| 1. |
- Bendix, Marie, 1971-
(författare)
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Neuroendocrine studies in patients with affective disorders
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Affective disorders are common and a major cause for increased disability and mortality worldwide. Exogenous stressors and biological variables, including neuroendocrine factors, are assumed to contribute to an increased vulnerability to mood dysregulation. Affective disorders are highly heterogeneous and different neuroendocrine systems may play differential roles in the phenotypic expression of affective disorders in men and women.Aims: The overall aim of this thesis was to study three neuroendocrine systems in relation to underlying behavioral endophenotypes (personality traits, self-directed and interpersonal violence, and psychiatric symptoms) in patients with affective disorders.Methods: In Study I oxytocin plasma levels were assessed in 101 general psychiatric outpatients and followed-up in 36 patients after one month. Patients underwent diagnostic, symptomatic, and personality trait assessments.In Study II insulin and glucagon levels in plasma and cerebrospinal fluid (CSF) were assessed in 28 patients hospitalized after a recent suicide attempt and 19 healthy controls. Study persons were assessed regarding lifetime violence expression, psychiatric diagnoses and symptoms.In Study III serum levels of allopregnanolone, progesterone and estradiol were assessed in 14 women with severe postpartum depression and psychosis who, as previously reported, responded with rapid symptom remission during sublingual estradiol treatment. Hormonal and symptomatic assessment were performed before and after 4 weeks of estradiol treatment. 28 healthy postpartum controls were included for baseline comparison.Results: I) Plasma oxytocin levels were positively associated with personality traits of impulsiveness (monotony avoidance) and negative emotionality (psychic anxiety) with potential gender differences.II) Patients after suicide attempt had higher insulin (plasma and CSF) and lower glucagon levels (CSF) than healthy controls. Insulin levels (plasma and CSF) were higher and glucagon levels (plasma) were lower in patients and controls with higher levels of prior violence expression.III) Serum allopregnanolone decreased in women with postpartum depression and psychosis during estradiol treatment. The ratio between allopregnanolone and progesterone was significantly lower in patients than in healthy controls at baseline and it remained unchanged after symptom remission.Conclusion: Behavioral endophenotypes, rather than categorical diagnoses, of affective disorders were associated with neuroendocrine variation in three different cohorts of patients with affective disorder. Hormonal variation pointed towards an association with trait, rather than state like facets of affective behavior, constituting potential vulnerability markers for affective dysregulation.
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| 2. |
- Bergerum, Carolina, 1967-
(författare)
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Patient and public involvement in hospital quality improvement interventions : the mechanisms, monitoring and management
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation focuses on the mechanisms, monitoring and management of patient and public involvement in hospital quality improvement (QI) interventions. Findings from a literature review generated an initial programme theory (PT) on active patient involvement in healthcare QI interventions (Paper 1). Empirical studies were also undertaken in order to describe what was actually happening in the hospital QI teams and what patients and professionals experience influence their joint involvement (Paper 2), and to compare hospital leaders’ and managers’ experiences of managing QI interventions involving patients and the public (Paper 3). Finally, it was studied how patient-reported measures stimulate patient involvement in QI interventions in practice (Paper 4). The research had a qualitative design. The approach was descriptive and comparative, and the studies were carried out prospectively. Data were collected in two hospital organisations in Sweden and in one hospital organisation in the Netherlands. Data collection methods were a literature search (Paper 1), interviews and field observations (Paper 2 and 3) and data collection meetings (Paper 4). Altogether, 93 team meetings and meetings between the team leaders and management were attended and a total of 20 days of study visits with different forms of meetings were made. Twelve patients, 12 healthcare professionals and 17 and 8 hospital leaders and managers, respectively, participated in the interviews and data collection meetings. Realist synthesis was used to formulate the initial PT (Paper 1). Constructivist grounded theory was used to analyse and describe what was happening in the QI teams and how it was experienced by the team members (Paper 2). To compare hospital leaders’ and managers’ different, contextual meanings in Sweden and the Netherlands, the reflexive thematic analysis informed by critical realism was used (Paper 3). To order, manage and map data from 31 examples of local QI interventions associated to patient-reported measures, the framework method was used (Paper 4). The results formulate a generic PT on the mechanisms, monitoring and management perspectives of co-produced QI interventions in hospital services where patients and the public are involved. The PT provides a hypothesis on the various mechanisms at play and outcomes obtained at the different levels of hospital organisations in the process. It is argued that focus should be on experiences, interaction, relationships and dialogue, integration of context, and the matching of hospital resources to patient and public demands and needs. Subsequently, the outcome will be the resources and reasoning interplay resulting in actions and processes, experiences and knowledge, ‘product’ benefits, emotions, judgements and motivations. Monitoring constitutes an important feedback loop to enable such learnings. The PT aligns the perspectives of the clinical microsystem, improvement science and the service-dominant logic, and has a potential to explain how patient and public involvement in QI interventions might work.
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| 3. |
- Handlin, Linda
(författare)
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Human-Human and Human-Animal Interaction : Some Common Physiological and Psychological Effects
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present thesis was to investigate hormonal and physiological effects in mothers during a breastfeeding session and in dogs and their owners in response to short-term interaction. In study one, sixty-six mothers receiving either exogenous oxytocin infusion and/or epidural analgesia (EDA) during labor or intramuscular oxytocin injection post partum were studied. Oxytocin, prolactin, adrenocorticotrophic hormone (ACTH) and cortisol levels, as well as blood pressure were measured during a breastfeeding session two days after birth. In response to breastfeeding two days after birth, the mothers displayed a pulsatile release of oxytocin and increasing prolactin levels. In addition, the activity in the HPA-axis was reduced and maternal blood pressure decreased. The results also show that EDA administration in combination with oxytocin during labor resulted insignificantly lower oxytocin levels and higher cortisol levels, as well as higher bloodpressure in response to breastfeeding two days after birth, compared to EDA administration alone. In addition, oxytocin infusions dose-dependently lowered the mothers’ endogenous oxytocin levels two days after birth. In study two, ten female dog owners and their male Labrador dogs participated, together with ten controls. Their levels of oxytocin, cortisol and insulin, as well as their heart rate, were measured. The connection between the quality of the dogowner relationship and hormone levels was also explored. Short-term interaction between dogs and their owners resulted in oxytocin release in both species and their cortisol levels and heart rate were also affected. Oxytocin levels and positive attitudes regarding the dog-owner relationship were positively correlated. In conclusion, both human-human and human-animal interactions induce oxytocin release and promote oxytocin mediated effects, such as decreasing cortisol levels and blood pressure. In addition, social interaction and oxytocin levels arepositively related.
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| 4. |
- Nordstedt, Maria
(författare)
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Konsten att göra (sprut)utbyten : Sprutbytets betydelse i skärningspunkten mellan politik, yrkespraktik och människors vardagsliv
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Art of Needle Exchange: The Significance of Needle Exchange Programs at the Intersection of Politics, Professional Practice, and People's Everyday LivesThis doctoral thesis discusses how social meanings are constructed in needle exchange programs. For nearly four decades, Sweden has implemented needle exchange programs to prevent the spread of bloodborne viral infections. However, a restrictive drug policy and resistance to harm reduction efforts have led to limitations in access to these programs, both in terms of geography and through an exclusionary regulatory framework. The effectiveness of needle exchange programs in reducing the risk of infection associated with injection-related behaviour is clearly positive. However, there are limited scientific studies on the more socially oriented meanings of needle exchange programs. With needle exchange programs as a physical and social place, the overarching aim of this thesis is to understand how the creation of social meanings of needle exchanges is achieved through time, space, and social interaction, primarily between the program's visitors and its staff. The empirical material primarily consists of 16 months of ethnographic fieldwork, including participant observations and informal conversations at two needle exchange programs in southern Sweden, as well as in the everyday lives of individuals who visit these programs. Through extensive ethnographic narratives and analyses based on theories of everyday life, resistance, time, and gifts, the thesis demonstrates that needle exchange programs hold multiple meanings created through interactions between visitors and staff. Two concurrent and parallel tracks contribute to understanding what needle exchange programs mean to those who visit them. One track starts with a counterproductive regulatory framework where requirements and rules result in some visitors coming less often than they need to or not at all. The other track involves countless material and relational exchanges that foster positive experiences of the needle exchange program, turning it into a place of social hope and a changed future. One of the thesis's most significant findings concerns the social work that takes place at the needle exchange program in the interactions between visitors and staff. These interactions also occur at the intersection of the norms and hierarchies of the drug world and the Swedish dream of a drug- free society. In the waiting room of the needle exchange program, negotiations are constantly underway to maintain it as a place of hopeful encounters, as opposed to a destructive refuge.
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| 5. |
- Petersson, Maria, 1954-
(författare)
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Djurhållning och betesdrift : Djur, människor och landskap i västra Östergötland under yngre bronsålder och äldre järnålder
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on animal husbandry and organised grazing in western Östergötland during the Late Bronze Age and Early Iron Age. The primary aim is to investigate how animal husbandry was organised from a practical perspective. The thesis consists of a series of analyses of different source-material groups that illuminate various aspects of prehistoric animal husbandry. Only a small number of the archaeologically investigated three-aisled longhouses had a byre area. The livestock were mainly kept outdoors, in winter as well as in summer. The animal bones from settlements show that more beef was consumed and more horses were found at high-status settlements than at those of lower status. From the period 1000 BC–BC there are isolated hearths and hearth groups in central Östergötland that previously could not be connected to a specific archaeological context. In the author’s opinion, these sites represent bases in a system of well-organised grazing. It was here that shepherds and animals rested, ate and drank, and probably also overnighted. Many of the sites were used repeatedly during the entire period in question. In this landscape there are stone fence systems which show a strong connection to the settlement structure formed during the Late Iron Age, and parts of the systems seem to be medieval. They may also have elements from the Early Iron Age. The distribution of graves from the Late Bronze Age and Early Iron Age coincides with the stone fence systems. A special type of site that has one or two graves, with particular kinds of superstructures, is linked to these areas. In historical time these areas comprised the central production grounds for animal husbandry, and it seems that the areas functioned as central grazing grounds as far back as the Late Bronze Age.
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| 6. |
- Petersson, Maria, 1976
(författare)
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Enhancement and Characterization of Films for Barrier and Release Applications
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Films and coatings can improve the quality and shelf-life of food products by acting as barriers to e.g. water vapour and oxygen. Many edible biopolymer films, based on polysaccharides and proteins, form excellent oxygen barriers but most often provide only poor water vapour barriers. Lipids on the other hand are hydrophobic and can provide better water vapour barrier properties. Films with enhanced and tailored properties can be produced by combining the good gas barrier properties of hydrophilic biopolymers with the moisture resistance of more hydrophobic components. This work focused mainly on the water vapour barrier and release properties of films and coatings to gain a deeper understanding of how material properties can affect such properties.The effect on water vapour permeability and mechanical properties of starch films was evaluated after addition of an acetoglyceride and the effect on phase separation was determined after film formation at different temperatures. The water vapour permeability of starch films was decreased by addition of the acetoglyceride and by using higher drying temperature. Addition of the acetoglyceride had a weakening effect on the films, whereas the drying temperature showed no great effect on the mechanical properties. Mixed film-forming systems most often phase separate during film formation. The phase separation behaviour of a mixture of an acetylated high amylose maize starch and the maize protein zein was studied in real-time during cooling and during solvent evaporation. It was concluded that solvent evaporation had a greater impact than cooling on the phase separation, but both the solution temperature during cooling and the solution composition during solvent evaporation affected the phase separation. The concentrations of the two biopolymers in the solution had impact on the formed microstructures.Active components can be incorporated in biopolymer or lipid films and be used in release applications. The release of two preservatives and four sugars from films made from the protein kafirin into model foods with different water activity was evaluated. It was concluded that the water activity of the model food had a great impact on the release from the film and diffusion of released substances in the model food. Two hydrophobic petroleum waxes, a petrolatum and a microcrystalline wax, with different water vapour barrier properties were investigated to gain a deeper understanding of inherent material properties that can affect the barrier properties. The petrolatum showed a more open crystalline structure, while a more network-like crystalline structure was seen in the microcrystalline wax. Both waxes melted and crystallized over a broad temperature range. The microcrystalline wax crystallized through a two-step process and the petrolatum crystallized through a one-step process. Recrystallization occurred in both waxes during ageing.
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| 7. |
- Petersson, Maria
(författare)
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Lärares beskrivningar av evolution som undervisningsinnehåll i biologi på gymnasiet
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Biological evolution is part of the syllabi for Biology and Science in Swedish upper secondary school. In the syllabi, evolution is not only presented as a topic in Biology courses, but is also regarded as a unifying theme. The teacher has a fundamental role in deciding how the national curriculum is translated into the educational situation. This thesis investigates teachers’ accounts of their teaching of evolution in Swedish upper secondary school, describing their understandings of the purpose of teaching and learning evolution as part of biology education.The thesis is based on interviews of teachers teaching the course Biology A, which is compulsory as dictated by the Natural Science Program. The interviews were supplemented with questionnaires. The interviews were orientated towards questions about selection of course content and the reasons for choosing this content. The interviews were focused on teachers experiences based on their own practice. Two aspects of content were examined: (1) the scientific content taught in terms of themes and (2) the socializing value-laden aspects, such as priorities taken by the teachers and the teachers´ overarching aims. The results showed that teachers described different teaching contents with regard to values, even when the core content of themes was similar. Four different selective traditions for choosing content were identified among teachers. The results are discussed in relation to the context and conditions that the teachers identify as influential on the content chosen. Teachers’ interactions with their students as well as their world views are important for their selection and adjustment of content. There are also indications that teachers’ personal views about purposes are important for selecting the teaching content.
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| 8. |
- Petersson, Maria
(författare)
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Sensitivity and selectivity studies in capillary electrophoresis
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Capillary electrophoresis is characterised by high separation efficiency, applicability to a wide range of compounds, small sample and solvent consumption and simple instrumentation. To improve sensitivity using on-line absorbance detectors, which are hampered by the short optical path length, sample volumes in the microlitre range were concentrated to nanolitre volumes either off-line or on-line. Sample enrichment in a single acoustically levitated droplet by solvent evaporation lowered the concentration detection limit by two orders of magnitude for dansylated amino acids. The sample was positioned in the levitator using a piezoelectric flow-through liquid microdispenser that ejected 100 droplets (each with a volume of 65 pL) per second. The levitated sample drop was then picked up using the separation capillary. Because levitation is a containerless technique, the sample was easily accessed and the risk of sample losses on container walls eliminated. Sample enrichment using miniaturised on-line solid-phase extraction lowered the concentration detection limit by almost four orders of magnitude using the basic drug terbutaline as model compound. A short length of capillary packed with reversed-phase sorbent particles was attached to the separation capillary inlet. The analytes were desorbed using an organic solvent, e.g. acetonitrile. The ratio between introduced sample volume and desorption volume was about 1000. The use of organic solvents promoted further enrichment by stacking. This contributed to the excellent separation efficiency and high concentration factors achieved. The concentration limit of detection was lowered by a factor of 7000, which allows low nanomolar concentrations to be detected using UV-absorbance detection. The selectivity in capillary electrophoresis was enhanced by addition of surfactant or cyclodextrin. Monomer and oligomers of a basic cyclic peptide were separated using micellar electrokinetic chromatography with sodium dodecyl sulphate. The complex cyclic peptide sample contained monomer, dimers, trimers and tetramers. Native and derivatised b -cyclodextrins were used for enantiomer separations of basic drugs (b -adrenergic antagonists) at low electrolyte pH. An entire enantiomer separation of a dansylated amino acid using b -cyclodextrin with the addition of organic solvent was captured in real-time using laser-induced fluorescence imaging detection. The migrating analytes were imaged in a 10 cm long detection window.
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| 9. |
- Petersson, Maria
(författare)
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Short- and long-term cardiovascular and behavioural effects of oxytocin : mechanisms involved and influence of female steroid hormones
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present thesis was to investigate short- and long-term cardiovascular and behavioural effects of oxytocin. In addition, the influence of female steroid hormones as well as possible mechanisms behind the oxytocin induced effects were investigated. For this purpose, blood pressure, heart rate, nociceptive thresholds, spontaneous motor activity, weight gain, food and water intake, responsiveness of alpha 2-adrenoreceptors and hormone plasma levels were measured in female and male rats. A single injection of oxytocin (1 mg/kg s.c.) induced a transient increase in nociceptive thresholds, plasma levels of corticosterone and ACTH, and blood pressure. The increase in blood pressure was most pronounced in female rats during proestrus and oestrus. Six hours after the oxytocin injection, a second increase in nociceptive thresholds occurred as well as a decrease in corticosterone levels. In addition, a tendency to a reduction in blood pressure was seen ten hours after the oxytocin injection. In female rats observed in an open-field arena, oxytocin (0.01-1 mg/kg s.c.) induced both anxiolytic-like and sedative effects. Oestrogens enhanced the anxiolytic-like effect, whereas progesterone enhanced the sedative effect of oxytocin. A five-day treatment with oxytocin (1 mg/kg s.c. or 1 [my]g/kg i.c.v.) increased nociceptive thresholds, decreased blood pressure, corticosterone as well as gastrin, insulin and cholecystokinin (CCK) levels, changed the pattern of spontaneous motor activity and promoted weight gain in female rats with a low spontaneous growth rate. All these effects were sustained for more than a week after the end of the oxytocin treatment. The decrease in blood pressure lasted for 3 weeks in cycling female rats. The same treatment with oxytocin decreased blood pressure also in male but not in female spontaneously hypertensive rats. Furthermore, oxytocin treatment increased the responsiveness of locus coeruleus (LC) alpha 2-adrenoreceptors. The decrease in gastrin, insulin and CCK levels as well as the increase in weight gain in female rats in response to oxytocin, were blocked by an oxytocin antagonist. In contrast, the antagonist did not abolish the sustained effects on nociceptive thresholds, blood pressure or spontaneous motor activity, neither when it was administered together with oxytocin for 5 days nor when given after the effects were established. The long-lasting increase in nociceptive thresholds could temporarily be reversed by the opioid antagonist naloxone. Thus, opioids might have been involved in this effect of oxytocin. The effect of the alpha 2-adrenoreceptor agonist clonidine on blood pressure and spontaneous motor activity was significantly enhanced in oxytocin pretreated rats. In addition, clonidine reversed the attenuation of plasma levels of insulin and CCK in the oxytocin treated rats to an enhancement. These findings together with the increased responsiveness of LC alpha 2-adrenoreceptors suggest that alpha 2-adrenoreceptors might have been involved in these long-term oxytocin-induced effects.
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| 10. |
- Wolmesjö, Maria
(författare)
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Ledningsfunktion i omvandling : Om förändringar av yrkesrollen för första linjens chefer inom den kommunala äldre- och handikappomsorgen
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the 1990s many of the local authorities have been forced to reduce expenditure on the care of the elderly and people with disabilities, and many organisational changes have been carried out. New problems and their solutions are often related to leadership and management. This dissertation deals with three trends in the development of the organisation: The first trend is a market orientation, one example of which is the attempt to increase effectiveness and efficiency by utilising a purchaser/provider model in the organisation. Here the needs assessment model is studied. The second trend is the response to the pressed situation due to heavy workloads that staff members and their managers express, exemplified by self-managing work teams and a year-based working hour system. Here called flexible work organisations. The third trend focused in this dissertation is the decentralisation of social services. It is connected to increased demands on involvement in, and participation from those who use the services, i.e. the elderly and people with disabilities. The aim of this dissertation is to shed light on how politicians and managers view, experience and describe management and leadership in three types of local authority organisations. The focus is on the demands on managers and how the working conditions for managers are described in the different organisations. The material includes three different empirical methods. The first is a questionnaire to politicians and local authority officials, mainly managers at different levels in the care of the elderly and persons with disabilities. The second method consists of qualitative interviews with politicians and managers. The third method involved a document study of local authority documents, e.g. official guidelines, plans and evaluations. The method of analysis, a ?qualified content analysis? is inspired by discourse analysis and focuses on a comparison between the different local authorities, between politicians and managers and between women and men. This dissertation shows that the organisational changes brought about unexpected consequenses for management and that the demands differ between politicians and managers and between different organisations. Politicians and higher-level management expect the managers to manage the organisation, and employees expect them to lead. The solution seems to be a high level of competence, but which competence is needed? There are two different ideals for leadership. One is associated with focus on effectiveness and efficiency and the other associated with focus on communication. The dissertation highlights the conditions of a management, which is currently being pushed further down in the organisation. The dilemma of leadership ? being a manager or a leader will not disappear. Somewhere in the organisation the perspective of effectiveness and efficiency and the perspective of communication have to meet. It might be seen as a dilemma that will not go away ? only be placed in different levels in the organisation.
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