| 1. |
- Alaie, Iman, et al.
(författare)
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Uppsala Longitudinal Adolescent Depression Study (ULADS)
- 2019
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To present the Uppsala Longitudinal Adolescent Depression Study, initiated in Uppsala, Sweden, in the early 1990s. The initial aim of this epidemiological investigation was to study the prevalence, characteristics and correlates of adolescent depression, and has subsequently expanded to include a broad range of social, economic and health-related long-term outcomes and cost-of-illness analyses.Participants: The source population was first-year students (aged 16-17) in upper-secondary schools in Uppsala during 1991-1992, of which 2300 (93%) were screened for depression. Adolescents with positive screening and sex/age-matched peers were invited to a comprehensive assessment. A total of 631 adolescents (78% females) completed this assessment, and 409 subsequently completed a 15year follow-up assessment. At both occasions, extensive information was collected on mental disorders, personality and psychosocial situation. Detailed social, economic and health-related data from 1993 onwards have recently been obtained from the Swedish national registries for 576 of the original participants and an age-matched reference population (N=200 000).Findings to date: The adolescent lifetime prevalence of a major depressive episode was estimated to be 11.4%. Recurrence in young adulthood was reported by the majority, with a particularly poor prognosis for those with a persistent depressive disorder or multiple somatic symptoms. Adolescent depression was also associated with an increased risk of other adversities in adulthood, including additional mental health conditions, low educational attainment and problems related to intimate relationships.Future plans: Longitudinal studies of adolescent depression are rare and must be responsibly managed and utilised. We therefore intend to follow the cohort continuously by means of registries. Currently, the participants are approaching mid-adulthood. At this stage, we are focusing on the overall long-term burden of adolescent depression. For this purpose, the research group has incorporated expertise in health economics. We would also welcome extended collaboration with researchers managing similar datasets.
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| 2. |
- Jonsson Widén, Anna, 1967-
(författare)
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Bildundervisning i möte med samtidskonst : bildlärares professionella utveckling i olika skolformer
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to describe and review the visual art teaching profession from a wider cultural perspective. This can lead to a better understanding of how teachers in 2000s Sweden manage change and relate to their task. This is a starting point for the formation of question areas that are of concern: the importance of their own specific interests in various visual art media for the development of their professional knowledge; what conditions different types of schools provide for the development of the subject and the strategies visual art teachers (in the study) use to develop their teaching on the theme of contemporary art. The theoretical framework is based on a socio-cultural perspective. Analysis combine cultural semiotic and frame factor models. Institutional art theory focuses on art’s audience and the art institutions which are central to contemporary art manifestations. The thesis is based on two case studies conducted by three separate teacher-training days at Bildmuseet in Umeå. 14 Visual Art teachers from four different types of schools: compulsory school, years 7-9, upper secondary school, folk high school and volountary art school (Swe. kulturskola) participated in the study. The investigations has generated data produced through interviews, observation, self-reports and images. Contemporary Art is involved in society's constant change and mix of new medias. The changes concernes the visual art educational field. The opportunities different school contexts provides for education, has an impact on how knowledge is transformed. Conformity, solid structures, formes of assessment and low legitimacy shape resistance. Teaching in visual art is highly based on teachers' own choices. A fragmented knowledge-culture with focus on manual or digital mediations leads to different knowledge-selection. This study highlights resistances that affect applying contemporary art on its own terms. Contemporary art’s starting points and new perspectives represent other paradigms than traditional art classifications. This sigifies tension between the artworld and the educational field. To reducie the tension, a dialogue and interaction between the fields on equal terms is recommended. The study identifies a lack of procedures and resources for formal continuing professional development. There is a need of developing the collective body of knowledge, covering both the theoretical and practical knowledge in the visual art teacher culture.
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| 3. |
- Bergström, Ulrica, 1970-
(författare)
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Fragility fractures in fragile people : epidemiology of the age quake
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Osteoporosis-related fracture is already today a major public health problem and the number of hip fractures is expected to double to 2030. Sweden has one of the highest hip fracture incidences worldwide. This may be explained by several factors: e.g. age, genetic, climatologic, geographic and a relative vitamin D deficiency, secondary to the limited sunlight exposure especially during winter months. Intrinsic and extrinsic factors contribute to a fracture, although a prior low energy fracture is one of the strongest predictors for a subsequent one and this should be a target for secondary fracture prevention in an orthopaedic setting. Since 1993 all injured patients admitted to the emergency floor and all in-hospital fractures at Umeå University Hospital, Sweden, were registered according to the Injury Data Base, former EHLASS. There were 31,173 fracture events (one or more fractures at the same time), of which 13,931 were in patients’ ≥ 50 years old. The fracture database was co analyzed with the Northern Sweden Health and Disease Study cohort in a nested case-control study for investigations of associations between osteoporotic fracture and serum markers, lifestyle data, nutrition etc. We found that there were differences in fracture pattern depending on age and sex. Both injury mechanism and fracture site were strongly dependent of age. The most severe fragility fracture, hip fracture, had a decreasing incidence. However, the incidence curve was right-shifting leading to an increase, both in numbers and in incidence of hip fractures among the oldest female. To identify people at high risk for fractures, re-fracture patients are useful. No less than 21% of the fracture patients had suffered more than one fracture event, accounting for 38% of all fracture events. The total risk ratio for a subsequent fracture was 2.2 (2.1-2.3 95% CI). In males the highest risk for re fracture was in the age cohort 70-79 years (RR 2.7, 2.3-3.2 95% CI), in females > 90 years (RR 3.9, 3.2-4.8 95% CI). Another possible risk factor in this subarctic population is the lack of sunlight, leading to a vitamin D deficit. The overall adjusted risk of sustaining a hip fracture in this population was 2.7 (95%CI:1.3-5.4) in subjects with a serum 25 hydroxyvitamin D below 50 nmol/l. The association was, however, different according to age at baseline. Thus in subjects aged 60 years and above at baseline, the adjusted odds ratio of sustaining a hip fracture was 6.2 (1.2-32.5 95%CI) for the group of individuals with a serum 25OHD below 50 nmol/l, whereas no significant association was found in the youngest age group. In the next 30 years the ongoing demographic changes will accelerate. The World War II baby boomers will cause an age quake. We can already see signs heralding a new fracture pattern: an increasing cohort of mobile but fragile elderly, with considerable co-morbidity is now at risk for fragility fractures. In fracture patients, clinical information is sufficient to pinpoint patients with a high risk for re-fractures. It is therefore clinically important to use the information provided by the fracture event. We suggest that trauma units and primary care units should screen for risk factors and inform patients about the treatment options, and to organize fracture liaison services. This seems to be especially cost-efficient for our oldest and frailest patients. Secondary prophylaxis and follow-up treatment after cardiovascular disorders are now a matter of course worldwide, but the screening for risk factors, in order to prevent a second fracture, is often neglected. This is one of the most important issues of fracture care in the future in order to improve general health.
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| 4. |
- Ekbladh, Elin, 1974-
(författare)
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Return to Work : Assessment of Subjective Psychosocial and Environmental Factors
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduktion: Sjukfrånvaron i Sverige är hög och kunskap om vad som påverkar återgång i arbete efter sjukskrivning behöver utvecklas. I processen kring återgång i arbete är bedömning av arbetsförmåga en viktig del. Bristen på valida, reliabla och teoretiskt förankrade bedömningsinstrument inom området är dock ett bekymmer eftersom tillförlitliga bedömningar av arbetsförmåga är en förutsättning för utformning och genomförande av interventioner för att stödja återgång i arbete. Denna typ av interventioner kräver multidisciplinär kompetens där arbetsterapeuter utgör en viktig funktion. Vid bedömning av arbetsförmåga bör personens subjektiva uppfattning om sin situation beaktas, då den har betydelse för utfallet av återgång i arbete. Worker Role Interview (WRI) och Work Environment Impact Scale (WEIS) är två arbetsrelaterade intervjuinstrument, som har utvecklats i syfte att bedöma subjektiva psykosociala och miljömässiga faktorers påverkan på arbetsförmåga. Den teoretiska grunden till WRI och WEIS är Model of Human Occupation, som är en modell med fokus på aktivitetsutförande i relation till psykosociala faktorer. Inledande prövningar av WRI och WEIS reliabilitet och validitet har genomförts. Bedömningsinstrumenten har bearbetats och översatts till svenska och används främst av arbetsterapeuter, som arbetar med personer med arbetsrelaterad problematik.Syfte: Det övergripande syftet med avhandlingen är att undersöka användbarheten av bedömningsinstrumenten Worker Role Interview och Work Environment Impact Scale för identifiering av psykosociala och miljömässiga rehabiliteringsbehov av betydelse för återgång i arbete.Metod: Avhandlingen består av fem empiriska studier. I samtliga studier har erhållen information bearbetats kvantitativt. I studie IV har även kvalitativ bearbetning genomförts. Studie I, II och IV är tvärsnittsstudier och studie II och V är två års longitudinella studier. I studie I samlades information in via enkät. I studie II, III och V bestod den huvudsakliga informationen av skattningar utifrån WRI variabler och i studie IV var bedömningar utifrån WEIS i form av skattningar och nedskrivna kommentarer till skattningarna den huvudsakliga informationen.Resultat: I studie I undersöktes vilka teoretiska utgångspunkter och professionsspecifika modeller arbetsterapeuter i Sverige ansåg påverka den psykiatriska vården och den psykiatriska arbetsterapin. Det psykosociala perspektivet var den teoretiska utgångspunkt som hade störst påverkan både på psykiatrisk vård och på psykiatrisk arbetsterapi. Den arbetsterapeutiska modell som flest identifierade var Model of Human Occupation. Detta resultat indikerar att Model of Human Occupation verkar vara användbar inom arbetsterapi och motiverade vidare användning av modellen i denna avhandling. Det som dock också framkom i studie I var att arbetsterapeuter inom psykiatrisk vård använde professionsspecifika modeller i en relativt liten utsträckning. Ett sätt att öka tillämpningen av teori i praktik är att använda teoretiskt grundade bedömningsinstrument. I studie II, III, IV och V har endera av de Model of Human Occupation- baserade bedömningsinstrumenten WRI och WEIS använts och värderats.I studie II och V prövades WRI:s förmåga att predicera återgång i arbete efter långvarig sjukskrivning. Det område i WRI som uppvisade bäst prediktivitet var området ”Självuppfattning” vars variabler beaktar personens motivation för återgång i arbete i form av personens upplevelse av kompetens och effektivitet för att utföra arbetsuppgifter och hantera utmaningar i arbetet. De två WRI variabler som bäst kunde predicera vilka som skulle återgå respektive inte återgå i arbete vid uppföljning efter två år var: ”Tro på sin arbetsförmåga”, och ”Dagliga vanor och rutiner”. Resultaten tyder på att kunskap om hur tro på den egna förmågan stärks och kunskap om dagliga vanor och rutiners påverkan på utförande av arbete är central vid genomförande av interventioner i syfte att stödja personer att återgå till arbete efter sjukskrivning.I studie III prövades WRI:s konstrukturella validitet i en internationell studie. Samtliga variabler i WRI, förutom de som tillhör miljöområdet, uppvisade en god konstrukturell validitet dvs mätte psykosociala faktorers påverkan på arbetsförmågan. WRI:s skattningsskala verkar stabil och valid mellan olika länder och för personer med olika diagnoser. I analysen framkom att WRI kunde särskilja mellan personers psykosociala arbetsförmåga på tre olika nivåer.I studie IV undersöktes hur personer med erfarenhet av långtidssjukskrivning uppfattar att faktorer i arbetsmiljön stödjer respektive hindrar personens utförande av arbete och välbefinnande genom bedömningar utifrån WEIS. De faktorer som uppfattades som meststödjande var olika former av sociala interaktioner på arbetet samt uppfattningen om arbetets värde och mening. De faktorer som uppfattades som mest hindrande var olika krav i relation till arbetsgenomförandet samt den belöning som erhålls för arbetet.Konklusion: Sammanfattningsvis så kan WRI användas för bedömning av psykosociala faktorers påverkan på arbetsförmågan. I WRI ingår variabler som kan predicera återgång till arbete upp till två år efter genomförd bedömning. WEIS verkar användbart för att identifiera arbetsmiljöfaktorer som stödjer respektive hindrar personers välbefinnande och utförande av arbete. Att komplettera olika datainsamlingsmetoder är en förutsättning för att uppnå en så god bedömning av arbetsförmåga som möjligt. Den information som WRI- och WEISintervjuer genererar är värdefull, då den kan utgöra en viktig grund för planering av individspecifika rehabiliteringsinsatser. Bedömningsinstrumenten WRI och WEIS med sin teoretiska förankring i Model of Human Occupation kan anses vara användbara för att identifiera psykosociala och miljömässiga rehabiliteringsbehov i syfte att stödja personer i processen åter till arbete efter sjukskrivning.
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| 5. |
- Jonsson, Patrik, 1968-
(författare)
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Surface Status Classification, Utilizing Image Sensor Technology and Computer Models
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a great need to develop systems that can continuously provide correct information about road surface status depending on the prevailing weather conditions. This will minimize accidents and optimize transportation. In this thesis different methods for the determination of the road surface status have been studied and analyzed, and suggestions of new technology are proposed. Information about the road surface status is obtained traditionally from various sensors mounted directly in the road surface. This information must then be analyzed to create automated warning systems for road users and road maintenance personnel. The purpose of this thesis is to investigate how existing technologies can be used to obtain a more accurate description of the current road conditions. Another purpose is also to investigate how existing technologies can be used to obtain a more accurate description of the current road conditions. Furthermore, the aim is to develop non-contact technologies able to determine and classify road conditions over a larger area, since there is no system available today that can identify differences in road surface status in the wheel tracks and between the wheel tracks.Literature studies have been carried out to find the latest state of the art research and technology, and the research work is mainly based on empirical studies. A large part of the research has involved planning and setting up laboratory experiments to test and verify hypotheses that have emerged from the literature studies. Initially a few traditional road-mounted sensors were analyzed regarding their ability to determine the road conditions and the impact on their measured values when the sensors were exposed to contamination agents such as glycol and oil. Furthermore, non-contact methods for determining the status of the road surface have been studied. Images from cameras working in the visible range, together data from the Swedish Transportation Administration road weather stations, have been used to develop computerized road status classification models that can distinguish between a dry, wet, icy and snowy surface. Field observations have also been performed to get the ground truth for developing these models. In order to improve the ability to accurately distinguish between different surface statuses, measurement systems involving sensors working in the Near-Infrared (NIR) range have been utilized. In this thesis a new imaging method for determining road conditions with NIR camera technology is developed and described. This method was tested in a field study performed during the winter 2013-2014 with successful results.The results show that some traditional sensors could be used even with future user-friendly de-icing chemicals. The findings from using visual camera systems and meteorological parameters to determine the road status showed that they provide previously unknown information about road conditions. It was discovered that certain road conditions such as black ice is not always detectable using this technology. Therefore, research was performed that utilized the NIR region where it proved to be possible to detect and distinguish different road conditions, such as black ice. NIR camera technology was introduced in the research since the aim of the thesis was to find a method that provides information on the status of the road over a larger area. The results show that if several images taken in different spectral bands are analyzed with the support of advanced computer models, it is possible to distinguish between a dry, wet, icy and snowy surface. This resulted in the development of a NIR camera system that can distinguish between different surface statuses. Finally, two of these prototype systems for road condition classification were evaluated. These systems were installed at E14 on both sides of the border between Sweden and Norway. The results of these field tests show that this new road status classification, based on NIR imaging spectral analysis, provides new information about the status of the road surface, compared to what can be obtained from existing measurement systems, particularly for detecting differences in and between the wheel tracks.
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| 6. |
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