| 1. |
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| 2. |
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| 3. |
- Andersson, Sarah, et al.
(författare)
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Malmbanan Diaries
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This booklet is a report for a case study visit during four day field trip, a group of nine PhD students and their supervisors – all part of the National Research School for Architecture and Planning in the Urban Landscape, APULA – set out to explore what may be considered the outback of Western Europe’s conurbations, the transnational region of Kiruna -Narvik.Both “remote” and “resourceful”, “threatened” and “thriving” (equally relative notions), this region seemed to offer possibilities to reflect upon many of the current tendencies influencing contemporary planning practice and research.
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| 4. |
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| 5. |
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| 6. |
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| 7. |
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| 8. |
- Elgåker, Hanna, et al.
(författare)
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Horse Keeping in Urban and Peri-Urban Areas: New Conditions for Physical Planning in Sweden
- 2010
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Ingår i: Geografisk Tidsskrift-Danish Journal of Geography. - : Informa UK Limited. - 0016-7223 .- 1903-2471. ; 110, s. 81-98
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Tidskriftsartikel (refereegranskat)abstract
- An increasing number of land use conflicts involving planning practice, equine activities and businesses and neighbouring landowners and residents have occurred in Swedish peri-urban areas. In a case study the disturbances and benefits arising from horses experienced by residents in two different areas of Sweden were investigated, together with a study of the attitudes of local planners to horse keeping near residential areas and subsequent policy documents. The results from the study found few conflicts between residents and horse keeping but revealed diverging practice and policy between municipalities, which may create a legal insecurity for the involved stakeholders. The results were mirrored in the broader perspective of spatial planning facing new challenges in the wake of the urban-rural diffusion. This was obtained by means of current planning theory discourse in examining the effects of set-back distance from rural contexts when applied in urban areas. The study illustrated a planning problem where the planning tools for managing this issue has been built on the urban- rural dichotomy providing unclear planning practice and policy in a peri-urban context. The result may be used to elucidate the character of this issue in the search for suitable planning tools in peri urban areas. Keywords Equine activity, land use, comprehensive planning, conflict, peri-urban
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| 9. |
- Elgåker, Hanna, et al.
(författare)
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Horse riding posing challenges to the Swedish Right of Public Access
- 2012
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Ingår i: Land Use Policy. - : Elsevier BV. - 0264-8377 .- 1873-5754. ; 29, s. 274-293
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Tidskriftsartikel (refereegranskat)abstract
- Increasing numbers of horses are being kept for sports and leisure purposes in peri-urban areas throughout the Western world. This expansion of the equestrian sector represents a multifunctional transition, with new production of rural goods and services and increasing influence on land use. In Sweden, the number of horses has increased from 70,000 to approximately 300,000 over the last 30 years. This increase is putting pressure on the traditional Right of Public Access, an old custom allowing the public to walk, cycle or ride on private or state-owned property. This paper analyses multifunctional land use in peri-urban areas in order to provide a deeper understanding of the potential conflicts arising due to the expanding equine sector and to assess how these can affect the Swedish right of public access and spatial planning. A survey of horse riders and landowners in three peri-urban regions of Sweden revealed that these groups differ in their attitudes towards the Right of Public Access. The data also showed that the expanding equine sector is generating new demands on rural areas and there are questions regarding how the current system of open accessibility can meet the increasing market for equestrian leisure activities. The main conclusion is that there seems to be a strong need for intervention and deliberate creation of new ways of handling the accessibility question, where both a bottom-up and top-down approach may be useful
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| 10. |
- Goncalves, Isabel, et al.
(författare)
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Activator protein-1 in carotid plaques is related to cerebrovascular symptoms and cholesteryl ester content
- 2011
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Ingår i: Cardiovascular pathology. - : Elsevier. - 1054-8807 .- 1879-1336. ; 20:1, s. 36-43
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Tidskriftsartikel (refereegranskat)abstract
- Transcription factor activator protein-1 regulates genes involved in inflammation and repair. The aim of this study was to determine whether transcription factor activator protein-1 activity in carotid plaques is related to symptoms, lipid accumulation, or extracellular matrix composition. Methods: Twenty-eight atherosclerotic carotid plaques were removed by endarterectomy and divided into two groups based on the presence or absence of ipsilateral symptoms (b1 month ago). Activator protein-1 DNA binding activity was assessed, and subunit (c-Jun, JunD, JunB, c-Fos, FosB, Fra-1, Fra-2) protein levels analyzed by immunoblotting. Distribution of c-Jun in plaques was analyzed by immunohistochemistry. Results: Plaques associated with symptoms had increased activator protein-1 activity and increased expression of c-Jun and JunD, as compared to asymptomatic plaques. Fra-1 and Fra-2 were present in equal amounts in both groups, whereas JunB, FosB, and c-Fos were undetectable. Activator protein-1 activity correlated with cholesteryl ester and elastin in plaques and decreased with age. Activator protein-1 activity did not correlate with collagen, calcified tissue, or proteoglycan content. Conclusions: Activator protein-1 is increased in plaques associated with symptoms. The correlation between activator protein-1 and cholesteryl esters suggests that high activator protein-1 is a marker of plaque vulnerability. Activator protein-1 expression can also reflect the activation of repair processes.
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| 11. |
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| 12. |
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| 13. |
- Hellström, Maria, et al.
(författare)
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Landscape at Play : Teaching Design as Rhetorical Action
- 2007
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Ingår i: PROCEEDINGS 18th International Annual ECLAS Conference, Landscape Assessment - From Theory to Practice: Applications in Planning and Design.. - : Faculty of Forestry, Belgrade, Serbia. ; , s. 249-257
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Today, ’design’ is a ubiquitous concept, dispersed throughout disciplines and fields of professions. In this situation, what does it mean ‘to design’? Is it a problem solving activity still aiming at Vitruvian durability, functionality, and pleasure? Is it an enhancing activity, a matter of transforming raw matter into conspicuous forms? Or is design a matter of signification and meaning in a broader sense? Irrespective of how we choose to respond, the questioning as such reveals a widened scope for design, which stretches beyond problem solving and formal enhancement. In this respect, the notion of design might have regained some of its initial meaning expressed by the Latin designare, to signify. Fundamentally communicative, design is an intermediating kind of action, indispensable in order to bridge the gap between humans as well as between humans and a complex, surrounding world. As for the practices of landscape architecture and planning, this entails a significant shift. Rather than descriptive or representative, ‘design’ unfolds as an imperative. Not only connoting the accommodation of a physical structure to a given ideal or vision, design presents itself as the challenging as-if-space where visions and ideals are constantly being negotiated and reproduced. Accordingly, it is possible to assume a shift also in the professional or expert role of the landscape architect or planner, an equivalent widening of the scope of action to include not only bio-morphological or infrastructural interaction but furthermore interaction of a more linguistic kind. In an attempt to meet the need to explore this new designer’s role, we have at the Dept. of Landscape Architecture Alnarp during a number of years offered the seminar course, “Design as Action”. In this course, the students are offered the possibility to develop a self-reflective, dialogic and exploratory design practice. Pedagogically, this is achieved through the establishing of what could be described as a rhetorical awareness, an awareness of the intimate relationship between the professional language practice and the design action. We identify two levels of rhetorical interference or language games, where the design action unfolds either through communicative ‘props’ or as meta-communicative ‘stagings’, explored through different forms of rhetorical and spatial activities, such as conceptual modelling, language games, role plays, and storytelling. The main argument developed in this paper is that a playful and spatially conscious, professional language development is one of the most important success criteria in landscape architecture education. Furthermore, already acquainted with the composite notion of ‘landscape’, landscape architecture students have special opportunities to develop a combined linguistic and spatial sensitivity with great relevance for a complex and potentially conflictive future.
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| 14. |
- Hitimana, Regis, et al.
(författare)
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Cost of antenatal care for the health sector and for households in Rwanda
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rwanda has made tremendous progress in reduction of maternal mortality in the last twenty years. Antenatal care is believed to have played a role in that progress. In late 2016, the World Health Organization published new antenatal care guidelines recommending an increase from four visits during pregnancy to eight contacts with skilled personnel, among other changes. There is ongoing debate regarding the cost implications and potential outcomes countries can expect, if they make that shift. For Rwanda, a necessary starting point is to understand the cost of current antenatal care practice, which, according to our knowledge, has not been documented so far.Methods: Cost information was collected from Kigali City and Northern province of Rwanda through two cross-sectional surveys: a household-based survey among women who had delivered a year before the interview (N = 922) and a health facility survey in three public, two faith-based, and one private health facility. A micro costing approach was used to collect health facility data. Household costs included time and transport. Results are reported in 2015 USD.Results: The societal cost (household + health facility) of antenatal care for the four visits according to current Rwandan guidelines was estimated at $160 in the private health facility and $44 in public and faith-based health facilities. The first visit had the highest cost ($75 in private and $21 in public and faith-based health facilities) compared to the three other visits. Drugs and consumables were the main input category accounting for 54% of the total cost in the private health facility and for 73% in the public and faith-based health facilities.Conclusions: The unit cost of providing antenatal care services is considerably lower in public than in private health facilities. The household cost represents a small proportion of the total, ranging between 3% and 7%; however, it is meaningful for low-income families. There is a need to do profound equity analysis regarding the accessibility and use of antenatal care services, and to consider ways to reduce households’ time cost as a possible barrier to the use of antenatal care.
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| 15. |
- Hitimana, Regis, 1982-
(författare)
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Health economic evaluation for evidence-informed decisions in low-resource settings : the case of Antenatal care policy in Rwanda
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The general aim of this thesis is to contribute to the use of health economic evidence for informed health care decisions in low-resource settings, using antenatal care (ANC) policy in Rwanda as a case study. Despite impressive and sustained progress over the last 15 years, Rwanda’s maternal mortality ratio is still among the highest in the world. Persistent gaps in health care during pregnancy make ANC a good candidate among interventions that can, if improved, contribute to better health and well-being of mothers and newborns in Rwanda.Methods: Data used in this thesis were gathered from primary and secondary data collections. The primary data sources included a cross-sectional household survey (N=922) and a health facility survey (N=6) conducted in Kigali city and the Northern Province, as well as expert elicitation with Rwandan specialists (N=8). Health-related quality of life (HRQoL) for women during the first-year post-partum was measured using the EQ-5D-3L instrument. The association between HRQoL and adequacy of ANC utilization and socioeconomic and demographic predictors was tested through bivariate and linear regression analyses (Paper I). The costs of current ANC practices in Rwanda for both the health sector and households were estimated through analysis of primary data (Paper II). Incremental cost associated with the implementation of the 2016 World Health Organization (WHO) ANC recommendations compared to current practice in Rwanda was estimated through simulation of attendance and adaptation of the unit cost estimates (Paper III). Incremental health outcomes of the 2016 WHO ANC recommendations were estimated as life-years saved from perinatal and maternal mortality reduction obtained from the expert elicitation (Paper III). Lastly, a systematic review of the evidence base for the cost and cost-effectiveness of routine ultrasound during pregnancy was conducted (Paper IV). The review included 606 studies published between January 1999 and April 2018 and retrieved from PubMed, Scopus, and the Cochrane database.Results: Sixty one percent of women had not adequately attended ANC according to the Rwandan guidelines during their last pregnancy; either attending late or fewer than four times. Adequate utilization of ANC was significantly associated with better HRQoL after delivery measured using EQ-VAS, as were good social support and household wealth. The most prevalent health problems were anxiety or depression and pain or discomfort. The first ANC visit accounted for about half the societal cost of ANC, which was $44 per woman (2015 USD) in public/faith-based facilities and $160 in the surveyed private facility. Implementing the 2016 WHO recommendations in Rwanda would have an incremental national annual cost between $5.8 million and $11 million across different attendance scenarios. The estimated reduction in perinatal mortality would be between 22.5% and 55%, while maternal mortality reduction would range from 7% to 52.5%. Out of six combinations of attendance and health outcome scenarios, four were below the GDP-based cost-effectiveness threshold. Out of the 606 studies on cost and cost-effectiveness of ultrasound during pregnancy retrieved from the databases, only nine reached the data extraction stage. Routine ultrasound screening was reported to be a cost-effective intervention for screening pregnant women for cervical length, for vasa previa, and congenital heart disease, and cost-saving when used for screening for fetal malformations.Conclusions: The use of health economic evidence in decision making for low-income countries should be promoted. It is currently among the least used types of evidence, yet there is a huge potential of gaining many QALYs given persistent and avoidable morbidity and mortality. In this thesis, ANC policy in Rwanda was used as a case to contribute to evidence informed decision-making using health economic evaluation methods. Low-income countries, particularly those that that still have a high burden of maternal and perinatal mortality should consider implementing the 2016 WHO ANC recommendations.
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| 16. |
- Hitimana, Regis, et al.
(författare)
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Health-related quality of life determinants among Rwandan women after delivery: does antenatal care utilization matter? A cross-sectional study
- 2018
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Ingår i: Journal of Health Population and Nutrition. - : Springer Science and Business Media LLC. - 1606-0997 .- 2072-1315. ; 37
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Despite the widespread use of antenatal care (ANC), its effectiveness in low-resource settings remains unclear. In this study, self-reported health-related quality of life (HRQoL) was used as an alternative to other maternal health measures previously used to measure the effectiveness of antenatal care. The main objective of this study was to determine whether adequate antenatal care utilization is positively associated with women's HRQoL. Furthermore, the associations between the HRQoL during the first year (113 months) after delivery and socio-economic and demographic factors were explored in Rwanda. Methods: In 2014, we performed a cross-sectional population-based survey involving 922 women who gave birth 1-13 months prior to the data collection. The study population was randomly selected from two provinces in Rwanda, and a structured questionnaire was used. HRQoL was measured using the EQ-5D-3L and a visual analogue scale (VAS). The average HRQoL scores were computed by demographic and socio-economic characteristics. The effect of adequate antenatal care utilization on HRQoL was tested by performing two multivariable linear regression models with the EQ-5D and EQ-VAS scores as the outcomes and ANC utilization and socio-economic and demographic variables as the predictors. Results: Adequate ANC utilization affected women's HRQoL when the outcome was measured using the EQ-VAS. Social support and living in a wealthy household were associated with a better HRQoL using both the EQ-VAS and EQ-5D. Cohabitating, and single/unmarried women exhibited significantly lower HRQoL scores than did married women in the EQ-VAS model, and women living in urban areas exhibited lower HRQoL scores than women living in rural areas in the ED-5D model. The effect of education on HRQoL was statistically significant using the EQ-VAS but was inconsistent across the educational categories. The women's age and the age of their last child were not associated with their HRQoL. Conclusions: ANC attendance of at least four visits should be further promoted and used in low-income settings. Strategies to improve families' socio-economic conditions and promote social networks among women, particularly women at the reproductive age, are needed.
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| 17. |
- Hitimana, Regis, et al.
(författare)
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Incremental cost and health gains of the 2016 WHO antenatal care recommendations for Rwanda: results from expert elicitation
- 2019
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Ingår i: Health Research Policy and Systems. - : Springer Science and Business Media LLC. - 1478-4505. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: High-quality evidence of effectiveness and cost-effectiveness is rarely available and relevant for health policy decisions in low-resource settings. In such situations, innovative approaches are needed to generate locally relevant evidence. This study aims to inform decision-making on antenatal care (ANC) recommendations in Rwanda by estimating the incremental cost-effectiveness of the recent (2016) WHO antenatal care recommendations compared to current practice in Rwanda. Methods: Two health outcome scenarios (optimistic, pessimistic) in terms of expected maternal and perinatal mortality reduction were constructed using expert elicitation with gynaecologists/obstetricians currently practicing in Rwanda. Three costing scenarios were constructed from the societal perspective over a 1-year period. The two main inputs to the cost analyses were a Monte Carlo simulation of the distribution of ANC attendance for a hypothetical cohort of 373,679 women and unit cost estimation of the new recommendations using data from a recent primary costing study of current ANC practice in Rwanda. Results were reported in 2015 USD and compared with the 2015 Rwandan per-capita gross domestic product (US$ 697). Results: Incremental health gains were estimated as 162,509 life-years saved (LYS) in the optimistic scenario and 65,366 LYS in the pessimistic scenario. Incremental cost ranged between $5.8 and $11 million (an increase of 42% and 79%, respectively, compared to current practice) across the costing scenarios. In the optimistic outcome scenario, incremental cost per LYS ranged between $36 (for low ANC attendance) and $67 (high ANC attendance), while in the pessimistic outcome scenario, it ranged between $90 (low ANC attendance) and $168 (high ANC attendance) per LYS. Incremental cost effectiveness was below the GDP-based thresholds in all six scenarios. Discussion: Implementing the new WHO ANC recommendations in Rwanda would likely be very cost-effective; however, the additional resource requirements are substantial. This study demonstrates how expert elicitation combined with other data can provide an affordable source of locally relevant evidence for health policy decisions in low-resource settings.
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| 18. |
- Jansson, Gunilla, 1950-, et al.
(författare)
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The social organization of assistance in multilingual interaction in Swedish residential care
- 2019
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Ingår i: Discourse Studies. - : SAGE Publications. - 1461-4456 .- 1461-7080. ; 21:1, s. 67-94
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we explore the organization of assistance in multilingual interaction in Swedish residential care. The data that form the basis for the study cover care encounters involving three residents with a language background other than Swedish, totalling 13 hours and 14 minutes of video documentation. The empirical data consists of a collection of 134 instances where residents seek assistance with the realization of a practical action. For this article, three examples that involve the manipulation of an object have been selected for analysis. We use the concept of ‘recruitment’ to encompass the various methods by which assistance is sought in the care encounter. In the first example, the need for assistance concerns the transfer of an object that is recognizable and physically available for both participants. This, in combination with the resident’s gestural work that pinpoints the description of the action, facilitates its realization. In the second and third examples, the realization of the action becomes more difficult because the object involved is not recognizable for the caregiver. The article highlights the collaborative ways in which residents manage to support their talk through bodily practices, and the strong and empathetic engagement with which caregivers become involved in interpreting the meaning of these practices. Finally, we discuss the implications of our findings for care provision in multilingual circumstances.
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| 19. |
- Lidén, Kerstin, 1960-, et al.
(författare)
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Breastfeeding patterns and diet in five 17th-century children from Sund, Åland Islands
- 2012
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Ingår i: Stones, Bones & Thoughts. - Oulu : [Milton Núñezin juhlakirjan toimituskunta]. - 9789529311286 - 9789529311293 ; , s. 166-174
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Breastfeeding patterns and diet in five 17th-century children from Sund on the Åland Islands were studied by means of stable carbon and nitrogen isotope analysis of bone and teeth. Although all individuals derive from the same burial context, the high-status location inside the church, they nevertheless show differences in diet and breastfeeding patterns. We found two dietary groups: one consuming almost exclusively terrestrial protein resources, and the other a mixture of marine and terrestrial resources, with a predominance of terrestrial protein. The individual breastfeeding patterns show great variability – from no breastfeeding at all, to exclusive breastfeeding for ten months. Weaning varied both with regard to onset and pace. The overall diet indicates that the analysed individuals originate from two different environments, possibly mainland Åland and the outer archipelago, respectively.
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| 20. |
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| 21. |
- Lindholm, Gunilla
(författare)
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Händelser i husgrunden
- 2018
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Ingår i: Tidskriften stad. - 2001-631X. ; , s. 48-48
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 22. |
- Lindholm, Gunilla
(författare)
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Land and Landscape; Linking Use, Experience and Property Development in Urban Areas
- 2019
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Ingår i: Land. - : MDPI AG. - 2073-445X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- This article brings together the concepts of land and landscape, tightly linked in urban transformative situations, but rarely used for the purpose to strengthen strategic planning for sustainability. They are investigated as a combined base for land use deliberations, in early phases of planning processes, in practices of different scale, especially in a European context, drawing on planning and landscape policies generally agreed upon, as well as the UN Sustainable Development Goals. This article argues for taking into consideration the landscape as experienced human habitat, in relation to the understanding of land as both a common resource, and as pieces of property. This is motivated partly by the more or less global political trend and the turn from state interventions to individualistic capitalism (calling for new methods to solve common challenges), but also by a changing planning profession, increased collaborative planning processes, increased significance of public space as a scarce resource in densified cities, the need for holistic perspectives in sustainable urban development and the need for unifying concepts for urban and rural land at a local and regional scale. A new concept "around-scape" is suggested, in order to make visible the subjective binding between available perceived resources and spatial transformation.
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| 23. |
- Lindholm, Gunilla
(författare)
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Svensk landskapsurbanism
- 2016
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Ingår i: Landskap nu! : samtida svensk landskapsarkitektur. - 9789186050979 ; , s. 86-89
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Bokkapitel (populärvet., debatt m.m.)
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| 24. |
- Lindholm, Gunilla
(författare)
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The Implementation of Green Infrastructure: Relating a General Concept to Context and Site
- 2017
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- In the quest for more sustainable urban landscape development, the concept of "green infrastructure" (GI) has become central in policy documents and as a multifunctional general planning tool. GI is not, however, a simple and unambiguous solution. While in policy documents there are claims for more and connected GI, actual urban development takes another direction. The densifying imperative is hard to combine with an increased and more connected GI. This paper argues for a critical and diversified approach to the concept of GI, in order to facilitate its implementation in urban planning and management. Any kind of GI will not deliver all ecosystems services in any place, not without land use conflicts, investments and long term operating costs. This calls for a GI concept linked to actors and mediating conflicting values. Linguistic as well as spatial definitions of the two relevant dichotomies of "green-grey" and "public-private" are crucial in GI location, design, construction and management, it is argued. Overarching representations of GI will be needed, but not only pictured as a separate system, but also displayed with necessary integration to the whole urban landscape. Development over time will need an intersectorial implementation and management program. Some of the GI intentions may be implemented in planning processes, some through re-organization and redesign of public space, and some by agreements with landowners. To reach out to implementation in ordinary urban development, GI needs to be described in a way that establishes points of connection to a variety of relevant actors and organizations taking part in implementation of GI.
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| 25. |
- Lindholm, Gunilla
(författare)
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The Inclusive Reductionist or to Use Landscape Perspectives in Urban Planning
- 2010
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Konferensbidrag (refereegranskat)abstract
- The gap between planning theory and planning practice has been discussed in planning (theory) journals, often expressed as theory ascending too far from “reality” (Allmendinger 2009). This paper takes another point of departure, arguing for not to change planning theory into either utopia construction or evaluation exercises, but to engage in the communication between planning theory and planning practice, understood as activities in their own right. Landscape concepts can be used as a way to handle the complexity within urban situations; as a way to understand the interrelationships between the different aspects and issues of the same site or area. To label an area as ‘landscape’ means to alter the focus from narrow and sectorial to broad and inclusive. This inclusiveness is, though, reductive in the way that the separate features and functions are superficially mapped, in a stage of ‘setting the landscape’. This is a precondition to discover and appreciate relationships between e. g. traffic functions/meeting places, plantations /stormwater management etc., preceding separate aspectual and functional analyses. Metaphorically, this kind of thinking can be applied also at a theoretical level. Today, the rifts are sometimes hard to bridge between the different academic subjects connected to planning theory, such as political science, sociology, geography and architecture. A ‘landscape perspective’ could make it possible to spot relationships and foster a broader understanding of the theoretical issues (Allmendinger 2002). The etymology of the word ’landscape‘ stems from rural situations; either it has signified a territory or a scene (Cosgrove 1990, Olwig 2002). Accordingly, ‘landscape’ is a concept not often used in urban planning, except from taking the qualities of the rural landscapes into consideration, in discussions on expanding the urban territory out into “the landscape”, in the areas surrounding the existing town. The subject for this paper is to actualize the potential use of landscape concepts within an urban planning discourse; partly due to a changing situation for planning, with a more diffuse border between the town and the countryside, between culture and nature and between the regulated and the occasional; but also considering the need for renewed planning procedures. The infra structure, means and routines for planning practice are not considerably changed since what could be called ‘the planning peak period’ (1950-1980). Since then, the awareness of ecological as well as social aspects of spatial planning has increased, and the comprehensive analyticism (specialization and sectorialization) has been complemented with other mega trends, such as inter- and transdisciplinarity within the research connected to planning (Hillier & Healy 2008). Landscape concepts and perspectives; earlier something exclusively studied by landscape scholars and professionals, such as geographers, ecologists or landscape YTK • Aalto University 103 Planning and Complexity architects; have recently become popular in a broader field. ‘Landscape studies’ is now a subject in most schools of architecture. ‘Landscape Urbanism’ is a trend within urban design and planning. Following The European Landscape Convention we should reflect upon landscape, in order to “promote the protection, management and planning of European landscapes and organize European co-operation on landscape issues” (Council of Europe 2001). ’Landscape‘ is one of the few concepts with merely positive connotations. Even in expressions such as ’waste landscapes‘, ’derelict landscapes‘ or even ’dystopian landscapes’, they have this aspect of artistic scenery that takes us away from smells, cold, hunger and privation, to a sheer visual and aesthetic level of contemplation. This “picturesque” aspect of landscapes could be used in e. g. planning dialogue situations; not to secure a certain appearance, but to question it and discuss the consequences of potential differences; in functional, ecological, economical and emotional terms. References Olwig, K. R. (2002) Landscape, Nature and the Body Politic. University of Wisconsin Press. Allmendinger, P. (2002) The post-positive landscape of planning theory, in Allmendinger, P. & TewdwrJones, M. , (eds) Planning Future, New Directions for Planning Theory. Routledge. Hillier, J. & Healy, P., eds. (2008) Critical Essays in Planning Theory, vol.1–3. Ashgate.
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| 26. |
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| 27. |
- Lindholm, Gunilla
(författare)
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'Visible gestures': On urban landscape perspectives in planning
- 2012
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Ingår i: Planning Theory. - : SAGE Publications. - 1473-0952 .- 1741-3052. ; 11, s. 5-19
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Tidskriftsartikel (refereegranskat)abstract
- In spite of the frequent use of landscape representations in planning, 'the urban landscape' is rarely the focus in discussions within planning practice or planning theory, be it in terms of representations or as a socio-material framework for planning actions. Instead it appears to be taken for granted and in this way affects planning theory and practice, leaving planning activities (professional as well as participatory) as rather haphazard events, hard to contextualize and to foresee any consequences of. Taking the landscape for granted excludes the possibility of discussing the differences between understanding the changing urban landscape from representations and understanding it in relation to experienced realities. This text argues for increased interdisciplinary elaborations on the meaning and content of urban landscape, by linking it to discourses in planning theory, urban theory and landscape theory.
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| 28. |
- Martinsson, Gunilla, et al.
(författare)
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Being altruistically egoistic : Nursing aides’ experiences of caring for older persons with mental disorders
- 2011
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:4, s. 7530-
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given
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| 29. |
- Martinsson, Gunilla, et al.
(författare)
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Mental disorders affect older persons in Sweden : a register-based study
- 2011
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 26:3, s. 277-283
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study aimed to estimate the prevalence of mental disorders based on pharmaceutical use among the old (age >/= 65) in Sweden for the years 2006-2008. METHODS: Data on the mental health of older persons were approximated on the basis of recommended prescriptions for pharmaceuticals, gathered from the Swedish Register on Prescribed Pharmaceuticals (SRPP). Each disorder (ICD-10, F20-F42, and F60-F61) was analyzed to identify associated recommended pharmaceuticals. Anatomical Therapeutic Chemical Classification codes were applied. The data covered 188 024 individuals who received 2 013 079 prescriptions for pharmaceuticals for mental disorders during a 3-year period. Persons with pharmaceuticals for dementia disorders were excluded from the calculations of the prevalence of mental disorders. RESULTS: The prevalence of mental disorders among the old in Sweden, measured on the basis of pharmaceutical use, was 6.6% in 2006, 2007, and 2008, respectively. Men constituted one-third of cases and women two-thirds. Prevalence was lowest in the age group 65-69 and increased subsequently with age. CONCLUSIONS: This fundamental register-based study included a great number of older persons and shows that mental disorders affect every fifteenth older person in Sweden. The prevalence of mental disorders increases with increasing age. The results highlight the extent of mental disorders among older persons, which is important to know when planning care for these patients. This study, by investigating a large population, provides a solid basis for general planning as well as for future mental disorder research.
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| 30. |
- Martinsson, Gunilla, et al.
(författare)
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Specialist prescribing of psychotropic drugs to older persons in Sweden : a register-based study of 188 024 older persons
- 2012
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Ingår i: BMC Psychiatry. - 1471-244X. ; 12:197
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (>=65) in Sweden, focused on the medical specialties of the prescribing physicians.MethodsData concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42) were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs), other specialists, and physicians without specialist education.ResultsGPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men.ConclusionsThis study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons' disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were commonly prescribed to older persons, emphasizing the need for continuous examination of pharmaceutical treatment for older persons. The results indicate a future need of more specialists in geriatrics and psychiatry.
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| 31. |
- Martinsson, Gunilla, et al.
(författare)
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Struggling for existence : - Life situation experiences of older persons with mental disorders
- 2012
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7:Art. nr. 18422
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. ‘‘Struggling for existence’’ emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care
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| 32. |
- Niemann-Jönsson, Audrey, et al.
(författare)
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Medial Expression of TNF-α and TNF Receptors Precedes the Development of Atherosclerotic Lesions in Apolipoprotein E/LDL Receptor Double Knockout Mice
- 2007
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Ingår i: International Journal of Biomedical Science. - 1550-9702 .- 1555-2810. ; 3:2, s. 117-123
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Tidskriftsartikel (refereegranskat)abstract
- TNF-α is present in atherosclerotic lesions, activates endothelial adhesion molecule expression, stimulates the release of proinflammatory cytokines and matrix metalloproteinases and promotes smooth muscle cell proliferation and migration. Taken together these observations suggest that TNF-α may be functionally involved in early atherosclerosis development. To further evaluate this hypothesis we compared vascular TNF-α and TNF receptor expression in atherosclerosis-susceptible apoE-/-/LDL receptor-/- mice and control C57BL/6 mice. The aortas of 8 week old apoE-/-/LDLreceptor-/- mice displayed immunoreactivity for TNF-α as well as TNF p55 and p75 receptors (2.1 ± 1.6%, 5.6 ± 1.5% and 3.6 ± 1.3% of total media area, respectively), but did not have any detectable lesions. A marginal increase in TNF-α and TNF receptor immunoreactivity was observed at 12 weeks and atherosclerotic plaques were detected in 1 out of 5 animals. At 16 weeks TNF-α expression in the media was increased more than four-fold as compared with 8 week old mice, and atherosclerosis was widespread. TNF-α immunoreactivity was also observed in all plaques. In addition, at the same age a tendency towards increased TNF-α mRNA levels was detected in the double knockout mice compared to age-matched controls. A further increase in TNF-α and TNF receptor immunoreactivity as well as plaque size was observed at 20 weeks. With only a few exceptions, no TNF-α or TNF receptor immunoreactivity was detected in C57BL/6 control mice. These findings demonstrate that medial TNF-α and TNF receptor expression precedes lesion formation in apoE-/-/LDL receptor-/- mice.
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| 33. |
- Nilsson, Jan, et al.
(författare)
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Inflammation and cholesterol
- 2002
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Ingår i: European Heart Journal Supplements. - : Oxford University Press. - 1520-765X .- 1554-2815. ; 4:Suppl A, s. 18-25
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Tidskriftsartikel (refereegranskat)abstract
- Atherosclerosis develops as a result of a chronic arterial inflammation and intimal Fibrosis. The disease represents in many respects a vascular repair process activated in response to injury caused by toxic breakdown products of aggregated and oxidized lipoproteins. The initial response of the artery involves expression of adhesion molecules and recruitment of leukocytes. Degenerated lipoproteins are removed front the extracellular space by macrophages. If lipoproteins continue to I process becomes chronic and accumulate. the inflammatory cytokines stimulate smooth muscle to migrate into the intima. These cells proliferate and form an atherosclerotic plaque. Plaque cell death and inflammation in response to oxidized lipids and other toxic factors May Cause plaques to rupture.
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| 34. |
- Nordin Fredrikson, Gunilla, et al.
(författare)
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Autoimmune responses against the apo B-100 LDL receptor-binding site protect against arterial accumulation of lipids in LDL receptor deficient mice.
- 2007
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Ingår i: Autoimmunity. - : Informa UK Limited. - 0891-6934 .- 1607-842X. ; 40:2, s. 122-130
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Tidskriftsartikel (refereegranskat)abstract
- Background: Oxidation of LDL is associated with generation of autoantibodies against a large number of different aldehyde-modified peptide sequences in apo B-100. Autoantibodies recognizing peptide sequences in the LDL receptor-binding region of apo B-100 could potentially affect both cholesterol metabolism and atherosclerosis. The aim of the present study was to determine physiological effects of induction of immune responses against the apo B-100 LDL receptor-binding site in mice deficient for the LDL receptor. Methods and results: Mice received three immunizations, beginning at 6 weeks of age, with aldehyde-modified or nonmodified peptides corresponding to the amino acid sequence of the LDL receptor-binding site. Analysis of antibody response by ELISA unexpectedly revealed high titers of pre-existing IgG against both native and aldehyde-modified binding site sequences in non-immunized mice. Immunization with aldehyde-modified binding site sequences resulted in an almost complete down-regulation of this autoimmune response. It was also associated with a rapid increase in lipid-rich plaques in the aorta and a substantial depletion of the lipid content of the liver, whereas plasma lipid and apo B values were similar in all groups. Conclusions: These observations demonstrate existence of an endogenous T cell-dependent autoimmune response against the LDL receptor-binding site in LDL receptor(-/-) mice and suggest that this may help to prevent accumulation of lipoprotein lipids in the artery wall, whereas immunization with the corresponding aldehyde modified sequence down-regulates this response and induces substantial atherosclerotic development.
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| 35. |
- Nordin Fredrikson, Gunilla, et al.
(författare)
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Inhibition of Atherosclerosis in ApoE-Null Mice by Immunization with ApoB-100 Peptide Sequences.
- 2003
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Ingår i: Arteriosclerosis, Thrombosis and Vascular Biology. - : The Assoc.. - 1524-4636 .- 1079-5642. ; 23:5, s. 879-884
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Tidskriftsartikel (refereegranskat)abstract
- Objective - LDL oxidation is believed to play an important role in the development of atherosclerosis, and oxidized LDL particles have been shown to become targets for the immune system. Immunization of animals with oxidized LDL results in reduction of atherosclerosis, suggesting an atheroprotective effect of this immune response. Methods and Results - Using a polypeptide library covering the complete sequence of apoB-100, a large number of native and malondialdehyde-modified peptide sequences in apoB-100 that are recognized by antibodies in human plasma were identified. We report here that immunization with apoB-100 peptide sequences, against which high levels of IgG and IgM antibodies are present in healthy human controls, reduce atherosclerosis in apoE-null mice by about 60%. Immunizations with these peptides were also found to increase the collagen content of subvalvular lesions. Conclusions - These studies have identified peptide sequences in apoB-100 that induce immune responses, which inhibits atherosclerosis. This suggests a way of developing an immunization therapy for coronary heart disease.
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| 36. |
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| 37. |
- Tobiasson, Magnus, et al.
(författare)
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Patient-Specific Measurable Residual Disease Markers Predict Outcome in Patients With Myelodysplastic Syndrome and Related Diseases After Hematopoietic Stem-Cell Transplantation
- 2024
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Ingår i: Journal of Clinical Oncology. - : American Society of Clinical Oncology. - 0732-183X .- 1527-7755. ; 42:12, s. 1378-1390
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Clinical relapse is the major threat for patients with myelodysplastic syndrome (MDS) undergoing hematopoietic stem-cell transplantation (HSCT). Early detection of measurable residual disease (MRD) would enable preemptive treatment and potentially reduced relapse risk.METHODS: Patients with MDS planned for HSCT were enrolled in a prospective, observational study evaluating the association between MRD and clinical outcome. We collected bone marrow (BM) and peripheral blood samples until relapse, death, or end of study 24 months after HSCT. Patient-specific mutations were identified with targeted next-generation sequencing (NGS) panel and traced using droplet digital polymerase chain reaction (ddPCR).RESULTS: Of 266 included patients, estimated relapse-free survival (RFS) and overall survival (OS) rates 3 years after HSCT were 59% and 64%, respectively. MRD results were available for 221 patients. Relapse was preceded by positive BM MRD in 42/44 relapses with complete MRD data, by a median of 71 (23-283) days. Of 137 patients in continuous complete remission, 93 were consistently MRD-negative, 39 reverted from MRD+ to MRD-, and five were MRD+ at last sampling. Estimated 1 year-RFS after first positive MRD was 49%, 39%, and 30%, using cutoff levels of 0.1%, 0.3%, and 0.5%, respectively. In a multivariate Cox model, MRD (hazard ratio [HR], 7.99), WHO subgroup AML (HR, 4.87), TP53 multi-hit (HR, 2.38), NRAS (HR, 3.55), and acute GVHD grade III-IV (HR, 4.13) were associated with shorter RFS. MRD+ was also independently associated with shorter OS (HR, 2.65). In a subgroup analysis of 100 MRD+ patients, presence of chronic GVHD was associated with longer RFS (HR, 0.32).CONCLUSION: Assessment of individualized MRD using NGS + ddPCR is feasible and can be used for early detection of relapse. Positive MRD is associated with shorter RFS and OS (ClinicalTrials.gov identifier: NCT02872662).
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