| 1. |
- Bartels, Sara Laureen, et al.
(författare)
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Development, evaluation and implementation of a digital behavioural health treatment for chronic pain : study protocol of the multiphase DAHLIA project
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Chronic pain affects about 20%-40% of the population and is linked to mental health outcomes and impaired daily functioning. Pharmacological interventions are commonly insufficient for producing relief and recovery of functioning. Behavioural health treatment is key to generate lasting benefits across outcome domains. However, most people with chronic pain cannot easily access evidence-based behavioural interventions. The overall aim of the DAHLIA project is to develop, evaluate and implement a widely accessible digital behavioural health treatment to improve well-being in individuals with chronic pain.METHODS AND ANALYSIS: The project follows the four phases of the mHealth Agile Development and Evaluation Lifecycle: (1) development and pre-implementation surveillance using focus groups, stakeholder interviews and a business model; (2) iterative optimisation studies applying single case experimental design (SCED) method in 4-6 iterations with n=10 patients and their healthcare professionals per iteration; (3) a two-armed clinical randomised controlled trial enhanced with SCED (n=180 patients per arm) and (4) interview-based post-market surveillance. Data analyses include multilevel modelling, cost-utility and indicative analyses.In October 2021, inter-sectorial partners are engaged and funding is secured for four years. The treatment content is compiled and the first treatment prototype is in preparation. Clinical sites in three Swedish regions are informed and recruitment for phase 1 will start in autumn 2021. To facilitate long-term impact and accessibility, the treatment will be integrated into a Swedish health platform (www.1177.se), which is used on a national level as a hub for advice, information, guidance and e-services for health and healthcare.ETHICS AND DISSEMINATION: The study plan has been reviewed and approved by Swedish ethical review authorities. Findings will be actively disseminated through peer-reviewed journals, conference presentations, social media and outreach activities for the wider public.TRIAL REGISTRATION NUMBER: NCT05066087.
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| 2. |
- Bartels, Sara Laureen, et al.
(författare)
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Using Personas in the development of eHealth interventions for chronic pain : A scoping review and narrative synthesis
- 2023
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 32
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Behavioral eHealth interventions can enhance self-management and improve well-being in people with chronic pain. The development of these interventions calls for a user-centered approach to ensure that patient needs are appreciated. However, it may be challenging to involve patients; particularly during the early stages of the process. Fictional user profiles, known as Personas, can represent needs and guide designing eHealth interventions. This article provides a comprehensive overview of the use of Personas in the development of behavioral eHealth interventions for people with chronic pain with the aim to identify benefits and challenges. Methods: Bibliographic databases (Medline, Web of Science Core Collection, PsycInfo, CINAHL) and registries (PubMed Central, medaRxiv) were systematically searched. In a double-reviewing process, n = 6830 hits and n = 351 full-texts were screened and read. Ten peer-reviewed studies published between 2017 and 2022 were included in the narrative synthesis. Findings: Ten studies reported using "Pain Personas" in the development of eHealth interventions for such purposes as to gain a shared understanding of the user and to discuss solutions in team meetings, or for patients to identify with (if Personas are included in the intervention). Personas were based on qualitative and/or quantitative data. However, the procedure for creating Personas was only described in half of the included studies (n = 5). These five studies provided descriptive details of the Personas (i.e., picture, name, narrative of their pain behavior, technological skills, and motivation). Conclusions: Although Personas have been used by pain researchers in recent projects and were highlighted as an important ingredient in the development process, available design guidelines for the creation and use of Personas are not followed or communicated transparently. Benefits and challenges when using Personas in the development of eHealth interventions for people with chronic pain are discussed to support future eHealth efforts and to improve the quality of eHealth innovation in the field of pain.
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| 5. |
- Consiglio, Camila, et al.
(författare)
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Immune system adaptation during gender-affirming testosterone treatment
- 2023
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Ingår i: Journal of Reproductive Immunology. - : Elsevier. - 0165-0378 .- 1872-7603. ; 159, s. 29-30
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Biological sex impacts human immune responses, modulating susceptibility and severity to immune-related diseases. Female generally mount more robust immune responses than males, resulting in lower infection severity and greater autoimmunity incidence. Here, we addressed the contribution of testosterone to human immune function by analyzing a cohort of subjects undergoing gender-affirming testosterone treatment. We performed systems-level immunomonitoring through mass cytometry, scRNA and scA-TAC-Sequencing, and proteome profiling of blood samples at baseline and following 3 and 12 months of treatment. Testosterone treatment was associated with a low-grade inflammatory profile, evidenced by upregulation of proinflammatory plasma proteome (e.g., EN-RAGE, OSM, TNF), and induction of an inflammatory transcriptional program associated with NFkB signaling, and TNF signaling. Following testosterone treatment, higher NFkB activity was revealed in CD4 T, CD8 T, and NK cells in scATACseq analyses. Further, testosterone increased monocytic inflammatory responses upon bacterial stimulation in vitro. Although testosterone was associated with this inflammatory profile, it also exerted negative effects on antiviral immunity. Firstly, the percentage of plasmacytoid dendritic cells (pDC) decreased over transition, with pDC also displaying phenotypic changes associated with lower IFN responses. Secondly, bulk transcriptomics analyses show an overall reduction of IFNa responses. Thirdly, testosterone treatment led to reduced IFNa production upon PBMCs stimulation with a viral agonist. Our results show that testosterone has broad effects on the human immune system, and significantly modulates important players in antiviral immunity and inflammatory response. Identifying pathways involved in immune sexual dimorphism will help define novel targets for effective prevention and treatment of immune-mediated diseases.
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| 6. |
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| 7. |
- Hellgren, Rikard, 1988-, et al.
(författare)
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Utökning av avbördningskapacitet : RAPPORT 2021:783
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport presenterar en sammanställning av genomförda projekt i Sverige under perioden 2000–2020 där avbördningskapaciteten säkrats eller utökats. Rapporten består av två delar, en kvantitativ del som innehåller data från enkätsvar från de svenska dammägarna samt en kvalitativ del som sammanställer diskussion och slutsatser från intervjuer och en genomförd workshop.Under de senaste decennierna har ett flertal projekt genomförts i Sverige med syftet att öka eller säkra avbördningskapaciteten för befintliga dammanläggningar. I vissa fall har nya utskov byggts i direkt anslutning till befintliga utskov eller så har utskov byggts i nya lägen. I andra fall har ett eller flera av de befintliga utskoven byggts om eller vilande utskov återtagits i bruk. I framtiden kommer ytterligare dammanläggningar byggas om för att möta moderna krav på tillräcklig och tillgänglig avbördande kapacitet. Även om varje projekt är unikt och tekniska lösningar måste anpassas efter lokala förutsättningar, finns det mycket beställare och projektörer kan lära av erfarenheter från tidigare genomförda projekt.Enkätsvaren beskriver det typiska projektet med allmänna data kring bakgrund, valda åtgärder och avbördningsstatistik. Extra vikt har lagts vid betongtekniska frågor relaterade till vattenkraft. En referenslista med identifierade projekt presenteras i Bilaga A där de är listade tillsammans med metadata om genomförda åtgärder. Dessutom presenteras aggregerade sammanställningar i kapitel 3. Den vanligast förekommande metoden för att öka avbördningsförmågan är att modifiera ett befintligt utskov eller bygga ett nytt. Sådana projekt innebär ofta stora ingrepp i anläggningens dammar och är tekniskt komplicerade. Det är vanligt förekommande med en eller flera typer av komplicerade gjutningar i denna typ av projekt.En stor del av detta projekt lades på att planera och genomföra en workshop för representanter från de svenska dammägarna. Workshopen bestod av flera olika ämnen relaterade till utökad avbördningsförmåga, respektive presentation med tillhörande diskussioner är presenterade i Kapitel 4. Presentationerna bidrar med att exemplifiera sammanställningen i kapitel 3 och visar på bredden och komplexiteten på frågeställningar i projektens alla faser.I kapitel fem presenteras en fördjupad studie av fyra projekt genomförda av samma dammägare och projektorganisation. Intervjuer har genomförts med projektledaren för utredningen, med dammteknisk sakkunnig och med projektledaren från byggtiden. Det innebär att erfarenheter från de genomförda projekten kan beskrivas från olika perspektiv, med fokus på likheter, skillnader och lärdomar.4
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| 9. |
- Lakshmikanth, Tadepally, et al.
(författare)
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Immune system adaptation during gender-affirming testosterone treatment
- 2024
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Ingår i: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 633:8028, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- Infectious, inflammatory and autoimmune conditions present differently in males and females. SARS-CoV-2 infection in naive males is associated with increased risk of death, whereas females are at increased risk of long COVID, similar to observations in other infections. Females respond more strongly to vaccines, and adverse reactions are more frequent, like most autoimmune diseases. Immunological sex differences stem from genetic, hormonal and behavioural factors but their relative importance is only partially understood. In individuals assigned female sex at birth and undergoing gender-affirming testosterone therapy (trans men), hormone concentrations change markedly but the immunological consequences are poorly understood. Here we performed longitudinal systems-level analyses in 23 trans men and found that testosterone modulates a cross-regulated axis between type-I interferon and tumour necrosis factor. This is mediated by functional attenuation of type-I interferon responses in both plasmacytoid dendritic cells and monocytes. Conversely, testosterone potentiates monocyte responses leading to increased tumour necrosis factor, interleukin-6 and interleukin-15 production and downstream activation of nuclear factor kappa B-regulated genes and potentiation of interferon-γ responses, primarily in natural killer cells. These findings in trans men are corroborated by sex-divergent responses in public datasets and illustrate the dynamic regulation of human immunity by sex hormones, with implications for the health of individuals undergoing hormone therapy and our understanding of sex-divergent immune responses in cisgender individuals.
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| 10. |
- Öqvist, Rikard, et al.
(författare)
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Listening test of walking noise from 20 Hz in dwellings
- 2017
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Ingår i: INTER-NOISE 2017. - : Institute of Noise Control Engineering.
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Konferensbidrag (refereegranskat)abstract
- Walking noise annoyance from the neighbor above tend to be higher in lightweight than in heavy constructions, even with exactly the same measured impact sound level. The Swedish research program AkuLite indicated that the correlation between measured impact sound insulation and annoyance was significantly improved by extending current ISO evaluation methods from 50 Hz down to 20 Hz. Consequently, there is a need to develop new metrics of impact sound insulation that better correspond to the perceived sound quality. The objective of this study was to verify whether frequencies between 20-50 Hz are important for walking noise annoyance and to evaluate which impact sound level metric that best correlates with walking noise annoyance. The methodology was to evaluate annoyance based on binaural recordings of walking noise in a two-part listening test. The stimuli were reproduced using a combination of headphones and subwoofer. Two living rooms were evaluated, one lightweight wooden construction and one heavy concrete construction. Both rooms achieved similar weighted impact sound level when evaluated from 50 Hz, but the rated annoyance differed significantly. The need to consider frequencies down to 20 Hz in lightweight constructions was verified. The best correlation between measured impact sound level and subjective response was achieved when the evaluation range was extended down to 20 or 25 Hz using a flat frequency weighting factor.
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| 11. |
- Öqvist, Rikard, 1982-
(författare)
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Measurement and perception of sound insulation from 20 Hz between dwellings
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Population growth and urbanization are projected by the United Nations to add 2,5 billionpeople to the world’s urban population by 2050. We need to construct buildings in anunprecedented scale to meet global housing demand. Sustainable development is critical.Compared to traditional heavy constructions, lightweight wooden constructions are moreenvironmentally friendly and will play a key role in meeting future demands. However, thereare two major problems with lightweight constructions that need to be addressed: 1) Limitedlow frequency sound insulation and 2) Variations in sound insulation.Annoyance from walking sound tend to be higher in lightweight than in heavy constructionseven with the same measured sound insulation. The Swedish research program AkuLiteindicated that the correlation between measured sound insulation and annoyance wassignificantly improved by extending current evaluation methods from 50 Hz down to 20 Hz.Secondly, large variations in sound insulation between nominally identical lightweightconstructions are common, which leads to larger safety margins. By identifying and quantifyingunderlying causes, production costs can be minimized and the performance can be improved.The aim of the thesis is to develop a new evaluation method for impact sound insulation thatbetter correspond to rated annoyance, and to identify and control underlying causes forvariations in sound insulation. The thesis contains six papers.In Paper I and II, sound insulation measurements were carried out in a large number ofnominally identical rooms of two different industrially prefabricated lightweight woodenconstructions. The purpose was to assess and quantify the variations in impact and airbornesound insulation. In Paper I, 30 nominally identical apartments of a volume based system wasevaluated. The apartments on the highest floor achieved significantly better sound insulationdue to the extra weight on lower floors affecting the elastic connections between stories. InPaper II, 18 rooms of a cross-laminated timber system of plate elements were evaluated.Additionally, several potential parameters related to measurement uncertainty wereinvestigated.Paper III deals with measurement uncertainty. An empirical study of reverberation timemeasurements showed that current methods need to be improved, if sound insulationrequirements are to be extended to 20 Hz.Paper IV and V verified that the frequency range 20-50 Hz is important for walking soundannoyance, and that alternative frequency adaptation terms can improve the correlation betweenmeasured impact sound insulation and annoyance ratings. In Paper IV, the methodology was toperform extensive field measurements in apartment buildings of various construction types andto perform questionnaire surveys among the residents. In Paper V, the methodology was toevaluate annoyance based on binaural recordings of walking sound in a two-part listening test.In Paper VI, 70 measurements in a lightweight wooden system were evaluated to quantify thetotal variations in impact and airborne sound insulation from 20 and 50 Hz, respectively. It wasconcluded that the proposed metrics of impact sound insulation were primarily determined bythe impact sound level 20-40 Hz and that the measurement methods must be evaluatedthoroughly to avoid excessive safety margins.A new evaluation method for impact sound insulation from 25 Hz, that correspond to the ratedannoyance for both heavy and lightweight constructions is proposed. By using the proposedmethod and attending the specific causes for variations, the lightweight industry will be able todevelop improved multi-story dwellings with higher perceived acoustic quality.
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| 12. |
- Öqvist, Rikard, 1982-, et al.
(författare)
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Walking sound annoyance vs. impact sound insulation from 20 Hz
- 2018
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Ingår i: Applied Acoustics. - : Elsevier. - 0003-682X .- 1872-910X. ; 135, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- There is a need to develop single number quantities (SNQ) of impact sound insulation that correlate better with walking sound annoyance. Previous research has indicated that impact sound insulation should be evaluated from 20 Hz in lightweight constructions, using modified spectrum adaptation terms. The purpose of our study was to verify whether frequencies between 20 and 50 Hz are important for perceived walking sound annoyance and to verify whether the proposed spectrum adaptation terms improve correlation with perceived walking sound annoyance. Binaural recordings of walking sound in one heavy and one lightweight construction were evaluated in a two-part listening test. The need to include frequencies from 20 Hz when evaluating lightweight constructions was verified. Both tested constructions achieved similar performance in terms of L′nT,w and L′nT,w + CI,50-2500, while a significant mismatch in the rated annoyance was observed. The correlation between SNQ and subjective response was considerably improved, when the impact sound insulation was evaluated from 20 or 25 Hz using a flat frequency-weighting factor.
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