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1.
  • Danielsson, Ulla EB, 1947- (författare)
  • Träffad av blixten eller långsam kvävning : genuskodade uttryck för depression i en primärvårdskontext
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Depression is a common mental health problem in primary health care. One third of the Swedish population is expected to experience depression at some point in their lives. The understanding of depression has expanded, both from a lay and primary health care perspective. The number of persons considering themselves as depressed, receiving the diagnosis, and getting treatment for it has increased steadily over the last decades. Unchanged, however, is that depression is diagnosed twice as often in women as in men, while twice as many men as women commit suicide. These gender differences appear in adolescence. In earlier research biomedical, psychological, and social-cultural explanations of gender differences have been discussed. Patient’s own perspectives have more seldom stood in focus, and men’s narratives in particular are still scarce. In this thesis, gender, i.e. how to be a woman or a man, is considered as a construct, formed and negotiated in social interaction. The aim of the study is to explore the gendered face of depression from a patient perspective: How is depression expressed and explained by patients in primary health care, by women and men, adults and adolescents? How are depressed women and men portrayed in the media? How do patient and media accounts of depression compare with the perspective offered in medical research articles? Method and material The analyses are based on data from three different sources: patient narratives, newspaper portrayals and scientific medical articles. – 37 in-depth interviews were undertaken with primary health care patients diagnosed with depression. Informants were chosen to include both men and women, grown-ups (Studies I + II) and young adults (Study V) of varying occupational and social class backgrounds. Data were analyzed according to grounded theory. – 26 articles portraying lay informants with depression (Study III) were drawn from three major Swedish daily newspapers by a search of database Mediearkivet 2002. The articles were analyzed by qualitative content analysis. –82 scientific articles concerning depression in relation to gender were identified in a PubMed search 2002. The understanding of depression in these articles was explored and compared with findings in the grown-up patient narratives and in the media portrayals by means of discourse analysis (Study IV). Findings Study I captured women’s and men’s formulations of their experiences of depression. To be marked with demands constituted a central experience for both women and men, but the outward manifestations differed in relation to gender as well as to class. Home and work had different priority. Men talked more about physical distress (often chest pain) than about emotions. Women readily verbalized emotional distress – shame and guilt – while physical symptoms were vague and secondary (often about the stomach). Men dealt with insecurity by aggrandizing their previous competence, women by self-effacement. Study II disclosed gendered trajectories into depression. Four symbolic illness narratives were identified: struck by lightning, nagging darkness, blackout and slowly suffocating. Most of the men considered their bodies suddenly “struck” by external circumstances beyond their control. The stories of women in the study were more diverse, reflecting all four illness narratives. However, the women had a tendency to blame their own personality and to describe depression as insidious and originating from the inside. The women expressed feelings of guilt and shame but also conveyed a personal responsibility and concern with relationships. Study III identified four themes in media portrayals of depression: displaying a successful facade, experiencing a cracking facade, losing and regaining control and explaining the illness. The mediated image of depression both upheld and challenged traditional gender stereotypes. The women’s stories were more detailed, relational, emotionally oriented and embodied. The portrayal of men was less emotional and expressive, and described a more dramatic onset of depression. Study IV revealed gaps in how depression in relation to gender is understood by the patients, the media, and the medical research establishment. There were differences in recognition, in understanding of the reasons, and in contextualization of depression. Although women and men described different symptoms and reasons for falling ill, in scientific articles these gendered differences were conceptualized mainly in terms of hormones and other biological markers. Study V elucidated the impact of gender on adolescent depression. The young women and men were all striving to be normal, influenced by demanding media images, confronted by identity trouble, and overwhelmed by feelings. They had dreams of an ordinary family and described normative expectations. Getting a safety net of friends and other adults was a way out. Both the young women and men were eager to communicate their distress when given the opportunity. This seemed especially important to some of the young men, who in talking about their emotional problems transgressed gender norms. Conclusions Patient perspectives enrich the understanding of gendered expressions of depression by making visible transgressions of and breaks with stereotype gender norms. Gender awareness is an important key in clinical consultation. To recognize gendered narratives of illness might have a salutary potential, making depression more visible among men, and relieving self-blame among women. By re-evaluating restrictive gender patterns, the clinician might encourage development of healthier practices of how to be a man or a woman, a development especially important for adolescents. An integrated model for understanding biological, gender and cultural aspects of depression has yet to be developed. As general practitioners we have a unique possibility to see and to study the whole individual in her social and cultural context.
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2.
  • Alvehus, Malin, et al. (författare)
  • Adipose tissue IL-8 is increased in normal weight women after menopause and reduced after gastric bypass surgery in obese women
  • 2012
  • Ingår i: Clinical Endocrinology. - : Wiley-Blackwell. - 0300-0664 .- 1365-2265. ; 77:5, s. 684-690
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective:  The menopausal transition is characterized by increased body fat accumulation, including redistribution from peripheral to central fat depots. This distribution is associated with an increased risk of type 2 diabetes and cardiovascular disease which are linked to low-grade inflammation. We determined whether postmenopausal women have higher levels of inflammatory markers, compared to premenopausal women. We also wanted to determine if these markers are reduced by stable weight loss in obese women. Design and methods:  Anthropometric data, blood samples, and subcutaneous adipose tissue biopsies were collected from normal weight premenopausal and postmenopausal women and obese women before and 2 years after gastric bypass surgery. Serum protein levels and adipose tissue gene expression of inflammatory markers were investigated. Results:  IL-8 expression in adipose tissue and circulating levels were higher in postmenopausal versus premenopausal women. IL-8 expression was associated with waist circumference, independent of menopausal status. IL-6 expression and serum levels of monocyte chemoattractant protein (MCP)-1 were higher in postmenopausal versus premenopausal women. Two years after gastric bypass surgery, adipose expression of IL-8, tumor necrosis factor-α, and MCP-1 decreased significantly. Serum insulin levels were associated with inflammation-related gene expression before gastric bypass surgery, but these associations disappeared after surgery. Conclusion:  Postmenopausal women have an increased inflammatory response in the subcutaneous fat and circulation. Inflammatory markers in adipose tissue decreased significantly after surgery-induced weight loss. This effect may be beneficial for metabolic control and reduced cardiovascular risk after weight loss. © 2011 Blackwell Publishing Ltd.
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4.
  • Bergström, Eva-Karin, 1974, et al. (författare)
  • Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat
  • 2014
  • Ingår i: Community Dentistry and Oral Epidemiology. - : Wiley. - 0301-5661. ; 42:5, s. 404-411
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesTo evaluate approximal caries increment among 12- to 16-year-olds in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride (F) varnish programme with Bifluorid 12 and Duraphat. MethodsThe design was a RCT study with 1365 adolescents, divided into following four groups: Group 1 Bifluorid 12 two applications/year; Group 2 Duraphat two applications/year; Group 3 Bifluorid 12 four applications/year and Group 4 no F varnish at school. 1143 children (84%) completed the study. Approximal caries was registered on bitewing radiographs. ResultsThere were no statistically significant differences in caries prevalence among the groups either at baseline or after 3.5years . The caries increment for Group 1 was 1.342.99 (mean +/- SD), 1.24 +/- 2.84 for Group 2, 1.07 +/- 2.66 for Group 3 and 1.25 +/- 2.75 for Group 4, with no statically significant differences either between Bifluorid 12 and Duraphat with the same frequency of F varnish applications or between the F groups and the control group. ConclusionsIn an area with low caries prevalence in Sweden, the supplementary caries-preventive effect of school-based F varnish applications, to regular use of F toothpaste at home and to regular caries prevention given at the Public Dental Clinics, appears to be nonsignificant regarding approximal caries increment.
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5.
  • Borgenvik, Marcus, et al. (författare)
  • Alterations in amino acid concentrations in the plasma and muscle in human subjects during 24 h of simulated adventure racing
  • 2012
  • Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 112, s. 3679-3688
  • Tidskriftsartikel (refereegranskat)abstract
    • This investigation was designed to evaluate changes in plasma and muscle levels of free amino acids during an ultra-endurance exercise and following recovery. Nine male ultra-endurance trained athletes participated in a 24-h standardized endurance trial with controlled energy intake. The participants performed 12 sessions of running, kayaking and cycling (4 x each discipline). Blood samples were collected before, during and after exercise, as well as after 28 h of recovery. Muscle biopsies were taken 1 week before the test and after exercise, as well as after 28 h of recovery. During the 24-h exercise, plasma levels of branched-chain (BCAA), essential amino acids (EAA) and glutamine fell 13%, 14% and 19% (P<0.05) respectively, whereas their concentrations in muscle were unaltered. Simultaneously, tyrosine and phenylalanine levels rose 38% and 50% (P<0.05) in the plasma and 66% and 46% (P<0.05) in muscle, respectively. After the 24-h exercise, plasma levels of BCAA were positively correlated with muscle levels of glycogen (r2=0.73, P<0.05), as was the combined concentrations of muscle tyrosine and phenylalanine with plasma creatine kinase (r2=0.55, P<0.05). Following 28-h of recovery, plasma and muscle levels of amino acids had either returned to their initial levels or were elevated. In conclusion, ultra-endurance exercise caused significant changes elevations in plasma and muscle levels of tyrosine and phenylalanine, which suggest an increase in net muscle protein breakdown during exercise. There was a reduction in plasma concentrations of EAA and glutamine during exercise, whereas no changes were detected in their muscle concentration after exercise.
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6.
  • Crespo, Ana, et al. (författare)
  • Phylogenetic generic classification of parmelioid lichens (Parmeliaceae,Ascomycota) based on molecular, morphological and chemical evidence.
  • 2010
  • Ingår i: Taxon. - : John Wiley & Sons. - 0040-0262 .- 1996-8175. ; 59:6, s. 1735-1753
  • Tidskriftsartikel (refereegranskat)abstract
    • Parmelioid lichens are a diverse and ubiquitous group of foliose lichens. Generic delimitation in parmelioid lichens has been in a state of flux since the late 1960s with the segregation of the large, heterogeneous genus Parmelia into numerous smaller genera. Recent molecular phylogenetic studies have demonstrated that some of these new genera were monophyletic, some were not, and others, previously believed to be unrelated, fell within single monophyletic groups, indicating the need for a revision of the generic delimitations. This study aims to give an overview of current knowledge of the major clades of all parmelioid lichens. For this, we assembled a dataset of 762 specimens, including 31 of 33 currently accepted parmelioid genera (and 63 of 84 accepted genera of Parmeliaceae). We performed maximum likelihood and Bayesian analyses of combined datasets including two, three and four loci. Based on these phylogenies and the correlation of morphological and chemical characters that characterize monophyletic groups, we accept 27 genera within nine main clades. We re-circumscribe several genera and reduce Parmelaria to synonymy with Parmotrema. Emodomelanelia Divakar & A. Crespo is described as a new genus (type: E. masonii). Nipponoparmelia (Kurok.) K.H. Moon, Y. Ohmura & Kashiw. ex A. Crespo & al. is elevated to generic rank and 15 new combinations are proposed (in the genera Flavoparmelia, Parmotrema, Myelochroa, Melanelixia and Nipponoparmelia). A short discussion of the accepted genera is provided and remaining challenges and areas requiring additional taxon sampling are identified.
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7.
  • de Flon, Pierre, et al. (författare)
  • Empirical evidence of underutilization of referrals for epilepsy surgery evaluation
  • 2010
  • Ingår i: European Journal of Neurology. - : Wiley. - 1351-5101 .- 1468-1331. ; 17:4, s. 619-625
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Epilepsy surgery is a treatment that can cure patients with intractable epilepsy. This study investigates whether referrals for epilepsy surgery evaluation are underutilized. Methods: Patients with epilepsy aged 18–60 years were identified in a computerized registry held by public health care providers in a Swedish county using ICD codes. Clinical data and data on referral status for epilepsy surgery were obtained from the patients' medical records. Potential candidates for epilepsy surgery evaluation were identified using pre-specified criteria. Obstacles for referral were analysed by comparing clinical data in patients who were considered for referral and those who were not. Appropriateness of non-referral was evaluated against recommendations from the Swedish Council on Technology in Health Care (SBU). Results: Of 378 patients with epilepsy in the registry, 251 agreed to participate. Of 251, 40 were already referred patients and 48 patients were identified as potential candidates for epilepsy surgery evaluation by study criteria. Referral had been considered but not performed in 15 of the potential candidates. Potential candidates not considered for referral were less likely to have seen a neurologist, to have had an EEG, CT and MRI, and more likely to have cognitive disturbances. Following the recommendations by the SBU, 28 of 48 potential candidates were identified as inappropriately not referred patients. Conclusion: The number of missed referrals for epilepsy surgery evaluation was estimated to be 60 per 100 000 inhabitants. Several important obstacles were found for not referring patients for epilepsy surgery evaluation.
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8.
  • Gerhardsson, Emma, et al. (författare)
  • The Swedish Version of the Breastfeeding Self-Efficacy Scale-Short Form : Reliability and Validity Assessment
  • 2014
  • Ingår i: Journal of Human Lactation. - : Sage Publications. - 0890-3344 .- 1552-5732. ; 30:3, s. 340-345
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Among Swedish mothers, breastfeeding duration has been declining in recent years. An instrument for early identification of women at risk for shorter breastfeeding duration may be useful in reversing this trend. Objectives: The aims of this study were to translate and psychometrically test the Swedish version of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), examine the relationship between breastfeeding self-efficacy and demographic variables, and evaluate associations with breastfeeding continuation plans in Swedish mothers. Methods: The BSES-SF was translated into Swedish using forward and back translation. The sample consisted of 120 mothers who, during the first week postpartum, came for a routine follow-up visit at the postnatal unit in a university hospital. The mothers were compared based on demographic data and their future breastfeeding plans. Results: The Cronbach’s alpha coefficient for internal consistency for the BSES-SF was 0.91 and the majority of correlation coefficients exceeded 0.3. A 1-factor solution was found that explained 46% of the total variance. There was no difference in confidence in breastfeeding between mothers with early hospital discharge and mothers who received postnatal care at the hospital. Primiparas who stayed longer at the hospital were less confident in breastfeeding than primiparas who had a shorter hospital stay. Breastfeeding mothers who planned to partially breastfeed in the near future had lower BSES-SF scores, compared to those who planned to continue exclusive breastfeeding. Conclusion: The Swedish version of the BSES-SF has good reliability, validity, and agreement with mothers’ plans regarding breastfeeding continuation and exclusivity.
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9.
  • Haraldsson, Katarina, et al. (författare)
  • Adolescent Girls' Experiences of Underlying Social Processes Triggering Stress in Their Everyday Life : A grounded theory study
  • 2011
  • Ingår i: Stress and Health. - Chichester : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 27:2, s. E61-E70
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to generate a theoretical model of underlying social processes that trigger stress in adolescent girls’ everyday life. In-depth interviews regarding the experiences of stress at home, school and during leisure time were conducted with 14 17-year-old schoolgirls. Data were analysed by means of the grounded theory method. Stress was triggered in the interaction between responsibility and the way in which the girls were encountered. Triggered emotional reactions took the form of four dimensions of stress included ambivalence, frustration, despair and downheartedness. These reactions were dependent on whether the girls voluntary assumed responsibility for various situations or whether they were forced, or felt they were being forced, to assume responsibility in interaction with an encounter characterized by closeness or distance. These forms of stress reactions could appear in one dimension and subsequently shift to another. From the public health perspective, the generated stress model can be used in the planning and implementation of future actions to prevent stress and promote well-being related to stress in adolescent girls.
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  • Kumlien, Eva, et al. (författare)
  • Attitudes towards epilepsy surgery : A nationwide survey among Swedish neurologists
  • 2010
  • Ingår i: Seizure. - : Elsevier BV. - 1059-1311 .- 1532-2688. ; 19:4, s. 253-255
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Epilepsy surgery is safe and effective for epilepsy that is refractory to medical treatment. However, only a minority of candidates for epilepsy surgery are referred for surgical evaluation. We investigated Swedish neurologists' views on and criteria for referral for epilepsy surgery. Materials and methods: A survey was sent out to neurologists who treat patients with epilepsy. We received responses from 81% of referring hospitals and 57% of private practices. Results: Sixty-one percent of respondents considered that epilepsy surgery reduced seizure frequency and 53% that it improved quality of life. Surgical treatment was thought to be cost-effective by 90% of respondents. Referral for surgery was considered if three or more antiepileptic drugs had failed. Seizure frequency and severity and, the patient's own wishes were regarded as the most important criteria for surgical referral. MRI and EEG findings were also important whereas duration of illness was considered less important. Age below 65 years and lack of mental retardation were important for considering referral. Conclusion: In general Swedish neurologists have a cautious but positive attitude towards epilepsy surgery. Uncertainties about eligibility criteria among referring clinicians may contribute to the underutilization of epilepsy surgery.
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12.
  • Liedholm Johnson, Eva, 1960- (författare)
  • Mineral Rights : Legal Systems Governing Exploration and Exploitation
  • 2010
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The objective of this thesis is to examine the legal procedures and systems concerning granting or possessing mineral rights, and how such rights may be exercised, particularly given the diametric interests of land use, ownership and land tenure. The study, comparative in its nature, aims at highlighting the similarities and differences between the countries and states of comparison, and thereby identify interesting solutions of issues relating to the granting and exercising of mineral rights. The study examines mineral rights and different legal systems regulating mineral exploration and exploitation. The focus is on mining and mineral legislation and its application, including the exercise of mineral rights. The systems chosen are those of Sweden, Finland and the states of Ontario and Western Australia. The main result is generated by the comparison dealing with the application, granting and possession of mineral rights related to the development of a mine. Several processes are thereby identified. In addition, the content and extent of the different rights and obligations related to exploration and exploitation activities are examined, as well as land areas open or closed for the exercise of these rights. The legal processes concerning granting mineral rights are in fact complex as evidenced by this work, particularly when land-use and environmental legislation is taken into account. The perception of a good balance in legislation between diametric interests of land use, ownership and land tenure is heavily linked to the view of sustainable development. The difficulties of achieving this are confirmed by the countries and states compared. The continuous change of mineral legislation during the course of this study is an indication of the complexity of the topic.    
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13.
  • Lindström, Eva, et al. (författare)
  • Schizofreni - läkemedelsbehandling, patientens delaktighet och vårdens organisation : En systematisk litteraturöversikt
  • 2012
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Schizofreni är i de flesta fall en kronisk och invalidiserande psykisk sjukdom. Antipsykotiska läkemedel (neuroleptika) är namnet på den grupp läkemedel som är avsedd att lindra de psykotiska symtomen som uppstår vid schizofreni. Antipsykotiska läkemedel kan indelas i första generationens antipsykotika och andra generationens antipsykotika. Denna litteraturöversikt kompletterar SBU:s systematiska översikt från år 1997 med en granskning av andra generationens antipsykotika. I översikten ingår också ett kapitel om den kunskap man idag har om hur personer med schizofreni upplever sin medverkan och sin delaktighet i behandling och vård. Dessutom ingår ett kapitel där man undersökt värdet av integrerade vårdformer för personer med olika psykiatriska tillstånd där huvuddelen av dem har schizofreni.
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14.
  • Meijer, Tomas, 1980-, et al. (författare)
  • Endoparasites in the endangered Fennoscandian population of arctic foxes (Vulpes lagopus)
  • 2011
  • Ingår i: European Journal of Wildlife Research. - : Springer Science and Business Media LLC. - 1612-4642 .- 1439-0574. ; 57:4, s. 923-927
  • Tidskriftsartikel (refereegranskat)abstract
    • The Fennoscandian arctic fox (Vulpes lagopus) population is endangered due to overharvest and competition with the larger red fox (Vulpes vulpes). In this study, we have screened the population in Sweden for endoparasites by analysis of non-invasively faecal samples collected at reproductive dens during two summers, one with low food abundance (2008) and the other with high food abundance (2010). Eggs, larvae and oocysts of a total of 14 different endoparasites were identified with a species richness per inhabited den of 3.2 (CI95% +/- 0.48) in 2008 and 2.7 (CI95% +/- 0.72) in 2010. Capillariidae-like eggs was identified at 59% of the dens in 2008 and 57% in 2010 and Toxocara canis with 7% (2008) and 30% (2010); Toxascaris leonina with 93% (2008) and 65% (2010); Uncinaria stenocephala 65% (2008) and 39% (2010); Crenosoma vulpis 3% (2008) and 4% (2010); Trichuris sp. 7% (2008) and 4% (2010); Cystoisospora canis-like oocysts 28% (2008) and 26% (2010); Cystoisospora ohiensis-like oocysts 38% (2008) and 4% (2010); Eimeria sp. 7% (2008) and 9% (2010); Sarcocystis sp. 3% (2008) and 9% (2010); Taenia sp. 10% (2008) and 4% (2010); Mesocestoides sp. 3% (2008) and 0% (2010); Balantidium sp. 0% (2008) and 9% (2010) and Spiruroidea-like eggs 0% (2008) and 4% (2010). To our knowledge, Balantidium sp., Sarcocystis sp. and Trichuris sp. has never been described before in wild arctic foxes.
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15.
  • Osterman Lind, Eva, et al. (författare)
  • Pearsonema (syn Capillaria) plica associated cystitis in a Fennoscandian arctic fox (Vulpes lagopus: a case report
  • 2010
  • Ingår i: Acta Veterinaria Scandinavica. - : Springer Science and Business Media LLC. - 0044-605X .- 1751-0147. ; 52
  • Tidskriftsartikel (refereegranskat)abstract
    • The bladderworm Pearsonema (syn Capillaria) plica affects domestic dogs and wild carnivores worldwide. A high prevalence in red foxes (Vulpes vulpes) has been reported in many European countries. P. plica inhabits the lower urinary tract and is considered to be of low pathogenic significance in dogs mostly causing asymptomatic infections. However, a higher level of pathogenicity has been reported in foxes. A severe cystitis associated with numerous bladderworms was found in a captive arctic fox (Vulpes lagopus) originating from the endangered Fennoscandian arctic fox population. To our knowledge this is the first description of P. plica infection in an arctic fox.
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16.
  • Simonyte, Kotryna, 1979-, et al. (författare)
  • Weight Loss after Gastric Bypass Surgery in Women Is Followed by a Metabolically Favorable Decrease in 11 beta-Hydroxysteroid Dehydrogenase 1 Expression in Subcutaneous Adipose Tissue
  • 2010
  • Ingår i: JOURNAL OF CLINICAL ENDOCRINOLOGY &amp; METABOLISM. - : Williams & Wilkins Co.. - 0021-972X .- 1945-7197. ; 95:7, s. 3527-3531
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND AND AIMS: The role of 11beta-hydroxysteroid dehydrogenase 1 (11beta-HSD1) in the pathogenesis of obesity has been elucidated in humans and in various rodent models. Obesity is accompanied by disturbances in glucocorticoid metabolism, circulating adipokine levels, and fatty acid (FA) reesterification. This study was undertaken to evaluate glucocorticoid metabolism in sc fat before and after weight loss and to explore putative associations between 11beta-HSD1 and leptin, adiponectin, and FA recycling. SUBJECTS AND METHODS: Twenty-seven obese (mean body mass index 44.4 + or - 4.4 kg/m(2)) women underwent gastric bypass surgery. Subcutaneous fat biopsies were collected before and 2 yr after surgery. The expression of 11beta-HSD1, leptin, adiponectin, and phosphoenolpyruvate carboxykinase (PEPCK) mRNA was evaluated with real-time PCR. Serum leptin and adiponectin protein levels were estimated by ELISA. RESULTS: Two years after gastric bypass surgery, significant reductions were observed in the mean body mass index (from 44.4 to 30.8 kg/m(2)) and mean waist circumference (from 121.9 to 90.6 cm). After weight loss, 11beta-HSD1 mRNA expression decreased 4-fold (P < 0.001). Both leptin and adiponectin mRNA expression decreased, with concomitantly decreased circulating leptin and increased circulating adiponectin levels. PEPCK mRNA expression did not change. CONCLUSION: Weight loss after gastric bypass surgery was followed by metabolically favorable changes in insulin sensitivity, circulating leptin and adiponectin, and peripheral glucocorticoid metabolism. A significant reduction in 11beta-HSD1 expression was observed in sc adipose tissue after weight loss. This suggests that up-regulation of 11beta-HSD1 is a consequence, rather than a cause, of obesity.
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17.
  • Tjernberg, Catharina, 1953- (författare)
  • Specialpedagogik i skolvardagen : En studie med fokus på framgångsfaktorer i läs- och skrivlärande
  • 2011
  • Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This is a praxis-oriented case study of written language activities in Forms 1–5 in the nine-year Swedish compulsory school. The emphasis is on pupils at risk of de­veloping reading and writing disabilities. The aim of this study is to analyse the factors underlying successful reading and writing education and the pedagogical conditions promoting re­flective didactic skills, focusing on the students’ develop­ment of reading and writing abili­ties. The praxis-oriented approach is expressed by means of working with classroom ob­servat­ions and reflective communication with the teachers. Four classes at the junior and intermedi­ate levels of the nine-year compulsory Swedish school have been studied for two years. Both the schools and the teachers have been chosen strategically. Quantita­tive and qualitative data indicate that the selected schools have special qualifications. The teachers were chosen because they have proved particu­larly successful in devel­oping reading and wri­ting abilities of their pupils, including those with docu­mented reading and writing disabilities. Reports from the National Swedish Agency for Education, as well as large inter­na­t­ional surveys, indicate that the consensus concerning reading and writing edu­cation achieved by science during the past decade has had very little impact on everyday class­room activities. One of the underlying questions is how research re­sults are suc­cessfully implemented in everyday school work. The results show that the teachers use a wide variety of methods in response to the wide variety of students´ requirements. The lessons are characterized by in­tense activity on the part of both teacher and pupils, and of a high level of interac­tivity in communi­cation, reading, writing and counting. A surprising pattern is that the teach­ers very consciously work with oral presentation in various topics and genres. This gives students with reading and writing difficulties an op­portunity to succeed. The instruction is notable for being well-structured, with a balance between form and function, a high level of challenging tasks and visibilization of individual pro­gress. The special needs education aspect of the instruction appears in the te­achers’ abilities to arrange pedagogical situations in which a wide variety of abilities can be expressed and developed. The teachers show a positive belief in their stu­dents and strive to make them successful in a social context. This study indicates the importance of a solid theoretical background, enabling the te­acher to identify the developmental stage the student is at and to adapt the instruction accordingly. Another important factor is the ability of the teacher to in­stantly see and grasp pedagogical opportunities and to interpret and utilize the diag­nostic signals in the classroom. One im­portant conclusion is that reading and writing education, in order to be successful, must be viewed in a context of lan­guage development as a whole, involving both its oral and its writ­ten aspects. This study also demonstrates that research results are perceived as more acces­si­ble and relevant by the teachers when the researchers’ focus is on applied peda­gog­ics, al­lowing theory and practical applications to interact. This opens up the possi­bility of es­tablishing and incor­porating scientific theories on learning in every­day, practical school work.
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