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1.
  • Ahmad, Amais, et al. (författare)
  • IMI – Oral biopharmaceutics tools project – Evaluation of bottom-up PBPK prediction success part 4 : Prediction accuracy and software comparisons with improved data and modelling strategies
  • 2020
  • Ingår i: European journal of pharmaceutics and biopharmaceutics. - : Elsevier BV. - 0939-6411 .- 1873-3441. ; 156, s. 50-63
  • Tidskriftsartikel (refereegranskat)abstract
    • Oral drug absorption is a complex process depending on many factors, including the physicochemical properties of the drug, formulation characteristics and their interplay with gastrointestinal physiology and biology. Physiological-based pharmacokinetic (PBPK) models integrate all available information on gastro-intestinal system with drug and formulation data to predict oral drug absorption. The latter together with in vitro-in vivo extrapolation and other preclinical data on drug disposition can be used to predict plasma concentration-time profiles in silico. Despite recent successes of PBPK in many areas of drug development, an improvement in their utility for evaluating oral absorption is much needed. Current status of predictive performance, within the confinement of commonly available in vitro data on drugs and formulations alongside systems information, were tested using 3 PBPK software packages (GI-Sim (ver.4.1), Simcyp® Simulator (ver.15.0.86.0), and GastroPlusTM (ver.9.0.00xx)). This was part of the Innovative Medicines Initiative (IMI) Oral Biopharmaceutics Tools (OrBiTo) project.Fifty eight active pharmaceutical ingredients (APIs) were qualified from the OrBiTo database to be part of the investigation based on a priori set criteria on availability of minimum necessary information to allow modelling exercise. The set entailed over 200 human clinical studies with over 700 study arms. These were simulated using input parameters which had been harmonised by a panel of experts across different software packages prior to conduct of any simulation. Overall prediction performance and software packages comparison were evaluated based on performance indicators (Fold error (FE), Average fold error (AFE) and absolute average fold error (AAFE)) of pharmacokinetic (PK) parameters.On average, PK parameters (Area Under the Concentration-time curve (AUC0-tlast), Maximal concentration (Cmax), half-life (t1/2)) were predicted with AFE values between 1.11 and 1.97. Variability in FEs of these PK parameters was relatively high with AAFE values ranging from 2.08 to 2.74. Around half of the simulations were within the 2-fold error for AUC0-tlast and around 90% of the simulations were within 10-fold error for AUC0-tlast. Oral bioavailability (Foral) predictions, which were limited to 19 APIs having intravenous (i.v.) human data, showed AFE and AAFE of values 1.37 and 1.75 respectively. Across different APIs, AFE of AUC0-tlast predictions were between 0.22 and 22.76 with 70% of the APIs showing an AFE > 1. When compared across different formulations and routes of administration, AUC0-tlast for oral controlled release and i.v. administration were better predicted than that for oral immediate release formulations. Average predictive performance did not clearly differ between software packages but some APIs showed a high level of variability in predictive performance across different software packages. This variability could be related to several factors such as compound specific properties, the quality and availability of information, and errors in scaling from in vitro and preclinical in vivo data to human in vivo behaviour which will be explored further. Results were compared with previous similar exercise when the input data selection was carried by the modeller rather than a panel of experts on each in vitro test. Overall, average predictive performance was increased as reflected in smaller AAFE value of 2.8 as compared to AAFE value of 3.8 in case of previous exercise.
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2.
  • Ederle, Joerg, et al. (författare)
  • Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial
  • 2010
  • Ingår i: The Lancet. - 1474-547X. ; 375:9719, s. 985-997
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Stents are an alternative treatment to carotid endarterectomy for symptomatic carotid stenosis, but previous trials have not established equivalent safety and efficacy. We compared the safety of carotid artery stenting with that of carotid endarterectomy. Methods The International Carotid Stenting Study (ICSS) is a multicentre, international, randomised controlled trial with blinded adjudication of outcomes. Patients with recently symptomatic carotid artery stenosis were randomly assigned in a 1:1 ratio to receive carotid artery stenting or carotid endarterectomy. Randomisation was by telephone call or fax to a central computerised service and was stratified by centre with minimisation for sex, age, contralateral occlusion, and side of the randomised artery. Patients and investigators were not masked to treatment assignment. Patients were followed up by independent clinicians not directly involved in delivering the randomised treatment. The primary outcome measure of the trial is the 3-year rate of fatal or disabling stroke in any territory, which has not been analysed yet. The main outcome measure for the interim safety analysis was the 120-day rate of stroke, death, or procedural myocardial infarction. Analysis was by intention to treat (ITT). This study is registered, number ISRCTN25337470. Findings The trial enrolled 1713 patients (stenting group, n=855; endarterectomy group, n=858). Two patients in the stenting group and one in the endarterectomy group withdrew immediately after randomisation, and were not included in the ITT analysis. Between randomisation and 120 days, there were 34 (Kaplan-Meier estimate 4.0%) events of disabling stroke or death in the stenting group compared with 27 (3.2%) events in the endarterectomy group (hazard ratio [HR] 1.28, 95% CI 0.77-2.11). The incidence of stroke, death, or procedural myocardial infarction was 8.5% in the stenting group compared with 5.2% in the endarterectomy group (72 vs 44 events; HR 1.69, 1.16-2.45, p=0.006), Risks of any stroke (65 vs 35 events; HR 1.92, 1.27-2.89) and all-cause death (19 vs seven events; HR 2.76, 1.16-6.56) were higher in the stenting group than in the endarterectomy group. Three procedural myocardial infarctions were recorded in the stenting group, all of which were fatal, compared with four, all non-fatal, in the endarterectomy group. There was one event of cranial nerve palsy in the stenting group compared with 45 in the endarterectomy group. There were also fewer haematomas of any severity in the stenting group than in the endarterectomy group (31 vs 50 events; p=0.0197). Interpretation Completion of long-term follow-up is needed to establish the efficacy of carotid artery stenting compared with endarterectomy. In the meantime, carotid endarterectomy should remain the treatment of choice for patients suitable for surgery.
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3.
  • Wendin, Karin, 1963-, et al. (författare)
  • Introducing mealworm as an ingredient in crisps and pâtés – sensory characterization and consumer liking
  • 2021
  • Ingår i: Future Foods. - : Elsevier. - 2666-8335. ; 4, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to evaluate sensory perception and consumers’ attitude and liking of products with different textures, crisps and pâtés, with added mealworm ingredient in different amounts. By addition of mealworm ( Tenebrio molitor L. ) in the crisps, the brittleness increased. However, an increase in mealworm also increased the darkness. Adding mealworms to pâté reduced the odour and flavour of vegetable and increased the flavour of cinnamon and pepper as well as the oily texture. There was no significant difference in total liking between 10 and 30% addition of mealworm, nor between 0 and 10% addition, in any of the two products. The crisps received higher liking score than the pâtés. Thus, there is also a much higher probability that a customer would buy insect crisps than insect pâté. Environmental sustainability and sensory properties were shown to be the main reasons for buying foods with added insect ingredients.
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4.
  • Ahnström, Johan, et al. (författare)
  • Farmers' Interest in Nature and Its Relation to Biodiversity in Arable Fields
  • 2013
  • Ingår i: International Journal of Ecology. - : Hindawi Publishing Corporation. - 1687-9708 .- 1687-9716.
  • Tidskriftsartikel (refereegranskat)abstract
    • Biodiversity declines in farmland have been attributed to intensification of farming at the field level and loss of heterogeneity at the landscape level. However, farmers are not solely optimizing production; their actions are also influenced by social factors, tradition and interest in nature, which indirectly influence biodiversity but rarely are incorporated in studies of farmland biodiversity. We used social science methods to quantify farmers’ interest in nature on 16 farms with winter wheat fields in central Sweden, and combined this with biodiversity inventories of five organism groups (weeds, carabid beetles, bumblebees, solitary bees, and birds) and estimates of landscape composition andmanagement intensity at the field level.Agricultural intensity,measured as crop density, and farmers’ interest in nature explained variation in biodiversity, measured as the proportion of the regional species richness found on single fields. Interest in nature seemed to incorporate many actions taken by farmers and appeared to be influenced by both physical factors, for example, the surrounding landscape, and social factors, for example, social motivations.This study indicates that conservation of biodiversity in farmland, and design of new agri-environmental subsidy systems, would profit from taking farmers’ interest in nature and its relation to agricultural practices into account.
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6.
  • Alkan Olsson, Johanna, et al. (författare)
  • Local stakeholders acceptance of model-generated data used as a communication tool in water management: The Ronnea study
  • 2005
  • Ingår i: Ambio. - : Royal Swedish Academy of Sciences. - 0044-7447 .- 1654-7209. ; 34:7, s. 507-512
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to increase the knowledge of local stakeholders acceptance of model-generated data when used as a communication tool in water quality management. The Ronnea catchment in the southwest of Sweden was chosen as the study area. The results indicate the model-generated data served as a uniting factor. Simultaneously, the stakeholders were concerned with presented data, the main problems being sources of pollution, which were not accounted for, lack of trustworthiness when measuring pollution, and the uncertainty of the impact of natural variation and delayed effects. Four clusters of factors were identified as influencing stakeholders acceptance of the model-generated data: confidence in its practical applications, confidence in the people involved in or providing material for the dialog (such as experts, decision-makers, and media), the social characteristics of the participants (such as age and profession), and the way of communicating the data (such as tone of communication, group composition, duration, and geographical scope of the dialog). The perception of the fairness of the practical application of given model-generated data was also an important factor for acceptance.
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7.
  • André, Malin, et al. (författare)
  • A survey of public knowledge and awareness related to antibiotic use and resistance in Sweden
  • 2010
  • Ingår i: Journal of Antimicrobial Chemotherapy. - : Oxford University Press (OUP). - 0305-7453 .- 1460-2091. ; 65:6, s. 1292-1296
  • Tidskriftsartikel (refereegranskat)abstract
    • To examine the level of knowledge about antibiotic treatment and awareness of antibiotic resistance among the general public in Sweden. A quantitative, cross-sectional interview study based on a structured questionnaire used during telephone interviews. The sample comprised 1000 randomly selected individuals aged 21-80 years throughout Sweden. Demographic data as well as level of agreement with various statements concerning antibiotics and antibiotic use were provided by the respondents. The response rate was 74.7%. Of the respondents, 19.1% agreed that antibiotics cure common colds more quickly; this belief was higher in those who had not previously received antibiotics. A high proportion, 80.7%, agreed that bacteria could become resistant to antibiotics. Trust in doctors was high, and significantly more respondents reported trusting the doctor not prescribing an antibiotic, 87.0%, than the doctor prescribing an antibiotic, 81.0%. The respondents showed some confusion surrounding the terms 'bacteria' and 'viruses', and the meaning of these in relation to the prescribing decision. The high level of trust in restrictive prescribing as well as the awareness of antibiotic resistance expressed by the Swedish public should be recognized by health professionals and utilized in future campaigns.
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8.
  • Bacchus, Philip, et al. (författare)
  • Civil-military collaboration to facilitate rapid deployment of a mobile laboratory in early response to covid-19 : A high-readiness exercise
  • 2021
  • Ingår i: HEALTH SECURITY. - : Mary Ann Liebert. - 2326-5094 .- 2326-5108. ; 19:5, s. 488-497
  • Tidskriftsartikel (refereegranskat)abstract
    • Rapid and adaptable diagnostic capabilities are of great importance in the face of emerging infectious diseases. In an outbreak, timely establishment of diagnostic routines is crucial to identifying cases and preventing the spread of the disease, especially when faced with high-consequence pathogens. In this article, we describe a multiagency exercise including the rapid deployment and diagnostic adaptation of the Swedish Armed Forces mobile laboratory (biological field analysis laboratory) in the context of COVID-19. This deployment was initiated as a high-readiness exercise at the end of January 2020, when the global development of the outbreak was still uncertain. Through collaboration with the Public Health Agency of Sweden and a civilian hospital, a real-time reverse transcriptase polymerase chain reaction method specific to SARS-CoV-2 was made available and adapted to the mobile laboratory, and the team established and evaluated a functional and efficient diagnostic asset along with a logistical support chain. We also organized and evaluated mobile testing teams, and the method was later used in large-scale, national, cross-sectional COVID-19 surveys in several regions of Sweden. In this article, we focus on the challenges of overbridging the civil-military interface in this context and identifying lessons learned and added values to the response during the early pandemic. We propose that the experiences from this exercise and governmental agency collaboration are valuable in preparation for future outbreaks.
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9.
  • Bean, Christopher, 1990-, et al. (författare)
  • Short sleep, psychosocial work stressors, and measures of obesity: results from an Australian cohort study
  • 2019
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Short sleep and workplace stress are both established risk factors for overweight and obesity, yet few studies have considered how these two factors may intersect. The aim of this study was to establish the associations between these two exposures and their relative associations with body mass index (kg/m2 ) and waist circumference (cm).Methods: A cross-sectional design sampled current employees (N=423) from an Australian cohort using a computer-assisted telephone interview and clinic-measured height, weight, and waist circumference. Short sleep (≤6h/ night) was reported by 25.8% of the participants. Psychosocial work stressors were defined using the Job Demand-ControlSupport (JDCS) model and calculated at the subscale level (psychological demands; skill discretion; decision authority; coworker support; supervisor support). General linear models were used to assess associations between short sleep, the JDCS subscales (split at median), and BMI and waist circumference.Results: Separate analyses identified short sleep and a lack of skill discretion at work as predictors of both BMI and waist circumference. Furthermore, when both predictors were entered in the same model, each was associated with elevated BMI (b=1.79, p=.003; b=1.08, p=.045) and waist circumference (b=4.20, p=.005; b=2.97, p=.028). Short sleep was also associated with high perceived psychological demands at work (b=1.81, p=.003). All models were adjusted for gender, age, work hours, blue vs. white collar job, and household income.Discussion: These findings indicate the importance of considering the interplay between short sleep and psychosocial work stressors, and their respective associations with measures of overweight Sleep Sci. 2019;12(Supl.3):1-75 26 and obesity. Further research using longitudinal data is needed to model potential mechanisms (e.g., behavioral and physiological). A novel feature was the subscale consideration of the prominent JDCS model of work stress. Advocacy for both improved habitual sleep (e.g., ≥7h/night) and job redesign to increase skill discretion at work may promote lower levels of overweight and obesity for employees.
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10.
  • Berg, Anne, et al. (författare)
  • Expanding Political Capital : Why Social Democratic Women Participated in Middle-Class Feminist Educational Organisations in Sweden c.1890–1910
  • 2024
  • Ingår i: History of Education. - 0046-760X .- 1464-5130.
  • Tidskriftsartikel (refereegranskat)abstract
    • This article seeks to introduce a new historical explanation as to why left-wing working-class women engaged in liberal, middle-class organisations during the first wave of feminism. The article specifically deals with middle-class associations and clubs that had educational purposes. Instead of focusing on the larger explanatory scheme of the power of patriarchal societal structures or bourgeois feminisms as a hegemonic force, the account revolves around the political educational functions of liberal feminist engagement for some politically active social democratic women in Sweden. The case of social democratic women who entered the liberal middle class educational organisation Tolfterna (the Dozen) is the point of departure for a micro-historical analysis of the political capital accumulation practices that class collaboration entailed. Finally, the article explores how working-class women’s choices and actions can be considered a group-specific strategy to expand their political resources to attain what is called feminist liberal political capital.
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11.
  • Berg, Johanna (författare)
  • Att tillgängliggöra kulturarvsmaterial för forskning i tal : Upptäckter och lärdomar från etttvärvetenskapligt samarbetsprojekt
  • 2021
  • Rapport (populärvet., debatt m.m.)abstract
    • Det här är den publika slutrapporten från projektet Tilltal – Tillgängligtkulturarv för forskning i tal, ett samarbete mellan Institutet för språk ochfolkminnen (Isof), Kungliga Tekniska högskolan (KTH) och Riksarkivet.Projektet finansierades av Kungl. Vitterhetsakademien och RiksbankensJubileumsfond inom ramen för satsningen Samlingarna och forskningen(SAF16-0917:1), och löper över perioden 2017–2021.I rapportens första del tecknar vi de studier och andra aktiviteter vi genomfört inom projektet, och de lärdomar vi dragit av gjorda erfarenheter. Iden andra delen beskriver vi översiktligt de juridiska ramar som omgärdarett projekt som Tilltal, och ger råd om hur de kan hanteras.Vi hoppas att rapporten ska vara till glädje och nytta för den som villarbeta med likartade frågeställningar och metoder. Vi vet att det finnsmånga som söker samverkan kring äldre samlingar, både inom universiteten och på minnesinstitutionerna. Vi hoppas att våra erfarenheter och rådkan göra det lite lättare för dem att komma vidare
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12.
  • Berg, Johanna, 1983, et al. (författare)
  • Continuing decrease in coronary heart disease mortality in sweden
  • 2014
  • Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 14:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Deaths from coronary heart disease (CHD) have been decreasing in most Western countries over the last few decades. In contrast, a flattening of the decrease in mortality has been recently reported among younger age groups in some countries. We aimed to determine whether the decrease in CHD mortality is flattening among Swedish young adults.Methods: We examined trends in CHD mortality in Sweden between 1987 and 2009 among persons aged 35 to 84 years using CHD mortality data from the Swedish National Register on Cause of Death. Annual percent changes in rates were examined using Joinpoint software.Results: Overall, CHD mortality rates decreased by 67.4% in men and 65.1% in women. Among men aged 35-54 years, there was a modest early attenuation from a marked initial decrease. In the oldest women aged 75-84 years, an attenuation in the mortality decrease was observed from 1989 to 1992, followed by a decrease, as in all other age groups.Conclusions: In Sweden, coronary heart disease deaths are still falling. We were unable to confirm a flattening of the decline in young people. Death rates continue to decline in men and women across all age groups, albeit at a slower pace in younger men since 1991. Continued careful monitoring of CHD mortality trends in Sweden is required, particularly among young adults. © 2014 Berg et al.; licensee BioMed Central Ltd.
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14.
  • Berg, Johanna, et al. (författare)
  • OpenChart-SE: A corpus of artificial Swedish electronic health records for imagined emergency care patients written by physicians in a crowd-sourcing project
  • 2023
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Electronic health records (EHRs) are a rich source of information for medical research and public health monitoring. Information systems based on EHR data could also assist in patient care and hospital management. However, much of the data in EHRs is in the form of unstructured text, which is difficult to process for analysis. Natural language processing (NLP), a form of artificial intelligence, has the potential to enable automatic extraction of information from EHRs and several NLP tools adapted to the style of clinical writing have been developed for English and other major languages. In contrast, the development of NLP tools for less widely spoken languages such as Swedish has lagged behind. A major bottleneck in the development of NLP tools is the restricted access to EHRs due to legitimate patient privacy concerns. To overcome this issue we have generated a citizen science platform for collecting artificial Swedish EHRs with the help of Swedish physicians and medical students. These artificial EHRs describe imagined but plausible emergency care patients in a style that closely resembles EHRs used in emergency departments in Sweden. In the pilot phase, we collected a first batch of 50 artificial EHRs, which has passed review by an experienced Swedish emergency care physician. We make this dataset publicly available as OpenChart-SE corpus (version 1) under an open-source license for the NLP research community. The project is now open for general participation and Swedish physicians and medical students are invited to submit EHRs on the project website (https://github.com/Aitslab/openchart-se). Additional batches of quality-controlled EHRs will be released periodically.
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15.
  • Berg, Johanna, et al. (författare)
  • Perceived usefulness of trauma audit filters in urban India: a mixed-methods multicentre Delphi study comparing filters from the WHO and low and middle-income countries
  • 2022
  • Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 12:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective To compare experts' perceived usefulness of audit filters from Ghana, Cameroon, WHO and those locally developed; generate context-appropriate audit filters for trauma care in selected hospitals in urban India; and explore characteristics of audit filters that correlate to perceived usefulness. Design A mixed-methods approach using a multicentre online Delphi technique. Setting Two large tertiary hospitals in urban India. Methods Filters were rated on a scale from 1 to 10 in terms of perceived usefulness, with the option to add new filters and comments. The filters were categorised into three groups depending on their origin: low and middle-income countries (LMIC), WHO and New (locally developed), and their scores compared. Significance was determined using Kruskal-Wallis test followed by Wilcoxon rank-sum test. We performed a content analysis of the comments. Results 26 predefined and 15 new filter suggestions were evaluated. The filters had high usefulness scores (mean overall score 9.01 of 10), with the LMIC filters having significantly higher scores compared with those from WHO and those newly added. Three themes were identified in the content analysis relating to medical relevance, feasibility and specificity. Conclusions Audit filters from other LMICs were deemed highly useful in the urban India context. This may indicate that the transferability of defined trauma audit filters between similar contexts is high and that these can provide a starting point when implemented as part of trauma quality improvement programmes in low-resource settings.
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16.
  • Berg, Johanna, 1983, et al. (författare)
  • Sex differences in survival after myocardial infarction in Sweden, 1987-2010
  • 2017
  • Ingår i: Heart. - : BMJ. - 1355-6037 .- 1468-201X. ; 103:20, s. 1625-1630
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective In this nationwide study, we investigated age-specific and sex-specific trends in sex differences in survival after acute myocardial infarction (AMI), including deaths from coronary heart disease (CHD) that occurred outside hospital. Methods Observational study in Sweden of 28-day and 1-year mortality among 658 110 persons (35.7% women) aged 35-84 years with a first-time CHD event 1987-2010 with data retrieved from the national Swedish death and hospital registries. Results Age-adjusted 28-day case fatality decreased from 23.5% to 8.5% over the period (p<0.05). In hospitalised cases, short-term survival in women aged 35-54 years compared with men of the same age was poorer, not changing appreciably over time (HRs for women relative to men 1.63 (95% CI 1.28 to 2.08) at age 35-54 years and 1.28 (95% CI 1.12 to 1.46) at age 55-64 years in 2005-2010), but after adjustment for comorbidities, differences between men and women were no longer significant (HR 1.25 (95% CI 0.97 to 1.61) and 1.05 (95% CI 0.91 to 1.20)). When CHD deaths outside hospital were included, women had better prognosis regardless of age and period. In patients surviving the first 28 days, age-adjusted 1-year case fatality decreased from 15.3% to 7.7% (p<0.05) for both men and women. After adjustment for comorbidities, no significant sex differences persisted below the age of 75 years in the last period. Female 28day survivors 75-84 years old had a consistently better prognosis than older men. Conclusions The worse short-term outcomes in women <55 years of age hospitalised with AMI did not persist after adjustment for comorbidities. When CHD deaths outside hospital were included, women had consistently better short-term prognosis. In 28-day survivors, women did not fare worse than men when differences in comorbidities were considered.
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17.
  • Berg, Johanna, 1983, et al. (författare)
  • Symptoms of a first acute myocardial infarction in women and men.
  • 2009
  • Ingår i: Gender medicine : official journal of the Partnership for Gender-Specific Medicine at Columbia University. - : Elsevier BV. - 1878-7398. ; 6:3, s. 454-62
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Many studies have compared women and men for symptoms of acute myocardial infarction (AMI), but findings have been inconsistent, largely because of varying inclusion criteria, different study populations, and different methods. OBJECTIVE: The purpose of this study was to analyze gender differences in symptoms in a well-defined, population-based sample of women and men who experienced a first AMI. METHODS: Information on symptoms was collected from the medical charts of all patients with a first AMI, aged 25 to 74 years, who had taken part in the INTERGENE (Interplay Between Genetic Susceptibility and Environmental Factors for the Risk of Chronic Diseases) study. INTERGENE was a population-based research program on risk factors for cardiovascular disease. Medical charts were reviewed for each patient to determine the symptoms of AMI, and the prevalence of each symptom was compared according to sex. RESULTS: The study included 225 patients with a first AMI: 52 women and 173 men. Chest pain was the most common symptom, affecting 88.5% (46/52) of the women and 94.8% (164/173) of the men, with no statistically significant difference between the sexes. Women had significantly higher rates of 4 symptoms: nausea (53.8% [28/52] vs 29.5% [51/173]; age-adjusted odds ratio [OR] = 2.78; 95% CI, 1.47-5.25), back pain (42.3% [22/52] vs 14.5% [25/173]; OR = 4.29; 95% CI, 2.14-8.62), dizziness (17.3% [9/52] vs 7.5% [13/173]; OR = 2.60; 95% CI, 1.04-6.50), and palpitations (11.5% [6/52] vs 2.9% [5/173]; OR = 3.99; 95% CI, 1.15-13.84). No significant gender differences were found in the proportions of patients experiencing arm or shoulder pain, diaphoresis, dyspnea, fatigue, neck pain, abdominal pain, vomiting, jaw pain, or syncope/lightheadedness. No significant differences were found in the duration, type, or location of chest pain. The medical charts listed numerically more symptoms in women than in men; 73.1% (38/52) of the women but only 48.0% (83/173) of the men reported >3 symptoms (age-adjusted OR = 3.26; 95% CI, 1.62-6.54). CONCLUSIONS: Chest pain is the most common presenting symptom in both women and men with AMI. Nausea, back pain, dizziness, and palpitations were significantly more common in women. Women as a group displayed a greater number of symptoms than did men.
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18.
  • Berg, Martin, 1977- (författare)
  • Självets garderobiär : självreflexiva genuslekar och queer socialpsykologi
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Det övergripande syftet med föreliggande studie är tudelat. För det första syftar den till att på teoretisk väg etablera en dialog mellan queerteoretisk och socialpsykologisk teoribildning om aktörer och aktörsskap med utgångspunkt i en kritisk läsning av Judith Butler och George Herbert Mead. För det andra syftar den till att på empirisk väg utveckla och fördjupa denna dialog i syfte att demonstrera och resonera kring de möjligheter som uppstår i spänningen mellan dessa teoretiska perspektiv. På detta sätt är avsikten att föra ett bidrag till såväl den queer- och genusteoretiska debatten som dess socialpsykologiska motsvarighet. Ambitionen är att detta sammantaget kan utgöra ett ramverk i vilket möjligheterna med en queer socialpsykologi skisseras. I jämförelsen mellan dessa teoretiska perspektiv fokuseras på frågan om hur människor antas bli till som aktörer och under vilka villkor och genom vilka processer detta äger rum. I centrum för denna diskussion positioneras relationen mellan deras respektive antagande om struktur och aktör samt hur denna relaterar till och förutsätts vara uppburen genom något slags praktik. För det andra diskuteras individens möjlighet att omförhandla sitt förvärvade aktörsskap och genom vilka processer och praktiker detta eventuellt kan göras möjligt. Avhandlingen är uppdelad i fyra delar. Den inledande delen (del 1: Inledande ord) introducerar studiens övergripande bakgrund, teoretiska position, syfte, material och de metodologiska överväganden som har gjorts under forskningsresans gång. Den andra delen (del 2: Teoretiska interventioner) utvecklar i tre kapitel den diskussion om spänningen mellan queerteori och socialpsykologi som påbörjades i avhandlingens första och inledande kapitel. I ett första kapitel fokuseras på Judith Butler för att ringa in och granska några centrala argument och faktorer i hennes tänkande. I ett andra kapitel diskuteras George Herbert Mead för att, i likhet med föregående kapitel, presentera hans övergripande argument och huvudsakliga tankegångar. Avslutningsvis avrundas avhandlingens andra del med ett kapitel som syftar till att summera och utveckla den spänningsrelation som hittas mellan dessa två teoretiker samtidigt som en diskussion förs om de möjligheter en empirisk utveckling av den teoretiska problematiken skulle kunna bidra med. Den teoretiska spänning som lokaliseras mellan Mead och Butler kretsar i första hand kring deras förståelse av relationen mellan aktör och praktik och med utgångspunkt i denna formuleras arbetsbegreppen transaktör och transpraktik som genomgående används i presentationen av det empiriska materialet. Avhandlingens tredje del (del 3: Empiriska nedslag) är i första hand av empirisk karaktär och är uppdelad i två kapitel. I det första av dessa förs en diskussion om hur de självreflexiva genuslekarna inbegriper formulerandet av ett särskilt transgenus och på vad sätt det är möjligt att förstå iscensättandet av genus som en i första hand självkommunikativ praktik. Gradvis demonstreras hur det går att utläsa en önskan om att iscensätta genus tillsammans med andra människor och därför kretsar det följande kapitlet kring en diskussion om betydelsen av social interaktion för detta iscensättande. Med andra ord går det att utläsa en rörelse från självkommunikation till (önskad) social interaktion och detta är ett tema som tydligt ringar in en stor del av den teoretiska problematik som genomsyrar denna studie. I den fjärde och avslutande delen (del 4: Avslutande reflektioner) knyts i tre kapitel de resonemang som hittills har presenterats och diskuterats ihop. Det inledande kapitlet för en teoretiskt orienterad diskussion om den föregående genomgången av det empiriska materialet. I ett därpå följande kapitel fokuseras på olika aspekter av självreflexiva genuslekar i relation till den klädda kroppen för att visa hur den tidigare presenterade praktik- och aktörsproblematiken är avhängig den klädda kroppens genusprägling. I detta sammanhang visas hur det är möjligt att upprätta en relation mellan självets framväxt, subjektivitet och den klädda kroppen. Avslutningsvis förs ett kortfattat resonemang kring avhandlingens huvudsakliga argumentationslinjer och vilka möjligheter ett tänkande inspirerat av queer socialpsykologi för med sig.
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19.
  • Björkman, Ingeborg, et al. (författare)
  • Awareness of antibiotic resistance and antibiotic prescribing in UTI treatment : A qualitative study among primary care physicians in Sweden
  • 2013
  • Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 31:1, s. 50-55
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesTo improve education and information for general practitioners in relation to rational antibiotic prescribing for urinary tract infection (UTI), it is important to be aware of GPs' views of resistance and how it influences their choice of UTI treatment. The aim of this study was to explore variations in views of resistance and UTI treatment decisions among general practitioners (GPs) in a county in Sweden.DesignQualitative, semi-structured interviews were analysed with a phenomenographic approach and content analysis.SettingPrimary care in Kronoberg, a county in southern Sweden.SubjectsA purposeful sample of 20 GPs from 15 of 25 health centres in the county.Main outcome measures.The variation of perceptions of antibiotic resistance in UTI treatment. How UTIs were treated according to the GPs.ResultsThree different ways of viewing resistance in UTI treatment were identified. These were: (A) No problem, I have never seen resistance, (B) The problem is bigger somewhere else, and (C) The development of antibiotic resistance is serious and we must be careful. Moreover, GPs' perceptions of antibiotic resistance were mirrored in how they reported their treatment of UTIs in practice.ConclusionThere was a hierarchal scale of how GPs viewed resistance as an issue in UTI treatment. Only GPs who expressed concerns about resistance followed prescribing guidelines completely. This offers valuable insights into the planning and most likely the outcome of awareness or educational activities aimed at changed antibiotic prescribing behaviour.
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20.
  • Borgegard, Tomas, et al. (författare)
  • Alzheimers Disease: Presenilin 2-Sparing gamma-Secretase Inhibition Is a Tolerable A beta Peptide-Lowering Strategy
  • 2012
  • Ingår i: Journal of Neuroscience. - : Society for Neuroscience. - 0270-6474 .- 1529-2401. ; 32:48, s. 17297-17305
  • Tidskriftsartikel (refereegranskat)abstract
    • gamma-Secretase inhibition represents a major therapeutic strategy for lowering amyloid beta (A beta) peptide production in Alzheimers disease (AD). Progress toward clinical use of gamma-secretase inhibitors has, however, been hampered due to mechanism-based adverse events, primarily related to impairment of Notch signaling. The gamma-secretase inhibitor MRK-560 represents an exception as it is largely tolerable in vivo despite displaying only a small selectivity between A beta production and Notch signaling in vitro. In exploring the molecular basis for the observed tolerability, we show that MRK-560 displays a strong preference for the presenilin 1(PS1) over PS2 subclass of gamma-secretases and is tolerable in wild-type mice but causes dose-dependent Notch-related side effect in PS2-deficient mice at drug exposure levels resulting in a substantial decrease in brain A beta levels. This demonstrates that PS2 plays an important role in mediating essential Notch signaling in several peripheral organs during pharmacological inhibition of PS1 and provide preclinical in vivo proof of concept for PS2-sparing inhibition as a novel, tolerable and efficacious gamma-secretase targeting strategy for AD.
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21.
  • Borgegård, Tomas, et al. (författare)
  • Alzheimer's Disease : Presenilin 2-Sparing γ-Secretase Inhibition Is a Tolerable Aβ Peptide-Lowering Strategy
  • 2012
  • Ingår i: Journal of Neuroscience. - 0270-6474 .- 1529-2401. ; 32:48, s. 17297-17305
  • Tidskriftsartikel (refereegranskat)abstract
    • γ-Secretase inhibition represents a major therapeutic strategy for lowering amyloid β (Aβ) peptide production in Alzheimer's disease (AD). Progress toward clinical use of γ-secretase inhibitors has, however, been hampered due to mechanism-based adverse events, primarily related to impairment of Notch signaling. The γ-secretase inhibitor MRK-560 represents an exception as it is largely tolerable in vivo despite displaying only a small selectivity between Aβ production and Notch signaling in vitro. In exploring the molecular basis for the observed tolerability, we show that MRK-560 displays a strong preference for the presenilin 1 (PS1) over PS2 subclass of γ-secretases and is tolerable in wild-type mice but causes dose-dependent Notch-related side effect in PS2-deficient mice at drug exposure levels resulting in a substantial decrease in brain Aβ levels. This demonstrates that PS2 plays an important role in mediating essential Notch signaling in several peripheral organs during pharmacological inhibition of PS1 and provide preclinical in vivo proof of concept for PS2-sparing inhibition as a novel, tolerable and efficacious γ-secretase targeting strategy for AD.
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22.
  • Carlsson, Jenny, et al. (författare)
  • Management of intrapartum care in expected normal childbirth: A prospective cross-sectional survey at a university hospital in Nepal
  • 2016
  • Ingår i: NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016. - 9789163742699
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background Women and children die needlessly in childbirth every day. Appropriate care may prevent this, and keeping birth normal is crucial to reduce the risk of complications. Nepal has radically reduced maternal and neonatal mortality in the last decade, yet the numbers remain high. Of the initiatives implemented by the government to ensure safe motherhood, none focuses on improving normal, physiological processes of childbirth. Aim To study the quality of intra-partum care in expected normal childbirth at a university hospital in Nepal Methods: Following ethical approval, a prospective cross-sectional study using a structured questionnaire was conducted in November 2013. Over three weeks, nurses employed at the labor ward collected data from 292 consecutive women giving birth. Of these, 164 were expected to have a normal childbirth and 107 (65%) were nulliparous. The questionnaire covered; background variables, previous pregnancies and births, current pregnancy, and current labor and birth. Care management was assessed using nine items, including the five that constitute the Bologna score: presence of a companion, use of partograph, absence of augmentation, non-supine position, and skin-to-skin care. Results Births were assisted by physicians (56%), nurses (41%), and medical or nursing students under supervision (2%). The mean Bologna score was 1.43 (variance 0-3, min 0, max 5). Circa half of the women had an episiotomy and two had a postpartum hemorrhage of >500 ml. All women were well after birth, and all infants had an Apgar score ≥7 at five minutes. Conclusion Intra-partum care in expected normal childbirth must be continuously assessed to safe-guard the normal, physiological process. Results indicate a medicalized perspective in the studied setting, including an over-use of medico-technical intervention. One important activity to support normal childbirth is to establish the professional midwife, educated with the right competencies. To support such initiative, further activities including research are needed.
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23.
  • Cederfeldt, Johanna, et al. (författare)
  • Quality of intra-partum care at a university hospital in Nepal: A prospective cross-sectional survey
  • 2016
  • Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756. ; 7, s. 52-57
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the quality of intra-partum care provided to women with an expected normal birth at a university hospital in Nepal. Methods: A prospective cross-sectional study was conducted during three weeks in November 2013. Nurses at the labor ward collected data from 292 consecutive births. Of these, 164 women of low risk were expected to have a normal birth and were included in the study; 107 (65%) were nulliparous. The selfadministered questionnaire covered maternal characteristics, previous pregnancies and births, current pregnancy, labor and birth. Nine items assessed care management, five of which comprised the Bologna score with a total possible score of 5: presence of a companion, use of partograph, non-use of augmentation, non-supine position, and skin-to-skin contact. Results: The women were assisted by physicians (56%), nurses (42%) or students under supervision (2%). All were in good health after birth. Two had a postpartum hemorrhage exceeding 500 ml and 49% had an episiotomy. Apgar score in all neonates was ≥ 7 at five minutes. Mean Bologna score was 1.43 (variance 0-3). Conclusions: The management of care in normal birth could be improved in the studied setting, and there is a need for more research to support such improvement.
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24.
  • Engert, Andreas, et al. (författare)
  • The European Hematology Association Roadmap for European Hematology Research : a consensus document
  • 2016
  • Ingår i: Haematologica. - Pavia, Italy : Ferrata Storti Foundation (Haematologica). - 0390-6078 .- 1592-8721. ; 101:2, s. 115-208
  • Tidskriftsartikel (refereegranskat)abstract
    • The European Hematology Association (EHA) Roadmap for European Hematology Research highlights major achievements in diagnosis and treatment of blood disorders and identifies the greatest unmet clinical and scientific needs in those areas to enable better funded, more focused European hematology research. Initiated by the EHA, around 300 experts contributed to the consensus document, which will help European policy makers, research funders, research organizations, researchers, and patient groups make better informed decisions on hematology research. It also aims to raise public awareness of the burden of blood disorders on European society, which purely in economic terms is estimated at (sic)23 billion per year, a level of cost that is not matched in current European hematology research funding. In recent decades, hematology research has improved our fundamental understanding of the biology of blood disorders, and has improved diagnostics and treatments, sometimes in revolutionary ways. This progress highlights the potential of focused basic research programs such as this EHA Roadmap. The EHA Roadmap identifies nine 'sections' in hematology: normal hematopoiesis, malignant lymphoid and myeloid diseases, anemias and related diseases, platelet disorders, blood coagulation and hemostatic disorders, transfusion medicine, infections in hematology, and hematopoietic stem cell transplantation. These sections span 60 smaller groups of diseases or disorders. The EHA Roadmap identifies priorities and needs across the field of hematology, including those to develop targeted therapies based on genomic profiling and chemical biology, to eradicate minimal residual malignant disease, and to develop cellular immunotherapies, combination treatments, gene therapies, hematopoietic stem cell treatments, and treatments that are better tolerated by elderly patients.
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25.
  • Eriksson, Pontus, et al. (författare)
  • Urodrill - a novel MRI-guided endoscopic biopsy technique to sample and molecularly classify muscle-invasive bladder cancer without fractionating the specimen during transurethral resection
  • 2023
  • Ingår i: European Urology Open Science. - 2666-1691. ; 53, s. 78-82
  • Tidskriftsartikel (refereegranskat)abstract
    • The current diagnostic pathway for patients with muscle-invasive bladder cancer (MIBC), which involves with computed tomography urography, cystoscopy, and transurethral resection of the bladder (TURB) to histologically confirm MIBC, delays definitive treatment. The Vesical Imaging-Reporting and Data System (VI-RADS) has been suggested for MIBC identification using magnetic resonance imaging (MRI), but a recent randomized trial reported misclassification in one-third of patients. We investigated a new endoscopic biopsy device (Urodrill) for histological confirmation of MIBC and assessment of molecular subtype by gene expression in patients with VI-RADS 4 and 5 lesions on MRI. In ten patients, Urodrill biopsies were guided by MR images to the muscle-invasive portion of the tumor via a flexible cystoscope under general anesthesia. During the same session, conventional TURB was subsequently performed. A Urodrill sample was successfully obtained in nine of ten patients. MIBC was verified in six of nine patients, and seven of nine samples contained detrusor muscle. In seven of eight patients for whom a Urodrill biopsy sample was subjected to RNA sequencing, single-sample molecular classification according to the Lund taxonomy was feasible. No complications related to the biopsy device occurred. A randomized trial comparing this new diagnostic pathway for patients with VI-RADS 4 and 5 lesions and the current standard (TURB) is warranted. Patient summary: We report on a novel biopsy device for patients with muscle-invasive bladder cancer that facilitates histology analysis and molecular characterization of tumor samples.
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26.
  • Fedosseev, V. N., et al. (författare)
  • ISOLDE RILIS : New beams, new facilities
  • 2008
  • Ingår i: Nuclear Instruments and Methods in Physics Research Section B. - : Elsevier BV. - 0168-583X .- 1872-9584. ; 266:19-20, s. 4378-4382
  • Tidskriftsartikel (refereegranskat)abstract
    • The resonance ionization laser ion source (RILIS) at the ISOLDE on-line isotope separator is based on the selective excitation of atomic transitions by tunable laser radiation. New ion beams have been produced with RILIS in recent years: Sb, Sc, Dy, Au, Hg and Po. In total, isotopes of 26 different elements have been selectively laser-ionized and separated at ISOLDE. In order to facilitate the work on development of atomic ionization schemes an off-line laser laboratory has been established at CERN. Operating independently of the on-line RI LIS setup, this laboratory will be capable of providing extensive data on atomic transitions, in particular between highly excited and auto-ionizing atomic states, which are required for the improvement of the RILIS efficiency. Additionally, the program gram of upgrading the on-line RI LIS system by the implementation of solid state lasers will be presented.
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27.
  • Fernholm, Johanna, 1973- (författare)
  • Uppförandekoder som etisk varumärkning? : Ansvar i företag med globala värdekedjor
  • 2013
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Since the late 1990s, the presence of ethical codes of conduct in companies has increased dramatically, especially in companies with strong brands, as well as in industries where companies outsource business to suppliers in low-income countries. The demands on, and renewed interest in, companies taking social responsibility, as often summarized in the concept of corporate social responsibility (CSR), for problems in their value chains, seems thus intertwined with the processes of globalization.The communication of social responsibility in companies is discussed in CSR communication and ethical branding , two emerging streams of research that are related to the overall classification of social responsibility, communication and branding in globalization. However, in spite of the extensive literature on social responsibility and communication in companies the last decades, there is a need for more research uncovering the contextualization of ethical codes of conduct in global brands.The aim of the thesis is to interpret the process by which ethical codes of conduct as communication of responsibility are developed in companies with global value chains, by examining the factors underlying this communication. An ethnographically inspired approach is used to facilitate a holistic understanding and included in the study are interviews with companies and NGOs, as well as field studies from value chains in Thailand and Vietnam.The study shows that the basic way in which responsibility are communicated in companies’ global value chains is in the shape of long interlinked “chains of responsibility”, which takes the form of staging. Staging captures how responsibility comes into play. It happens gradually through dramatized events, based on ethical codes of conduct that are themselves standardized scripts. They take place in border movements between the front stage and backstage, where the actors play the roles that are increasingly expected to identify with them.
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28.
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29.
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30.
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31.
  • Gouw, Samantha C., et al. (författare)
  • F8 gene mutation type and inhibitor development in patients with severe hemophilia A: systematic review and meta-analysis
  • 2012
  • Ingår i: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 119:12, s. 2922-2934
  • Forskningsöversikt (refereegranskat)abstract
    • This systematic review was designed to provide more precise effect estimates of inhibitor development for the various types of F8 gene mutations in patients with severe hemophilia A. The primary outcome was inhibitor development and the secondary outcome was high-titer-inhibitor development. Asystematic literature search was performed to include cohort studies published in peer-reviewed journals with data on inhibitor incidences in the various F8 gene mutation types and a mutation detection rate of at least 80%. Pooled odds ratios (ORs) of inhibitor development for different types of F8 gene mutations were calculated with intron 22 inversion as the reference. Data were included from 30 studies on 5383 patients, including 1029 inhibitor patients. The inhibitor risk in large deletions and nonsense mutations was higher than in intron 22 inversions (pooled OR = 3.6, 95% confidence interval [95% CI], 2.3-5.7 and OR = 1.4, 95% CI, 1.1-1.8, respectively), the risk in intron 1 inversions and splice-site mutations was equal (pooled OR = 0.9; 95% CI, 0.6-1.5 and OR = 1.0; 95% CI, 0.6-1.5), and the risk in small deletions/insertions and missense mutations was lower (pooled OR = 0.5; 95% CI, 0.4-0.6 and OR = 0.3; 95% CI, 0.2-0.4, respectively). The relative risks for developing high titer inhibitors were similar. (Blood. 2012;119(12):2922-2934)
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32.
  • Gouw, Samantha C., et al. (författare)
  • Factor VIII Products and Inhibitor Development in Severe Hemophilia A
  • 2013
  • Ingår i: New England Journal of Medicine. - 0028-4793. ; 368:3, s. 231-239
  • Tidskriftsartikel (refereegranskat)abstract
    • Background For previously untreated children with severe hemophilia A, it is unclear whether the type of factor VIII product administered and switching among products are associated with the development of clinically relevant inhibitory antibodies (inhibitor development). Methods We evaluated 574 consecutive patients with severe hemophilia A (factor VIII activity, <0.01 IU per milliliter) who were born between 2000 and 2010 and collected data on all clotting-factor administration for up to 75 exposure days. The primary outcome was inhibitor development, which was defined as at least two positive inhibitor tests with decreased in vivo recovery of factor VIII levels. Results Inhibitory antibodies developed in 177 of the 574 children (cumulative incidence, 32.4%); 116 patients had a high-titer inhibitory antibody, defined as a peak titer of at least 5 Bethesda units per milliliter (cumulative incidence, 22.4%). Plasma-derived products conferred a risk of inhibitor development that was similar to the risk with recombinant products (adjusted hazard ratio as compared with recombinant products, 0.96; 95% confidence interval [CI], 0.62 to 1.49). As compared with third-generation full-length recombinant products (derived from the full-length complementary DNA sequence of human factor VIII), second-generation full-length products were associated with an increased risk of inhibitor development (adjusted hazard ratio, 1.60; 95% CI, 1.08 to 2.37). The content of von Willebrand factor in the products and switching among products were not associated with the risk of inhibitor development. Conclusions Recombinant and plasma-derived factor VIII products conferred similar risks of inhibitor development, and the content of von Willebrand factor in the products and switching among products were not associated with the risk of inhibitor development. Second-generation full-length recombinant products were associated with an increased risk, as compared with third-generation products. (Funded by Bayer Healthcare and Baxter BioScience.)
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33.
  • Gouw, Samantha C., et al. (författare)
  • Intensity of factor VIII treatment and inhibitor development in children with severe hemophilia A: the RODIN study
  • 2013
  • Ingår i: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 121:20, s. 4046-4055
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to examine the association of the intensity of treatment, ranging from high-dose intensive factor VIII (FVIII) treatment to prophylactic treatment, with the inhibitor incidence among previously untreated patients with severe hemophilia A. This cohort study aimed to include consecutive patients with a FVIII activity <0.01 IU/mL, born between 2000 and 2010, and observed during their first 75 FVIII exposure days. Intensive FVIII treatment of hemorrhages or surgery at the start of treatment was associated with an increased inhibitor risk (adjusted hazard ratio [aHR], 2.0; 95% confidence interval [CI], 1.3-3.0). High-dose FVIII treatment was associated with a higher inhibitor risk than low-dose FVIII treatment (aHR, 2.3; 95% CI, 1.0-4.8). Prophylaxis was only associated with a decreased overall inhibitor incidence after 20 exposure days of FVIII. The association with prophylaxis was more pronounced in patients with low-risk F8 genotypes than in patients with high-risk F8 genotypes (aHR, 0.61, 95% CI, 0.19-2.0 and aHR, 0.85, 95% CI, 0.51-1.4, respectively). In conclusion, our findings suggest that in previously untreated patients with severe hemophilia A, high-dosed intensive FVIII treatment increases inhibitor risk and prophylactic FVIII treatment decreases inhibitor risk, especially in patients with low-risk F8 mutations.
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34.
  • Gouw, Samantha C., et al. (författare)
  • Recombinant versus plasma-derived factor VIII products and the development of inhibitors in previously untreated patients with severe hemophilia A: the CANAL cohort study
  • 2007
  • Ingår i: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 109:11, s. 4693-4697
  • Tidskriftsartikel (refereegranskat)abstract
    • It has been suggested that plasma-derived factor VIII products induce fewer inhibitors than recombinant factor VIII products. We investigated the relationship of factor VIII product type and switching between factor VIII products with the risk to develop inhibitors. This multicenter retrospective cohort study included 316 patients with severe hemophilia A born between 1990 and 2000. The outcome was clinically relevant inhibitor development, defined as the occurrence of at least 2 positive inhibitor titers with decreased recovery. The risk of inhibitor development was not clearly lower in plasma-derived compared with recombinant factor VIII products (relative risk [RR],. 0.8; 95% confidence interval [CI], 0.5-1.3). Among high-titer inhibitors, the possible reduction in risk was even less pronounced (RR, 0.9; CI, 0.5-1.5). Plasma-derived products with considerable quantities of von Willebrand factor (VWF) carried the same risk for inhibitor development as recombinant factor VIII products (RR, 1.0; CI, 0.6-1.6). Switching between factor VIII products did not increase the risk for inhibitors (RR, 1.1; CI, 0.6-1.8). In conclusion, our findings support neither the notion that plasma-derived factor VIII products with considerable concentrations of VWF confer a lower risk to develop inhibitory antibodies than recombinant factor VIII products, nor that switching between factor VIII product brands increases inhibitor risks in previously untreated patients with severe hemophilia A.
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35.
  • Henriksson, Martin, et al. (författare)
  • The transfer of clinical prediction models for early trauma care had uncertain effects on mistriage
  • 2020
  • Ingår i: Journal of Clinical Epidemiology. - : Elsevier BV. - 0895-4356 .- 1878-5921. ; 128, s. 66-73
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: This study aimed to assess how transfers of clinical prediction models for early trauma care between different care contexts within a single health system affected mistriage rates. Study Design and Setting: Patients aged 15 years or older, registered between 2011 and 2016 in the Swedish national trauma registry, SweTrau, were included. Three data set groups were created: high- and low-volume centers, metropolitan and nonmetropolitan centers, and multicenters and single centers. Clinical prediction models were developed using logistic regression in each data set group and transferred between data sets within groups. Model performance was evaluated using mistriage rate, undertriage rate, and overtriage rate. Multiple imputation using chained equations was used to handle missing data. Model performance was reported as medians with 95% confidence intervals (CIs). Results: A total of 26,965 patients were included. Changes in mistriage rates after transfer ranged from −0.25 (95% CI −0.21 to 0.04) to 0.29 (95% CI 0.13–0.39). Both overtriage and undertriage rates were affected. Conclusions: Transferring clinical prediction models for early trauma care is associated with substantial uncertainty in regards to the effect on model performance. Depending on the care context, model transfer led to either increased or decreased mistriage. Overtriage was more affected by model transfer than undertriage.
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36.
  • Jahns, Anika C., et al. (författare)
  • Microbiology of folliculitis : a histological study of 39 cases
  • 2014
  • Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley-Blackwell. - 0903-4641 .- 1600-0463. ; 122:1, s. 25-32
  • Tidskriftsartikel (refereegranskat)abstract
    • Folliculitis is a common inflammatory skin syndrome. Several microbial organisms have been put forward as causative agents, but few studies visualized microbes directly in inflamed hair follicles. This retrospective study investigated bacterial and fungal colonization of inflamed hair follicles in patients with clinically diagnosed non-infectious folliculitis. Skin biopsies from 39 folliculitis patients and 27 controls were screened by fluorescence in situ hybridization (FISH) using broad-range bacterial and fungal probes and by immunofluorescence microscopy using a monoclonal antibody towards Gram-positive bacteria. Specific monoclonal and polyclonal antibodies towards Staphylococcus spp. and Propionibacterium acnes were applied for further species identification. Inflamed follicles were associated with bacterial colonization in 10 samples (26%) and fungal colonization in three samples (8%). Staphylococcus spp. were observed in inflamed follicles in seven samples (18%). Two samples were positive for P. acnes, which were identified as either type II or type IB/type III. Both Staphylococcus spp. and P. acnes were seen in macrocolonies/biofilm structures. In conclusion, one-third of patients with clinically diagnosed, non-infectious folliculitis exhibited microbial colonization with predominance of Staphylococcus spp.
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37.
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38.
  • Karlsson, Oskar, et al. (författare)
  • Pesticide-induced multigenerational effects on amphibian reproduction and metabolism
  • 2021
  • Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 775
  • Tidskriftsartikel (refereegranskat)abstract
    • Underlying drivers of species extinctions need to be better understood for effective conservation of biodiversity. Nearly half of all amphibian species are at risk of extinction, and pollution may be a significant threat as seasonal high-level agrochemical use overlaps with critical windows of larval development. The potential of environmental chemicals to reduce the fitness of future generations may have profound ecological and evolutionary implications. This study characterized effects of male developmental exposure to environmentally relevant concentrations of the anti-androgenic pesticide linuron over two generations of offspring in Xenopus tropicalis frogs. The adult male offspring of pesticide-exposed fathers (F1) showed reduced body size, decreased fertility, and signs of endocrine system disruption. Impacts were further propagated to the grand-offspring (F2), providing evidence of transgenerational effects in amphibians. The adult F2 males demonstrated increased weight and fat body palmitoleic-to-palmitic acid ratio, and decreased plasma glucose levels. The study provides important cross-species evidence of paternal epigenetic inheritance and pollutant-induced transgenerational toxicity, supporting a causal and complex role of environmental contamination in the ongoing species extinctions, particularly of amphibians.
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39.
  • Kärrman, Erik, et al. (författare)
  • Översikt över återvinning av fosfor och kväve från avlopp i nio utvalda länder
  • 2019
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • There has been an increased focus on nutrients recycling specifically in Europe over the last years. This paper gives an overview of the situation in nine countries regarding status, policies and future perspectives in the area of phosphorus and nitrogen recycling from wastewater and sewage sludge. The study includes the situation in Sweden, Germany, Switzerland, Denmark, Netherlands, Great Britain, Norway, Finland and Canada. The information was received through interviews with national coordinators complemented with information from literature and other sources. The following topics were included:- Main management of sewage sludge and phosphorus extraction today- Expected future management of sewage sludge and phosphorus extraction, 5-10 years ahead- Experiences of nitrogen extraction from sewage- Experiences of source separated sewage systems- National targets, regulations and financial instruments to promote nutrients recycling from sewage- Ongoing research, development and innovation activitiesFrom the compilation of the results the countries were categorized in three groups 1)The Legislation group, 2) the Investigation group, and 3) the Limit group. The categorization was based on the current management of sewage sludge in combination with ambitions and future perspectives.The legislation group includes Germany and Switzerland where the latter is the only country with a prohibition of spreading sewage sludge in agriculture, implemented 2006. Germany is a frontrunner with a newly implemented legislation. Spreading of sewage sludge is today rare in Germany since limits are getting more and more strict over time. Incineration is a common method in both Switzerland and Germany and both countries are in the frontline regarding the introduction of phosphorus extraction from the ashes.Six countries still use considerable amounts sewage sludge on agriculture, where four countries; Great Britain, Denmark, Norway and Canada has no plans in changing this (the Limit group). The Netherlands is also part of the Limit group but is different since they do not spread any sewage sludge on agriculture due to tough limits.The investigation group contain Finland and Sweden. They are spreading relatively large amounts of sewage sludge but has also an ambition to start extract and recycle phosphorus. This is done with support of a policy in Finland and in with a governmental investigation in Sweden with aim at formulating new regulations.A general observation is that the current handling of sewage sludge in each country is more dependent on local conditions than a more scientific evaluation of different opportunities. The explanations can rather be found in the structure of the agriculture (the access of manure or the access of agricultural land convenient for spreading sewage sludge), traditions and attitude to incineration, possibilities of alternative use of sludge (cover of mines and landfills), debate of sewage sludge or other reasons.
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40.
  • Lambrechts, Diether, et al. (författare)
  • Meta-analysis of VEGF variations in ALS : increased susceptibility in male carriers of the -2578AA genotype
  • 2008
  • Ingår i: Journal of Medical Genetics. - London : BMJ Publishing Group. - 0022-2593 .- 1468-6244. ; 46:12, s. 840-846
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Targeted delivery of the angiogenic factor, vascular endothelial growth factor (VEGF), to motor neurons prolongs survival in rodent models of amyotrophic lateral sclerosis (ALS), while mice expressing reduced VEGF concentrations develop motor neuron degeneration reminiscent of ALS, raising the question whether VEGF contributes to the pathogenesis of ALS. An initial association study reported that VEGF haplotypes conferred increased susceptibility to ALS in humans, but later studies challenged this initial finding. Methods and findings: A meta-analysis was undertaken to critically reappraise whether any of the three common VEGF gene variations (−2578C/A, −1154G/A and −634G/C) increase the risk of ALS. Over 7000 subjects from eight European and three American populations were included in the analysis. Pooled odds ratios were calculated using fixed-effects and random-effects models, and four potential sources of heterogeneity (location of disease onset, gender, age at disease onset and disease duration) were assessed. After correction, none of the genotypes or haplotypes was significantly associated with ALS. Subgroup analysis by gender revealed, however, that the −2578AA genotype, which lowers VEGF expression, increased the risk of ALS in males (OR = 1.46 males vs females; 95% CI = 1.19 to 1.80; p = 7.8 10E-5), even after correction for publication bias and multiple testing. Conclusions: This meta-analysis does not support the original conclusion that VEGF haplotypes increase the risk of ALS in humans, but the significant association of the low-VEGF −2578AA genotype with increased susceptibility to ALS in males reappraises the link between reduced VEGF concentrations and ALS, as originally revealed by the fortuitous mouse genetic studies.
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41.
  • Lauri, Johanna, 1976-, et al. (författare)
  • Finansiell feminism? : Jämställdhet & ekonomi i självhjälpsformat
  • 2024
  • Ingår i: Kulturella perspektiv - Svensk etnologisk tidskrift. - : Föreningen Kulturella Perspektiv. - 1102-7908. ; 33
  • Tidskriftsartikel (refereegranskat)abstract
    • In a contemporary popular cultural Swedish context, gender equality and economic equality seem to be increasingly formulated in financial terms, through narratives centered around succeeding on the stock market, owning assets or practicing venture capitalism. In this context, self-help books in financial speculation targeting women are marketed with a gender equality narrative. In this article, we focus on how values of feminism, gender equality and economy are shaped and maintained by such books. By effectively hiding power relationships and presenting financial freedom as an attainable goal for everyone and through a condensed narrative of happiness and balance in the future, we read the fantasy of financial freedom as cruel optimism through Lauren Berlant's perspective. The fantasy of financial freedom also produces a feminist subject who, with her investments, both can and should maintain control over her own life and her family as well as navigate around the vulnerabilities of life. 
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42.
  • Lindahl, Johanna, et al. (författare)
  • An inclusive and participatory approach to changing policies and practices for improved milk safety in Assam, northeast India
  • 2018
  • Ingår i: GLOBAL FOOD SECURITY-AGRICULTURE POLICY ECONOMICS AND ENVIRONMENT. - : Elsevier BV. - 2211-9124. ; 17, s. 9-13
  • Forskningsöversikt (refereegranskat)abstract
    • Animal products are highly nutritious, but also highly perishable. In India milk is an important source of animal protein, but problems with low quality of the milk, high degrees of adulterated milk on the market, high bacterial loads, and sometimes presence of zoonotic pathogens persist. Most dairy farmers in India are resource-poor small-holders, often with limited knowledge about the importance of food safety and hygiene. Milk quality problems including adulteration and bacterial contamination is common in the country.This paper describes a training intervention for improved food safety in Guwahati, Assam, India, conducted in 2009–2013. The training was designed to be short, simple and customized, cheap to deliver, easily accessible, and accompanied by incentives to bring change in knowledge, attitude and practices (KAP). In 2014 three outcomes were assessed: changed KAP; milk production; and, mastitis prevalence. Selected food safety hazards were also assessed, although their management had not been included in training. We found evidence of improved KAP among trained farmers, 14% higher milk production, and a tendency towards less mastitis, but no effects on food safety hazard levels.This study shows that a training intervention can have a medium-term impact, while the issue of food safety is more complex and cannot be assumed to automatically follow from even successful training.
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43.
  • Lysholm, Sara, et al. (författare)
  • Crossing the Line : Seroprevalence and Risk Factors for Transboundary Animal Diseases Along the Tanzania-Zambia Border
  • 2022
  • Ingår i: Frontiers in Veterinary Science. - : Frontiers Media S.A.. - 2297-1769. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Transboundary pathogens pose a threat to livelihood security in countries such as Zambia and Tanzania. This study aimed to investigate the seroprevalence of peste des petits ruminants virus (PPRV), foot and mouth disease virus (FMDV), sheep and goat pox virus (SGPV), Rift Valley fever virus (RVFV) and Brucella spp. in sheep and goats along the Tanzania-Zambia border. Another aim was to assess the association between certain predictor variables and seroprevalence, focusing on trade and proximity to an international border, to a town and to the Tanzania-Zambia highway. During September-October 2018, 486 serum samples from small ruminants in Zambia and 491 in Tanzania were collected and analyzed using enzyme-linked immunosorbent assays (ELISA). A questionnaire focused on management strategies was administered to each household. The animal-level seroprevalence in Zambia was 0.21% [95% confidence interval (CI) (0.01-1.14) for PPRV, 1.03% (95% CI 0.33-2.39) for FMDV, 0% (95% CI 0-0.76) for SGPV, 2.26% (95% CI 1.14-4.01) for RVFV and 1.65% (95% CI 0.71-3.22) for Brucella spp.]. In Tanzania, animal-level seroprevalence was 2.85% (95% CI 1.57-4.74) for PPRV, 16.9% (95% CI 13.7-20.5) for FMDV, 0.20% (95% CI 0.01-1.13) for SGPV, 3.26% (95% CI 1.87-5.24) for RVFV and 20.0% (95% CI 14.5-26.5) for Brucella spp. For PPRV (OR 6.83, 95% CI 1.37-34.0, p = 0.019) and FMDV (OR 5.68, 95% CI 1.58-20.3, p = 0.008), herds situated more than 30 km from an international border were more likely to be seropositive, while being located 10-30 km (OR 4.43, 95% CI 1.22-16.1 p = 0.024) from a border was identified as a risk factor for Brucella spp. For FMDV (OR 79.2, 95% CI 4.52-1388.9, p = 0.003), being situated within 30 km from a town was associated with seropositivity. Furthermore, contact with wild ruminants (OR 18.2, 95% CI 1.36-244), and the presence of sheep in the household (OR 5.20, 95% CI 1.00-26.9, p = 0.049), was associated with seropositivity for PPRV, and FMDV. No significant associations between trade or distance to the Tan-Zam highway and seroprevalence were found. We recommend that the impact of trade and proximity to borders, towns and roads should be further evaluated in larger studies, ideally incorporating aspects such as temporal trade fluctuations.
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44.
  • Løvvik, Tone S., et al. (författare)
  • Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2) : a randomised, double-blind, placebo-controlled trial
  • 2019
  • Ingår i: The Lancet Diabetes and Endocrinology. - : Elsevier. - 2213-8587 .- 2213-8595. ; 7:4, s. 256-266
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy complications. Epi-analysis of two previous randomised controlled trials that compared metformin with placebo during pregnancy in women with PCOS showed a significant reduction in late miscarriages and preterm births in the metformin group. The aim of this third randomised trial (PregMet2) was to test the hypothesis that metformin prevents late miscarriage and preterm birth in women with PCOS.Methods: PregMet2 was a randomised, placebo-controlled, double-blind, multicentre trial done at 14 hospitals in Norway, Sweden, and Iceland. Singleton pregnant women with PCOS aged 18-45 years were eligible for inclusion. After receiving information about the study at their first antenatal visit or from the internet, women signed up individually to participate in the study. Participants were randomly assigned (1: 1) to receive metformin or placebo by computer-generated random numbers. Randomisation was in blocks of ten for each country and centre; the first block had a random size between one and ten to assure masking. Participants were assigned to receive oral metformin 500 mg twice daily or placebo during the first week of treatment, which increased to 1000 mg twice daily or placebo from week 2 until delivery. Placebo tablets and metformin tablets were identical and participants and study personnel were masked to treatment allocation. The primary outcome was the composite incidence of late miscarriage (between week 13 and week 22 and 6 days) and preterm birth (between week 23 and week 36 and 6 days), analysed in the intention-to-treat population. Secondary endpoints included the incidence of gestational diabetes, preeclampsia, pregnancy-induced hypertension, and admission of the neonate to the neonatal intensive care unit. We also did a post-hoc individual participant data analysis of pregnancy outcomes, pooling data from the two previous trials with the present study. The study was registered with ClinicalTrials. gov, number NCT01587378, and EudraCT, number 2011-002203-15.Findings: The study took place between Oct 19, 2012, and Sept 1, 2017. We randomly assigned 487 women to metformin (n=244) or placebo (n=243). In the intention-to-treat analysis, our composite primary outcome of late miscarriage and preterm birth occurred in 12 (5%) of 238 women in the metformin group and 23 (10%) of 240 women in the placebo group (odds ratio [OR] 0.50, 95% CI 0.22- 1.08; p = 0.08). We found no significant differences for our secondary endpoints, including incidence of gestational diabetes (60 [25%] of 238 women in the metformin group vs 57 [24%] of 240 women in the placebo group; OR 1.09, 95% CI 0.69-1.66; p=0.75). We noted no substantial between-group differences in serious adverse events in either mothers or offspring, and no serious adverse events were considered drug-related by principal investigators. In the post-hoc pooled analysis of individual participant data from the present trial and two previous trials, 18 (5%) of 397 women had late miscarriage or preterm delivery in the metformin group ]compared with 40 (10%) of 399 women in the placebo group (OR 0.43, 95% CI 0.23-0.79; p=0.004).Interpretation: In pregnant women with PCOS, metformin treatment from the late first trimester until delivery might reduce the risk of late miscarriage and preterm birth, but does not prevent gestational diabetes.
  •  
45.
  • Meinderts, Sanne M., et al. (författare)
  • Human and murine splenic neutrophils are potent phagocytes of IgG-opsonized red blood cells
  • 2017
  • Ingår i: Blood Advances. - : American Society of Hematology. - 2473-9529 .- 2473-9537. ; 1:14, s. 875-886
  • Tidskriftsartikel (refereegranskat)abstract
    • Red blood cell (RBC) clearance is known to occur primarily in the spleen, and is presumed to be executed by red pulp macrophages. Erythrophagocytosis in the spleen takes place as part of the homeostatic turnover of RBCs to remove old RBCs. It can be strongly promoted by immunoglobulin G (IgG) opsonization of RBCs, a condition that can occur as a consequence of autoantibody or alloantibody formation. The purpose of our study was to investigate which phagocytes are involved in IgG-mediated RBC clearance in the human spleen. We developed a highly specific in vitro assay to monitor RBC phagocytosis in total human splenocytes. Surprisingly, we have found that whereas homeostatic clearance of RBCs is primarily a task for splenic macrophages, neutrophils and, to a lesser extent, also monocytes can be a major factor in clearance of IgG-opsonized RBCs. Erythrophagocytosis by neutrophils is strongly dependent on the degree of opsonization of the RBCs. Additionally, the process is enhanced after blocking the "do not eat me" signal CD47 on the opsonized RBCs, which binds signal regulatory protein a, a myeloid inhibitory receptor that restricts phagocytosis. Moreover, RBCs isolated from autoimmune hemolytic anemia patients, opsonized by auto-IgGs, were shown to be readily phagocytosed by neutrophils. Finally, priming of neutrophils by inflammatory mediators such as tumor necrosis factor a and lipopolysaccharide further increases the magnitude of erythrophagocytosis. Collectively, our data suggest that neutrophils contribute significantly to the phagocytosis of antibody-opsonized RBCs, especially under inflammatory conditions. This indicates a hereto unanticipated contribution of neutrophils in RBC phagocytosis, especially under pathological conditions such as alloimmunization or autoimmunization.
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46.
  • Nielsen, Susanne, 1969, et al. (författare)
  • Sex-specific trends in 4-year survival in 37 276 men and women with acute myocardial infarction before the age of 55 years in Sweden, 1987-2006: a register-based cohort study.
  • 2014
  • Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 4:5
  • Tidskriftsartikel (refereegranskat)abstract
    • To examine sex-specific trends in 4-year mortality among young patients with first acute myocardial infarction (AMI), 1987-2006. Results From the first to last 5-year period, the absolute excess risk decreased from 1.38 to 0.50 and 1.53 to 0.59 per 100 person-years among men aged 25–44 and 45–54years, respectively. Corresponding figures for women were a decrease from 2.26 to 1.17 and from 1.93 to 1.45 per 100 person-years, respectively. Trends for women were non-linear, decreasing to the same extent as those for men until the third period, then increasing. For the last 5-year period, the standardised mortality ratio for young survivors of AMI compared with the general population was 4.34 (95% CI 3.04 to 5.87) and 2.43 (95% CI 2.12 to 2.76) for men aged 25–44 and 45–54years, respectively, and 13.53 (95% CI 8.36 to 19.93) and 6.42 (95% CI 5.24 to 7.73) for women, respectively. Deaths not associated with cardiovascular causes increased from 21.5% to 44.6% in men and 41.5% to 65.9% in women. Conclusions Young male survivors of AMI have low absolute long-term mortality rates, but these rates remain twofold to fourfold that of the general population. After favourable development until 2001, women now have higher absolute mortality than men and a 6-fold to 14-fold risk of death compared with women in the general population.
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47.
  •  
48.
  • Nyberg, Lena, 1979, et al. (författare)
  • A single-step competitive binding assay for mapping of single DNA molecules
  • 2012
  • Ingår i: Biochemical and Biophysical Research Communications - BBRC. - : Elsevier BV. - 0006-291X .- 1090-2104. ; 417:1, s. 404-408
  • Tidskriftsartikel (refereegranskat)abstract
    • Optical mapping of genomic DNA is of relevance for a plethora of applications such as scaffolding for sequencing and detection of structural variations as well as identification cif pathogens like bacteria and viruses. For future clinical applications it is desirable to have a fast and robust mapping method based on as few steps as possible. We here demonstrate a single-step method to obtain a DNA barcode that is directly visualized using nanofluidic devices and fluorescence microscopy. Using a mixture of YOYO-1, a bright DNA dye, and netropsin, a natural antibiotic with very high AT specificity, we obtain a DNA map with a fluorescence intensity profile along the DNA that reflects the underlying sequence. The netropsin binds to AT-tetrads and blocks these binding sites from YOYO-1 binding which results in lower fluorescence intensity from AT-rich regions of the DNA. We thus obtain a DNA barcode that is dark in AT-rich regions and bright in GC-rich regions with kilobasepair resolution. We demonstrate the versatility of the method by obtaining a barcode on DNA from the phage T4 that captures its circular permutation and agrees well with its known sequence.
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49.
  • Nyokabi, Ndungu S., et al. (författare)
  • Exploring the adoption of food safety measures in smallholder dairy systems in Ethiopia : implications for food safety and public health
  • 2024
  • Ingår i: Food Security. - : Springer. - 1876-4517 .- 1876-4525. ; 16:2, s. 423-435
  • Tidskriftsartikel (refereegranskat)abstract
    • Milk is highly perishable and can be a conduit for the transmission of zoonotic foodborne pathogens. This cross-sectional survey involving 159 farming households and 18 participant observations in participating farms was undertaken in Addis Ababa and surrounding areas in Oromia, Ethiopia to assess the adoption of food safety measures in smallholder farms. Adoption of food safety measures at the farm level influences milk quality and safety across the entire milk value chain, from "grass to glass". This study considered the adoption of 36 different food safety measures (FSM) including animal health, milking hygiene, hygienic milk storage, and hygienic milking premises. A weighted food safety index (FSI, ranging from 0 to 100) was calculated for each household based on FSM adopted. Ordinary Least Squares linear regression was used to quantify the factors of FSM adoption by smallholder farmers. The overall food safety index ranged between 59.97-60.75. A majority of farmers may be classified as moderate adopters of FSM (index ranging between 30-70%). Farm and farmers' characteristics such as herd size, farmer's education level, farmer's expertise in dairying, and participation of the farm in the formal milk value- chain, were shown to positively influence the level of adoption of FSM. Low farm-level adoption of FSM has food safety and public health implications as it can lead to milk contamination and, therefore, expose consumers to foodborne diseases. There is an imperative for policymakers to design and implement policies and intervention strategies that lead to increased farmer training related to livestock production and awareness of the important role that FSM adoption can play in improving food safety and public health.
  •  
50.
  • Nyokabi, Ndungu S., et al. (författare)
  • Exploring the composition and structure of milk and meat value chains, food safety risks and governance in the Addis Ababa and Oromia regions of Ethiopia
  • 2023
  • Ingår i: Frontiers in Sustainable Food Systems. - : Frontiers Media S.A.. - 2571-581X. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • Demand for animal-source foods (ASF) is increasing globally, driven by population growth and changing dietary preferences. In global south countries, low compliance with good agricultural practices (GAPs) and food safety standards in the production of ASF is a major public health concern due to the high prevalence of foodborne diseases. This study examines the composition and structure of milk and meat value chains and explores food safety risks and governance in the Addis Ababa and Oromia regions of Ethiopia. Stakeholder discussions, key informant interviews and participant observation were undertaken to collect data on milk and meat value chain actors' perceptions of opportunities and constraints to improving access to safe, high-quality milk and meat products. The results reveal low compliance with rules and standards by milk and meat value chain actors which could compromise food safety and quality and expose consumers to public health risks. There was stricter enforcement of GAPs and food safety standards in the case of milk and meat products destined for export compared to products sold in the local market. The main barriers to compliance with food safety regulations were actors' low knowledge, small profit margins, absence of critical food safety infrastructure such as electricity and road and low access to capital to invest in the recommended equipment such as aluminum containers, coolers and fridges. This paper concludes there is a need for targeted efforts to support the adoption of low-cost technologies that could mitigate food safety risks. Additionally, there is a need for improved communication and tailored training for value chain actors that reflect local social, cultural and economic context to incentivise compliance with rules governing food safety and quality.
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