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- Almqvist, Linnea, 1987-
(författare)
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Asthma epidemiology : prognosis of asthma with onset in childhood and in adulthood
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: to update the knowledge on the epidemiology of asthma with onset in childhood and adulthood as well as examine the importance of risk factors in early childhood and clinical characteristics on the incidence and prognosis of asthma.Methods: The thesis is based on the epidemiological research program Obstructive Lung Disease in Northern Sweden (OLIN) studies. Pediatric cohort: recruited in 1996 (age 8y, n=3430, 97% of invited) and followed annually by questionnaire about asthma, allergy and risk factors until 19y and a postal questionnaire at 28y. Clinical examinations included skin prick tests (SPT at 8, 12 and 19y) and spirometry (19y). Adult cohort: 309 adults (age 20–60y) with asthma onset in the last 12 months were recruited 1995-99 and re-examined in 2012-14 (n=205). Structured interviews, spirometry and SPT were performed at recruitment and follow-up and bronchial hyperreactivity (BHR) at recruitment.Results: The asthma incidence rate was 10-13/1000/year in childhood and adolescence and 6/1000/year in young adulthood. Several risk factors in early life were associated with asthma onset in childhood, adolescence and young adulthood, e.g. family history of asthma, <3 months breastfeeding, rhinoconjunctivitis and positive SPT at 8y, while low birthweight, maternal smoking during pregnancy, severe respiratory infections and eczema were associated with onset in childhood and adolescence. Among those with asthma at 8y, 62% still had asthma at 28y and this was associated with positive SPT, rhinoconjunctivitis, severe respiratory infection in childhood, and bronchial hyperreactivity (BHR) in adolescence. Coexistence of asthma, rhinitis and eczema increased by age, especially among those with a positive SPT. However, having all three conditions was uncommon. In the 15y follow-up adult onset asthma, 89% had persistent asthma. Better lung function at recruitment and less severe BHR was associated with remission. Remission rate of adult onset asthma was <1% per year.Conclusion: The incidence of asthma was high during childhood and adolescence and then decreased in young adulthood. Factors in early life that were associated with incident asthma during childhood were still associated with the incidence in adult age. Among those with asthma onset by 8 years, 62%, still had asthma as young adults. The coexistence of asthma, rhinitis and eczema varied from 8 to 28y without following a specific pattern, only a small proportion reported having all three conditions. Remission of adult onset asthma was rare.
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| 2. |
- Andersson Granberg, Tobias, 1973-, et al.
(författare)
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Sensor Requirements for Logistics Analysis of Emergency Incident Sites
- 2020
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Ingår i: Proceedings of the 17th ISCRAM Conference. - : Information Systems for Crisis Response and Management. - 9781949373271 ; , s. 952-960
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Konferensbidrag (refereegranskat)abstract
- Using sensors to collect data at emergency incident sites can facilitate analysis of the logistic operations. This can be used to improve planning and preparedness for new operations. Furthermore, real-time information from the sensors can serve as operational decision support. In this work in progress, we investigate the requirements on the sensors, and on the sensor data, to facilitate such an analysis. Through observations of exercises, the potential of using sensors for data collection is explored, and the requirements are considered. The results show that the potential benefits are significant, especially for tracking patients, and understanding the interaction between the response actors. However, the sensors need to be quite advanced in order to capture the necessary data.
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| 4. |
- Kriit, Hedi Katre, 1990-
(författare)
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Improved health economic assessments of sustainable transport solutions in urban environments
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Part of the European Strategy to achieve climate neutrality in the transport sector is to increase the proportion of electric vehicles (EVs) and active commuting. Health co-benefits from reduced air pollution and increased active commuting are assumed to follow; however, all dimensions of expected health effects are not quantified nor valued monetarily. Current state-of-the art health impact assessments (HIAs) of air pollution assume immediate change in health with exposure; however, the time-window of importance for health outcomes is unknown. Moreover, the currently applied risk estimate of sick leaves in relation to air pollution is poorly generalizable due to outdated exposure assessment and subjective data on outcome. The overall aim of this thesis is to assess the health economic effects of sustainable urban transport solutions and improve the epidemiological knowledge base of air pollution effects. Methods: The health effects of increased active commuting and the resulting change in air pollution exposure were valued monetarily from a health care perspective, and a cost-effectiveness analysis of investment in bicycle infrastructure was conducted. A health economic assessment from a societal perspective was also conducted for an increased proportion of EVs in the vehicle fleet, considering a change in both exhaust and non-exhaust particles. The exposure-lag response between air pollution and risk for ischemic heart disease (IHD) and stroke was assessed in a multi-cohort study using distributed lag-nonlinear models (DLNMs). A case cross-over study design was applied to estimate the odds of sick leaves in relation to short-term PM2.5 exposure, and production losses were valued using the human capital method. Results: Investing in bicycle infrastructure to enable increased active commuting was estimated to be cost-effective from a health care perspective. An increased proportion of EVs was estimated to decrease population-weighted PM2.5 concentrations without the use of studded winter tires, but was estimated to increase with the current use of studded winter tires in Stockholm Sweden. For a 0-50% use of studded winter tires the health economic costs ranged between €20 and €122 million (M). An independent effect of PM2.5 on sick leaves was estimated to correspond to €2M per year in productivity loss for the population of Stockholm municipality. Exposure time windows closer in time and local sources of air pollution were suggested to be of greater importance for incident IHD and stroke.Conclusions: This thesis has demonstrated the health economic potential in policies seeking to transform the transport sector towards sustainability. Investment in the transport sector could lead to decreased morbidity and decreased monetary burden in the health care sector. Non-exhaust particles should be considered in order to fully assess the health economic effects of EVs. Moreover, the risk estimate of sick leaves in relation to air pollution exposure could be included in international HIAs.
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| 5. |
- Liwång, Hans, Docent, Lektor, 1974-, et al.
(författare)
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How can systemic perspectives on defence capability development be strengthened?
- 2023
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Ingår i: Defence Studies. - : Informa UK Limited. - 1470-2436 .- 1743-9698. ; 23:3, s. 399-420
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Tidskriftsartikel (refereegranskat)abstract
- Over the last thirty years, suggestions for how to develop defence capability have developed rapidly. However, supporting theory and structured concept development lag behind. Despite this imbalance, countries need to continuously spend resources on defence development. This study identifies central challenges in relation to the scientific perspectives and approaches needed to support the development of defence capability. The results show that the support for developing interactions between technology and social components is especially weak and that relevant supporting theories and methods from related fields are not considered. This study also shows that it is important to be able to address these questions from various perspectives and not to be limited by a specific scientific tradition. Finally, this study also identifies a possible emerging cluster of reports on capability-related research that provide a base for a much-needed cross-disciplinary approach to the development of defence capability.
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| 6. |
- Nouf-Latif, Faten, 1985-
(författare)
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Ett meningsfullt liv med arbete? : Högfungerande individer med autism mellan funktionshinder- och arbetsmarknadspolitik
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to study notions of employment among high-functioning individuals with autism (HiA) and their experiences of vocational rehabilitation or work-preparatory programs and to analyze how these experiences reflect upon the labor market policy’s and disability policy’s common shared goal of supporting individuals towards a socially included life with meaningful work. This study was conducted through ethnographic fieldwork in a private company (VRP) that operated as a service provider for the Employment Service Agency, and a Swedish residential folk high school (FHS). Both of the organizations provided work-preparative programs specifically for HiA. Three of the four sub-studies are based on qualitative data consisting of individual interviews, focus group interviews, and field notes from participant observations. The fourth sub-study represents an analysis of legal documents targeting employment and health in disability policy.The results in sub-study 1 illustrate that the narratives provided by HiA strongly address the subject position of the citizen-worker. Their suggested ideal jobs were deprioritized in favor of more available jobs on the market. The central incentives to pursue either the ideal or second-option jobs can be identified as the personal perception of attaining a sense of meaningfulness through work, which was depicted as central to the sense of self-fulfillment, identity, and wellbeing. As the second sub-study shows, the fulfillment of personal ambitions and ideas of meaningful work was not met in the case of the VRP participants. Social inclusion was not experienced as a result of the received service provisions. The results rather indicate a manifestation of the normalization principle’s basic attributes with regard to spatial integration in work-like activities (disability-worker contexts) rather than social inclusion on an equal basis with others (citizen-worker contexts). The third sub-study then showcases how social work practices were produced at the intersection of clients’ needs and personas and the organizations’ conditional premises in FHS and VRP. The analysis resulted in the conclusion that a person-centered approach was lacking in the VRP whereas highly present in the FHS. The fourth and last sub-study focuses on how Swedish disability policy is constructed to meet the objectives of the CRPD regarding active citizenship that is associated with health (engagements in private life, work-life, community life, social/family life, etc.) and thereby full participation on an equal basis with others. The results suggest that the policy area of employment, implicitly and explicitly, overshadows the policy area of health and intimately associated life-areas that are important to wellbeing.The conclusions are that FHS and ARP both reflect a strong dedication to provide services that aim towards preparing individuals for work. However, a more holistic approach in professional practices must be practiced in VRPs if a socially included life with a sustainable work situation for HiA is strived for. With regard to a socially included life with meaningful work, the above must be accounted for in addition to individuals’ personal perceptions and notions of meaningfulness.
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