| 1. |
- Gustafsson, Mattias, 1972-
(författare)
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Energy efficiency measures in the built environment - some aspects to consider in Sweden
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The traditional energy system as we know it today will change in the future. There is a worldwide concern about the global warming situation and there are different actions implemented to limit the consequences from, mainly, the use of fossil fuels.In this thesis, multi-unit apartment buildings have been simulated according to how the global CO2 emissions change when different energy efficiency measures are implemented. The simulated buildings have also been used to investigate how the calculated energy efficiency of a building according to Swedish building regulations varies depending on which technology for heating is used in the building and if the building has a solar PV installation or solar thermal system. When the energy efficiency of a building is calculated accord-ing to Swedish building regulations, this thesis shows that heat pumps are a favored technology compared to district heating. Another result is that electric-ity use/production within the investigated district heating system is the most important factor to consider when minimizing global CO2 emissions.This thesis also investigates how the configuration of electric meters owned by the distribution system operator affects the monitored amount of self-consumed and produced excess electricity. Finally, four local low-voltage distri-bution networks were simulated when a future charging scenario of electric vehicles was implemented.If a single-family house installs a solar PV installation, this thesis reveals that the configuration of the electric meter is important for the monitored amount of self-consumed electricity. This thesis also shows that the investigated low-voltage distribution networks can handle future power demand from electric vehicles and a high share of solar PV installations, but rural low-volt-age distribution networks will need to be reinforced or rebuilt to manage the investigated future scenarios.
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| 2. |
- Hälleberg-Nyman, Maria, 1968-
(författare)
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Urinary catheter policies for short-term bladder drainage in hip surgery patients
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to evaluate methods for urinary catheter handling in patients undergoing hip surgery. The intention was to gain knowledge in order to provide optimal and cost- effective care regarding urinary catheterisation in this group of patients.In Study I , 45 of the 86 catheterised patients (52%) contracted nosocomial urinary tract infections (UTIs). Diabetes was a risk factor for developing UTI, and cloxacillin as a perioperative antibiotic prophylaxis seemed to offer a certain protection. Study II was a randomised controlled trial on the effect of clamping (n = 55) or not (n = 58) of the indwelling urinary catheter before removal. No significant differences were found between the groups with respect to time to normal bladder function, need for recatheterisation, or length of hospital stay. Study III was a randomised controlled trial among patients with hip fracture and hip arthroplasty, in which the patients were randomised to intermittent (n = 85) or indwelling (n = 85) urinary catheterisation. No significant differences in nosocomial UTIs (9% vs. 12%) or cost-effectiveness were shown. The patients in the intermittent group regained normal bladder function significantly sooner after surgery. Fourteen percent of the patients in the intermittent group did not need any catheterisation. In Study IV , 30 patients were interviewed about their experiences of bladder emptying and urinary catheterisation. The patients’ views were described through the main category ‘An issue but of varying impact’. Both bladder emptying through micturition and bladder emptying through catheterisation were described as convenient, but also as uncomfortable and an intrusion on dignity. The patients were aware of risks and complications of urinary catheterisation.In conclusion, this thesis indicates that UTI is common in hip surgery patients. Clamping of indwelling catheters seems not necessary. There is no preference for either intermittent or indwelling urinary catheterisation according to the results of this thesis, either for the development of nosocomial UTI or, for cost-effectiveness, or from the patient perspective. Nurses should be aware that catheterisation might make the patients feel exposed, and it is essential that their practice reflect the best available evidence.
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| 3. |
- Jackmann, Natalja, 1968-
(författare)
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Vitamin D, bone turnover markers and hCAP-18 in children with hemato-oncological diseases
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Children with hemato-oncological diseases may have significant skeletal morbidities. Vitamin D is essential for the maintenance of skeletal health and may also be important for immunological functions and cancer outcomes. As vitamin D deficiency is a recognized problem in children worldwide, it is important to evaluate its prevalence among children and adolescents with hemato-oncological diseases in Sweden.In this thesis, I investigated vitamin D status and its predictors, serum hCAP-18 (the pro-protein of the antimicrobial peptide LL-37 produced during neutrophil differentiation in the bone marrow), and bone turnover markers in children with hemato-oncological diseases at the time of diagnosis. Vitamin D deficiency was found in 30.9–46% of the children. Lower 25-hydroxyvitamin D level correlated with older age, seasons outside summer, a more recent calendar year of sampling, lack of vitamin D supplementation, and country of parental origin located between latitudes -45° and 45°. In preschool children with leukemia, a 25-hydroxyvitamin D level < 50 nmol/L was associated with inferior overall survival. There was no correlation between serum 25-hydroxyvitamin D and hCAP-18 neither in children with hemato-oncological diseases nor in healthy controls. Children with diseases that impair myelopoiesis presented low hCAP-18 levels, whereas those with non-hematological malignancies displayed serum hCAP-18 levels in the same range as that of healthy children.Children diagnosed with leukemia had lower levels of bone formation and resorption markers than those of children with solid tumors or bone marrow failure. Adolescents with osteosarcoma displayed high bone alkaline phosphatase levels.The identification of patients with suboptimal vitamin D status and compromised bone remodeling at cancer diagnosis may aid the development of supportive treatments that reduce the adverse effects of cancer and its treatment.
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| 4. |
- Wester Oxelgren, Ulrika, 1960-
(författare)
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Intellectual Disability and coexisting Autism and ADHD in Down syndrome - a population-based study
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis investigated associated neurodevelopmental/neuropsychiatric aspects in a population-based cohort of 60 children and adolescents (5–17 years) with Down syndrome (DS).Forty-one subjects were comprehensively assessed by a clinical research team; 17 (41%) and 14 (34%) met DSM criteria for autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), respectively.Forty-nine subjects had a formal cognitive test and 11 had clinical assessments due to profound intellectual disability (ID). Mild ID (IQ 50–70) was found in 9% of the teenagers (13–18 years) and in 35% of the younger (5–12 years) children. Corresponding figures for severe ID (IQ <50) were 91% and 65%, respectively. The ID was more severe in individuals with coexisting ASD.Levels and profiles of autistic symptoms, according to ADOS Module-1, were analysed. Children with DS and ASD, with different levels of ID, had significantly more symptoms within all autism domains, than those with DS only – a difference which remained when subgroups with severe ID were compared. A considerable proportion of subjects with DS had ASD in addition to ID, but there was a group with DS and severe ID without ASD. The autism profiles of children with DS and ASD were similar to those of children with idiopathic autism. The commonly used investigation tools used to diagnose ASD in the study, seemed to be appropriate in this patient group.An intervention programme, including education for parents and school staff, adapted to the specific needs of schoolchildren with DS and ASD was performed and evaluated. Although the studied group comprised older children and adolescents, most of whom with severe or profound ID, they could achieve goals and skills previously not managed. In addition, the parents’ views on the intervention were encouraging.In conclusion, there is a need of awareness of the increased prevalence of ASD and ADHD in children with DS. We suggest that screening for ASD and ADHD should be implemented for children with DS at the age of 3–5 years and at early school years, respectively. We also suggest that children with DS should be re-evaluated regarding level of ID before entering secondary school.
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| 5. |
- Ahlsson, Fredrik, 1967-
(författare)
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Being Born Large for Gestational Age : Metabolic and Epidemiological Studies
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Obesity is a major health problem in the Western world. Mean birth weight has increased during the last 25 years. One explanation is that the proportion of large for gestational age (LGA) infants has increased. Such infants risk developing obesity, cardiovascular disease and diabetes later in life. Despite the risk of neonatal hypoglycemia, their postnatal metabolic adaptation has not been investigated. Our data, obtained with stable isotope labeled compounds, demonstrate that newborn LGA infants have increased lipolysis and decreased insulin sensitivity. After administration of glucagon, the plasma levels of glucose and the rate of glucose production increased. The simultaneous increase in insulin correlated with the decrease in lipolysis, indicating an antilipolytic effect of insulin in these infants.We also demonstrated an intergenerational effect of being born LGA, since women born LGA, were at higher risk of giving birth to LGA infants than women not born LGA. Further, the LGA infants formed three subgroups: born long only, born heavy only, and born both long and heavy. Infants born LGA of women with high birth weight or adult obesity were at higher risk of being LGA concerning weight alone, predisposing to overweight and obesity at childbearing age. In addition we found that pregnant women with gestational diabetes were at increased risk of giving birth to infants that were heavy alone. This could explain the risk of both perinatal complications and later metabolic disease in infants of this group of women.To identify determinants of fetal growth, 20 pregnant women with a wide range of fetal weights were investigated at 36 weeks of gestation. Maternal fat mass was strongly associated with insulin resistance. Insulin resistance was related to glucose production, which correlated positively with fetal size. The variation in resting energy expenditure, which was closely related to fetal weight, was largely explained by BMI, insulin resistance, and glucose production. Lipolysis was not rate limiting for fetal growth in this group of women. Consequently, high maternal glucose production due to a high fat mass may result in excessive fetal growth.
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| 6. |
- Grannäs, Jan, 1967-
(författare)
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Framtidens demokratiska medborgare : Om ungdomar, medborgarskap och demokratifostran i svensk skola
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis attempts to deepen our understanding of the democratic assignment for Swedish schools. The school is a public space that all children and youth are a part of which gives it a prominent opportunity for fostering democratic citizens of the future. The purpose of the study is to increase the knowledge of this assignment, based on the students’ stories of how they experience it. The theoretical framework draws upon a spatial perspective and educational theory inspired by a radical view of democracy. A multiple case study was conducted based on three cases, chosen in order to achieve socioeconomic variation. A mixed method approach has been applied to the study: interviews, observations, documents and quantitative data have been analyzed using a thematic analysis framework. The results show that the democratic assignment of schools is complex and filled with legal, social, ideological, and ethical tensions. For the purpose of creating a school environment that meets the democratic assignment, systematic work and guidelines for school personnel, students, and parents appear to be necessary. The study has clearly shown that the conditions for the democratic assignment may differ markedly between schools and that peer socialization is of great importance for the outcome. The influence and potential of diversity on the democratic assignment of schools is clear. From a curriculum micro perspective, the study has brought attention to how the view of the (non-)competent student is relevant for the democratic assignment, as well as the bases on which this notion of (non-)competence rest. It is suggested that the view of the democratic assignment is extended, from a narrow focus on democratic decision-making processes to a wider focus that also takes into account the ongoing everyday negotiation processes between teachers and students that have impact on what is perceived as political action and democratic arenas.
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| 7. |
- Gustafsson, Jörgen, 1972-
(författare)
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Historielärobokens föreställningar : Påbjuden identifikation och genreförändring i den obligatoriska skolan 1870–2000
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis sets out to address the question: How is Swedish history put forward as expected identification in history textbooks for the years of compulsory schooling and how did this change during the period 1870-2000? This question is legitimate since the writing of history is a form of meaning-creation that is built through the merging of different components (place, time, actors, objectives, etc.) into a coherent narrative. The writing of history is therefore a form of power.The study include a quantitative total enquiry into all published history textbooks in Sweden between 1870-2000 aimed at compulsory schooling, as well as läroverk and gymnasium. In aim to map out and analyse the framing patterns displayed by the genre in order to answer questions about its characteristics and find out which have been the dominant history textbooks. These have formed basis for the qualitative investigation. The genre has its own clear inherent components such as images which are used over a very long time and found in book after book and publisher after publisher. The genre of history textbooks has an independence in relation to current research in academia and equally The only time there is a fundamental change is after the 1950s and then the whole school system had been recast, but after a while the greater part of the elements under study returned. The results of the thesis point to the consumer side as being what largely upholds the tradition of the genre.A clear change is the significantly increased female representation during the 1990s. When the female representation is portrayed, it is more connected to traditional female values such as family than ever before. I argue that this is a consequence of the gender system’s logic of separation. When there is more space given to female representation, it becomes increasingly important to mark the boundaries between the female and the male.
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| 8. |
- Gustafsson, Tommy, 1969-
(författare)
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En fiende till civilisationen : manlighet, genusrelationer, sexualitet och rasstereotyper i svensk filmkultur under 1920-talet
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The setting for this study is Swedish film culture of the 1920s, which has been studied with a focus on representations of masculinity and gender relations according to four themes: 1) children and youth 2) fatherhood and love 3) sexuality and popularity 4) ethnicity and racial stereotyping. The rise of new consumer culture in the first decades of the 20th century created turmoil between traditional and modern values, not least when it came to conceptions of gender. Studies on masculinity have often directed its efforts towards writing a history of ideals, bound by the concept of hegemonic masculinity; a concept that exclude women as insignificant for the social construction of masculinity. One ambition with this thesis has been to counter the long-lasting concept of hegemonic masculinity, and in the process, try to build a bridge between men and women studies. One other ambition has been question the canonisation of the “Golden Age” of Swedish silent filmmaking by introducing the concept of “the pluralism of film”, and by using a vast material including: Swedish feature films, reviews, articles from fan magazines and trade paper, screen plays, censorship cards, official reports, etc; thereby circumventing the concept of film as “art” in order to focus on film as representation in a more reliably way. One conclusion is the revelation of the diversity that surrounds social constructions of masculinity and gender relations in both film culture and society. In addition, Swedish film of the 20s hardly contained any male characters that upheld the hegemonic ideal, giving way to a more prominent presence of strong female characters, often in the shape of the New Woman. Women did as well have a great influence on the formation of masculinity. However, a notion of a Swedish normative masculinity became visible when contrasted with numerous racial stereotypes, such as malicious representations of Black people and Travellers. The emphasis on gender relations, rather than on ideals, has also contributed to a wider understanding of gender, where criteria such as generation, class, ethnicity and sexuality ought to be included. When it comes to the canonisation of the “Golden Age”, a strong notion exists about the integrated use of nature in film narratives as being a Swedish national trait, when in fact this could be linked only to a few films. If one would point out a trait that permeates Swedish film of the 1920s, it would not be the use of nature, but instead the flagrant racism and xenophobia.
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| 9. |
- Holmquist, Sofie, 1987-
(författare)
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Analyzing self-report data : assessing basic psychological needs in education and at work
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aims of this thesis were 1) to investigate how to measure and model basic psychological needs in higher education and work contexts, specifically in Swedish-speaking populations, and 2) to analyze the psychometric properties of basic psychological needs self-report instruments.The thesis consists of four studies and a summary. The main concepts studied were the basic psychological needs for autonomy, competence, and relatedness, as conceptualized in the Self- Determination Theory (SDT).The first study identified subgroups of early career psychologists characterized by their ratings on self- efficacy, psychological flexibility, and basic psychological need satisfaction. The results show that the groups differed in self-rated health, well-being, and intention to leave their profession. Higher basic psychological need satisfaction, self-efficacy, and psychological flexibility were associated with better self-rated health and well-being.The second study was an extensive psychometric evaluation of the need satisfaction and frustration scale (NSFS) in a large sample of Swedish workers. The analyses supported measurement invariance longitudinally and for gender, as well as the nomological validity of the scale. The dimensionality analyses supported a six-dimensional structure of the NSFS that takes small cross-loadings into account in an exploratory structural equation modeling representation. However, poor discrimination between need satisfaction and need frustration was present for some items.The third study translated a revised Swedish version of the NSFS, adapted to the educational domain, and validated it in a sample of Swedish university students. Dimensionality analyses supported using the NSFS as a three-dimensional measure of students' need for autonomy, need for competence, and need for relatedness. In support of nomological validity, each need uniquely contributed to predicting perceived stress and academic burnout. However, unexpectedly, autonomy did not provide incremental value beyond competence and relatedness in predicting life satisfaction and academic engagement.The fourth study translated and adapted the basic psychological need satisfaction and frustration scale (BPNSFS) to Swedish and the educational domain (BPNSFS-ED). This study also investigated the coherence between the BPNSFS-ED and the NSFS. Factor analyses showed support for using the scale as a six- dimensional measure of students' needs satisfaction and need frustration. The coherence between the BPNSFS-ED and the NSFS was moderate, and the BPNSFS-ED appears to be a more SDT coherent measure of students’ basic psychological needs.The main contribution of this thesis was providing researchers with a validated self-report instrument to assess basic psychological needs in Swedish education. The results also highlight challenges with measuring and modeling basic psychological needs and question whether items from well-used basic needs self-rating scales properly tap into the concept of need frustration. Finally, the results show that the need for autonomy seems to differ between basic psychological needs instruments which calls for mindfulness when choosing an instrument to measure basic psychological needs, and when comparing results across studies. Based on the results of this thesis, the BPNSFS-ED self-report instrument appears to be a good choice for researchers interested in assessing basic psychological needs in Swedish education.
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| 10. |
- Kvernby, Sofia, 1987-
(författare)
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Myocardial Tissue Characterization Using Magnetic Resonance Imaging
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In cardiovascular disease, which is the most common cause of death in the world, early diagnosis is crucial for disease outcome. Diagnosis of cardiovascular disease can be challenging, though. Quantification of myocardial T1 and T2 relaxation times with MRI has demonstrated to be a promising method for characterizing myocardial tissue, but long measurement times have hampered clinical use. The overall aim of this doctoral thesis was to develop, validate and, in patient studies, evaluate a very fast three-dimensional method for simultaneous quantification of myocardial T1 and T2 relaxation times with whole coverage of the left ventricle.The 3D-QALAS method is presented in Paper I of this thesis. It is a method that simultaneous measures both T1 and T2 relaxation times in a three-dimensional volume of the heart. The method requires 15 heartbeats, to produce 13 short-axis slices of the left ventricle with voxelwise information of both T1 and T2 relaxation times. The 3D-QALAS method was validated in phantoms and in 10 healthy volunteers by comparing the method with reference methods and demonstrated good accuracy and robustness both in-vitro and in-vivo.In Paper II, the 3D-QALAS method was carefully validated in-vivo by investigating accuracy and precision in 10 healthy volunteers, while the clinical feasibility of the method was investigated in 23 patients with various cardiac pathologies. Repeated independent and dependent scans together with the intra-scan repeatability, demonstrated all a very good precision for the 3D-QALAS method in healthy volunteers.In Paper III and IV, the 3D-QALAS method was applied and evaluated in patient cohorts where the heart muscle alters over time. In Paper III, patients with severe aortic stenosis underwent MRI examinations with 3D-QALAS before, 3 months after and 12 months after aortic valve surgery. Changes in T1 and T2 were observed, which might be used as markers of myocardial changes with respect to edema and fibrosis, which may develop due to increased workload over a long period of time.In study IV, 3D-QALAS was used to investigate 10 breast cancer patients treated with radiation therapy prior to treatment, 2-3 weeks into treatment, and one and 6 months after completion of treatment, to investigate any changes in T1 and T2 and further if they can be correlated to unwanted irradiation of the heart during radiation therapy.
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