| 1. |
- Petridou, Evangelia, 1972-
(författare)
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Political Entrepreneurship in Swedish : Towards a (Re)Theorization of Entrepreneurial Agency
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Public policies affect all of us, regardless of who we are or where we live. The study of public policymaking necessarily entails the study of the entire political system and to this end, researchers employ a multitude of frameworks, theories, and models, which tend to be complementary rather than mutually exclusive. The focus of this dissertation is on political entrepreneurship as an actor-based framework to examine and understand policy change. The dissertation’s main aim is to conceptually enhance entrepreneurship and the entrepreneur in the polis by leveraging them in the Swedish political context. In this research, political entrepreneurship and the political entrepreneur are examined in the background of the Swedish corporatist policymaking system with its consensual sensibilities. The five (two theoretical and three empirical) papers as well as the cover essay comprising this dissertation attempt to answer the following questions: first, how do contextual factors inform the realization of entrepreneurial agency? Second, how do contextual factors inform the strategies entrepreneurial actors use to affect change? Third, what is the role of political entrepreneurship and the political entrepreneur in macro-level theories such as critical junctures and policy transfer? Contextual factors here are understood to be the general political system; the level of governance; the substantive policy sector, and the stage of the policy process. Predominantly qualitative methods and a variety of analytical tools, ranging from formal social network analysis (SNA) to process tracing are used to investigate the research questions in the national, regional, and local levels of governance and in the fields of crisis management, risk governance, and economic development respectively. Findings suggest that overwhelmingly, political entrepreneurs come from the ranks of public officials and thus political entrepreneurship is a feature of the policy implementation stage rather than the agenda setting stage of policymaking. There is not a place for the outsider, single issue entrepreneur in the Swedish consensual system, which provides for extensive inclusion, but of actors organized in interest groups. Political entrepreneurs are action-oriented, problem solving doers, characterized by perseverance and resourcefulness and are key in consolidating policy change in the aftermath of a crisis. Though in broad terms the strategies political entrepreneurs use in the Swedish context are concomitant with the ones used in pluralistic contexts, specificities diverge. In the Swedish corporatist consensual system, political entrepreneurship becomes a conduit facilitating interconnections among a multitude of actors; opens up additional channels of communication, while the political entrepreneur is a network maker. Finally, political entrepreneurship is focused on forging a consensus rather than winning the competition: the art of quiet cooperation and collaboration.
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| 2. |
- Ekstrand, Eva-Maria, 1985-
(författare)
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Anaerobic digestion in the kraft pulp and paper industry : Challenges and possibilities for implementation
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The pulp and paper industry is a large producer of wastewater and sludge, putting high pressure on waste treatment. In addition, more rigorous environmental legislation for pollution control and demands to increase the use of renewable energy have put further pressure on the pulp and paper industry’s waste treatment, where anaerobic digestion (AD) and the production of methane could pose a solution. Kraft pulping makes up 80% of the world production of virgin wood pulp, thus, the wastewaters from this sector represent a large unused potential for methane production.There are three main types of substrates available for AD at pulp and paper mills, the wastewaters, the primary sludge/fibre sludge, and the waste activated sludge. AD treatment of these streams has been associated with several challenges, such as the presence of inhibiting compounds or low degradability during AD. The aim of this thesis was to experimentally address these challenges and potentials, focusing on wastes from kraft mills.Methane potential batch tests showed that many wastewater streams still posed challenges to AD, but the alkaline elemental chlorine-free bleaching stream and the condensate effluents had good methane potentials. Further, the methane potential of kraft mill fibre sludge was high, and co-digestion of kraft mill fibre sludge and waste activated sludge was feasible in stirred tank reactors with sludge recirculation. By increasing the organic loading in a pilot-scale activated sludge facility and thereby lowering the sludge age, the degradability of the waste activated sludge was improved. The higher wastewater treatment capacity achieved by this method provides an opportunity for the mills to increase their pulp and paper production. Further, by dewatering the digestate after AD and returning the liquid to the activated sludge treatment, costs for nutrient supplementation can be reduced.In conclusion, the thesis shows that AD of wastes from the kraft pulp and paper industry was feasible and carried many benefits regarding the generation of methane as a renewable energy carrier, improved wastewater treatment and reduced costs. Different strategies on how AD may be implemented in the kraft pulp and paper industry were formulated and discussed.
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| 3. |
- Genero, Magalí Martí
(författare)
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Microbial Communities in Boreal Peatlands : Responses to Climate Change and Atmospheric Nitrogen and Sulfur Depositions
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Myrmarker har en stor roll i regleringen av den globala kolbalansen och koncentrationerna av koldioxid och metan i atmosfären, vilket gör dem till speciellt viktiga ekosystem ur ett klimatförandringsperspektiv. Förändringar av myrmarker genom naturlig utveckling eller antropogen påverkan kan därför få långtgående störningar av myrars klimatreglerande funktion. Mikroorganismer har en avgörande roll i biogeokemiska processer genom att t ex bryta ned organisk material i mark och därmed styra kolets kretslopp. För att förstå hur myrsystemen reagerar på störningar är det därför väsentligt att veta hur mikroorganismsamhällena reagerar genom förändringar i sammansättning och biogeokemisk aktivitet. Målet för studierna, som ligger till grund för denna avhandling, var att undersöka hur mikroorganismsamhällen i myrar reagerar på uppvärmning genom klimatförändring och ökade kväve- (N) och svavel- (S) halter i nederbörd. High through-put sekvensering användes för att studera taxonomiska och funktionella egenskaper hos mikroorganismerna i myrar och quantative PCR användes för att mer specifikt studera de metanbildande arkeorna. Två fältkampanjer vardera omfattande tre ombrotrofa myrar med olika klimatförhållanden och olika mängder N och S inederbörden användes för att undersöka lokala och storskaliga effekter på myrars mikrobiella samhällen. Resultaten visade att latudinell variation i geoklimatologiska förhållanden (temperatur ochnederbördsmängd) och deposition av näringsämnen hade en påverkan på sammansättningen av de mikrobiella samhällena och aktiva metanbildare förr än variationen i den kemiska miljön inom varje specifik myr. Myrväxtsamhällenas sammansättning för en specifik myr visades sig i stor utsträckning styra sammansättningen av motsvarande mikrobiella samhälle i torvprofilen. Detta framgick klart av i en analys av samexisterande nätverk av mikroorganismsamhällen och motsvarande växtsamhällen i en studie av tre geografiskt skilda myrar med olika kvävedeposition. Effekterna av klimatförändring och nederbörd med olika mängder av N och S studerades mer specifikt genom att analysera de mikrobiellasamhällena i ett långliggande (18 år) försök. Påverkan av var och en av dessa manipulationer antingen förstärktes eller minskades, när de förekom i kombinationer. Ökad kvävedeposition var den faktor som hade starkast effekt. De långvariga störningarna medförde stora förändringar i den mikrobiella taxonomin inom samhällena. Detta återspeglades dock inte i den fysiologiska kapaciteten, vilket visar att det finns en stark buffring i myrarnas mikrobiella funktion. Detta tyder på att framtida utveckling av myrar i relation till olika störningar sannolikt inte kommer att påverka myrarnas roll för kolbalans och växthusgasutbyte med atmosfären.
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| 4. |
- Larsson, Madeleine
(författare)
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Anaerobic Digestion of Wastewaters from Pulp and Paper Mills : A Substantial Source for Biomethane Production in Sweden
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Swedish pulp and paper industry is the third largest exporter of pulp and paper products worldwide. It is a highly energy-demanding and water-utilising industry, which generates large volumes of wastewater rich in organic material. These organic materials are to different extents suitable for anaerobic digestion (AD) and production of energy-rich biomethane. The implementation of an AD process within the wastewater treatment plant of a mill would increase the treatment capacity and decrease the overall energy consumption due to less aeration and lower sludge production and in addition produce biomethane. Despite the many benefits of AD it is only applied at two mills in Sweden today. The reason for the low implementation over the years may be due to problems encountered linked to the complexity and varying composition of the wastewaters. Due to changes in market demands many mills have broadened their product portfolios and turned towards more refined products. This has increased both the complexity and the variations of the wastewaters´ composition even further, as the above changes can imply an increased pulp bleaching and utilisation of more diverse raw materials within the mills.The main aim of this thesis was therefore to generate knowledge needed for an expansion of the biomethane production within the pulp and paper industry. As a first step to achieve this an evaluation of the biomethane potential and the suitability for AD of wastewaters within a range of Swedish pulp and paper mills was performed. Thus, around 70 wastewater streams from 11 different processes at eight mills were screened for their biomethane potential. In a second step, the impact of shifts in wood raw material and bleaching on the AD process and the biomethane production was investigated and further evaluated in upflow anaerobic sludge bed (UASB) reactors.The screening showed that the biomethane potential within the Swedish pulp and paper industry could be estimated to 700 GWh, which corresponds to 40% of the Swedish biomethane production during 2014. However, depending on the conditions at each specific mill the strategy for the establishment of AD needs to differ. For mills producing kraft pulp the potential is mainly found in wastewaters rich in fibres, alkaline kraft bleaching wastewaters and methanol-rich condensates. The biomethane potential within thermo-mechanical pulp- (TMP) and chemical thermo-mechanical pulp (CTMP) mills is mainly present in the total effluents after pre-sedimentation and in the bleaching effluents as these holds high concentrations of dissolved organic material. The screening further showed that the raw material used for pulp production is an important factor for the biomethane potential of a specific wastewater stream, i.e. hardwood (HW) wastewaters have higher potentials than those from softwood (SW) pulp production. This was confirmed in the lab-scale UASB reactor experiments, in which an alkaline kraft bleaching wastewater and a composite pulping and bleaching CTMP wastewater were used as substrates. AD processes were developed and maintained stable throughout shifts in wastewater composition related to changes in the wood raw materials between SW and HW for the kraft wastewater and spruce, aspen and birch for the CTMP wastewater. The lower biomethane production from SW- compared to HW wastewaters was due to a lower degradability together with a higher ratio of sulphuric compounds per TOC for the SW case. The impact of shifts between bleached and unbleached CTMP production could not be fully evaluated in the continuous process mainly due to technical problems. However, due to the large increase in dissolved organic material when bleaching is applied, the potential biomethane production will increase during the production of bleached pulp compared to unbleached pulp. Based on the biomethane potentials obtained for one of the included CTMP mills, their yearly production of biomethane was estimated to 5-27 GWh with the lowest and the highest value corresponding to the production of unbleached spruce pulp vs. bleached birch pulp.Thus, the results of the investigations presented in this thesis show that the UASBreactor is suitable for AD of wastewaters within the pulp and paper industry. The results also show that challenges related to variations in the organic material composition of the wastewaters due to variations in wood raw materials could be managed. The outcome of the thesis work also imply that the production of more refined products, which may include the introduction of an increased number of raw materials and extended bleaching protocols, could increase the potential biomethane production, especially if the pulp production will make use of more HW.
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| 5. |
- Nyberg, Jan, 1960-
(författare)
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On implant integration in irradiated bone : clinical and experimental studies
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Radiation has an impact on the processes involved in bone- healing, regeneration and remodeling. The mechanisms that cause impaired bone healing of dental implants are not fully understood. Adjunctive treatments to revers radiation effects are limited. Dental implant surgery can be a risk in irradiated jaws and the risk for osteoradionecrosis is of concern. There is no consensus when to install implant after completed radiation therapy or what radiation dosage might cause impaired bone healing. The overall aim of the studies was to investigate bone tissue reactions adjacent to implants after irradiation.I. A clinically long-term follow-up study was performed to assess the outcome of 18 dental implants inserted in five patients with and without irradiated fibula-reconstructed mandibles. Bone tissue reactions adjacent to 14 micro-implants were histologically evaluated. In the clinical follow-up, 15 implants were in function, with an overall success rate of 83%. The histomorphometric analyses demonstrated an impaired osseointegration with reduced bone-to-implant contact (BIC) and bone area (BA), in irradiated sides.II. In an experimental animal study the aim was to find a critical level for a given single external radiation dosages causing impaired implant osseointegration. 9 rats received a single radiation dose of 2, 5, 10, 20 and 30 Gy, respectively to one hind-leg while the other served as a control. Three days post radiation two implants were inserted in each hind-leg and after a period of 5 weeks the implants (n=36) were harvested for histological examination. BIC and BA were lower for irradiated samples for dosages of 20 Gy and higher.III. The aim was to investigate the effects of HBO on osseointegration of titanium implants in irradiated bone. 15 rats received an external single radiation dose of 20 Gy to one hind-leg. 3-days post-irradiation 2 implants were inserted in each hind-leg (n=60). The rats were divided in to 2 groups and one group received hyperbaric oxygen treatment (HBOT) 3 days post-implant insertion (n=8). After 5 weeks the distal implants were harvested for histological examination (n=30) and the proximal implants were used for removal torque tests (n=30). BIC obtained significant higher values for non-irradiated side, independent of HBO or not. BA obtained significant higher values for irradiated sides in the non-HBO group.IV. The aim was to investigate gene expression in irradiate bone after implant insertion for bone formation, resorption and remodelling. 8 rats, received a single radiation dose of 20 Gy to one hind-leg and two implants inserted in each hind-leg 8 weeks after completed radiation therapy. After 5 weeks bone samples with implants were collected for gene expression analysis. ALP, OC (formation) and RANKL/OPG (remodelling) were down regulated in irradiated samples.Conclusion: Bone-anchored dental bridges can be used in selected oro-mandibular reconstructed patients. Bone quality disturbances with impaired osseointegration for dosages of 20 Gy and more were demonstrated in an animal study model. HBO did not enhance osseointegration of implants placed in rat bone during a five-week follow-up period. Irradiation significant reduces bone formation and remodeling under influence of pro-inflammatory and growth factor cytokines
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| 6. |
- Lindberg, Jens, 1980-
(författare)
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Orsak: Våldtäkt : om våldtagna män i medicinsk praktik
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Within the Swedish healthcare system, the care of raped men varies and many hospitals lack specific programmes. The aim of the thesis is to describe and analyse how meanings about rape and raped men are produced within Swedish healthcare. The central question is how different patient positions and conceptions about the phenomenon of male rape are created through care practices and how, in turn, that affects the care of raped men.The empirical material consists of interviews with healthcare professionals who have worked with raped men, field notes from participant observations and materials such as legislation, care protocols and medical records. In order to analyse how rape and raped men are articulated in practice and to highlight the norms that govern health- and rape care, the material has been analysed from a poststructuralist ‘logics’ perspective.The analysis departs from a number of healthcare settings – two emergency departments, one gynaecological department, one rape clinic, one health crisis recovery unit and a regional healthcare project developing new procedures for the care of raped women, children and men – and their work with predominantly male rape.One of the central aspects of the thesis is that it demonstrates that the care of raped men in many places lack clear procedures and that, consequently, health professionals either draw on ill-suited general care practices or make up new ones as they go. Norms about gender, sexuality, masculinity, rape and patienthood, but also organizational aspects and aspects of professional identity, greatly influence how raped men are treated.In the thesis it is also suggested that rape care is governed by a ’logic of need’. The logic of need is a logic that care professionals and settings need to follow to produce good healthcare, and which emphasizes and recreates differences between how the rape of women and the rape of men are understood. At the same time there are care practices that seek to create equivalences between the rape of men and the rape of women. These alternative articulations of rape care are both in line with, and in some ways challenging, dominant rape care. In doing so they have an impact on what is considered good care for raped men.Above all, the logic of need enables the articulation of established notions of raped men and healthcare’s long-standing preoccupation with good corporeal healthcare. The logic constructs male rape as a specific phenomenon and organises healthcare in such ways that create sometimes unequal health conditions for male victims. The logic limits raped men’s access to certain care practices and in many cases fails to offer raped men an established patient position. This in turn seems to limit the emergence of specially adapted care for that group of patients.
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| 7. |
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| 8. |
- Själander, Sara, 1981-
(författare)
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Stroke prevention in atrial fibrillation
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The Framingham Study from 1991 showed a clear correlation between atrial fibrillation (AF) and ischemic stroke, where patients with AF had an almost fivefold increase in risk of stroke compared with patients without AF. Since then, several trials have evaluated different antithrombotic treatments to reduce the risk of stroke in patients with AF. Other trials have investigated factors that increase the risk of stroke in patients with AF and risk score systems have been developed to categorize patients into low or increased risk of stroke to help clinicians to decide which patients benefit from antithrombotic treatment and in whom it can be abstained, not to expose patients with low stroke risk to an increased risk of bleeding conferred by antithrombotic treatment. The aims of this thesis were: [1] to evaluate if a warfarin dosing algorithm can increase hit rate and decrease mean error compared with manually changed doses; [2] to assess the prevalence and net clinical benefit of aspirin as monotherapy for stroke prevention in AF; [3] to investigate the risk of thromboembolic and haemorrhagic complications within 30 days after electrical cardioversion (ECV) of AF in patients with and without oral anticoagulation (OAC) pre-treatment; and [4] to assess the proportion of patients discontinuing OAC after pulmonary vein isolation (PVI), identify factors predicting stroke after PVI and to investigate risk of complications after PVI with and without OAC.Materials and methods: All studies are retrospective and based on data from Swedish national quality registries. In paper I, data from Auricula was used to compare the resulting INR values after algorithmic warfarin dose suggestions and manually changed doses. In paper II data was extracted from the Swedish National Patient Register, the Dispensed Drugs Register and the Cause of Death Register. Patients with aspirin treatment were compared with patients without any antithrombotic treatment regarding risk of thromboembolic and haemorrhagic complications. In paper III data was collected from the Swedish National Patient Register and the Dispensed Drugs Register to examine risk of complications (thromboembolic and haemorrhagic events) within 30 days after cardioversion, comparing patients with and without oral anticoagulation pre-treatment. In paper IV data from six different Swedish national quality registries were used (Swedish Catheter Ablation Register, Auricula, Swedish National Patient Register, Dispensed Drugs Register, Cause of Death Register and Riksstroke). Patients undergoing pulmonary vein isolation (PVI) were investigated for adherence to guidelines regarding oral anticoagulation, predictors for stroke after PVI, as well as risk of ischemic stroke or intracranial haemorrhage after PVI in patients with and without treatment.Results: Paper I showed that a computerized dosing algorithm for warfarin in most cases perform as well or better compared with doses that have been changed manually, with a better hit-rate (0.72 vs. 0.67) and a lower mean error (0.44 vs. 0.48). Paper II showed that 32% of 182.678 patients with a diagnosis of AF were on monotherapy with aspirin for stroke prevention. A total of 115.185 patients were included, 58.671 with aspirin treatment and 56.514 without antithrombotic treatment at baseline. After stratification after CHA2DS2-VASc score and after multivariable adjustment, aspirin treatment did not confer a decrease in thromboembolic events. After propensity score mathcing, rate of ischemic stroke was 7.4%/year (95% CI 7.1-7.6) in aspirin treated patients and 6.6%/year (95% CI 6.4-6.9) in patients without antithrombotic treatment. In paper III 22.874 patients undergoing electrical cardioversion were included, 10.722 with and 12.152 without OAC pre-treatment. In patients with low stroke risk (CHA2DS2-VASc 0-1), no thromboembolic complication was seen within 30 days after cardioversion. In patients with CHA2DS2-VASc ≥2, the risk of thromboembolic complications was increased when no oral anticoagulation pre-treatment was used, results that remained after propensity score matching. No difference regarding haemorrhagic complications was seen. Paper IV included a total of 1585 patients undergoing PVI with a mean follow up of 2.6 years. Adherence to current guidelines regarding oral anticoagulation was good in patients with CHA2DS2-VASc ≥2. Previous ischemic stroke was a predictor for a new stroke after PVI. In patients with CHA2DS2-VASc ≥2 stroke risk was increased in patients discontinuing OAC compared to those continuing OAC (1,60%/year vs. 0.34%/year).Conclusion: Oral anticoagulation is still underutilized for prevention of stroke and systemic embolism in patients with atrial fibrillation. Patients with risk factors for stroke (CHA2DS2-VASc ≥2p) benefit from continuous oral anticoagulation treatment to prevent stroke, also in conjunction with electrical cardioversion and after pulmonary vein isolation. If warfarin is chosen, a computerised dosing algorithm can facilitate and standardize warfarin dosing and lead to better resulting INR values than manually changed doses. Aspirin should not be used for stroke prevention in patients with atrial fibrillation.
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