| 1. |
- Franklin, Karl, et al.
(författare)
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Early life environment and snoring in adulthood
- 2008
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Ingår i: Respiratory Research. - : Springer Science and Business Media LLC. - 1465-9921 .- 1465-993X. ; 9:1, s. 63-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To our knowledge, no studies of the possible association of early life environment with snoring in adulthood have been published. We aimed to investigate whether early life environment is associated with snoring later in life. METHODS: A questionnaire including snoring frequency in adulthood and environmental factors in early life was obtained from 16,190 randomly selected men and women, aged 25-54 years, in Sweden, Norway, Iceland, Denmark and Estonia (response rate 74%). RESULTS: A total of 15,556 subjects answered the questions on snoring. Habitual snoring, defined as loud and disturbing snoring at least 3 nights a week, was reported by 18%. Being hospitalized for a respiratory infection before the age of two years (adjusted odds ratio (OR) = 1.27; 95% confidence interval (CI) 1.01-1.59), suffering from recurrent otitis as a child (OR = 1.18; 95%CI 1.05-1.33), growing up in a large family (OR = 1.04; 95%CI 1.002-1.07) and being exposed to a dog at home as a newborn (OR = 1.26; 95%CI 1.12-1.42) were independently related to snoring later in life and independent of a number of possible confounders in adulthood. The same childhood environmental factors except household size were also related with snoring and daytime sleepiness combined. CONCLUSION: The predisposition for adult snoring may be partly established early in life. Having had severe airway infections or recurrent otitis in childhood, being exposed to a dog as a newborn and growing up in a large family are environmental factors associated with snoring in adulthood.
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| 2. |
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| 3. |
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| 5. |
- Jönsson, Elias, et al.
(författare)
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Pulmonary fibrosis in relation to genetic loci in an inception cohort of patients with early rheumatoid arthritis from northern Sweden
- 2022
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Ingår i: Rheumatology. - : British Society for Rheumatology. - 1462-0324 .- 1462-0332. ; 61:3, s. 943-952
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Pulmonary manifestations in RA are common comorbidities. Interstitial lung disease (ILD), both idiopathic and in RA, has been associated with several genetic variants. We assessed pulmonary fibrosis (PF) in an inception cohort of RA patients in relation to genetic variants and disease-related factors.METHODS: A total of 1466 early RA patients were consecutively included and followed prospectively from the index date until death or 31 December 2016. Clinical and laboratory data and treatment were continuously registered according to the Swedish Rheumatology Quality Register. DNA was available from 1184 patients and 571 151 genome-wide single-nucleotide polymorphisms (SNPs) were analysed. Thirteen identified genetic variants were extracted. At follow-up, the patients answered a questionnaire regarding disease progression and lung involvement that was validated by reviewing medical records and analysing radiological examinations.RESULTS: The prevalence of PF was 5.6% and the annualized incidence rate was 5.0/1000 (95% CI 3.80, 6.54). Four SNPs were associated with PF in RA: rs35705950 [MUC5B; OR 2.5 (95% CI 1.5, 4.0), adjusted P-value = 0.00016, q-value = 0.0021]; rs111521887 [TOLLIP; OR 1.9 (95% CI 1.3, 2.8), adjusted P-value = 0.0014, q-value = 0.0092]; rs2609255 [FAM13A; OR 1.7 (95% CI 1.1, 2.5), adjusted P-value = 0.013, q-value = 0.055] and rs2736100 [TERT; OR 1.5 (95% CI 1.0, 2.2), adjusted P-value = 0.046, q-value = 0.15]. Older age and RF positivity were associated with increased risk, while MTX treatment was associated with a lower risk of PF.CONCLUSIONS: Development of PF in an inception cohort of RA patients was associated with 4 of 12 ILD risk genes. RA-related factors except for age at diagnosis and RF positivity were of limited importance in PF development.
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| 6. |
- Alshamari, Muhammed, 1975-, et al.
(författare)
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Diagnostic accuracy of low-dose CT compared with abdominal radiography in non-traumatic acute abdominal pain : prospective study and systematic review
- 2016
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Ingår i: European Radiology. - New York : Springer. - 0938-7994 .- 1432-1084. ; 26:6, s. 1766-1774
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Abdominal radiography is frequently used in acute abdominal non-traumatic pain despite the availability of more advanced diagnostic modalities. This study evaluates the diagnostic accuracy of low-dose CT compared with abdominal radiography, at similar radiation dose levels.Methods: Fifty-eight patients were imaged with both methods and were reviewed independently by three radiologists. The reference standard was obtained from the diagnosis in medical records. Sensitivity and specificity were calculated. A systematic review was performed after a literature search, finding a total of six relevant studies including the present.Results: Overall sensitivity with 95 % CI for CT was 75 % (66-83 %) and 46 % (37-56 %) for radiography. Specificity was 87 % (77-94 %) for both methods. In the systematic review the overall sensitivity for CT varied between 75 and 96 % with specificity from 83 to 95 % while the overall sensitivity for abdominal radiography varied between 30 and 77 % with specificity 75 to 88 %.Conclusions: Based on the current study and available evidence, low-dose CT has higher diagnostic accuracy than abdominal radiography and it should, where logistically possible, replace abdominal radiography in the workup of adult patients with acute non-traumatic abdominal pain.Key points: • Low-dose CT has a higher diagnostic accuracy than radiography. • A systematic review shows that CT has better diagnostic accuracy than radiography. • Radiography has no place in the workup of acute non-traumatic abdominal pain.
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| 7. |
- Alshamari, Muhammed, 1975-, et al.
(författare)
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Impact of iterative reconstruction on image quality of low-dose CT of the lumbar spine
- 2017
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Ingår i: Acta Radiologica. - London : Sage Publications. - 0284-1851 .- 1600-0455. ; 58:6, s. 702-709
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Tidskriftsartikel (refereegranskat)abstract
- Background: Iterative reconstruction (IR) is a recent reconstruction algorithm for computed tomography (CT) that can be used instead of the standard algorithm, filtered back projection (FBP), to reduce radiation dose and/or improve image quality.Purpose: To evaluate and compare the image quality of low-dose CT of the lumbar spine reconstructed with IR to conventional FBP, without further reduction of radiation dose.Material and Methods: Low-dose CT on 55 patients was performed on a Siemens scanner using 120 kV tube voltage, 30 reference mAs, and automatic dose modulation. From raw CT data, lumbar spine CT images were reconstructed with a medium filter (B41f) using FBP and four levels of IR (levels 2-5). Five reviewers scored all images on seven image quality criteria according to the European guidelines on quality criteria for CT, using a five-grade scale. A side-by-side comparison was also performed.Results: There was significant improvement in image quality for IR (levels 2-4) compared to FBP. According to visual grading regression, odds ratios of all criteria with 95% confidence intervals for IR2, IR3, IR4, and IR5 were: 1.59 (1.39-1.83), 1.74 (1.51-1.99), 1.68 (1.46-1.93), and 1.08 (0.94-1.23), respectively. In the side-by-side comparison of all reconstructions, images with IR (levels 2-4) received the highest scores. The mean overall CTDIvol was 1.70 mGy (SD 0.46; range, 1.01-3.83 mGy). Image noise decreased in a linear fashion with increased strength of IR.Conclusion: Iterative reconstruction at levels 2, 3, and 4 improves image quality of low-dose CT of the lumbar spine compared to FPB.
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| 8. |
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| 9. |
- Alshamari, Muhammed, 1975-, et al.
(författare)
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Low-dose computed tomography of the lumbar spine: a phantom study on imaging parameters and image quality
- 2014
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Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 55:7, s. 824-832
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lumbar spine radiography has limited diagnostic value but low radiation dose compared with computed tomography (CT). The average effective radiation dose from lumbar spine radiography is about 1.1 mSv. Low-dose lumbar spine CT may be an alternative to increase the diagnostic value at low radiation dose, around 1 mSv. Purpose: To determine the optimal settings for low-dose lumbar spine CT simultaneously aiming for the highest diagnostic image quality possible. Material and Methods: An ovine lower thoracic and lumbar spine phantom, with all soft tissues around the vertebrae preserved except the skin, was placed in a 20 L plastic container filled with water. The phantom was scanned repeatedly with various technical settings; different tube potential, reference mAs, and with different convolution filters. Five radiologists evaluated the image quality according to a modification of the European guidelines for multislice computed tomography (MSCT) quality criteria for lumbar spine CT 2004. In a visual comparison the different scans were also ranked subjectively according to perceived image quality. Image noise and contrast were measured. Results: A tube potential of 120 kV with reference mAs 30 and medium or medium smooth convolution filter gave the best image quality at a sub-millisievert dose level, i.e. with an effective dose comparable to that from lumbar spine radiography. Conclusion: Low-dose lumbar spine CT thus opens a possibility to substitute lumbar spine radiography with CT without obvious increase in radiation dose.
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| 10. |
- Alshamari, Muhammed, 1975-, et al.
(författare)
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Low dose CT of the lumbar spine compared with radiography : a study on image quality with implications for clinical practice
- 2016
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Ingår i: Acta Radiologica. - London, United Kingdom : Sage Publications. - 0284-1851 .- 1600-0455. ; 57:5, s. 602-611
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lumbar spine radiography is often performed instead of CT for radiation dose concerns.Purpose: To compare image quality and diagnostic information from low dose lumbar spine CT at an effective dose of about 1 mSv with lumbar spine radiography.Material and Methods: Fifty-one patients were examined by both methods. Five reviewers scored all examinations on eight image quality criteria using a five-graded scale and also assessed three common pathologic changes.Results: Low dose CT scored better than radiography on the following: sharp reproduction of disc profile and vertebral end-plates (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.3-2.5), intervertebral foramina and pedicles (OR, 4.3; 95% CI, 3.1-5.9), intervertebral joints (OR, 139; 95% CI, 59-326), spinous and transverse processes (OR, 7.0; 95% CI, 4.3-11.2), sacro-iliac joints (OR, 4.2; 95% CI, 3.2-5.7), reproduction of the adjacent soft tissues (OR, 2.9; 95% CI, 2.1-4.0), and absence of any obscuring superimposed gastrointestinal gas and contents (OR, 188; 95% CI, 66-539). Radiography scored better on sharp reproduction of cortical and trabecular bone (OR, 0.3; 95% CI, 0.2-0.4). The reviewers visualized disk degeneration, spondylosis/diffuse idiopathic skeletal hyperostosis (DISH) and intervertebral joint osteoarthritis more clearly and were more certain with low dose CT. Mean time to review low dose CT was 204 s (95% CI, 194-214 s.), radiography 152 s (95% CI, 146-158 s.). The effective dose for low dose CT was 1.0-1.1 mSv, for radiography 0.7 mSv.Conclusion: Low dose lumbar spine CT at about 1 mSv has superior image quality to lumbar spine radiography with more anatomical and diagnostic information.
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| 11. |
- Amanda, Demir, et al.
(författare)
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The Influence of Mesenteric Defects Closure on the Use of Computed Tomography for Abdominal Pain 5 Years After Laparoscopic Gastric Bypass-a Post Hoc Analysis of a Randomized Clinical Trial
- 2022
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Ingår i: Obesity Surgery. - : Springer. - 0960-8923 .- 1708-0428. ; 32:2, s. 266-272
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Abdominal pain after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common and unwanted complication that typically leads to further exploration through radiology. Concerns have been raised regarding the consequences of this radiation exposure and its correlation with the lifetime risk of cancer. The aim of this study was to evaluate the differences in computed tomography (CT) use between LRYGB patients with open and closed mesenteric defects and to assess the radiological findings and radiation doses.METHODS: This subgroup analysis included 300 patients randomized to either closure (n = 150) or nonclosure (n = 150) of mesenteric defects during LRYGB. The total number of CT scans performed due to abdominal pain in the first 5 postoperative years was recorded together with the radiological findings and radiation doses.RESULTS: A total of 132 patients (44%) underwent 281 abdominal CT scans, including 133 scans for 67 patients with open mesenteric defects (45%) and 148 scans for 65 patients with closed mesenteric defects (43%). Radiological findings consistent with small bowel obstruction or internal hernia were found in 31 (23%) of the scans for patients with open defects and in 18 (12%) of the scans for patients with closed defects (p = 0.014). The other pathological and radiological findings were infrequent and not significantly different between groups. At the 5-year follow-up, the total radiation dose was 82,400 mGy cm in the nonclosure group and 85,800 mGy cm in the closure group.CONCLUSION: Closure of mesenteric defects did not influence the use of CT to assess abdominal pain.
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| 12. |
- Andersson, Karin M., 1989-, et al.
(författare)
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Metal artefact reduction in CT imaging of hip prostheses-an evaluation of commercial techniques provided by four vendors
- 2015
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 88:1052
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to evaluate commercial metal artefact reduction (MAR) techniques in X-ray CT imaging of hip prostheses.Methods: Monoenergetic reconstructions of dual-energy CT (DECT) data and several different MAR algorithms, combined with single-energy CT or DECT, were evaluated by imaging a bilateral hip prosthesis phantom. The MAR images were compared with uncorrected images based on CT number accuracy and noise in different regions of interest.Results: The three MAR algorithms studied implied a general noise reduction (up to 67%, 74% and 77%) and an improvement in CT number accuracy, both in regions close to the prostheses and between the two prostheses. The application of monoenergetic reconstruction, without any MAR algorithm, did not decrease the noise in the regions close to the prostheses to the same extent as did the MAR algorithms and even increased the noise in the region between the prostheses.Conclusion: The MAR algorithms evaluated generally improved CT number accuracy and substantially reduced the noise in the hip prostheses phantom images, both close to the prostheses and between the two prostheses. The study showed that the monoenergetic reconstructions evaluated did not sufficiently reduce the severe metal artefact caused by large orthopaedic implants.Advances in knowledge: This study evaluates several commercially available MAR techniques in CT imaging of large orthopaedic implants.
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| 13. |
- Andersson, Karin M., 1989-, et al.
(författare)
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Metal Artifacts in CT Imaging of Hip Prostheses : Evaluation of Metal Artifact Reduction Techniques Provided by Four Vendors
- 2015
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- PURPOSE: The aim of this study was to evaluate metal artifact reduction (MAR) techniques, provided by four vendors, in CT imaging of hip prostheses.METHOD AND MATERIALS: A water phantom containing hip prostheses mounted in calf bones was scanned with four CT scanners; Philips Ingenuity; Toshiba Aquilion ONE Vision edition; GE Discovery 750 HD and Siemens SOMATOM Definition Flash. An uncorrected (reference) image was obtained for every CT and compared with images acquired with the scanner specific MAR technique; either monoenergetic reconstruction of Dual Energy CT (DECT) data (GE and Siemens) or the use of a MAR algorithm software (Philips and Toshiba), or a combination of the two (GE). The MAR techniques were applied for varying tube voltage, kernel and reconstruction technique. The reference images were quantitatively compared to the MAR images by analyzing the noise and the CT number accuracy in region of interests (ROIs). Visual grading was performed by five radiologists based on ten image quality (IQ) criteria.RESULTS: The MAR algorithms implied a general noise reduction (by up to 77%) and improved IQ based on the majority of the visual grading criteria. The use of monoenergetic reconstructions of DECT data, without any MAR algorithm, did not decrease the noise in the ROIs to the same extent as the MAR algorithms (up to 41%) and did even increase the noise in one ROI. The visual grading evaluation showed that monoenergetic reconstructions in general degraded the IQ for one of the DECT scanners and improved the IQ for only a few of the criteria for the other DECT scanner.CONCLUSION: The quantitative analysis and the visual grading evaluation showed that the IQ was generally improved when the MAR algorithms were used. However, additional artifacts and degradation of the IQ were noted in some MAR image regions. The use of monoenergetic reconstruction was concluded to not reduce metal artifacts to the same extent as the MAR algorithms and to even degrade the IQ in several image regions.CLINICAL RELEVANCE/APPLICATION: This study points out advantages and potential risks of using MAR techniques in CT imaging of hip prostheses and will be useful for clinics when optimizing CT scan protocols and purchasing new CT systems.
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| 14. |
- Andersson, Karin M., 1989-, et al.
(författare)
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Visual grading evaluation of commercially available metal artefact reduction techniques in hip prosthesis computed tomography
- 2016
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Ingår i: British Journal of Radiology. - London, United Kingdom : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 89:1063
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate metal artefact reduction (MAR) techniques from four computed tomography (CT) vendors in hip prosthesis imaging.Methods: Bilateral hip prosthesis phantom images, obtained by using MAR algorithms for single energy CT data or dual energy CT (DECT) data and by monoenergetic reconstructions of DECT data, were visually graded by five radiologists using ten image quality criteria. Comparisons between the MAR images and a reference image were performed for each scanner separately. Ordinal probit regression analysis was used.Results: The MAR algorithms in general improved the image quality based on the majority of the criteria (up to between 8/10 and 10/10) with a statistically improvement in overall image quality (P<0.001). However, degradation of image quality, such as new artefacts, was seen in some cases. A few monoenergetic reconstruction series improved the image quality (P<0.004) for one of the DECT scanners, but it was only improved for some of the criteria (up to 5/10). Monoenergetic reconstructions resulted in worse image quality for the majority of the criteria (up to 7/10) for the other DECT scanner.Conclusions: The MAR algorithms improved the image quality of the hip prosthesis CT images. However, since additional artefacts and degradation of image quality were seen in some cases, all algorithms should be carefully evaluated for every clinical situation. Monoenergetic reconstructions were in general concluded to be insufficient for reducing metal artifacts. Advances in knowledge: Qualitative evaluation of the usefulness of several MAR techniques from different vendors in CT imaging of hip prosthesis.
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| 15. |
- Andersson, Karin, 1989-
(författare)
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Metal artifacts in computed tomography : impact of reduction methods on image quality and radiotherapy treatment planning
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Degradation of image quality by metal artifacts is a common problem in computed tomography (CT) imaging, which can limit the diagnostic value of a CT examination and also introduce inaccuracies in radiotherapy (RT) treatment planning. In recent years, commercial metal artifact reduction (MAR) methods have been launched by several CT vendors. The overall aim of this thesis was to evaluate MAR methods in diagnostic imaging and RT treatment planning.Evaluations of hip prosthesis phantom CT images showed that MAR algorithms in general improved image quality, based on both visual grading analysis and quantitative measures, while the application of virtual monoenergetic reconstructions insufficiently reduced metal artifacts. In some cases additional artifacts were introduced by the MAR algorithms. MAR algorithms were also evaluated in hip prosthesis phantom CT imaging used for proton therapy treatment planning, where improvements in dose calculation accuracy were observed.Studies of Head & Neck (H&N) implant CT images in RT treatment planning were also performed. By visual grading of anatomy visualization with respect to target delineation in dental implant patient images, MAR algorithms were shown to significantly improve image quality. However, only minor effects of H&N implant artifacts on proton dose distributions were seen. The impact might be greater for more severe artifacts than those studied here, and thus further investigations of such cases are needed.In conclusion, MAR algorithms have been shown to enhance image quality for diagnostic applications and to improve anatomy visualization in RT treatment planning. The MAR algorithms led to increased proton dose calculation accuracy in some cases, while in other situations only minor changes were seen.
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| 16. |
- Andresen, Erika, et al.
(författare)
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Non-medical formula use in newborn infants still common at two Swedish hospitals after a breastfeeding support program.
- 2023
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Ingår i: Acta Paediatrica. - 0803-5253 .- 1651-2227. ; 112:10, s. 2121-2128
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the effectiveness of a breastfeeding support programme on reducing infant formula use and to investigate indications for formula in newborn infants in Sweden.METHODS: A quasi-experimental study design was carried out. It included 255 mother-infant pairs in a control group, who received standard care and 254 pairs in an intervention group, who took part in a breastfeeding support programme. Data were collected by reviewing patient records from two regional hospitals in Uppsala and Gotland and recruitment took place between 2017 and 2019.RESULTS: Median age of mothers were 31 years (range 20-49) and median gestational age of infants were 39 + 6 weeks/days (range 37 + 0 to 42 + 4). The intervention did not reduce infant formula use. In total, 87/507 (17%) of the infants received formula. Among children receiving formula 30/87 (34%) had a medical indication, whereas 57/87 (66%) had no medical indication. Main reasons for medically indicated formula use were hypoglycaemia, 13/30 (43%), and weight loss, 13/30 (43%). Main reasons for non-medical use were mothers'/parents' wishes, 25/57 (44%) and infants' dissatisfaction, 11/57 (19%).CONCLUSION: Continued efforts are needed to develop effective breastfeeding interventions with increased focus on infant formula reduction.
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| 17. |
- Berg, Eva, et al.
(författare)
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Assessing performance of supply chain risk management programmes : A tentative approach
- 2008
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Ingår i: International Journal of Risk Assessment and Management. - 1466-8297. ; 9:3, s. 288-310
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Forskningsöversikt (refereegranskat)abstract
- This exploratory study provides initial directions about how risk management programmes could be assessed in a supply chain setting and discusses how such a measurement system could be designed. Measures are needed both for the management to evaluate the success of actions taken in supply chain risk management, as well as for the (supply chain) risk manager to communicate the value of his work. A number of indicators could show whether it is successful, for example, in reducing risk consequences, addressing the right risk sources and developing the right risk management processes. A central question within assessing risk management programmes is how to link risk management activities to outcomes. A tentative framework, based on a quality model, is proposed to assess the performance of supply chain risk management work. It highlights the importance of trying to capture both the capabilities of supply chain risk management and the results of the work.
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| 18. |
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| 19. |
- de Maré, Lena, et al.
(författare)
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A cultivation technique for E. coli fed-batch cultivations operating close to the maximum oxygen transfer capacity of the reactor
- 2005
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Ingår i: Biotechnology Letters. - : Springer Science and Business Media LLC. - 0141-5492 .- 1573-6776. ; 27:14, s. 983-990
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Tidskriftsartikel (refereegranskat)abstract
- A cultivation strategy combining the advantages of temperature-limited fed-batch and probing feeding control is presented. The technique was evaluated in fed-batch cultivations with E. coli BL21(DE3) producing xylanase in a 3 liter bioreactor. A 20% increase in cell mass was achieved and the usual decrease in specific enzyme activity normally observed during the late production phase was diminished with the new technique. The method was further tested by growing E. coli W3110 in a larger bioreactor (50 l). It is a suitable cultivation technique when the O2 transfer capacity of the reactor is reached and it is desired to continue to produce the recombinant protein.
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| 20. |
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| 21. |
- Fuchtbauer, Laila, et al.
(författare)
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Increased Number of Retinal Vessels in Acromegaly.
- 2020
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Ingår i: European journal of endocrinology. - 1479-683X. ; 182:3, s. 293-302
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Tidskriftsartikel (refereegranskat)abstract
- Excess of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), as in acromegaly, is associated with an increased risk of diabetes, but whether retinal vessels are altered is unknown. The aim of this study was to evaluate retinal vessel morphology in patients with acromegaly at diagnosis and after treatment and to describe the prevalence of diabetic retinopathy in patients with long-standing acromegaly and diabetes.Two independent observational studies, one being prospective and the other retrospective and cross-sectional.Retinal vessel morphology of 26 patients with acromegaly was examined at diagnosis and 1 year after treatment and compared to 13 healthy controls. Cross-sectional evaluation of 39 patients with long-standing acromegaly and diabetes was performed. Fundus photographs were digitally analyzed for vessel morphology.Patients with acromegaly had a median (interquartile range) of 34.3 (30.0-39.0) vessel branching points compared to 27.0 (24.0-29.0) for healthy controls (P < 0.001). Tortuosity of arterioles and venules remained unchanged. Vessel morphology did not change significantly after treatment. Patients with acromegaly and diabetes for a median of 14 years also had a high number of branching points [34.2 (32.5-35.6)], but the prevalence of diabetic retinopathy was not higher than expected in diabetic patients without acromegaly.Patients with acromegaly have an increased number of vascular branching points in the retina without an alteration of macroscopic vessel morphology. This is consistent with an angiogenic effect of GH/IGF-1 in humans. The prevalence of diabetic retinopathy was not increased in patients with acromegaly and diabetes.
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| 22. |
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| 23. |
- Geijer, Håkan, et al.
(författare)
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Optimizing the tube potential for lumbar spine radiography with a flat-pane digital detector
- 2009
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Ingår i: British Journal of Radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 82:973, s. 62-68
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to find the optimal settings for lumbar spine radiography with a flat-panel detector. A CDRAD contrast-detail phantom was imaged at various tube potentials, system speeds and filtration settings. Factorial experiments yielded a range of optimized exposure settings, which were submitted to visual grading analysis with images of an Alderson phantom. The first optimized settings involved a system speed increase from 400 to 800. For anteroposterior projection, the optimal tube potential was reduced from the default of 77 kV to 60 kV to give the best image quality without increasing the effective dose, or to 66 kV to give the lowest dose without reducing image quality. For lateral projection, the tube potential was similarly reduced from the default of 90 kV to 70 kV or 77 W. Visual grading analysis confirmed the results, with significantly better image quality when optimizing for image quality. The study thus shows that the tube potential can be reduced as long as the system speed is increased simultaneously. This leads to a lower effective dose and/or increased image quality depending on the settings chosen. The factorial experiments provided a powerful way to evaluate several parameters concomitantly.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
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| 28. |
- Holm, Mathias, 1969, et al.
(författare)
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Remission of asthma : a prospective longitudinal study from northern Europe (RHINE study).
- 2007
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 30:1, s. 62-5
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to investigate the remission rate of adult asthma in a general population sample in relation to age, sex, asthma symptoms, allergic rhinitis and smoking. A follow-up of the random population samples from the European Community Respiratory Health Survey in Northern Europe was conducted from 1999-2001 on 1,153 individuals (aged 2653 yrs) with reported asthma. Remission was defined as no asthmatic symptoms in two consecutive years and no current use of asthma medication. Remission rates per 1,000 personyrs were calculated and Cox regression models, adjusting for confounders, were used to estimate hazard ratios (HR) with 95% confidence intervals (Cl). An average remission rate of 20.2 per 1,000 person-yrs was found. There was no significant difference according to sex; the remission rates were 21.7 and 17.8 per 1,000 person-yrs in females and males, respectively. An increased remission rate was observed among subjects who quit smoking during the observation period. Subjects not reporting any asthma symptom at baseline had an increased remission rate. In the Cox regression model, ex-smoking (HR 1.65, 95% Cl 1.01-2.71) was associated with increased remission rate, and reporting any asthma symptom at baseline was associated with decreased remission rate (HR 0.7, 95% Cl 0.40-0.90). In conclusion, the present prospective longitudinal study showed that quitting smoking and the presence of mild disease appeared to favour remission.
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| 29. |
- Hunter, Erik, et al.
(författare)
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Quantifying differences in alternative food network supply chain activities and their relationship with socio-economic outcomes
- 2022
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Ingår i: International Food and Agribusiness Management Review. - 1559-2448. ; 25:1, s. 83-101
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Tidskriftsartikel (refereegranskat)abstract
- Alternative food networks (AFNs) have the potential to enhance and redistribute value in favour of producers and consumers through novel ways of organizing supply chain activities. What is more, AFNs are often characterized by their ‘sustainability promise’ – or the idea that their networks foster social, ecological or environmental improvements over conventional food networks. Based on a purposive sample of 286 producers across five Swedish AFNs (i.e. community supported agriculture, REKO-rings, farmers’ markets, farm stores and food nodes), we explore how differences in how supply chain activities are managed and relate them to profitability, fair wages, cooperation, logistics efforts, happiness and future beliefs. Using a combination of correlation analysis, linear regression and means comparisons, we challenge the notion that AFNs achieve their sustainability promise or enhance value through novel combinations of supply chain activities. Our findings include several key differences in how supply chain management (SCM) activities are organized across AFNs and their variant importance for profitability. Moreover, we find significant differences in happiness across AFNs that are better explained through beliefs about the future than profitability or fair wages. By exploring happiness and profitability, we offer insights into why some AFN actors thrive despite poor economic returns.
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| 30. |
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| 31. |
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| 32. |
- Laerum, Birger N, et al.
(författare)
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Young maternal age at delivery is associated with asthma in adult offspring
- 2007
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 101:7, s. 1431-1438
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Some studies have shown an association between lower maternal age at delivery and increased asthma in children and young adults. It is unclear whether this represents an effect of maternal ageing or a protective effect of siblings. In a North-European population based study, we investigated whether mother's age at delivery was associated with risk for asthma and hay fever in adult offspring, taking into account relevant confounders. Methods: A total of 16,190 subjects (74%) aged 23-54yr answered a postal questionnaire in a follow-up of the European Community Respiratory Health Survey (ECRHS I). Results: The associations of maternal age at delivery with hay fever, respiratory symptoms and diagnosed asthma were analysed using logistic regression, adjusting for household size, dwelling, parental education, centre, gender, adult hay fever, smoking, age and body mass index (BMI). The adjusted odds ratios (95% CI) for wheeze with breathlessness, wheeze without a cold and asthma in the offspring were 0.94 (0.90-0.99), 0.89 (0.86-0.94) and 0.92 (0.88-0.97), respectively, per 5yr increase in maternal age. No heterogeneity between centres was found (p = 0.84). The estimates remained similar in sub-sample analyses when adjusting for siblings, maternal smoking (n = 3109) and for birth weight (n = 1686). Hay fever was more common among those with the youngest and oldest mothers. Conclusions: In this large North-European multi-centre study, asthma was less common with increasing maternal age. This effect was consistent between centres and persisted with adjustment for several potential confounders, suggesting that the association may possibly be explained by biological changes related to maternal ageing.
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| 33. |
- Molin, Fredrik, 1977-, et al.
(författare)
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Transformational Change and Digitalization-The Case of the Swedish Road and Transport Administration
- 2023
-
Ingår i: Behavioral Sciences. - : MDPI. - 2076-328X. ; 13:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Digitalization is one of the drivers of change in both public and private organizations. It is therefore relevant to understand how a government agency like the Swedish Transport Administration manage and experience change.Methods: In this qualitative study, interviews (n = 15) with respondents with insight and connection to digitalization and change highlight factors related to digitalization and change-capacity within the agency.Results: The results of the interviews are presented in a thematic analysis. Five themes were identified: Digitalization, management control, stability requirements, organizational culture, and lack of a comprehensive view. The research literature in the field of change creates a fund for a discussion about the Administration's situation regarding digitalization, development, and transformational change.Conclusions: The results indicate that the Transport Administration still has a long way to travel in terms of organizational readiness for change. To address this issue, the Transport Administration should prioritize the development and implementation of a comprehensive change management strategy including clear communication, active engagement, and participation from all employees, and a focus on building a culture of adaptability and continuous improvement.
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| 34. |
- Neuman, Åsa, et al.
(författare)
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Dyspnea in relation to symptoms of anxiety and depression : A prospective population study
- 2006
-
Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 100:10, s. 1843-1849
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Respiratory symptoms are related to anxiety and depression in several cross-sectional studies but the association has not been explored in longitudinal studies. Study objectives: To prospectively study the change in dyspnea in relation to symptoms of anxiety and depression over a 9-year time period. Methods: The study comprised of 515 adults from a population sample who had participated in the European Commission Respiratory Health Survey (ECRHS) I in 1991-1992 and in the ECRHS II in 1999-2000. The questionnaire included a modified British Medical Research Council Scale for dyspnea grading and the Hospital Anxiety and Depression scale questionnaire. Results: The prevalence of dyspnea was 10.7% in the first and 12.6% in the second survey. Symptoms of depression was an independent determinants for dyspnea in both surveys (OR (95% CI) 3.72 (1.51-9.17) and 3.40 (1.49-7.80), respectively). In subjects that did not have dyspnea at the first survey onset of symptoms of anxiety (OR 3.53 (1.03-12.1)) and depression (OR 12.2 (3.97-37.5)) were significantly related to having dyspnea at the second survey, whereas onset of dyspnea was not significantly associated with developing symptoms of anxiety or depression when each disorder was entered separately. Conclusion: Our data indicates that there is a causal relationship between development of symptoms of anxiety and depression and dyspnea. Psychological status is therefore an important factor to consider both when evaluating the results of epidemiological respiratory studies and in clinical settings when treating patients that have dyspnea.
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| 35. |
- Norrman, Andreas, et al.
(författare)
-
Logistikutmaningar, lönsamhet och tillfredsställelse i svenska alternativa korta matkanaler
- 2020
-
Rapport (populärvet., debatt m.m.)abstract
- Projektet handlar om logistiska utmaningar för små matproducenter som prövar nya mer direkta distributionskanaler, s.k. alternativa korta matkanaler (AKM). Denna växande rörelse syftar till att kortsluta konventionella långa försörjningskedjor med stora livsmedelsproducenter, grossister och butikskedjor. AKM är t.ex. traditionella gårdsbutiker, torghandel (t.ex. i form av Bondens marknad) och andelsjordbruk (CSA) men även nya fenomen som Reko-ringar och Lokala matnoder har spridits snabbt senaste åren. Vissa små matproducenter försöker genom AKM få mer av ”matkronan” och öka sin lönsamhet. För andra aktörer kommer inte ekonomi i första hand, utan drivkrafterna kan vara mer ideologiskt värderingsgrundade. Oavsett drivkraft, borde AKM bidra till en mer levande landsbygd.Logistik och försörjningskedjor (SCM) är viktigt att förstå för att få mat från ”jord till bord” eller ”hage till mage”, och handlar om att skapa effektiva flöden av varor, information och betalningar. Vissa AKM innebär direktkontakt mellan producent och konsument, där bonden själv försöker utföra den logistik och försäljning som tidigare de större specialiserade aktörerna gjort. I andra AKM uppstår nya mellanhänder för att överbrygga gap i logistikflöden. Projektet undersöker erfarenheter från logistiska utmaningar som olika alternativa korta matkanaler skapar, och hur olika sätt att arbeta med logistik och SCM påverkar de mindre aktörernas upplevda lönsamhet och tillfredsställelse. Studien inleddes med en förstudie där över 1100 hemsidor (producenters och mellanhänders) hemsidor studerades avseende information kring sortiment, leveransalternativ, leveranstider, transporter, prissättning, betalningsalternativ m.m. Huvudstudien baseras sedan dels på en enkätstudie med svar från 286 olika producenter från olika AKM, samt parallella intervjustudier av både producenter och nya typer av mellanhänder. Resultatet ger en djupare kunskap om uppfattade logistiska styrkor och utmaningar för olika AKM, samt vilka logistikaktiviteter man lägger tid och energi på, och hur man uppfattar att detta leder till ökad konkurrenskraft, lönsamhet eller tillfredsställelse. Producentens bakomliggande motiv verkar påverka val av AKM, för olika AKM hur tid och energi läggs på olika logistikaktiviteter, vars bidrag till uppfattad konkurrenskraft sedan skiljer sig åt. Generellt läggs mer tid på att hantera kundrelationer och ge leveransinformation, men mindre på transport och lagring trots att man uppfattar sig som mindre konkurrenskraftiga på dessa aktiviteter. Medan t.ex. CSA i sin logik innebär att vissa logistikutmaningar förenklas, så hanteras utmaningar i andra (t.ex. Reko-ring och Lokala matnoder) genom att virtuella plattformar samordnar leveransplatser och tidpunkter. Dock upplevs ibland att mycket tid och energi då istället läggs på administration. I motsats till praxis inom andra branscher, eller rekommenderat i annan forskning, ser vi generellt lite utnyttjande av externa logistikaktörer eller logistiksamarbete mellan producenter, utan man sköter logistiken själva. Många producenter räknar dock inte med kostnad för egen arbetstid, och andra anser att man inte får en rättvis lön för det arbete man lägger ner. Man utnyttjar istället obetalda arbetsinsatser, något som ofta kallas ”sweat equity”.Producenter är generellt tillfredsställda oavsett AKM. Men skillnader finns, och olika aspekter förklarar tillfredsställelse för olika AKM. För många är framtidstro en viktig förklaringsvariabel, men för andra är det rättvis lön, eller om kanalen reducerar logistikarbete eller förenklar kundservice, som verkar viktigast. Dagens lönsamhet verkade generellt påverka mindre, och ibland (t.ex. för Reko-ringar) indikeras t.o.m. ett omvänt samband mellan dagens lönsamhet och producentens tillfredsställelse. Istället verkar producentens syn på framtidsmöjligheter påverka deras tillfredsställelse. Intervjustudier med andra aktörer, som försökt skapa nya roller som mellanhänder, visar att de inte sällan får omarbeta eller utveckla sin affärsmodell p.g.a. låg lönsamhet, begränsade möjligheter att skala upp, svårigheter att komma in på marknaden och få konsumenter att välja dem istället för konventionella butiker. Vissa har lämnat försöken att själva driva mellanhandsplattform till att istället utveckla IT-verktyg för producenterna. De mellanhänder som har utvecklat affärsmodellen siktar på ökad lönsamhet, men har också viljan att skapa alternativa matkanaler i samarbete med lokala producenter för att svara på den ökade efterfrågan av lokala produkter på marknaden. Projektet bidrar med fördjupad kunskap kring vikten av att förstå logistikutmaningar och nya kostnader det innebär att kortsluta konventionella matkanaler, men också en mer nyanserad syn där olika typer av alternativa korta matkanaler och deras olika utmaningar illustreras. Det bidrar till ökad förståelse kring vad som, ur producentens perspektiv, bidrar till tillfredsställelse och glädje vilket är nytt perspektiv. Avslutningsvis trycker vi på vikten av att försöka kombinera plattformar som kan skapa skalfördelar och samarbete i de logistiska flödena, utan att viktiga värderingsorienterade och lokala dimensioner försvinner. För att få sådana plattformar att fungera, och vara skalbara, kan dock ofta någon form av mellanhand behövas.
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| 36. |
- Norrman, Andreas, et al.
(författare)
-
Systematiska och processorienterade mätsystem : En teoriöversikt
- 2015
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten är en teoriöversikt över systematiska mätsystem och hur de kan utformas med hänsyn till olika perspektiv, såsom strategi, process, försörjningsnätverk och anläggning, men också för att ge en integrerad helhetssyn. Rapporten identifierar intressanta fördjupningsområden för framtida forskningsområden i uppdrag av Trafikverket.Med ett kritiskt förhållningssätt har en systematisk genomgång av litteraturen gjorts. Litteraturstudien pekar på att det finns problem med terminologin och standardisering av vad som menas med systematiska mätsystem. Trots att forskning kring mätsystem har bedrivits under lång tid är problembilden den samma idag som för tjugo år sedan och få konkreta lösningar på dessa problem har forskats fram. Det finns konceptuella modeller kring design och implementering av mätsystem, men det finns lite forskning kring användning av mätsystem och dess effekter på organisationen.Ur ett akademiskt perspektiv innebär det att mätsystem är inte är ett etablerat forskningsområde. Det finns med andra ord brister i teoribasen, brister i utvärderingen av mätsystemen, brister i empiri och kvalitet när det gäller forskningen.I praktiken innebär det att det är en liten koppling mellan teori och praktik. Det finns ett analytiskt synsätt snarare än en systemsyn. Konceptuellt finns en stark koppling mellan strategi och mätsystemet, men i praktiken finns det brister i kopplingen och få empiriska bevis. Processorientering är underutvecklat och kartläggningen av processer ignoreras. Det brister även i kopplingen mellan intressenter och mätsystemet. Speciellt ur ett kund- eller medborgarfokus. Det finns också lite fokus på förändringsarbete och vilka framgångsfaktorer som medför lyckade utformningar och implementeringar av mätsystem.Trafikverket är till stor del beroende av underleverantörer för att leverera sin prestation. Det är därför relevant att mäta också påverkan och prestation av partners och leverantörer. Denna ansats, att mäta i försörjningskedjor med en systemansats, har börjat uppmärksammas inom logistikforskningen de senaste femton åren. Denna forskning har för övrigt samma grundperspektiv, och kan tillskrivas samma kritik, som övrig forskning.Det finns framtida forskningsbehov kring både implementera och utvärdera mätsystem samt i högre grad testa och bevisa konceptuella modeller empiriskt. Det finns också ett behov av större teori- och metoddriven forskning. Att utforma processorienterade mätsystem med ett underliggande försörjnings- och systemsynsätt, kan vara länken till att stärka kopplingen mellan strategier, mätsystemet och dess effekt.
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| 37. |
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| 38. |
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| 39. |
- Norrman Brandt, Eva, et al.
(författare)
-
Leader capabilities in the 21st century
- 2014
-
Konferensbidrag (refereegranskat)abstract
- We know from decades of empirical research in adult development that leaders at more advanced stages of development are more effective than their counterparts in carrying out a variety of leaderships’ tasks, but also that few leaders have these advanced level of leadership (Joiner & Josephs 2007; Torbert 1987). But are leaders up to the task of handling complex issues at work? Knowing that the complexity and speed of change requires higher levels of adult development it seems obvious that there is a need for supporting managers to develop their level of development and maybe recruit leaders with a higher level of development. There is a need for research focusing on the link between adult ego development in leaders and transformational leadership (McCauley, Drath, Palus, O´Connor&Baker 2006), and studies on leader-follower interaction.The aim of this study is firstly to examine the correlation between leadership behaviors, value systems and complexity, and secondly if the correlation between self report and subordinates evaluation of leadership are higher for individuals with more advanced levels of value systems and/or levels of leadership.Participants are managers in 4 Scandinavian organizations in different market segments including municipalities. The mangers are invited to answer a basic web survey including three instruments: a value system questionnaire (Sjölander et al.2013); Developmental Leadership Questionnaire which is a hierarchical test based on the theory of transformational leadership and it measures leadership behaviors through a self-evaluation and a 360 test where subordinates evaluate leadership of the manager; and a complexity test. Some managers do only the self-evaluation and some a full 360 feedback test. The study is carried out in the spring 2014 and preliminary results will be presented.
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| 40. |
- Norrman Brandt, Eva, et al.
(författare)
-
The future trip : A story of transformational change
- 2019
-
Ingår i: Journal of Organizational Change Management. - : Emerald Group Publishing Limited. - 0953-4814 .- 1758-7816. ; 32:7, s. 669-686
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose – The study of successful transformational change processes in organizations has been limited. The aim was to understand a change process and the type of change that occurred in a pharmaceutical company in Sweden 2005–2014.Method – An interactive research design was used, and semi-structured interviews were conducted with 19 individuals, asking about their views on the change journey. Meetings and dialogue with leaders from the organization also took place. Observations from feedback meetings with leaders were included in the analysis. The results were analysed using a time-ordered display identifying key events, interpreted by a theoretical lens determining the type of change over a period of 10 years.Findings – This was a transformational change caused by external pressure, supported by visionary and transparent leadership, collaborative methods aiming at broad involvement, and systemic understanding. The results indicated a 40% increase in productivity and altered organizational design and culture. Sense-making activities, persistent adoption of quality improvement tools, dispersed power, and sequential change activities underpinned the success.Practical implications – The results provide insight into the processes of transformational change. Change leaders were provided with knowledge, inspiration and insight when facing transformations.Social implications – Increased prevalence of transformational change calls for new organizational competencies and altered roles for leaders and employees. There is a need for new ways of developing competence and new recruitment policies for leaders.Originality/value – This case presents unique empirical evidence of a successful cultural transformation led by a leader using post-conventional principles.
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| 41. |
- Norrman Brandt, Eva, et al.
(författare)
-
Transformational change by a post-conventional leader
- 2019
-
Ingår i: Leadership & Organization Development Journal. - : Emerald Group Publishing Limited. - 0143-7739 .- 1472-5347. ; 40:4, s. 457-471
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to examine people’s experience of a change process and if and how post-conventional leadership principles are expressed in the change process.Design/methodology/approach: The study used a retrospective exploratory qualitative design. In total, 19 semi-structured interviews and 4 workshops were conducted and analyzed in accordance with a thematic qualitative analysis.Findings: The post-conventional leadership appears to have facilitated an organizational transformation where explorative work methods aimed at innovation and improvement as well as holistic understanding was used. Dispersed power and mandate to employees, within set frames and with clear goals, created new ways of organizing and working. The leader showed personal consideration, acknowledged the importance of the emotionally demanding aspects of change and admitted the leader’s own vulnerability. Balance between challenge and support created courage to take on new roles and responsibilities. Most employees thrived and grew with the possibilities given, but some felt lack of support and clear directions.Practical implications: Inspiration from this case on work methods and involvement of employees can be used on other change efforts.Social implications: This study provides knowledge on leadership capabilities needed for facilitation of transformational change.Originality/value: Few transformational change processes by post-conventional leaders are thoroughly described, and this study provides in-depth descriptions of post-conventional leadership in transformational change.
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| 42. |
- Norrman Brandt, Eva
(författare)
-
Transformativ förändring och postkonventionellt ledarskap : en retrospektiv fallstudie med fokus på förändringsprocessen och ledarskapet
- 2019
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduktion. Förändringstakten ökar i samhället och påverkar organisationer och dess medlemmar. Förändringstrycket orsakas av en rad faktorer som teknisk utveckling, förändrad lagstiftning, kunders/intressenters behov och krav och ökande konkurrens på en global arena. Förändring är utmanande och många förändrings-initiativ når inte sina mål. Behovet av transformativ förändring i samhället ökar och forskning har visat på ett samband mellan ledares nivå av vuxenutveckling och framgång i att driva transformativa förändringar.Syfte. Syftet med avhandlingen är dels att studera en tioårig förändringsprocess i en läkemedelsfabrik för att identifiera olika typer av förändring, samt att undersöka om kriterier för transformativ förändring uppfylls. Syftet är även att undersöka ledarskapets påverkan på förändringsprocessen och medarbetares upplevelser av det.Design och metod. Avhandlingen är en retrospektiv single case studie med kvalitativ, induktiv och interaktiv design. Två studier har genomförts grundade på samma empiriska material men med olika analysmetoder. Empirin är inhämtad via 19 semistrukturerade intervjuer samt 4 workshops med ledare i den undersökta organisationen. Mediamaterial, böcker och hemsidor har också använts. I studie I har a/ processdata analyserats kronologiskt och b/ i enlighet med en förändringsmatris som identifierar olika typer av förändring, och c/ i enlighet med kriterierna för transformativ förändring. I studie II har en tematisk innehållsanalys använts med fokus på ledarskap och medarbetares upplevelse av ledarskap och arbetsmetoder. Data har analyserats för att undersöka förekomsten av post-konventionella ledarskapsprinciper.Resultat. Delstudie I redovisar stegen i förändringsprocessen där förändringens karaktär i tre tidsperioder skiftar från finjustering och trimning av verksamheten, via an-passning till en förändringskategori som betecknas nytt vägval. På ett strukturellt plan gjordes en förändring från avdelningar (funktionell organisation) till att organiseras kring läkemedelsproduktflöden där medarbetare med mixade kompetenser arbetade tillsammans. De kulturella antagandena förändrades vid sidan av de rent strukturella förändringarna. Förändringsresan kan betecknas som transformativ, en kulturförflyttning utanför tidigare ramar. Resultatet diskuteras utifrån Pettigrews perspektiv på förändring.Delstudie II visar resultatet av den tematiska studien på förändringar i arbetsmetoder och förhållningssätt, bland annat en förflyttning av mandat och makt ut i organisationens alla delar. Ledarens interventioner och förhållningssätt understödde den organisatoriska och kulturella förflyttningen, och de postkonventionella interventionerna 2011–2014 var sannolikt nödvändiga för att åstadkomma den kraftfulla förflyttning som krävdes. Medarbetare reagerade mestadels positivt på det ökade mandatet och möjligheten att ta ansvar och involveras, men en grupp medarbetare vittnar om osäkerhet och brist på stöd i det nya sättet att leda och arbeta.Konklusion och praktiska implikationer. Transformativ förändring tar tid och kräver involvering av hela organisationen. Ledarskapet har en betydande påverkan även om ett samspel mellan olika faktorer blir betydelsefulla. Denna avhandling ger ett exempel på en transformativ förändring där man lyckats balansera yttre kontextuella krav med inre organisatoriska förflyttningar. Begripliga mål som ändrats i takt med nya ändrade kontextuella förutsättningar har formulerats och känslan för var och när i organisationen nya mål skall driva stycks ha funnits hos ledningen. Avhandlingen stärker tesen att transformativ förändring tar tid, och att postkonventionella ledarskapsprinciper verkar gynnsamt i denna typ av förändring där involvering och samskapande krävs. Avhandlingen bidrar även med en del fakta och exempel som skulle kunna inspirera andra organisationer och ledare till att ta ett steg i riktning mot postkonventionell logik i ledarskapet då detta förefaller skapa förutsättningar för transformation av en organisation och dess kultur.
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| 43. |
- Norrman, Eva, et al.
(författare)
-
A clinical evaluation of the image quality computer program, CoCIQ
- 2005
-
Ingår i: Journal of digital imaging. - : Springer Science and Business Media LLC. - 0897-1889 .- 1618-727X. ; 18:2, s. 138-144
-
Tidskriftsartikel (refereegranskat)abstract
- To provide an objective way of measuring image quality, a computer program was designed that automatically analyzes the test images of a contrast-detail (CD) phantom. The program gives a quantified measurement of image quality by calculating an Image Quality Figure (IQF). The aim of this work was to evaluate the program and adjust it to clinical situations in order to find the detectable level where the program gives a reliable figure of the contrast resolution. The program was applied on a large variety of images with lumbar spine and urographic parameters, from very low to very high image qualities. It was shown that the computer program produces IQFs with small variations and there were a strong linear statistical relation between the computerized evaluation and the evaluation performed by human observers (R2 = 0.98). This method offers a fast and easy way of conducting image quality evaluations.
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| 44. |
- Norrman, Eva, et al.
(författare)
-
A factorial experiment on image quality and radiation dose
- 2005
-
Ingår i: Radiation Protection Dosimetry. - : Oxford University Press (OUP). - 0144-8420 .- 1742-3406. ; 114:1-3, s. 246-252
-
Tidskriftsartikel (refereegranskat)abstract
- To find if factorial experiments can be used in the optimisation of diagnostic imaging, a factorial experiment was performed to investigate some of the factors that influence image quality, kerma area product (KAP) and effective dose (E). In a factorial experiment the factors are varied together instead of one at a time, making it possible to discover interactions between the factors as well as major effects. The factors studied were tube potential, tube loading, focus size and filtration. Each factor was set to two levels (low and high). The influence of the factors on the response variables (image quality, KAP and E) was studied using a direct digital detector. The major effects of each factor on the response variables were estimated as well as the interaction effects between factors. The image quality, KAP and E were mainly influenced by tube loading, tube potential and filtration. There were some active interactions, for example, between tube potential and filtration and between tube loading and filtration. The study shows that factorial experiments can be used to predict the influence of various parameters on image quality and radiation dose.
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| 45. |
- Norrman, Eva, 1952, et al.
(författare)
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Akut svår astma
- 1999
-
Ingår i: Allergi och annan överkänslighet i praktisk sjukvård, Andra upplagan. - Lund : Studentlitteratur. - 9144009100 ; , s. 219-233
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 46. |
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| 47. |
- Norrman, Eva, 1966-
(författare)
-
Optimisation of radiographic imaging by means of factorial experiments
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the optimisation process of radiographic imaging, factorial designed experiments can be applied. The parameters (factors) are varied together instead of one at a time, making it possible to discover interactions between the factors as well as main influences of them on the result variable. A 2k design implies having k number of factors each one set to two different levels (low and high).A computer program, CoCIQ, designed to automatically analyse and evaluate test images of a contrast-detail phantom, was evaluated and adjusted to clinical situations using a flat panel detector. The program gives a quantified measurement of image quality by calculating an Image Quality Figure (IQF) for the X-ray image. It was shown that the program produces IQF with small variations. It was also found that there was a strong linear statistical relation between the computerised evaluation and the evaluation performed by human observers.2k factorial experiments were evaluated by investigating the influence of tube potential, tube loading, focus size and filtration on the result variables IQF, Kerma Area Product (KAP) and effective dose using a flat panel detector. It was found that the result variables were mainly influenced by tube loading, tube potential and filtration. Interactions between tube potential and filtration as well as between tube loading and filtration were observed, too. This work demonstrates that accepted knowledge was reproduced and that the effects of interactions between parameters were revealed.Extended 2k experiments were then applied at three different optimisation procedures. Two studies were performed using a flat panel detector for lumbar spine radiography. The aim was to find optimal settings for tube potential, system sensitivity and filtration for different sized patients and, in a separate study, to investigate the effect of the image post processing parameters and the possibility for dose reduction by adjusting these. The parameters are ROI (Region Of Interest) density, gamma, detail contrast enhancement, unsharp masking, kernel size and noise compensation.After determining the optimal settings from these experiments, X-ray images of the lumbar spine of an Alderson phantom were acquired and evaluated in a visual grading analysis (VGA).The results illustrated that the image quality was maintained at a lower effective dose by operating with a reduced tube potential and increased sensitivity of the X-ray system.The experiments on image post process parameters revealed their influence on image quality and indicated that image quality could be improved by changing the settings of the process parameters.Factorial experiments were also performed, using a multislice CT scanner to investigate the possibility for dose reduction at paediatric head examinations. An anthropomorphic phantom simulating a one-year-old child was scanned using different settings of tube potential, tube loading and reconstruction filter.The study showed that a 25 % reduction of dose was possible with maintained image quality by reducing the tube loading.Factorial designed experiments provide an effective method to simultaneously predict the influence of various parameters on image quality and radiation dose in the optimisation in diagnostic radiology.
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| 48. |
- Norrman, Eva, et al.
(författare)
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Optimization of image process parameters through factorial experiments using a flat panel detector
- 2007
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Ingår i: Physics in Medicine and Biology. - Bristol : IOP publishing. - 0031-9155 .- 1361-6560. ; 52:17, s. 5263-5276
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Tidskriftsartikel (refereegranskat)abstract
- In the optimization process of lumbar spine examinations, factorial experiments were performed addressing the question of whether the effective dose can be reduced and the image quality maintained by adjusting the image processing parameters. A 2(k)-factorial design was used which is a systematic and effective method of investigating the influence of many parameters on a result variable. Radiographic images of a Contrast Detail phantom were exposed using the default settings of the process parameters for lumbar spine examinations. The image was processed using different settings of the process parameters. The parameters studied were ROI density, gamma, detail contrast enhancement (DCE), noise compensation, unsharp masking and unsharp masking kernel (UMK). The images were computer analysed and an image quality figure (IQF) was calculated and used as a measurement of the image quality. The parameters with the largest influence on image quality were noise compensation, unsharp masking, unsharp masking kernel and detail contrast enhancement. There was an interaction between unsharp masking and kernel indicating that increasing the unsharp masking improved the image quality when combined with a large kernel size. Combined with a small kernel size however the unsharp masking had a deteriorating effect. Performing a factorial experiment gave an overview of how the image quality was influenced by image processing. By adjusting the level of noise compensation, unsharp masking and kernel, the IQF was improved to a 30% lower effective dose.
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| 49. |
- Norrman, Jenny, 1971, et al.
(författare)
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Enriching social and economic aspects in sustainability assessments of remediation strategies – Methods and implementation
- 2020
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 707
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Tidskriftsartikel (refereegranskat)abstract
- Over the last decade, there has been rapid development in promoting and implementing sustainable remediation. It is now common to include at least some sustainability considerations in remediation projects. Specific challenges that have been highlighted often relate to economic and social aspects not receiving enough attention: broadening the social aspects, community and meaningful stakeholder engagement, understanding stakeholders' risk perception, and a need for better estimates of site-specific economic costs and benefits. This study presents an application of the Sustainable Choice of REmediation (SCORE) framework with special focus on (1) demonstrating the working process for a broad sustainability assessment and (2) sharing the lessons learned from its application. Specific objectives are to describe (a) the types of stakeholders involved in the assessment, (b) the methods for collection of social and economic sustainability data, (c) residents' perception of risks, (d) the use of the sustainability assessment results in the decision-making process, and (5) possibilities for improving the methods and working process. SCORE was applied and evaluated with input from, and together with, stakeholders at the BT Kemi industrial site in the village of Teckomatorp, south Sweden, a former pesticide production site associated with the most infamous Swedish environmental scandal. A questionnaire (n = 78) was used to collect input from residents regarding local acceptance and economic externalities of the remediation alternatives. Alternatives with a high degree of removal of contaminants received a high ranking in the assessment, primarily due to social and economic effects. The working process can be improved, specifically regarding workshop preparation and workshop structure. A broad representation of stakeholders and early establishment of communication channels to residents is key for robust assessment of social aspects. The information from the sustainability assessment was used in the decision-making process, not least for revising remediation options.
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| 50. |
- Piippo-Huotari, Oili, 1959-, et al.
(författare)
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New patient-controlled abdominal compression method in radiography : radiation dose and image quality
- 2018
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Ingår i: Acta Radiologica Open. - : Sage Publications. - 2058-4601. ; 7:5, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: The radiation dose for patients can be reduced with many methods and one way is to use abdominal compression. In this study, the radiation dose and image quality for a new patient-controlled compression device were compared with conventional compression and compression in the prone position.Purpose: To compare radiation dose and image quality of patient-controlled compression compared with conventional and prone compression in general radiography.Material and Methods: An experimental design with quantitative approach. After obtaining the approval of the ethics committee, a consecutive sample of 48 patients was examined with the standard clinical urography protocol. The radiation doses were measured as dose-area product and analyzed with a paired t-test. The image quality was evaluated by visual grading analysis. Four radiologists evaluated each image individually by scoring nine criteria modified from the European quality criteria for diagnostic radiographic images.Results: There was no significant difference in radiation dose or image quality between conventional and patient-controlled compression. Prone position resulted in both higher dose and inferior image quality.Conclusion: Patient-controlled compression gave similar dose levels as conventional compression and lower than prone compression. Image quality was similar with both patient-controlled and conventional compression and was judged to be better than in the prone position.
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