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| 4. |
- Johansson, Håkan, 1972-, et al.
(författare)
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Characterization of Campylobacter spp. isolated from wild birds in the Antarctic and Sub-Antarctic
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 13:11
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Tidskriftsartikel (refereegranskat)abstract
- A lack of knowledge of naturally occurring pathogens is limiting our ability to use the Antarctic to study the impact human-mediated introduction of infectious microorganisms have on this relatively uncontaminated environment. As no large-scale coordinated effort to remedy this lack of knowledge has taken place, we rely on smaller targeted efforts to both study present microorganisms and monitor the environment for introductions. In one such effort, we isolated Campylobacter species from fecal samples collected from wild birds in the Antarctic Peninsula and the sub-Antarctic island of South Georgia. Indeed, in South Georgia, we found Campylobacter lari and the closely related Campylobacter peloridis, but also distantly related human-associated multilocus sequence types of Campylobacter jejuni. In contrast, in the Antarctic Peninsula, we found C. tart and two closely related species, Campylobacter subantarcticus and Campylobacter volucris, but no signs of human introduction. In fact, our finding of human-associated sequence types of C. jejuni in South Georgia, but not in the Antarctic Peninsula, suggests that efforts to limit the spread of infectious microorganisms to the Antarctic have so far been successful in preventing the introduction of C. jejuni. However, we do not know how it came to South Georgia and whether the same mode of introduction could spread it from there to the Antarctic Peninsula.
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| 5. |
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| 6. |
- Balk, Lennart, et al.
(författare)
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Widespread episodic thiamine deficiency in Northern Hemisphere wildlife
- 2016
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Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Many wildlife populations are declining at rates higher than can be explained by known threats to biodiversity. Recently, thiamine (vitamin B-1) deficiency has emerged as a possible contributing cause. Here, thiamine status was systematically investigated in three animal classes: bivalves, ray-finned fishes, and birds. Thiamine diphosphate is required as a cofactor in at least five life-sustaining enzymes that are required for basic cellular metabolism. Analysis of different phosphorylated forms of thiamine, as well as of activities and amount of holoenzyme and apoenzyme forms of thiaminedependent enzymes, revealed episodically occurring thiamine deficiency in all three animal classes. These biochemical effects were also linked to secondary effects on growth, condition, liver size, blood chemistry and composition, histopathology, swimming behaviour and endurance, parasite infestation, and reproduction. It is unlikely that the thiamine deficiency is caused by impaired phosphorylation within the cells. Rather, the results point towards insufficient amounts of thiamine in the food. By investigating a large geographic area, by extending the focus from lethal to sublethal thiamine deficiency, and by linking biochemical alterations to secondary effects, we demonstrate that the problem of thiamine deficiency is considerably more widespread and severe than previously reported.
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| 7. |
- Barth, Julia M.I., et al.
(författare)
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Genome architecture enables local adaptation of Atlantic cod despite high connectivity
- 2017
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Ingår i: Molecular Ecology. - : Wiley. - 0962-1083 .- 1365-294X. ; 26:17, s. 4452-4466
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Tidskriftsartikel (refereegranskat)abstract
- Adaptation to local conditions is a fundamental process in evolution; however, mechanisms maintaining local adaptation despite high gene flow are still poorly understood. Marine ecosystems provide a wide array of diverse habitats that frequently promote ecological adaptation even in species characterized by strong levels of gene flow. As one example, populations of the marine fish Atlantic cod (Gadus morhua) are highly connected due to immense dispersal capabilities but nevertheless show local adaptation in several key traits. By combining population genomic analyses based on 12K single nucleotide polymorphisms with larval dispersal patterns inferred using a biophysical ocean model, we show that Atlantic cod individuals residing in sheltered estuarine habitats of Scandinavian fjords mainly belong to offshore oceanic populations with considerable connectivity between these diverse ecosystems. Nevertheless, we also find evidence for discrete fjord populations that are genetically differentiated from offshore populations, indicative of local adaptation, the degree of which appears to be influenced by connectivity. Analyses of the genomic architecture reveal a significant overrepresentation of a large ~5 Mb chromosomal rearrangement in fjord cod, previously proposed to comprise genes critical for the survival at low salinities. This suggests that despite considerable connectivity with offshore populations, local adaptation to fjord environments may be enabled by suppression of recombination in the rearranged region. Our study provides new insights into the potential of local adaptation in high gene flow species within fine geographical scales and highlights the importance of genome architecture in analyses of ecological adaptation.
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| 8. |
- Benatar, Michael, et al.
(författare)
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Safety and efficacy of arimoclomol in patients with early amyotrophic lateral sclerosis (ORARIALS-01) : a randomised, double-blind, placebo-controlled, multicentre, phase 3 trial
- 2024
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Ingår i: Lancet Neurology. - : Elsevier. - 1474-4422 .- 1474-4465. ; 23:7, s. 687-699
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Tidskriftsartikel (refereegranskat)abstract
- Background: Amyotrophic lateral sclerosis is a progressive neurodegenerative disorder leading to muscle weakness and respiratory failure. Arimoclomol, a heat-shock protein-70 (HSP70) co-inducer, is neuroprotective in animal models of amyotrophic lateral sclerosis, with multiple mechanisms of action, including clearance of protein aggregates, a pathological hallmark of sporadic and familial amyotrophic lateral sclerosis. We aimed to evaluate the safety and efficacy of arimoclomol in patients with amyotrophic lateral sclerosis.Methods: ORARIALS-01 was a multinational, randomised, double-blind, placebo-controlled, parallel-group trial done at 29 centres in 12 countries in Europe and North America. Patients were eligible if they were aged 18 years or older and met El Escorial criteria for clinically possible, probable, probable laboratory-supported, definite, or familial amyotrophic lateral sclerosis; had an ALS Functional Rating Scale-Revised score of 35 or more; and had slow vital capacity at 70% or more of the value predicted on the basis of the participant's age, height, and sex. Patients were randomly assigned (2:1) in blocks of 6, stratified by use of a stable dose of riluzole or no riluzole use, to receive oral arimoclomol citrate 1200 mg/day (400 mg three times per day) or placebo. The Randomisation sequence was computer generated centrally. Investigators, study personnel, and study participants were masked to treatment allocation. The primary outcome was the Combined Assessment of Function and Survival (CAFS) rank score over 76 weeks of treatment. The primary outcome and safety were analysed in the modified intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT03491462, and is completed.Findings: Between July 31, 2018, and July 17, 2019, 287 patients were screened, 245 of whom were enrolled in the trial and randomly assigned. The modified intention-to-treat population comprised 239 patients (160 in the arimoclomol group and 79 in the placebo group): 151 (63%) were male and 88 (37%) were female; mean age was 57·6 years (SD 10·9). CAFS score over 76 weeks did not differ between groups (mean 0·51 [SD 0·29] in the arimoclomol group vs 0·49 [0·28] in the placebo group; p=0·62). Cliff's delta comparing the two groups was 0·039 (95% CI –0·116 to 0·194). Proportions of participants who died were similar between the treatment groups: 29 (18%) of 160 patients in the arimoclomol group and 18 (23%) of 79 patients in the placebo group. Most deaths were due to disease progression. The most common adverse events were gastrointestinal. Adverse events were more often deemed treatment-related in the arimoclomol group (104 [65%]) than in the placebo group (41 [52%]) and more often led to treatment discontinuation in the arimoclomol group (26 [16%]) than in the placebo group (four [5%]).Interpretation: Arimoclomol did not improve efficacy outcomes compared with placebo. Although available biomarker data are insufficient to preclude future strategies that target the HSP response, safety data suggest that a higher dose of arimoclomol would not have been tolerated.Funding: Orphazyme.
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| 10. |
- Berg, Hanna, et al.
(författare)
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A Semi-supervised Approach for De-identification of Swedish Clinical Text
- 2020
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Ingår i: Proceedings of the 12th Conference on Language Resources and Evaluation (LREC 2020). - : European Language Resources Association. - 9791095546344 ; , s. 4444-4450
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Konferensbidrag (refereegranskat)abstract
- An abundance of electronic health records (EHR) is produced every day within healthcare. The records possess valuable information for research and future improvement of healthcare. Multiple efforts have been done to protect the integrity of patients while making electronic health records usable for research by removing personally identifiable information in patient records. Supervised machine learning approaches for de-identification of EHRs need annotated data for training, annotations that are costly in time and human resources. The annotation costs for clinical text is even more costly as the process must be carried out in a protected environment with a limited number of annotators who must have signed confidentiality agreements. In this paper is therefore, a semi-supervised method proposed, for automatically creating high-quality training data. The study shows that the method can be used to improve recall from 84.75% to 89.20% without sacrificing precision to the same extent, dropping from 95.73% to 94.20%. The model’s recall is arguably more important for de-identification than precision.
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| 11. |
- Berg, Hanna, et al.
(författare)
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Augmenting a De-identification System for Swedish Clinical Text Using Open Resources and Deep Learning
- 2019
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Ingår i: Proceedings of the Workshop on NLP and Pseudonymisation. - Linköping : Linköping University Electronic Press. - 9789179299965 ; , s. 8-15
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Konferensbidrag (refereegranskat)abstract
- Electronic patient records are produced in abundance every day and there is a demand to use them for research or management purposes. The records, however, contain information in the free text that can identify the patient and therefore tools are needed to identify this sensitive information. The aim is to compare two machine learning algorithms, Long Short-Term Memory (LSTM) and Conditional Random Fields (CRF) applied to a Swedish clinical data set annotated for de-identification. The results show that CRF performs better than deep learning with LSTM, with CRF giving the best results with an F1 score of 0.91 when adding more data from within the same domain. Adding general open data did, on the other hand, not improve the results.
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| 12. |
- Berg, Hanna
(författare)
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Bilder av människor i marknadsföring
- 2014
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Ingår i: Marknadsföring och påverkan på konsumenten. - 9789144105284 ; , s. 53-76
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Berg, Hanna, et al.
(författare)
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Building a De-identification System for Real Swedish Clinical Text Using Pseudonymised Clinical Text
- 2019
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Ingår i: Proceedings of the Tenth International Workshop on Health Text Mining and Information Analysis (LOUHI 2019). - : Association for Computational Linguistics. - 9781950737772 ; , s. 118-125
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Konferensbidrag (refereegranskat)abstract
- This article presents experiments with pseudonymised Swedish clinical text used as training data to de-identify real clinical text with the future aim to transfer non-sensitive training data to other hospitals. Conditional Random Fields (CFR) and Long Short-Term Memory (LSTM) machine learning algorithms were used to train de-identification models. The two models were trained on pseudonymised data and evaluated on real data. For benchmarking, models were also trained on real data, and evaluated on real data as well as trained on pseudonymised data and evaluated on pseudonymised data. CRF showed better performance for some PHI information like Date Part, First Name and Last Name; consistent with some reports in the literature. In contrast, poor performances on Location and Health Care Unit information were noted, partially due to the constrained vocabulary in the pseudonymised training data. It is concluded that it is possible to train transferable models based on pseudonymised Swedish clinical data, but even small narrative and distributional variation could negatively impact performance.
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| 18. |
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| 19. |
- Berg, Hanna, et al.
(författare)
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De-identification of Clinical Text for Secondary Use : Research Issues
- 2021
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Ingår i: Proceedings of the 14th International Joint Conference on Biomedical Engineering Systems and Technologies - (Volume 5). - : SciTePress. - 9789897584909 ; , s. 592-599
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Konferensbidrag (refereegranskat)abstract
- Privacy is challenged by both advances in AI-related technologies and recently introduced legal regulations. The problem of privacy has been extensively studied within the privacy community, but has largely focused on methods for protecting and assessing the privacy of structured data. Research aiming to protect the integrity of patients based on clinical text has primarily referred to US law and relied on automatically recognising predetermined, both direct and indirect, identifiers. This article discusses the various challenges concerning the re-use of unstructured clinical data, in particular in the form of clinical text, and focuses on ambiguous and vague terminology, how different legislation affects the requirements for de-identification, differences between methods for unstructured and structured data, the impact of approaches based on named entity recognition and replacing sensitive data with surrogates, as well as the lack of measures for usability and re-identification risk.
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| 20. |
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| 21. |
- Berg, Hanna, et al.
(författare)
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Elderly consumers in marketing research: A systematic literature review and directions for future research
- 2022
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Ingår i: International Journal of Consumer Studies. - : Wiley. - 1470-6431 .- 1470-6423. ; 46:5, s. 1640-1664
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports a theme-based structured systematic literature review of the growing body of marketing research about elderly consumers. By synthesizing, explicating, and relating this research, the paper offers a structured view of the past and present state of the research field and integrates it into a theoretical framework. The literature review was based on 209 marketing research articles published from the early 1970s to 2021. It identified 13 research topics, which were subsequently grouped into three themes: (1) describing and defining the elderly market segment, (2) age changes and the elderly consumer, and (3) marketing responses of elderly consumers. Based on these themes, the paper presents a theoretical framework and provides directions for future marketing research on elderly consumers. The systematic literature review thus provides clarity to a wide and interdisciplinary research field, facilitating its continued growth.
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| 22. |
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| 23. |
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| 24. |
- Berg, Hanna
(författare)
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Headless: The Role of Gender and Self-Referencing in Consumer Response to Cropped Pictures of Decorative Models
- 2015
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Ingår i: Psychology and Marketing. - : Wiley: 24 months. - 0742-6046. ; 32:10, s. 1002-1016
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Tidskriftsartikel (refereegranskat)abstract
- Product pictures with 'headless' decorative models, whose heads have been cropped out of the pictures, are often used in online retailing. This article reports findings from three experiments comparing attitudes for clothing displayed in pictures with cropped and uncropped male and female models, focusing on the moderating effects of consumer and model gender and the mediating effects of product self-referencing. Results indicate that the effects on product attitudes are moderated by the gender of both models and consumers and mediated by self-referencing. Pictures with uncropped male models result in more positive product attitudes, irrespective of consumer gender. For product pictures with female models, male consumer attitudes are also more positive for products displayed with uncropped models. In fact, attitudes are only more positive for clothing shown with cropped, 'headless' models when both models and consumers are female. Implications of the findings for research and practitioners are discussed.
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| 25. |
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| 26. |
- Berg, Hanna, et al.
(författare)
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Online product size perceptions : Examining liquid volume size perceptions based on online product pictures
- 2021
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Ingår i: Journal of Business Research. - : Elsevier BV. - 0148-2963 .- 1873-7978. ; 122, s. 192-203
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Tidskriftsartikel (refereegranskat)abstract
- This study examines consumers' liquid volume size perceptions based on standardized product pictures in online stores. Four empirical studies compare liquid volume size perceptions for the same products when displayed online and offline. The findings indicate that size perceptions require more effort online than they do offline and that the online display decreases the accuracy of the size perceptions. Online size perceptions require more effort in terms of time and visual attention, as consumers need to study product labels to determine product sizes. The study also introduces a new visual bias to consumer research: the familiar size bias. A consideration of this bias reveals that consumer size perceptions are less accurate online, where consumers tend to overestimate the sizes of small products and underestimate the sizes of large products.
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| 27. |
- Berg, Hanna, et al.
(författare)
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Spreading joy : examining the effects of smiling models on consumer joy and attitudes
- 2015
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Ingår i: Journal of Consumer Marketing. - : Emerald. - 0736-3761 .- 2052-1200. ; 32:6, s. 459-469
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - The purpose of this paper is to examine consumer response to pictures of smiling models in marketing, focusing on the roles of emotional contagion from the smiling models and the perceived typicality of marketing with smiling models. Design/methodology/approach - This paper reports the findings from three experimental studies, comparing consumer response to two versions of an advertisement (Study 1) and a packaging design (Study 2 and 3), including either a picture of a smiling or a non-smiling model. To measure consumer response, a combination of self-report questionnaires and eye-tracking methodology was used. Findings - The pictures of smiling models produced more consumer joy and more positive attitudes for the marketing. The positive effects on attitudes were mediated by consumer joy, and the effects on consumer joy were mediated by the perceived typicality of the marketing with smiling models. Originality/value - Despite the ubiquity of photos of smiling faces in marketing, very few studies have isolated the effects of the smile appeal on consumer response to marketing objects. By comparing marketing where the same model is shown smiling or with a neutral facial expression, the positive effects were isolated. The roles of emotional contagion and perceived typicality in this mechanism were also examined and implications of the findings for research and practitioners are discussed.
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| 28. |
- Berg, Hanna, et al.
(författare)
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The Impact of De-identification on Downstream Named Entity Recognition in Clinical Text
- 2020
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Ingår i: The 11th International Workshop on Health Text Mining and Information Analysis LOUHI 2020. - USA : Association for Computational Linguistics. - 9781952148811 ; , s. 1-11
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Konferensbidrag (refereegranskat)abstract
- The impact of de-identification on data quality and, in particular, utility for developing models for downstream tasks has been more thoroughly studied for structured data than for unstructured text. While previous studies indicate that text de-identification has a limited impact on models for downstream tasks, it remains unclear what the impact is with various levels and forms of de-identification, in particular concerning the trade-off between precision and recall. In this paper, the impact of de-identification is studied on downstream named entity recognition in Swedish clinical text. The results indicate that de-identification models with moderate to high precision lead to similar downstream performance, while low precision has a substantial negative impact. Furthermore, different strategies for concealing sensitive information affect performance to different degrees, ranging from pseudonymisation having a low impact to the removal of entire sentences with sensitive information having a high impact. This study indicates that it is possible to increase the recall of models for identifying sensitive information without negatively affecting the use of de-identified text data for training models for clinical named entity recognition; however, there is ultimately a trade-off between the level of de-identification and the subsequent utility of the data.
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| 29. |
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| 30. |
- Berg, Hanna, et al.
(författare)
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Why Casting Older Female Models Is Good for Advertising : The Positive Effects of Challenging The Underrepresentation of Older Women in Ads
- 2023
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Ingår i: Journal of Advertising Research. - : Advertising Research Foundation. - 1740-1909 .- 0021-8499. ; 63:1, s. 61-80
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Tidskriftsartikel (refereegranskat)abstract
- Older people-particularly women-continue to be underrepresented in advertising. Some companies, however, have recently begun featuring more older women as decorative models in their advertisements. That practice goes against earlier research dating back to the late 1980s, which recommended that advertisers should avoid featuring older women in advertisements. The purpose of this article is to examine consumer responses to advertising featuring older female decorative models. In four experiments, the effects of advertisements of mostly female-gendered products, featuring older and younger female decorative models, are compared. The findings indicate positive effects of advertisements featuring older female decorative models for both younger and older female consumers, and that these effects can be explained by increased social connectedness with the decorative models.
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| 31. |
- Berg, Lotta, et al.
(författare)
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Minkhållning i Sverige
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den här rapporten är framtagen av SLUs vetenskapliga råd för djurskydd i syfte att utvärdera djurvälfärden hos minkar inom svensk pälsdjursproduktion och bedöma om den vetenskapliga litteraturen ger stöd för att produktionen, så som den bedrivs i dag, ger djuren möjlighet att bete sig naturligt. Minkar som föds upp för pälsproduktion i Sverige måste hållas och skötas enligt Statens jordbruksverks föreskrifter och allmänna råd (SJVFS 2012:14) om uppfödning och hållande av pälsdjur. Rapporten har tagits fram på uppdrag av Jordbruksverket som en del i ett regeringsuppdrag om minkhållning. Den beskriver minkens ursprung och domesticering, naturligt beteende hos vild mink, inhysning och skötsel vid pälsuppfödning, onormalt beteende, miljöberikningar, smittskydd, förekommande sjukdomar och avlivningsmetoder. I rapporten ges rekommendationer baserat på tillgänglig vetenskaplig litteratur, och behov av framtida forskning identifieras.Minken är en opportunistisk köttätare som behöver äta relativt ofta. I pälsdjursproduktionen tillämpas i princip fri tillgång på foder till digivande honor och växande valpar men inför parningssäsongen innebär den fria tillgången ökad risk för komplikationer vid valpningen på grund av övervikt hos honan. Fodringen behöver därför anpassas under vintern för att minska risken för feta honor och därmed ökad dödlighet vid valpningen. Neddragen fodertillgång kan orsaka frustration som då visar sig i beteendestörningar. Olika aspekter på utfodring bör därför beaktas i framtida forskning. Den vilda minken lever solitärt under stora delar av året, dock kan en till flera honor leva inom en hanes revir. I pälsdjursproduktionen bör därför vuxna minkar hållas individuellt, undantaget är växande ungminkar som med fördel kan hållas tillsammans. Att hålla två minkar tillsammans är det vanligaste, dock fungerar det att hålla tre ungminkar i etagebur om de ges extra foder och god tillsyn. Grupper med fler än tre djur bör undvikas då riskerna för aggression ökar. En lya fastsatt utanpå buren är viktigt för alla minkar året runt då de naturligt vilar mycket i sina bohål, samt även för att minkhonan ska kunna ta hand om de outvecklade ungarna första tiden efter födelsen. I fångenskap används halm för att skapa ett varmt bo under den kalla årstiden samt för att bygga ett bo för ungarna under uppfödningsperioden.Systematisk genetisk selektion för önskat beteende (temperament) förbättrar välfärden hos minken. Systemet tillämpas på svenska gårdar genom att minkar som uppvisar rädsla eller stress selekteras bort vid avelsurvalet. Urvalet av avelsdjur görs kontinuerligt från det att valparna föds, då reproduktion, valpöverlevnad och temperament registreras tidigt och är viktiga parametrar att ta hänsyn till i urvalet. Det slutliga urvalen sker på hösten då längd, vikt och pälsegenskaper graderas. Ju tidigare dessa urval görs desto tidigare kan utfodringen anpassas för att undvika att avelsdjuren blir överviktiga under hösten. Det är viktigt att aveln inte resulterar i för stora djur, då detta kan leda till välfärdsproblem i framtiden.Mink i vilt tillstånd använder vatten i sin jakt på bytesdjur, men är inget vattenlevande djur, per se. Badvatten till mink bedöms däremot vara en positiv berikning, dock inte vetenskapligt belagt, som ett grundläggande beteendebehov. Forskning visar att beteendestörningar kan förebyggas genom att minkarna ges fri tillgång på foder, hålls i etageburar med bolåda, hyllor, strömedel och berikningar som byts ut regelbundet. I svenska djurskyddsföreskrifter ingår dessa som krav för hållande av mink för pälsdjursproduktion. Mer kunskap behövs för hur ofta berikningar bör skiftas.Djurvälfärd i samband med livdjurstransport och avlivning av mink lyfts fram som angelägna forskningsområden. En snabb avlivning vid hemmaburen bedöms vara det bästa ur djurvälfärdssynpunkt. För att minska risken för spridning av sjukdomar bör importerade minkar hållas i karantän och hög biosäkerhet tillämpas på gården.
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| 32. |
- Berg, Linda, 1974-, et al.
(författare)
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Solidaritet i samexistens : om ett begrepp värt att värna
- 2023
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Ingår i: Feminism och konvivialitet. - Malmö : Gleerups Utbildning AB. - 9789151108735 ; , s. 25-35
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I följande kapitel står termen solidaritet i centrum för vår undersökning. Solidaritet är ett begrepp som ofta uppfattas som entydigt positivt, men det kan användas på många olika sätt. Det används av enskilda personer, av olika grupper och det kan få olika konsekvenser. Vi har tidigare studerat olika rörelser och grupper som använder sig av det och slagits av den bredd av betydelser som termen tillskrivs. I en samtid när ordet har blivit populärt att använda inom politiken och i vardagligt tal, ser vi det som angeläget att uppmärksamma risker med ett oreflekterat bruk och manar till att se solidaritet som ett begrepp att värna och omsätta i praktik. I antologin utgör denna del således ett bidrag till hur vi som forskare kan stanna upp och reda i till synes självklara ord. I kapitlet diskuterar vi därför dess mångtydiga innebörd i relation till bokens röda tråd: konvivialitet, att leva tillsammans.
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| 33. |
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| 34. |
- Berg, Marie, 1955, et al.
(författare)
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Room4Birth - the effect of an adaptable birthing room on labour and birth outcomes for nulliparous women at term with spontaneous labour start: study protocol for a randomised controlled superiority trial in Sweden
- 2019
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215 .- 1745-6215. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: An important prerequisite for optimal healthcare is a secure, safe and comfortable environment. There is little research on how the physical design of birthing rooms affects labour, birth, childbirth experiences and birthing costs. This protocol outlines the design of a randomised controlled superiority trial (RCT) measuring and comparing effects and experiences of two types of birthing rooms, conducted in one labour ward in Sweden. METHODS/DESIGN: Following ethics approval, a study design was developed and tested for feasibility in a pilot study, which led to some important improvements for conducting the study. The main RCT started January 2019 and includes nulliparous women presenting to the labour ward in active, spontaneous labour and who understand either Swedish, Arabic, Somali or English. Those who consent are randomised on a 1:1 ratio to receive care either in a regular room (control group) or in a newly built birthing room designed with a person-centred approach and physical aspects (such as light, silencer, media installation offering programmed nature scenes with sound, bathtub, birth support tools) that are changeable according to a woman's wishes (intervention group). The primary efficacy endpoint is a composite score of four outcomes: no use of oxytocin for augmentation of labour; spontaneous vaginal births (i.e. no vaginal instrumental birth or caesarean section); normal postpartum blood loss (i.e. bleeding < 1000 ml); and a positive overall childbirth experience (7-10 on a scale of 1-10). To detect a difference in the composite score of 8% between the groups we need 1274 study participants (power of 80% with significance level 0.05). Secondary outcomes include: the four variables in the primary outcome; other physical outcomes of labour and birth; women's self-reported experiences (the birthing room, childbirth, fear of childbirth, health-related quality of life); and measurement of costs in relation to the hospital stay for mother and neonate. Additionally, an ethnographic study with participant observations will be conducted in both types of birthing rooms. DISCUSSION: The findings aim to guide the design of birthing rooms that contribute to optimal quality of hospital-based maternity care. TRIAL REGISTRATION: ClinicalTrials.gov NCT03948815. Registered 13 May 2019-retrospectively registered.
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| 35. |
- Berg, Matilda, et al.
(författare)
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The Role of Learning Support and Chat-Sessions in Guided Internet-Based Cognitive Behavioral Therapy for Adolescents With Anxiety: A Factorial Design Study
- 2020
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background Increased awareness of anxiety in adolescents emphasises the need for effective interventions. Internet-based cognitive behavioural therapy (ICBT) could be a resource-effective and evidence-based treatment option, but little is known about how to optimize ICBT or which factors boost outcomes. Recently, the role of knowledge in psychotherapy has received increased focus. Further, chat-sessions are of interest when trying to optimize ICBT for youths. This study aimed to evaluate the role of learning support and chat-sessions during ICBT for adolescent anxiety, using a factorial design. Method A total of 120 adolescents were randomised to one of four treatment groups, in a 2x2 design with two factors: with or without learning support and/or chat-sessions. Results Anxiety and depressive symptoms were reduced (Beck Anxiety Inventory- BAI; Cohensd=0.72; Beck Depression Inventory- BDI;d=0.97). There was a main effect of learning support on BAI (d=0.38), and learning support increased knowledge gain (d =0.42). There were no main effects or interactions related to the chat-sessions. Treatment effects were maintained at 6-months, but the added effect of learning support had by then vanished. Conclusion ICBT can be an effective alternative when treating adolescents with anxiety. Learning support could be of importance to enhance short-term treatment effects, and should be investigated further.
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| 36. |
- Bäckström, Hanna, 1986-
(författare)
-
Att hjälpa andra : gåvans, rättvisans och medkänslans aporier i frivilligarbete
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis addresses the issue of social work in Swedish civil society, focusing on the ambition and practice of helping others as an existential as well as a social, political and cultural phenomenon. The aim is to study the ambiguities and aporetic conflicts that imbue helping activities and the desire to help others, using ethnographic as well as philosophical method. An interview study comprising of 12 volunteers and activists, all working with begging EU-citizens in Sweden, was carried out between 2015 and 2016. The interviews aimed to gather context specific experiences of helping others from a vulnerable group, especially concerning questions of power asymmetry and moral and political dilemmas. Subsequently, a reading of the participants’ narratives informed by Jacques Derrida’s deconstruction was performed. Following Derrida’s understanding of deconstruction as a bipartite process, focusing on genealogy and representation as well as the logico-formal paradoxes, aporias or ‘undecidables’, that characterise certain phenomena, two strands of research questions guided the analysis: Firstly, how do the participants understand and create meaning regarding their helping activities? And secondly, what seemingly impossible paradoxes, aporias, emerge in the constituting ideas and practices of helping, as they are expressed in the participants' narratives?Resulting from this reading and a parallel literature study, three main areas of conflict were identified: altruistic gift-giving vs. reciprocity and exchange, objective and structural justice vs. personal relations and exceptions, and lastly, the meaning of empathy as well as the difficulty of representing the suffering of others. The main theoretical sources are Derrida, Emmanuel Levinas, Hélène Cixous and Jessica Benjamin, whose writings on economy, gifts, responsibility, desire and intersubjectivity respectively, are employed to understand and theoretically develop the participants' experiences.Connecting the difficulty of doing a good deed to feminist ethical elaborations on care and justice, I conclusively argue for a deconstructive ethics of care, that takes the aporetic character of helping others into account, while not relinquishing the responsibility towards the other and the possibility of solidarity.
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| 37. |
- Bäckström, Hanna, 1986-, et al.
(författare)
-
Plats att mötas och växa : en kvalitativ studie av öppna mötesplatser i Umeå kommun
- 2024
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I Umeå kommun finns ett flertal öppna mötesplatser; träffpunkter där människor kan umgås, hålla möten, skapa och uppleva kultur, idrotta, lära sig saker etcetera. I denna rapport presenteras tre av dessa verksamheter: Ersboda Folkets Hus, Kulturhuset Klossen och Mötesplats Stöcke, som alla drivs av civilsamhällesorganisationer. Följande studie baseras primärt på intervjuer med verksamma från mötesplatserna, med syfte att undersöka betydelser för användare, närområdet och för Umeå kommun, vilken roll organisationerna förväntas spela samt vilka förutsättningar de har för att verka. Mötesplatserna beskrivs som mycket viktiga ur flera perspektiv. De bidrar till att främja lokal sammanhållning och en positiv bild av stadsdelen och de ger människor tillgång till samlingslokaler som annars skulle sakna det. Medan kärnverksamheterna kan sägas handla om kultur, nöje, bildning och fysisk aktivitet, så fyller mötesplatserna också viktiga sociala funktioner för många målgrupper. De bidrar till att motverka ensamhet och psykisk ohälsa för den enskilde, och de utgör centrala forum för individuell utveckling och lärande, inte minst för barn och unga. Som lokalt förankrade öppna verksamheter beskrivs mötesplatserna ha en unik potential att främja social hållbarhet i både närområdet och Umeå i stort. Deltagarna lyfter också ett antal utmaningar. Mötesplatserna måste finna en balans mellan öppenhet och trygghet, så att alla besökare känner sig välkomna och trygga i miljön. Det inkluderar en balansgång mellan planering och spontanitet. Deltagarna lyfter att vissa målgrupper behöver mycket låga trösklar, medan andra behöver förväntningar och att aktivt få delta i utformandet av verksamheten. Långsiktig ekonomisk hållbarhet beskrivs vidare som en utmaning för alla organisationer. De erhåller alla olika typer av ekonomiskt stöd från offentliga aktörer, men detta stöd är oftast villkorat och tidsbegränsat och räcker sällan till för vad organisationerna skulle vilja och behöver göra på sikt. Alternativa inkomstkällor är främst viss kommersiell verksamhet respektive sponsring från företag eller privatpersoner. För att fortsätta vara just öppna mötesplatser, till nytta för närområdet, är det dock viktigt att denna typ av finansiering inte gör huset mindre tillgängligt för vissa grupper. Vi vill avslutningsvis betona betydelsen av mötesplatsernas medborgardrivna karaktär. Företrädare från alla verksamheter menar att de skulle kunna bedriva ännu mer social verksamhet, särskilt för barn och unga, om de hade ekonomiska förutsättningar. I det fall mötesplatsernas sociala dimensioner ska utvecklas, vill vi dock framhålla vikten av inte betrakta dem som renodlade serviceproducenter som ska leverera något till de boende. Det är viktigt att värna om mötesplatsernas mervärde och särskilda förtroende, som framstår som nära knutet till deras gräsrotsbaserade verksamhet.
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| 38. |
- Campbell, PJ, et al.
(författare)
-
Pan-cancer analysis of whole genomes
- 2020
-
Ingår i: Nature. - : Springer Science and Business Media LLC. - 1476-4687 .- 0028-0836. ; 578:7793, s. 82-
-
Tidskriftsartikel (refereegranskat)abstract
- Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale1–3. Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4–5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter4; identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation5,6; analyses timings and patterns of tumour evolution7; describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity8,9; and evaluates a range of more-specialized features of cancer genomes8,10–18.
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| 39. |
- Carlsson, Hanna, et al.
(författare)
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How to study social media practises in converging library spaces. Making the case for deploying co-presence ethnography in studies of 2.0-libraries
- 2011
-
Ingår i: Information Science and Social Media. Proceedings of the International Conference Information Science and Social Media ISSOME 2011, August 24-26, Åbo/Turku, Finland. - Åbo : Åbo Akademi University. - 2242-0495. ; , s. 83-90, s. 83-90
-
Konferensbidrag (refereegranskat)abstract
- Ethnographically inspired methods have in recent years been successfully applied in Information Science (IS) research on different forms of social media related practices (c.f. Sundin & Francke 2009a; 2009b, Kjellberg 2010). This paper aims to contribute to an emerging discussion on the use of this methodological approach for analysing and comprehending consequences of the 2.0-turn in public libraries. Drawing on the experiences of a one-year long ethnographic study of everyday work-related social media practices in a Swedish public library, I suggest that there are significant epistemic benefits of using the ethnographic approach in this field. By shifting focus to everyday practices and routines in local settings, new features of the 2.0-phenomena are accentuated, contributing to different understandings of the role of social media in public library development.
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| 40. |
- Daunfeldt, Sven-Olov, et al.
(författare)
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Happy to see you: the positive effects of in-store service encounters on the satisfaction of older consumers
- 2023
-
Ingår i: International Review of Retail, Distribution and Consumer Research. - : Routledge. - 1466-4402 .- 0959-3969. ; 33:5, s. 479-493
-
Tidskriftsartikel (refereegranskat)abstract
- Although older consumers constitute a growing consumer segment with substantial buying power, not much is known about their satisfaction with retail stores and its antecedents. This study examines how having in-store, face-to-face service encounters with store personnel affects the store satisfaction of older consumers, focusing on the moderating role of consumer age and the mediating role of positive emotions. An empirical study demonstrates positive effects of service encounters with store employees on the store satisfaction and positive emotions of older consumers. Consumer age moderates these effects, so that there are no similar positive effects of in-store service encounters on store satisfaction or positive emotions for the younger consumers. Positive emotions also mediate the effects of in-store service encounters on store satisfaction for the older consumers, but not for the younger consumers.
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| 41. |
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Det mångsidiga verktyget : elva utbildningshistoriska uppsatser
- 2009
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- År 1764: den 17-årige Lars Olofsson bestraffas av det svenska rättssystemet. Han förses med halsjärn inför ”en hel samling ungdom, som med tjenlig förestälning förmanades”.År 2001: en akademiker ur den svenska medelklassen studerar sin släkts historia.Vad binder samman dessa två händelser, som vid första påseende verkar så olika?Svaret är utbildning. Bestraffningen av Lars Olofsson utformades i fostrande syfte: åskådarna skulle lära sig något av straffet. Släktforskaren, å andra sidan, utbildar sig själv. Centralmaktens hårdhänta undervisning om rätt och fel har ersatts av individens eget kunskapssökande. Eller?I den här antologin får vi möta 1600- och 1700-talens unga brottslingar, dagens släktforskare, och en mängd lärare, elever, folkbildare, filantroper och lobbyister däremellan. Tillsammans berättar deras historier om hur bildning, i bred bemärkelse, format den moderna människan.Antologin inleds med ett förord där redaktörerna ger sitt förslag till hur bildningens funktion kan förstås i ett historievetenskapligt sammanhang: som ett verktyg för klassformering, för hantering av samhällets unga, och för skapande av identiteter. Den avslutas med en text som diskuterar hur dagens historiker bör ställa sig till en av de senaste utbildningspolitiska frågorna: bildandet av européer med hjälp av en gemensam historieskrivning inom EU.
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| 42. |
- Eijkemans, Marianne, et al.
(författare)
-
Physical activity, sedentary behaviour, and childhood asthma: a European collaborative analysis
- 2024
-
Ingår i: BMJ Open Respiratory Research. - : BMJ PUBLISHING GROUP. - 2052-4439. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate the associations of physical activity (PA) and sedentary behaviour in early childhood with asthma and reduced lung function in later childhood within a large collaborative study.Design Pooling of longitudinal data from collaborating birth cohorts using meta-analysis of separate cohort-specific estimates and analysis of individual participant data of all cohorts combined.Setting Children aged 0-18 years from 26 European birth cohorts.Participants 136 071 individual children from 26 cohorts, with information on PA and/or sedentary behaviour in early childhood and asthma assessment in later childhood.Main outcome measure Questionnaire-based current asthma and lung function measured by spirometry (forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity) at age 6-18 years.Results Questionnaire-based and accelerometry-based PA and sedentary behaviour at age 3-5 years was not associated with asthma at age 6-18 years (PA in hours/day adjusted OR 1.01, 95% CI 0.98 to 1.04; sedentary behaviour in hours/day adjusted OR 1.03, 95% CI 0.99 to 1.07). PA was not associated with lung function at any age. Analyses of sedentary behaviour and lung function showed inconsistent results.Conclusions Reduced PA and increased sedentary behaviour before 6 years of age were not associated with the presence of asthma later in childhood.
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| 43. |
- Frentzas, Sophia, et al.
(författare)
-
Vessel co-option mediates resistance to anti-angiogenic therapy in liver metastases
- 2016
-
Ingår i: Nature Medicine. - : Springer Science and Business Media LLC. - 1078-8956 .- 1546-170X. ; 22:11, s. 1294-1302
-
Tidskriftsartikel (refereegranskat)abstract
- The efficacy of angiogenesis inhibitors in cancer is limited by resistance mechanisms that are poorly understood. Notably, instead of through the induction of angiogenesis, tumor vascularization can occur through the nonangiogenic mechanism of vessel co-option. Here we show that vessel co-option is associated with a poor response to the anti-angiogenic agent bevacizumab in patients with colorectal cancer liver metastases. Moreover, we find that vessel co-option is also prevalent in human breast cancer liver metastases, a setting in which results with anti-angiogenic therapy have been disappointing. In preclinical mechanistic studies, we found that cancer cell motility mediated by the actin-related protein 2/3 complex (Arp2/3) is required for vessel co-option in liver metastases in vivo and that, in this setting, combined inhibition of angiogenesis and vessel co-option is more effective than the inhibition of angiogenesis alone. Vessel co-option is therefore a clinically relevant mechanism of resistance to anti-angiogenic therapy and combined inhibition of angiogenesis and vessel co-option might be a warranted therapeutic strategy.
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| 44. |
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| 45. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
-
Effekten av att föda barn i ett speciellt utformat födslorum: En randomiserad kontrollerad studie
- 2023
-
Ingår i: Konferensbidrag Reproduktiv Hälsa, Karlstad.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Den upplevda miljön har betydelse för födselns fysiologiska processer hos kvinnor. Då majoriteten barn föds på sjukhus är det därav betydelsefullt att utforma sjukhusmiljön utifrån aspekter som främjar trygghet och förtrogenhet. Syfte: Att utvärdera om ett speciellt utformat rum ger bättre utfall i samband med födsel, i jämförelse med standardrum. Metod: En randomiserad kontrollerad studie genomfördes under åren 2019–2020 vid ett sjukhus i västra Sverige. Förstföderskor med en singelgraviditet i fullgången tid lottades till att vårdas antingen i ett rum speciellt utformat för att stödja födselns fysiologiska processer (testrummet) eller i ett standardrum. Hypotesen var att det primära kompositutfallet skulle uppfyllas hos fler kvinnor i testrummet, det vill säga: vaginal spontan födsel, ingen användning av oxytocindropp, positiv förlossningsupplevelse, samt blödning <1000ml. För att kunna påvisa en skillnad på 8% mellan de randomiserade grupperna i det primära utfallet, krävdes 1274 studiedeltagare. Bland sekundära utfall fanns andra perinatala utfall samt självskattad förlossningsupplevelse upp till ett år efter födsel. Resultat: Studien avslutades i förtid på grund av Covid-19-pandemin, vilket gjorde att 406 kvinnor randomiserades totalt. Därav uppnåddes inte tillräcklig styrka för att kunna påvisa en statistiskt signifikant skillnad mellan grupperna avseende det primära utfallet. I testrummet uppfylldes det primära utfallet hos 42% av kvinnorna jämfört med 35% i standardrummet (odds ratio: 1.35, 95% CI 0.90–2.01). Kvinnor i testrummet använde epiduralanalgesi i lägre utsträckning. De rapporterade även mer positiva förlossningsupplevelser 3 och 12 månader efter födsel i jämförelse med kvinnor i standardrummen. Konklusion: Denna för tidigt avslutade studie kunde inte verifiera om testrummet förbättrar det primära utfallet. Däremot använde kvinnor i det testrummet i lägre grad farmakologisk smärtlindring och skattade bättre förlossningsupplevelse över tid. Finansiering: Vetenskapsrådet (2018–02406), Institutionen för Vårdvetenskap och Hälsa, Göteborgs Universitet.
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| 46. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
-
Impact of Birthing Room Design on Maternal Childbirth Experience: Results From the Room4Birth Randomized Trial
- 2023
-
Ingår i: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 16:1, s. 200-218
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To study the effect of the birthing room design on nulliparous women’s childbirth experience up to 1 year after birth. Background: Although it is known that the birth environment can support or hinder birth processes, the impact of the birthing room design on maternal childbirth experience over time is insufficiently studied. Methods: The Room4Birth randomized controlled trial was conducted at a labor ward in Sweden. Nulliparous women in active stage of spontaneous labor were randomized (n = 406) to either a regular birthing room (n = 202) or a new birthing room designed with more person-centered considerations (n = 204). Childbirth experiences were measured 2 hr, 3 months, and 12 months after birth by using a Visual Analogue Scale of Overall Childbirth Experience (VAS-OCE), the Fear of Birth Scale (FOBS), and the Childbirth Experience Questionnaire (CEQ2). Results: Women randomized to the new room had a more positive childbirth experience reported on the VAS-OCE 3 months (p =.002) and 12 months (p =.021) after birth compared to women randomized to a regular room. Women in the new room also scored higher in the total CEQ2 score (p =.039) and within the CEQ2 subdomain own capacity after 3 months (p =.028). The remaining CEQ2 domains and the FOBS scores did not differ between the groups. Conclusions: These findings show that a birthing room offering more possibilities to change features and functions in the room according to personal needs and requirements, positively affects the childbirth experience of nulliparous women 3 and 12 months after they have given birth.
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| 47. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
-
Impact of the built environment on labour and birth outcomes: the Swedish Room4Birth randomised trial
- 2023
-
Ingår i: 33rd ICM Triennal Congress, Bali, Indonesia, 11-14 June 2023.
-
Konferensbidrag (refereegranskat)abstract
- Background: Attempts have been made to improve hospital birth environments to preserve birth physiology and, thereby, reduce unnecessary interventions in labour. However, research about the effect of these improvements on birth outcomes shows contradictory results. Objective: To evaluate whether a birthing room redesigned with person-centred considerations improves birth outcomes and experiences of nulliparous women, compared with regular birthing rooms. Methods: We conducted a randomised controlled trial in nulliparous women admitted to a Swedish labour ward. Women were randomised to either the redesigned room (New room) or a Regular room. An estimated number of 1274 participants were needed to detect a difference of 8% between the groups in the primary composite outcome: spontaneous vaginal birth, no oxytocin augmentation, post-partum blood loss <1000ml, and positive childbirth experience. Secondary outcomes included birth outcomes and questionnaire-based data regarding childbirth experience 3 and 12 months after birth. Results: Due to the Covid-19 pandemic, the trial was terminated early, and 406 women were included (n=204 in the New room, n=202 in the Regular room). No statistically significant difference was found in the primary outcome (42.2% versus 35.1%; odds ratio: 1.35, 95% CI 0.90–2.01). Women in the New room required epidural analgesia to a lower extent and had a more positive childbirth experience 3 and 12 months after birth compared with women in the Regular room. Conclusion: This prematurely terminated trial could not verify that the New room would improve the primary outcome. Nonetheless, the findings demonstrate that a birth environment with conscientious design positively affects women’s childbirth experience up to one year after birth. Key message: These findings provide knowledge about the value of the built environment in improving women’s childbirth experiences and perceptions of pain. Ethical approval No 478-18 (Gothenburg regional ethics board). ClinicalTrials.gov Identifier: NCT03948815. The authors declare no conflicts of interest.
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| 48. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
-
Implementing a new birthing room design: a qualitative study with a care provider perspective.
- 2023
-
Ingår i: BMC health services research. - 1472-6963. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- Research shows that interventions to protect the sensitive physiological process of birth by improving the birthing room design may positively affect perinatal outcomes. It is, however, crucial to understand the mechanisms and contextual elements that influence the outcomes of such complex interventions. Hence, we aimed to explore care providers' experiences of the implementation of a new hospital birthing room designed to be more supportive of women's birth physiology.This qualitative study reports on the implementation of the new birthing room, which was evaluated in the Room4Birth randomised controlled trial in Sweden. Individual interviews were undertaken with care providers, including assistant nurses, midwives, obstetricians, and managers (n=21). A content analysis of interview data was conducted and mapped into the three domains of the Normalisation Process Theory coding manual: implementation context, mechanism, and outcome.The implementation of the new room challenged the prevailing biomedical paradigm within the labour ward context and raised the care providers' awareness about the complex interplay between birth physiology and the environment. This awareness had the potential to encourage care providers to be more emotionally present, rather than to focus on monitoring practices. The new room also evoked a sense of insecurity due to its unfamiliar design, which acted as a barrier to integrating the room as a well-functioning part of everyday care practice.Our findings highlight the disparity that existed between what care providers considered valuable for women during childbirth and their own requirements from the built environment based on their professional responsibilities. This identified disparity emphasises the importance of hospital birthing rooms (i) supporting women's emotions and birth physiology and (ii) being standardised to meet care providers' requirements for a functional work environment.ClinicalTrials.gov: NCT03948815, 14/05/2019.
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| 49. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
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Room4Birth – The effect of giving birth in a hospital birthing room designed with person-centred considerations: A Swedish randomised controlled trial
- 2022
-
Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5764 .- 1877-5756. ; 32
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate if a birthing room designed with person-centred considerations improves labour and birth outcomes for nulliparous women when compared to regular birthing rooms. Methods: A randomised controlled trial was conducted at a Swedish labour ward between January 2019 and October 2020. Nulliparous women in spontaneous labour were randomised either to a birthing room designed with person-centred considerations (New room) or a Regular room. The primary outcome was a composite of four variables: vaginal non-instrumental birth; no oxytocin augmentation; postpartum blood loss < 1000 ml; and a positive childbirth experience. To detect a difference of 8% between the groups, 1274 study participants were needed, but the trial was terminated early due to consequences of the Covid-19 pandemic. Results: A total of 406 women were randomised; 204 to the New room and 202 to the Regular room. There was no significant difference in the primary outcome between the groups (42.2% versus 35.1%; odds ratio: 1.35, 95% Confidence Interval 0.90–2.01; p = 0.18). Participants in the New room used epidural analgesia to a lower extent (54.4% versus 65.3%, relative risk: 0.83, 95% Confidence Interval 0.71–0.98; p = 0.03) and reported to a higher degree that the room contributed to a sense of safety, control, and integrity (p=<0.001). Conclusions: The hypothesis that the New room would improve the primary outcome could not be verified. Considering the early discontinuation of the study, results should be interpreted with caution. Nevertheless, analyses of our secondary outcomes emphasise the experiential value of the built birth environment in improving care for labouring women.
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| 50. |
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