| 1. |
- amundsen, silja, et al.
(författare)
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A comprehensive screen for SNP associations on chromosome region 5q31-33 in Swedish/Norwegian celiac disease families.
- 2007
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Ingår i: European Journal of Human genetics. - : Springer Science and Business Media LLC. - 1018-4813 .- 1476-5438. ; 15:9, s. 980-987
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Tidskriftsartikel (refereegranskat)abstract
- Celiac disease (CD) is a gluten-induced enteropathy, which results from the interplay between environmental and genetic factors. There is a strong human leukocyte antigen (HLA) association with the disease, and HLA-DQ alleles represent a major genetic risk factor. In addition to HLA-DQ, non-HLA genes appear to be crucial for CD development. Chromosomal region 5q31–33 has demonstrated linkage with CD in several genome-wide studies, including in our Swedish/Norwegian cohort. In a European meta-analysis 5q31–33 was the only region that reached a genome-wide level of significance except for the HLA region. To identify the genetic variant(s) responsible for this linkage signal, we performed a comprehensive single nucleotide polymorphism (SNP) association screen in 97 Swedish/Norwegian multiplex families who demonstrate linkage to the region. We selected tag SNPs from a 16 Mb region representing the 95% confidence interval of the linkage peak. A total of 1404 SNPs were used for the association analysis. We identified several regions with SNPs demonstrating moderate single- or multipoint associations. However, the isolated association signals appeared insufficient to account for the linkage signal seen in our cohort. Collective effects of multiple risk genes within the region, incomplete genetic coverage or effects related to copy number variation are possible explanations for our findings.
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| 2. |
- Nyström, Ingrid, 1965, et al.
(författare)
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Biokombi Rya - Biobränsleförgasning satt i system
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom projekt Biokombi Rya har ett flertal olika forskargrupper gemensamt studerat systemeffekterna av att introducera förgasning av biobränsle i Göteborgs fjärrvärmesystem, i Västsverige som region och ur ett mer generellt och långsiktigt systemperspektiv. Syftet med projektet är att öka kunskapen inför eventuell framtida utbyggnad av biobränsleförgasning i Sverige samt att utreda vilka förutsättningar som är nödvändiga för att sådana anläggningar ska bli ekonomiskt och miljömässigt intressanta inom en relativt kort tidsrymd (ca 10 år). Fokus ligger på integration av anläggningar för förgasning av biobränsle med befintliga kraftvärmeverk med kombicykel samt med fjärrvärme. Projektet vänder sig till beslutsfattare inom området på nationell, regional och lokal nivå.Övergripande systemanalys inom projektet har särskilt fokuserat på biobränslemarknaden och framtida prisbildning för biobränsle samt på den långsiktiga konkurrenskraften för biodrivmedel via förgasning. Projektet i övrigt utgår från en tillämpad fallstudie av delvis konvertering av Rya Kraftvärmeverk (Rya KVV) i Göteborg till förgasat biobränsle, vilket alltså innebär integration mellan förgasningsanläggning och ett naturgaseldat gaskombikraftvärmeverk knutet till ett fjärrvärmesystem. I denna del ingår även en konceptuell studie över olika tekniska processalternativ för produktion av värme, el och drivmedel, inklusive ett mer långsiktigt alternativ för vätgasproduktion. Inom projektet används gemensamma scenarier för energimarknaderna ca år 2020.Några av projektets viktigaste slutsatser är:• Förgasning av biobränsle kan bli intressant för både el- och drivmedelsproduktion och bidra till reducerade CO2-utsläpp, förutsatt att nivån på priset på biobränsle inte är alltför hög relativt fossilbränslepriserna. I de flesta fall är också riktade styrmedel för att premiera förnybar el- och/eller drivmedelsproduktion (t ex certifikat) en förutsättning. Vid gynnsamma förutsättningar för både ”grön” el- och drivmedelsproduktion kan en konkurrenssituation om biobränsle uppstå.• Den långsiktiga konkurrenskraften för biodrivmedel från förgasning är i hög grad beroende av teknik- och kostnadsutveckling inom både transportsektorn och andra sektorer, t ex för lagring av el och väte, bränsleceller och uthållig CO2-fri elproduktion. Tillgängligheten för insamling och lagring av CO2 från fossila anläggningar ökar konkurrenskraften betydligt, men denna effekt neutraliseras om CO2 samlas in även från biobaserade anläggningar. Vilken typ av biodrivmedel som får bäst konkurrenskraft beror till stor del på distributions- och fordonskostnader.• Göteborgs fjärrvärmesystem, med en stor andel spillvärme, och Rya Kraftvärmeverk, med relativt andra kombicykler låg elverkningsgrad, har egentligen inte de optimala förutsättningarna för att förgasning av biobränsle ska vara ekonomiskt intressant.• I flera fall kan det trots detta vara ekonomiskt intressant att bygga en anläggning för förgasning av biobränsle i Göteborg. Av de förgasningsbaserade alternativ som studerats, visar sig produktion av syntetisk naturgas från flis för användning som fordonsbränsle var den ekonomiskt mest robusta lösningen, förutsatt att det finns riktade styrmedel för ”grön” drivmedelsproduktion, t ex drivmedelscertifikat. Ombyggnad av Rya Kraftvärmeverk till delvis biobränslebaserad kraftvärme via förgasning är även detta ekonomiskt intressant i flera fall. Kraftvärme baserad på biobränsleförgasning med högre elverkningsgrad än vad som är möjligt i Rya Kraftvärmeverk skulle dock kunna vara än mer intressant.• För att en förgasningsanläggning ska vara ekonomiskt intressant är det viktigt att uppnå så hög el- respektive drivmedelsverkningsgrad som möjligt samt att anläggningen får längsta möjliga drifttid. För drivmedelsproduktion finns det betydande fördelar med att kunna utnyttja värmeöverskottet från anläggningen i ett fjärrvärmesystem eller liknande.• För fjärrvärmesystemen i regionen som helhet finns det, enligt modellresultaten och för de scenarier som använts, starka drivkrafter att öka elproduktionen i kraftvärmeverk. Med gynnsamma förutsättningar för biobränslebaserad elproduktion har konventionell biobränslebaserad kraftvärme bäst ekonomi. Med drivmedelscertifikat eller liknande kan förgasningsanläggningar istället få en betydande roll för produktion av biodrivmedel, även knutet till medelstora fjärrvärmenät.• Produktion av biodrivmedel, som DME och vätgas, kan ske till kostnader som är konkurrenskraftiga gentemot dagens bensinpris, särskilt om produktionen blir möjlig att integrera med svartlutsförgasning (här studerat för vätgas). För vätgasproduktion är i samtliga fall ekonomin och den totala effekten på CO2-utsläppen dock starkt beroende av möjligheterna att samla in och lagra CO2.• För samtliga studerade tekniker och delsystem påverkar scenarieantaganden om utvecklingen av energimarknaderna och omvärldens energisystem i hög grad resultaten. För att utvärdera robustheten och de totala klimateffekterna för en enskild investering krävs därför systemanalys, som tar hänsyn till denna omvärld.
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| 3. |
- Rafsten, Lena, et al.
(författare)
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Gothenburg Very Early Supported Discharge study (GOTVED) : a randomised controlled trial investigating anxiety and overall disability in the first year after stroke
- 2019
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 19, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine.METHODS: A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients' degree of overall disability, measured by the modified Rankin Scale (mRS).RESULTS: No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke.CONCLUSIONS: The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement of overall disability compared to ordinary rehabilitation. We suggest considering coordinated VESD for patients with mild to moderate stroke in addition to ordinary rehabilitation as part of the service from a stroke unit.TRIAL REGISTRATION: Clinical Trials.gov: NCT01622205. Registered 19 June 2012 (retrospectively registered).
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| 4. |
- Zhou, Anna, 1966-, et al.
(författare)
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Aging with my family: a grounded theory approach on the role of family when aging as foreign-born
- 2024
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundResearch indicates that it is the quality of the closest relationships in the mixture of social relations that matters most for older adults. For older foreign-born, especially those who migrate late in life, the family is often the only socioeconomical resource they can lean on. This study aims to explore how older foreign-born perceive the role of family as they age.MethodsThe study design has a grounded theory approach. Data consist of individual open-ended interviews with 15 foreign-born informants aged between 60 and 85 years old who migrated to Sweden as adults from various parts of the world.ResultsThe findings demonstrate that family was an essential part of the informants' lives as they lived for their families and their families lived for them. Family solidarity was described as a cultural heritage they took over from their original families and a cultural heritage they wished to pass on to their future generations. They found that this was what separated them as foreign-born from native-born. Memories of their parents reminded them of their biological, social, and cultural heritages. The intimate relationship with their spouses in a life course had served as a source of validation of their individual identities and promoted personal growth and self-esteem. The role as a loving and caring parent entailed a sense of accomplishment and satisfaction for the life lived. And now as grandparents, the role as a link between the family's historical heritage and the future generation entailed not only a sense of coherence as they aged but also hope and meaning beyond their own lives.ConclusionsThe older foreign-born experienced life satisfaction as they aged with their families. Family meant community and solidarity. It was in the family that they found their distinct roles that had defined them. Family was an indispensable part of their social identity. The findings highlight the importance of older foreign-born being studied from a family and lifetime perspective.
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| 5. |
- Ahlgren, Erik, 1962, et al.
(författare)
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Biokombi Rya - slutrapporter från ingående delprojekt
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom projektet Biokombi Rya har ett flertal olika forskargrupper samarbetat för att studera system¬effekterna av förgasning av biobränsle ur olika aspekter. Syftet med projektet är att öka kunskapen om biobränsleförgasning i Sverige samt att utreda förutsättningar för att sådana anläggningar ska vara ekonomiskt och miljömässigt intressanta. En referensgrupp har varit kopplad till projektet där förutsättningar, resultat och slutsatser har behandlats.I denna underlagsrapport har slutrapporterna från projektets delprojekt samlats. De beskriver förutsättningar, metodansatser, använda data och resultat utförligt och utgör på så sätt ett viktigt komplement till den mer övergripande beskrivningen i projektets syntesrapport. De delrapporter som ingår har valts för att täcka in samtliga delar av projektet som är av allmänt intresse. Projektresultat som publicerats på annat sätt berörs dock mer kortfattat.Projektet Biokombi Rya har pågått under två år (2005-2006) och drivits av Chalmers EnergiCentrum. Förutom de omfattande analysinsatser som författarna till denna rapport står för, har Avdelningen för kemisk teknologi vid KTH, Siemens Industrial Turbines AB och Göteborg Energi AB bidragit med expertstöd. CIT Industriell Energianalys, med undertecknad som projektledare, har stått för projektledning och koordination.Projektet har finansierats av Energimyndigheten, Göteborg Energis forsknings¬stiftelse samt Göteborg Energi AB.
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| 6. |
- Andreassen, Maria, et al.
(författare)
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Assessing occupational performance in special housing in Sweden
- 2018
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 25:6, s. 428-435
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Tidskriftsartikel (refereegranskat)abstract
- Background: Assessing occupational performance is commonly done by occupational therapists[OT] working in special housing in municipal elder care. Assessments should be relevant and evidence-based. Even so, we know little about how assessment of occupational performance is conducted in special housing.Aim: The aim of this study was to identify OTs’ use and perceptions of different methods to assess occupational performance for elderly clients living in special housing. Method: An email questionnaire was sent to OTs working in special housing in Sweden. Data was analyzed using descriptive and parametric statistics.Results: The findings, based on data from 660 respondents, showed that OTs regularly assessed occupational performance but did not use standardized assessment instruments or structured methods to any great extent. In general, OTs reported that they were not pleased with their ability to assess their clients; however, OTs with higher education and with responsibility for fewer clients were more pleased with their assessments and stated that they had more knowledge about assessment methods. Conclusion: To support OTs in using structured assessments of occupational performance in everyday practice, organization as well as structures in the work environment and educational development need to be taken into consideration.
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| 7. |
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| 8. |
- Bergström, Maria, 1983-, et al.
(författare)
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A dyadic exploration of support in everyday life of persons with RA and their significant others
- 2023
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Ltd. - 1103-8128 .- 1651-2014. ; 30:5, s. 616-627
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Tidskriftsartikel (refereegranskat)abstract
- Background Support from significant others is important for participation in everyday life for persons with rheumatoid arthritis (RA). Meanwhile, significant others also experience limitations. Aims To explore how support is expressed by persons with RA and significant others, and how support relates to participation in everyday life of persons with RA. Material and methods Sixteen persons with RA and their significant others participated in individual semi-structured interviews. The material was analyzed using dyadic analysis. Results Persons with RA and significant others reported that RA and support had become natural parts of everyday life, especially emotional support. The reciprocal dynamics of support were also expressed as imperative. Also, support from people outside of the dyads and well-functioning communication facilitated everyday life. Conclusions Significant others and the support they give are prominent factors and facilitators in everyday life of persons with RA. Concurrently, the support persons with RA provide is important, along with support from outside of the dyads. Significance The results indicate that the interaction between persons with RA and the social environment is central to gain insight into how support should be provided for optimal participation in everyday life. Significant others can preferably be more involved in the rehabilitation process.
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| 9. |
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| 10. |
- Bergström, Maria, 1983-
(författare)
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Participation and support in everyday life over a decade : perspectives of persons with rheumatoid arthritis and their significant others
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The treatment of rheumatoid arthritis (RA) has evolved over recent decades. Today, many previous limitations related to, for example, joint damage have become rare, and persons with RA can often continue to work and engage in different aspects of everyday life. Nonetheless, persons with RA still report restrictions in everyday life, as they can be negatively impacted by symptoms like pain, stiffness and fatigue. As these symptoms might be invisible to others, the significant others of persons with RA can find it difficult to comprehend the effect of the disease. As a consequence, both the person with RA and the significant other may be affected, despite today’s effective treatment.As participation is a central concept within healthcare, it is also a prominent factor within rehabilitation and its goals. Despite access to contemporary treatment during the whole disease course, persons with RA still report participation restrictions. Since RA is a chronic disease, these remaining restrictions are of particular interest from a longitudinal perspective. However, support from the social environment, such as significant others, has the possibility to positively influence participation in everyday life. Therefore, it is essential to explore the influence of significant others and their support with the goal of enhanced participation in the everyday life of persons with RA, from a longitudinal perspective.Aim: The general aim of this thesis is to explore participation in the everyday life of persons with RA over a decade, and in relation to this investigate the influence of significant others and their support.Methods: This thesis consists of four studies that used different methodological approaches: qualitative, quantitative and mixed methods.Study I was a qualitative study where 59 persons with RA participated in semi-structured interviews approximately three years after diagnosis. Questions covered experiences in everyday life and participation. The material was analysed through content analysis.In Study II, longitudinal data from 274 persons with RA were analysed regarding disease activity (assessed by DAS28), grip force (assessed by Grippit), pain intensity (VAS mm) and activity limitations (assessed by HAQ). The data were collected at inclusion, year one and year two after diagnosis. Data related to sickness absence were also obtained, as well as self-assessed perceptions of experienced support. Through regression analyses, associations between disease-related variables and sickness absence were investigated, with support as a moderator.The data in Study III comprise semi-structured individual interviews with 16 persons with RA and their significant others, conducted approximately a decade after diagnosis. The interview guide was developed with Study I in mind and included similar topics, with the addition of support. This material was analysed using dyadic analysis, where a person with RA and the significant other comprised a dyad.Finally, in Study IV, a convergent mixed methods approach was used. Longitudinal data regarding disease-related variables (same as Study II) were collected during the first decade after diagnosis and analysed through linear mixed models. The qualitative material consisted of individual interviews conducted three and ten years after diagnosis and analysed by directed content analysis. The quantitative and qualitative results were integrated in accordance with the chosen method.Results: Significant others of persons with RA could encompass both facilitators and hinders to participation in the everyday life of persons with RA. Through the provision of support and helpful attitudes towards needed adaptations, they had a positive influence on participation in the everyday life of persons with RA. This was a continuous process since the persons with RA were still affected by the disease a decade after diagnosis, and adaptations by the significant others might also still be needed.Experiences of RA were found to differ between men and women over the first decade after diagnosis. Moreover, through a mixed methods design, discrepancies were found between the persons’ own descriptions in interviews and the quantitative results. For instance, women expressed issues related to grip force and disease activity in the interviews, but these issues were not detected in the same way in the quantitative results. These discrepancies were additionally not seen in men; however, both men and women still showed signs of disability a decade after RA diagnosis. Nevertheless, over time, the persons with RA and their significant others had learned to live with the disease and there was a sense of togetherness in everyday life with RA. Namely, they approached the disease together as a unit.Support was identified as a positive aspect that facilitated everyday life. It entailed both the support between the person with RA and the significant other, as well as the support from others outside of the dyad. Support could also come in different forms. For example, the person with RA could receive emotional support from a significant other, or healthcare professionals (HCPs) could provide informational support to either or both of the parties. In connection to the latter, a continuous need for knowledge was identified in both the persons with RA and the significant others. Support from significant others also proved to have an impact on work life specifically, as more perceived support was associated with an increased risk of sickness absence.Conclusively, significant others and their support can influence participation in the everyday life of persons with RA, and this influence can be facilitated through positive attitudes and different types of support during the first decade after diagnosis.Conclusions: Significant others are essential providers of support as facilitators for participation in the everyday life of persons with RA, including many years after diagnosis. However, they must also be attentive towards the further need for adaptations and possible emotional burden in the persons with RA. It is also important for significant others to find a balance between overprotecting and contributing to independence.The significant others in their turn might need support in understanding the impact of the disease. In this case, HCPs should be providers of support to both persons with RA and their significant others and consult with both of them as a unit in the rehabilitation process. This also exemplifies the need for support from outside the dyads of persons with RA and their significant others.Support is requested both at an early stage and throughout the disease course. Different types of support from significant others can therefore preferably be part of the rehabilitation process as a way to enhance participation in the everyday life of persons with RA.
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