and gender are reproduced and changed in contemporary technology research that in various ways links to AI. The theoretical framework consists primarily of feminist science and technology studies (STS). Thus, the overall theoretical starting point is that technology and gender are “done” in relation to each other in ways that involve notions, and values about what is important. In addition, some concepts and perspectives from feminist organization studies are used, especially the concept of gender structure and centre-construction. Empirically, the study is based on semi-structured interviews with researchers and doctoral students in two academic technology research environments, and on observations of their everyday research practices. At both of these environments’ respective universities, the work on gender equality was extensive by international standards. The gender structure of the environments differed: where one of the environments was numerically male-dominated in general and had no female assistant professors, associate professors or full professors, the other environment had a relatively high proportion of women, especially among the full professors.Central to the thesis is how the researchers and doctoral students made a distinction between traditional and new/contemporary AI. Whereas traditional AI was articulated as a delimited technology discipline with the aim of imitating humans, the new form of AI was articulated as disciplinarily vaguer and as striving to support humans; the new AI was articulated as technologies in the service of humans. Based on this division, the thesis examines which technologies, which humans and what kinds of services the articulation of the new AI refers to. It also explores the norms and ideals of being a researcher or doctoral student in the two technology research environments. The thesis highlights some specific ways in which structural and discursive aspects can impact upon how gendered norms and ideals are reproduced and challenged in technology research on influential technologies. The findings indicate that a disruption of the conventional male-dominated gender structure of technology research enables alternative understandings and ways of conducting such research. By examining how interviewees from different gendered technology research directions described their research’s relationship with AI, the thesis also illustrates how researchers’ and doctoral students’ ways of relating to emerging technological phenomena can be understood as parts of wider negotiations about the status of gendered research directions. Furthermore, the thesis discusses how the interviewees’ articulations of the potential benefits of influential technology were influenced by both power-blind and power-critical discourses. This highlights nuances in how researchers and doctoral students engaged in technology research on influential technology understand the relationship between technology research and the wider context of technology. These nuances enable a situated criticism, with greater potential to be heard from within the field itself.
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| 9. |
- Johansson Stark, Åsa, 1959-
(författare)
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Empowering knowledge and Quality of Recovery after hip or knee replacement
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundArthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today’s shorter hospital stay may be a challenge for the patients and their spouses. Patient education is linked to and promotes the recovery process and can improve the outcome after elective hip or knee replacement. Fulfilment of knowledge expectations is essential for enabling people to become empowered during the period of recovery.AimThe overall aim was to explore the association between empowering knowledge and patients’ quality of recovery after elective hip or knee replacement.MethodsThe design of the four papers was descriptive, prospective and comparative. Consecutively included patients and their spouses from Cyprus, Finland, Greece, Iceland and Sweden answered questionnaires before surgery and at discharge from hospital. Data was collected during the years 2009-2012. Relationships and associations between a number of factors and fulfilment of knowledge expectations, and patients’ quality of recovery were investigated. Comparisons between patients undergoing hip or knee replacement and between patients and their spouses were made.ResultsPatients and their spouses had similar knowledge expectations, and these were not fulfilled during the hospital stay. Spouses had less fulfilled knowledge expectations compared with the patients. Swedish patients and spouses had less fulfilled knowledge expectations compared with the Icelandic and Finnish ones. Patients who experienced the hospital stay as meeting their general expectations had more fulfilled knowledge expectations compared with those who did not.Access to knowledge was the main predictor of the variance in fulfilment of knowledge expectations. Negative emotions, such as depressive state and impatience, were associated with less fulfilled knowledge expectations. For patients undergoing hip replacement, a higher level of professional education was associated with less fulfilled knowledge expectations. For patients undergoing knee replacement, a history of employment in social services or healthcare was associated with less fulfilled knowledge expectations.Patients’ experience of greater satisfaction with care was associated with better quality of recovery for both kinds of arthroplasty. Patients with fulfilled knowledge expectations experienced better quality of recovery. The spouserelated factors, namely uncertainty and depressive state, were associated with lower quality of recovery. Factors associated with greater quality of recovery among the patients were spouses with a history of employment in social services or health care, and nurses explaining matters concerning the care and treatment for the spouses.ConclusionPatients and their spouses had high knowledge expectations that were not fulfilled during the hospital stay. Patients’ emotional state and their access to knowledge were important for their fulfilment of knowledge expectations. Patients’ and spouses’ emotional state also played an important role in determining the patients’ quality of recovery, and greater satisfaction with care among the patients was associated with better quality of recovery.These results emphasise the need to detect patients and their spouses in need of support in their preparation and recovery process. It is therefore important to assess patients’ and spouses’ personal knowledge expectations, and adapt to their emotional state while fulfilling them.The content of patient education should be personalised in future care, and informal caregivers should be seriously taken into account during the period of early recovery. The results of this thesis can be used in the development and testing of person-centred educational interventions for patients undergoing elective hip or knee replacements.
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| 10. |
- Johansson, Åsa, 1973-
(författare)
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Charge dynamics and electronic structure of pi-conjugated systems
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The research presented in this theses deals with the electronic properties of 1rconjugated molecular systems. Charge dynamics has been studied in order to get a better understanding of the physical processes behind charge transport in these materials, intended to be used in organic molecular electronic devices. The systems were investigated theoretically employing quantum mechanical methods.Carbon based materials have been shown to exist in several different forms in addition to the well known phases of graphite and diamond. The relatively rare combination of hard and elastic properties has been found in carbon nitride materials. These materials have the specific structure of crosslinked, curved graphite layers incorporated with nitrogen atoms. To understand and improve such properties, it is necessary to investigate the chemical environment of nitrogen within the material. In the work included in this thesis, the binding energy of the N(ls) level has been calculated for different model molecules. This was done using the .6.-SCF method. The results, identifying both sp2 and sp3 bonded nitrogen, were compared with experimental X-ray photoelectron spectroscopy data.In recent years the interest in molecular electronics has grown tremendously. It is now possible to measure the electrical conductance through individual molecules. One of the key issues is to have a good contact between the molecule or molecular wire and the metal electrode. For this purpose a thiol group is used as an interconnecting bridge. The work presented as a part of this thesis investigates the interaction of a small sulphur bonded molecule with a gold substrate. Using ab initio Hartree-Fock theory, it was shown that the electronic system of the gold surface interacts with the conducting states of the molecular wire at certain energies. Thus such a gold-thiol bridge allows for efficient charge transfer.The process of charge transport through the molecular wire itself - or more generally, any system of conjugated polymers - is a subject of huge interest. The discovery that these light weight, mechanically flexible materials can be doped to high electrical conductivity was the starting point of this research field about 25 years ago. The focus has now shifted towards the semiconducting properties. Conjugated polymers are currently being used as active materials in electronic devices such as light-emitting diodes and solar cells. The main part of the research described in this thesis is aimed at investigating the motion of polaronic excitations in model polymer systems. The well known Su-Schrieffer-Heeger model has been applied with the additional potential of an external electric field. It was observed that charge delocalize over several chains and the transport properties are strongly dependent on the interchain coupling and the field strength. For the application of conjugated polymers in solar cells, a mixture with C60 fullerenes have proven very successful. This molecule tends to separate a electron-hole pair on the polymer chain in such a way that the negative charge is moved over to the C60 and from there, further away in the system.
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