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1.
  • Borisov, S, et al. (författare)
  • Surveillance of adverse events in the treatment of drug-resistant tuberculosis: first global report
  • 2019
  • Ingår i: The European respiratory journal. - : European Respiratory Society (ERS). - 1399-3003 .- 0903-1936. ; 54:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The World Health Organization (WHO) recommends that countries implement pharmacovigilance and collect information on active drug safety monitoring (aDSM) and management of adverse events.The aim of this prospective study was to evaluate the frequency and severity of adverse events to anti-tuberculosis (TB) drugs in a cohort of consecutive TB patients treated with new (i.e. bedaquiline, delamanid) and repurposed (i.e. clofazimine, linezolid) drugs, based on the WHO aDSM project. Adverse events were collected prospectively after attribution to a specific drug together with demographic, bacteriological, radiological and clinical information at diagnosis and during therapy. This interim analysis included patients who completed or were still on treatment at time of data collection.Globally, 45 centres from 26 countries/regions reported 658 patients (68.7% male, 4.4% HIV co-infected) treated as follows: 87.7% with bedaquiline, 18.4% with delamanid (6.1% with both), 81.5% with linezolid and 32.4% with clofazimine. Overall, 504 adverse event episodes were reported: 447 (88.7%) were classified as minor (grade 1–2) and 57 (11.3%) as serious (grade 3–5). The majority of the 57 serious adverse events reported by 55 patients (51 out of 57, 89.5%) ultimately resolved. Among patients reporting serious adverse events, some drugs held responsible were discontinued: bedaquiline in 0.35% (two out of 577), delamanid in 0.8% (one out of 121), linezolid in 1.9% (10 out of 536) and clofazimine in 1.4% (three out of 213) of patients. Serious adverse events were reported in 6.9% (nine out of 131) of patients treated with amikacin, 0.4% (one out of 221) with ethionamide/prothionamide, 2.8% (15 out of 536) with linezolid and 1.8% (eight out of 498) with cycloserine/terizidone.The aDSM study provided valuable information, but implementation needs scaling-up to support patient-centred care.
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  • Singh, K. P., et al. (författare)
  • Clinical standards for the management of adverse effects during treatment for TB
  • 2023
  • Ingår i: The International Journal of Tuberculosis and Lung Disease. - : International Union Against Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 27:7, s. 506-519
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Adverse effects (AE) to TB treatment cause morbidity, mortality and treatment interruption. The aim of these clinical standards is to encourage best practise for the diagnosis and management of AE.METHODS: 65/81 invited experts participated in a Delphi process using a 5-point Likert scale to score draft standards.RESULTS: We identified eight clinical standards. Each person commencing treatment for TB should: Standard 1, be counselled regarding AE before and during treatment; Standard 2, be evaluated for factors that might increase AE risk with regular review to actively identify and manage these; Standard 3, when AE occur, carefully assessed and possible allergic or hypersensitiv-ity reactions considered; Standard 4, receive appropriate care to minimise morbidity and mortality associated with AE; Standard 5, be restarted on TB drugs after a serious AE according to a standardised protocol that includes active drug safety monitoring. In addition: Standard 6, healthcare workers should be trained on AE including how to counsel people undertaking TB treatment, as well as active AE monitoring and management; Standard 7, there should be active AE monitoring and reporting for all new TB drugs and regimens; and Standard 8, knowledge gaps identified from active AE monitoring should be systematically addressed through clinical research.CONCLUSION: These standards provide a person -centred, consensus-based approach to minimise the impact of AE TB treatment.
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  • Alffenaar, J. W. C., et al. (författare)
  • Clinical standards for the dosing and management of TB drugs
  • 2022
  • Ingår i: The International Journal of Tuberculosis and Lung Disease. - Paris, France : International Union Against Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 26:6, s. 483-
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Optimal drug dosing is important to ensure adequate response to treatment, prevent development of drug resistance and reduce drug toxicity. The aim of these clinical standards is to provide guidance on 'best practice' for dosing and management of TB drugs.Methods: A panel of 57 global experts in the fields of microbiology, pharmacology and TB care were identified; 51 participated in a Delphi process. A 5-point Likert scale was used to score draft standards. The final document represents the broad consensus and was approved by all participants.Results: Six clinical standards were defined: Standard 1, defining the most appropriate initial dose for TB treatment; Standard 2, identifying patients who may be at risk of sub-optimal drug exposure; Standard 3, identifying patients at risk of developing drug-related toxicity and how best to manage this risk; Standard 4, identifying patients who can benefit from therapeutic drug monitoring (TDM); Standard 5, highlighting education and counselling that should be provided to people initiating TB treatment; and Standard 6, providing essential education for healthcare professionals. In addition, consensus research priorities were identified.Conclusion: This is the first consensus-based Clinical Standards for the dosing and management of TB drugs to guide clinicians and programme managers in planning and implementation of locally appropriate measures for optimal person-centred treatment to improve patient care.
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  • Karadenizli, A., et al. (författare)
  • Genomic analyses of Francisella tularensis strains confirm disease transmission from drinking water sources, Turkey, 2008, 2009 and 2012
  • 2015
  • Ingår i: Eurosurveillance. - 1025-496X .- 1560-7917. ; 20:21
  • Tidskriftsartikel (refereegranskat)abstract
    • Waterborne epidemics of tularaemia caused by Francisella tularensis are increasingly reported in Turkey. We have used whole genome sequencing to investigate if F. tularensis isolated from patients could be traced back to drinking water sources. Tonsil swabs from 33 patients diagnosed with oropharyngeal tularaemia in three outbreaks and 140 water specimens were analysed. F. tularensis subsp. holarctica was confirmed by microagglutination and PCR in 12 patients and five water specimens. Genomic analysis of three pairs of patient and water isolates from outbreaks in Sivas, Corum, and Kocaeli showed the isolates to belong to two new clusters of the F. tularensis B. 12 genetic clade. The clusters were defined by 19 and 15 single nucleotide polymorphisms (SNPs) in a multiple alignment based on 507 F. tularensis genomes. One synonymous SNP was chosen as a new canonical SNP (canSNP) for each cluster for future use in diagnostic assays. No SNP was identified between the genomes from the patient-water pair of isolates from Kocaeli, one SNP between the pair of isolates from Sivas, whereas the pair from Corum differed at seven SNPs. These results illustrate the power of whole genome sequencing for tracing F. tularensis patient isolates back to their environmental source.
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  • Rohmer, Laurence, et al. (författare)
  • Comparison of Francisella tularensis genomes reveals evolutionary events associated with the emergence of human pathogenic strains
  • 2007
  • Ingår i: Genome Biology. - : BioMed Central. - 1465-6906 .- 1474-760X. ; 8:6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Francisella tularensis subspecies tularensis and holarctica are pathogenic to humans, whereas the two other subspecies, novicida and mediasiatica, rarely cause disease. To uncover the factors that allow subspecies tularensis and holarctica to be pathogenic to humans, we compared their genome sequences with the genome sequence of Francisella tularensis subspecies novicida U112, which is nonpathogenic to humans. RESULTS: Comparison of the genomes of human pathogenic Francisella strains with the genome of U112 identifies genes specific to the human pathogenic strains and reveals pseudogenes that previously were unidentified. In addition, this analysis provides a coarse chronology of the evolutionary events that took place during the emergence of the human pathogenic strains. Genomic rearrangements at the level of insertion sequences (IS elements), point mutations, and small indels took place in the human pathogenic strains during and after differentiation from the nonpathogenic strain, resulting in gene inactivation. CONCLUSION: The chronology of events suggests a substantial role for genetic drift in the formation of pseudogenes in Francisella genomes. Mutations that occurred early in the evolution, however, might have been fixed in the population either because of evolutionary bottlenecks or because they were pathoadaptive (beneficial in the context of infection). Because the structure of Francisella genomes is similar to that of the genomes of other emerging or highly pathogenic bacteria, this evolutionary scenario may be shared by pathogens from other species.
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  • Afset, J. E., et al. (författare)
  • Phylogeographical pattern of Francisella tularensis in a nationwide outbreak of tularaemia in Norway, 2011
  • 2015
  • Ingår i: Eurosurveillance. - 1025-496X .- 1560-7917. ; 20:19, s. 9-14
  • Tidskriftsartikel (refereegranskat)abstract
    • In 2011, a nationwide outbreak of tularaemia occurred in Norway with 180 recorded cases. It was associated with the largest peak in lemming density seen in 40 years. Francisella tularensis was isolated from 18 patients. To study the geographical distribution of F. tularensis genotypes in Norway and correlate genotype with epidemiology and clinical presentation, we performed whole genome sequencing of patient isolates. All 18 genomes from the outbreak carried genetic signatures of F. tularensis subsp. holarctica and were assigned to genetic clades using canonical single nucleotide polymorphisms. Ten isolates were assigned to major genetic clade B.6 (subclade B.7), seven to clade B.12, and one to clade B.4. The B.6 subclade B.7 was most common in southern and central Norway, while clade B.12 was evenly distributed between the southern, central and northern parts of the country. There was no association between genotype and clinical presentation of tularaemia, time of year or specimen type. We found extensive sequence similarity with F. tularensis subsp. holarctica genomes from high-endemic tularaemia areas in Sweden. Finding nearly identical genomes across large geographical distances in Norway and Sweden imply a life cycle of the bacterium without replication between the outbreaks and raise new questions about long-range migration mechanisms.
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  • Ahlinder, J., et al. (författare)
  • Use of metagenomic microbial source tracking to investigate the source of a foodborne outbreak of cryptosporidiosis
  • 2022
  • Ingår i: FOOD AND WATERBORNE PARASITOLOGY. - : Elsevier. - 2405-6766. ; 26
  • Tidskriftsartikel (refereegranskat)abstract
    • Cryptosporidium is a protozoan parasite of global public health importance that causes gastroenteritis in a variety of vertebrate hosts, with many human outbreaks reported yearly, often from ingestion of contaminated water or food. Despite the major public health implications, little is typically known about sources of contamination of disease outbreaks caused by Cryptosporidium. Here, we study a national foodborne outbreak resulted from infection with Cryptosporidium parvum via romaine lettuce, with the main goal to trace the source of the parasite. To do so, we combined traditional outbreak investigation methods with molecular detection and characterization methods (i.e. PCR based typing, amplicon and shotgun sequencing) of romaine lettuce samples collected at the same farm from which the contaminated food was produced. Using 18S rRNA typing, we detected C. parvum in two out of three lettuce samples, which was supported by detections in the metagenome analysis. Microbial source tracking analysis of the lettuce samples suggested sewage water as a likely source of the contamination, albeit with some uncertainty. In addition, the high degree of overlap in bacterial species content with a public human gut microbial database corroborated the source tracking results. The combination of traditional and molecular based methods applied here is a promising tool for future source tracking investigations of food- and waterborne outbreaks of Cryptosporidium spp. and can help to control and mitigate contamination risks.
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  • Anckarsäter, Henrik, et al. (författare)
  • New evidence for an association between the CSF HVA:5-HIAA ratio and psychopathic traits
  • 2003
  • Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ. - 1468-330X .- 0022-3050. ; 74:7, s. 918-921
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To replicate the relation between the CSF HVA:5-HIAA ratio and psychopathic traits previously reported in a pilot group of 22 perpetrators of violent crimes. METHODS: CSF monoamine metabolite concentrations in another 28 violent and sexual offenders, aged 45 or below, referred to pretrial forensic psychiatric investigation, were compared to features of psychopathy according to the Psychopathy Checklist-Revised (PCL-R). RESULTS: Our previous finding was repeated in the new study group, where the HVA:5-HIAA ratio was strongly associated with psychopathic traits (r = 0.50, p = 0.010), particularly its behavioural aspects (r = 0.523, p = 0.004). In subsamples of individuals from both study groups who had no medication (n = 25) or no current axis I disorder, including a history of mood disorder or substance dependence (n = 21), the HVA:5-HIAA ratio remained strongly associated with all psychopathy factors but most closely with the behavioural features. Retrospective assessments of childhood disruptive symptomatology, such as attention deficit hyperactivity disorder or conduct disorder, analysed in relation to the monoamine metabolites, showed the same association with the HVA:5-HIAA ratio. CONCLUSIONS: Violent and aggressive behavioural traits with childhood onset and adult expression as psychopathic features are associated with changed activity in the brain dopaminergic system, possibly as a result of serotonergic dysregulation.
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  • Flannagan, Carol. A. C., et al. (författare)
  • Comparing motor-vehicle crash risk of EU and US vehicles
  • 2018
  • Ingår i: Accident Analysis and Prevention. - : Elsevier. - 0001-4575 .- 1879-2057. ; 117, s. 392-397
  • Tidskriftsartikel (refereegranskat)abstract
    • This study examined the hypotheses that passenger vehicles meeting European Union (EU) safety standards have similar crashworthiness to United States (US) -regulated vehicles in the US driving environment, and vice versa. The first step involved identifying appropriate databases of US and EU crashes that include in-depth crash information, such as estimation of crash severity using Delta-V and injury outcome based on medical records. The next step was to harmonize variable definitions and sampling criteria so that the EU data could be combined and compared to the US data using the same or equivalent parameters. Logistic regression models of the risk of a Maximum injury according to the Abbreviated Injury Scale of 3 or greater, or fatality (MAIS3+F) in EU-regulated and US-regulated vehicles were constructed. The injury risk predictions of the EU model and the US model were each applied to both the US and EU standard crash populations. Frontal, near-side, and far-side crashes were analyzed together (termed "front/side crashes") and a separate model was developed for rollover crashes.For the front/side model applied to the US standard population, the mean estimated risk for the US-vehicle model is 0.035 (sd = 0.012), and the mean estimated risk for the EU-vehicle model is 0.023 (sd = 0.016). When applied to the EU front/side population, the US model predicted a 0.065 risk (sd = 0.027), and the EU model predicted a 0.052 risk (sd = 0.025). For the rollover model applied to the US standard population, the US model predicted a risk of 0.071 (sd = 0.024), and the EU model predicted 0.128 risk (sd = 0.057). When applied to the EU rollover standard population, the US model predicted a 0.067 risk (sd = 0.024), and the EU model predicted 0.103 risk (sd = 0.040).The results based on these methods indicate that EU vehicles most likely have a lower risk of MAIS3+F injury in front/side impacts, while US vehicles most likely have a lower risk of MAIS3+F injury in llroovers. These results should be interpreted with an understanding of the uncertainty of the estimates, the study limitations, and our recommendations for further study detailed in the report.
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  • Flannagan, Carol A., et al. (författare)
  • Comparing motor-vehicle crash risk of EU and US vehicles
  • 2015
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • This study examined the hypotheses that vehicles meeting EU safety standards perform similarly to US-­regulated vehicles in the US driving environment, and vice versa. The analyses used three statistical approaches to “triangulate” evidence regarding differences in crash and injury risk. Separate analyses assessed crash avoidance technologies, including headlamps and mirrors. The results suggest that when controlling for differences in environment and exposure, vehicles meeting EU standards offer reduced risk of serious injury in frontal/side crashes and have driver‐side mirrors that reduce risk in lane-change crashes better, while vehicles meeting US standards provide alower risk of injury in rollovers and have headlamps that make pedestrians more conspicuous.
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  • Laaksonen, T., et al. (författare)
  • Sympatric divergence and clinal variation in multiple coloration traits of Ficedula flycatchers
  • 2015
  • Ingår i: Journal of Evolutionary Biology. - : Wiley. - 1010-061X .- 1420-9101. ; 28:4, s. 779-790
  • Tidskriftsartikel (refereegranskat)abstract
    • Geographic variation in phenotypes plays a key role in fundamental evolutionary processes such as local adaptation, population differentiation and speciation, but the selective forces behind it are rarely known. We found support for the hypothesis that geographic variation in plumage traits of the pied flycatcher Ficedula hypoleuca is explained by character displacement with the collared flycatcher Ficedula albicollis in the contact zone. The plumage traits of the pied flycatcher differed strongly from the more conspicuous collared flycatcher in a sympatric area but increased in conspicuousness with increasing distance to there. Phenotypic differentiation (P-ST) was higher than that in neutral genetic markers (F-ST), and the effect of geographic distance remained when statistically controlling for neutral genetic differentiation. This suggests that a cline created by character displacement and gene flow explains phenotypic variation across the distribution of this species. The different plumage traits of the pied flycatcher are strongly to moderately correlated, indicating that they evolve non-independently from each other. The flycatchers provide an example of plumage patterns diverging in two species that differ in several aspects of appearance. The divergence in sympatry and convergence in allopatry in these birds provide a possibility to study the evolutionary mechanisms behind the highly divergent avian plumage patterns.
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  • Pape Møller, Anders, et al. (författare)
  • Interaction of climate change with effects of conspecific and heterospecific density on reproduction
  • 2020
  • Ingår i: Oikos. - : Wiley. - 0030-1299 .- 1600-0706. ; 129:12, s. 1807-1819
  • Tidskriftsartikel (refereegranskat)abstract
    • We studied the relationship between temperature and the coexistence of great tit Parus major and blue tit Cyanistes caeruleus, breeding in 75 study plots across Europe and North Africa. We expected an advance in laying date and a reduction in clutch size during warmer springs as a general response to climate warming and a delay in laying date and a reduction in clutch size during warmer winters due to density‐dependent effects. As expected, as spring temperature increases laying date advances and as winter temperature increases clutch size is reduced in both species. Density of great tit affected the relationship between winter temperature and laying date in great and blue tit. Specifically, as density of great tit increased and temperature in winter increased both species started to reproduce later. Density of blue tit affected the relationship between spring temperature and blue and great tit laying date. Thus, both species start to reproduce earlier with increasing spring temperature as density of blue tit increases, which was not an expected outcome, since we expected that increasing spring temperature should advance laying date, while increasing density should delay it cancelling each other out. Climate warming and its interaction with density affects clutch size of great tits but not of blue tits. As predicted, great tit clutch size is reduced more with density of blue tits as temperature in winter increases. The relationship between spring temperature and density on clutch size of great tits depends on whether the increase is in density of great tit or blue tit. Therefore, an increase in temperature negatively affected the coexistence of blue and great tits differently in both species. Thus, blue tit clutch size was unaffected by the interaction effect of density with temperature, while great tit clutch size was affected in multiple ways by these interactions terms.
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  • Yang, Liyun, et al. (författare)
  • Towards Smart Work Clothing for Automatic Risk Assessment of Physical Workload
  • 2018
  • Ingår i: IEEE Access. - : Institute of Electrical and Electronics Engineers (IEEE). - 2169-3536. ; 6, s. 40059-40072
  • Tidskriftsartikel (refereegranskat)abstract
    • Work-related musculoskeletal and cardiovascular disorders are still prevalent in today's working population. Nowadays, risk assessments are usually performed via self-reports or observations, which have relatively low reliability. Technology developments in textile electrodes (textrodes), inertial measurement units, and the communication and processing capabilities of smart phones/tablets provide wearable solutions that enable continuous measurements of physiological and musculoskeletal loads at work with sufficient reliability and resource efficiency. In this paper, a wearable system integrating textrodes, motion sensors, and real-time data processing through a mobile application was developed as a demonstrator of risk assessment related to different types and levels of workload and activities. The system was demonstrated in eight subjects from four occupations with various workload intensities, during which the heart rate and leg motion data were collected and analyzed with real-time risk assessment and feedback. The system showed good functionality and usability as a risk assessment tool. The results contribute to designing and developing future wearable systems and bring new solutions for the prevention of work-related disorders.
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  • Abtahi, Farhad, 1981-, et al. (författare)
  • Big Data & Wearable Sensors Ensuring Safety and Health @Work
  • 2017
  • Ingår i: GLOBAL HEALTH 2017, The Sixth International Conference on Global Health Challenges. - 9781612086040
  • Konferensbidrag (refereegranskat)abstract
    • —Work-related injuries and disorders constitute a major burden and cost for employers, society in general and workers in particular. We@Work is a project that aims to develop an integrated solution for promoting and supporting a safe and healthy working life by combining wearable technologies, Big Data analytics, ergonomics, and information and communication technologies. The We@Work solution aims to support the worker and employer to ensure a healthy working life through pervasive monitoring for early warnings, prompt detection of capacity-loss and accurate risk assessments at workplace as well as self-management of a healthy working life. A multiservice platform will allow unobtrusive data collection at workplaces. Big Data analytics will provide real-time information useful to prevent work injuries and support healthy working life
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  • Abtahi, Farhad, 1981-, et al. (författare)
  • Wearable Sensors Enabling Personalized Occupational Healthcare
  • 2018
  • Ingår i: Intelligent Environments 2018. - Amsterdam : IOS Press. - 9781614998730 - 9781614998747 ; , s. 371-376
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • This paper presents needs and potentials for wearable sensors inoccupational healthcare. In addition, it presents ongoing European and Swedishprojects for developing personalized, and pervasive wearable systems for assessingrisks of developing musculoskeletal disorders and cardiovascular diseases at work.Occupational healthcare should benefit in preventing diseases and disorders byproviding the right feedback at the right time to the right person. Collected datafrom workers can provide evidence supporting the ergonomic and industrial tasksof redesigning the working environment to reduce the risks.
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  • Björkman, Lena, 1965, et al. (författare)
  • The Neutrophil Response Induced by an Agonist for Free Fatty Acid Receptor 2 (GPR43) Is Primed by Tumor Necrosis Factor Alpha and by Receptor Uncoupling from the Cytoskeleton but Attenuated by Tissue Recruitment
  • 2016
  • Ingår i: Molecular and Cellular Biology. - : Informa UK Limited. - 0270-7306 .- 1098-5549. ; 36:20, s. 2583-2595
  • Tidskriftsartikel (refereegranskat)abstract
    • Ligands with improved potency and selectivity for free fatty acid receptor 2 (FFA2R) have become available, and we here characterize the neutrophil responses induced by one such agonist (Cmp1) and one antagonist (CATPB). Cmp1 triggered an increase in the cytosolic concentration of Ca2+, and the neutrophils were then desensitized to Cmp1 and to acetate, a naturally occurring FFA2R agonist. The antagonist CATPB selectively inhibited responses induced by Cmp1 or acetate. The activated FFA2R induced superoxide anion secretion at a low level in naive blood neutrophils. This response was largely increased by tumor necrosis factor alpha (TNF-alpha) in a process associated with a recruitment of easily mobilizable granules, but neutrophils recruited to an aseptic inflammation in vivo were nonresponding. Superoxide production induced by Cmp1 was increased in latrunculin A-treated neutrophils, but no reactivation of desensitized FFA2R was induced by this drug, suggesting that the cytoskeleton is not directly involved in terminating the response. The functional and regulatory differences between the receptors that recognize short-chain fatty acids and formylated peptides, respectively, imply different roles of these receptors in the orchestration of inflammation and confirm the usefulness of a selective FFA2R agonist and antagonist as tools for the exploration of the precise role of the FFA2R.
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  • Brindefalk, B., et al. (författare)
  • Bacterial composition in Swedish raw drinking water reveals three major interacting ubiquitous metacommunities
  • 2022
  • Ingår i: Microbiologyopen. - : Wiley. - 2045-8827. ; 11:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Surface raw water used as a source for drinking water production is a critical resource, sensitive to contamination. We conducted a study on Swedish raw water sources, aiming to identify mutually co-occurring metacommunities of bacteria, and environmental factors driving such patterns. Methods The water sources were different regarding nutrient composition, water quality, and climate characteristics, and displayed various degrees of anthropogenic impact. Water inlet samples were collected at six drinking water treatment plants over 3 years, totaling 230 samples. The bacterial communities of DNA sequenced samples (n = 175), obtained by 16S metabarcoding, were analyzed using a joint model for taxa abundance. Results Two major groups of well-defined metacommunities of microorganisms were identified, in addition to a third, less distinct, and taxonomically more diverse group. These three metacommunities showed various associations to the measured environmental data. Predictions for the well-defined metacommunities revealed differing sets of favored metabolic pathways and life strategies. In one community, taxa with methanogenic metabolism were common, while a second community was dominated by taxa with carbohydrate and lipid-focused metabolism. Conclusion The identification of ubiquitous persistent co-occurring bacterial metacommunities in freshwater habitats could potentially facilitate microbial source tracking analysis of contamination issues in freshwater sources.
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  • Broman, T, et al. (författare)
  • Molecular Detection of Persistent Francisella tularensis Subspecies holarctica in Natural Waters
  • 2011
  • Ingår i: International Journal of Microbiology. - : Hindawi Publishing Corporation. - 1687-918X .- 1687-9198. ; 2011, s. Article ID 851946-
  • Tidskriftsartikel (refereegranskat)abstract
    • Tularemia, caused by the bacterium Francisella tularensis, where F. tularensis subspecies holarctica has long been the cause of endemic disease in parts of northern Sweden. Despite this, our understanding of the natural life-cycle of the organism is still limited. During three years, we collected surface water samples (n = 341) and sediment samples (n = 245) in two areas in Sweden with endemic tularemia. Real-time PCR screening demonstrated the presence of F. tularenis lpnA sequences in 108 (32%) and 48 (20%) of the samples, respectively. The 16S rRNA sequences from those samples all grouped to the species F. tularensis. Analysis of the FtM19InDel region of lpnA-positive samples from selected sampling points confirmed the presence of F. tularensis subspecies holarctica-specific sequences. These sequences were detected in water sampled during both outbreak and nonoutbreak years. Our results indicate that diverse F. tularensis-like organisms, including F. tularensis subsp. holarctica, persist in natural waters and sediments in the investigated areas with endemic tularemia.
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  • Bäckström, Caroline A., et al. (författare)
  • Parents' Experiences of Receiving Professional Support Through Extended Home Visits During Pregnancy and Early Childhood : A Phenomenographic Study
  • 2021
  • Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: While becoming a parent can be challenging for all, it can particularly be challenging for those parents and children who are in a vulnerable situation—e.g., in families whose members have problems related to health, relationships, or socioeconomic status. It is essential for health care professionals to identify the more vulnerable families at an early stage. Home visits are one cost-effective way of identifying and supporting such families. This study describes the parental experiences of an intervention that involves professional support in the form of extended home visits. The aim of the study is to describe the parents' understanding of their experiences of receiving professional support through extended home visits both during pregnancy and the first 15 months of their child's life. Methods/Design: A phenomenographic approach was used. Semi-structured interviews were conducted with 12 parents who had received the intervention. The interviews were analyzed using the seven-step phenomenography model described by Sjöström and Dahlgren. Results: The following three descriptive categories emerged from the analysis: (1) conceptions concerning the meaning of the physical environment, (2) conceptions concerning extended home visits promoting feelings of self-confidence in the parental role, and (3) conceptions concerning extended home visits promoting parental participation and relations. Conclusion and Clinical Implications: Extended home visits as a form of professional support appear to promote parental self-confidence in parenting ability, giving parents a feeling of security that facilitates conversation with professionals. Children and their entire families had natural roles during home visits, which allowed the children to behave more characteristically. Furthermore, the home visits were understood to facilitate social support through social activities at the child health center as well as integration into Swedish society for migrant parents. Professional support should be adjusted to the unique individual needs of parents, which demands a variety of supportive interventions—for example, reorganizing one or two of the regular clinical visits currently being scheduled as home visits instead.
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  • Collentine, D., et al. (författare)
  • Catch : Decision support for stakeholders in catchment areas
  • 2002
  • Ingår i: Water Policy. - 1366-7017 .- 1996-9759. ; 4:5, s. 447-463
  • Forskningsöversikt (refereegranskat)abstract
    • Policy proposals for the management of water resources need to take into account two emerging themes: public involvement in the development of resource use policy and water management on a catchment level. The CATCH-model, a decision support system for catchment-based water management, builds on the use of 'discourse and deliberation' within stakeholder groups to define relevant socio-economic parameters and the relationships between these parameters. The sets of matrices that describe these parameters and their interrelation serve as the basis for evaluation of alternative management strategies and evaluation of specific measures for improving water quality. © 2002 Elsevier Science Ltd. All rights reserved.
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46.
  • Dobbins, Trevor David, 1965, et al. (författare)
  • Search & rescue and maritime security in the arctic - System design challenges and solutions
  • 2015
  • Ingår i: International Conference on Ice Class Vessels; London; United Kingdom. - 9781909024397 ; , s. 17-22
  • Konferensbidrag (refereegranskat)abstract
    • The increasing prevalence of voyages within the Arctic region is highlighting the growing need to understand the implications of delivering Search And Rescue (SAR) and Maritime Security (MARSEC) within the Arctic. Operating within this hostile environment requires specific system capabilities and resilience. This capability is not delivered by a single type or class of vessel, but rather a system-of-systems, including multinational cooperation. The issue of the large distances between safe havens is recognized, particularly the problem of it taking a long time for help to reach a vessel in distress assuming communication is possible. Therefore vessels need to be designed and outfitted with systems and equipment to support the crew and passengers for many days in harsh conditions, as well as the capability to help other vessels in distress, e.g. greater capability for deployable rescue craft assets. Therefore Arctic SAR and MARSEC operations require resilient System-of-Systems solutions, with embedded Human Systems Integration (HSI), to support safe and effective Arctic voyages.
  •  
47.
  • Dobbins, T, et al. (författare)
  • Information architecture for fast response craft - Command & control & human systems integration
  • 2013
  • Ingår i: RINA, Royal Institution of Naval Architects - International Conference on SURV 2013, Surveillance Search and Rescue Craft. - 9781909024137 ; , s. 117-120
  • Konferensbidrag (refereegranskat)abstract
    • Command & Control (C2) is required for safe and effective maritime operations. To facilitate effective decision-making and C2, it is essential that the crew can access the required information. It is therefore essential that the appropriate information architecture is used. Navigation, being an essential aspect of C2, has seen a radical change from paper charts and individual instruments to computer systems capable of sophisticated data fusion to provide enhanced situational awareness. The development of the required information architecture is not a software/engineering issue, but rather lies within the human factors domain as it requires an understanding of how humans perceive information, how they use mental models and subsequently make safe and effective decisions. © 2013: The Royal Institution of Naval Architects.
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48.
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49.
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50.
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