| 1. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 2. |
- Zamora, Juan Carlos, et al.
(författare)
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Considerations and consequences of allowing DNA sequence data as types of fungal taxa
- 2018
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Ingår i: IMA Fungus. - : INT MYCOLOGICAL ASSOC. - 2210-6340 .- 2210-6359. ; 9:1, s. 167-185
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Tidskriftsartikel (refereegranskat)abstract
- Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.
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| 3. |
- Hedin, Katarina, et al.
(författare)
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Initial symptoms and three months follow-up after acute COVID-19 in outpatients : An international prospective cohort study
- 2023
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Ingår i: European Journal of General Practice. - : Informa UK Limited. - 1381-4788 .- 1751-1402. ; 29:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most studies on long-term follow-up of patients with COVID-19 focused on hospitalised patients. No prospective study with structured follow-up has been performed in non-hospitalised patients with COVID-19. Objectives: To assess long-COVID and post-COVID (WHO definition: symptomatic at least 12 weeks), describe lingering symptoms, their impact on daily activities, and general practice visits and explore risk factors for symptom duration in outpatients. Methods: A prospective study of adult outpatients with confirmed SARS-CoV-2 infection and symptoms consistent with COVID-19 in 11 European countries, recruited during 2020 and 2021 from primary care and the community. Structured follow-up by phone interviews (symptom rating, symptom impact on daily activities and general practice visits) was performed at weeks 2, 4, 8, and 12 by study personnel. Data was analysed descriptively by using correlation matrixes and Cox regression. Results: Of 270 enrolled patients, 52% developed long-COVID and 32% post-COVID-syndrome. When only considering the presence of moderate or (very) severe symptoms at weeks 8 and 12, these percentages were 28% and 18%, respectively. Fatigue was the most often reported symptom during follow-up. The impact of lingering symptoms was most evident in sports and household activities. About half (53%) had at least one general practice contact during follow-up. Obese patients took twice as long to return to usual health (HR: 0.5, 95%CI: 0.3–0.8); no other risk profile could predict lingering symptoms. Conclusion: Long-COVID and post-COVID are also common in outpatients. In 32%, it takes more than 12 weeks to return to usual health.
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| 4. |
- Moberg, Anna, et al.
(författare)
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C-reactive protein influences the doctors degree of suspicion of pneumonia in primary care: a prospective observational study
- 2020
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Ingår i: European Journal of General Practice. - : TAYLOR & FRANCIS LTD. - 1381-4788 .- 1751-1402. ; 26:1, s. 210-216
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Tidskriftsartikel (refereegranskat)abstract
- Background In primary care, the diagnosis of pneumonia is often based on history and clinical examination alone. However, a previous study showed that the general practitioners degree of suspicion correlates well with findings on chest X-ray, when the C-reactive protein (CRP) value is known. Objectives The present study aimed to investigate to what extent the physicians degree of suspicion is affected by the CRP level when community-acquired pneumonia is suspected in primary care. Methods A prospective observational study was conducted at five primary health care centres in Sweden between October 2015 and December 2017. Adult patients (n = 266) consulting their health care centre with symptoms of lower respiratory tract infection, where the physician suspected pneumonia, were included consecutively. Anamnestic information and findings from clinical examination were documented in a case report form. All patients were tested for CRP. The physicians rated their degree of suspicion as unsure, quite sure, and sure before and after the CRP result. Results The degree of suspicion of pneumonia changed in 69% of the cases; most often to a lower degree (40%). In 28% of the cases, there was no longer any suspicion of pneumonia after CRP. Conclusion Our results indicate that CRP testing highly influences the physicians degree of suspicion of pneumonia in primary care and that it seems to be of most value when not sure of the diagnosis.
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| 5. |
- Adevi, Anna, et al.
(författare)
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Therapeutic interventions in a rehabilitation garden may induce temporary extrovert and/or introvert behavioural changes in patients, suffering from stress-related disorders
- 2018
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Ingår i: Urban Forestry & Urban Greening. - : Elsevier BV. - 1618-8667 .- 1610-8167. ; 30, s. 182-193
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Tidskriftsartikel (refereegranskat)abstract
- Patients being treated for stress-related mental illness were observed during two summer programs in order to investigate the influence of multimodal nature-based therapy in a specially designed healing garden on patient recovery. The aim was to distinguish specific qualities, patterns and/or processes during the participants' stay in the healing garden. The study is a single-case study, using participatory observation. The data were coded following an inductive research process. The results showed that patients who underwent psychotherapy were more open and contact-seeking, and carried out extrovert recreational walks. By contrast, patients who underwent physiotherapy were introverted, emotionally withdrawn and performed introvert recreational walks. Interpretation of the data suggested that treatment combined with activities in certain parts of the rehabilitation garden induced and supported different psycho-physiological processes. The mechanisms and progress of these are discussed from the theory of situated cognition, and how these processes are stimulated and supported by characteristics in the garden. Oxytocin, a hypothalamic peptide which stimulates social interaction, induces anti-stress effects and stimulates growth and healing, may hypothetically be involved in these processes.
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| 6. |
- Ahlstedt, Carina, 1969-, et al.
(författare)
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Do illegitimate tasks matter for registered nurses' work motivation? : A cross-sectional study based on a nationally representative sample of Swedish nurses
- 2023
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Ingår i: International Journal of Nursing Studies Advances. - : Elsevier. - 2666-142X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: A challenge in Western countries is the growing need for registered nurses (RNs') in hospitals, primary care and home healthcare. Decreasing illegitimate tasks and strengthening RNs' work motivation are some strategies to address this challenge.Objective: Our overall aim was to explore the association between RNs' experiences of illegitimate tasks and work motivation operationalised as four dimensions: work engagement, opportunities to provide high-quality care, employer satisfaction and intention to remain at the workplace. To address this aim, three specific research questions were asked: (1) Is there an association between illegitimate tasks and work motivation? (2) Do the levels of reported illegitimate tasks differ between RNs working in hospitals and those working in primary care or home healthcare settings? (3) Do associations between illegitimate work tasks and work motivation differ with type of workplace?Design: A cross-sectional design.Methods: We used responses from a stratified population of RNs in Sweden, n = 2,333, working either in hospitals, primary care or home healthcare. Calibrating weights were applied in all analyses to ascertain the generalisability of the findings. Illegitimate tasks were measured with the Bern Illegitimate Tasks Scale. Data were analysed using chi-squared tests and linear or logistic regression analysis. Interaction was measured on the multiplicative scale by adding an interaction term to the fully adjusted models.Results: Overall, approximately 25 % of RNs reported frequently experiencing illegitimate tasks. There were statistically significant associations between higher perceptions of illegitimate tasks and lower ratings in the four dimensions of work motivation: work engagement [beta coefficient [beta] = -0.14, confidence interval [CI] 95 % = -0.18; -0.10], opportunities to provide highquality care [beta = -0.46, CI 95 % = -0.51; -40] and employer satisfaction [beta = -0.60, CI 95 % = -0.67; -0.54]. Experiencing higher levels of illegitimate tasks also related to a decreased intention to remain at the workplace [illegitimate tasks: odds ratio = 0.32, CI 95 % = 0.27; 0.29]. RNs who worked in home healthcare reported higher levels of illegitimate tasks than RNs who worked in hospitals.Conclusions: Reducing the amount of illegitimate tasks may contribute to counteracting the shortage of RNs by increasing work motivation and willingness to remain at the workplace.
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| 7. |
- Ahlstedt, Carina, 1969-
(författare)
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Registered nurses' work motivation and intention to stay at the workplace
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is currently a shortage of registered nurses (RNs) and high turnover of RNs, both nationally and internationally. Work motivation is an important part of a healthy work environment and something we need to know more about from an RN perspective.The overarching aim of this thesis was to enhance our understanding of the organisational and social workplace factors that contribute to an attractive environment for RNs, by exploring factors associated with work motivation. Four research questions were posed. (i) What factors create the conditions for motivation in RNs’ daily work? (ii) What role does social support in the workplace play in RNs’ work motivation? (iii) What role does the opportunity to work with relevant tasks play in RNs’ work motivation? (iv) Are there differences between healthcare settings regarding RNs’ social support, illegitimate tasks, and associations with work motivation? Four empirical studies were performed to answer these questions. Two were qualitative studies based on an ethnographic approach and two were quantitative cross-sectional studies based on a stratified national sample of RNs. The results of the qualitative studies indicate that crucial factors for RNs' work motivation include a friendly and permissive atmosphere in daily work. Visible progress and receiving feedback from the work itself also positively contributed to motivation. Additionally, RNs' opportunities to learn and support each other through ongoing communication during daily work tended to have a positive impact on work motivation. Effective collaboration between physicians and RNs with mutual respect, understanding of each other's competencies, and creating an environment where RNs could seek clarification were also central to work motivation. The quantitative studies revealed that the opportunity for social support from the immediate manager or co-workers was significant for dimensions related to RNs’ work motivation and the willingness to stay in the workplace. The associations differed in strength between healthcare settings. Furthermore, the results indicated that a factor in RNs' work motivation was the ability to work with tasks perceived as relevant, not illegitimate. However, the results highlighted that a significant portion of RNs performed illegitimate tasks, and that illegitimate tasks were more prevalent for RNs in home healthcare than those in primary care and hospitals. This is something to consider as more complex care is being conducted outside of hospitals. The thesis adds new knowledge that can be useful to the development of attractive workplaces, which could contribute to more RNs choosing to remain in their position for a longer period.
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| 8. |
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| 9. |
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| 10. |
- Andersen, Anna-Eva, et al.
(författare)
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Lesbian, gay and bisexual parents' experiences of nurses' attitudes in child health care : a qualitative study
- 2017
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 5065-5071
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe lesbian, gay and bisexual parents' experiences of nurses' attitudes in child health care.BACKGROUND: Lesbian, gay and bisexual people are often reluctant to disclose their gender identity for fear of discrimination. This fear may lead to avoidance of healthcare for themselves or their children and may negatively affect families' health and well-being.DESIGN: A qualitative inductive design was employed.METHODS: Semi-structured interviews were conducted with 14 lesbian, gay or bisexual parents (11 mothers and 3 fathers) with child health care experiences in southern Sweden. Interviews were analysed using qualitative content analysis.RESULTS: Two themes were identified. One, a 'sense of marginalization', included lesbian, gay and bisexual parents' experiences of heteronormative attitudes among child health care nurses which led them to feel alienated and questioned as parents. Another, 'being respected for who you are', included experiences of being respected and included at child health care appointments.CONCLUSIONS: Findings paint a complex picture of lesbian, gay and bisexual parents' interactions with child health care nurses in that they experienced both positive and negative attitudes. Knowledge gaps about lesbian, gay and bisexual families within the child health care field must be filled.RELEVANCE TO CLINICAL PRACTICE: Child health care nurses should work with the entire family to provide the best care for the child; however, discrimination in health care is common and often caused by a lack of knowledge. The number of children living with same-sex parents has increased more than ten-fold since the end of the 1990s. It is therefore important to explore lesbian, gay and bisexual parents' experiences with child health care nurses' attitudes to improve quality of care.
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| 11. |
- Andersen, Anna-Eva, et al.
(författare)
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Lesbian, gay and bisexual parents' experiences of nurses' attitudes in child health care : a qualitative study
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 5065-5071
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe lesbian, gay and bisexual parents' experiences of nurses' attitudes in child health care. BACKGROUND: Lesbian, gay and bisexual people are often reluctant to disclose their gender identity for fear of discrimination. This fear may lead to avoidance of healthcare for themselves or their children and may negatively affect families' health and well-being. DESIGN: A qualitative inductive design was employed. METHODS: Semi-structured interviews were conducted with 14 lesbian, gay or bisexual parents (11 mothers and 3 fathers) with child health care experiences in southern Sweden. Interviews were analysed using qualitative content analysis. RESULTS: Two themes were identified. One, a 'sense of marginalization', included lesbian, gay and bisexual parents' experiences of heteronormative attitudes among child health care nurses which led them to feel alienated and questioned as parents. Another, 'being respected for who you are', included experiences of being respected and includedat child health care appointments. CONCLUSIONS: Findings paint a complex picture of lesbian, gay and bisexual parents' interactions with child health care nurses in that they experienced both positive and negative attitudes. Knowledge gaps about lesbian, gay and bisexual families within the child health care field must be filled. RELEVANCE TO CLINICAL PRACTICE: Child health care nurses should work with the entire family to provide the best care for the child; however, discrimination in health care is common and often caused by a lack of knowledge. The number of children living with same-sex parents has increased more than ten-fold since the end of the 1990s. It is therefore important to explore lesbian, gay and bisexual parents' experiences with child health care nurses' attitudes to improve quality of care.
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| 12. |
- Arntsberg, Louise, et al.
(författare)
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Management and documentation of pneumonia–a comparison of patients consulting primary care and emergency care
- 2024
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Ingår i: Scandinavian Journal of Primary Health Care. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724.
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Tidskriftsartikel (refereegranskat)abstract
- Patients may attend either primary or emergency care without referral in Sweden. Guidelines recommend a severity assessment, including assessment of vital signs, to be performed for all patients presenting with suspected pneumonia. Objective: To compare management and documentation of vital signs, symptoms and infection severity in pneumonia patients seeking primary care and emergency care without referral. Design: Medical record review of vital signs, examination findings and severity of pneumonia. Setting: Primary and emergency care. Subjects: Two hundred and forty patients diagnosed with pneumonia. Main outcome measures: Vital signs, examination findings and severity of pneumonia. Assessments of pneumonia severity according to the reviewers, the traffic light score and CRB-65. Results: Respiratory rate, blood pressure, heart rate and oxygen saturation were less often documented in primary care (p < .001). Chest X-ray was performed in 5% of primary care patients vs. 88% of emergency care patients (p < .01). Primary care patients had longer symptom duration, higher oxygen saturation and lower respiratory rate. In total, the reviewers assessed 63% of all pneumonias as mild and 9% as severe. The traffic light scoring model identified 11 patients (9%) in primary care and 53 patients (44%) in emergency care at high risk of severe infection. Conclusions: Vital signs were documented less often in primary care than in emergency care. Patients in primary care appear to have a less severe pneumonia, indicating attendance to the correct care level. The traffic light scoring model identified more patients at risk of severe infection than CRB-65, where the parameters were documented to a limited extent.
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| 13. |
- Arushanyan, Yevgeniya
(författare)
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Environmental Impacts of ICT: Present and Future
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- ICT is developing rapidly and is playing an increasingly important role in society. High expectations are placed on ICT in relation to sustainable development. In order to provide basis for decision-making and ensure that ICT is used in the best possible way for enabling sustainable development, the sustainability impacts of ICT need to be studied.This thesis aims to provide new knowledge on the environmental impacts related to ICT, to explore the potential of ICT to contribute to sustainability, and discuss ways of assessing environmental impacts of ICT. In order to fulfill the aim a literature review of existing LCA studies of ICT was done, an LCA case study of printed and online media was performed, a methodological framework for sustainability assessment of scenarios was developed and then applied for environmental assessment of future ICT societies.The results show that manufacturing and use phase are the life cycle stages contributing the most to the ICT environmental impacts. For online newspapers online distribution and content production may give significant contribution to the overall impact. User behavior was observed to be crucial for the results of comparisons of ICT solutions with their traditional counterparts.The following key issues were concluded to influence the environmental risks and opportunities in future ICT societies: energy mix, economic conditions, life styles, technology, and environmental ambitions, incentives and regulation. The potential of ICT for sustainability is affected by these key issues.A new methodological framework (SAFS) was developed for the assessment of future scenarios (societal level). Life cycle assessment (LCA) was used for assessment on a product level. Application of both methods, their benefits, drawbacks, and challenges of assessment were discussed. Both types of assessments were concluded to be important to support decision-making.
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| 14. |
- Arushanyan, Yevgeniya, 1984-
(författare)
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LCA of ICT solutions: environmental impacts and challenges of assessment
- 2013
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Information and communication technology (ICT) is playing an important role in modern society, contributing to economic growth and affecting society and people’s lifestyles. There are high expectations on ICT to contribute to sustainable development, e.g. through greenhouse gas emissions reductions. ICT solutions (ICT products and services) are often perceived as having low or no environmental impacts compared with conventional alternatives. In order to determine the potential of ICT to reduce environmental impacts, environmental assessments of ICT solutions compared with other alternatives are needed. A number of studies have already assessed the environmental impacts of individual ICT solutions and the ICT sector. However, more research is needed, covering different types of impacts (primary, secondary, rebound, etc.) in a variety of impact categories (e.g. climate change, ozone depletion, eutrophication, human and ecotoxicity, etc.). The findings then need to be systematised in order to identify hot-spots and draw generic conclusions. As the area is rather new and fast-developing, assessment methods need to be critically appraised in order to identify challenges and developments necessary for high quality assessments.This thesis aims to contribute to the knowledge on the direct life cycle environmental impacts of ICT solutions and to investigate and analyse the challenges of applying Life Cycle Assessment (LCA) as a tool for environmental assessment of ICT solutions. Two research questions: “What life cycle environmental impacts and their causes can be identified for ICT solutions?” and “What are the methodological challenges of assessing the ICT solutions using LCA?” were analysed by reviewing published LCAs on ICT solutions and conducting a case study of online and printed newspapers. The literature review helped identify hotspots in the life cycle of ICT solutions, draw generic conclusions concerning environmental impacts and their causes, and identify major challenges to LCA application. The case study assessed the environmental impacts of traditional and new media solutions and provided information on methodological challenges.The results show that impacts other than climate change potential and energy use are not well-studied in the ICT sector, creating a risk of possible sub-optimisation and problem shifting. Manufacturing and the use phase are concluded to be the most environmentally intense life cycle stages of ICT products in many studies. However, transportation and end-of-life treatment should not be omitted in the assessments, although their impacts appear lower, as uncertainty and lack of data might be a reason for underestimations.As ICT is under constant and rapid development, environmental assessment of ICT solutions faces challenges regarding e.g. data quality and availability; choice of data type; methodological choices (e.g. choice of functional unit, scope definition and allocation); and assumptions on user behaviour. These affect the final results and thus need to be carefully considered by LCA practitioners.The outcomes of this thesis can benefit practitioners and decision-makers, improving knowledge on the environmental impacts of ICT solutions and challenges in applying LCA for assessment of ICT solutions, and providing improved grounds for more informed decision-making. Areas for further research regarding methodology development and filling knowledge gaps are also identified.
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| 15. |
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| 16. |
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| 17. |
- Buckley, Sarah, et al.
(författare)
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Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum : a systematic review with implications for the function of the oxytocinergic system
- 2023
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding.AIM: To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems.METHODS: Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables.RESULTS: Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2-3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.CONCLUSIONS: Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2-3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.
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| 18. |
- Bystrova, Ksenia, et al.
(författare)
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Early Contact versus Separation : Effects on Mother-Infant Interaction One Year Later
- 2009
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 36:2, s. 97-109
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Tidskriftsartikel (refereegranskat)abstract
- Background: A tradition of separation of the mother and baby after birth still persists in many parts of the world, including some parts of Russia, and often is combined with swaddling of the baby. The aim of this study was to evaluate and compare possible long-term effects on mother-infant interaction of practices used in the delivery and maternity wards, including practices relating to mother-infant closeness versus separation. Methods: A total of 176 mother-infant pairs were randomized into four experimental groups: Group I infants were placed skin-to-skin with their mothers after birth, and had rooming-in while in the maternity ward. Group II infants were dressed and placed in their mothers' arms after birth, and roomed-in with their mothers in the maternity ward. Group III infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group IV infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or dressed in baby clothes. Episodes of early suckling in the delivery ward were noted. The mother-infant interaction was videotaped according to the Parent-Child Early Relational Assessment (PCERA) 1 year after birth. Results: The practice of skin-to-skin contact, early suckling, or both during the first 2 hours after birth when compared with separation between the mothers and their infants positively affected the PCERA variables maternal sensitivity, infant's self-regulation, and dyadic mutuality and reciprocity at 1 year after birth. The negative effect of a 2-hour separation after birth was not compensated for by the practice of rooming-in. These findings support the presence of a period after birth (the early ""sensitive period"") during which close contact between mother and infant may induce long-term positive effect on mother-infant interaction. In addition, swaddling of the infant was found to decrease the mother's responsiveness to the infant, her ability for positive affective involvement with the infant, and the mutuality and reciprocity in the dyad. Conclusions: Skin-to-skin contact, for 25 to 120 minutes after birth, early suckling, or both positively influenced mother-infant interaction 1 year later when compared with routines involving separation of mother and infant.
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| 19. |
- Bystrova, Ksenia, et al.
(författare)
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Maternal axillar and breast temperature after giving birth : Effects of delivery ward practices and relation to infant temperature
- 2007
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Ingår i: Birth. - 0730-7659 .- 1523-536X. ; 34:4, s. 291-300
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little is known about the development and control of skin temperature in human mothers after birth. The purpose of this study was to explore the effects of delivery ward practices and early suckling on maternal axillar and breast temperatures during the first 2 hours postpartum and to relate them to the infant's foot and axillar temperatures. Methods: Three groups of 176 mother-infant pairs were randomized as follows-group I: infants lying prone in skin-to-skin contact on their mother's chest, named the ""skin-to-skin group"" (n = 44), group II: infants who were dressed and lying prone on their mother's chest, named the ""mother's arms group"" (n = 44), and group III: infants who were dressed and kept in the nursery, named the ""nursery group"" (n = 88). Maternal axillar and breast temperatures and infants' axillar and foot temperatures were measured at 15-minute intervals from 30 to 120 minutes after birth. Episodes of early suckling were noted. Results: The axillar and breast temperatures rose significantly in all mothers. The rise of temperature over time was significantly higher in multiparas than in primiparas but was influenced only slightly by group assignment. The variation in breast temperature was highest in mothers in the skin-to-skin group and lowest in mothers in the nursery group. In the mother's arms group, variation in breast temperature was larger in those mothers exposed to early suckling than in those not exposed. A positive relationship was found between the maternal axillar temperature and the infant foot and axillar temperature 90 minutes after the start of the experiment (120 min after birth) in the skin-to-skin and mother's arms groups. The rise in temperature in the infant's foot was nearly twice that in the axilla. No such relationship was established in the nursery group. In addition, foot temperature in infants from the skin-to-skin group was nearly 2 degrees C higher than that in infants from the mother's arms group. Conclusions: Maternal temperature rose after birth, and the rise was higher in multiparas than in primiparas. Skin-to-skin contact and early suckling increased temperature variation. Maternal temperature was related to infant foot and axillar temperatures.
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| 20. |
- Carlsson, Sara, et al.
(författare)
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Antibiotic Treatment for Lower Respiratory Tract Infections in Primary Care: A Register-Based Study Examining the Role of Radiographic Imaging
- 2023
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Ingår i: Antibiotics. - : MDPI. - 2079-6382. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- When imaging (i.e., chest-x-ray or computed tomography) is used to differentiate between acute bronchitis and pneumonia, many patients are being prescribed antibiotics despite the absence of radiographic pneumonia signs. This study of lower respiratory tract infections (LRTIs) with negative chest imaging compares cases where antibiotics were prescribed and not prescribed to find characteristics that could explain the prescription. Data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for patients aged 18-79 years diagnosed with acute bronchitis or pneumonia and who had any chest radiologic imaging between 2007-2014. Of 696 cases without evidence of pneumonia on imaging, 55% were prescribed antibiotics. Age, sex, and co-morbidity did not differ between those with or without antibiotics. The median level of C-reactive protein was low in both groups but differed significantly (21 vs. 10 mg/L; p < 0.001). Resident physicians prescribed antibiotics more frequently than interns or specialists (p < 0.001). It is unclear what features prompted the antibiotic prescribing in those with negative imaging indicating overuse of antibiotics for LRTIs.
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| 21. |
- Daly, D., et al.
(författare)
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How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries
- 2020
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Design Observational study Setting Twelve countries, eleven European and South Africa. Sample National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Methods Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67 mu g for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Results Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference. Conclusion Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution's mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.
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| 22. |
- Esgard, Veronica Frey, et al.
(författare)
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Diagnostic methods and written advice for acute otitis media in primary health care
- 2024
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Ingår i: SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Otomicroscopy and pneumatic methods are superior to otoscopy alone in diagnosing acute otitis media (AOM). There is a lack of knowledge regarding the use of different diagnostic methods for AOM in primary health care in Sweden and Norway. Methods: This cross-sectional study included a questionnaire completed by general practitioners (GPs) and specialist trainees (STs/residents/registrars) working in primary care in Sweden and Norway. Multivariable binary logistic regressions were performed to evaluate the use of diagnostic methods and written advice adjusted for educational level, sex and country. Results: Otoscopy was the most frequently used method. Sweden had greater access to the more accurate diagnostic methods. In Norway, the following methods were used to a lesser extent: pneumatic otoscopy, adjusted OR 0.15 (95% CI 0.10-0.23; p < .001), otomicroscopy, adjusted OR 0.013 (95% CI 0.070-0.027; p < .001), pneumatic otomicroscopy, adjusted OR 0.028 (95% CI 0.010-0.078; p < .001) and tympanometry, adjusted OR 0.31 (95% CI 0.21-0.45; p < .001). Written advice was used to a greater extent in Norway, adjusted OR 4.5 (95% CI 3.1-6.7; p < .001). The STs used pneumatic otoscopy and pneumatic otomicroscopy to a lesser extent, adjusted OR 0.65 (95% CI 0.45-0.93; p = .019) and 0.63 (95% CI 0.43-0.92; p = .016). Conclusions: Swedish physicians both used and had greater access to the significantly better diagnostic methods compared with Norwegian physicians while the opposite applied to the use of written information. The GPs used pneumatic otoscopy and pneumatic otomicroscopy to a greater extent than STs. Compared with 2012, the Swedish physicians now more frequently used pneumatic otoscopy.
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| 23. |
- Etminani, Farzaneh, 1984-, et al.
(författare)
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Randomised, siteless study to compare systematic atrial fibrillation screening using enrichment by a risk prediction model with standard care in a Swedish population aged ≥ 65 years : CONSIDERING-AF study design
- 2024
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Ingår i: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia and confers an increased risk of mortality, stroke, heart failure and cognitive decline. There is growing interest in AF screening; however, the most suitable population and device for AF detection remains to be elucidated. Here, we present the design of the CONSIDERING-AF (deteCtiON and Stroke preventIon by moDEl scRreenING for Atrial Fibrillation) study. METHODS AND ANALYSIS: CONSIDERING-AF is a randomised, controlled, siteless, non-blinded diagnostic superiority trial with four parallel groups and a primary endpoint of identifying AF during a 6-month study period set in Region Halland, Sweden. In each group, 740 individuals aged≥65 years will be included. The primary objective is to compare the intervention of AF screening enrichment using a risk prediction model (RPM), followed by 14 days of a continuous ECG patch, with no intervention (standard care). Primary outcome is defined as the incident AF recorded in the Region Halland Information Database after 6 months as compared with standard care. Secondary endpoints include the difference in incident AF between groups enriched or not by the RPM, with and without an invitation to 14 days of continuous ECG recording, and the proportions of oral anticoagulation treatment in the four groups. ETHICS AND DISSEMINATION: This study has ethical approval from the Swedish Ethical Review Authority. Results will be published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER: NCT05838781. © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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| 24. |
- Finnveden, Göran, et al.
(författare)
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Environmental and economic assessment methods for waste management decision-support : possibilities and limitations
- 2007
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Ingår i: Waste Management & Research. - 0734-242X .- 1096-3669. ; 25:3, s. 263-269
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Tidskriftsartikel (refereegranskat)abstract
- A large number of methods and approaches that can be used for supporting waste management decisions at different levels in society have been developed. In this paper an overview of methods is provided and preliminary guidelines for the choice of methods are presented. The methods introduced include: Environmental Impact Assessment, Strategic Environmental Assessment, Life Cycle Assessment, Cost-Benefit Analysis, Cost-effectiveness Analysis, Life-cycle Costing, Risk Assessment, Material Flow Accounting, Substance Flow Analysis, Energy Analysis, Exergy Analysis, Entropy Analysis, Environmental Management Systems, and Environmental Auditing, The characteristics used are the types of impacts included, the objects under study and whether the method is procedural or analytical The different methods can be described as systems analysis methods. Waste management systems thinking is receiving increasing attention. This is, for example, evidenced by the suggested thematic strategy on waste by the European Commission where life-cycle analysis and life-cycle thinking get prominent positions. Indeed, life-cycle analyses have been shown to provide policy-relevant and consistent results. However, it is also clear that the studies will always be open to criticism since they are simplifications of reality and include uncertainties. This is something all systems analysis methods have in common. Assumptions can be challenged and it may be difficult to generalize from case studies to policies. This suggests that if decisions are going to be made, they are likely to be made on a less than perfect basis.
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| 25. |
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| 26. |
- FitzGerald, Edward A., et al.
(författare)
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Multiplexed experimental strategies for fragment library screening using SPR biosensors
- 2020
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Surface plasmon resonance biosensor technology (SPR) is ideally suited for fragment-based lead discovery. However, generally suitable experimental procedures or detailed protocols are lacking, especially for structurally or physico-chemically challenging targets or when tool compounds are lacking. Success depends on accounting for the features of both the target and the chemical library, purposely designing screening experiments for identification and validation of hits with desired specificity and mode-of-action, and availability of orthogonal methods capable of confirming fragment hits. By adopting a multiplexed strategy, the range of targets and libraries amenable to an SPR biosensor-based approach for identifying hits is considerably expanded. We here illustrate innovative strategies using five challenging targets and variants thereof. Two libraries of 90 and 1056 fragments were screened using two different flow-based SPR biosensor systems, allowing different experimental approaches. Practical considerations and procedures accounting for the characteristics of the proteins and libraries, and that increase robustness, sensitivity, throughput and versatility are highlighted.Competing Interest StatementAnna Moberg, Maria T. Lindgren and Claes Holmgren work for Cytiva, which produce Biacore systems.
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| 27. |
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| 28. |
- FitzGerald, Edward, et al.
(författare)
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Multiplexed experimental strategies for fragment library screening against challenging drug targets using SPR biosensors
- 2024
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Ingår i: SLAS Discovery. - : Elsevier. - 2472-5560 .- 2472-5552. ; :1, s. 40-51
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Tidskriftsartikel (refereegranskat)abstract
- Surface plasmon resonance (SPR) biosensor methods are ideally suited for fragment-based lead discovery. However, generally applicable experimental procedures and detailed protocols are lacking, especially for structurally or physico-chemically challenging targets or when tool compounds are not available. Success depends on accounting for the features of both the target and the chemical library, purposely designing screening experiments for identification and validation of hits with desired specificity and mode-of-action, and availability of orthogonal methods capable of confirming fragment hits. The range of targets and libraries amenable to an SPR biosensor-based approach for identifying hits is considerably expanded by adopting multiplexed strategies, using multiple complementary surfaces or experimental conditions. Here we illustrate principles and multiplexed approaches for using flow-based SPR biosensor systems for screening fragment libraries of different sizes (90 and 1056 compounds) against a selection of challenging targets. It shows strategies for the identification of fragments interacting with 1) large and structurally dynamic targets, represented by acetyl choline binding protein (AChBP), a Cys-loop receptor ligand gated ion channel homologue, 2) targets in multi protein complexes, represented by lysine demethylase 1 and a corepressor (LSD1/CoREST), 3) structurally variable or unstable targets, represented by farnesyl pyrophosphate synthase (FPPS), 4) targets containing intrinsically disordered regions, represented by protein tyrosine phosphatase 1B (PTP1B), and 5) aggregation-prone proteins, represented by an engineered form of human tau (tau K18M). Practical considerations and procedures accounting for the characteristics of the proteins and libraries, and that increase robustness, sensitivity, throughput and versatility are highlighted. The study shows that the challenges for addressing these types of targets is not identification of potentially useful fragments per se, but establishing methods for their validation and evolution into leads.
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| 29. |
- Forsare, Carina, et al.
(författare)
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Evolution of estrogen receptor status from primary tumors to metastasis and serially collected circulating tumor cells
- 2020
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Ingår i: International Journal of Molecular Sciences. - : MDPI AG. - 1661-6596 .- 1422-0067. ; 21:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: The estrogen receptor (ER) can change expression between primary tumor (PT) and distant metastasis (DM) in breast cancer. A tissue biopsy reflects a momentary state at one location, whereas circulating tumor cells (CTCs) reflect real-time tumor progression. We evaluated ER-status during tumor progression from PT to DM and CTCs, and related the ER-status of CTCs to prognosis. Methods: In a study of metastatic breast cancer, blood was collected at different timepoints. After CellSearch® enrichment, CTCs were captured on DropMount slides and evaluated for ER expression at baseline (BL) and after 1 and 3 months of therapy. Comparison of the ER-status of PT, DM, and CTCs at different timepoints was performed using the McNemar test. The primary endpoint was progression-free survival (PFS). Results: Evidence of a shift from ER positivity to negativity between PT and DM was demonstrated (p = 0.019). We found strong evidence of similar shifts from PT to CTCs at different timepoints (p <0.0001). ER-positive CTCs at 1 and 3 months were related to better prognosis. Conclusions: A shift in ER-status from PT to DM/CTCs was demonstrated. ER-positive CTCs during systemic therapy might reflect the retention of a favorable phenotype that still responds to therapy.
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| 30. |
- Fransson, Linda, et al.
(författare)
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Minor Enantiomer Recycling-Effect of Two Reinforcing Catalysts on Product Yield and Enantiomeric Excess
- 2010
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Ingår i: ChemCatChem. - : Wiley. - 1867-3880 .- 1867-3899. ; 2:6, s. 683-693
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Tidskriftsartikel (refereegranskat)abstract
- Kinetic modeling of a recycling procedure in which the minor product enantiomer from an enantioselective catalytic reaction is selectively retransformed to starting material by a second chiral catalyst demonstrates that the enantiomeric excess of the product is not affected by the relative amounts of the two catalysts, but that the yield increases when the amount of the catalyst for the product-forming reaction is increased. The yield, but not the enantiomeric excess, is also affected by the initial substrate concentration. The recycling process is compared to sequential processes in which either the second catalyst is added after completion of the first reaction or in which the two catalysts are added simultaneously. In the sequential processes, high enantioselectivity can be obtained at the expense of product yield, whereas under recycling conditions both high enantiomeric excess and high yield can be achieved. Experimental data from a recycling procedure providing qualitative support for results from kinetic modeling are presented.
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| 31. |
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| 32. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
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Effekten av att föda barn i ett speciellt utformat födslorum: En randomiserad kontrollerad studie
- 2023
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Ingår i: Konferensbidrag Reproduktiv Hälsa, Karlstad.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Den upplevda miljön har betydelse för födselns fysiologiska processer hos kvinnor. Då majoriteten barn föds på sjukhus är det därav betydelsefullt att utforma sjukhusmiljön utifrån aspekter som främjar trygghet och förtrogenhet. Syfte: Att utvärdera om ett speciellt utformat rum ger bättre utfall i samband med födsel, i jämförelse med standardrum. Metod: En randomiserad kontrollerad studie genomfördes under åren 2019–2020 vid ett sjukhus i västra Sverige. Förstföderskor med en singelgraviditet i fullgången tid lottades till att vårdas antingen i ett rum speciellt utformat för att stödja födselns fysiologiska processer (testrummet) eller i ett standardrum. Hypotesen var att det primära kompositutfallet skulle uppfyllas hos fler kvinnor i testrummet, det vill säga: vaginal spontan födsel, ingen användning av oxytocindropp, positiv förlossningsupplevelse, samt blödning <1000ml. För att kunna påvisa en skillnad på 8% mellan de randomiserade grupperna i det primära utfallet, krävdes 1274 studiedeltagare. Bland sekundära utfall fanns andra perinatala utfall samt självskattad förlossningsupplevelse upp till ett år efter födsel. Resultat: Studien avslutades i förtid på grund av Covid-19-pandemin, vilket gjorde att 406 kvinnor randomiserades totalt. Därav uppnåddes inte tillräcklig styrka för att kunna påvisa en statistiskt signifikant skillnad mellan grupperna avseende det primära utfallet. I testrummet uppfylldes det primära utfallet hos 42% av kvinnorna jämfört med 35% i standardrummet (odds ratio: 1.35, 95% CI 0.90–2.01). Kvinnor i testrummet använde epiduralanalgesi i lägre utsträckning. De rapporterade även mer positiva förlossningsupplevelser 3 och 12 månader efter födsel i jämförelse med kvinnor i standardrummen. Konklusion: Denna för tidigt avslutade studie kunde inte verifiera om testrummet förbättrar det primära utfallet. Däremot använde kvinnor i det testrummet i lägre grad farmakologisk smärtlindring och skattade bättre förlossningsupplevelse över tid. Finansiering: Vetenskapsrådet (2018–02406), Institutionen för Vårdvetenskap och Hälsa, Göteborgs Universitet.
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| 33. |
- Goldkuhl, Lisa, 1983, et al.
(författare)
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Room4Birth – The effect of giving birth in a hospital birthing room designed with person-centred considerations: A Swedish randomised controlled trial
- 2022
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Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5764 .- 1877-5756. ; 32
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate if a birthing room designed with person-centred considerations improves labour and birth outcomes for nulliparous women when compared to regular birthing rooms. Methods: A randomised controlled trial was conducted at a Swedish labour ward between January 2019 and October 2020. Nulliparous women in spontaneous labour were randomised either to a birthing room designed with person-centred considerations (New room) or a Regular room. The primary outcome was a composite of four variables: vaginal non-instrumental birth; no oxytocin augmentation; postpartum blood loss < 1000 ml; and a positive childbirth experience. To detect a difference of 8% between the groups, 1274 study participants were needed, but the trial was terminated early due to consequences of the Covid-19 pandemic. Results: A total of 406 women were randomised; 204 to the New room and 202 to the Regular room. There was no significant difference in the primary outcome between the groups (42.2% versus 35.1%; odds ratio: 1.35, 95% Confidence Interval 0.90–2.01; p = 0.18). Participants in the New room used epidural analgesia to a lower extent (54.4% versus 65.3%, relative risk: 0.83, 95% Confidence Interval 0.71–0.98; p = 0.03) and reported to a higher degree that the room contributed to a sense of safety, control, and integrity (p=<0.001). Conclusions: The hypothesis that the New room would improve the primary outcome could not be verified. Considering the early discontinuation of the study, results should be interpreted with caution. Nevertheless, analyses of our secondary outcomes emphasise the experiential value of the built birth environment in improving care for labouring women.
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| 34. |
- Goncalves, Isabel, et al.
(författare)
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Elastin- and Collagen-Rich Human Carotid Plaques Have Increased Levels of the Cysteine Protease Inhibitor Cystatin C.
- 2008
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Ingår i: Journal of Vascular Research. - : S. Karger AG. - 1423-0135 .- 1018-1172. ; 45:5, s. 395-401
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cystatin C is a major inhibitor of the elastin- and collagen-degrading cysteine proteases and may therefore have an important role in preserving atherosclerotic plaque stability. In this study we analyzed the associations between human carotid plaque cystatin C expression and the plaque content of collagen and elastin. Methods: Thirty-one plaques were removed by endarterectomy and homogenized. Cystatin C levels were analyzed by densitometry of Western blots and elastin and collagen levels were determined colorimetrically. Results: The plaque content of cystatin C correlated with total elastin (r = 0.58, p = 0.001) and collagen (r = 0.50, p = 0.004), as well as with cross-linked forms of elastin (r = 0.42, p = 0.022) and collagen (r = 0.52, p = 0.003). Immunohistochemical analysis demonstrated that cystatin C colocalized with elastin and collagen. No correlation was seen between cystatin C and the amount of degraded elastin or collagen in plaques. Conclusion: The positive correlation between cystatin C levels and collagen and elastin levels in plaques supports the notion that cystatin C plays an important role in maintaining atherosclerotic plaque stability. Copyright (c) 2008 S. Karger AG, Basel.
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| 35. |
- Groussot, Xavier, et al.
(författare)
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The Rise of Procedural Rule of Law in the European Union - Historical and Normative Foundations
- 2021
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Ingår i: Rule of Law in the EU - 30 Years After the Fall of the Berlin Wall. - 9781509941599 - 9781509941605 ; :15
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Bokkapitel (refereegranskat)abstract
- The rule of law in the EU is not only substantive and formal, it is also procedural. From the early years of European integration until now – and this through the interpretative lens of either the terse Article 31 ECSC or the robust Article 19 TEU - the procedural rule of law has always been thriving and jolting in the case law of both the European Coal and Steal Community (ECSC) Court and the Court of Justice of the European Union (CJEU). Yet, in the last years, the place of the procedural rule of law in the European jurisprudence has increased significantly with the help of the newly drafted Article 19 TEU (replacing Article 220 EC, ex article 164 EEC) and the entry into force of the EU Charter of Fundamental Rights and notably its Article 47, which incorporates and codifies the general principle of effective judicial protection. Another reason of this contemporary rise of the procedural of law is the present ‘crisis context’ epitomized, for instance, by the state of economic emergency and the bailout case law of the CJEU. Claire Kilpatrick has relied on the concept of the procedural rule of law to show the malfunctioning of the EU judicial and administrative reviews of bailouts. Our contribution builds on her analysis, but is using a broader spectrum of investigation by not focusing merely on the situation of economic emergency and by tracing back the ‘procedural rule of law culture’ of the CJEU. We will inquire, therefore, the historical and normative foundations of the procedural rule of law by studying the roots of effet utile, effectiveness and effective judicial protection in the EU legal order and by viewing procedural effectiveness as idée directrice (directing idea) of EU Law. At the end of the historical circle, the ruling of the German Federal Constitutional Court in Weiss, from the 5th of May 2020, constitutes a great exemplification of the normative clash between the EU procedural rule of law applied in the context of economic emergency by the CJEU and a national judicial vision of the ‘proper’ standard of judicial review to be realized in such a situation. This contribution is divided into three parts. First, it maps the doctrinal debate on EU procedural law. In this section, it views the principle of effectiveness as the core ‘foundational’ norm of procedural rule of law. Second, it analyses the various applications of the procedural rule of law as procedural effectiveness in the CJEU case law by looking at effet utile, national procedural autonomy and effective judicial protection. This is done by tracking the historical roots of procedural effectiveness in the ECSC and CJEU Courts case law. Third, it uses the case law of the CJEU in the recent context of economic emergency as a test case of the application of the procedural rule of law.
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| 36. |
- Handlin, Linda, et al.
(författare)
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Effects of Sucking and Skin-to-Skin Contact on Maternal ACTH and Cortisol Levels During the Second Day Postpartum - Influence of Epidural Analgesia and Oxytocin in the Perinatal Period
- 2009
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Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 4:4, s. 207-220
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: In this study we made a detailed analysis of the mothers' release pattern of adreno-corticotropic hormone (ACTH) and cortisol during a breastfeeding session during the second day postpartum and related these patterns to maternal oxytocin levels as well to the duration of sucking and the duration of skin-to-skin contact before sucking the breast. Furthermore, we investigated if epidural analgesia and oxytocin administration during and after labor influenced the release pattern of ACTH and cortisol.Methods: Sixty-three primiparae were included in the study. Fourteen received oxytocin intramuscularly postpartum, nine received oxytocin infusion, 14 received epidural analgesia combined with oxytocin infusion, and six received epidural analgesia alone. Twenty mothers did not receive any of these medical interventions. Blood samples were analyzed for ACTH and cortisol by enzyme-linked immunoassay.Results: Both ACTH and cortisol levels fell significantly during the breastfeeding session. A significant negative relationship was found between oxytocin and ACTH levels, but not between oxytocin and cortisol levels. A contact before onset of sucking was significantly and negatively associated with lower cortisol levels, but not with ACTH levels. Cortisol levels differed significantly between mothers having received epidural analgesia with and without oxytocin.Conclusions: Breastfeeding is associated with a decrease of ACTH and cortisol levels. Skin-to-skin contact contributes to this effect. ACTH correlated negatively with the duration of sucking and median oxytocin levels, whereas cortisol levels correlated inversely with the duration of skin-to-skin contact preceding sucking, suggesting a partial dissociation between the mechanisms regulating ACTH and cortisol release. In addition, medical interventions in connection with birth influence the activity of the hypothalamic-pituitary-adrenal axis 2 days after birth.
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| 37. |
- Handlin, Linda, et al.
(författare)
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Influence of Common Birth Interventions on Maternal Blood Pressure Patterns During Breastfeeding 2 Days After Birth
- 2012
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Ingår i: Breastfeeding Medicine. - : Mary Ann Liebert. - 1556-8253 .- 1556-8342. ; 7:2, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study investigated possible influences of medical interventions during labor on maternal blood pressure during a breastfeed 2 days postpartum.Subjects and Methods: Sixty-six primiparae with normal deliveries were consecutively recruited. Blood pressure was measured at –5, 10, 30, and 60 minutes during a morning breastfeed 2 days postpartum. Five treatment groups were formed based on the medical interventions received during labor: Non-medicated mothers (Control group, n=21); mothers receiving epidural analgesia (EDA) with oxytocin (OT) stimulation (EDAOT group, n=14); mothers receiving EDA without OT stimulation (EDAnon-OT group, n=7); mothers receiving OT stimulation only (OT intravenously [iv] group, n=9); and mothers receiving 10 IU of OT intramuscularly (im) only (OT im group, n=15).Results: Baseline diastolic, but not systolic, blood pressure differed between the groups as displayed by significantly lower diastolic blood pressure in the EDAnon-OT group compared with the Control group, the OT iv group, and the EDAOT group (p=0.045, p=0.041, and p=0.024, respectively). Both systolic and diastolic blood pressure fell significantly during the breastfeeding session in the Control group (p=0.001 and p=0.004, respectively), the OT im group (p=0.006 and p=0.001, respectively), and the EDAOT group (p=0.028 and p=0.002, respectively), and the fall in diastolic blood pressure tended to be significant in the OT iv group (p=0.050). The duration of skin-to-skin contact before breastfeeding correlated positively with the decrease in systolic blood pressure in the OT im group (Rs=0.540, p=0.046).Conclusion: Administration of EDA during labor lowers baseline diastolic blood pressure and abolishes the fall in blood pressure in response to a breastfeed 2 days after birth.
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| 38. |
- Handlin, Linda, et al.
(författare)
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Short-Term Interaction between Dogs and Their Owners : Effects on Oxytocin, Cortisol, Insulin and Heart Rate-An Exploratory Study
- 2011
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Ingår i: Anthrozoos. - : Taylor & Francis. - 0892-7936 .- 1753-0377. ; 24:3, s. 301-315
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this exploratory study was to determine heart rate and the levels of oxytocin, cortisol, and insulin in dogs and their owners in response to a short-term interaction. In addition, the dogs' behavior was studied. The owners' responses were compared with those obtained from a control group. Ten female volunteers and their own male Labrador dogs participated in an experiment during which the owner stroked, petted, and talked with her dog during the first 3 minutes. Blood samples were collected from both dog and owner before (0) and at 1, 3, 5, 15, 30, and 60 minutes after the start of the interaction. Blood samples were analyzed by EIA. Heart rate was monitored telemetrically. The data were analyzed using linear mixed models and paired t-tests. The dogs' oxytocin levels were significantly increased 3 minutes after the start of the interaction (p = 0.027). Cortisol levels were significantly increased after 15 and 30 minutes (p = 0.004 and p = 0.022, respectively), and heart rate was significantly decreased after 55 minutes (p = 0.008). The dogs displayed normal behaviors during the experiment. The owners' oxylocin levels peaked between 1 and 5 minutes after interaction (p = 0.026). No such effect was seen in the controls. Cortisol levels displayed a significant decrease at 15 or 30 minutes in both owners and controls, and insulin levels did so at 60 minutes (p = 0.030, p = 0.002 and p = 0.002, p < 0.0001, respectively). Heart rate decreased significantly in the owners at 55 and 60 minutes (p = 0.0008) but not in the controls. In conclusion, short-term sensory interaction between dogs and their owners influences hormonal levels and heart rate. However, further studies need to be performed in order to better understand the effects of interaction between dogs and their owners.
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| 39. |
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| 40. |
- Holmbom, Martin, 1984-, et al.
(författare)
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Prehospital delay is an important risk factor for mortality in community-acquired bloodstream infection (CA-BSI) : a matched case–control study
- 2021
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:11
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to identify prehospital and early hospital risk factors associated with 30-day mortality in patients with blood culture-confirmed community-acquired bloodstream infection (CA-BSI) in Sweden.Methods A retrospective case–control study of 1624 patients with CA-BSI (2015–2016), 195 non-survivors satisfying the inclusion criteria were matched 1:1 with 195 survivors for age, gender and microorganism. All forms of contact with a healthcare provider for symptoms of infection within 7 days prior CA-BSI episode were registered. Logistic regression was used to analyse risk factors for 30-day all-cause mortality.Results Of the 390 patients, 61% (115 non-survivors and 121 survivors) sought prehospital contact. The median time from first prehospital contact till hospital admission was 13 hours (6–52) for non-survivors and 7 hours (3–24) for survivors (p<0.01). Several risk factors for 30-day all-cause mortality were identified: prehospital delay OR=1.26 (95% CI: 1.07 to 1.47), p<0.01; severity of illness (Sequential Organ Failure Assessment score) OR=1.60 (95% CI: 1.40 to 1.83), p<0.01; comorbidity score (updated Charlson Index) OR=1.13 (95% CI: 1.05 to 1.22), p<0.01 and inadequate empirical antimicrobial therapy OR=3.92 (95% CI: 1.64 to 9.33), p<0.01. In a multivariable model, prehospital delay >24 hours from first contact remained an important risk factor for 30-day all-cause mortality due to CA-BSI OR=6.17 (95% CI: 2.19 to 17.38), p<0.01.Conclusion Prehospital delay and inappropriate empirical antibiotic therapy were found to be important risk factors for 30-day all-cause mortality associated with CA-BSI. Increased awareness and earlier detection of BSI in prehospital and early hospital care is critical for rapid initiation of adequate management and antibiotic treatment.All data relevant to the study are included in the article or uploaded as supplemental information.
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| 41. |
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| 42. |
- Jonsson, Ulf, 1974-, et al.
(författare)
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Internet-delivered psychological treatment as an add-on to treatment as usual for common mental disorders : A systematic review with meta-analysis of randomized trials
- 2023
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 322, s. 221-234
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Psychological treatments for common mental disorders are increasingly being delivered remotely via the internet. Evidence suggests that internet-delivered cognitive behavioural therapy (iCBT) is superior to waitlist. However, the benefits are unclear of using this treatment modality as an add-on to treatment as usual (TAU) in regular healthcare.METHODS: The literature was systematically searched up to August 2021 for randomized trials of internet-delivered psychological treatments using TAU as the comparator. Eligible participants were diagnosed with depressive, anxiety, obsessive-compulsive, or trauma- and stress-related disorders. Outcomes of interest were symptoms, functioning, quality of life, healthcare utilization, and negative effects. Results were synthesized using random-effects meta-analyses. Quality of evidence was assessed using GRADE.RESULTS: The included studies evaluated iCBT for adults with depression (k = 9), depressive or anxiety disorders (k = 4), and post-traumatic stress disorder (k = 2) and were conducted in primary care or similar settings. For depression, low-certainty evidence suggested beneficial short-term effects on symptoms (g = -0.23; 95 % CI: = -0.37, -0.09), response rate (OR = 2.46; 1.31, 4.64), and remission (OR = 1.70; 1.19, 2.42;). The certainty of evidence was very low for long-term effects, other outcomes, and other disorders.LIMITATIONS: TAU varied across studies and was often insufficiently described.CONCLUSIONS: iCBT as a complement to usual care for adult with depression may result in a small incremental effect, which potentially could be clinically important. Studies are lacking for several common disorders and for children, adolescents, and the elderly. More robust studies of long-term effects are also needed, to better inform clinical decision-making.
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| 43. |
- Jönbrink, Anna Karin, et al.
(författare)
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Policy for Circular Economy : Prestudy for improved policy development
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This paper describes mainly the approach and results from a project “Polcirkeln” within the research program RE:Source, funded by three Swedish agencies: the Swedish Energy Agency, Vinnova and Formas. Polcirceln has studied the current situation and possible future effects of various measures for a circular economy. Among others, the EU's proposed policy package for a circular economy has been studied. A selection of today's flows of products, materials and waste constitutes a starting point and challenges and possible effects on material flows and sustainability have been formulated and analyzed based on experiences and views from different actors in the value chain (mainly from industry), and other experts. Methods used in the study are e.g. interviews, web-surveys, workshops and scenario analysis.The importance of Policies moving towards a more holistic approach to achieve more circular flows has been stressed by all stakeholders in the study described in the paper. Instead of dividing activities, obstacles and opportunities between waste, materials, production and consumption, a holistic approach should be introduced in the analysis of the challenges and designing of solutions. Another main finding is that a change to a Circular Economy needs an increased and developed cooperation between companies and other actors along the value chain, thus there is a need to develop policies in order to support the new improved ways for cooperation
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| 44. |
- Larsson, Anna-Karin, 1975-, et al.
(författare)
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Breaking Norms : Depictions of Violent Girls in Swedish Newspapers
- 2024
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Ingår i: Deviant behavior. - : Taylor & Francis. - 0163-9625 .- 1521-0456.
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the portrayal of girls engaged in violence within Swedish newspapers, focusing on contemporary representations in the media landscape. News media plays a pivotal role in shaping societal perceptions and norms, including those surrounding violence and gender. Analyzing media depictions of girls’ violence is crucial as it influences our understanding of gender norms and violence. We examined newspaper articles from 2021 to discern how violent girls were depicted, the portrayal of their actions, and whether they were given agency in the narratives. Utilizing gender theory with an intersectional lens, we scrutinized how Swedish media reported on and portrayed girls’ violence. Three key themes emerged: the characteristics of violent girls, the forms of violence, and explanations for their behavior. Notably, explanations for girls’ violence often focused narrowly on individual or relational factors, neglecting broader social contexts. Additionally, the girls were rarely given a platform to express their perspectives. Media portrayals positioned them as deviant from both feminine and violent norms, reinforcing societal stereotypes.
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| 45. |
- Larsson, Anna-Karin, 1975-, et al.
(författare)
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Våldsamma flickor
- 2024
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Ingår i: Texter om våld. - Örebro : Centrum för våldsstudier, Örebro universitet. - 2004-3775. ; :1, s. 17-24
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 46. |
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| 47. |
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| 48. |
- Laurell, Anna, et al.
(författare)
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Opposite Enantiomers from Minor Enantiomer Recycling and Dynamic Kinetic Resolution Using a Single Biocatalyst
- 2011
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Ingår i: European Journal of Organic Chemistry. - : Wiley. - 1434-193X .- 1099-0690. ; :20-21, s. 3980-3984
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Tidskriftsartikel (refereegranskat)abstract
- A one-pot recycling procedure comprising Lewis acid catalyzed enantioselective addition of acetyl cyanide to (E)-2-butenal to give the O-acetylated cyanohydrin and enzyme-catalyzed conversion of the minor product enantiomer back to (E)-2-butenal provided essentially enantiopure (2R,3E)-2-acetoxy-3-pentenenitrile in close to quantitative yield. The opposite enantiomer was obtained, albeit in lower yield and with lower enantiomeric purity than that observed from the minor enantiomer recycling, by dynamic kinetic resolution consisting of reversible addition of HCN to the aldehyde coupled to enzyme-catalyzed acetylation of the cyanohydrin.
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| 49. |
- Laurell Nash, Anna
(författare)
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Development and Studies of the Processes Involved in Minor Enantiomer Recycling
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis describes the development and rationalization of processes involved in a new methodology developed in our group, minor enantiomer recycling.The first part of the thesis addresses mechanistic studies of one of the reactions involved in minor enantiomer recycling, dual Lewis acid-Lewis base catalyzed acetylcyanation of aldehydes. The methodology uses a combination of a chiral titanium-salen complex with a tertiary amine as a catalytic system in the enantioselective synthesis of O-acylated cyanohydrins from aldehydes and ketonitriles. Mechanistic investigations revealed that the rate-determining step in the reaction changes, depending on the nature of the aldehyde that was used. It was also concluded that cyanohydrin is coordinated to the Lewis acid in the acylation step.The second part of the thesis deals with minor enantiomer recycling, a highly selective one-pot recycling system. In a first step the product is formed as a minor and a major enantiomer by asymmetric catalysis. Recycling of the minor enantiomer, by selective kinetic resolution, regenerates the starting material. Continuous addition of a second reagent, also involved in a coupled exergonic process, leads to an increase of both yield and enantiomeric excess. Recycling procedures for the synthesis of O-acylated and O-formylated cyanohydrins have been developed with high yield and high enantiomeric excess of the products. The study includes development of the systems, comparison to other methodologies in asymmetric catalysis, and attempts to understand the processes involved.
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| 50. |
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