| 1. |
- Mattias, Lindh, et al.
(författare)
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Handbok för nordlig solel
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Solen är en för människan evig energikälla och solel har en given plats i ett framtida hållbart och förnybart energisystem – globalt och i Sverige. Kostnaden för en solelanläggning har sjunkit drastiskt de senaste åren och tillgängligheten har ökat. Det gör solel relevant utanför de regioner som har störst solinstrålning; även i norra Skandinavien är det en långsiktigt hållbar investering ur både ett energi- och ekonomiskt perspektiv.Nordlig solel har goda men annorlunda förutsättningar jämfört med de i södra Sverige och Centraleuropa. Solens position på himlen och den instrålade energin per år är lägre, det är en stor andel diffust ljus och man kan förvänta sig mer reflektioner från en snötäckt mark på vintern. På sommaren är soltimmarna fler och solens bana längre. Medeltemperaturen är betydligt lägre på årsbasis men skillnaden mot sydligare breddgrader är mindre under sommaren då instrålningen är stor. En annan avgörande faktor är snö som under stora delar av året i norr täcker marken och potentiellt solelanläggningar. Om snötäckningen kan begränsas till de mörkaste månaderna blir årseffekterna på energiproduktionen små, men snölaster ställer höga krav på solelanläggningars kvalitet, både ur installations- och komponentperspektiv.Genom att beakta följande fem rekommendationer kan man minska risken för problem:1. Undersök snöförhållandena på platsen innan installation. Anläggningsägaren vet ofta bäst var snön brukar ansamlas och när den smälter bort eller glider av.2. Säkerställ att installationen är genomtänkt ur ett snöperspektiv. En noggrann kontroll av att installationen följer leverantörernas anvisningar är extra viktigt när förhållandena är krävande.3. Välj robusta moduler och fästanordningar – en solelanläggning ska hålla i många år och bör utformas för att klara lokala snöförhållanden.4. Utforma om möjligt anläggningen så att snöröjning inte krävs. Röj (varsamt) undan snö från anläggningen om det trots det blir nödvändigt: för att undvika takras, skydda solelanläggningen mot tryck- och glidskador från ett tjockt snötäcke och för att möjliggöra elproduktion från tidig vår.5. Montera modulerna med rätt orientering. Söderläge och så hög lutning som möjligt upp till om kring 50° (i Piteå) är generellt bäst. Ofta är man begränsad av takets utformning men även avvikelser från söder mot öst eller väst och mindre lutningar kan ge ett acceptabelt energiutbyte.Huvudregeln bör vara att: Montera solceller där solinstrålningen är stor men snö inte ansamlas!
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| 2. |
- Adamson, Carly, et al.
(författare)
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Dapagliflozin for Heart Failure According to Body Mass Index : The DELIVER Trial.
- 2022
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 43:41, s. 4406-4417
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Obesity is common and associated with unique phenotypic features in heart failure with preserved ejection fraction (HFpEF). Therefore, understanding the efficacy and safety of new therapies in HFpEF patients with obesity is important. The effects of dapagliflozin were examined according to body mass index (BMI) among patients in the Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure trial. METHODS AND RESULTS: Body mass index was analysed by World Health Organization (WHO) categories and as a continuous variable using restricted cubic splines. Body mass index ranged from 15.2 to 50 kg/m2 with a mean value of 29.8 (standard deviation +/- 6.1) kg/m2. The proportions, by WHO category, were: normal weight 1343 (21.5%); overweight 2073 (33.1%); Class I obesity 1574 (25.2%); Class II obesity 798 (12.8%); and Class III obesity 415 (6.6%). Compared with placebo, dapagliflozin reduced the risk of the primary outcome to a similar extent across these categories: hazard ratio (95% confidence interval): 0.89 (0.69-1.15), 0.87 (0.70-1.08), 0.74 (0.58-0.93), 0.78 (0.57-1.08), and 0.72 (0.47-1.08), respectively (P-interaction = 0.82). The placebo-corrected change in Kansas City Cardiomyopathy Questionnaire total symptom score with dapagliflozin at 8 months was: 0.9 (-1.1, 2.8), 2.5 (0.8, 4.1), 1.9 (-0.1, 3.8), 2.7 (-0.5, 5.8), and 8.6 (4.0, 13.2) points, respectively (P-interaction = 0.03). The placebo-corrected change in weight at 12 months was: -0.88 (-1.28, -0.47), -0.65 (-1.04, -0.26), -1.42 (-1.89, -0.94), -1.17 (-1.94, -0.40), and -2.50 (-4.4, -0.64) kg (P-interaction = 0.002). CONCLUSIONS: Obesity is common in patients with HFpEF and is associated with higher rates of heart failure hospitalization and worse health status. Treatment with dapagliflozin improves cardiovascular outcomes across the spectrum of BMI, leads to greater symptom improvement in patients with obesity, compared with those without, and has the additional benefit of causing modest weight loss.
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| 3. |
- af Winklerfelt Hammarberg, Sandra, et al.
(författare)
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Clinical effectiveness of care managers in collaborative primary health care for patients with depression : 12-and 24-month follow-up of a pragmatic cluster randomized controlled trial
- 2022
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Ingår i: BMC Primary Care. - : Springer Nature. - 2731-4553. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In previous studies, we investigated the effects of a care manager intervention for patients with depression treated in primary health care. At 6 months, care management improved depressive symptoms, remission, return to work, and adherence to anti-depressive medication more than care as usual. The aim of this study was to compare the long-term effectiveness of care management and usual care for primary care patients with depression on depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and 24 months after the start of the intervention. Methods Cluster randomized controlled trial that included 23 primary care centers (11 intervention, 12 control) in the regions of Vastra Gotaland and Dalarna, Sweden. Patients >= 18 years with newly diagnosed mild to moderate depression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed a structured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care manager followed up symptoms and treatment, encouraged behavioral activation, provided education, and communicated with the patient's general practitioner as needed. Patients at control centers received usual care. Adjusted mixed model repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptoms and remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specific questionnaire). Results The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) but not 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differences in remission and self-efficacy were not significant, but patients in the intervention group were more confident that they could get information (53% vs 38%; P = 0.02) and professional emotional support (51% vs 40%; P = 0.05) from the primary care center. Conclusions Patients with depression who had a care manager maintained their 6-month improvements in symptoms at the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients with care managers also had significantly more confidence in primary care and belief in future support than controls.
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| 4. |
- Agredo Chavez, Angelica Maria, et al.
(författare)
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Cracking and Fatigue of Heavy Loaded Prestressed Concrete Bridge in Sweden
- 2022
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Ingår i: IABSE Symposium Prague 2022: Challenges for Existing and Oncoming Structures - Report, International Association for Bridge and Structural Engineering. - Zürich : International Association for Bridge and Structural Engineering. ; , s. 792-799
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Konferensbidrag (refereegranskat)abstract
- A prestressed concrete bridge was built in 1963 with BBRV cables. It has three spans and a total length of 134.8 m. Due to mining activities the bridge was loaded with trucks with a total weight of 90 ton during 2012-2014 and from 2019. Crack development has been monitored manually and from 2020 with strain gauges and LVDTs.Cracks normally vary between 0.1 to 0.3 mm in width and grow in length with time. In November 2020 some of the strain gauges on the concrete showed alarming growth and the bridge was closed for traffic. Additional strain gauges were installed on vertical reinforcement bars and an assessment was carried out of the fatigue capacity of the bridge. It was found that the new strain gauges did not indicate any growth in strain and that the fatigue capacity was sufficient. The bridge could be opened again for traffic after being closed for five weeks. Monitoring drift in the strain gauges and fatigue are discussed.
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| 5. |
- Amouzad Mahdiraji, Saeid, et al.
(författare)
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An Optimization Model for the Placement of Mobile Stroke Units
- 2024
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Ingår i: Advanced Research in Technologies, Information, Innovation and Sustainability - 3rd International Conference, ARTIIS 2023, Proceedings. - : Springer. - 1865-0929 .- 1865-0937. - 9783031488573 - 9783031488580 ; 1935 CCIS, s. 297-310
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Konferensbidrag (refereegranskat)abstract
- Mobile Stroke Units (MSUs) are specialized ambulances that can diagnose and treat stroke patients; hence, reducing the time to treatment for stroke patients. Optimal placement of MSUs in a geographic region enables to maximize access to treatment for stroke patients. We contribute a mathematical model to optimally place MSUs in a geographic region. The objective function of the model takes the tradeoff perspective, balancing between the efficiency and equity perspectives for the MSU placement. Solving the optimization problem enables to optimize the placement of MSUs for the chosen tradeoff between the efficiency and equity perspectives. We applied the model to the Blekinge and Kronoberg counties of Sweden to illustrate the applicability of our model. The experimental findings show both the correctness of the suggested model and the benefits of placing MSUs in the considered regions.
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| 6. |
- Annerbo, Kerstin, 1964-, et al.
(författare)
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Bibliotekarier och forskningsutställningar : "Mission impossible"?
- 2021
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Ingår i: När nyfikenhet, driv och kreativitet möts. - Stockholm : Kungliga biblioteket. - 9789170004315 - 9789170004322 - 9789170004339 ; , s. 53-61
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Bokkapitel (populärvet., debatt m.m.)abstract
- Att bibliotekens uppgifter kan skifta eller ändra fokus, så att?arbetsformer förändras och bibliotekariers roller därigenom?omformas, är varken nytt eller konstigt. Så har det alltid varit.?En av de nya rollerna för bibliotekarier som blivit vanligare?på senare år är utvecklings- och producentrollen. Ta del av ett?samtal om hur verksamheten med att skapa forskningsutställningar har utvecklats på Linköpings universitetsbibliotek.
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| 7. |
- Arlien-Soborg, Mai C., et al.
(författare)
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Acromegaly management in the Nordic countries: A Delphi consensus survey
- 2024
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Ingår i: Clinical Endocrinology. - : WILEY. - 0300-0664 .- 1365-2265.
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveAcromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.MethodsA Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1-7). Consensus was defined as >= 80% of panelists rating their agreement as >= 5 or <= 3 on the Likert-type scale.ResultsConsensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.ConclusionThis consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
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| 8. |
- Arlien-Søborg, Mai C., et al.
(författare)
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Acromegaly management in the nordic countries : a Delphi consensus survey
- 2024
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Ingår i: Clinical Endocrinology. - : John Wiley & Sons. - 0300-0664 .- 1365-2265.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Acromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.Methods: A Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1−7). Consensus was defined as ≥80% of panelists rating their agreement as ≥5 or ≤3 on the Likert-type scale.Results: Consensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.Conclusion: This consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
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| 9. |
- Bergerum, Carolina, 1967-
(författare)
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Patient and public involvement in hospital quality improvement interventions : the mechanisms, monitoring and management
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation focuses on the mechanisms, monitoring and management of patient and public involvement in hospital quality improvement (QI) interventions. Findings from a literature review generated an initial programme theory (PT) on active patient involvement in healthcare QI interventions (Paper 1). Empirical studies were also undertaken in order to describe what was actually happening in the hospital QI teams and what patients and professionals experience influence their joint involvement (Paper 2), and to compare hospital leaders’ and managers’ experiences of managing QI interventions involving patients and the public (Paper 3). Finally, it was studied how patient-reported measures stimulate patient involvement in QI interventions in practice (Paper 4). The research had a qualitative design. The approach was descriptive and comparative, and the studies were carried out prospectively. Data were collected in two hospital organisations in Sweden and in one hospital organisation in the Netherlands. Data collection methods were a literature search (Paper 1), interviews and field observations (Paper 2 and 3) and data collection meetings (Paper 4). Altogether, 93 team meetings and meetings between the team leaders and management were attended and a total of 20 days of study visits with different forms of meetings were made. Twelve patients, 12 healthcare professionals and 17 and 8 hospital leaders and managers, respectively, participated in the interviews and data collection meetings. Realist synthesis was used to formulate the initial PT (Paper 1). Constructivist grounded theory was used to analyse and describe what was happening in the QI teams and how it was experienced by the team members (Paper 2). To compare hospital leaders’ and managers’ different, contextual meanings in Sweden and the Netherlands, the reflexive thematic analysis informed by critical realism was used (Paper 3). To order, manage and map data from 31 examples of local QI interventions associated to patient-reported measures, the framework method was used (Paper 4). The results formulate a generic PT on the mechanisms, monitoring and management perspectives of co-produced QI interventions in hospital services where patients and the public are involved. The PT provides a hypothesis on the various mechanisms at play and outcomes obtained at the different levels of hospital organisations in the process. It is argued that focus should be on experiences, interaction, relationships and dialogue, integration of context, and the matching of hospital resources to patient and public demands and needs. Subsequently, the outcome will be the resources and reasoning interplay resulting in actions and processes, experiences and knowledge, ‘product’ benefits, emotions, judgements and motivations. Monitoring constitutes an important feedback loop to enable such learnings. The PT aligns the perspectives of the clinical microsystem, improvement science and the service-dominant logic, and has a potential to explain how patient and public involvement in QI interventions might work.
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| 10. |
- Bergerum, Carolina, et al.
(författare)
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'We are data rich but information poor' : how do patient-reported measures stimulate patient involvement in quality improvement interventions in Swedish hospital departments?
- 2022
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Ingår i: BMJ Open Quality. - : BMJ Publishing Group Ltd. - 2399-6641. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThis study aimed to investigate if and how patient-reported measures from national and local monitoring stimulate patient involvement in hospital quality improvement (QI) interventions. We were also interested in the factors that influence the level and degree of patient involvement in the QI interventions.MethodsThe study used a qualitative, descriptive design. Inspired by the Framework Method, we created a working analytical framework. Four hospital departments participated in the data collection. Collaborating with a QI leader from each department, we identified the monitoring systems for the patient-reported measures that were used to initiate or evaluate QI interventions. Thereafter, the level and degree of patient involvement and the factors that influenced this involvement were analysed for all QI interventions. Data were mapped in an Excel spreadsheet to analyse connections and differences.ResultsDepartments used patient-reported measures from both national and local monitoring systems to initiate or evaluate their QI interventions. Thirty-one QI interventions were identified and analysed. These interventions were mainly conducted at the direct care and organisational levels. By participating in questionnaires, patients were involved to the degree of consultation. Patients were not involved to the degree of partnership and shared leadership for the identified QI interventions.ConclusionsOverall, hospital departments have limited knowledge regarding patient-reported measures and how they are best applied in QI interventions and how they support improvements. Applying patient-reported measures to hospital QI interventions does not enhance patient involvement beyond the degree of consultation.
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