| 1. |
- Andreas, Lale, et al.
(författare)
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Chemical and hydraulic conditions in a landfill/deposit for wood-based ash
- 2004
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Ingår i: The 3rd Intercontinental Landfill Research Symposium November 29th - December 2nd, 2004 in Toya, Hokkaido Japan. - Hokkaido : Center for Applied Ethics and Philosophy, Hokkaido University. ; , s. 121-129
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 2. |
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| 3. |
- Andreas, Lale, et al.
(författare)
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Use of secondary materials in landfill constructions
- 2007
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Ingår i: SARDINIA 2007. - Cagliari : CISA, Environmental Sanitary Engineering Centre. - 9788862650038
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Konferensbidrag (refereegranskat)abstract
- Many landfills are subject to closure in the near future. Roughly 2,000 hectares of landfill area have to be covered only in Sweden, equivalent to about 100 million tonnes of construction material. In addition to material costs in the order of tens of billions Euro, this also puts a strain on the environment through the exploitation of non-renewable virgin construction materials. Many landfill operators are considering alternative cover designs and materials in order to reduce resource spending. However, there is a fair amount of uncertainty with regard to functional and environmental consequences of using alternative (secondary) materials, both from the side of the companies and the authorities. This paper gives an overview over potential waste based construction materials and the use of some of them in projects presently ongoing in Sweden.Research on the use of secondary materials in landfill covers is quite recent. Substitutes for natural or synthetic materials in a landfill cover can be various types of waste from process industry, construction and demolition, or comparable activities. Alternative materials that have been investigated are ashes, slags, sewage and fibre sludges, treated soils and compost. Table 1 gives an overview over potential waste based construction materials. The total of potential materials is well in excess of the material needs for landfill construction, but they may not be available at the right time, place or quality.Besides being economically viable, the substitute materials should have suitable technical and environmental properties in order to secure a proper function of the construction. Experiences from three field studies (landfills at Tveta/Södertälje, Hagfors and Alvkarleby) are discussed looking at relevant issues during 1) construction, 2) active after care phase, and 3) long term processes.Using SCM poses additional problems compared to using conventional materials. Often, the supply of material has to be planned in advance and the materials may have to be stored on site. Storing, however, can cause problems if the materials have properties that change over time e.g. due to climate. For other materials storing may be necessary in order to achieve desired properties. One example is the ageing of strongly alkaline materials that react with atmospheric carbon dioxide and thus obtain better leaching properties. Table 1 Overview over potential waste based construction materials and examplesSourceExamplesMining and mineral industryWaste rock, flotation sand, etc...Construction and demolition (C&D)Crushed concrete, gypsum, asphalt, reinforced polymers, woodProcess industryDifferent types of slag from steel making, green liquor and fibre sludge from paper production, ashes and foundry wastesWastewater treatmentDigested sewage sludge, sandIncinerationBottom ash, fly ashThe evidence is mounting that the desired technical function of a landfill cover can be attained using suitable combinations of secondary construction materials. So far, all three field tests indicate leachate amounts between less then one and 30 l (m2 yr)-1 below the liner. In comparison with the average annual precipitation of about 600 mm yr-1 at the Swedish East coast, only 0.2-5 % of the precipitation seeped through the liner so far; i.e. the leachate generation is reduced with about 90 % or more.The issue is more if the materials may cause adverse impacts of the landfill and its recipients. A low water infiltration through the liner means that the most of infiltrating water is removed as drainage water and thus the leaching of the layers above the liner are of the greatest concern.Infiltrating water will yield a liquid to solid ratio of about 1-2 l kg-1 in the layers above the liner after about 10 years. The most mobile elements, such as nitrogen, will be leached to a great extent already at such low L/S ratios, so a forecast with regard to the need of treatment of drainage water points at about two to three decades.In the long term perspective the mineral changes of the construction materials become important. E.g. one of the incentives for using fly ash in liners is their capacity for chemical-mineralogical changes leading to the formation of clay-like structures. This could mean that a liner built of ashes will attain a lower permeability over time. Other mineral changes that can occur in ashes include the trapping of metals in the structure, e g in clay and carbonate phases.Much is still to be learned about the long term processes and the factors that control them. Ongoing studies include the assessment of climatic variables, different material combinations as well as the impact of landfill gases.The following conclusions can be drawn:The use of secondary materials in construction is important due to substantial resource and environmental impacts. An increased use should be beneficial, provided that the problems of using such materials can be managed.In addition to legislative and bureaucratic barriers, there are also practical issues which need to be dealt with in order to pave the way for a wider use of alternative construction materials. In the construction phase more planning is needed due to temporal and geographical limitation of the material availability. Some materials are not ready for immediate use but need to be pre-treated. All of these factors may cause a need for more space and time. A system for quality assurance comparable to that of traditional construction materials is another issue that needs to be resolved. Most likely some kind of legislative pressure is needed for this.In the medium term leaching of pollutants from the construction materials may be the most important issue when using secondary construction materials, which underlines the double standards applied, since traditional construction materials will not be scrutinized in the same manner. Anyhow, the long term interactions between materials and their environment need to be considered and further studies are necessary for secondary construction materials as well as for conventional materials. Existing data indicate both possibilities and problems.In the long term issues of material interactions will remain and the mechanical impact of mineral changes in the secondary construction materials may be added to the list of issues to clarify. Some of the material changes may be beneficial for the function of the construction, e.g. clay formation in liner materials may make them more impervious, but there may also be negative changes caused by deteriorated material properties. The rate and extent of such processes and the factors that enhance or retard them need to be understood better.Secondary construction materials have always been used and some of the "traditional" materials used today were wastes before. There is no reason to believe that this development should not continue.
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| 4. |
- Andreas, Lale, et al.
(författare)
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Utvärdering av fullskaleanvändning av askor och andra restprodukter vid sluttäckning av Tveta Återvinningsanläggning
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In 2000 Telge Återvinning - a waste management recycling company - started investigating ashes from incineration of industrial and biowaste waste. The company was given a permit from the Swedish Environmental Court to cover four hectares of the house hold waste landfill area. In 2006 the company received an unlimited permit to cover the remaining part of the landfill when the works end some thirty years later.Ashes were used the first time in 1966 for testing. Literature studies indicated the ashes can have a low hydraulic conductivity under certain conditions. In 1999 collaboration started with the Division of Waste Science and Technology at Luleå University of Technology.Residuals from household and industrial waste were subject to investigation. Initially, biowaste incineration products were subject to testing and were later extended to other waste products, e.g. sludge, contaminated soils, foundry, and compost material. Several different sub-fractions of ashes were included in the investigation e.g. bottom and fly ash, various slag products after up-grading including dewatering, separation and sifting. Subsequently, a complete covering system of a landfill consists of residuals.Six test areas were outlined in order to give a good representation for cover construction in flat and steep areas with different compositions of liner material.The results show that in all areas the hydraulic conductivity construction yields less then 50 liters per square meters and years and can be less the than 5 liters in a repository for hazardous waste if required. In accordance with literature data the field observations show the liner material constructed only by ash material under certain conditions can form a monolithic structure due to very slow processes thus indicating small pore volumes that unable water - air to interact with other media.The concept of using ash can be related to natural analogues of volcanic ashes and has been used in old defence walls and other buildings thousand years back. The last part of the report brings a number of topics for future research and a discussion about problems to with the authorities to use residuals for covering landfills.
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| 5. |
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| 6. |
- Brundin, Herman, et al.
(författare)
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Långtidsegenskaper hos tätskikt innehållande bentonit
- 2001
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bentonit är en starkt vattenupptagande och svällande naturlig lera med låg vattengenomsläpplighet. Huvudkomponenten är mineralet montmorillonit, som tillhör gruppen smektiter och som ger bentoniten dess unika egenskaper. Syftet med uppdraget är att söka identifiera vilka mekanismer och faktorer som kan vara begränsande för funktionen på kort och lång sikt hos tätskikt innehållande bentonitmattor samt blandningar av bentonit och andra material. I rapporten ges underlag för projektering, utformning och drift av deponier med tätskikt innehållande bentonit. Där redovisas också tre fallstudier från Högbytorp, Löt och Tveta.
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| 7. |
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| 8. |
- Brännvall, Evelina, et al.
(författare)
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Influence of accelerated ageing on acid neutralization capacity and mineralogical transformations in refuse derived-fuel fly ashes
- 2009
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Ingår i: SARDINIA 2009. - Cagliari : CISA, Environmental Sanitary Engineering Centre. - 9788862650076
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Konferensbidrag (refereegranskat)abstract
- This study is a part of a long-term collaboration between Telge Återvinning AB at Södertälje in South Sweden and Lulea University of Technology (LTU) in the Northern part of Sweden. Ashes and other industrial wastes used for landfill cover construction have been studied for several years. However, there is a need for further investigations with regard to the long-term mechanical and chemical stability of ash liners in landfill cover constructions. Long-term changes of ashes are investigated by laboratory studies on accelerated weathering (ageing) using experimental design. With regard to weathering, several stages can be identified: hydration and carbonation are well known processes while the processes surrounding the conversion of ash to clay minerals are less well known. There are a number of studies showing that the process of mineral transformation during the ageing of coal or MSWI ashes is quite similar to that of volcanic ashes in nature. Yet, the time frames are quite different: while volcanic ashes need several thousands of years for clay mineral development, there are evidences as well that e.g. clay illite is formed from glass phases in MSWI bottom ash after only 12 y or that clay like amorphous material can be formed in micro-scale throughout the surfaces of coal ash particles after 8 y of natural weathering (Zevenbergen et al., 1999; Zevenbergen et al., 1998). There are a lot of studies performed on rapid fly ash conversion into zeolites by hydrothermal alkaline treatment, the success of which strongly depends on alkaline conditions and the silica-alumina composition of the fly ash source (Inada et al., 2005). These results provide further support to the hypothesis that the observed rapid clay like mineral formation arose as a result of the initially high pH of ash, which promotes rapid dissolution of certain components of aluminosilicate glasses. Furthermore, in a long term perspective these aluminosilicates can transform into zeolites, smectites or halloysites dependent on the solution pH and leaching rate. Based on these studies on volcanic, coal or MSWI ashes we presume that refuse derived fuel (RDF) ashes, like those that are used in the Tveta landfill cover, will be subject to analogical weathering and mineral transformation processes.In order to investigate the mineral transformation in RDF fly ashes, a designed laboratory experiment was performed. A reduced factorial experimental design for accelerated ageing has been applied to evaluate the influence of five factors: carbon dioxide (CO2), temperature, relative air humidity, time and, quality of added water (Table 1). Table 1 Factors and levels tested in the reduced multivariate factorial design for the study of accelerated ageing of RFD fly ashesFactorLowMiddleHighCarbon dioxide, CO2 (%)Atmosphere (0.038)20*100Temperature, ºC5 3060Relative air humidity, Rh (%)3065100Time, months31022Water qualityDistilled -LeachateThe influence of these factors on mineralogical composition, leaching behaviour and acid neutralization capacity (ANC) is analysed and evaluated with the aid of multivariate data analysis. The MVDA modelling was performed with SIMCA-P+ 11.5 version program developed by Umetrics AB (Eriksson and Umetrics Academy, 2006). Principle component analysis (PCA) technique was used and presented in this paper. PCA is an interdependence model where all variables are analysed simultaneously as a single set in a data matrix X. Triplicates were tested for each factor combination. Sampling was performed after 3, 10 and 22 months of accelerated ageing. Mineral composition was analysed by X-Ray Diffraction (XRD). Acid neutralisation capacity was performed at 8.3 and 4.5 pH with 0.1 M HCl solution. The experimental set-up of accelerated ageing of RDF fly ashes is showed in Fig. 1. Preliminary evaluation of the mineral transformations in aged RDF fly ashes revealed that the carbonation process was not yet completed in the some of the specimens (Fig.2). This still caused high pH (pH=12.7) in the solution even though a calcite phase was found in all aged fly ashes. Multivariate data analysis confirmed that carbon dioxide affects the pH and ANC of fly ashes during ageing of RDF fly ashes. The specimens prepared with leachate water had higher ANC than the specimens with distilled water. The ANC8.3 was most influenced by 30 ºC temperature and 65 % relative humidity (ANC8.3 = 0.05 mmol/g) and this well corresponds to the results found in the literature. The ageing time factor has the highest influence on ANC4.5. A more detailed analysis of other mineral phases including clay-like minerals in aged fly ashes will be performed later.The results of this study will contribute to the better understanding of ash formation processes and improved possibilities to make beneficial use of ashes as an alternative to landfilling.Figure 1. Experimental set-up for investigations of the long-term behaviour of the ashes under different environmental conditions. Figure 2. XRD patterns of RDF fly ashes at different ageing conditions. a) N33, b) N71, c) N15, d) N85, and e) N51. The peaks are labelled A (anhydrite), C (calcite), E (ettringite), F (Friedel's Salt), Ge (gehlenite), H (halite), He (hematite), P (portlandite), Q (quartz), S (sylvite), V (vaterite).
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| 9. |
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| 10. |
- Karimi, Masoud, et al.
(författare)
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A retrospective study of extracolonic, non-endometrial cancer in Swedish Lynch syndrome families
- 2018
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Ingår i: Hereditary Cancer in Clinical Practice. - : BMC. - 1731-2302 .- 1897-4287. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundLynch Syndrome is an autosomal dominant cancer syndrome caused by pathogenic germ-line variants in one of the DNA-mismatch-repair (MMR) genes MLH1, MSH2, MSH6 or PMS2. Carriers are predisposed to colorectal and endometrial cancer, but also other cancer types. The purpose of this retrospective study was to characterize the tumour spectrum of the Swedish Lynch syndrome families.MethodsData were obtained from genetically verified 235 Lynch families from five of the six health care regions in Sweden. The material was stratified for gender, primary cancer, age and mutated gene and the relative proportions of specific cancer types were compared to those in the general population.ResultsA total of 1053 family members had 1493 cancer diagnoses of which 1011 were colorectal or endometrial cancer. Individuals with pathogenic variants in MLH1 and MSH2 comprised 78% of the cohort. Among the 482 non-colorectal/non-endometrial cancer diagnoses, MSH2 carriers demonstrated a significantly increased proportion of urinary tract, gastric, small bowel, ovarian and non-melanoma skin cancer compared to the normal population. MLH1 carriers had an elevated proportion of gastrointestinal cancers (gastric, small bowel, pancreas), while MSH6 carriers had more ovarian cancer than expected. Gastric cancer was predominantly noted in older generations.ConclusionLynch syndrome confers an increased risk for multiple cancers other than colorectal and endometrial cancer. The proportions of other cancers vary between different MMR genes, with highest frequency in MSH2-carriers. Gender and age also affect the tumour spectrum, demonstrating the importance of additional environmental and constitutional parameters in determining the predisposition for different cancer types.
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| 11. |
- Karimi, Masoud, et al.
(författare)
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A retrospective study of extracolonic, non-endometrial cancer in Swedish Lynch syndrome families 11 Medical and Health Sciences 1112 Oncology and Carcinogenesis 11 Medical and Health Sciences 1117 Public Health and Health Services
- 2018
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Ingår i: Hereditary Cancer in Clinical Practice. - : Springer Science and Business Media LLC. - 1731-2302 .- 1897-4287. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lynch Syndrome is an autosomal dominant cancer syndrome caused by pathogenic germ-line variants in one of the DNA-mismatch-repair (MMR) genes MLH1, MSH2, MSH6 or PMS2. Carriers are predisposed to colorectal and endometrial cancer, but also other cancer types. The purpose of this retrospective study was to characterize the tumour spectrum of the Swedish Lynch syndrome families. Methods: Data were obtained from genetically verified 235 Lynch families from five of the six health care regions in Sweden. The material was stratified for gender, primary cancer, age and mutated gene and the relative proportions of specific cancer types were compared to those in the general population. Results: A total of 1053 family members had 1493 cancer diagnoses of which 1011 were colorectal or endometrial cancer. Individuals with pathogenic variants in MLH1 and MSH2 comprised 78% of the cohort. Among the 482 non-colorectal/non-endometrial cancer diagnoses, MSH2 carriers demonstrated a significantly increased proportion of urinary tract, gastric, small bowel, ovarian and non-melanoma skin cancer compared to the normal population. MLH1 carriers had an elevated proportion of gastrointestinal cancers (gastric, small bowel, pancreas), while MSH6 carriers had more ovarian cancer than expected. Gastric cancer was predominantly noted in older generations. Conclusion: Lynch syndrome confers an increased risk for multiple cancers other than colorectal and endometrial cancer. The proportions of other cancers vary between different MMR genes, with highest frequency in MSH2-carriers. Gender and age also affect the tumour spectrum, demonstrating the importance of additional environmental and constitutional parameters in determining the predisposition for different cancer types.
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| 12. |
- Marklinder, Ingela, 1959-, et al.
(författare)
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A Structural Equation Model Demonstrating the Relationship between Food Safety Background, Knowledge, Attitudes and Behaviour among Swedish Students
- 2022
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Ingår i: Foods. - : MDPI. - 2304-8158. ; 11:11
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally, food safety knowledge has been seen as a factor in improving food safety behaviour. However, the relationship between knowledge and behavior is complex. The aim of the present study was to investigate self-reported data from 408 university students regarding food safety background, knowledge, attitudes, and behaviour using Structural Equation Model (SEM) to examine the influence of different factors on food safety behaviour. The SEM was applied to four factors derived from the data: Background, Knowledge, Attitude and Behaviour. The novelty of this current investigation is the inclusion of the Background factor (genus; experience of cooking and handling different food items; experience of a food safety education course; the foremost sources of food safety knowledge). The factors were constructed from variables with sufficient factor loadings and set up in a predetermined structure confirmed to be valid in previous studies. The results, demonstrated as regression coefficients between factors, confirm that the Background factor strongly influenced Knowledge (0.842). The Knowledge factor, in turn, strongly affected Attitude (0.605), while it did not directly affect Behaviour (0.301) in the same way as Attitude. Attitude had a stronger influence on Behaviour (0.438) than Knowledge. Thus, the Attitude factor seemed to play a mediating role between Knowledge and Behaviour. This indicates that students ' attitudes towards the importance of food safety may have an impact on their food safety behavior, which should have implications for the development of food safety education. This warrants further investigation and practical development.
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| 13. |
- Marklinder, Ingela, et al.
(författare)
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Attitudes Related to Food Safety Behavior Among Students in Sweden
- 2021
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Ingår i: IAFP:s European Symposium on food safety. Virtual meeting 27-28 April 2021.. ; , s. 65-
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Konferensbidrag (refereegranskat)abstract
- Introduction: It has earlir been shown through an online questionnaire performed on 606 students from 24 different Swedish universities that the foremost sources of food safety knowledge were family and friends. However, more than a third of the students had experienced food safety education which was shown to provide knowledge and promoted more optimal food safety behavior.Purpose: Self-reported food safety attitudes, knowledge and behaviour among university students in Sweden were investigated through multivariate path analysis in order to identify factors' influence on behavior.Methods: A nationwide web-based questionnaire targeting university students in Sweden was distributed through social media, email and various university contacts. A structural equation model was applied on statistics from the questionnaire. Four factors: Background, Knowledge, Attitude and Behavior were derived from the data. The factors, built up from variables with sufficient factor loadings were set up in a predetermined structure. The structure was based on whether background affects knowledge and whether knowledge affects behavior and attitude, and whether attitude affects behavior. The structure has been confirmed valid in previous studies done.Results: The factor loadings were ranging from -1 to 1 where the closer to 1 indicates a stronger loading. Background affected knowledge (0.841). Attitude has a stronger influence on the Behavior (0.457) than Knowledge (0.278). However, Knowledge has directly a strong effect on Attitude (0.606). Out of 606 respiondents, 408 answers were deemed usable for the analysis. More than half of the variables have sufficient loadings to their respective factors to be included. The goodness-of-fit indices, indicated that the model had a good fit to the data, and this including hypothesis testing with a significance of < 0.005.Significance: It can be confirmed that background such as attending a food safety education strongly influenced knowledge. Knowledge in turns strongly affects attitudes but it does not directly affect bahavior. Thus, attitudes seemed to have a mediating role between food safety knowledge and behavior.
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| 14. |
- Omran, Meis, et al.
(författare)
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Whole-Body MRI Surveillance : Baseline Findings in the Swedish Multicentre Hereditary TP53-Related Cancer Syndrome Study (SWEP53)
- 2022
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- A surveillance strategy of the heritable TP53-related cancer syndrome (hTP53rc), commonly referred to as the Li–Fraumeni syndrome (LFS), is studied in a prospective observational nationwide multi-centre study in Sweden (SWEP53). The aim of this sub-study is to evaluate whole-body MRI (WB-MRI) regarding the rate of malignant, indeterminate, and benign imaging findings and the associated further workup generated by the baseline examination. Individuals with hTP53rc were enrolled in a surveillance program including annual whole-body MRI (WB-MRI), brain-MRI, and in female carriers, dedicated breast MRI. A total of 68 adults ≥18 years old have been enrolled to date. Of these, 61 fulfilled the inclusion criteria for the baseline MRI scan. In total, 42 showed a normal scan, while 19 (31%) needed further workup, of whom three individuals (3/19 = 16%) were diagnosed with asymptomatic malignant tumours (thyroid cancer, disseminated upper GI cancer, and liver metastasis from a previous breast cancer). Forty-three participants were women, of whom 21 had performed risk-reducing mastectomy prior to inclusion. The remaining were monitored with breast MRI, and no breast tumours were detected on baseline MRI. WB-MRI has the potential to identify asymptomatic tumours in individuals with hTP53rc syndrome. The challenge is to adequately and efficiently investigate all indeterminate findings. Thus, a multidisciplinary team should be considered in surveillance programs for individuals with hTP53rc syndrome.
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| 15. |
- Omran, Meis, et al.
(författare)
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Whole-body MRI surveillance in TP53 carriers is perceived as beneficial with no increase in cancer worry regardless of previous cancer : Data from the Swedish TP53 Study
- 2023
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Ingår i: Cancer. - : Wiley. - 0008-543X .- 1097-0142. ; 129:6, s. 946-955
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Tidskriftsartikel (refereegranskat)abstract
- Background: To evaluate the psychosocial consequences of surveillance with whole-body MRI (WB-MRI) in individuals with the heritable TP53-related cancer (hTP53rc) syndrome, also known as the Li-Fraumeni syndrome, with regard to cancer worry, perceived benefits and risks to surveillance and overall health. Patients and methods: Since 2016, the national Swedish TP53 Study (SWEP53) has offered surveillance with WB-MRI to all individuals with hTP53rc syndrome. Seventy-five individuals have been included in the study. Sixty consecutive participants fulfilled a base-line evaluation as well as an evaluation after 1 year with structured questionnaires including the Cancer Worry Scale (CWS), perceived benefits and risks of surveillance, and the 36-item Short Form Survey (SF-36). Individuals with or without previous personal cancer diagnosis were enrolled and results at baseline and after 1 year of surveillance were compared. For SF-36, a comparison with the normal population was also made. Results: Participants with previous cancer tend to worry more about cancer, but both individuals with and without cancer had a positive attitude toward surveillance with no differences regarding perceived benefits and barriers to surveillance. Participants with a previous cancer scored significantly lower on some of the SF-36 subscales, but between-group differences were found only for social functioning after 1 year. Conclusions: Surveillance with WB-MRI is feasible from a psychosocial point of view both among TP53 carriers with as well as without a previous history of cancer and does not increase cancer worry in any of the groups. Plain language summary: Individuals with heritable TP53-related cancer syndrome (also known as the Li-Fraumeni syndrome) have a high lifetime risk of developing cancer. These TP53 carriers are offered surveillance with whole-body MRI to detect cancer early. There are few reports of the psychosocial impact of surveillance. In this study, we wanted to evaluate cancer worry, benefits and barriers to participation, and perceived overall health. Our study shows no increase in cancer worry after 1 year of surveillance, regardless of previous cancer.
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| 16. |
- Patomella, Ann-Helen, et al.
(författare)
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General practitioners' reasoning on risk screening and primary prevention of stroke : a focus group study
- 2018
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Ingår i: BMC Family Practice. - : BioMed Central (BMC). - 1471-2296. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundBy screening and modifying risk factors, stroke incidence can be reduced. Clinical guidelines states that primary prevention of stroke is a responsibility and task of primary health care, but research shows that this not always the case. The aim of the study was to explore and describe what characterizes GPs' reasoning around risk screening and primary prevention among persons at risk for stroke in primary health care.MethodsA qualitative design based in a grounded theory approach was chosen in order to investigate this unexplored research area. Data collection was done using focus group interviews and data was analysed using a constant comparative method. Twenty-two GPs were interviewed in four focus groups.ResultsFindings showed that GPs perceived difficulties in prioritizing patients with an unhealthy lifestyle and described a lack of systematicity in their procedures, which complicated their clinical decisions concerning patients with stroke risk factors. The results showed a lack of systematic risk screening methods. Time constraints and the reimbursement system were described as hindering the preventive work.ConclusionThere is a need for a more proactive, transparent and systematic approach in the distribution of GPs' time and reimbursement of prevention in primary health care. The findings suggest, by developing new methods and approaches such as digital clinical decision-making tools and by implementing inter-professional team-work, the quality of the primary prevention of stroke could be improved.
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| 17. |
- Renman, Gunno, et al.
(författare)
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A multi-stage treatment system for landfill leachate : design and performance
- 2004
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Ingår i: Waste 2004 - Integrated waste management and pollution control: Policy and practice, research and solutions. - : The Waste Conference Limited, The Barclay centre, University of warwick Science Park, Coventry, UK. ; , s. 528-535
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A new system for on-site treatment of leachate has been implemented at the Tveta landfill, adjacent to the city of Södertalje, Sweden, and an initial investigation of its performance has been carried out. This is a multi-stage treatment system consisting of steps for aeration and sedimentation in an open pond, indoor treatment with chemicals for precipitation of metals, use of a constructed wetland and forest irrigation for removal of nitrogen. Treatment results from 2002 and 2003 show that the system is able to meet very high effluent standards and therefore the water can be discharged to sensitive water bodies. The chemical treatment can be questioned since operational problems occur with clogging of mechanical devices due to precipitation of calcium as well as generally low metal concentrations do not motivate the high treatment costs. The constructed wetland is of novel design with a removal efficiency of up to 75% for NH4-N, corresponding to an inorganic mass removal rate of up to 5.1 g m-2 d-1. Water sampling in a control ditch adjacent to the forest irrigation revealed a concentration of 1 mg/l for NH4-N.
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| 18. |
- Renman, Gunno, et al.
(författare)
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Metod och anordning för rening av lakvatten
- 1997
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Patent (populärvet., debatt m.m.)abstract
- Purifying seepage water from a disposal site comprises passing the water through a series of treatment steps in the following sequence - sedimentation, chemichal precipitation, sorption and retention. Also claimed is the apparatus for the above which comprises a chemical precipitation apparatus, and a combined sorption and retention apparatus, comprising a compact wet soil system. USE - The method allows metals and nutrients to be removed from different types of contaminated water. ADVANTAGE - The relatively low amount of electricity needed to power the process equipment and the reduced amount of chemicals that need to be added make the process relatively cost effective, while the purification process is readily adaptable according to local needs.
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| 19. |
- Renman, Gunno, et al.
(författare)
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New trends in waste management for optimising landfill leachate treatment - A case study
- 2005
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Ingår i: 6Th International Conference Environmental Engineering, Vols 1 and 2. - 9986058503 ; , s. 425-428
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Konferensbidrag (refereegranskat)abstract
- Most landfills today encounter considerable problems when treating leachate due to the mixture of waste deposited there in the past. In order to prevent complex leachate being emitted, it is necessary to identify onsite sources of pollution and impose source separation of waste material. Parallel to source separation of household waste and other comparable wastes, a comprehensive study has been undertaken to examine various materials that can be used for recycling purposes. Such materials consist of ashes from incineration plants, foundries, contaminated soils, sewage sludge etc. These have been tested both in laboratory and in full scale studies at the Tveta plant to define which material can be re-used, for instance, to cover abandoned parts of the landfill. After landfills are closed, the amount of leachate will be reduced by a factor of 10 or more. Today, the Tveta Recycling Plant in Sodertalje, Sweden, produces approximately of 70 000 m(3) of leachate per year. A program has been initiated to separate different types of water, which are today all defined as leachate, at their source. For example, storm water from car parks or other hard surfaces used for sorting of building material at the plant should be separated and treated elsewhere.
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| 20. |
- Tesi, Bianca, et al.
(författare)
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Diagnostic yield and clinical impact of germline sequencing in children with CNS and extracranial solid tumors : a nationwide, prospective Swedish study
- 2024
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChildhood cancer predisposition (ChiCaP) syndromes are increasingly recognized as contributing factors to childhood cancer development. Yet, due to variable availability of germline testing, many children with ChiCaP might go undetected today. We report results from the nationwide and prospective ChiCaP study that investigated diagnostic yield and clinical impact of integrating germline whole-genome sequencing (gWGS) with tumor sequencing and systematic phenotyping in children with solid tumors.MethodsgWGS was performed in 309 children at diagnosis of CNS (n = 123, 40%) or extracranial (n = 186, 60%) solid tumors and analyzed for disease-causing variants in 189 known cancer predisposing genes. Tumor sequencing data were available for 74% (227/309) of patients. In addition, a standardized clinical assessment for underlying predisposition was performed in 95% (293/309) of patients.FindingsThe prevalence of ChiCaP diagnoses was 11% (35/309), of which 69% (24/35) were unknown at inclusion (diagnostic yield 8%, 24/298). A second-hit and/or relevant mutational signature was observed in 19/21 (90%) tumors with informative data. ChiCaP diagnoses were more prevalent among patients with retinoblastomas (50%, 6/12) and high-grade astrocytomas (37%, 6/16), and in those with non-cancer related features (23%, 20/88), and ≥2 positive ChiCaP criteria (28%, 22/79). ChiCaP diagnoses were autosomal dominant in 80% (28/35) of patients, yet confirmed de novo in 64% (18/28). The 35 ChiCaP findings resulted in tailored surveillance (86%, 30/35) and treatment recommendations (31%, 11/35).InterpretationOverall, our results demonstrate that systematic phenotyping, combined with genomics-based diagnostics of ChiCaP in children with solid tumors is feasible in large-scale clinical practice and critically guides personalized care in a sizable proportion of patients.
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| 21. |
- Tesi, Bianca, et al.
(författare)
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Diagnostic yield and clinical impact of germline sequencing in children with CNS and extracranial solid tumors : a nationwide, prospective Swedish study
- 2024
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Ingår i: The Lancet Regional Health. - : Elsevier. - 2666-7762. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood cancer predisposition (ChiCaP) syndromes are increasingly recognized as contributing factors to childhood cancer development. Yet, due to variable availability of germline testing, many children with ChiCaP might go undetected today. We report results from the nationwide and prospective ChiCaP study that investigated diagnostic yield and clinical impact of integrating germline whole-genome sequencing (gWGS) with tumor sequencing and systematic phenotyping in children with solid tumors.Methods: gWGS was performed in 309 children at diagnosis of CNS (n = 123, 40%) or extracranial (n = 186, 60%) solid tumors and analyzed for disease-causing variants in 189 known cancer predisposing genes. Tumor sequencing data were available for 74% (227/309) of patients. In addition, a standardized clinical assessment for underlying predisposition was performed in 95% (293/309) of patients.Findings: The prevalence of ChiCaP diagnoses was 11% (35/309), of which 69% (24/35) were unknown at inclusion (diagnostic yield 8%, 24/298). A second-hit and/or relevant mutational signature was observed in 19/21 (90%) tumors with informative data. ChiCaP diagnoses were more prevalent among patients with retinoblastomas (50%, 6/12) and high-grade astrocytomas (37%, 6/16), and in those with non-cancer related features (23%, 20/88), and ≥2 positive ChiCaP criteria (28%, 22/79). ChiCaP diagnoses were autosomal dominant in 80% (28/35) of patients, yet confirmed de novo in 64% (18/28). The 35 ChiCaP findings resulted in tailored surveillance (86%, 30/35) and treatment recommendations (31%, 11/35).Interpretation: Overall, our results demonstrate that systematic phenotyping, combined with genomics-based diagnostics of ChiCaP in children with solid tumors is feasible in large-scale clinical practice and critically guides personalized care in a sizable proportion of patients.Funding: The study was supported by the Swedish Childhood Cancer Fund and the Ministry of Health and Social Affairs.
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| 22. |
- Tham, Gustav, et al.
(författare)
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Use of ashes in a landfill covers
- 2006
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Ingår i: Abstract proceedings of the 4th Intercontinental Landfill Research Symposium, [June 14th to 16th 2006, Gällivare, Sweden]. - Luleå : Luleå tekniska universitet. ; , s. 201-202
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 23. |
- Tham, Gustav, et al.
(författare)
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Utilization of ashes in a landfill cover system
- 2004
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Ingår i: he 3rd Intercontinental Landfill Research Symposium November 29th - December 2nd, 2004 in Toya, Hokkaido Japan. - Hokkaido : Center for Applied Ethics and Philosophy, Hokkaido University. ; , s. 135-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 24. |
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| 25. |
- Travar, Igor, et al.
(författare)
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Assessing the environmental impact of ashes used in a landfill cover construction
- 2009
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Ingår i: Waste Management. - : Elsevier BV. - 0956-053X .- 1879-2456. ; 29:4, s. 1336-1346
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Tidskriftsartikel (refereegranskat)abstract
- Large amounts of construction materials will be needed in Europe in anticipation for capping landfills that will be closed due to the tightening up of landfill legislation. This study was conducted to assess the potential environmental impacts of using refuse derived fuel (RDF) and municipal solid waste incineration (MSWI) ashes as substitutes for natural materials in landfill cover designs. The leaching of substances from a full-scale landfill cover test area built with different fly and bottom ashes was evaluated based on laboratory tests and field monitoring. The water that drained off above the liner (drainage) and the water that percolated through the liner into the landfill (leachate) were contaminated with Cl-, nitrogen and several trace elements (e.g., As, Cu, Mo, Ni and Se). The drainage from layers containing ash will probably require pre-treatment before discharge. The leachate quality from the ash cover is expected to have a minor influence on overall landfill leachate quality because the amounts generated from the ash covers were low, <3-30 l (m2 yr)-1. Geochemical modelling indicated that precipitation of clay minerals and other secondary compounds in the ash liner was possible within 3 years after construction, which could contribute to the retention of trace elements in the liner in the long term. Hence, from an environmental view point, the placement of ashes in layers above the liner is more critical than within the liner.
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| 26. |
- Travar, Igor, et al.
(författare)
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Development of drainage water quality from landfill covers built with ashes and sewage sludge
- 2009
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Ingår i: SARDINIA 2009. - Cagliari : CISA, Environmental Sanitary Engineering Centre. - 9788862650076
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Konferensbidrag (refereegranskat)abstract
- An alternative to virgin and artificial materials in landfill cover can be various types of waste materials like ashes and sewage sludge. From the environmental point of view, the most interesting question to study is the quality of the drainage water generated above the liner in landfill cover built with waste materials. Thus, the main aim of this paper is the evaluation of drainage water quality and time required for its treatment. Results from a full scale test, physical models and a column test were used in the evaluation of the drainage water quality development. The main contaminants identified in drainage water were N-tot, As, Cu, Cd, Pb, Zn and Ni. The laboratory tests showed higher concentrations of N-tot, NH4-N, TOC, As and Pb, but lower values of Cl, Zn, Ba and Ni in comparison with drainage water from the field. It was probably a result of different factors that may have influence on leaching but interactions of the protection layer with the vegetation layer and the liner surface are expected to influence the results from the field. According to results from the laboratory experiments, drainage water will probably need treatment for at least two-three decades after covering.
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| 27. |
- Travar, Igor, et al.
(författare)
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Environmental impact of ashes used in a landfill cover construction
- 2007
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Ingår i: SARDINIA 2007. - Cagliari : CISA, Environmental Sanitary Engineering Centre. - 9788862650038
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Konferensbidrag (refereegranskat)abstract
- Large amounts of construction materials will be needed both in Sweden and other European countries for capping landfills that will be closed in the near future. In order to reduce exploitation of virgin materials and to save natural resources, an option can be utilization of various types of secondary construction materials (SCM) e.g. ash, slag, sand from fluid bed incineration and compost. However, at the same time this may represent potential risks due to the release of trace elements and other pollutants into environment. The main aim of this work is to evaluate the environmental impact of water that discharges from different parts of a landfill cover built with ashes and other SCM.From 2003 to 2005, a four hectares large test area was established at Tveta landfill, southwest of Stockholm, Sweden. Test area is divided into six sub areas with regard to different recycled materials used in different layers of the cover construction (Figure 1).Figure 1. Design of the landfill cover test area at the Tveta landfill. BA = Bottom ash; FA = Fly ash; FC = Friedland clay Infiltrating water through the landfill cover either drains off in the drainage layer as drainage water or percolates through the liner into landfill body as leachate. At Tveta landfill, leachate amounts between 1 l (m2 yr)-1 and 30 l (m2 yr)-1 have been observed below highly compacted ash liner. Results show that leachate samples have higher pH, salt forming elements (e.g. K, Na, Ca and Cl) and concentrations of Cd, Ba As, Al, and Mo, and lower concentrations of Mn, Zn, Mg, Fe, Ni, and Pb compared to drainage water. The concentrations of Cr and total N are in the same range in leachate and drainage water while NH4-N is higher in leachate. Leachate of areas 1 and 4 shows higher content of organic matter than drainage water in these areas. A strong correlation is observed between EC, K, Na and Cl as well as between Cu and TOC. The comparison of the leachate and drainage water quality with different limit values showed that the leachate had elevated concentrations of As, Mo, Cl and nitrogen while the drainage water was mainly contaminated by Ni, Zn, Cl and nitrogen with the addition of As, Cu, Mo, and Pb in areas 2 and 4.Following conclusions can be drawn by now:The hydraulic properties of the landfill cover satisfy legislative requirements for non hazardous waste landfills; in some cases/areas also for hazardous waste landfills.Most of the infiltrating water through the landfill cover is discharged as drainage water. Thus, the design of layers above the liner is most important with regard to the environmental impact of the construction. Both leachate and drainage water need treatment before discharge into the local recipient. Organic matter in the protection layer is likely to contribute to the mobilization of Cu and Ni in short term.The sea might be a suitable recipient in cases where ashes are used in landfill covers because both leachate and drainage contain salt forming elements in elevated concentrations which may harm groundwater or freshwater but do not pose a risk to salt-water.The leaching of most pollutants did not show any clear tendencies during first three years. Thus, assessing the time period for treatment needs is difficult. However, it is expected that the contaminants in the drainage water will be depleted within few decades.Leachate might be contaminated by salt forming and trace elements for one hundred years. However, generated leachate amounts are low and it is expected that leachate from landfill cover will not influence overall landfill leachate with full extent.The ageing of the ashes in connection with mineral transformations is an important process that is expected to reduce the release of pollutants. Further research is needed with regard to long term changes of the material properties and the treatment needs for water.
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| 28. |
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| 29. |
- Travar, Igor, et al.
(författare)
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Use of secondary construction materials in a landfill covers
- 2006
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Ingår i: Abstract proceedings of the 4th Intercontinental Landfill Research Symposium, [June 14th to 16th 2006, Gällivare, Sweden]. - Luleå : Luleå tekniska universitet. ; , s. 207-208
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 30. |
- van de Vegte, Yordi, et al.
(författare)
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Genetic insights into resting heart rate and its role in cardiovascular disease
- 2023
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Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- The genetics and clinical consequences of resting heart rate (RHR) remain incompletely understood. Here, the authors discover new genetic variants associated with RHR and find that higher genetically predicted RHR decreases risk of atrial fibrillation and ischemic stroke. Resting heart rate is associated with cardiovascular diseases and mortality in observational and Mendelian randomization studies. The aims of this study are to extend the number of resting heart rate associated genetic variants and to obtain further insights in resting heart rate biology and its clinical consequences. A genome-wide meta-analysis of 100 studies in up to 835,465 individuals reveals 493 independent genetic variants in 352 loci, including 68 genetic variants outside previously identified resting heart rate associated loci. We prioritize 670 genes and in silico annotations point to their enrichment in cardiomyocytes and provide insights in their ECG signature. Two-sample Mendelian randomization analyses indicate that higher genetically predicted resting heart rate increases risk of dilated cardiomyopathy, but decreases risk of developing atrial fibrillation, ischemic stroke, and cardio-embolic stroke. We do not find evidence for a linear or non-linear genetic association between resting heart rate and all-cause mortality in contrast to our previous Mendelian randomization study. Systematic alteration of key differences between the current and previous Mendelian randomization study indicates that the most likely cause of the discrepancy between these studies arises from false positive findings in previous one-sample MR analyses caused by weak-instrument bias at lower P-value thresholds. The results extend our understanding of resting heart rate biology and give additional insights in its role in cardiovascular disease development.
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| 31. |
- Wikman, Karin, et al.
(författare)
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Injektering av flygaska i hushållsavfallsdeponi
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Totalt har cirka 100 ton askslurry injekterats vid pilotförsök på Tveta Återvinningsanläggning, vilket uppskattningsvis motsvarar en utfyllnad av cirka 12-16 % av de tillgängliga hålrummen inom injekteringsområdet på deponin. Slutsatsen när det gäller injekteringen är att aska blandar sig väl med vatten till en pumpbar slurry som kan injekteras utan risk för härdning i injekteringsutrustningen. Varken avfallet eller det injekterade materialet gav under pilotförsöken något mottryck och inget tyder på att avfallet i deponin trycks undan av den injekterade askan utan istället rinner askslurryn genom håligheter i avfallet. I deponin stelnar askan, inom uppskattningsvis några dagar, till hårda men något spröda klumpar som kan bidra till en ökad stabilitet i deponin.Den ekonomiska bedömningen är att kostnaden för injektering med en utrustning med en kapacitet på 10 ton/h i perforerade rör i en hushållsavfallsdeponi blir cirka 800 SEK/ton torr aska. Emellertid kan kostnaden troligtvis komma ner i nivå med dagens skatt för deponering, d.v.s. 370 SEK/ton, genom att borrning och injektering sker i ett steg samt genom införandet av två skift.
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