| 1. |
- Ejhed, Helene, et al.
(författare)
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Enskilda avlopp som källa till läkemedelsrester och andra kemikalier
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I Sverige finns cirka 700 000 fastigheter med enskilda avlopp, varav cirka 75 % utgörs av markbaserade anläggningar där det renade avloppsvattnet direkt eller via grundvattnet når ytvattenrecipienter. Syftet med detta projekt har varit: att undersöka om halter av läkemedel och andra kemikalier från enskilda avlopp är detekterbara i en recipient med känd påverkan av enskilda avlopp, att kvantifiera spridning av ett antal substanser av läkemedel från enskilda avlopp samt att undersöka reningseffektivitet i enskilda avlopp avseende läkemedel och andra kemikalier. Projektet har genomförts i samarbete med Södertälje kommun. Provtagning genomfördes i Lillsjön med tillflöden, i Hölö inom Södertälje kommun. Analyser genomfördes av vatten, sediment och biota av ett urval läkemedel- och andra hushållrelaterade kemikalier som perfluoroktansulfonsyra (PFOS) och etylendiamintetraättiksyra (EDTA). Provtagning genomfördes även av läkemedelsubstanser i inkommande och utgående vatten i två markbäddar. I den ena anläggningen tillsattes manuellt (spikades) en känd mängd läkemedelssubstanser och bromid som spårämne. I den andra anläggningen analyserades läkemedelsubstanser som användes av brukarna. Analyser genomfördes även av pH, total fosfor, "biochemical oxygen demand" (BOD) och totalt organiskt kol (TOC) för att kontrollera markbäddarnas funktion. Analyserna av vatten och sediment i Lillsjön uppvisade endast små mängder läkemedelsrester, PFOS och EDTA. Läkemedelsrester påvisades dock i det tillflöde som sammantaget är mest befolkat med enskilda avlopp samt i ett utlopp med utsläpp från Hölö församlingshem, vilket visar att enskilda avlopp bidrar till spridning av läkemedelsrester till miljön. Markbäddarna uppvisade en god reduktion av de femton analyserade läkemedlen och låg generellt sett över den genomsnittliga reduceringsgraden avseende dessa ämnen i fyra stora svenska reningsverk. Undantagen var diklofenak och ketoprofen där reduceringsgraden var betydligt lägre än för de fyra svenska reningsverken. Orsaken tros vara problem att detektera substanserna i ingående avloppsvatten och att reduktionen därmed inte kunde bestämmas på ett rättvisande sätt. Beräkning av total mängd som passerade användare med enskilda avlopp har beräknats baserat på nationell statistik om permanentboende med enskilda avlopp, statistik från Apotekens service avseende försåld mängd och uppmätt reduktion i markbäddarna. Enskilda avlopp står för en betydande del av avloppsflödet i Sverige. Cirka tio gånger större mängder av karbamazepin och diklofenak sprids från enskilda avlopp avseende hela Sverige än från Henriksdals reningsverk i Stockholm. Paracetamol är den substans som står för störst utsläpp enligt beräkningarna, cirka 12 ton år 2010. Reduktion av läkemedelsubstanser i markbaserade anläggningar beror på utformning och skötsel av avloppsanläggningen. God syresättning och lång uppehållstid i markbaserade anläggningar är gynnsamma förutsättningar. Reduktionen sker dock inte i lika hög grad för samtliga substanser och anläggningar som brister i utformningen kan ge utsläpp till vattenmiljön och grundvatten, vilket har noterats i både denna studie och i internationell litteratur. Ytterligare studier behövs för att bestämma om substanserna bryts ner och hur de bryts ner i de enskilda avloppen. Risker med avseende på spridning av läkemedelsrester och andra kemikalier från enskilda avlopp bör undersökas vidare.
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| 2. |
- von Tottleben, Malte, et al.
(författare)
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An Integrated Care Platform System (C3-Cloud) for Care Planning, Decision Support, and Empowerment of Patients With Multimorbidity: Protocol for a Technology Trial
- 2022
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Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support.Objective: The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems.Methods: This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 “testing and evaluation” phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening.Results: The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product.Conclusions: Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalized care plan platforms for patients and collaboration platforms for members of MDTs can help tackle the specific challenges of clinical guideline reconciliation for patients with multimorbidity and improve the management of polypharmacy. The initial evaluative phases have indicated promising results of platform usability. Results of phases 3 and 4 were methodologically useful, yet limited due to the COVID-19 pandemic.
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| 3. |
- Adler, Sara, et al.
(författare)
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Symptoms and risk factors of Cryptosporidium hominis infection in children : data from a large waterborne outbreak in Sweden
- 2017
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Ingår i: Parasitology Research. - : Springer Berlin/Heidelberg. - 0932-0113 .- 1432-1955. ; 116:10, s. 2613-2618
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Tidskriftsartikel (refereegranskat)abstract
- Cryptosporidium is a major cause of diarrheal disease worldwide. In developing countries, this infection is endemic and in children, associated with growth faltering and cognitive function deficits, with the most severe impact on those aged <2 years. Little has been reported about symptoms and risk factors for children in industrialized countries, although the disease incidence is increasing in such regions. In November 2010, a large waterborne outbreak of C. hominis occurred in the city of Östersund in Sweden. Approximately 27,000 of the 60,000 inhabitants were symptomatic. We aimed to describe duration of symptoms and the risk factors for infection with C. hominis in children aged <15 years in a Western setting. Within 2 months after a boil water advisory, a questionnaire was sent to randomly selected inhabitants of all ages, including 753 children aged <15 years. Those with ≥3 loose stools/day were defined as cases of diarrhoea. The response rate was 70.3%, and 211 children (39.9%) fulfilled the case definition. Mean duration of diarrhoea was 7.5 days (median 6, range 1-80 days). Recurrence, defined as a new episode of diarrhoea after ≥2 days of normal stools, occurred in 52.5% of the cases. Significant risk factors for infection, besides living within the distribution area of the contaminated water plant, included a high level of water consumption, male sex, and a previous history of loose stools. The outbreak was characterized by high attack and recurrence rates, emphasizing the necessity of water surveillance to prevent future outbreaks.
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| 4. |
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| 5. |
- Baaz, Mikael, 1966, et al.
(författare)
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Borders in the mind and on the ground - (Re)categorization as “peace-building resistance”in the Preah Vihear Temple conflict
- 2019
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Ingår i: Heritage and borders. Editor: Anna Källén.. - Stockholm : Kungliga Vitterhets historie och antikvitets akademien. - 0348-1433. - 9789188763143 ; , s. 83-104
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Borders now seem to be everywhere, just like it is often said in heritage studies that the past is everywhere. In this edited volume a multidisciplinary group of scholars explore what happens, philosophically and in practice, when these two concepts and phenomena, heritage and borders, are combined. The findings show that heritage, as well as borders, exist just as much in the mind as on the ground. Heritage and borders can be understood both in terms of roots and routes. They are matters of administration, but they are also matters of consideration, matters of competition, and matters of contention. They are defended in the name of security and protection, longing for belonging, and good will. And they are contested in the name of philosophical critique, or political and artistic activism. In six articles and a joint conversation, the volume addresses key issues and entangled complexities in discussions on heritage and borders that take place in and across academic disciplines today.
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| 6. |
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| 7. |
- Baaz, Mikael, 1966, et al.
(författare)
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Defining and Analyzing “Resistance”: Possible Entrances to the Study of Subversive Practices
- 2016
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Ingår i: Alternatives: Global, Local, Political. - THOUSAND OAKS, CA 91320 USA : SAGE Publications. - 0304-3754 .- 2163-3150. ; 41:3, s. 137-153
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Tidskriftsartikel (refereegranskat)abstract
- This article explores the meaning of “resistance” and suggests a new path for “resistance studies,” which is an emerging and interdisciplinary field of the social sciences that is still relatively fragmented and heterogeneous. Resistance has often been connected with antisocial attitudes, destructiveness, reactionary or revolutionary ideologies, unusual and sudden explosions of violence, and emotional outbursts. However, we wish to add to this conceptualization by arguing that resistance also has the potential to be productive, plural and fluid, and integrated into everyday social life. The first major part of the article is devoted to discuss existing understandings of resistance with the aim of seeking to capture distinctive features and boundaries of this social phenomenon. Among other things, we will explore resistance in relation to other key concepts and related research fields. We then, in the article’s second major part, propose a number of analytical categories and possible entrances aiming at inspire more in-depth studies of resistance.
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| 8. |
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| 9. |
- Baaz, Mikael, 1966, et al.
(författare)
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Emotions and resistance: An introduction
- 2018
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Ingår i: Resistance and Emotions: interrogating Crossroads and Social change. - Abingdon, Oxon : Routledge. - 9781138482531
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Baaz, Mikael, 1966, et al.
(författare)
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I Felt a Little Homosexual Today, So I Called in Sick: The Formation of “Reverse Discourse” by Swedish Gay Activists in the 1970s
- 2022
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Ingår i: Global Society. - : Informa UK Limited. - 1360-0826 .- 1469-798X. ; 36:3, s. 330-346
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Tidskriftsartikel (refereegranskat)abstract
- This article revolves around the legal and epistemic battles around “homosexuality” in Sweden in 1979, which led to the abolition of homosexuality being classified as a “disease”. Among other things, gay activists “called in sick” to the Social Insurance Agency (SIA) and claimed that they were unable to work because they were homosexuals (read as mentally disordered). The phone calls can be understood as a formation of “reverse” discourse; that is, gay people starting to speak on their own behalf, while using the same categories by which they were labelled. By analysing this resistance and a sit-in that was organised at the Swedish National Board of Health and Welfare (NBHW), we conclude that reverse discourse, as a productive yet rupturing practice, is not a single- handed and unaccompanied resistance strategy but materialises as one practice among many in a complex web of resistance and power.
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