| 1. |
- Andersson, Tommy, et al.
(författare)
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2020 års Ekonomipris till Paul Milgrom och Robert Wilson
- 2020
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Ingår i: Ekonomisk Debatt. - : Nationalekonomiska Föreningen. - 0345-2646. ; 48:8, s. 5-12
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Kungl. Vetenskapsakademien har beslutat dela ut årets Ekonomipris till Paul Milgrom och Robert Wilson, båda från Stanford University, USA, för ”förbättringar av auktionsteorin och uppfinningar av nya auktionsformat”. Årets pristagare har i sin forskning sammanfört teori och praktik, till nytta för enskilda individer, företag och samhällen världen över.
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| 2. |
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| 3. |
- Campana, Pietro Elia, 1984-, et al.
(författare)
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Evaluation of the first agrivoltaic system in Sweden
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Photovoltaic (PV) systems in Sweden have primarily been seen as an energy efficiency measure to reduce the amount of purchased electricity for buildings, both residential and commercial. Only recently utility-scale solar systems have begun to increase their share of the solar market to support national energy and emissions targets. Due to the economies of scale, conventional ground-mounted PV (CGMPV) installations represent the best solution for producing electricity at the lowest specific initial investment costs. This relatively new solar market segment, with large-scale ground-mounted solar farms on agricultural land, has faced several challenges with the permitting process. Agricultural land that is suitable for cultivation is of "national importance" according to the Swedish Environmental Code. Cultivable agricultural land may be exploited for other purposes on a permanent basis only if it is necessary to satisfy essential societal interests and there is no other possible land to use within the area in question. Traditionally, ground-mounted solar farms have increased competition for land resources for food production and drawn criticism in the so-called "food-versus-fuel (electricity)" debate over whether agricultural land should be used for electricity generation or food production. Agrivoltaic (APV) systems represent an intelligent solution to avoid land use competition by combining arable farming and electricity production on the same agricultural land. The main objective of this project was to study how APV systems perform from an energy, agricultural and economic perspective compared to CGMPV systems and agriculture production. The project aimed to highlight advantages and disadvantages of APV systems at northern latitudes with an energy-food-water perspective. The aim was pursued by establishing an APV test site, the first APV system in Sweden, monitoring its performance both from an energy and agricultural point of view, and developing new techno-economic models. Data from the APV test site were used to better understand how APV systems at northern latitudes affect: 1) the efficiency of the solar modules; 2) crop productivity, and 3) the financial return for ground-based solar PV systems. The first agrivoltaic system in Sweden has been built on a permanent ley grass field, at Kärrbo Prästgård, Västerås, and research activities have been carried out on the ley grass during 2021 and 2022. As in previous research studies in other countries, we defined three sub-fields: 1) a sub-field is covered only by the ley grass (reference area), 2) a sub-field is a CGMPV system 11.8 kWp solar PV system with two rows of solar modules with a 30° tilt and 3) the last subfield is a 22.8 kWp APV system with three rows of vertically mounted solar modules, with ley grass between the modules. This field set-up allowed for comparisons between practices (agriculture and electricity generation) and technologies (CGMPV systems versus APV systems). The calculated specific electricity production during a typical meteorological year for the APV system and the CGMPV system was 1,067 kWh/kWp/year and 1,116 kWh/kWp/year, respectively. Nevertheless, the APV system tends to have higher efficiency than the CGMPV systems due to the solar irradiation patterns on the solar cell surfaces and wind cooling of the PV modules. The main results of the project in terms of shadow effects on the ley grass showed that the APV system did not significantly affect the productivity of the forage grass in 2021-2022. There was no statistically significant difference between the yield of the samples taken in the APV system and the reference area. Even so, the yield per hectare is reduced by approximatively 10%, when the distance between the vertically mounted solar modules is 10 meters, due to the area under the solar modules that cannot be mechanically harvested. The measurements performed at the test site allowed us to validate the earlier developed model for both electricity production and the effects of shading on crop production. Having a model to assess crop yields under APV systems is of utmost importance to be able to pre-assess the system's effects on food production, which is one of the main goals of APV system regulations worldwide. From an economic perspective, APV systems cannot compete with CGMPV systems due to lower electricity production per hectare, lower density of the solar modules per hectare, and higher investment costs per hectare. Nevertheless, APV systems can be the solution to overcome the legal obstacles that prohibit or hinder the use of agricultural land for electricity generation with PV systems.
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| 4. |
- Edholm, David, et al.
(författare)
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Very low risk of short bowel after Roux-en-Y gastric bypass : a large nationwide Swedish cohort study
- 2024
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 20:4, s. 362-366
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Roux-en-Y gastric bypass (RYGB) is one of the most common bariatric procedures. Internal herniation may lead to small bowel ischemia requiring small bowel resection, resulting in short bowel syndrome. OBJECTIVE: To determine the incidence of extensive small bowel resection in patients operated with RYGB. We also aimed to look for early clinical warning signs among patients requiring extensive small bowel resection.SETTING: Cohort from national quality registers.METHODS: All patients having undergone RYGB between January 2007 to June 2019 were analyzed in the Scandinavian Obesity Surgery Registry (SOReg). We identified patients with small bowel obstruction (SBO) for whom small bowel resection was necessary. Additionally, we assessed clinical signs in these patients.RESULTS: The study included 57,255 patients having undergone RYGB. Closure of the mesenteric openings was performed in 78%. Surgery for SBO was required in 3659 (6%) of patients, and small bowel resection in 188 (.3%). Extensive small bowel resection, resulting in less than 1.5 meters of remaining small bowel, was required in 7 patients (.01%). All patients with extensive small bowel resection presented with abdominal pain and had confirmed internal herniation as the cause of the small bowel resection, and 2 of 7 patients died. Closure of mesenteric defects was not associated with a reduction in overall small bowel resection rates (P = .89)CONCLUSION: Surgery for SBO after RYGB was common (6%). The risk of extensive small bowel resection leading to short bowel was low (.01%). Patients with abdominal pain after RYGB should be assessed for internal hernia, as it can be devastating.
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| 5. |
- Gasslander, Nils, et al.
(författare)
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Tailored internet-based cognitive behavioral therapy for individuals with chronic pain and comorbid psychological distress : a randomized controlled trial
- 2022
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Ingår i: Cognitive Behaviour Therapy. - : Taylor & Francis. - 1650-6073 .- 1651-2316. ; 51:5, s. 408-434
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Tidskriftsartikel (refereegranskat)abstract
- Comorbid psychological problems are commonly related to chronic pain but addressing heterogeneous comorbidities in traditional settings is often difficult. Delivering individually tailored treatment using the internet could be a viable alternative. The present study investigates whether a guided, individually tailored and internet-delivered cognitive behavioral therapy (ICBT) could improve mood and reduce disability in individuals suffering from chronic pain and comorbid psychological distress. Participants were recruited from a pain clinic and randomized to either ICBT or waiting list. The participants (n = 187) individually tailored treatments included 6-13 modules targeting different types of psychological distress. Modules were designed to be completed weekly, and feedback was provided by clinicians. Participants completed an average of 5.1 (49.7%) modules, with 22.9% completing all assigned modules. Intention-to-treat analyses showed significantly larger improvements in depression, disability, pain acceptance, catastrophizing, and quality of life in the ICBT-group compared to the control group. Between-group effect sizes were very small or small at post for the primary outcomes depression (d = 0.18) and pain interference (d = 0.22). Other effect sizes ranged from very small to small, with the largest effect being improvements in pain acceptance (d = 0.3). All significant changes were stable at 12-month follow up.
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| 6. |
- Gerhardt, Karin, et al.
(författare)
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Nog nu, politiker – ta klimatkrisen på allvar
- 2022
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Ingår i: Aftonbladet Debatt. - 1103-9000. ; -:-
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1944 svenska forskare och anställda i forskarvärlden: Vad är det ni inte förstår?
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| 7. |
- Gu, Tianbao, et al.
(författare)
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Advanced simulation of a 750 t/d municipal solid waste grate boiler to better accommodate feedstock changes due to waste classification
- 2022
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Ingår i: Energy. - : Elsevier BV. - 0360-5442 .- 1873-6785. ; 254
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Tidskriftsartikel (refereegranskat)abstract
- To better accommodate changes in municipal solid waste (MSW) properties due to waste classification, advanced computational fluid dynamics (CFD) simulations are carried out for a 750 t/d MSW moving-grate boiler. A moving-grate bed model is developed and iteratively coupled to the freeboard simulation which is performed in Ansys Fluent. The model is first validated by the measurement data for the daily operation case incinerating current feedstock. Then, the model is deployed to investigate the impacts of feedstock change and adjust boiler operation for better accommodating the new MSW. The results indicate incineration of the new MSW leads to irrational utilization of oxygen, non-uniform temperature distribution and low mixing, while maintaining current operation conditions. Subsequently, adjustments of air supply and thermal input are proposed and conducted by the model, which address the potential issues and benefit boiler operation and energy recycling. Finally, the uniformity of velocity and turbulent kinetic energy which indicates mixing, are compared for different cases. The latter is increased by 51.39% and 81.04% after the adjustments of air supply and thermal input. The investigation provides solid references for incinerating new MSW in the current boiler.
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| 8. |
- Hedberg, Suzanne, et al.
(författare)
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Comparison of Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass : A Randomized Clinical Trial
- 2024
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE: Laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) are widely used bariatric procedures for which comparative efficacy and safety remain unclear.OBJECTIVE: To compare perioperative outcomes in SG and RYGB.DESIGN, SETTING, AND PARTICIPANTS: In this registry-based, multicenter randomized clinical trial (Bypass Equipoise Sleeve Trial), baseline and perioperative data for patients undergoing bariatric surgery from October 6, 2015, to March 31, 2022, were analyzed. Patients were from university, regional, county, and private hospitals in Sweden (n = 20) and Norway (n = 3). Adults (aged ≥18 years) eligible for bariatric surgery with body mass indexes (BMIs; calculated as weight in kilograms divided by height in meters squared) of 35 to 50 were studied.INTERVENTIONS: Laparoscopic SG or RYGB.MAIN OUTCOMES AND MEASURES: Perioperative complications were analyzed as all adverse events and serious adverse events (Clavien-Dindo grade >IIIb). Ninety-day mortality was also assessed.RESULTS: A total of 1735 of 14 182 eligible patients (12%; 1282 [73.9%] female; mean (SD) age, 42.9 [11.1] years; mean [SD] BMI, 40.8 [3.7]) were included in the study. Patients were randomized and underwent SG (n = 878) or RYGB (n = 857). The mean (SD) operating time was shorter in those undergoing SG vs RYGB (47 [18] vs 68 [25] minutes; P < .001). The median (IQR) postoperative hospital stay was 1 (1-1) day in both groups. The 30-day readmission rate was 3.1% after SG and 4.0% after RYGB (P = .33). There was no 90-day mortality. The 30-day incidence of any adverse event was 40 (4.6%) and 54 (6.3%) in the SG and RYGB groups, respectively (odds ratio, 0.71; 95% CI, 0.47-1.08; P = .11). Corresponding figures for serious adverse events were 15 (1.7%) for the SG group and 23 (2.7%) for the RYGB group (odds ratio, 0.63; 95% CI, 0.33-1.22; P = .19).CONCLUSIONS AND RELEVANCE: This randomized clinical trial of 1735 patients undergoing primary bariatric surgery found that both SG and RYGB were performed with a low perioperative risk without clinically significant differences between groups.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02767505.
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| 9. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 10. |
- Paul, Rebecca, 1978-, et al.
(författare)
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Motherhood and motivations for bariatric surgery - a qualitative study
- 2023
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Ingår i: Human Fertility. - : TAYLOR & FRANCIS LTD. - 1464-7273 .- 1742-8149. ; 26:2, s. 257-265
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Tidskriftsartikel (refereegranskat)abstract
- Obesity and its concomitant comorbidities have a myriad of detrimental effects on health, fertility, and quality of life. Bariatric surgery is an effective treatment for inducing weight loss and reduction of obesity-related comorbidities including subfertility. The aim of this study was to explore the expectations and experiences of women with a desire to have children as a motivation for undergoing bariatric surgery. An inductive qualitative design was used. Fourteen women were interviewed, and transcriptions were analysed with thematic analysis. Two themes emerged: (i) Motherhood and Femininity and (ii) A Normal Life. Participants found no other solution than to seek bariatric surgery to be able to become pregnant and carry a child to term. Coping physically with pregnancy and being an active mother were important factors. Overall, postoperative expectations were met, and the women experienced the effects of normalised sex hormone levels, were more physically mobile, and were released from the previous social hindrances that obesity caused them. This study has clinical implications for providing support and information to women with subfertility considering bariatric surgery and to better understand their experiences of life after bariatric surgery.
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| 11. |
- Paul, Rebecca, 1978-
(författare)
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Obesity and Effects of Bariatric Surgery - with a Certain Focus on Women's Health
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Severe obesity influences sex hormone levels in women, which may result in subfertility, menstrual disturbances, anovulation and hyperandrogenism as well as increased risk for complications during pregnancy and birthing. Bariatric surgery leads to long-term weight loss and resolution of several comorbidities including hormone imbalance. However, the impact of altered sex hormones in women with obesity is insufficiently understood. Little is known concerning potential influences of changed sex hormone levels on women's function and quality of life following bariatric surgery and subsequent weight loss. This thesis aims to understand sex hormone balance in women with severe obesity and after bariatric surgery and to explore women’s experiences of changes in life after bariatric surgery and weight loss. Study I included 100 women and utilized blood assay to investigate changes in serum sex- hormone levels and questionnaires concerning sexual function and health-related quality of life (HRQoL) in women with severe obesity before and one year after bariatric surgery. Findings from Study I indicated that testosterone and sex hormone binding globulin normalized, and questionnaires showed improvements in several domains of sexual function, psychological well-being and general health in women one year after surgery. Study II used a qualitative method, specifically thematic analysis, to explore women's pre- and postoperative experiences, indicating that increased fertility and achieved motherhood were motivating factors to undergo bariatric surgery. Fourteen women were interviewed, and the themes of “Experiencing Motherhood and Femininity” and “Achieving a Normal Life” emerged from the data. Study III applied the qualitative method with Gadamer’s hermeneutic analysis to understand the lived experiences of premenopausal women with obesity before and after having undergone bariatric surgery. A focus was on influences of altered sex hormones and potential restoration of levels after surgery. Ten women were included, and analysis of the horizons created the fusions of “Recognition of Unhealthy Body Weight”, “Dealing with Other People’s Opinions and Society’s Norms”, “Life has Changed in a Positive Way” and “Accepting Inner Self and Bodily Changes”. Finally, to elaborate on previous studies' findings and better understand the current knowledge base, a systematic review and interpretative meta-synthesis of published literature involving qualitative methods concerning women’s experiences of womanliness related to changes after undergoing bariatric surgery was conducted in study IV. Ten relevant studies were included, and a meta-synthesis, according to Gadamer’s hermeneutics, created the fusions of “Womanliness,” “A Healthy and Functioning Body,” and “Mind and Body Connection.” This thesis provides a clearer understanding of the experiences of living with obesity that motivate premenopausal women to seek bariatric surgery. The importance of postoperative benefits such as restored function, health and womanliness are illustrated as well as clarifying difficulties involving adaptations to life after surgery. These findings may inform potential bariatric surgery candidates and healthcare professionals of the experiences of women living with obesity, as well as expectations, postoperative experiences and challenges. These findings promote patient-centred guidance prior to surgery and during postoperative follow-up.
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| 12. |
- Paul, Rebecca, et al.
(författare)
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Womens lived experiences of sex hormones and life-related to bariatric surgery: an interpretative qualitative study
- 2023
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe study aimed to explore the lived experiences of women with severe obesity before and after undergoing bariatric surgery with a special focus on possible effects of changed sex hormone levels. DesignA qualitative interview study with transcribed text analysis based on Gadamers hermeneutics. SettingRegional hospital and outpatient bariatric clinic in central Sweden. ParticipantsTen women (age 23-38 years) having undergone Roux-en-Y gastric bypass surgery between 2016 and 2019 were interviewed. ResultsThe transcribed interviews were analysed according to Gadamers hermeneutics. Text horizons, interpreter horizons and fact horizons were derived and formed the fusions Recognition of unhealthy body weight, Dealing with other peoples opinions and societys norms, Life has changed in a positive way and Accepting inner self and bodily changes. ConclusionWomen highlighted weight and body size in their responses. The study provided a deeper understanding of the situation of women living with obesity and pros and cons of having undergone bariatric surgery. Experiences of changes in sex hormones and fertility were discussed but not central to the informants. Participants emphasised the need to be prepared and properly supported in dealing with changes in life after bariatric surgery and subsequent weight loss.
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| 13. |
- Sillén, Linda, et al.
(författare)
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Obstruction after Sleeve Gastrectomy, Prevalence, and Interventions : a Cohort Study of 9,726 Patients with Data from the Scandinavian Obesity Surgery Registry (SOReg)
- 2021
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Ingår i: Obesity Surgery. - : Springer Nature. - 0960-8923 .- 1708-0428. ; 31, s. 4701-4707
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Tidskriftsartikel (refereegranskat)abstract
- Background Sleeve gastrectomy (SG) is the most common bariatric procedure worldwide. Obstructive symptoms, together with leaks, are among the most serious postoperative complications. This study aimed to investigate the incidence of symptomatic obstruction after SG in Sweden and to explore risk factors, treatment strategies, and outcome. Methods A retrospective analysis of prospectively collected data from the Scandinavian Obesity Surgery Registry (SOReg) of patients undergoing SG and developed obstruction symptoms within the first postoperative year was performed. For patients who had undergone any re-intervention, such as endoscopic dilatation or remedial surgery, medical charts were reviewed. Results From 2007 to 2018, a total of 9,726 SG were performed, and 59 (0.6%) of them developed postoperative obstruction. Intolerance of solid food was the most common symptom associated with obstruction (80%). Sixty-one percent of the patients had obstruction at the level of incisura angularis. Longer operative time, higher rate of perioperative complications, longer hospital stay, and oversewing the staple line were associated with an increased risk of obstruction. Endoscopic balloon dilatation was performed in 59% of patients (n=35) and successful in 18 patients (51%). Twenty-one patients (36%) underwent surgical conversion to Roux-en-Y gastric bypass (RYGB). After revisional surgery, 11 (52%) reported complete relief of symptoms. Conclusions Obstruction was rare (0.6%) and most often located at the incisura angularis. Obstruction was associated with longer operative time, perioperative complications, oversewing of the staple line, and longer hospital stay. Endoscopic dilatation or surgical conversion to RYGB frequently alleviates symptoms, but despite treatment, almost 50% reported residual symptoms.
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| 14. |
- Spetz, Kristina, et al.
(författare)
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A smartphone application to improve adherence to vitamin and mineral supplementation after bariatric surgery
- 2022
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Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 30:10, s. 1973-1982
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Tidskriftsartikel (refereegranskat)abstract
- Objective This trial evaluated a smartphone applications effectiveness in improving adherence to vitamin and mineral supplementation postoperatively. Methods This study was a randomized controlled trial comprising 140 patients undergoing bariatric surgery (gastric bypass or sleeve gastrectomy). Participants were randomized 1:1 to the 12-week intervention, using the smartphone application PromMera, or to standard care. The primary end point was adherence to vitamin and mineral supplementation. Results Initiation rate and overall adherence to supplementation were high in both groups. Change in objectively measured adherence rate from before the intervention to 1 year post surgery, measured with pharmacy refill data, did not differ between groups for vitamin B-12 (-9.6% [SD = 27%] vs. -9.3% [SD = 30%]; p = 0.48) or calcium/vitamin D (-12.3% [SD = 29%] vs. -11.5% [SD = 32%]; p = 0.44). A modest effect on the secondary end point (subjectively measured adherence, using the Medication Adherence Report Scale-5) was seen immediately after the intervention (intervention group 0.00 [SD = 1.3] vs. control group -1.2 [SD = 3.5]; p = 0.021), but this effect did not persist 1 year post surgery. No differences were detected in the prevalence of biochemical deficiencies. Conclusions The use of the smartphone application PromMera did not obtain a lasting improvement in adherence to vitamin and mineral supplementation 1 year post bariatric surgery.
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| 15. |
- Spetz, Kristina, 1981-, et al.
(författare)
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A Smartphone Application to Improve Adherence to Vitamin and Mineral Supplementation after Bariatric Surgery : a Randomized Controlled Trial
- 2022
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Ingår i: The 25th world congress of IFSO (International Federation for the Surgery of Obesity and Metabolic Disorders) held in Miami, USA, 23-27 August 2022.
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Konferensbidrag (refereegranskat)abstract
- Introduction: Previous studies suggest insufficient adherence to vitamin and mineral supplementation after bariatric surgery. Objective: This trial evaluated a smartphone application’s effectiveness in improving adherence to vitamin and mineral supplementation postoperatively. Methods: A two-arm, randomized controlled trial comprising 140 patients undergoing bariatric surgery (gastric bypass or sleeve gastrectomy). Participants were randomized 1:1 post-surgery to 12-week intervention, using the smartphone application PromMera, or standard care. The PromMera application was designed to promote vitamin and mineral use and physical activity after bariatric surgery. The primary end point was adherence to vitamin and mineral supplementation, objectively assessed with pharmacy claim data the first-year post-surgery. Additional endpoints were adherence subjectively assessed with change in MARS-5 score, measured pre-intervention, and at 18 weeks and one year post surgery and development of nutritional deficiencies one-year post-surgery.Results: Initiation rate and overall adherence to supplementation were high in both groups. Change in objectively measured adherence rate from before intervention to 1 year post surgery, measured with pharmacy refill data, did not differ between groups for vitamin B12 (-9.6% [SD 27%] vs. -9.3% [SD 30%]; p=0.48) or calcium/vitamin D (-12.3% [SD 29%] vs. -11.5% [SD 32%]; p=0.44). A modest effect on the secondary end point (subjectively measured adherence, using the Medication Adherence Report Scale-5 [MARS-5]) was seen immediately after the intervention (intervention group 0.00 [SD 1.3] vs. control group -1.2 [SD 3.5]; p=0.021), but this effect did not persist 1 year post surgery. No differences were detected in the prevalence of biochemical deficiencies.Conclusions The use of the smartphone application PromMera did not obtain a lasting improvement in adherence to vitamin and mineral supplementation one year post bariatric surgery.
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| 16. |
- Spetz, Kristina, et al.
(författare)
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Adherence to vitamin and mineral supplementation after bariatric surgery – A two-year cohort study
- 2022
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Ingår i: Obesity Research and Clinical Practice. - : Elsevier. - 1871-403X .- 1878-0318. ; 16:5, s. 407-412
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lifelong vitamin and mineral supplementation is recommended after bariatric surgery to prevent nutritional deficiencies, but it is not clear to which extent patients adhere to the recommended medication. The aim of this study was to assess adherence to supplementation. Additionally, we assessed predictors of low adherence and biochemical deficiencies.Methods: 263 adults were followed two years post bariatric surgery (89.4 % Roux-en-Y gastric bypass, 10.6 % sleeve gastrectomy) regarding adherence to calcium-vitamin D, vitamin B12 and iron. Pharmacy refill data was used to objectively capture adherence-rate. Predictors of low adherence were assessed via questionnaires and medical records. Blood sampling was performed preoperatively, and 1-and 2-years post-surgery.Results: About 60 % of the study participants had high adherence-rate (>= 80 %) two years post-surgery, but a significant proportion had discontinued the intended lifelong supplementation: 15 % for calcium-vitamin D and 12 % for B12. Biochemical deficiencies were uncommon two years after surgery, both in adherent and non -persistent subjects, except for a 10 % prevalence of anemia. Younger age, experience of side effects, mental health problems and no regular use of medication before surgery, were factors associated with low adherence.Conclusion: Substantial variation existed in adherence to supplementation regimens after bariatric surgery during the first two years after bariatric surgery, but biochemical deficiencies were rare. The results indicate need for tailored follow-up and strategies to support long-term persistence.
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| 17. |
- Spetz, Kristina, 1981-, et al.
(författare)
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Screening for adherence to vitamin and mineral supplementation after bariatric surgery
- 2023
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Ingår i: Screening for adherence to vitamin and mineral supplementation after bariatric surgery.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Poor adherence to the lifelong vitamin and mineral supplementation post bariatric surgery is common and can be a challenge for healthcare professionals to recognize. There are several questionnaires for self-reporting of adherence to chronic medication, but none has been evaluated for assessment of adherence to vitamin and mineral supplementation post bariatric surgery.Aim: To assess the accuracy of the 5-item Medication Adherence Report Scale (MARS-5) in measuring adherence to vitamin and mineral supplementation post bariatric surgery. Method: We validated the psychometric properties of MARS-5 for vitamin and mineral supplementation in two cohorts: one at 1 year post bariatric surgery (n=120) and one at 2 years post-surgery (n=211). The validity was compared to pharmacy refill data for vitamin B12 and combined Calcium/vitamin D as reference.Results: Correlation analyzes demonstrated that the MARS-5 demonstrated acceptable validity compared to objectively measured adherence rate from pharmacy refill data calculated as continuous, multiple-interval measures of medication availability/gaps (coefficient ranged from 0.49 to 0.54). Internal reliability (Cronbach's α) was high: 0.81 and 0.95, respectively. A ceiling effect was seen, where one out of three scored max in MARS-5.Conclusion: MARS-5 demonstrated acceptable, but not optimal, psychometric properties for assessment of adherence to vitamin and mineral supplementation post bariatric surgery. We encourage further validation of other questionnaires for assessing adherence of vitamin and mineral supplementation post bariatric surgery.
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| 18. |
- Spetz, Kristina, et al.
(författare)
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Using the 5-Item Medication Adherence Report Scale (MARS-5) to Screen for Non-adherence to Vitamin and Mineral Supplementation After Bariatric Surgery
- 2024
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Ingår i: Obesity Surgery. - : Springer. - 0960-8923 .- 1708-0428. ; 34, s. 576-582
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionPoor adherence to recommended vitamin and mineral supplementation after bariatric surgery is common and challenging for healthcare professionals to identify. There are several questionnaires for self-reporting of adherence to chronic medication, but none has so far been evaluated for assessment of adherence to vitamin and mineral supplementation after bariatric surgery. The aim of this study was to assess the accuracy of the 5-item Medication Adherence Report Scale (MARS-5) in measuring adherence to vitamin and mineral supplementation post bariatric surgery (gastric bypass or sleeve gastrectomy).MethodThe psychometric properties of MARS-5 for vitamin and mineral supplementation were validated in two cohorts: one at 1 year post bariatric surgery (n = 120) and the other at 2 years post-surgery (n = 211). MARS-5 was compared to pharmacy refill data for vitamin B12 and combined calcium/vitamin D as reference.ResultsCorrelation analyses demonstrated that the MARS-5 had acceptable validity compared to objectively measured adherence rates from pharmacy refill data (calculated as continuous, multiple-interval measures of medication availability/gaps-coefficient ranged from 0.49 to 0.54). Internal reliability (Cronbach's alpha) was high: 0.81 and 0.95, respectively. There was a clear ceiling effect where one out of three had a maximum score on MARS-5.ConclusionMARS-5 demonstrated acceptable psychometric properties for assessment of adherence to vitamin and mineral supplementation post bariatric surgery.
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| 19. |
- Sun, Li, et al.
(författare)
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In vitro fermentation of substrates from Saccharina latissima by broiler chicken's caecal microbiota
- 2024
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Ingår i: Animal Feed Science and Technology. - 0377-8401 .- 1873-2216. ; 308
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated seasonal variations in the composition of the kelp species Saccharina latissima cultivated on the Swedish west coast and, using an in vitro fermentation system, evaluated the effect of fermented whole S. latissima biomass or biomass components on the gut microbiota of broiler chickens. Caecal contents of six Ross 308 broilers fed a standard wheat and soy-based diet were retrieved on two different occasions, with three birds sampled per occasion. Two in vitro fermentation batches (A, B) were established using caecal contents as inoculum, and whole S. latissima, ethanol-washed S. latissima, laminarin extract or inulin (control) as substrate. Total short-chain fatty acid (SCFA) content, gas production, pH and changes in microbiota composition were studied after 6, 12 and 24 h of fermentation. Analysis of seasonal variations revealed that S. latissima harvested in June had the highest laminarin content and lowest ash and crude protein content. Broiler microbiota, SCFA profile, gas production and pH mainly varied depending on fermentation inoculum, but there were also some variations depending on substrate. For instance, uncultured bacterium from Clostridiales_vadinBB60_group showed higher relative abundance (RA) in batch A, while Faecalibacterium showed higher RA in batch B. Whole and ethanol-washed S. latissima resulted in highest RA of unclassified Ruminococcaceae and Tyzzerella for both batches, while ethanol-washed S. latissima and laminarin gave highest RA of Erysipelatoclostridium. Inulin resulted in highest RA for the genus Subdoligranulum. Acetic, n-butyric and propionic acid were the main fermentation products and total SCFA level was higher in batch B. Within batch B, inulin and laminarin generated higher levels of acetic and butyric acid. When using inulin and laminarin, gas production was lower in batch B compared with batch A. In summary, this study showed that S. latissima is a good source of laminarin, especially when harvested in summer. Within the in vitro system, the microbiota was affected by different substrates, but inoculum source was identified as an important contributor to microbial community development during fermentation.
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