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Sökning: WFRF:(Sjöström Malin)

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1.
  • Alvehus, Malin, et al. (författare)
  • The human visceral fat depot has a unique inflammatory profile
  • 2010
  • Ingår i: Obesity. - : Nature Publishing Group. - 1930-7381 .- 1930-739X. ; 18:5, s. 879-883
  • Tidskriftsartikel (refereegranskat)abstract
    • Obesity can be considered as a low-grade inflammatory condition, strongly linked to adverse metabolic outcomes. Obesity-associated adipose tissue inflammation is characterized by infiltration of macrophages and increased cytokine and chemokine production. The distribution of adipose tissue impacts the outcomes of obesity, with the accumulation of fat in visceral adipose tissue (VAT) and deep subcutaneous adipose tissue (SAT), but not superficial SAT, being linked to insulin resistance. We hypothesized that the inflammatory gene expression in deep SAT and VAT is higher than in superficial SAT. A total of 17 apparently healthy women (BMI: 29.3 +/- 5.5 kg/m2) were included in the study. Body fat (dual-energy X-ray absorptiometry) and distribution (computed tomography) were measured, and insulin sensitivity, blood lipids, and blood pressure were determined. Inflammation-related differences in gene expression(real-time PCR) from VAT, superficial and deep SAT biopsies were analyzed using univariate and multivariate data analyses. Using multivariate discrimination analysis, VAT appeared as a distinct depot in adipose tissue inflammation,while the SAT depots had a similar pattern, with respect to gene expression. A significantly elevated (P < 0.01)expression of the CC chemokine receptor 2 (CCR2) and macrophage migration inhibitory factor (MIF) in VAT contributed strongly to the discrimination. In conclusion, the human adipose tissue depots have unique inflammatory patterns, with CCR2 and MIF distinguishing between VAT and the SAT depots.
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2.
  • Asklund, Ina, 1978- (författare)
  • A mobile app for self-management of urinary incontinence : treatment effect and user experience
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background Urinary incontinence affects 25-45% of all women. The most common type is stress urinary incontinence, which is the leakage of urine on physical exertion. Pelvic floor muscle training is an effective first-line treatment for this condition but many women do not seek help from their ordinary health care service. There is a need to evaluate new methods to offer effective treatment, and internet-based treatment has previously been found to be effective for women with stress urinary incontinence.Aim To evaluate the mobile app Tät® which has a self-management program focused on pelvic floor muscle training for women with stress urinary incontinence, with respect to treatment effect, factors associated with successful treatment, user experience and use by pregnant and postnatal women.Methods Papers I, II and III are based on the same study population from a randomized controlled trial (RCT). We recruited adult women who had stress urinary incontinence at least weekly via our website. In total, 123 women  were randomized to the app group (n=62) or the control group (n=61). The app included information about incontinence, the pelvic floor and lifestyle factors associated with incontinence, pelvic floor muscle training exercises and functions for reminders and training statistics. Treatment outcome after three months was evaluated using validated questionnaires assessing incontinence symptoms, quality of life, subjective improvement and a leakage diary. Outcomes were compared between the two groups. Factors associated with a successful outcome in the app group were further analysed using logistic regression. We strategically selected 15 women who had used the app and interviewed them about their experiences of using the app. The interviews were analysed according to Grounded Theory. After closing the RCT we made the app freely available and continued to follow its use on a larger scale by incorporating an anonymous questionnaire that appeared within the app upon download and after three months. The data from these questionnaires is used in paper IV.  Results Participants in the RCT had a mean age of 44.7 years (range 27-72) and 120 of the 123 women had moderate/severe incontinence. The app group reported significant improvements in the primary outcomes, the incontinence symptom score (mean ICIQ-UI SF reduction 3.9, 95% CI 3.0-4.7) and the quality of life score (mean ICIQ LUTSqol reduction 4.8, 95% CI 3.4-6.2), and the difference between the groups was significant. The app group also reduced their number of leakages and use of incontinence aids compared to the control group. At follow-up 92% of women in the app group experienced subjective improvement and 56% had improved “much” or “very much” and were classified as having a successful treatment outcome.Factors associated with a successful outcome were higher expectations of treatment effect (OR 11.38, 95% CI 2.02-64.19), weight control (OR 0.44 per kg gained, 95% CI 0.24-0.79), and self-assessed improvement of pelvic floor muscle strength (OR 35.54, 95% CI 4.96-254.61).The main finding from the interviews was that women experienced that the app “enabled their independence”. They described that the app was “something new” that helped with “keeping motivation up” although they sometimes wondered whether their training efforts were “good enough”.The freely available app was downloaded by 10,456 pregnant and postnatal women during a period of ten months (41% of all users). At inclusion 51% experienced incontinence and their mean ICIQ-UI SF score was 6.7 (SD 3.45). After three months, 1,805 women answered the follow-up. The majority of women with incontinence at inclusion experienced improvement with greater improvement in the postnatal group than in the pregnant group.Conclusion The mobile app Tät® offers a new, easily accessible and effective self-management program for women with stress urinary incontinence. Women appreciated that the app enabled them to manage their pelvic floor muscle training independently. Once the app was freely released it reached a large population with many pregnant and postnatal women. We believe that the app could be useful for the prevention of urinary incontinence among pregnant women. We also believe that the app could be used both as a stand-alone treatment and as a complement to other treatments provided by the ordinary health care service.
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3.
  • Asklund, Ina, et al. (författare)
  • Mobile app for treatment of stress urinary incontinence : a randomized controlled trial
  • 2017
  • Ingår i: Neurourology and Urodynamics. - : John Wiley & Sons. - 0733-2467 .- 1520-6777. ; 36:5, s. 1369-1376
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To evaluate the effect of a mobile app treatment for stress urinary incontinence (SUI) in women.METHODS: Randomized controlled trial, conducted 2013-2014 in Sweden. Community-dwelling adult women with ≥1 SUI episode/week recruited through our website and randomized to app treatment (n = 62) or control group (postponed treatment, n = 61). One participant from each group was lost to follow-up. Intervention was the mobile app Tät(®) with a treatment program focused on pelvic floor muscle training (PFMT), and information about SUI and lifestyle factors. Primary outcomes, 3 months after randomization: symptom severity (International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form [ICIQ-UI SF]); and condition-specific quality of life (ICIQ Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]).RESULTS: One hundred and twenty-three women were included (mean age 44.7), with moderate/severe SUI (97.5%, 120/123), mean ICIQ-UI SF score 11.1 (SD 2.8) and mean ICIQ-LUTSqol score 34.4 (SD 6.1) at baseline. At follow-up, the app group reported improvements in symptom severity (mean ICIQ-UI SF score reduction: 3.9, 95% confidence interval 3.0-4.7) and condition-specific quality of life (mean ICIQ-LUTSqol score reduction: 4.8, 3.4-6.2) and the groups were significantly different (mean ICIQ-UI SF score difference: -3.2, -4.3to -2.1; mean ICIQ-LUTSqol score difference: -4.6, -7.8 to -1.4). In the app group, 98.4% (60/61) performed PFMT at follow-up, and 41.0% (25/61) performed it daily.CONCLUSIONS: The mobile app treatment was effective for women with SUI and yielded clinically relevant improvements. This app may increase access to first-line treatment and adherence to PFMT.
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4.
  • Asklund, Ina, et al. (författare)
  • User Experience of an App-Based Treatment for Stress Urinary Incontinence : Qualitative Interview Study
  • 2019
  • Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 21:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Stress urinary incontinence (SUI) affects 10%-39% of women. Its first-line treatment consists of lifestyle interventions and pelvic floor muscle training (PFMT), which can be performed supervised or unsupervised. Health apps are increasing in number and can be used to improve adherence to treatments. We developed the Tät app, which provides a 3-month treatment program with a focus on PFMT for women with SUI. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life. In this qualitative interview study, we investigated participant experiences of the app-based treatment.Objective: This study aimed to explore women’s experiences of using an app-based treatment program for SUI.Methods: This qualitative study is based on telephone interviews with 15 selected women, with a mean age of 47 years, who had used the app in the previous randomized controlled trial. A semistructured interview guide with open-ended questions was used, and the interviews were transcribed verbatim. Data were analyzed according to the grounded theory.Results: The results were grouped into three categories: “Something new!” “Keeping motivation up!” and “Good enough?” A core category, “Enabling my independence,” was identified. The participants appreciated having a new and modern way to access a treatment program for SUI. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects. The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. The participants felt confident that they could perform the treatment program on their own, even though they expressed some uncertainty about whether they were doing the pelvic floor muscle contractions correctly. They felt that the app-based treatment increased their self-confidence and enabled them to take responsibility for their treatment.Conclusions: Use of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment. They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program.Trial Registration: ClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)
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5.
  • Björk, Anna-Bell, et al. (författare)
  • Women's Experiences of Internet-Based or Postal Treatment for Stress Urinary Incontinence
  • 2014
  • Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 24:4, s. 484-493
  • Tidskriftsartikel (refereegranskat)abstract
    • Stress urinary incontinence is common and sometimes embarrassing. New, simple, and easily accessible treatments are needed. We telephone interviewed 21 women who participated in a randomized controlled study comparing two treatment programs based on instructions for pelvic floor muscle training. One program was Internet-based and included email support by a urotherapist; the other was sent by post. There was no face-to-face contact in either program. Our main aim was to explore the women's experiences of the Internet-based treatment. Grounded theory analysis revealed three categories: hidden but present, at a distance but close, and by myself but not alone. These were incorporated in a core category: acknowledged but not exposed. The leakage was often a well-hidden secret, but the study treatments lowered the barrier for seeking care. In the Internet group, a supportive patient-provider relationship developed despite the lack of face-to-face contact. Internet-based treatment programs can increase access to care and empower women.
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6.
  • Björnheden, Tom, 1945, et al. (författare)
  • Computerized determination of adipocyte size.
  • 2004
  • Ingår i: Obesity research. - 1071-7323. ; 12:1, s. 95-105
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Fat cell size is a fundamental parameter in the study of adipose tissue metabolism, because it markedly influences the cellular rates of metabolism. Previous techniques for the sizing of adipocytes are often complicated or time-consuming. The aim of this study was to develop a new, computerized method for rapid and accurate determination of adipocyte size in a cell suspension obtained by incubating human or rat adipose tissue biopsies with collagenase. RESEARCH METHODS AND PROCEDURES: The cell suspension was placed between a siliconized glass slide and a cover slip. Using the reference method [designated as (R)], the cell diameters were determined manually using a microscope with a calibrated ocular. The new method presented here [designated as (C)] was based on computerized image analysis. RESULTS: After two well-defined corrective adjustments, measurements with (R) and (C) agreed very well. The small remaining differences seemed, in fact, to depend on inconsistencies in (R). DISCUSSION: We propose that (C) constitutes a valuable tool to study fat cell size, because this method is fast and allows the assessment of a sufficient number of cells to get reliable data on size distribution. Furthermore, images of cell preparations may be stored for future reference.
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7.
  • Bokne, Kajsa, et al. (författare)
  • Self-management of stress urinary incontinence : effectiveness of two treatment programmes focused on pelvic floor muscle training, one booklet and one Internet-based
  • 2019
  • Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 37:3, s. 380-387
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: In a previous study, self-management of stress urinary incontinence (SUI), via an Internet-based programme or a booklet improved symptoms and quality of life. We wanted to evaluate the effectiveness of these programmes when implemented for free use, as well as to characterize the users.Design: Pragmatic prospective cohort study.Setting and subjects: Information about the Internet programme and the booklet was provided at www.tät.nu and by nurse midwives. Both programmes included a three-month pelvic floor muscle training (PFMT) programme. Questionnaires were used at the start and after three months.Main outcome measures: Characteristics of the participants regarding age and education. Reductions in symptom severity was measured using the validated ICIQ-UI SF.Results: 109 women using the booklet, and 166 women using the Internet-based programme responded to the pre-treatment questionnaire. Of these, 53 (48.6%) in the booklet group and 27 (16.3%) in the Internet group responded to the follow-up. The mean age of booklet users was higher, 59.4 years vs. 54.5 years (p = .005). The proportion of women with post-secondary education was high, 59% in the booklet group and 67% in the Internet group. The mean reduction in the symptom score was 2.6 points (SD 3.4) in the booklet group, and 3.4 (SD 2.9) in the Internet group. These reductions were significant within both groups, with no difference between the groups, and in the same order of magnitude as in the previous randomised controlled study.Conclusion: Two self-management programmes for SUI, one provided as a booklet and one as an Internet-based programme, also rendered clinically relevant improvements when made freely available.Key points:Female stress urinary incontinence can be treated using self-management programmes focused on pelvic floor muscle training. This study evaluates the effect of two different programmes, one provided as a booklet and one Internet-based, when made freely available to the public.Both programmes rendered clinically relevant improvements, in the same order of magnitude as in the previous randomised controlled study.Self-management of stress urinary incontinence should be recommended to women that request treatment.
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8.
  • Boks, Marije, et al. (författare)
  • Increased incidence of late-onset inflammatory bowel disease and microscopic colitis after a Cryptosporidium hominis outbreak
  • 2022
  • Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis Group. - 0036-5521 .- 1502-7708. ; 57:12, s. 1443-1449
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: In 2010, 27,000 inhabitants (45% of the population) of Östersund, Sweden, contracted clinical cryptosporidiosis after drinking water contaminated with Cryptosporidium hominis. After the outbreak, local physicians perceived that the incidence of inflammatory bowel disease (IBD), including ulcerative colitis (UC), Crohn's disease (CD), and IBD-unclassified, and microscopic colitis (MC) increased. This study assessed whether this perception was correct.MATERIALS AND METHODS: This observational study included adult patients (≥18 years old) from the local health care region who were diagnosed with pathology-confirmed IBD or MC during 2006-2019. We collected and validated the diagnosis, date of diagnosis, age at diagnosis, and sex from the Swedish quality register SWIBREG and electronic patient records. Population data were collected from Statistics Sweden. The incidences for 2006-2010 (pre-outbreak) and 2011-2019 (post-outbreak) were evaluated by negative binomial regression analysis and presented as incidence rate ratios (IRRs). Data were analyzed for IBD, for UC and CD separately, and MC.RESULTS: During the study period, we identified 410 patients with new onset IBD and 155 new cases of MC. Overall, we found a trend toward an increased incidence of IBD post-outbreak (IRR 1.39, confidence interval (CI) 0.99-1.94). In individuals ≥40 years old, the post-outbreak incidence significantly increased for IBD (IRR 1.69, CI 1.13-2.51) and CD (IRR 2.23, CI 1.08-4.62). Post-outbreak incidence of MC increased 6-fold in all age groups (IRR 6.43, CI 2.78-14.87).CONCLUSIONS: The incidence of late-onset IBD and MC increased after the Cryptosporidium outbreak. Cryptosporidiosis may be an environmental risk factor for IBD and MC.
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9.
  • Boks, Marije, et al. (författare)
  • Persisting symptoms after Cryptosporidium hominis outbreak : a 10-year follow-up from Östersund, Sweden
  • 2023
  • Ingår i: Parasitology Research. - : Springer Nature. - 0932-0113 .- 1432-1955. ; 122:7, s. 1631-1639
  • Tidskriftsartikel (refereegranskat)abstract
    • In late 2010, an outbreak of Cryptosporidium hominis affected 27,000 inhabitants (45%) of Östersund, Sweden. Previous research shows that abdomen and joint symptoms commonly persist up to 5 years post-infection. It is unknown whether Cryptosporidium is associated with sequelae for a longer duration, how persisting symptoms present over time, and whether sequelae are associated with prolonged infection. In this prospective cohort study, a randomly selected cohort in Östersund was surveyed about cryptosporidiosis symptoms in 2011 (response rate 69.2%). A case was defined as a respondent reporting new diarrhoea episodes during the outbreak. Follow-up questionnaires were sent after 5 and 10 years. Logistic regressions were used to examine associations between case status and symptoms reported after 10 years, with results presented as adjusted odds ratios (aOR) with 95% confidence intervals. Consistency of symptoms and associations with case status and number of days with symptoms during outbreak were analysed using X 2 and Mann–Whitney U tests. The response rate after 10 years was 74% (n = 538). Case status was associated with reporting symptoms, with aOR of ~3 for abdominal symptoms and ~2 for joint symptoms. Cases were more likely to report consistent symptoms. Cases with consistent abdominal symptoms at follow-up reported 9.2 days with symptoms during the outbreak (SD 8.1), compared to 6.6 days (SD 6.1) for cases reporting varying or no symptoms (p = 0.003). We conclude that cryptosporidiosis was associated with an up to threefold risk for reporting symptoms 10 years post-infection. Consistent symptoms were associated with prolonged infection.
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10.
  • Brulin, E., et al. (författare)
  • Healthcare in distress: A survey of mental health problems and the role of gender among nurses and physicians in Sweden
  • 2023
  • Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 339, s. 104-110
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction:The present article aimed to investigate 1) if mental health problems (depression and burnout including the dimensions; emotional exhaustion, mental distance and cognitive and emotional impairment) differed between nurses and physicians in Sweden, 2) if any differences were explained by differences in sex compositions, and 3) if any sex differences were larger within either of the two professions. Method:Data were derived from a representative sample of nurses (n = 2903) and physicians (n = 2712) in 2022. Two scales were used to assess burnout (KEDS and BAT) and one to assess depression (SCL-6). The BAT scale has four sub-dimensions. Descriptive statistics and logistic regression were used to analyse each scale and dimension separately. Results:Results showed that 16-28 % of nurses and physicians reported moderate to severe symptoms of burnout. The prevalence differed between occupations across the scales and dimensions used. Nurses reported higher scores on KEDS while physicians reported higher scores on BAT including the four dimensions. Also, 7 % of nurses' and 6 % of physicians' scores were above the cut-off for major depression. The inclusion of sex in the models changed the odds ratios of differences between doctors and nurses in all mental health dimensions except mental distance and cognitive impairment. Limitations: This study was based on cross-sectional survey data which has some limitations. Conclusion:Our study suggests that the prevalence of mental health problems is prominent among nurses and physicians in Sweden. Sex plays an important role in the difference in the prevalence of mental health problems between the two professions.
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11.
  • Brulin, Emma, et al. (författare)
  • Money talks : performance-based reimbursement systems impact on perceived work, health and patient care for physicians in Sweden
  • 2023
  • Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The study aimed to investigate in which way performance-based reimbursement (PBR) systems in Swedish healthcare services (1) subjectively impacted physicians’ work and patient care and (2) were associated with the occurrence of stress-induced exhaustion disorders among physicians.Method: The study applied a mixed-method design. Data were collected from a representative sample of Swedish physicians. In the questionnaire, respondents were asked to answer an open-ended question regarding their reflections on PBR. The answers to the open-ended question were analysed using thematic analysis. Respondents were also asked to rate the impact of PBR on their work. The association between PBR and self-rated stress-induced exhaustion disease was analysed with logistic regressions. Stress-induced exhaustion disorder was measured using the Burnout Assessment Scale.Results: Thematic analysis resulted in four themes: (1) Money talks, (2) Patients are affected, (3) Medical morals are challenged, and (4) PBR increase the quantity of illegitimate tasks. Logistic regressions showed that physicians who experienced PBR had an impact on their work and had a two-fold higher risk of stress-induced exhaustion disorder.Discussion: Our findings suggest that current reimbursement systems in Sweden play an essential role in Swedish healthcare and negatively influence physicians’ work and health. Also, current PBR impact patients negatively. No previous study has explored the potentially harmful impact of PBR on how physicians perceive work, health and patient care. Results indicate that policymakers should be encouraged to deeply review PBR systems and focus on ways that they can limit the negative impact on physicians’ work and health while meeting future challenges.
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12.
  • Ekersund, J., et al. (författare)
  • A mobile app for the treatment of female mixed and urgency incontinence : a cost-effectiveness analysis in Sweden
  • 2022
  • Ingår i: International Urogynecology Journal. - : Springer Science+Business Media B.V.. - 0937-3462 .- 1433-3023. ; 33, s. 1273-1282
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction and hypothesis: A previous randomized controlled trial (RCT) demonstrated that the app Tät II, for self-management of mixed urinary incontinence (MUI) and urgency urinary incontinence (UUI), yielded significant, clinically relevant improvements in symptom severity and quality of life (QoL) compared with a control group. We aimed to assess the cost-effectiveness of Tät II.Methods: A cost–utility analysis with a 1-year societal perspective was carried out, comparing Tät II with an information app. Data were collected alongside an RCT: 122 community-dwelling women aged ≥18 years with MUI or UUI ≥2 times/week were randomized to 3 months of Tät II treatment focused on pelvic floor muscle training (PFMT) and bladder training (BT; n = 60), or to an information app (n = 62). Self-assessed data from validated questionnaires were collected at baseline and at 3-month and 1-year follow-ups. Costs for assessment, treatment delivery, incontinence aids, laundry, and time for PFMT and BT were included. We calculated quality-adjusted life-years (QALYs) using the International Consultation on Incontinence Modular Questionnaire Lower Urinary Tract Symptoms Quality of Life. The incremental cost-effectiveness ratio (ICER) between the groups was our primary outcome. Sensitivity analyses were performed.Results: The mean age was 58.3 (SD = 9.6) years. Annual overall costs were €738.42 in the treatment group and €605.82 in the control group; annual QALY gains were 0.0152 and 0.0037 respectively. The base case ICER was €11,770.52; ICERs in the sensitivity analyses ranged from €−9,303.78 to €22,307.67.Conclusions: The app Tät II is a cost-effective treatment method for women with MUI and UUI.
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13.
  • Gabrielsson, Britt, 1957, et al. (författare)
  • Depot-specific expression of fibroblast growth factors in human adipose tissue.
  • 2002
  • Ingår i: Obesity research. - : Wiley. - 1071-7323 .- 1550-8528. ; 10:7, s. 608-16
  • Tidskriftsartikel (refereegranskat)abstract
    • We have investigated the expression of several fibroblast growth factors (FGFs) and FGF-receptors (FGFRs) in human adipose tissue and adipose-tissue cell fractions obtained from both subcutaneous (sc) and omental (om) depots.
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14.
  • Gabrielsson, Britt, 1957, et al. (författare)
  • High expression of complement components in omental adipose tissue in obese men.
  • 2003
  • Ingår i: Obesity research. - : Wiley. - 1071-7323 .- 1550-8528. ; 11:6, s. 699-708
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Accumulation of visceral fat is recognized as a predictor of obesity-related metabolic disturbances. Factors that are predominantly expressed in this depot could mediate the link between visceral obesity and associated diseases. RESEARCH METHODS AND PROCEDURES: Paired subcutaneous and omental adipose tissue biopsies were obtained from 10 obese men. Gene expression was analyzed by DNA microarrays in triplicate and by real-time polymerase chain reaction. Serum C3 and C4 were analyzed by radial immunodiffusion assays in 91 subjects representing a cross section of the general population. Body composition was measured by computerized tomography. RESULTS: Complement components C2, C3, C4, C7, and Factor B had higher expression in omental compared with subcutaneous adipose tissue ( approximately 2-, 4-, 17-, 10-, and 7-fold, respectively). In addition, adipsin, which belongs to the alternative pathway, and the classical pathway components C1QB, C1R, and C1S were expressed in both depots. Analysis of tissue distribution showed high expression of C2, C3, and C4 in omental adipose tissue, and only liver had higher expression of these genes. Serum C3 levels correlated with both visceral and subcutaneous adipose tissue in both men (r = 0.65 and p < 0.001 and r = 0.52 and p < 0.001, respectively) and women (r = 0.34 and p = 0.023 and r = 0.49 and p < 0.001, respectively), whereas C4 levels correlated with only visceral fat in men (r = 0.36, p = 0.015) and with both depots in women (visceral: r = 0.58, p < 0.001; and subcutaneous: r = 0.51, p < 0.001). DISCUSSION: Recent studies show that the metabolic syndrome is associated with chronically elevated levels of several immune markers, some of which may have metabolic effects. The high expression of complement genes in intra-abdominal adipose tissue might suggest that the complement system is involved in the development of visceral adiposity and/or contributes to the metabolic complications associated with increased visceral fat mass.
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15.
  • Gabrielsson, Britt, 1957, et al. (författare)
  • Molecular characterization of a local sulfonylurea system in human adipose tissue.
  • 2004
  • Ingår i: Molecular and cellular biochemistry. - 0300-8177 .- 1573-4919. ; 258:1-2, s. 65-71
  • Tidskriftsartikel (refereegranskat)abstract
    • ATP-sensitive potassium (KATP) channels are present in many cell types and link cellular metabolism to the membrane potential. These channels are heterooctamers composed of two subunits. The sulfonylurea receptor (SUR) subunits are targets for drugs that are inhibitors or openers of the KATP channels, while the inwardly rectifying K+ (Kir) subunits form the ion channel. Two different SUR genes (SUR1 and SUR2) and two different Kir6.x genes (Kir6.1 and Kir6.2) have been identified. In addition, isoforms of SUR2, SUR2A and SUR2B, have been described. We have previously performed expression profiling on pooled human adipose tissue and found high expression of SUR2. Others have reported expression of SUR1 in human adipocytes. The aim of this study was to characterize the expression of the sulfonylurea receptor complex components in human adipose tissue. RT-PCR analysis, verified by restriction enzyme digestions and DNA sequencing, showed that SUR2B, Kir6.1 and alpha-endosulfine, but not SUR1, SUR2A or Kir6.2, are expressed in human adipose tissue. Real-time RT-PCR showed that SUR2B was expressed at higher levels in subcutaneous compared with omental adipose tissue in paired biopsies obtained from seven obese men (p < 0.05). Analysis of tissue distribution showed that SUR2B expression in adipose tissue was lower than that in muscle, similar to that in heart and liver, while the expression in pancreas was lower. The effect of caloric restriction was tested in obese men (n = 10) treated with very low calorie diet for 16 weeks, followed by a gradual reintroduction of ordinary food for 2 weeks. Biopsies were taken at week 0, 8 and 18. There was no consistent effect of weight reduction on SUR2B or Kir6.1 expression. We conclude that the necessary components for a local sulfonylurea system are expressed in human adipose tissue and that the sulfonylurea receptor complex in this tissue is composed of SUR2B and Kir6.1. The expression of SUR2B was higher in subcutaneous compared with omental adipose tissue and was not affected by weight loss.
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16.
  • Hagqvist, Emma, 1980-, et al. (författare)
  • The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians
  • 2022
  • Ingår i: Chronic Stress. - : SAGE Publications. - 2470-5470. ; 6
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic. Method: The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout. Results: Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements. Conclusions: In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.
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19.
  • Hedman, Mante, 1960- (författare)
  • The community hospital model in northern Sweden
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Rural community hospitals (CHs) are vital in delivering healthcare services in sparsely populated regions such as northern Sweden. In Sweden these facilities act as primary care units, staffed by general practitioners (GPs), nurses, and other healthcare professionals. They provide hospital beds, emergency care, and basic diagnostics. The CH model, with GPs responsible for hospital care has not been studied earlier in Sweden. Aims: This thesis aimed to examine the role and practices of the Swedish rural CH model within the healthcare system and the local community. Furthermore, to investigate the perspectives of rural doctors in Sweden and New Zealand (NZ) working within their respective hospital models. Specific aims: To characterise patients admitted to hospitals in Norrbotten and Västerbotten Regions and to compare hospitalisations at rural community hospitals and general hospitals (Study I)To describe registered care measures carried out in rural community hospitals during episodes of hospital care for patients with heart failure, in comparison with a general hospital (Study II)To explore rural hospital doctors’ experiences of providing care in rural hospitals in Southern New Zealand (Study III)To explore rural general practitioners’ experiences of providing care in rural community hospitals in northern Sweden (Study IV) Methods and results: Four original papers form the basis of this thesis. In study I, hospital register data from Norr- and Västerbotten Regions were analysed, focusing on hospital admissions of patients enrolled at CHs 2010-2014. We compared CH admissions with general hospital admissions, examining factors such as age, sex, and diagnoses. CH patients were older than those in general hospitals (median age 80 vs. 68 years), and women had a higher likelihood of admission to CHs compared to men. Common diagnoses in the elderly, such as heart failure and pneumonia were more likely admitted to CHs than to general hospitals. Study II utilized hospital register data from Region Västerbotten to describe registered care measures carried out in rural CHs during episodes of hospital care for patients with heart failure 2015-2019, in comparison with a general hospital. CHs showed documentations by fewer individual doctors, more frequent nursing documentation, and fewer blood tests compared to general hospitals. Radiology, including echocardiography, was performed in general hospitals only but in a minority of cases. Documentation by physiotherapists, occupational therapists, and dietitians was limited in both hospital models.Studies III and IV involved interviews with rural hospital (RH) doctors in New Zealand (NZ), and rural GPs in northern Sweden, respectively, to explore the role of their RH/CH. In both countries, doctors emphasised advantages with proximity and holistic, patient-centred care for elderly, multimorbid, and end-of-life patients. Their RHs/CHs were described to play a central role in rural patients' healthcare journeys, utilizing small, multidisciplinary teams and collaborating with general hospitals and municipal caregivers. Reported challenges for doctors in RHs and CHs included limited resources and inexperience in handling life-threatening, rare cases, and ethical dilemmas unique to rural practice. Despite this, RH doctors considered RH patient safety similar or better than that in general hospitals. CH doctors prompted the idea of expanding the CH model to urban areas. Conclusion: We conclude that CHs admit elderly and multimorbid patients elsewhere common in general hospitals. Care for patients with heart failure at CHs showed more nursing notes, greater doctor continuity, and less biomedical examinations. Our results suggest potential for further development in the multidisciplinary care in both hospital models. Rural generalist doctors in Sweden and NZ emphasise the central role of CHs/RHs, their proximity to patients, and their holistic, generalist approach, and they suggest advantages in the RH/CH care for the elderly compared to general hospitals. In Sweden, the importance of relational continuity was stressed, as rural GPs are familiar with their CH patients from primary care. 
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20.
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21.
  • Hällberg, Petter, 1988-, et al. (författare)
  • Disentangling seasonal and annual precipitation signals in the tropics over the Holocene: insights from δD, alkanes and GDGTs
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Rainfall seasonality in the tropics has a substantial impact on both ecosystems and human livelihoods. Yet, reconstructions of past rainfall variability have so far generally been unable to differentiate between annual and seasonal precipitation changes. Past variations in seasonality are therefore largely unknown. Here, we disentangle hydrogen isotopic (dD) signals from terrestrial leaf waxes and algae in an 8000-year peat core from Sumatra, which reflect annually integrated versus wet season signals, respectively. We validate these results using lipid biomarkers by reconstructing vegetation dynamics via n-alkane distributions and peatland hydrological conditions using glycerol dialkyl glycerol tetraethers (GDGTs). Finally, we reconstruct biomass burning using levoglucosan concentrations in the core. Algal dD indicate stronger winter (~DJF) monsoon precipitation in the Mid-Holocene, between 8-4.2 ka BP. A period of alternating flooding, droughts and wildfires is reconstructed between 6-4.2 ka BP, implicating very strong monsoonal precipitation and drying out and burning during a longer and intensified dry season. We attribute this strong rainfall seasonality in the Mid-Holocene mainly to orbitally forced insolation seasonality, and a strenghtened Indonesian-Australian summer monsoon. In terms of annually integrated conditions, terrestrial plant dD, vegetation composition and GDGTs all indicate wetter conditions peaking between 3-4.5 ka BP, preceded by drier conditions, and followed by drastic and rapid drying in the late Holocene from around 2.8 ka BP. Our multiproxy annual precipitation reconstruction thereby indicates the wettest overall conditions approximately 1500-2000 years later than a nearby speleothem d18O record, which instead follows the dD recorded by algae in our record. We therefore hypothesize that speleothem reconstructions predominantly record the wet season isotopic signal, due to cave groundwater recharge occurring mainly after heavy precipitation. These results resolve the seasonal versus annual components of past rainfall variability in the Indo Pacific Warm Pool region, and highlight the importance of considering seasonality in rainfall reconstructions.
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22.
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23.
  • Johannsson, Gudmundur, 1960, et al. (författare)
  • Growth hormone treatment of abdominally obese men reduces abdominal fat mass, improves glucose and lipoprotein metabolism, and reduces diastolic blood pressure.
  • 1997
  • Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 0021-972X. ; 82:3, s. 727-34
  • Tidskriftsartikel (refereegranskat)abstract
    • The most central findings in both GH deficiency in adults and the metabolic syndrome are abdominal/visceral obesity and insulin resistance. Abdominal obesity is associated with blunted GH secretion and low serum insulin-like growth factor-I concentrations. GH treatment in GH-deficient adults has demonstrated favorable effects on most of the features of GH deficiency in adults, but it is not known whether GH can improve some of the metabolic aberrations observed in abdominal/visceral obesity. Thirty men, 48-66 yr old, with abdominal/visceral obesity were treated with recombinant human GH (rhGH) in a 9-month randomized, double-blind, placebo-controlled trial. The daily dose of rhGH was 9.5 micrograms/kg. Body fat was assessed from total body potassium, and abdominal sc and visceral adipose tissue was measured using computed tomography. The glucose disposal rate (GDR) was measured during an euglycemic, hyperinsulinemic glucose clamp. In response to the rhGH treatment, total body fat and abdominal sc and visceral adipose tissue decreased by 9.2 +/- 2.4%, 6.1 +/- 3.2%, and 18.1 +/- 7.6%, respectively. After an initial decrease in the GDR at 6 weeks, the GDR increased in the rhGH-treated group as compared with the placebo-treated one (P < 0.05). The mean serum concentrations of total cholesterol (P < 0.01) and triglyceride (P < 0.05) decreased, whereas blood glucose and serum insulin concentrations were unaffected by the rhGH treatment. Furthermore, diastolic blood pressure decreased and systolic blood pressure was unchanged in response to rhGH treatment. This trial has demonstrated that GH can favorably affect some of the multiple perturbations associated with abdominal/visceral obesity. This includes a reduction in abdominal/visceral obesity, an improved insulin sensitivity, and favorable effects on lipoprotein metabolism and diastolic blood pressure.
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24.
  • Karlsson, C, et al. (författare)
  • Human adipose tissue expresses angiotensinogen and enzymes required for its conversion to angiotensin II.
  • 1998
  • Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 83:11, s. 3925-9
  • Tidskriftsartikel (refereegranskat)abstract
    • Angiotensin II regulates blood pressure and may affect adipogenesis and adipocyte metabolism. Angiotensin II is produced by cleavage of angiotensinogen by renin and angiotensin-converting enzyme in the circulation. In addition, angiotensin II may be produced in various tissues by enzymes of the renin-angiotensin system (RAS) or the nonrenin-angiotensin system (NRAS). We have analyzed the expression of angiotensinogen and enzymes required for its conversion to angiotensin II in human adipose tissue. Northern blot demonstrated angiotensinogen expression in adipose tissue from nine obese subjects. Western blot revealed a distinct band of expected size of the angiotensinogen protein (61 kDa) in isolated adipocytes. RT-PCR, followed by Southern blot, demonstrated renin expression in human adipose tissue. Angiotensin-converting enzyme messenger RNA was detected by RT-PCR, and the identity of the PCR products was verified by restriction enzyme cleavage. Transcripts for cathepsin D and cathepsin G, components of the NRAS, were detected by RT-PCR, verified by restriction enzyme cleavage. We conclude that human adipose tissue expresses angiotensinogen and enzymes of RAS and NRAS. This opens the possibility that angiotensinogen-derived peptides, produced in adipose tissue itself, may affect adipogenesis and play a role in the pathogenesis of obesity.
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25.
  • Koskinen Holm, Cecilia, et al. (författare)
  • Successful rehabilitation after multiple severe complications following orthognathic surgery : a case report
  • 2023
  • Ingår i: BMC Oral Health. - : BioMed Central (BMC). - 1472-6831. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Complications of orthognathic surgery are quite rare, but they cause suffering in affected individuals.The range of complications is broad and includes both hard and soft tissue.Case presentation: We here present a case of a fully healthy woman without signs of impaired healing capacity. Thepatient underwent bimaxillary orthognathic surgery and experienced multiple complications both peri- and postoperatively.During the post operative period, the patient also suffered from soft tissue complications after an orthopaedicinjury. Therefore, we referred the patient to her general practitioner for further medical investigation. Wealso present the result after restorative surgery and endodontic and prosthodontic treatment resulting in a successfulrehabilitation.Conclusion: This case report clearly shows the need for a good collaboration between different odontologicaland medical fields to achieve a good and predictable result. In situations where normal healing processesdo not occur, in-depth analysis must be carried out.Highlights: Orthognathic surgery affects soft and hard tissue which can result in adverse healing and complications.It is of great importance to follow up performed surgery to see late complications. Be restrictive with earlyre-operations when there are signs of necrosis. Always use a multidisciplinary approach when handling complicationsafter surgery.
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26.
  • Kourie, Mourad, et al. (författare)
  • ABC om Ikterus hos vuxna : [Jaundice in the adult patient]
  • 2022
  • Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 119:48-49, s. 34-38
  • Tidskriftsartikel (refereegranskat)abstract
    • Jaundice is an alarm symptom that should always be treated urgently, regardless of whether the responsible doctor is in primary care or in the emergency room. The differential diagnoses can be significantly delimited (hepatocellular vs. cholestasis) and several clues to the etiology can be determined from a carefully performed anamnesis, clinical examination, and basic laboratory tests. Exclusion of cholestatic etiology is essential due to life-threatening differential diagnoses and complications, but acute medical conditions also occur, such as acute liver failure. Prompt processing at the correct instance can be crucial for the short-term and long-term prognosis of the patient.
  •  
27.
  • Kylander, Malin E., et al. (författare)
  • Mineral dust as a driver of carbon accumulation in northern latitudes
  • 2018
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322 .- 2045-2322. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Peatlands in northern latitudes sequester one third of the world's soil organic carbon. Mineral dusts can affect the primary productivity of terrestrial systems through nutrient transport but this process has not yet been documented in these peat-rich regions. Here we analysed organic and inorganic fractions of an 8900-year-old sequence from Store Mosse (the "Great Bog") in southern Sweden. Between 5420 and 4550 cal yr BP, we observe a seven-fold increase in net peat-accumulation rates corresponding to a maximum carbon-burial rate of 150 g C m(-2) yr(-1) -more than six times the global average. This high peat accumulation event occurs in parallel with a distinct change in the character of the dust deposited on the bog, which moves from being dominated by clay minerals to less weathered, phosphate and feldspar minerals. We hypothesize that this shift boosted nutrient input to the bog and stimulated ecosystem productivity. This study shows that diffuse sources and dust dynamics in northern temperate latitudes, often overlooked by the dust community in favour of arid and semi-arid regions, can be important drivers of peatland carbon accumulation and by extension, global climate, warranting further consideration in predictions of future climate variability.
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28.
  • Kylander, Malin E., 1977-, et al. (författare)
  • Storm chasing : Tracking Holocene storminess in southern Sweden using mineral proxies from inland and coastal peat bogs
  • 2023
  • Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 299, s. 107854-
  • Tidskriftsartikel (refereegranskat)abstract
    • Severe extratropical winter storms are a recurrent feature of the European climate and cause widespread socioeconomic losses. Due to insufficient long-term data, it remains unclear whether storminess has shown a notable response to changes in external forcing over the past millennia, which impacts our ability to project future storminess in a changing climate. Reconstructing past storm variability is essential to improving our understanding of storms on these longer, missing timescales. Peat sequences from coastal ombrotrophic bogs are increasingly used for this purpose, where greater quantities of coarser grained beach sand are deposited by strong winds during storm events. Moving inland however, storm intensity decreases, as does sand availability, muting potential paleostorm signals in bogs. We circumvent these issues by taking the innovative approach of using mid-infrared (MIR) spectral data, supported by elemental information, from the inorganic fraction of Store Mosse Dune South (SMDS), a 5000-year-old sequence from a large peatland located in southern Sweden. We infer past changes in mineral composition and thereby, the grain size of the deposited material. The record is dominated by quartz, whose coarse nature was confirmed through analyses of potential local source sediments. This was supported by further mineralogical and elemental proxies of atmospheric input. Comparison of SMDS with within-bog and regionally relevant records showed that there is a difference in proxy and site response to what should be similar timing in shifts in storminess over the-100 km transect considered. We suggest the construction of regional storm stacks, built here by applying changepoint modelling to four transect sites jointly. This modelling approach has the effect of reinforcing signals in common while reducing the influence of random noise. The resulting Southern Sweden-Storm Stack dates stormier periods to 4495-4290, 3880-3790, 2885-2855, 2300-2005, 1175-1065 and 715-425 cal yr BP. By comparing with a newly constructed Western Scotland-Storm Stack and proximal dune records, we argue that regional storm stacks allow us to better compare past storminess over wider areas, gauge storm track movements and by extension, increase our understanding of the drivers of storminess on centennial to millennial timescales.
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29.
  • Lindh, Anna, et al. (författare)
  • Non-face-to-face treatment of stress urinary incontinence : predictors of success after 1 year
  • 2016
  • Ingår i: International Urogynecology Journal. - : Springer London. - 0937-3462 .- 1433-3023. ; 34:S3, s. S443-S444
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION AND HYPOTHESIS: The objective was to determine predictors of long-term success in women with stress urinary incontinence (SUI) treated with a 3-month pelvic floor muscle training (PFMT) program delivered via the Internet or a brochure.METHODS: We included 169 women with SUI ≥1 time/week who completed the 1-year follow-up (n = 169, mean age 50.3, SD 10.1 years). Three outcome variables defined success after 1 year: Patient Global Impression of Improvement (PGI-I), International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF), and sufficient treatment. Using logistic regression, we analyzed data from the baseline, and from the 4-month and 1-year follow-ups, for potential predictors of success.RESULTS: Of the participants, 77 % (129 out of 169) were successful in ≥1 of the outcomes, 23 % (37 out of 160) were successful in all 3. Participants with successful short-term results were more likely to succeed in the corresponding outcome at 1 year than those without successful short-term results (adjusted odds ratios [ORs]: PGI 5.15, 95 % confidence interval [CI] 2.40-11.03), ICIQ-UI SF 6.85 (95 % CI 2.83-16.58), and sufficient treatment 3.78 (95 % CI 1.58-9.08). Increasing age predicted success in PGI-I and sufficient treatment (adjusted OR 1.06, 95 % CI 1.02-1.10, and 1.08, 95 % CI, 1.03-1.13 respectively). Compared with not training regularly, regular PFMT at 1 year predicted success for PGI and sufficient treatment (adjusted OR 2.32, 95 % CI 1.04-5.20, and 2.99, 95 % CI 1.23-7.27 respectively).CONCLUSION: The long-term success of a non-face-to-face treatment program for SUI with a focus on PFMT can be predicted by successful short-term results, increasing age, and the performance of regular PFMT after 1 year.
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30.
  • Lönn, Lars, 1956, et al. (författare)
  • Body weight and body composition changes after treatment of hyperthyroidism.
  • 1998
  • Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 0021-972X. ; 83:12, s. 4269-73
  • Tidskriftsartikel (refereegranskat)abstract
    • Body composition changes in nine adults with hyperthyroidism were determined with dual energy x-ray absorptiometry and computed tomography at diagnosis and after 3 and 12 months of euthyroidism achieved by surgery, antithyroid drugs, or treatment with radioiodine. Mean body weight was 67.6 kg at diagnosis and increased 2.7 kg (P=0.06) and 8.7 kg (P < 0.001) after 3 and 12 months of euthyroidism, respectively. Basal metabolic rate decreased from 2087 Cal/24 h at diagnosis to 1601 Cal/24 h at 12 months (P=0.001), whereas reported energy intake dropped from 3244 to 2436 Cal/24 h (P=0.01). According to dual energy x-ray absorptiometry, body fat was unchanged at 3 months, but increased by 5.3 kg (P < 0.0001) at 12 months. Fat-free mass increased 2.7 kg (P=0.003) at 3 months and 3.5 kg (P < 0.0001) at 12 months. Changes in bone mineral content and density did not reach significance. According to computed tomography, skeletal muscle plus skin areas increased by 11% (trunk) and 18% (thigh) at 3 months and by 17% (trunk) and 25% (thigh) at 12 months. There was no increase in sc adipose tissue (AT) at 3 months, but at 12 months this AT depot increased by 15% (thigh) and 33% (trunk). Intraperitoneal AT showed a borderline significant increase by 28% (P=0.08) at 3 months and by 40% (P=0.015) at 12 months. Areas of visceral organs and bone tissue of femur did not change significantly during the study. It is concluded that during early recovery from hyperthyroidism, priority is given to the replenishment of skeletal muscles and ip AT, whereas sc AT is increased at a later stage.
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31.
  • Martínez Cortizas, Antonio, et al. (författare)
  • 9000 years of changes in peat organic matter composition in Store Mosse (Sweden) traced using FTIR-ATR
  • 2021
  • Ingår i: Boreas. - : Wiley. - 0300-9483 .- 1502-3885. ; 50:4, s. 1161-1178
  • Tidskriftsartikel (refereegranskat)abstract
    • Store Mosse (the ‘Great Bog’ in Swedish) is one of the most extensive bog complexes in southern Sweden (~77 km2), where pioneering palaeoenvironmental research has been carried out since the early 20th century. This includes, for example, vegetation changes, carbon and nitrogen dynamics, peat decomposition, atmospheric metal pollution, mineral dust deposition, dendrochronology, and tephrochronology. Even though organic matter (OM) represents the bulk of the peat mass and its compositional change has the potential to provide crucial ecological information on bog responses to environmental factors, peat OM molecular composition has not been addressed in detail. Here, a 568-cm-deep peat sequence was studied at high resolution, by attenuated reflectance Fourier-transform infrared spectroscopy (FTIR-ATR) in the mid-infrared region (4000–400 cm–1). Principal components analysis was performed on selected absorbances and change-point modelling was applied to the records to determine the timing of changes. Four components accounted for peat composition: (i) depletion/accumulation of labile (i.e. carbohydrates) and recalcitrant (i.e. lignin and other aromatics, aliphatics, organic acids and some N compounds) compounds, due to peat decomposition; (ii) variations in N compounds and carbohydrates; (iii) residual variation of lignin and organic acids; and (iv) residual variation of aliphatic structures. Peat decomposition showed two main patterns: a long-term trend highly correlated to peat age (r = 0.87), and a short-term trend, which showed five main phases of increased decomposition (at ~8.4–8.1, ~7.0–5.6, ~3.5–3.1, ~2.7–2.1 and ~1.6–1.3 ka) – mostly corresponding to drier climate and its effect on bog hydrology. The high peat accumulation event (~5.6–3.9 ka), described in earlier studies, is characterized by the lowest degree of peat decomposition of the whole record. Given that FTIR-ATR is a quick, non-destructive, cost-effective technique, our results indicate that it can be applied in a systematic way (including multicore studies) to peat research and provide relevant information on the evolution of peatlands.
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32.
  • Martínez Cortizas, Antonio, et al. (författare)
  • Investigating the Mineral Composition of Peat by Combining FTIR-ATR and Multivariate Analysis
  • 2021
  • Ingår i: Minerals. - : MDPI AG. - 2075-163X. ; 11:10
  • Tidskriftsartikel (refereegranskat)abstract
    • The mineral content of peat has received little attention until the last few decades, when peat cores have been increasingly used to study past dust deposition. Paleodust deposition is commonly reconstructed through elemental datasets, which are used to infer deposition rates, storminess patterns, mineral composition, source identification, and fertilization effects. To date, only a few studies have directly analyzed the mineralogy (by XRD and SEM) and particle size of peat mineral matter, and the conducted studies have usually been constrained by the need to remove a large amount of organic matter, which risks altering the mineral component. One alternative is to use quick, nondestructive techniques, such as FTIR-ATR, that require little sample preparation. In this study, we analyzed by FTIR-ATR both the bulk peat and ash fractions of a sequence taken in a minerogenic mire that covered a wide inorganic matter content range (6%–57%). Aided by principal component analysis on transposed IR spectral data, we were able to identify the main minerals in bulk peat and ash, quartz, mica (likely muscovite), K feldspar (likely microcline), and plagioclase (likely anorthite), which are consistent with the local geology of the mire catchment. Changes in mineral composition during the last ca. 2800 years were coeval with previously reconstructed environmental changes using the same core. Our results suggest that FTIR-ATR has great potential to investigate peat mineral matter and the processes that drive its compositional change.
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33.
  • Mårin, P, et al. (författare)
  • The morphology and metabolism of intraabdominal adipose tissue in men.
  • 1992
  • Ingår i: Metabolism: clinical and experimental. - 0026-0495. ; 41:11, s. 1242-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Mass, morphology, and metabolism of total adipose tissue and its subcutaneous, visceral, and retroperitoneal subcompartments were examined in 16 men with a wide variation of total body fat. Computerized tomography (CT) scans showed that the intraabdominal fat mass comprised approximately 20% of total fat mass. Visceral and retroperitoneal fat masses were approximately 80% and 20% of total intraabdominal fat mass, respectively. Enlargement of intraabdominal fat depots was due to a parallel adipocyte enlargement only. Direct significant correlations were found between these adipose tissue masses and blood glucose and plasma insulin levels, blood pressure, and liver function tests, while glucose disposal rate during euglycemic glucose clamp measurements at submaximal insulin concentrations (GDR), plasma testosterone, and sex hormone-binding globulin concentrations correlated negatively. The correlations for glucose, insulin, and GDR were strongest with visceral fat mass. Adipose tissue lipid uptake, measured after oral administration of labeled oleic acid in triglyceride, was approximately 50% higher in omental than in subcutaneous adipose tissues. Adipocytes from omental fat also showed a higher lipolytic sensitivity and responsiveness to catecholamines. Furthermore, these adipocytes were less sensitive to the antilipolytic effects of insulin. Both lipid uptake and lipolytic sensitivity and responsiveness showed strong correlations (r = 0.8 to 0.9) to blood glucose and plasma insulin concentrations and also to the GDR (negative), while no such correlations were found with lipid uptake in subcutaneous or retroperitoneal abdominal adipose tissues. Taken together, these results suggest a higher turnover of lipids in visceral than in the other fat depots, which is closely correlated to systemic insulin resistance and glucose metabolism in men.
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34.
  • Nilsson, Karin, et al. (författare)
  • Physicians' experiences of challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in Sweden
  • 2022
  • Ingår i: International Journal of Health Governance. - : Emerald Group Publishing Limited. - 2059-4631. ; 27:3, s. 254-267
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care. Design/methodology/approach: The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material. Findings: The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients. Practical implications: The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services. Originality/value: This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis.
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35.
  • Nyström, Emma, et al. (författare)
  • ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence
  • 2015
  • Ingår i: Neurourology and Urodynamics. - : Wiley-Blackwell. - 0733-2467 .- 1520-6777. ; 34:8, s. 747-751
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To determine whether changes in questionnaire scores on symptoms and condition-specific quality of life reflect clinically relevant improvements in women with stress urinary incontinence (SUI).METHODS: We retrospectively analyzed questionnaires collected during a randomized controlled trial in women with SUI, that received pelvic floor muscle training (PFMT) in two different formats. We included 218 women that answered validated self-assessment questionnaires at baseline and at a 4-month follow-up. We registered changes on two questionnaires, the International Consultation on Incontinence Modular Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol). We compared these score changes to responses from the Patient Global Impression of Improvement (PGI-I) questionnaire. Differences were analyzed with the Spearman rho and one-way-ANOVA. The minimum important difference (MID) was the mean change in score for women that experienced a small improvement.RESULTS: The PGI-I correlated significantly to both the ICIQ-UI SF (r = 0.547, P < 0.0001) and ICIQ-LUTSqol (r = 0.520, P < 0.0001). Thus, larger reductions in symptoms or quality of life scores were associated with greater impressions of improvement. The changes in ICIQ-UI SF and ICIQ-LUTSqol scores were significant across all PGI-I groups from "no change" to "very much improved" (P < 0.05). The MIDs were 2.52 (SD 2.56) for ICIQ-UI SF and 3.71 (SD 4.95) for ICIQ-LUTSqol.CONCLUSIONS: The change in ICIQ-UI SF and ICIQ-LUTSqol scores after PFMT reflected clinically relevant improvements in women with SUI. The MIDs established for this population may facilitate future research, treatment evaluations, and comparisons between studies. 
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36.
  •  
37.
  • Nyström, Emma, 1987- (författare)
  • Self-Management of Urinary Incontinence Using eHealth : clinically relevant improvement, treatment effect and factors associated with success
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Urinary incontinence is common among women, with prevalence most often reported to be between 25% and 45%. The most common type is stress urinary incontinence (SUI), defined as leakage upon exertion. First-line treatment includes pelvic floor muscle training (PFMT) and lifestyle advice. eHealth, the use of information and communication technology for health, can lower barriers to seeking help, save time and provide easily accessible care. In other conditions, the use of mobile technology has been argued to improve adherence to, and serve as a support for, self-management leading to improved symptom control.Aim: To evaluate self-management of urinary incontinence via eHealth with respect to clinically relevant improvement, treatment effect and factors associated with success. This thesis focuses on self-management of SUI via the mobile app Tät®.Methods: This thesis is based on four papers (I-IV) with data from three different studies (1-3). Studies 1 and 2 were randomised controlled trials, to which adult, community-dwelling women with at least weekly SUI were recruited via the website of the research project. In study 3, we studied the use of the Tät® app once it had been made freely available after study 2. All users with urinary incontinence that were 18 years of age or older were included. All interventions were developed within the research project, focused on PFMT and included lifestyle adviceIn study 1, participants were randomised to either internet-based or brochurebased SUI management. Data from both groups were analysed for correlation with the Patient Global Impression of Improvement (PGI-I) questionnaire and the changes in validated symptom (ICIQ-UI SF) questionnaire and in the quality of life (ICIQ-LUTSqol) questionnaire. We then determined a minimal important difference (MID) for non-face-to-face treatment of SUI. (Paper I)In study 2, participants were randomised to three months of self-management with the Tät® app or to control group (waiting list). The primary outcomes were ICIQ-UI SF and ICIQ-LUTSqol. These were analysed according to intention to treat using a linear mixed model. (Paper II) Data from the participants that were randomised to app management were analysed using logistic regression to identify factors associated with success. Success was defined as participants stating that they were much/very much better according to PGI-I. (Paper III)In study 3, users were asked to participate by completing questionnaires upon download of the app and three months thereafter. Background factors, PFMT iv frequency and app usage were analysed using logistic regression to identify factors associated with three outcomes: completion of three months of selfmanagement, improvement (according to PGI-I) and success (defined as described above). (Paper IV)Results: We found that the symptom and quality of life scores capture a clinically relevant improvement. The MIDs were determined to be a reduction of 2.52 points for ICIQ-UI SF and 3.71 points for ICIQ-LUTSqol. (Paper I)The Tät® app had a positive effect on symptoms with a mean ICIQ-UI SF reduction of 3.9 points (95% CI 3.0 -4.7), and improved quality of life with a mean ICIQ-LUTSqol reduction of 4.8 points (95% CI 3.4-6.2). These scores differed significantly from the control group and were well above the MIDs, and therefore clinically relevant improvements. Women in the intervention groups also had a greater decrease in incontinence episode frequency, and significantly reduced their pad use compared to the control group. In terms of patient satisfaction, 97% found the app to be “good” or “very good”. (Paper II)After three months of self-management with Tät®, 34 out of 61 participants (56%) stated that they were much or very much better. Three factors were associated with successful management: high expectations on treatment, weight control and self-assessed improvement in pelvic floor muscle strength. (Paper III)Once the app was freely available, 1 861 of 13 257 users (14%) completed the three-month follow-up. Four factors predicted completion: age, higher educational level, stress-type incontinence episodes and language. Together these factors accounted for 2.7% of the variability (Nagelkerke R2). Among the users that completed self-management, 68% improved and 29% were successful according to the PGI-I. Stress-type leakage and language were also associated with improvement. At least weekly PFMT and app usage predicted both improvement and successful self-management. (Paper IV)Conclusion: Self-management for urinary incontinence via a mobile app has clinically relevant effects on symptoms and quality of life. This is particularly the case for women with high expectations on app self-management and for those who used the app and exercised their pelvic floor at least weekly. Furthermore, beyond the study setting once the app was freely available, the majority of users’ symptoms improved if users completed three months of training.
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38.
  • Nyström, Emma, et al. (författare)
  • Treatment of stress urinary incontinence with a mobile app : factors associated with success
  • 2018
  • Ingår i: International Urogynecology Journal. - : Springer. - 0937-3462 .- 1433-3023. ; 29:9, s. 1325-1333
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction and hypothesis: Stress urinary incontinence is common among women. First-line treatment includes pelvic floor muscle training (PFMT) and lifestyle advice, which can be provided via a mobile app. The efficacy of app-based treatment has been demonstrated in a randomized controlled trial (RCT). In this study, we aimed to analyze factors associated with successful treatment.Methods: Secondary analysis of data from the RCT. At baseline and 3-month follow-up, participants (n = 61) answered questions about symptoms, quality of life, background, and PFMT. Success was defined as rating the condition as much or very much better according to the validated Patient Global Impression of Improvement questionnaire. Factors possibly associated with success were analyzed with univariate logistic regression; if p < 0.20, the factor was entered into a multivariate model that was adjusted for age. Variables were then removed stepwise.Results: At follow-up, 34 out of 61 (56%) of participants stated that their condition was much or very much better. Three factors were significantly associated with success: higher expectations for treatment (odds ratio [OR] 11.38, 95% confidence interval [CI] 2.02-64.19), weight control (OR 0.44 per kg gained, 95% CI 0.25-0.79), and self-rated improvement of pelvic floor muscle strength (OR 35.54, 95% CI 4.96-254.61). Together, these factors accounted for 61.4% (Nagelkerke R-2) of the variability in success.Conclusion: These results indicate that app-based treatment effects are better in women who are interested in and have high expectations of such treatment. Also, the findings underline the importance of strengthening the pelvic floor muscles and offering lifestyle advice.
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39.
  • Olbers, Torsten, 1964, et al. (författare)
  • Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS)
  • 2012
  • Ingår i: International Journal of Obesity. - : Springer Science and Business Media LLC. - 1476-5497 .- 0307-0565. ; 36:11, s. 1388-1395
  • Tidskriftsartikel (refereegranskat)abstract
    • CONTEXT: The prevalence of obesity among adolescents has increased and we lack effective treatments. OBJECTIVE: To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care. DESIGN, SETTING AND PATIENTS: Intervention study for 81 adolescents (13-18 years) with a body mass index (BMI) range 36-69 kg m(-2) undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (n = 81) and an adolescent group (n = 81) receiving conventional care. MAIN OUTCOME MEASUREMENTS: Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group. RESULTS: Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5 +/- 6.1 (mean +/- s.d.) at baseline and 30.2 (confidence interval 29.1-31.3) after 2 years (P<0.001) corresponding to a 32% weight loss and a 76% loss of excess BMI. The 2-year weight loss was 31% in adult surgery patients, whereas 3% weight gain was seen in conventionally treated adolescents. At baseline, hyperinsulinemia (>20 m Ul(-1)) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients. CONCLUSIONS: Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention. International Journal of Obesity (2012) 36, 1388-1395; doi:10.1038/ijo.2012.160; published online 25 September 2012
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40.
  • Olsson, Erik, et al. (författare)
  • U-CARE : a research program on psychosocial care via the internet
  • 2012
  • Konferensbidrag (refereegranskat)abstract
    • U-CARE is one of the Swedish government’s strategic research programs atUppsala University. The overarching goal is to promote psychosocial healthamong patients suffering from somatic disease and their significant others by means of self-help programs delivered via an internet platform. Another goal is to reduce costs for individuals and the society caused by emotional distress in response to somatic disease. Professionals within clinical psychology, health economics, and information systems collaborate to reach this goal.Approximately 20% of patients suffering from somatic disease as well as theirsignificant others experience a clinically relevant level of emotional distress in response to disease and treatment. This is in itself alerting, but becomes even moreproblematic since physicians and nurses show low sensitivity and specificityin detecting patients and significant others experiencing a clinically relevant level of distress. This can result in persistent distress causing human suffering as well as costs for individuals and the society.During 2010-2011 an internet platform: www.u-care.se to provide interactive support and cognitive behavioral therapy has been constructed within the U-CARE program. The platform supports, among other things, rule-based unfolding of self-help material for participants, interaction between participants and therapists, interaction within a participant community, and research including a detailed log of participants’ behaviors on the platform. In addition self-help programs of interactive support and cognitive behavioural therapy for adolescents with cancer: U-CARE: TeenCan, adults with cancer: U-CARE: AdultsCan, and adults having had a myocardial infarct: U-CARE: Heart to be provided via www.u-care.se have been constructed.Through a multi-disciplinary and design-oriented approach, the U-CARE program aims at developing new evidence-based knowledge in basic and applied psychosocial health care,and actively promoting its implementation in health care practice as well as in undergraduate and advanced education.
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41.
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42.
  • Ryberg, Eleonor E., et al. (författare)
  • Postglacial peatland vegetation succession in Store Mosse bog, south-central Sweden : An exploration of factors driving species change
  • 2022
  • Ingår i: Boreas. - : Wiley. - 0300-9483 .- 1502-3885. ; 51:3, s. 651-666
  • Tidskriftsartikel (refereegranskat)abstract
    • Boreal peatlands are facing significant changes in response to a warming climate. Sphagnum mosses are key species in these ecosystems and contribute substantially to carbon sequestration. Understanding the factors driving vegetation changes on longer time scales is therefore of high importance, yet challenging since species changes are typically affected by a range of internal and external processes acting simultaneously within the system. This study presents a high-resolution macrofossil analysis of a peat core from Store Mosse bog (south-central Sweden), dating back to nearly 10 000 cal. a BP. The aim is to identify factors driving species changes on multidecadal to millennial timescales considering internal autogenic, internal biotic and external allogenic processes. A set of independent proxy data was used as a comparison framework to estimate changes in the bog and regional effective humidity, nutrient input and cold periods. We found that Store Mosse largely follows the expected successional pathway for a boreal peatland (i.e. lake -> fen -> bog). However, the system has also been affected by other interlinked factors. Of interest, we note that external nutrient input (originating from dust deposition and climate processes) has had a negative effect on Sphagnum while favouring vascular plants, and increased fire activity (driven by allogenic and autogenic factors) typically caused post-fire, floristic wet shifts. These effects interactively caused a floristic reversal and near disappearance of a once-established Sphagnum community, during which climate acted as an indirect driver. Overall, this study highlights that the factors driving vegetation change within the peatland are multiple and complex. Consideration of the role of interlinked factors on Sphagnum is crucial for an improved understanding of the drivers of species change on short- and long-term scales.
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43.
  • Rydberg, Christian, et al. (författare)
  • Transdisciplinär transeuropeisk transformering : ett didaktiskt modelleringsprojekt med fokus på ämnesövergripande arbete kring kontroversiella hållbarhetsfrågor inom ett internationellt utbyte
  • 2016
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Denna studie undersöker ett didaktiskt modelleringsprojekt där fem europeiska högstadieskolor inom ett EU-finansierat Erasmus+-partnerskap skapar ämnesövergripande undervisningsarenor, dels lokalt i form av ämnesövergripande temadagar, dels inom ramen för internationella elevutbyten. Det övergripande syftet med skolpartnerskapet är en förändrad undervisning som utvecklar elevers förmågor att värdera information, diskutera, argumentera och fatta politiska beslut kring tekniska innovationers konsekvenser för individ, samhälle och miljö. Som medel för detta arbetar lärare och elever under en tvåårsperiod med olika kontroversiella hållbarhetsfrågor med naturvetenskapligt, tekniskt och samhällsvetenskapligt innehåll och med socio-politiska och etiska aspekter i olika tema. Ett belyser frågeställningar som rör användning av robotar och tekniker för att skapa syntetiskt liv i ett framtidsscenario placerat på en imaginär planet kallad ”PromethEUs”. Inom ramen för ett doktorandprojekt studeras och analyseras på vilka sätt denna didaktiska modell kan erbjuda lärarna redskap att utveckla och förändra sin undervisningspraktik. Hur tas elevuppgiften emot och hanteras av skolor med begränsad erfarenhet av denna typ av undervisning? Hur väljer de att använda och anpassa den i sin nationella kontext? Vilka ”motstånd” stöter de olika skolorna på i sin implementeringsprocess och hur hittar de lösningar på dessa? Hur kan dialog och reflektion i samband med internationella utbyten bidra till transformation av lärarnas referensramar och deras perspektiv på sin undervisning? Dessa frågor undersöks genom fokusgruppsintervjuer och deltagande observationer och analyseras preliminärt med hjälp av bland andra Engeström.
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44.
  • Sjöström, John, et al. (författare)
  • Hur styrs arbetsmiljön?
  • 2019. - 1:1
  • Ingår i: Arbete &amp; välfärd. - Lund : Studentlitteratur AB. - 9789144116310 ; , s. 391-413
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Förbättrad arbetsmiljö har förts fram som svar på frågan om hur exkludering och utslagning av arbetskraft från arbetsmarknaden kan förhindras. Frågan om hur konkurrenskraft och kvalitet kan stärkas hos företag och organisationer har besvarats på samma sätt: förbättrad arbetsmiljö. I svensk arbetsmiljölagstiftning betonas betydelsen av hur arbetet organiseras och styrs. Detta kapitel är tänkt att skapa en bättre förståelse av vad arbetsmiljöstyrning syftar till och att visa på en rad utmaningar som de som genom arbetsmiljöstyrning vill verka för en hälsosam arbetsmiljö ställs inför. Dessutom beskrivs hur arbetsmiljöstyrningen har utvecklats över tid.  
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45.
  • Sjöström, Jenny K., et al. (författare)
  • Holocene storminess dynamics in northwestern Ireland : shifts in storm duration and frequency between the mid- and late Holocene
  • 2024
  • Ingår i: Quaternary Science Reviews. - : Elsevier. - 0277-3791 .- 1873-457X. ; 337
  • Tidskriftsartikel (refereegranskat)abstract
    • Substantial uncertainties exist regarding how future climate change will affect storminess (storm frequency and intensity) in Ireland and the United Kingdom (UK). Knowledge about spatiotemporal variations of past storminess gives us a better understanding of its mechanisms on centennial to millennial time scales, as well as the impact of external forcing on future storminess in climate models. Here, we present the oldest storm record to date from Ireland, covering the last 8000 years, reconstructed from the Roycarter Bog, a coastal blanket bog in north-western Ireland. The sequence was analysed for grain-size, chemical, mineral and organic molecular composition. The chronology was built on 11 AMS radiocarbon dates. The deposit characteristics, location and low inorganic content suggest aeolian transport of particles to the bog throughout the studied period. Cluster analysis of the grain-size frequency curves, along with the coarse to fine sand ratio, allowed the identification of eleven storm periods (cal yr BP): 6150–5500 (1); 4970–4130 (2); 4000 (3); 3490–3290 (4); 3230 (5); 2850–2590 (6); 2170–1920 (7); 1440 (8); 1225–890 (9); 620–470 (10); and 290–230 (11).During the mid-Holocene, the relative sea level was lower and the local beach sources located further away, giving a longer transport distance compared to the late Holocene. In the latter part of the mid-Holocene (6150–4130 cal yr BP), during the Holocene thermal maximum, increased storminess and wind strengths were inferred for north-western Ireland, manifested as two longer storm periods. During the late Holocene the storm frequency increased, and a greater number (9) of shorter storm periods were recorded. Comparison between our results and regional peat palaeostorm records from Scotland, north of our study site, showed an antiphase relationship between storminess in Ireland and Scotland during the latter part of the mid-Holocene, but mostly in-phase storminess over the last 3000 years. Taken together, enhanced wind strength and storminess were recorded during the warmer mid-Holocene, while an increased frequency of storm events occurred in the cooler late Holocene. Mid-Holocene storm periods occurred during locally wet periods, while most of the storm periods during late Holocene occurred during drier phases. Alternatively, the elevated mineral input during late Holocene promoted microbial activity and peat decomposition. The apparent variability in cyclicity and frequency between the mid- and late Holocene indicates that the processes governing storminess in the region shifted. This calls for further studies ahead, including climate modelling, to disentangle the complex processes governing storminess on millennial to centennial time scale.
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46.
  • Sjöström, Jenny K., 1978-, et al. (författare)
  • Late Holocene peat paleodust deposition in south-western Sweden : exploring geochemical properties, local mineral sources and regional aeolian activity
  • 2022
  • Ingår i: Chemical Geology. - : Elsevier. - 0009-2541 .- 1872-6836. ; 602
  • Tidskriftsartikel (refereegranskat)abstract
    • Atmospheric mineral dust not only interacts with the climate system by scattering incoming solar radiation and affecting atmospheric photochemistry, but also contributes critical nutrients to marine and terrestrial ecosystems. In a high-resolution analysis of paleodust deposition, peat development and soil dust sources, we assess the interplay between dust deposition and bog development of the Davidsmosse bog in south-western Sweden. Analyses of the 5400-year record (458 cm) included radiocarbon dating, bulk density, ash content, chemical and mineralogical composition and carbon stable isotopes, subsequently explored using principal component analysis. Fourteen dust events (DEs) were recorded (cal BP) in the peat sequence: 3580–3490; 3280; 3140; 3010–2840; 2740; 2610; 2480; 2340; 2240–2130; 1690; 1240; 960, 890–760, and 620–360. The majority of the DEs were coupled to increases in peat accumulation rates and increased nutrient content (N, P and K) suggesting that the DEs contributed with nutrients to the bog ecosystem, promoting increased accumulation. We also analyzed the chemical and mineral composition of potential mineral source deposits (separated into 6 grain-size fractions) from sites within a 4 km radius as well as aeolian dunes closer to the coast (25 km). The composition deposited on the present-day bog surface indicates that the bulk of the contemporary minerals have a local origin (<1.5 km), but the DEs may be of a more distant origin. The results also indicate that quartz and plagioclase feldspar content consistently increase with increasing grain-size, both in the source samples as well as in the peat sequence, and that the Si/Al ratio can be used to infer grain size changes in the peat. Two longer phases saw numerous DEs, between 2800 and 2130 cal BP and a stepwise increase from 960 towards 360 cal BP. The episodic character of the events, together with the inferred coarse grain size, suggest that the particles were deposited by (winter) storms. Future studies should include grain size analysis as well as a more in-depth comparison with regional paleo dust and storm records to increase knowledge on both transport processes (creep, saltation, suspension) and the climate processes driving late Holocene dust and storm events in Scandinavia.
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47.
  • Sjöström, Jenny K., et al. (författare)
  • Paleodust deposition and peat accumulation rates : bog size matters
  • 2020
  • Ingår i: Chemical Geology. - : Elsevier. - 0009-2541 .- 1872-6836. ; 554
  • Tidskriftsartikel (refereegranskat)abstract
    • We present a high-resolution peat paleodust and accumulation rate record spanning the last 8300 years from Draftinge Mosse (400 ha), southern Sweden (57 degrees 06'27.6 '' N 13 degrees 42'54.1 '' E). The record was analysed for peat accumulation rates (PAR), elemental concentrations, mineralogy, and plant macrofossil content. Five periods of increased mineral deposition were recorded. The first event occurred between similar to 6280 and similar to 5570 cal BP, during the fen to bog transition. This is followed by four atmospheric mineral dust events (DE) which were recorded in the ombrotrophic section of the sequence at (cal BP): similar to 2200; similar to 1385-1150; similar to 830-590, and from similar to 420 to the present. Statistical analysis and elemental ratios indicated that both the mineralogy and grain size shifted when the system transitioned from fen into bog, showing that the governing transport process shifted with the peat-land succession stages. This highlights the importance of identifying peatland succession stages within peat paleodust studies. Following all four DE, increases in PAR were observed, implying a coupling to dust deposition. Comparison of DE and PAR with a paleodust record from Store Mosse, a 20 times larger bog located ca 18 km away (Kylander et al. 2016), showed that both PAR and dust deposition are largely represented by single-core reconstructions, indicating that they are driven by a common climate forcing mechanism. However, higher PAR and dust deposition rates were observed in the more moderately sized Draftinge Mosse, suggesting that the size of the bog is important to consider in peat paleodust studies. Furthermore, the smaller bog responded more rapidly to hydrological changes, indicating that the size of the bog affects its' buffering capacity. Authigenic carbonates, observed here during episodes of rapid peat growth, coincide with changes in REE ratios, indicating that authigenic peat processes potentially cause REE fractionation.
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48.
  • Sjöström, Jenny K., et al. (författare)
  • Procedure for Organic Matter Removal from Peat Samples for XRD Mineral Analysis
  • 2019
  • Ingår i: Wetlands (Wilmington, N.C.). - : Springer. - 0277-5212 .- 1943-6246. ; 39:3, s. 473-481
  • Tidskriftsartikel (refereegranskat)abstract
    • Ombrotrophic peatlands are recognized archives of past atmospheric mineral dust deposition. Net dust deposition rates, grain size, mineral hosts and source areas are typically inferred from down-core elemental data. Although elemental analysis can be time efficient and data rich, there are some inherent limitations. X-ray diffraction (XRD) analysis allowsdirect identification of mineral phases in environmental samples but few studies have applied this method to peat samples and a well-developed protocol for extracting the inorganic fraction of highly organic samples (>95%) is lacking. We tested and compared different levels of pre-treatment: no pre-treatment, thermal combustion (300, 350, 400, 450, 500 and 550 degrees C) and chemical oxidation (H2O2 and Na2S2O8) using a homogenised highly organic (>98%) composite peat sample. Subsequently, minerals were identified by XRD. The results show that combustion is preferred to chemical oxidation because it most efficiently removes organic matter (OM), an important pre-requisite for identifying mineral phases by XRD analysis. Thermally induced phase transitions can be anticipated when temperature is the only factor to take into consideration. Based on the data required in this studythe recommended combustion temperature is 500 degrees C which efficiently removes OM while preserving a majority of common dust minerals.
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49.
  • Sjöström, Jenny, 1978- (författare)
  • Mid-Holocene mineral dust deposition in raised bogs in southern Sweden : Processes and links
  • 2021
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Atmospheric mineral dust is a key component of the climate system, which affects insolation, brings nutrients to marine and terrestrial ecosystems, and acts as a cloud condensation nuclei. To reconstruct past patterns in terrestrial dust deposition natural archives may be utilized, such as loess, dunes, lakes, and peat bogs. Bogs became an established dust archive in the early 2000s, and the number of studies has since increased. However, most studies use single records to represent dust deposition, meaning that we have limited understanding of regional paleodust dynamics or about the representativeness of single bog records. This thesis aims to address these uncertainties by comparing paleodust deposition between bogs located on a 65 km transect. The thesis includes a methodological development for organic matter removal from peat samples for XRD mineral analysis (Paper I) and two peat paleodust reconstruction studies (Paper II, III). The first paleodust reconstruction from Draftinge Mosse (mosse translates to bog in English), Småland, showed that four dust events (DE) were recorded during the ombrotrophic stage (Paper II). These results were compared to a previously conducted study on Store Mosse, 20 km northeast of Draftinge Mosse, which showed similar patterns in DE and peat accumulation rate (PAR), indicating that the events were at least regional in character. However, the magnitude of the DE differed, which was related to differences in the sizes of the two bogs. The second paleodust reconstruction, from (Davidsmosse) located c. 25 km from the west coast, recorded many more DE (14) compared to the more inland sites (Paper III). Two longer periods saw numerous DE, dominated by coarse particles: between 2800 and 2130 cal BP, and from 1000 towards 490 cal BP. These two periods occurred during regionally cold periods. Human activities also intensified during the latter period, possibly amplifying the DE. Most of these episodic events were not recorded at the inland sites, and the Davidsmosse record seemed to be more in line with previously constructed coastal paleostorm records. That the bog located closer to the coast recorded many more events compared to the inland sites suggests that the location of a bog will influence the aeolian events recorded. However, the DE observed at the inland sites were also recorded at Davidsmosse, indicating that the inland events might represent winds that were sustained over longer distance, or alternatively, that regionally dry conditions prevailed during these periods. The paleostorm records from south-western Sweden, including the new results from Davidsmosse presented here, suggest that storm intensities have varied during the last 3000 years, with increased storminess frequency coupled to colder episodes related to extended sea ice and a southward shift of storm tracks. When comparing DE and PAR at both sites studied here, a recurring pattern of increased accumulation rates were observed during a majority of DE, supporting the suggestion of previous studies that dust deposition may affect peat growth, and thus also peat carbon sequestration.Combining elemental data with XRD mineral analysis enabled anchoring of elemental inferences with mineral observations, allowed identification of authigenic minerals, and aided in source tracing. Despite the fact that local factors affect mineral deposition and PAR, this work has outlined some of the possible mechanisms behind these observations (e.g. distance to the coast, or bog size difference) which may be important for future peat paleodust studies to consider. For example, future studies should include grain size analysis (down-core, as well as across a bog surface); pollen analysis to further elaborate on human activities and vegetation cover; and further investigate differences in mass accumulation rates between bogs.
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50.
  • Sjöström, Jenny, 1978-, et al. (författare)
  • Mid-Holocene reconstruction of peat paleodust deposition and accumulation rates in southern Sweden during the last 5400 years : processes and links
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • We present a peat paleodust and accumulation rates study from Davidsmosse, Halland region, south-west Sweden. The 458 cm peat sequence was studied for peat composition, bulk density, elemental composition and ash content. The results were quantitatively assessed using principal component analysis and related to calendar ages by radiocarbon dating. Local soil and sediments samples from the surrounding area (within 4 km radius) as well as aeolian dunes located closer to the coast (25 km) were analysed for elemental concentrations and mineral content. These results were compared to the minerals on the current bog surface and their similarity suggests that the deposited minerals have a local origin. From the peat paleodust reconstruction fourteen dust events (DE) were recorded (cal BP): 3580–3490; 3280; 3140; 3010–2840; 2740; 2610; 2480; 2340; 2240–2130; 2050; 1890; 1690; 1240; and 960–490. A majority of these events were coupled to increases in peat accumulation rates (13 of 14), indicating a relationship between these two processes. Davidsmosse recorded two longer phases that saw numerous DE with larger inferred grain size between 2800 and 2130 cal BP and a stepwise increase from 1000 towards 490 cal BP. These phases overlap in time with increased storm activity recorded in previous studies, both in nearby bog records as well as from dune records in Denmark, and a coastal bog in Scotland, suggesting storminess as a driver of DE signals at Davidsmosse. These stormier periods are related to colder periods, coupled to extended sea ice south of Iceland and a southward shift in storm tracks. Comparison with peat paleodust records further inland did not register these events, indicating that the location of the bog will affect which type of DE that will be recorded. Those DE found at both coastal and inland sites may represent periods with particularly strong winds, or alternatively, regionally dry phases. Further studies are required to untangle which of these processes are responsible for this pattern, for example by conducting grain size analysis on an event recorded at all three bogs, coupled with high resolution dating. 
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