| 1. |
- Halliday, Alison, et al.
(författare)
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10-year stroke prevention after successful carotid endarterectomy for asymptomatic stenosis (ACST-1) : A multicentre randomised trial
- 2010
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 376:9746, s. 1074-1084
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Tidskriftsartikel (refereegranskat)abstract
- Background If carotid artery narrowing remains asymptomatic (ie, has caused no recent stroke or other neurological symptoms), successful carotid endarterectomy (CEA) reduces stroke incidence for some years. We assessed the long-term effects of successful CEA. Methods Between 1993 and 2003, 3120 asymptomatic patients from 126 centres in 30 countries were allocated equally, by blinded minimised randomisation, to immediate CEA (median delay 1 month, IQR 0·3-2·5) or to indefinite deferral of any carotid procedure, and were followed up until death or for a median among survivors of 9 years (IQR 6-11). The primary outcomes were perioperative mortality and morbidity (death or stroke within 30 days) and non-perioperative stroke. Kaplan-Meier percentages and logrank p values are from intention-to-treat analyses. This study is registered, number ISRCTN26156392. Findings 1560 patients were allocated immediate CEA versus 1560 allocated deferral of any carotid procedure. The proportions operated on while still asymptomatic were 89·7 versus 4·8 at 1 year (and 92·1 vs 16·5 at 5 years). Perioperative risk of stroke or death within 30 days was 3·0 (95 CI 2·4-3·9; 26 non-disabling strokes plus 34 disabling or fatal perioperative events in 1979 CEAs). Excluding perioperative events and non-stroke mortality, stroke risks (immediate vs deferred CEA) were 4·1 versus 10·0 at 5 years (gain 5·9, 95 CI 4·0-7·8) and 10·8 versus 16·9 at 10 years (gain 6·1, 2·7-9·4); ratio of stroke incidence rates 0·54, 95 CI 0·43-0·68, p<0·0001. 62 versus 104 had a disabling or fatal stroke, and 37 versus 84 others had a non-disabling stroke. Combining perioperative events and strokes, net risks were 6·9 versus 10·9 at 5 years (gain 4·1, 2·0-6·2) and 13·4 versus 17·9 at 10 years (gain 4·6, 1·2-7·9). Medication was similar in both groups; throughout the study, most were on antithrombotic and antihypertensive therapy. Net benefits were significant both for those on lipid-lowering therapy and for those not, and both for men and for women up to 75 years of age at entry (although not for older patients). Interpretation Successful CEA for asymptomatic patients younger than 75 years of age reduces 10-year stroke risks. Half this reduction is in disabling or fatal strokes. Net benefit in future patients will depend on their risks from unoperated carotid lesions (which will be reduced by medication), on future surgical risks (which might differ from those in trials), and on whether life expectancy exceeds 10 years. Funding UK Medical Research Council, BUPA Foundation, Stroke Association.
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| 2. |
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| 3. |
- Arvidsson, A, et al.
(författare)
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Water with Food Intake Does Not Influence Caloric Intake After Gastric Bypass (GBP): a Cross-Over Trial.
- 2015
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Ingår i: Obesity Surgery. - : Springer Science and Business Media LLC. - 1708-0428 .- 0960-8923. ; 25:2, s. 249-253
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Tidskriftsartikel (refereegranskat)abstract
- Bariatric patients seeking information meet very different recommendations on postoperative diet and eating behaviour. A reason for variability may be lack of hard evidence. A national survey on current dietary advice was conducted to serve as background for the present study on how drinking during a meal influenced caloric consumption.
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| 4. |
- Arvidsson, Elin, et al.
(författare)
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Exercise training and physiological responses to acute stress: study protocol and methodological considerations of a randomised controlled trial
- 2018
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Ingår i: BMJ Open Sport & Exercise Medicine. - : BMJ. - 2055-7647. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: This paper describes the protocol and methodological prerequisites for a randomised controlled exercise intervention. Selected baseline data from the study are also presented, demonstrating some methodological challenges related to exercise intervention trials. The aim of the trial was to study the effects of exercise training on physiological responses to acute psychosocial stress in untrained individuals. Methods: Individuals with a low level of physical activity were invited to participate in an exercise intervention lasting for 6 months. A total of 119 participants were included and went through a peak oxygen uptake test and a psychosocial stress test at baseline. Adrenocorticotropic hormone (ACTH) and cortisol were measured in connection to the stress test to identify the physiological response. Results: Almost 90% of the participants reported themselves as untrained, but results from the objectively measured oxygen uptake did not seem to correspond to the reported sedentary lifestyle. The primary outcome measures at baseline varied between individuals. The mean change from pre-test to peak value was 214% for ACTH and 94% for cortisol. Of these, 13 individuals did not respond in ACTH and/or and cortisol. Discussion: Supposedly untrained individuals seeking participation in an exercise intervention might not be as untrained as they report, a methodological consideration of importance when evaluating the effects of training. Another important consideration is related to the primary outcome measure, which should be measurable and possible to affect. Absence of reaction at baseline means that changes can only be detected as an increased reaction.
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| 5. |
- Arvidsson, Louise, et al.
(författare)
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Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study
- 2017
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children's adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association. Methods: Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL (R) and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children's dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values. Results: A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0; 1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1; 1.3 and OR 1.3, 95% CI 1.2; 1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0; 1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children. Conclusion: Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children's weight status.
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| 6. |
- Arvidsson, Niklas, et al.
(författare)
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Passivitet inom avtalsrätten
- 2019
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Ingår i: Festskrift till Göran Millqvist. - 9789172237476 ; , s. 97-123
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Fick, Jerker, et al.
(författare)
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Therapeutic levels of levonorgestrel detected in blood plasma of fish: results from screening rainbow trout exposed to treated sewage effluents.
- 2010
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Ingår i: Environmental science & technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 44:7, s. 2661-2666
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Tidskriftsartikel (refereegranskat)abstract
- Pharmaceuticals are found in surface waters worldwide, raising concerns about effects on aquatic organisms. Analyses of pharmaceuticals in blood plasma of fish could provide means to assess risk for pharmacological effects, as these concentrations could be compared with available human therapeutic plasma levels. In this study we investigated if fish exposed to sewage effluents have plasma concentrations of pharmaceuticals that are approaching human therapeutic levels. We also evaluated how well the bioconcentration of pharmaceuticals into fish blood plasma can be predicted based on lipophilicity. Rainbow trout were exposed to undiluted, treated sewage effluents at three sites in Sweden for 14 days. Levels of 25 pharmaceuticals in blood plasma and effluents were analyzed with liquid chromatography-mass spectrometry/mass spectrometry and gas chromatography-high resolution mass spectrometry. The progestin pharmaceutical levonorgestrel was detected in fish blood plasma at concentrations (8.5-12 ng mL(-1)), exceeding the human therapeutic plasma level. In total 16 pharmaceuticals were detected in fish plasma at concentrations higher than 1/1000 of the human therapeutic plasma concentration. Twenty-one pharmaceuticals were detected in either plasma or effluent, and 14 were detected in both compartments, allowing plasma bioconcentration factors to be determined. For 11 of these, theoretically calculated and experimentally measured values were in reasonably good agreement. However a few drugs, including levonorgestrel, did not bioconcentrate according to the screening model used. This study shows that rainbow trout exposed to sewage effluents have blood plasma levels of pharmaceuticals similar to human therapeutic concentrations, suggesting a risk for pharmacological effects in the fish. There is a particular concern about effects of progestin pharmaceuticals. For levonorgestrel, the measured effluent level (1 ng/L) was higher than water levels shown to reduce the fertility of fish.
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| 8. |
- Gerber, Markus, et al.
(författare)
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Promoting Graded Exercise as a Part of Multimodal Treatment in Patients Diagnosed with Stress-Related Exhaustion
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:13-14, s. 1904-1915
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives The purpose of this study was to examine, by using patient cohort data, the changes in exercise habits during a 12-month multimodal treatment period, in patients seeking specialist care for stress-related exhaustion. Background Randomised controlled trials have greatly contributed to the fact that both physicians and patients regard regular exercise participation as a highly valuable and effective treatment for mental health disorders. Nevertheless, little is known about the adherence to physical activity recommendations for patients with stress-related mental problems in a clinical setting. Knowledge about what can be achieved within the clinical context, and how current treatments can be improved, is crucial for clinicians, researchers, educators, managers and policy makers involved in nursing practice. Design Longitudinal analysis of patient cohort data. Methods The sample consisted of 169 patients (79% women; mean age = 42·7 years) who were referred to a stress clinic due to stress-related exhaustion. All patients received multimodal treatment with similar components. Two different approaches to promote exercise were used in the clinical work (general comprehensive instruction either with or without an 18-week coached exercise programme). The self-reported overall exercise level was assessed at baseline and at three, six and 12 months after the first visit. Group by time effects were examined with repeated measures analyses of variance. Results The frequency, duration and intensity of exercise increased substantially during the first three months of multimodal treatment. Although exercise levels tended to decrease thereafter, there was still a significant time effect at the 12-month follow-up showing that follow-up exercise levels were higher than at baseline. Conclusion Both general exercise instructions and coached exercise were effective in promoting exercise involvement. Relevance to clinical practice Exercise can be successfully promoted as a part of multimodal treatment in patients with stress-related exhaustion.
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| 9. |
- Liimatainen, H., et al.
(författare)
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Driving forces of road freight CO2 in 2030
- 2015
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Ingår i: International Journal of Physical Distribution & Logistics Management. - : Emerald. - 0960-0035. ; 45:3, s. 260-285
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - Road freight carbon dioxide (CO2) emissions are determined by a complex interaction between shippers and hauliers within the boundaries set by regulations and economic factors. It is necessary to gain understanding about the various driving forces and trends affecting these to promote low carbon future. The purpose of this paper is to find out what factors affect the long-term future development of road freight CO2 emissions and whether the long-term emission targets will be achieved. Design/methodology/approach - An international comparison of similar Delphi surveys is carried out in Finland, Norway, and Sweden. Findings - The Delphi surveys indicate that the structural change of the economy, changes of consumer habits, concerns of energy and environment and changes in logistics practices and technology are the overarching trends shaping the future of the energy efficiency and CO2 emissions of road freight transport. The expert forecasts for Finland and Sweden highlight that reaching the carbon emission target of 30 per cent reduction for the year 2030 is possible. However, the CO2 emissions may also increase significantly even though the CO2 intensity would decrease, as the Norwegian forecast shows. Originality/value - This study combined quantitative and qualitative analysis. The results confirmed that similar factors are seen to affect the future in all three countries, but with some national differences in the likely effects of the factors. Future research using the same methodology would enable wider analysis of the global significance of these driving forces.
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| 10. |
- Liimatainen, H., et al.
(författare)
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Energy efficiency of road freight hauliers-A Nordic comparison
- 2014
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Ingår i: Energy Policy. - : Elsevier BV. - 0301-4215. ; 67, s. 378-387
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Tidskriftsartikel (refereegranskat)abstract
- In order to promote policy targets for decarbonising road freight, it is important to gain knowledge on the current energy efficiency practices of hauliers in various countries. This research aimed to provide such knowledge to enable international comparison of the energy efficiency practices of road freight hauliers. This was achieved by replicating the Finnish haulier survey in Denmark, Norway and Sweden. Energy efficiency index was developed to provide a simple metric for international comparison. The EEI covers various aspects of energy efficiency to provide a comprehensive outlook into the issue. The monitoring practices are fairly similar in all four countries, with typical monitoring done manually when filling the tank and data kept on a computer. Tonne-kilometre data is rarely monitored, but some other performance measures may be used. Current level of implementation of various energy efficiency actions is rather similar between the four countries. The simple and inexpensive actions, like choosing the lorry according to the cargo and idling avoidance, are most widely implemented. The energy efficiency index developed in this research proved to be a very useful tool for comparing the hauliers in the four countries. © 2013 Elsevier Ltd.
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| 11. |
- Ludvigsson, Johnny, et al.
(författare)
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GAD65 antigen therapy in recently diagnosed type 1 diabetes mellitus
- 2012
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Ingår i: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 366:5, s. 433-442
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The 65-kD isoform of glutamic acid decarboxylase (GAD65) is a major autoantigen in type 1 diabetes. We hypothesized that alum-formulated GAD65 (GAD-alum) can preserve beta-cell function in patients with recent-onset type 1 diabetes.METHODS: We studied 334 patients, 10 to 20 years of age, with type 1 diabetes, fasting C-peptide levels of more than 0.3 ng per milliliter (0.1 nmol per liter), and detectable serum GAD65 autoantibodies. Within 3 months after diagnosis, patients were randomly assigned to receive one of three study treatments: four doses of GAD-alum, two doses of GAD-alum followed by two doses of placebo, or four doses of placebo. The primary outcome was the change in the stimulated serum C-peptide level (after a mixed-meal tolerance test) between the baseline visit and the 15-month visit. Secondary outcomes included the glycated hemoglobin level, mean daily insulin dose, rate of hypoglycemia, and fasting and maximum stimulated C-peptide levels.RESULTS: The stimulated C-peptide level declined to a similar degree in all study groups, and the primary outcome at 15 months did not differ significantly between the combined active-drug groups and the placebo group (P=0.10). The use of GAD-alum as compared with placebo did not affect the insulin dose, glycated hemoglobin level, or hypoglycemia rate. Adverse events were infrequent and mild in the three groups, with no significant differences.CONCLUSIONS: Treatment with GAD-alum did not significantly reduce the loss of stimulated C peptide or improve clinical outcomes over a 15-month period.
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| 12. |
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| 13. |
- Olaya-Contreras, Patricia, 1964, et al.
(författare)
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The effect of the stay active advice on physical activity and on the course of acute severe low back pain.
- 2015
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Ingår i: BMC sports science, medicine and rehabilitation. - : Springer Science and Business Media LLC. - 2052-1847. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Disability due to acute low back pain (ALBP) runs parallel with distress and physical inactivity. If low back pain persists, this may lead to long-term sick leave and chronic back pain. This prospective randomized study evaluated the effect on physical activity and on the course of ALBP of two different treatment advices provided in routine care.
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| 14. |
- Olsson, Viktoria, et al.
(författare)
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Sensory characteristics of meat from steers of various breeds and rearing intensities
- 2019
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Konferensbidrag (refereegranskat)abstract
- The most common category of young cattle slaughtered for beef in Sweden is bulls of dairy breed, most often reared indoors. There is however a potential in raising steers (castrated bulls) for slaughter on semi-natural pasture, which may have an impact on sensory properties of the meat. Furthermore, weight gain and carcass characteristics may be improved by crossing dairy breeds with specialised beef breeds. In combination with the new technique of sex-sorted dairy semen, beef breed semen can be used to the less superior cows in the herd without jeopardizing an adequate number of replacement heifers from the superior cows. The aim of the study was to investigate whether there are any differences in sensory meat quality between cross bred and purebred cattle and between two rearing intensities including semi-natural pasture. Sensory properties were evaluated by a trained, analytical panel consisting of six assessors by the use of descriptive analysis. The intensity of iron, acidic, tallow, milky and barny odour as well as metallic, barny and gamey flavour and basic tastes were assessed in triplicate along with attributes describing the appearance and texture of the meat. Differences were mainly found in appearance and texture attributes, but also gamey flavour and the intensity of umami were affected by the rearing and breeding regimes. The meat quality results from this study will be combined with results from other disciplines such as animal science, business administration and environmental science. It is important to be able to demonstrate various possible added values that comes from pasture-based beef production systems under Swedish conditions.
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| 15. |
- Olsson, Viktoria, et al.
(författare)
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Sensory characteristics of meat from steers of various breeds and rearing intensities
- 2019
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The most common category of young cattle slaughtered for beef in Sweden is bulls of dairy breed, most often reared indoors. There is however a potential in raising steers (castrated bulls) for slaughter on semi-natural pasture, which may have an impact on sensory properties of the meat. Furthermore, weight gain and carcass characteristics may be improved by crossing dairy breeds with specialised beef breeds. In combination with the new technique of sex-sorted dairy semen, beef breed semen can be used to the less superior cows in the herd without jeopardizing an adequate number of replacement heifers from the superior cows. The aim of the study was to investigate whether there are any differences in sensory meat quality between cross bred and purebred cattle and between two rearing intensities including semi-natural pasture. Sensory properties were evaluated by a trained, analytical panel consisting of six assessors by the use of descriptive analysis. The intensity of iron, acidic, tallow, milky and barny odour as well as metallic, barny and gamey flavour and basic tastes were assessed in triplicate along with attributes describing the appearance and texture of the meat. Differences were mainly found in appearance and texture attributes, but also gamey flavour and the intensity of umami were affected by the rearing and breeding regimes. The meat quality results from this study will be combined with results from other disciplines such as animal science, business administration and environmental science. It is important to be able to demonstrate various possible added values that comes from pasture-based beef production systems under Swedish conditions.
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| 16. |
- Onerup, Aron, 1983, et al.
(författare)
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Physical activity on prescription in accordance with the Swedish model increases physical activity: a systematic review.
- 2019
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Ingår i: British journal of sports medicine. - : BMJ. - 1473-0480 .- 0306-3674. ; 53:6, s. 383-388
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Forskningsöversikt (refereegranskat)abstract
- This study investigates the effects of the core elements of the Swedish model for physical activity on prescription (PAP) by evaluating studies that compared adults who received PAP with adults who did not receive PAP. All participants were adults identified by a healthcare professional as in need of increased physical activity. Primary outcome was level of physical activity.Systematic review. ELIGIBILITY CRITERIA: (1) Published 1999. (2) Systematic review, randomised controlled trial (RCT), non-RCT or case series (for adverse events). (3) ≥12 weeks' follow-up. (4) Performed in the Nordic countries. (5) Presented in English, Swedish, Norwegian or Danish.Systematic searches in PubMed, Embase, the Cochrane Library, AMED, CINAHL and SweMed+ in September 2017. Included articles were evaluated using checklists to determine risk of bias.Nine relevant articles were included: seven RCTs, one cohort study and one case series.Primary outcome was reported in seven articles from six studies (five RCTs, one cohort study, 642 participants). Positive results were reported from three of the five RCTs and from the cohort study. No study reported any negative results. Swedish PAP probably results in an increased level of physical activity (GRADE⊕⊕⊕Ο).Although the number of the reviewed articles was relatively modest, this systematic review shows that PAP in accordance with the Swedish model probably increases the level of physical activity. As a model for exercise prescription, Swedish PAP may be considered as part of regular healthcare to increase physical activity in patients.
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| 17. |
- Stenberg, Elin, et al.
(författare)
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How four typical Swedish production systems for lambs affect sensory attributes of the meat
- 2018
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Ingår i: Proceedings 27th European Grassland Federation General Meeting. ; , s. 780-782
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Konferensbidrag (refereegranskat)abstract
- The aim of this study was to evaluate the effect of the four most typical producdon systems for Swedish lamb on sensory atrributes of meat, including appearance, texture, taste and flavour using an analytical panel. The experiment included four production treatments for weaned intact male lambs: (1) indoor fed with grass and clover silage ad libitum and 0.8 kg concentrate daily per lamb; (2) grazing on cultivated pasture with; or (3) without 0.3 kg concentrate supplementation daily per lamb; and (4) grazing on semi natura! pasture; eight lambs per producdon treatment were used. Feed radons, pasture height and live weight of the lambs were recorded. At slaughter, live weight, carcass conformation, fatness, pH and temperature decline in musde during 24 hoursafi:er slaughter were registered. Sensory and technological meat quality parameters were tested in cooked samples of M longissimus dorsi. Meat colour was not affected by treatment. Most sensor attributes were unaffected by producdon system hut for 'hay odour' and 'resistance to cutting; differences between the systems were manifested.
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| 18. |
- Stenberg, Elin, et al.
(författare)
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How four typical Swedish production systems for lambs affect sensory attributes of the meat
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to evaluate the effect of the four most typical producdon systems for Swedish lamb on sensory atrributes of meat, including appearance, texture, taste and flavour using an analytical panel. The experiment included four production treatments for weaned intact male lambs: (1) indoor fed with grass and clover silage ad libitum and 0.8 kg concentrate daily per lamb; (2) grazing on cultivated pasture with; or (3) without 0.3 kg concentrate supplementation daily per lamb; and (4) grazing on semi natura! pasture; eight lambs per producdon treatment were used. Feed radons, pasture height and live weight of the lambs were recorded. At slaughter, live weight, carcass conformation, fatness, pH and temperature decline in musde during 24 hoursafi:er slaughter were registered. Sensory and technological meat quality parameters were tested in cooked samples of M longissimus dorsi. Meat colour was not affected by treatment. Most sensor attributes were unaffected by producdon system hut for 'hay odour' and 'resistance to cutting; differences between the systems were manifested.
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| 19. |
- Wang, Dong V., et al.
(författare)
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Disrupting Glutamate Co-transmission Does Not Affect Acquisition of Conditioned Behavior Reinforced by Dopamine Neuron Activation
- 2017
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Ingår i: Cell Reports. - : Elsevier BV. - 2211-1247. ; 18:11, s. 2584-2591
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Tidskriftsartikel (refereegranskat)abstract
- Dopamine neurons in the ventral tegmental area (VTA) were previously found to express vesicular glutamate transporter 2 (VGLUT2) and to co-transmit glutamate in the ventral striatum (VStr). This capacity may play an important role in reinforcement learning. Although it is known that activation of the VTA-VStr dopamine system readily reinforces behavior, little is known about the role of glutamate co-transmission in such reinforcement. By combining electrode recording and optogenetics, we found that stimulation of VTA dopamine neurons in vivo evoked fast excitatory responses in many VStr neurons of adult mice. Whereas conditional knockout of the gene encoding VGLUT2 in dopamine neurons largely eliminated fast excitatory responses, it had little effect on the acquisition of conditioned responses reinforced by dopamine neuron activation. Therefore, glutamate co-transmission appears dispensable for acquisition of conditioned responding reinforced by DA neuron activation.
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| 20. |
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