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| 3. |
- Bergman, Stefan, 1959-, et al.
(author)
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Chronic Widespread Pain in Adolescents Is Highly Associated to Stress and Anxiety
- 2015
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In: Arthritis & Rheumatology. - Hoboken, NJ : John Wiley & Sons. - 2326-5191 .- 2326-5205. ; 67:Suppl. S10
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Journal article (peer-reviewed)abstract
- Background/Purpose: Chronic widespread pain (CWP), one of the hallmarks of fibromyalgia, is not uncommon in adolescents and it has previously been shown that adolescents with pain often become young adults with pain. CWP often co-varies with anxiety, depression, and stress symptoms in adults, but the knowledge regarding this is small in youth and young adults.The aim was to study the associations between CWP, anxiety, depression and stress in adolescents attending first year of high school.Methods: A computerized questionnaire to 296 adolescents attending Swedish high school, with validated questions regarding presence and distribution of pain (Epipain mannequin), stress symptoms (ELO question), anxiety and depression (Hospital Anxiety and Depression Scale – HADS), and health related quality of life (HRQL as measured by EQ5D). Pain was considered chronic when persistent for more than three months, and the subgroup CWP was defined according to the 1990 ACR criteria for fibromyalgia. Statistical analyses in SPSS v21 with comparison of means by Student’s t-test and proportions by chi2-test or Fischer’s exact test.Results: 257 (87%) out of 296 eligible students, mean (SD) age 16.1 (0.7) and 65.8% girls, responded to the questionnaire. Prevalence of chronic pain was 20.8% and that of the subgroup CWP was 4.7%, without any gender differences (boys 18.2% vs girls 22.2%; p=0.224, and 3.4% vs 5.4%; p=0.692). High level (4 or 5 on a 5 point scale) of stress symptoms were less common in boys (16.0% vs 28.2%; p=0.015), as was possible or probable anxiety (17.1% vs 44.4%; p<0.001), but not depression (10.3% vs 12.5%; p=0.764). Students with high level of stress reported CWP five times more often than those with less stress (30.4% vs 5.8%; p=0.001). Students with probable anxiety reported CWP ten times more often than students with no anxiety (17.6% vs 1.8%; p=0.001), and CWP was also more common, but not statistically significant, in students with probable depression (20.0% vs 3.1%; p=0.163). Those reporting CWP had significantly lower HRQL (0.58 vs 0.87; p=0.038) than students with no chronic pain.Conclusion: The high prevalence of chronic pain and the strong associations between CWP and reports of stress and anxiety in adolescents highlights that a multifactorial background to chronic pain must be considered early in life. An apparent lower score in EQ5D also indicates that the presence of CWP has an marked impact on HRQL also in adolescents.
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| 4. |
- Malmborg, Julia, 1988-, et al.
(author)
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Sleeping Problems and Anxiety is Associated to Chronic Multisite Musculoskeletal Pain in Swedish High School Students
- 2018
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In: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77:Suppl. 2, s. 226-226
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Journal article (other academic/artistic)abstract
- Background: The relationship between chronic multisite musculoskeletal pain (CMP) and sleep is complex, where pain can lead to sleeping problems and lack of sleep can intensify the pain perception. Most previous studies relates to adults, but adolescents may also suffer from CMP, and there is a need for more knowledge regarding the relationships between CMP and sleeping problems, stress, anxiety, depression, and health status.Objectives: To study background factors associated to CMP in first year Swedish high school students.Methods: First year Swedish high school students (n=296) were invited to complete questionnaires on chronic pain (mannequin with 18 body regions), sleeping problems (Uppsala Sleep Inventory, four items scored from 1–5), stress (ELO questions, scored from 1–5), anxiety and depression (Hospital Anxiety and Depression Scale, scored from 0–21), health status (EQ-5D, scored from 0 to 1, worst to best) and physical activity (International Physical Activity Questionnaire, categorised into low, moderate and high levels). Stress and sleeping items were dichotomized into 1–3 points (best) vs 4–5 points (worst). Individuals scoring at least severe problems (4 points) at one or more sleeping items were classified as having severe sleeping problems. HADS were categorised as non-cases (0–7), possible7–10 and probable cases (11–21 points). Students were grouped as having CMP (pain present in ≥3 regions) or not (no chronic pain or chronic pain in 1–2 regions). Multiple logistic regression analyses (adjusted for sex) with CMP as dependent variable were performed in SPSS, version 24.Results: 254 students (86% of total sample, 87 boys and 167 girls) with a mean age of 16.1 (SD 0.6) years participated in the study. CMP was present in 25 (9.8%) students with no differences between boys and girls (8.0% vs 10.8%; p=0.488). Having CMP was associated with reporting severe sleeping problems (OR 2.49, 95% CI: 1.06 to 5.81, p=0.035) with initiating sleep, maintaining sleep, early morning awakenings and/or not feeling restored after sleep in comparison to the other students. Students with CMP were more likely to be categorised as probable cases for anxiety (OR 3.06, 95% CI: 1.09 to 8.61, p=0.034), but there were no associations for possible cases for anxiety (OR 1.15, 95% CI: 0.38 to 3.51, p=0.800), possible cases (OR 2.03, 95% CI: 0.63 to 6.54), or probable cases for depression (OR 3.35, 95% CI: 0.33 to 33.83). There was a nearly significant association between stress and belonging to the CMP group (OR 2.31, 95% CI: 0.97 to 5.53, p=0.059). A higher self-reported health status was associated to a lower likelihood for CMP (OR 0.04, 95% CI: 0.01 to 0.27, p=0.001). Distribution of physical activity levels of low, moderate and high was not significantly associated to having CMP in comparison with not having it.Conclusions: One in ten high school students fulfilled criteria for having chronic multisite musculoskeletal pain. CMP was associated to sleeping problems, anxiety, and a worse health status. The results from this study may be used by school health-care professionals in their preventive work to promote student’s health.Disclosure of Interest: None declared
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- Ahlén Bergman, Emma, et al.
(author)
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Increased CD4+ T cell lineage commitment determined by CpG methylation correlates with better prognosis in urinary bladder cancer patients
- 2018
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In: Clinical Epigenetics. - : BMC. - 1868-7083 .- 1868-7075. ; 10
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Journal article (peer-reviewed)abstract
- BACKGROUND: Urinary bladder cancer is a common malignancy worldwide. Environmental factors and chronic inflammation are correlated with the disease risk. Diagnosis is performed by transurethral resection of the bladder, and patients with muscle invasive disease preferably proceed to radical cystectomy, with or without neoadjuvant chemotherapy. The anti-tumour immune responses, known to be initiated in the tumour and draining lymph nodes, may play a major role in future treatment strategies. Thus, increasing the knowledge of tumour-associated immunological processes is important. Activated CD4+ T cells differentiate into four main separate lineages: Th1, Th2, Th17 and Treg, and they are recognized by their effector molecules IFN-γ, IL-13, IL-17A, and the transcription factor Foxp3, respectively. We have previously demonstrated signature CpG sites predictive for lineage commitment of these four major CD4+ T cell lineages. Here, we investigate the lineage commitment specifically in tumour, lymph nodes and blood and relate them to the disease stage and response to neoadjuvant chemotherapy.RESULTS: Blood, tumour and regional lymph nodes were obtained from patients at time of transurethral resection of the bladder and at radical cystectomy. Tumour-infiltrating CD4+ lymphocytes were significantly hypomethylated in all four investigated lineage loci compared to CD4+ lymphocytes in lymph nodes and blood (lymph nodes vs tumour-infiltrating lymphocytes: IFNG -4229 bp p < 0.0001, IL13 -11 bp p < 0.05, IL17A -122 bp p < 0.01 and FOXP3 -77 bp p > 0.05). Examination of individual lymph nodes displayed different methylation signatures, suggesting possible correlation with future survival. More advanced post-cystectomy tumour stages correlated significantly with increased methylation at the IFNG -4229 bp locus. Patients with complete response to neoadjuvant chemotherapy displayed significant hypomethylation in CD4+ T cells for all four investigated loci, most prominently in IFNG p < 0.0001. Neoadjuvant chemotherapy seemed to result in a relocation of Th1-committed CD4+ T cells from blood, presumably to the tumour, indicated by shifts in the methylation patterns, whereas no such shifts were seen for lineages corresponding to IL13, IL17A and FOXP3.CONCLUSION: Increased lineage commitment in CD4+ T cells, as determined by demethylation in predictive CpG sites, is associated with lower post-cystectomy tumour stage, complete response to neoadjuvant chemotherapy and overall better outcome, suggesting epigenetic profiling of CD4+ T cell lineages as a useful readout for clinical staging.
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- Alklind Taylor, Anna-Sofia, et al.
(author)
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Spelbaserad simulering för insatsutbildning : Slutrapport
- 2012
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Reports (other academic/artistic)abstract
- Denna rapport är en avrapportering av projektet Spelbaserad simulering för insatsutbildning. Projektet syftar till att:Studera hur serious games kan förstärka lärandemiljön i träning och utbildningPraktiskt testa och analysera användningen av spelteknologi för att ta fram rekommendationer för konstruktion av träningssimulatorerSkapa underlag för utveckling av Räddningsverkets utbildningsmetoder genom samarbete mellan forskare och praktikerSerious games och spelbaserad simulatorträning ses som en möjlighet att vidareutveckla undervisnings- och träningsmiljön inom räddningstjänst. Begreppet serious games definieras som att använda spel och spelteknik för att uppnå syften utöver ren underhållning. För att utnyttja områdets potential i största möjliga mån krävs en kombination av att utveckla och anpassa teknik så att den passar för ändamålet, detta kan till exempel innebära att utnyttja de möjligheter som modern spelteknik ger för att logga användarbeteende och resultat. Dessutom innefattar serious games en komponent av speldesign, det vill säga att utnyttja möjligheter som spel ger för att skapa en motiverande och engagerande lärandemiljö. Detta kan till exempel innebära att skapa tävlingsmoment och poängsystem som sporrar till upprepad användning. I projektet har vi utnyttjat såväl teknik- som speldesignskomponenten.Projektets syften har uppnåtts genom att producera och utvärdera ett prototypspel för insatsträning samt en modell för hur serious games kan användas i träning och utbildning. De huvudsakliga resultaten består av en spelprototyp av ett webbaserat spel för att träna beslutsfattande på taktisk nivå samt en pedagogisk modell för spelbaserad träning. Prototypen och modellen har testats på en distanskurs för Räddningsledarutbildning i regi av Myndigheten för samhällsskydd och beredskap (MSB). Utvärderingen visar på goda resultat vad gäller systemets användbarhet. Den pedagogiska potentialen har inte kunnat utvärderas fullt ut då prototypen inte blev en tillräckligt integrerad del i kursen där den utvärderades.Projektet visar att spelbaserad träning kan vara en möjlighet för pedagogisk utveckling med avseende på både teknik och pedagogisk kontext. I detta sammanhang är det viktigt att poängtera vikten av att genomföra och utvärdera pedagogiska anpassningar i samband med spelbaserad träning. Vidare har projektet har samarbetat med olika konstellationer av lärare och kursdeltagare vid MSB. En viktig lärdom är att tydliga resurser och organisatoriskt engagemang finns på plats i den här typen av samproducerande forskningsprojekt.
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| 8. |
- Andersson, Martin, et al.
(author)
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A microscopy-compatible temperature regulation system for single-cell phenotype analysis - demonstrated by thermoresponse mapping of microalgae
- 2021
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In: Lab on a Chip. - : Royal Society of Chemistry. - 1473-0197 .- 1473-0189. ; 21:9, s. 1694-1705
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Journal article (peer-reviewed)abstract
- This work describes a programmable heat-stage compatible with in situ microscopy for the accurate provision of spatiotemporally defined temperatures to different microfluidic devices. The heat-stage comprises an array of integrated thin-film Joule heaters and resistance temperature detectors (RTDs). External programming of the heat-stage is provided by a custom software program connected to temperature controllers and heater–sensor pairs. Biologically relevant (20–40 °C) temperature profiles can be supplied to cells within microfluidic devices as spatial gradients (0.5–1.5 °C mm−1) or in a time-varying approach via e.g. step-wise or sinusoidally varying profiles with negligible temperature over-shoot. Demonstration of the device is achieved by exposing two strains of the coral symbiont Symbiodinium to different temperature profiles while monitoring their single-cell photophysiology via chlorophyll fluorometry. This revealed that photophysiological responses to temperature depended on the exposure duration, exposure magnitude and strain background. Moreover, thermal dose analysis suggested that cell acclimatisation occurs under longer temperature (6 h) exposures but not under shorter temperature exposures (15 min). As the thermal sensitivity of Symbiodinium mediates the thermal tolerance in corals, our versatile technology now provides unique possibilities to research this interdependency at single cell resolution. Our results also show the potential of this heat-stage for further applications in fields such as biotechnology and ecotoxicology.
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| 9. |
- Andersson-Sköld, Yvonne, et al.
(author)
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An integrated method for assessing climate-related risks and adaptation alternatives in urban areas
- 2015
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In: Climate Risk Management. - : Elsevier BV. - 2212-0963. ; 7, s. 31-50
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Journal article (peer-reviewed)abstract
- © 2015 The Authors. The urban environment is a complex structure with interlinked social, ecological and technical structures. Global warming is expected to have a broad variety of impacts, which will add to the complexity. Climate changes will force adaptation, to reduce climate-related risks. Adaptation measures can address one aspect at the time, or aim for a holistic approach to avoid maladaptation. This paper presents a systematic, integrated approach for assessing alternatives for reducing the risks of heat waves, flooding and air pollution in urban settings, with the aim of reducing the risk of maladaptation. The study includes strategies covering different spatial scales, and both the current climate situation and the climate predicted under climate change scenarios. The adaptation strategies investigated included increasing vegetation; selecting density, height and colour of buildings; and retreat or resist (defend) against sea-level rise. Their effectiveness was assessed with regard to not only flooding, heat stress and air quality but also with regard to resource use, emissions to air (incl. GHG), soil and water, and people's perceptions and vulnerability. The effectiveness of the strategies were ranked on a common scale (from -3 to 3) in an integrated assessment. Integrated assessments are recommended, as they help identify the most sustainable solutions, but to reduce the risk of maladaptation they require experts from a variety of disciplines. The most generally applicable recommendation, derived from the integrated assessment here, taking into account both expertise from different municipal departments, literature surveys, life cycle assessments and publics perceptions, is to increase the urban greenery, as it contributes to several positive aspects such as heat stress mitigation, air quality improvement, effective storm-water and flood-risk management, and it has several positive social impacts. The most favourable alternative was compact, mid-rise, light coloured building design with large parks/green areas and trees near buildings.
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| 10. |
- Bergman, Filip, 1992-
(author)
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Sustainability performance of multi-utility tunnels : Sustainability assessments for furthering knowledge and understanding
- 2022
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Licentiate thesis (other academic/artistic)abstract
- The multi-utility tunnel has received increased attention as an alternative method for the installation of subsurface infrastructure for the distribution of electricity, water, sewage and district heating. In previous research, the multi-utility tunnel (MUT) has been described as a more sustainable technology compared to the conventionally used technique where the cables and pipes are placed with open-cut excavation (OCE), especially when the entire life cycle is taken into account. This thesis aims to contribute to an improved understanding of MUT's sustainability performance in relation to conventional installation using open-cut excavation. This is done by using literature study, interview study and quantitative sustainability assessments to gain an understanding of the current state of knowledge. Furthermore, this thesis also focuses on how knowledge can be deepened with the help of quantitative sustainability assessments and the challenges of conducting this type of assessment. This thesis shows that the state of knowledge regarding MUT's sustainability performance is low and scattered, with a lack of a holistic approach. Direct economic performance has gained the most attention, followed by indirect and social impact, and the environmental impact has so far barely been assessed. The sustainability performance depends to a large extent on the conditions of the specific case, and these should be considered when assessing the technology. Quantitative assessments have the potential to help deepen the knowledge of the sustainability implications of using MUT. The characteristics of MUT have some similarities with other types of physical infrastructure. Similarities are that the systems are long-lived, have project conditions that affect sustainability performance, and impact a broad spectrum of actors. One difference to typical infrastructure systems is that the owner and management structure of MUT is, by design, more complex as several types of utility systems are in use. The characteristics of MUT give some practical considerations that need to be addressed: data availability, including practitioners; detailed data; transparency; and flexibility. This thesis highlights the complexity of assessing MUT´s sustainability performance and advocates that future studies should have a learning-oriented approach so that the knowledge level can collectively and gradually improve over time rather than focusing on decision-oriented studies.
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