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2.
  • Migueles, Jairo H., et al. (författare)
  • Effects of an Exercise Program on Cardiometabolic and Mental Health in Children With Overweight or Obesity A Secondary Analysis of a Randomized Clinical Trial
  • 2023
  • Ingår i: JAMA Network Open. - : AMER MEDICAL ASSOC. - 2574-3805. ; 6:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Importance Childhood obesity is a risk factor associated with type 2 diabetes, cardiovascular disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise program on cardiometabolic and mental health in children with overweight or obesity may provide new insights on the potential benefits of exercise on overall health. Objective To investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity. Design, Setting, and Participants This secondary analysis of a parallel-group randomized clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context. Intervention The exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus resistance training for 20 weeks. The wait-list control group continued with their usual routines. Main Outcomes and Measures Cardiometabolic outcomes as specified in the trial protocol included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators. Results The 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys [61%]) had a mean (SD) age of 10.0 (1.1) years. The exercise program reduced the cardiometabolic risk score byapproximately0.38 (95% CI, -0.74 to -0.02) SDs; decreased low-density lipoprotein cholesterol level by -7.00 (95% CI, -14.27 to 0.37) mg/dL (to convert to mmol/L, multiply by 0.0259), body mass index (calculated as weight in kilograms divided by height in meters squared) by -0.59 (95% CI, -1.06 to -0.12), fat mass index by -0.67 (95% CI, -1.01 to -0.33), and visceral adipose tissue by -31.44 (95% CI, -58.99 to -3.90) g; and improved cardiorespiratory fitness by 2.75 (95% CI, 0.22-5.28) laps in the exercise group compared with the control group. No effects were observed on mental health outcomes. Conclusions and Relevance In this secondary analysis of a randomized clinical trial, an aerobic plus resistance exercise program improved cardiometabolic health in children with overweight or obesity but had no effect on mental health.
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3.
  • Alexandrou, Christina, et al. (författare)
  • Effectiveness of a Smartphone App (MINISTOP 2.0) integrated in primary child health care to promote healthy diet and physical activity behaviors and prevent obesity in preschool-aged children: randomized controlled trial
  • 2023
  • Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : BMC. - 1479-5868. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Childhood overweight and obesity is a public health priority. We have previously reported the efficacy of a parent-oriented mobile health (mHealth) app-based intervention (MINISTOP 1.0) which showed improvements in healthy lifestyle behaviors. However, the effectiveness of the MINISTOP app in real-world conditions needs to be established. Objective:To evaluate the real-world effectiveness of a 6-month mHealth intervention (MINISTOP 2.0 app) on childrens intake of fruits, vegetables, sweet and savory treats, sweet drinks, moderate-to-vigorous physical activity, and screen time (primary outcomes), and on parental self-efficacy (PSE) for promoting healthy lifestyle behaviors, and childrens body mass index (BMI) (secondary outcomes). Methods:A hybrid type 1 effectiveness-implementation design was utilized. For the effectiveness outcomes, a two-arm, individually randomized controlled trial was conducted. Parents (n = 552) of 2.5-to-3-year-old children were recruited from 19 child health care centers across Sweden, and, randomized to either a control (standard care) or intervention group (MINISTOP 2.0 app). The 2.0 version was adapted and translated into English, Somali and Arabic to increase reach. All recruitment and data collection were conducted by the nurses. Outcomes were assessed at baseline and after six months, using standardized measures (BMI) and a questionnaire (health behaviors, PSE). Results:Among the participating parents (n = 552, age: 34.1 +/- 5.0 years), 79% were mothers and 62% had a university degree. Twenty-four percent (n = 132) of children had two foreign-born parents. At follow-up, parents in the intervention group reported lower intakes of sweet and savory treats (-6.97 g/day; p = 0.001), sweet drinks (-31.52 g/day; p < 0.001), and screen time (-7.00 min/day; p = 0.012) in their children compared to the control group. The intervention group reported higher total PSE (0.91; p = 0.006), PSE for promoting healthy diet (0.34; p = 0.008) and PSE for promoting physical activity behaviors (0.31; p = 0.009) compared to controls. No statistically significant effect was observed for childrens BMI z-score. Overall, parents reported high satisfaction with the app, and 54% reported using the app at least once a week. Conclusion:Children in the intervention group had lower intakes of sweet and savory treats, sweet drinks, less screen time (primary outcomes) and their parents reported higher PSE for promoting healthy lifestyle behaviors. Our results from this real-world effectiveness trial support the implementation of the MINISTOP 2.0 app within Swedish child health care.
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4.
  • Bränn, Emma, 1988-, et al. (författare)
  • Metabolic Profiling Indicates Diversity in the Metabolic Physiologies Associated With Maternal Postpartum Depressive Symptoms
  • 2021
  • Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Postpartum depression (PPD) is a devastating disease requiring improvements in diagnosis and prevention. Blood metabolomics identifies biological markers discriminatory between women with and those without antenatal depressive symptoms. Whether this cutting-edge method can be applied to postpartum depressive symptoms merits further investigation. Methods: As a substudy within the Biology, Affect, Stress, Imagine and Cognition Study, 24 women with PPD symptom (PPDS) assessment at 6 weeks postpartum were included. Controls were selected as having a score of ≤ 6 and PPDS cases as ≥12 on the Edinburgh Postnatal Depression Scale. Blood plasma was collected at 10 weeks postpartum and analyzed with gas chromatography-mass spectrometry metabolomics. Results: Variations of metabolomic profiles within the PPDS samples were identified. One cluster showed altered kidney function, whereas the other, a metabolic syndrome profile, both previously associated with depression. Five metabolites (glycerol, threonine, 2-hydroxybutanoic acid, erythritol, and phenylalanine) showed higher abundance among women with PPDSs, indicating perturbations in the serine/threonine and glycerol lipid metabolism, suggesting oxidative stress conditions. Conclusions: Alterations in certain metabolites were associated with depressive pathophysiology postpartum, whereas diversity in PPDS physiologies was revealed. Hence, plasma metabolic profiling could be considered in diagnosis and pathophysiological investigation of PPD toward providing clues for treatment. Future studies require standardization of various subgroups with respect to symptom onset, lifestyle, and comorbidities.
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5.
  • Henriksson, Hanna, et al. (författare)
  • MINISTOP 2.0: a smartphone app integrated in primary child health care to promote healthy diet and physical activity behaviours and prevent obesity in preschool-aged children: protocol for a hybrid design effectiveness-implementation study
  • 2020
  • Ingår i: BMC Public Health. - : BMC. - 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundChildhood obesity is still a major health problem in many countries, including Sweden. Childhood obesity and obesity-related behaviours in childhood, such as low physical activity and unhealthy eating habits, tend to track into adulthood, which highlights the need for early prevention. Our aims are to evaluate whether a parent-oriented mobile health app (the MINISTOP 2.0 app) integrated into primary child health care can improve diet and physical activity behaviours and reduce the prevalence of overweight and obesity in preschool-aged children as well as to evaluate the implementation among child health care nurses and parents.MethodsThis trial uses a hybrid type 1 effectiveness-implementation design. Families (n=500) who attend a routine visit to one of 15-20 primary child health care centres throughout Sweden, when their child is 2.5years, are offered participation in a randomised controlled trial (effectiveness evaluation). After acceptance, families will be randomised (1:1) to control or intervention groups. The intervention group receives a 6-month parent-oriented smartphone intervention aimed at improving the dietary and activity behaviours of their child (the MINISTOP 2.0 app) and the control group receives routine child health care. Dietary habits, physical activity and screen time (primary outcomes), body weight and height in children, and parental self-efficacy (secondary outcomes) are measured at baseline and at 6months post randomisation. Implementation outcomes (i.e. perceived acceptability, appropriateness, and feasibility) of the intervention will be assessed among primary child health care nurses and parents in the trial through questionnaires and qualitative interviews.DiscussionThis trial will evaluate whether the MINISTOP 2.0 app can be used in primary child health care to improve diet and physical activity behaviours, and prevent overweight and obesity, in preschool-aged children. If effectiveness is proven, and the MINISTOP 2.0 app is considered acceptable, appropriate and feasible, it can be implemented nationally as part of the preventive strategies to combat childhood obesity provided by routine child health care.Trial registrationThe trial was registered at the Clinicaltrials.gov register platform (ID NCT04147039) on 31 October 2019.
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7.
  • Henriksson, Malin, et al. (författare)
  • Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trial.
  • 2022
  • Ingår i: Journal of affective disorders. - : Elsevier BV. - 1573-2517 .- 0165-0327. ; 297, s. 26-34
  • Tidskriftsartikel (refereegranskat)abstract
    • There is a need for high-quality research regarding exercise interventions for persons with anxiety disorders. We investigate whether a 12-week exercise intervention, with different intensities, could reduce anxiety symptoms in patients with anxiety disorders.286 patients were recruited from primary care in Sweden. Severity of symptoms was self-assessed using the Beck Anxiety Inventory (BAI) and the Montgomery Åsberg Depression Rating Scale (MADRS-S). Participants were randomly assigned to one of two group exercise programs with cardiorespiratory and resistance training and one control/standard treatment non-exercise group, with 1:1:1 allocation.Patients in both exercise groups showed larger improvements in both anxiety and depressive symptoms compared to the control group. No differences in effect sizes were found between the two groups. To study a clinically relevant improvement, BAI and MADRS-S were dichotomized with the mean change in the control group as reference. In adjusted models the odds ratio for improved symptoms of anxiety after low-intensity training was 3.62 (CI 1.34-9.76) and after moderate/high intensity 4.88 (CI 1.66-14.39), for depressive symptoms 4.96 (CI 1.81-13.6) and 4.36 (CI 1.57-12.08) respectively. There was a significant intensity trend for improvement in anxiety symptoms.The use of self-rating measures which bears the risk of an under- or overestimation of symptoms.A 12-week group exercise program proved effective for patients with anxiety syndromes in primary care. These findings strengthen the view of physical exercise as an effective treatment and could be more frequently made available in clinical practice for persons with anxiety issues.
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8.
  • Nyberg, Jenny, 1976, et al. (författare)
  • Anxiety severity and cognitive function in primary care patients with anxiety disorder: a cross-sectional study.
  • 2021
  • Ingår i: BMC psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Deficits in cognitive performance are reported in patients with anxiety disorders, but research is limited and inconsistent. We aimed to investigate cross-sectional associations between cognitive function, with focus on executive function, and anxiety severity in primary care patients diagnosed with anxiety disorders.189 Swedish patients aged 18-65years (31% men) with anxiety disorders diagnosed according to Mini International Neuropsychiatric Interview were included. Severity of anxiety was assessed using Beck Anxiety Inventory self-assessment scale. Digit span, block design and matrix reasoning tests from the Wechsler Adult Intelligence Scale IV, and the design fluency test from the Delis-Kaplan Executive Function System were used. Multivariable linear regression models were applied to investigate the relationship of anxiety severity and cognitive functioning. Comparisons were also performed to a normed non-clinical population, using the Wilcoxon signed rank test.More severe anxiety was associated with lower digit span test scores (R2=0.109, B=-0.040, p=0.018), but not with block design, matrix reasoning or design fluency tests scores, after adjustment for comorbid major depression in a multivariable model. When compared to a normed population, patients with anxiety performed significantly lower on the block design, digit span forward, digit span sequencing and matrix reasoning tests.Severity of anxiety among patients with anxiety disorder was associated with executive functions related to working memory, independently of comorbid major depression, but not with lower fluid intelligence. A further understanding of the executive behavioral control in patients with anxiety could allow for more tailored treatment strategies including medication, therapy and interventions targeted to improve specific cognitive domains.
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9.
  • Rizzi, Maria C., 1987-, et al. (författare)
  • Snabbcykelstråk i planeringen och praktiken : erfarenheter från Sverige, Norge och Danmark
  • 2022
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Syftet med studien har varit att ge en övergripande bild av vilka utmaningar, kunskapsluckor och behov som transportaktörer i Sverige, Norge och Danmark möter i hanteringen av snabbcykelstråk. Fokus har varit på hur tjänstemän från dessa tre länder med ansvar eller engagemang i snabbcykelstråk upplever planering, utformning, drift och underhåll samt utvärdering av stråken. I rapporten lyfts områden där det upplevs saknas stöd eller kunskap, samt likheter och skillnader mellan länderna.En webbenkät med efterföljande intervjuer har använts som datainsamlingsmetod. Webbenkäten sändes till 40 personer i Sverige, Norge och Danmark som på olika sätt arbetar med snabbcykelstråk. Svar inkom från 25 personer. Av dessa valdes sju personer ut för att genomföra en efterföljande intervju.Förutsättningarna att arbeta med snabbcykelstråk skiljer sig mellan länderna, till exempel med hänsyn till väghållaransvar och finansieringsmöjligheter, men även inom länderna kan förutsättningar skilja sig. Det tycks finnas ett behov av nationell samordning kring snabbcykelstråk, samtidigt som man inte ville se några ”tvingande regler” kring utformning. I Sverige efterlyser man särskilt en samordning kring skyltning av snabbcykelstråk, något som redan finns i Danmark. Det upplevdes svårare att planera för snabbcykelstråk jämfört med annan cykelinfrastruktur och det finns aspekter av snabbcykelstråk som skiljer sig från annan cykelinfrastruktur, som till exempel högre krav på utformning, underhåll och säkerhet, samt högre krav på samarbete och samordning. Utvärdering av snabbcykelstråken är något man arbetar med lokalt, och det finns ingen sammanställd systematisk kunskap kring de modeller eller metoder som används för utvärdering. Informationsutbyte mellan olika aktörer i Sverige, Norge och Danmark skulle kunna öka kunskapen och ge nya infallsvinklar hur planering och genomförande av snabbcykelvägar kan förbättras.
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10.
  • Runheim, Hannes, et al. (författare)
  • The cost-effectiveness of whole genome sequencing in neurodevelopmental disorders
  • 2023
  • Ingår i: Scientific Reports. - : NATURE PORTFOLIO. - 2045-2322. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Whole genome sequencing (WGS) has the potential to be a comprehensive genetic test, especially relevant for individuals with neurodevelopmental disorders, syndromes and congenital malformations. However, the cost consequences of using whole genome sequencing as a first-line genetic test for these individuals are not well understood. The study objective was to compare the healthcare costs and diagnostic yield when WGS is performed as the first-line test instead of chromosomal microarray analysis (CMA). Two cohorts were analyzed retrospectively using register data, cohort CMA (418 patients referred for CMA at the department of Clinical Genetics, Karolinska University Hospital, during 2015) and cohort WGS (89 patients included in a WGS-first prospective study in 2017). The analysis compared healthcare consumption over a 2-year period after referral for genetic testing, the diagnostic yield over a 2- and 3-year period after referral was also compiled. The mean healthcare cost per patient in cohort WGS was $2,339 lower compared to cohort CMA ($ - 2339, 95% CI - 12,238-7561; P = 0.64) including higher costs for genetic investigations ($1065, 95% CI 834-1295; P < 0.001) and lower costs for outpatient care ($ - 2330, 95% CI - 3992 to (- 669); P = 0.006). The diagnostic yield was 23% higher for cohort WGS (cohort CMA 20.1%, cohort WGS 24.7%) (0.046, 95% CI - 0.053-0.145; P = 0.36). WGS as a first-line diagnostic test for individuals with neurodevelopmental disorders is associated with statistically non-significant lower costs and higher diagnostic yield compared with CMA. This indicates that prioritizing WGS over CMA in health care decision making will yield positive expected outcomes as well as showing a need for further research.
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11.
  • Arias Tellez, Maria Jose, et al. (författare)
  • Association of Neck Circumference with Anthropometric Indicators and Body Composition Measured by DXA in Young Spanish Adults
  • 2020
  • Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 12:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Due to a clinical and public health interest of neck circumference (NC), a better understanding of this simple anthropometric measurement, as a valid marker of body composition is necessary. Methods: A total of 119 young healthy adults participated in this study. NC was measured over the thyroid cartilage and perpendicular to the longitudinal axis of the neck. Body weight, height, waist circumference (WC), and hip circumference were measured. A Dual X-ray absorptiometry (DXA) scan was used to determine fat mass, lean mass, and visceral adipose tissue (VAT). Additionally, body mass index (BMI) and triponderal mass index (TMI), the waist to hip and waist to height ratios, and the fat mass and lean mass indexes (FMI and LMI, respectively) were calculated. Results: NC was positively associated in women (W) and men (M), with BMI (rW = 0.70 and rM = 0.84, respectively), TMI (rW = 0.63 and rM = 0.80, respectively), WC (rW = 0.75 and rM = 0.86, respectively), VAT (rW = 0.74 and rM = 0.82, respectively), Waist/hip (rW = 0.51 and rM = 0.67, respectively), Waist/height (rW = 0.68 and rM = 0.83, respectively) and FMI (rW = 0.61 and rM = 0.81, respectively). The association between NC and indicators of body composition was however weaker than that observed by BMI, TMI, WC and Waist/height in both women and men. It is of note that in women, NC was associated with FMI, VAT and LMI independently of BMI. In men, adding NC to anthropometric variables did not improve the prediction of body composition, while slight improvements were observed in women. Conclusions: Taken together, the present study provides no indication for NC as a useful proxy of body composition parameters in young adults, yet future studies should explore its usefulness as a measure to use in combination with BMI, especially in women.
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12.
  • Biggs, Reinette, et al. (författare)
  • Social-ecological change : insights from the Southern African Program on Ecosystem Change and Society
  • 2022
  • Ingår i: Ecosystems and People. - : Informa UK Limited. - 2639-5908 .- 2639-5916. ; 18:1, s. 447-468
  • Tidskriftsartikel (refereegranskat)abstract
    • Social-ecological systems (SES) research has emerged as an important area of sustainability science, informing and supporting pressing issues of transformation towards more sustainable, just and equitable futures. To date, much SES research has been done in or from the Global North, where the challenges and contexts for supporting sustainability transformations are substantially different from the Global South. This paper synthesises emerging insights on SES dynamics that can inform actions and advance research to support sustainability transformations specifically in the southern African context. The paper draws on work linked to members of the Southern African Program on Ecosystem Change and Society (SAPECS), a leading SES research network in the region, synthesizing key insights with respect to the five core themes of SAPECS: (i) transdisciplinary and engaged research, (ii) ecosystem services and human well-being, (iii) governance institutions and management practices, (iv) spatial relationships and cross-scale connections, and (v) regime shifts, traps and transformations. For each theme, we focus on insights that are particularly novel, interesting or important in the southern African context, and reflect on key research gaps and emerging frontiers for SES research in the region going forward. Such place-based insights are important for understanding the variation in SES dynamics around the world, and are crucial for informing a context-sensitive global agenda to foster sustainability transformations at local to global scales.
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13.
  • Biggs, Reinette, et al. (författare)
  • The Southern African Program on Ecosystem Change and Society : an emergent community of practice
  • 2023
  • Ingår i: Ecosystems and People. - : Informa UK Limited. - 2639-5908 .- 2639-5916. ; 19:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Sustainability-focused research networks and communities of practice have emerged as a key response and strategy to build capacity and knowledge to support transformation towards more sustainable, just and equitable futures. This paper synthesises insights from the development of a community of practice on social-ecological systems (SES) research in southern Africa over the past decade, linked to the international Programme on Ecosystem Change and Society (PECS). This community consists of a network of researchers who carry out place-based SES research in the southern African region. They interact through various cross-cutting working groups and also host a variety of public colloquia and student and practitioner training events. Known as the Southern African Program on Ecosystem Change and Society (SAPECS), its core objectives are to: (1) derive new approaches and empirical insights on SES dynamics in the southern African context; (2) have a tangible impact by mainstreaming knowledge into policy and practice; and (3) grow the community of practice engaged in SES research and governance, including researchers, students and practitioners. This paper reflects on experiences in building the SAPECS community, with the aim of supporting the development of similar networks elsewhere in the world, particularly in the Global South.
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14.
  • Bonagas, Nadilly, et al. (författare)
  • Pharmacological targeting of MTHFD2 suppresses acute myeloid leukemia by inducing thymidine depletion and replication stress
  • 2022
  • Ingår i: NATURE CANCER. - : Springer Science and Business Media LLC. - 2662-1347. ; 3:2, s. 156-
  • Tidskriftsartikel (refereegranskat)abstract
    • The folate metabolism enzyme MTHFD2 (methylenetetrahydrofolate dehydrogenase/cyclohydrolase) is consistently overexpressed in cancer but its roles are not fully characterized, and current candidate inhibitors have limited potency for clinical development. In the present study, we demonstrate a role for MTHFD2 in DNA replication and genomic stability in cancer cells, and perform a drug screen to identify potent and selective nanomolar MTHFD2 inhibitors; protein cocrystal structures demonstrated binding to the active site of MTHFD2 and target engagement. MTHFD2 inhibitors reduced replication fork speed and induced replication stress followed by S-phase arrest and apoptosis of acute myeloid leukemia cells in vitro and in vivo, with a therapeutic window spanning four orders of magnitude compared with nontumorigenic cells. Mechanistically, MTHFD2 inhibitors prevented thymidine production leading to misincorporation of uracil into DNA and replication stress. Overall, these results demonstrate a functional link between MTHFD2-dependent cancer metabolism and replication stress that can be exploited therapeutically with this new class of inhibitors. Helleday and colleagues describe a nanomolar MTHFD2 inhibitor that causes replication stress and DNA damage accumulation in cancer cells via thymidine depletion, demonstrating a potential therapeutic strategy in AML tumors in vivo.
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15.
  • Cadenas-Sanchez, Cristina, et al. (författare)
  • Fitness, physical activity and academic achievement in overweight/obese children
  • 2020
  • Ingår i: Journal of Sports Sciences. - : TAYLOR & FRANCIS LTD. - 0264-0414 .- 1466-447X. ; 38:7, s. 731-740
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine the associations of fitness and physical activity with academic achievement in children with overweight/obesity. A total of 106 (10.0 +/- 1.1y, 61 boys) children participated. The fitness components were assessed by field and laboratory-based tests. Physical activity was measured via accelerometry. The academic achievement was assessed by a standardised test and school-grades. Field-based cardiorespiratory fitness was associated with language skills (ss-standardised- ranging from 0.281 to 0.365, p amp;lt; 0.01). The field-based muscular strength was associated with grade point average, natural and social sciences, and foreign language (ss = 0.280-0.326, all p amp;lt;= 0.01). Speed-agility was associated with some language-related skills (ss = 0.325-0.393, all p amp;lt;= 0.01). The laboratory-based muscular strength also showed an association with mathematics skills (ss = 0.251-0.306, all p amp;lt;= 0.01). Physical activity did not show significant association with academic achievement (p amp;gt; 0.01). Overall, the significant associations observed for muscular strength and speed/agility were attenuated and disappeared in many cases after additional adjustments for body mass index and cardiorespiratory fitness, indicating that these associations are inter-dependent. Our study contributes by indicating that other fitness components apart from cardiorespiratory fitness, such as muscular strength and speed-agility, are positively associated with academic achievement. However, these associations appear to be dependent on body mass index and cardiorespiratory fitness.
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16.
  • Cederberg, Christel, 1959, et al. (författare)
  • Gräsmarkernas användning i Sverige
  • 2020
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Sammanfattning I denna rapport redovisas beräkningar och skattningar för hur landets gräsmarker, vilka omfattar slåtter- och betesvallar på åkermark samt naturbetesmarker, nyttjas och används av landets gräsätande tamdjur. Eftersom denna typ av estimat inte har gjorts tidigare är rapportens fokus inriktat på att redovisa metoder och data. Arbetet har utförts genom att: 1) inventera uppgifter om foderstater och baserat på dessa, skatta förbrukningen av vallfoder (ensilage, hösilage, hö) samt bete för olika kategorier av nötkreatur, får och hästar; 2) beräkna gräsmarkernas produktion samt 3) utifrån punkt 1 och 2 beräkna vilka arealer slåtter-och betesvallar samt naturbetesmarker de gräsätande tamdjuren behöver och jämföra dessa estimat med tillgängliga arealer. Arealskattningarna tar även hänsyn till foderförluster och spill i hela foderkedjan. Dataunderlaget baseras så långt det är möjligt på officiell statistik från SCB och Jordbruks-verket samt forskningsrapporter. Vid behov har expertkunskap tillfrågats och vid dataluckor har antaganden fått göras, ofta i diskussion med experter inom rådgivning. All indata från den officiella statistiken har beräknats som ett medelvärde för de tre åren 2015, 2016 och 2017. För statistik som inte redovisas årligen har de senast publicerade uppgifterna använts. Beräkningarna är företrädesvis utförda på länsnivå där sådana uppgifter har funnits att tillgå (djurantal, arealer, skördenivåer). Dessa länsvisa beräkningar har sedan aggregerats till totala resultat för landet samt delats upp på regionerna Syd, Väst, Öst, Mellan och Norr. Nötkreaturens, fårens och hästarnas årliga konsumtion av ensilage, hösilage och hö från vallar skattas till totalt cirka 3,1 miljoner ton torrsubstans och betesintaget till ca 1,5 miljoner ton torrsubstans. Mjölkproduktionen är den största konsumenten av skördat vallfoder, motsvarande nästan hälften. Nötkreaturen i köttproduktionen står i gengäld för nästan hälften av betesintaget. Hästsektorn är en betydande konsument av vallfoder och hästarnas intag av hösilage och hö är i samma storleksordning som konsumtionen inom nötköttssektorn. En jämförelse av djurens totala konsumtion av vallfoder inklusive foderförluster och spill, med produktionen på tillgänglig areal visar att dessa är i hyfsad balans. Av drygt 1 miljon hektar vall på åker beräknas mjölksektorn nyttja cirka 40 % medan häst- och nötköttssektorn står för runt 30 % respektive 25 % av användningen. Naturbetesmarkernas knappt 450 000 ha nyttjas framförallt av djur i nötköttsproduktionen, uppskattningsvis cirka 70 % av arealen. Vallar och betesmarker växer på hälften av Sveriges jordbruksmark och har stor betydelse för landsbygdens försörjning, särskilt i mellan- och skogsbygd. Denna markanvändning är viktig för landets livsmedelsförsörjning samt en rad andra ekosystemtjänster som t ex kolinlagring i mark, pollinering, rekreation och naturupplevelser samt för bevarandet av biologisk mångfald i odlingslandskap. Trots dessa flerfaldiga nyttor är gräsmarkerna och användningen av deras biomassaproduktion på många sätt bristfälligt undersökta inom statistik och forskning. Denna rapport bidrar till en översikt om vilka data och uppgifter som behöver tas fram för att få ett bättre kunskapsunderlag för planering och utveckling av gräsmarkernas framtida användning. Summary This report describes calculations and estimates for how Sweden´s grasslands, a land use including temporary grasslands (i.e. leys in crop rotations on arable land) and pastures on semi-natural grasslands, are used by cattle, horses and sheep. The focus of the report is a description of methods and data used in the calculations. The main method has been to: 1) collect data on feed rations and based on these, calculate the consumption of silage, hay and pasture for different categories of cattle, horses and sheep; 2) estimate the biomass production from different types of grasslands and 3) based on 1 and 2, calculate the acreages of temporary grasslands and pastures that are needed by the livestock and compare these estimates with available areas in the statistics. The estimates of needed acreages also consider waste and losses in the overall fodder chain. Input data are based on official statistics from Sweden Statistics, Board of Agriculture and research literature. In case of data gaps, assumptions have been made, often in discussion with expertise from advisory service and/or research. The calculations are made as a yearly average of the three years 2015, 2016 and 2017. Some data needed were not reported yearly, here the latest available data have been used. The calculations are foremost done at county level and then aggregated at national level, and also also divided between the five regions South, West, East, Mid and North. The yearly consumption of biomass from the grasslands in Swedish agriculture is estimated at approximately 3.1 million tons dry matter of silage and hay, and around 1.5 million tons dry matter of pasture. Dairy production is the largest consumer of silage and hay, almost half of total. Cattle in the beef production consume almost half of the pasture biomass. The horse sector is a significant consumer of silage and hay, in the same magnitude as the beef sector.   A comparison of the animals´ total consumption of silage, hay and pasture, including losses and waste in the fodder chain, with the biomass yields from the grasslands shows that those two are in reasonable balance. From a total area of roughly one million hectares temporary grasslands on arable land, it is estimated that the dairy sector uses 40 % while the horse- and beef sector use 30 % and 25 % respectively. The semi-natural grasslands of close to 450 000 hectares are grazed and foremost used by beef cattle, approximately 70% of this area. Grasslands in forms of temporary leys and semi-natural pastures cover half of Sweden´s agricultural land, and are very important for the rural economy, especially in regions close to forest areas (inland and north). This land use is important for food supply and other ecosystem services such carbon sequestration, pollination, recreation and biodiversity in agricultural landscapes, but is inadequately covered in statistics and research. This report contributes to an overview of what data that are needed to improve our understanding and knowledge of grasslands in Sweden.
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17.
  • Demmelmaier, Ingrid, 1960-, et al. (författare)
  • Does exercise intensity matter for fatigue during (neo-)adjuvant cancer treatment? The Phys-Can randomized clinical trial
  • 2021
  • Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 31:5, s. 1144-1159
  • Tidskriftsartikel (refereegranskat)abstract
    • Exercise during cancer treatment improves cancer-related fatigue (CRF), but the importance of exercise intensity for CRF is unclear. We compared the effects of high- vs low-to-moderate-intensity exercise with or without additional behavior change support (BCS) on CRF in patients undergoing (neo-)adjuvant cancer treatment. This was a multicenter, 2x2 factorial design randomized controlled trial (Clinical Trials NCT02473003) in Sweden. Participants recently diagnosed with breast (n = 457), prostate (n = 97) or colorectal (n = 23) cancer undergoing (neo-)adjuvant treatment were randomized to high intensity (n = 144), low-to-moderate intensity (n = 144), high intensity with BCS (n = 144) or low-to-moderate intensity with BCS (n = 145). The 6-month exercise intervention included supervised resistance training and home-based endurance training. CRF was assessed by Multidimensional Fatigue Inventory (MFI, five subscales score range 4-20), and Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F, score range 0-52). Multiple linear regression for main factorial effects was performed according to intention-to-treat, with post-intervention CRF as primary endpoint. Overall, 577 participants (mean age 58.7 years) were randomized. Participants randomized to high- vs low-to-moderate-intensity exercise had lower physical fatigue (MFI Physical Fatigue subscale; mean difference −1.05 [95% CI: −1.85, −0.25]), but the difference was not clinically important (ie <2). We found no differences in other CRF dimensions and no effect of additional BCS. There were few minor adverse events. For CRF, patients undergoing (neo-)adjuvant treatment for breast, prostate or colorectal cancer can safely exercise at high- or low-to-moderate intensity, according to their own preferences. Additional BCS does not provide extra benefit for CRF in supervised, well-controlled exercise interventions.
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18.
  • Einarsson, Rasmus, 1988, et al. (författare)
  • The nitrogen footprint of Swedish food consumption
  • 2022
  • Ingår i: Environmental Research Letters. - : IOP Publishing. - 1748-9318 .- 1748-9326. ; 17:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Food systems are major drivers of environmental and health impacts. While the emissions and other pressures causing these impacts mainly occur in primary agricultural production, the deeper causes and much of the mitigation potential are distributed throughout food systems, including dietary choices and multiple inefficiencies in the whole chain from agricultural production to consumption and waste management. An environmental indicator based on this systems perspective is the nitrogen (N) footprint, defined as the emissions of reactive N due to the consumption of an individual or other entity. Here, we present a method to estimate the N footprint of Swedish food consumption, using a detailed inventory of agricultural production, food and feed processing, food waste, waste management, and wastewater treatment. Limitations of data sources and methods are discussed in detail. The estimated Swedish food N footprint is 12.1 kg N capita(-1) yr(-1), of which 42% is emitted in Swedish production, 38% in production abroad, 1% in consumer waste management, and 19% in wastewater treatment. Animal food products account for 81% of the food N footprint and 70% of the protein intake. Average protein intake exceeds nutritional requirements by about 60%, which suggests that at least 35% reduction of food-related reactive N emissions could be achieved through dietary change. Of the apparent food N consumption (6.9 kg N capita(-1) yr(-1)), about 22% is food waste N (1.5 kg N capita(-1) yr(-1)). We estimate that 76% of food waste N is unavoidable (bones and other parts not commonly eaten). Avoidable food waste is about 7% of the edible food supply, implying that a hypothetical complete elimination of food waste would reduce emissions by about 7%. In summary, we present a detailed method, discuss its limitations, and demonstrate possible uses of the N footprint as a complement to existing territorial and sectoral environmental indicators.
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19.
  • Eriksson, Jenny, 1975-, et al. (författare)
  • Oskyddade trafikanters inblandning i olyckor och deras skadeutfall : en jämförande studie mellan fotgängare, cyklister, mopedister och motorcyklister
  • 2022
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • I tidigare arbete för säker gång-, cykel- och mopedtrafik har faktaunderlag tagits fram för olyckor och skador. Det finns en stor efterfrågan på uppdaterade analyser samt att utvidga innehållet till mopedister och motorcyklister. Syftet är dels att se över klassificeringsmetoden, dels att öka kunskapen om oskyddade trafikanters inblandning i olyckor och deras skador. Olycksunderlaget är hämtat från olycksdatabasen Strada, främst från sjukvården, för åren 2014–2019. Resvanedata är hämtade från den nationella resvaneundersökningen RVU Sverige 2011–2016. Måttet allvarligt skadad används och med det menas att personen bedöms få en framtida medicinsk invaliditet på minst en procent. Under aktuell sexårsperiod blev 19 042 fotgängare, 11 195 cyklister, 1 325 mopedister och 1 393 motorcyklister allvarligt skadade. En majoritet av dessa var singelolyckor. Fotgängare bestod av en övervägande del kvinnor i åldern 45 år och äldre. För cyklister var det något fler män som skadades allvarligt och åldersgruppen 10–14 år hade högst andel allvarligt skadade. De allvarligt skadade mopedisterna bestod av en övervägande del män och över hälften var i åldern 15–17 år. Nio av tio allvarligt skadade motorcyklister var män och de flesta var i åldern 25–64 år. Oavsett trafikantgrupp var det vanligaste ärendet fritid vid skadetillfället. Halka var bland den vanligaste uppgivna orsaken, mellan 30–60 procent, där snö/is var vanligast för fotgängare, snö/is och löst grus för cyklister och löst grus för mopedister och motorcyklister. Ojämnt/hål och gropar var också något som var vanligt, mellan 9 och 17 procent beroende på trafikantkategori. För cyklister, mopedister och motorcyklister var följande angivna orsak vanlig för singelolyckor utöver halka: • Väjt för annan trafikant, mellan 6–11 procent, • inbromsning 6–22 procent, • svängt/kurva 9–30 procent. Risken att skadas allvarligt per resa är högst bland motorcyklister och per en miljon kilometer var det mopedister.
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20.
  • Galvez-Fernandez, Patricia, et al. (författare)
  • Convergent Validation of a Self-Reported Commuting to and from School Diary in Spanish Adolescents
  • 2023
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine the convergent validity of self-reported diary times for commuting to and from school with device-measured positional data (Global Positioning System; GPS) in Spanish adolescents. Methods: Cross-sectional data were obtained from four Spanish public secondary schools in 2021, comprising 47 adolescents and 141 home-school and school-home trips. Participants self-reported the time they left and arrived at home and school through a commuting diary. They wore a GPS device recording the objective time during three trips (i.e., one home-school trip and two school-home trips). Agreement between commuting diary and GPS data regarding home-school trips and school-home trips was evaluated using Bland-Altman plots. Results: Total commuting time differed by 1 min (95% limits of agreement were 16.1 min and -18.1 min) between subjective and objective measures (adolescents reported 0.8 more minutes in home-school trips and 1 more minute in school-home trips compared to objective data). Passive commuters reported 0.7 more minutes and active commuters reported 1.2 more minutes in the total commuting time compared to objective data. Conclusions: Self-reported commuting diaries may be a useful tool to obtain commuting times of adolescents in epidemiological research or when tools to measure objective times are not feasible.
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21.
  • Henriksson, Malin, 1971- (författare)
  • Att bygga ett samhälle : Tid, rum och politiska visioner i bostadspolitiken 1901–1947
  • 2021
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This dissertation is a study of political modernization in Sweden, focusing on the formation of modern housing policy. The analysis reveals how changing concepts relating to time and space redefine a political and social order, thereby laying the foundation for the welfare state. In the late nineteenth and the early twentieth century Sweden saw rapid industrialization, urbanization and extensive migration in and out of the country, but also problems such as poverty, poor working conditions, overcrowded housing and epidemics. Housing policy did not only express ideas and strategies for how people should live in the modern industrialized world; it was also introduced as a political instrument to create a modern society and a modern population. In the first decades of the twentieth century, government reports and bills on housing presented new ways of constructing political subjects and political community, along with an emerging conviction that political reforms were necessary to create a modern society.The investigation emphasizes the importance of adopting a longer time frame when analyzing political change. It combines Reinhart Koselleck’s research program and method for the study of diachronic conceptual change with Quentin Skinner’s speech-act theory and tools for the synchronic study of political rhetoric. The aim of the dissertation is to analyze conceptual change in Swedish public policy about housing in the period 1901–1947. The aim is specified by the following research questions: How does the construction of political subjects and political community change during this period? How does meaning-making concerning time and space change, and how does such change relate to new ways of conceptualizing political subjects and political community? How do these conceptual shifts contribute to shape the conditions for the welfare state?The dissertation contributes to the scholarly understanding of welfare state formation by demonstrating how temporality and spatiality in conceptual formations contributed to the making of the Swedish welfare state. It demonstrates in empirical detail how time and space were used in the shift from an organically interpreted nation to a modern society, and in the emphasizing and evaluation of political subjects such as the earth-bound and loyal peasant, the transcendent modern worker, the flexible yet stable nuclear family, and the sociable democratic human being.
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22.
  • Henriksson, Maria P., 1968, et al. (författare)
  • Functional leadership in a changing and bounded World: The relevance of managerial behavioral training
  • 2023
  • Ingår i: International Journal of Organizational Leadership. - 2383-1103 .- 2345-6744. ; 12:4, s. 349-368
  • Tidskriftsartikel (refereegranskat)abstract
    • Successful organizations require functional leadership. This article evaluates a new leadership development intervention, Managerial Behavioral Training (MBT), that targets concrete leadership behaviors associated with flexible, healthy, and successful work environments. Within an applied behavioral analytical framework, managers participating in MBT were trained by a leadership coach during six biweekly sessions in specific functional leadership behaviors. Sixteen managers were interviewed one year after participating in this individualized leadership intervention. Functional contextualism was used as the theoretical framework to analyze the interview transcripts, and a mind-mapping approach was used to illustrate themes. The findings show four success factors and indicate that MBT provides managers with analytical tools and training opportunities for developing functional leadership behaviors, allowing them to successfully manage organizational change. Participating managers described the scheduled time for reflection with a coach as important for adjusting dysfunctional leadership behaviors in new situations. Taking time to listen to employees’ perspectives gave managers a way to engage employees that increased productivity. Scheduling time for planning and setting clear goals for the team and for individual employees was found to be important for the employees’ motivation and productivity. Stress management, taking time for recovery, and having a meaningful private life were found to enable successful managerial decision-making. The four success factors for functional leadership are discussed and related to theories on organizational management and leadership.
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23.
  • Henriksson, Pontus, et al. (författare)
  • Body composition, physical fitness and cardiovascular risk factors in 9-year-old children
  • 2022
  • Ingår i: Scientific Reports. - : Nature Portfolio. - 2045-2322. ; 12:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The independent associations of body composition and physical fitness components with cardiovascular disease (CVD) risk factors in childhood are not fully understood. Thus, this cross-sectional study examined the independent associations of body composition and physical fitness with CVD risk factors in Swedish 9-year-old children (n = 411). Unadjusted linear regression analyses showed that body mass index (BMI), % fat mass and fat mass index were all positively associated with systolic and diastolic blood pressure, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and Metabolic Syndrome (MetS) score (all β ≥ 0.229, P ≤ 0.001). These associations were virtually unaffected by adjustments for basic covariates (child’s age and sex, maternal educational level and maternal BMI), fat-free mass and physical fitness. Fat-free mass index had generally weak associations with CVD risk factors and no associations were statistically significant after adjustments (all P > 0.27). Greater cardiorespiratory fitness and motor fitness were associated with lower HOMA-IR and MetS score in unadjusted models (all β ≤ − 0.158, P ≤ 0.039) but not after adjustments for basic covariates and body composition. These findings indicate that cardiovascular health promotion in childhood may focus on the maintenance of a healthy fat mass. 
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24.
  • Henström, Maria, et al. (författare)
  • Self-reported (IFIS) versus measured physical fitness, and their associations to cardiometabolic risk factors in early pregnancy
  • 2021
  • Ingår i: Scientific Reports. - : Nature Portfolio. - 2045-2322. ; 11:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Physical fitness is a strong marker of health, but objective fitness measurements are not always feasible. The International FItness Scale (IFIS) for self-reported fitness is a simple-to-use tool with demonstrated validity and reliability; however, validation in pregnancy needs to be confirmed. Also, its association with cardiometabolic health in pregnant women is unknown. Hence, we examined (1) the validity of the IFIS with objectively measured fitness, and (2) the associations of self-reported versus objectively measured cardiorespiratory fitness (CRF) and muscular strength with cardiometabolic risk factors in early pregnancy. Women (n = 303) from the HealthyMoms trial were measured at gestational week 14 for: CRF (6-min walk test); upper-body muscular strength (handgrip strength test); self-reported fitness (IFIS), body composition (air-displacement plethysmography); blood pressure and metabolic parameters (lipids, glucose, insulin). Higher self-reported fitness was associated with better measured fitness (ANOVA overall p < 0.01 for all fitness types), indicating the usefulness of the IFIS in pregnancy. Furthermore, higher self-reported overall fitness and CRF were associated with lower cardiometabolic risk scores (ANOVA p < 0.001), with similar results shown for measured CRF (ANOVA p < 0.001). The findings suggest that IFIS could be useful to stratify pregnant women in appropriate fitness levels on a population-based level where objective measurement is not possible.
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25.
  • Herraiz-Adillo, Ángel, et al. (författare)
  • Life's Essential 8 and Life's Simple 7 in Relation to Coronary Atherosclerosis: Results From the Population-Based SCAPIS Project.
  • 2024
  • Ingår i: Mayo Clinic proceedings. - : Elsevier. - 1942-5546 .- 0025-6196. ; 99:1, s. 69-80
  • Tidskriftsartikel (refereegranskat)abstract
    • To examine the associations between the American Heart Association scores ("Life's Essential 8" [LE8] and "Life's Simple 7" [LS7]) and 2 subclinical coronary atherosclerosis indicators: coronary computed tomographic angiography (CCTA)-stenosis and coronary artery calcium (CAC).We included a population-based sample, aged 50 to 64 years, recruited between 2013 and 2018 from the Swedish Cardiopulmonary Bioimage Study (n=24,819, 50.3% women). CCTA-stenosis was graded as no stenosis, stenosis (1%-49%) or severe stenosis (≥50%), whereas CAC was graded as 0, 1 to 99, 100 to 399, or ≥400 Agatston units. Multinomial logistic regression and receiver operating characteristic (ROC) curves were used to study the associations between cardiovascular health scores and subclinical coronary atherosclerosis.Odds ratios (ORs) for CCTA-stenosis and severe CCTA-stenosis between the lowest (<50 points) vs the highest (≥80 points) LE8 group were 4.18 (95% CI, 3.56 to 4.91) and 11.17 (95% CI, 8.36 to 14.93), respectively. For corresponding CAC results, ORs were 3.36 (95% CI, 2.84 to 3.98), 7.72 (95% CI, 6.03 to 9.89), and 14.94 (95% CI, 10.47 to 21.31) for CAC scores of 1 to 99, 100 to 399, and ≥400, respectively. Area under ROC curves for predicting any stenosis were 0.642 (95% CI, 0.635 to 0.649) and 0.631 (95% CI, 0.624 to 0.638, P<.001) for LE8 and LS7, respectively.Our data indicate that LE8 showed a strong, graded, and inverse association with CCTA-stenosis and CAC score. The capacity to predict CCTA-stenosis was comparable between LE8 and LS7, although LE8 had slightly higher prediction capacity of any stenosis. This study provides novel evidence that the LE8 score may be a useful tool for monitoring cardiovascular health.
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26.
  • Higueras-Fresnillo, Sara, et al. (författare)
  • Low prevalence of ideal cardiovascular health in the general Swedish population: Results from the Swedish CArdioPulmonary bioImage Study (SCAPIS)
  • 2023
  • Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 51:4, s. 527-530
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the current study was to examine the prevalence of ideal cardiovascular health (iCVH) in the general Swedish middle-aged population. To address this aim, we utilised data from the Swedish CArdioPulmonary bioImage Study (SCAPIS) which is a large Swedish population-based study (N=30,154) that combined comprehensive state-of-the-art imaging technology with clinical examinations and included all iCVH components. A total iCVH score was calculated as the number of iCVH metrics at an ideal level for the seven components and classified as: ideal (> 5 ideal components), intermediate (3-4 ideal components) and poor (<= 2 ideal components). Our results showed that only 18.2% of the population reached ideal status (i.e. > 5 components at the ideal level), whereas 51.9% were classified as intermediate status and 29.9% as poor status of iCVH. Women had a higher prevalence of iCVH status (23.9% vs. 12.0%) and a lower prevalence of poor iCVH status (23.5% vs. 36.8%). Our data may serve as benchmarks for future national and international comparisons and motivate efforts to promote cardiovascular health in the general population, given the strong link between iCVH with all-cause and cardiovascular disease mortality and morbidity.
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27.
  • Hildebrandt, Franziska, 1994-, et al. (författare)
  • scDual-Seq of Toxoplasma gondii-infected mouse BMDCs reveals heterogeneity and differential infection dynamics
  • 2023
  • Ingår i: Frontiers in Immunology. - : Frontiers Media S.A.. - 1664-3224. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • Dendritic cells and macrophages are integral parts of the innate immune system and gatekeepers against infection. The protozoan pathogen, Toxoplasma gondii, is known to hijack host immune cells and modulate their immune response, making it a compelling model to study host-pathogen interactions. Here we utilize single cell Dual RNA-seq to parse out heterogeneous transcription of mouse bone marrow-derived dendritic cells (BMDCs) infected with two distinct genotypes of T. gondii parasites, over multiple time points post infection. We show that the BMDCs elicit differential responses towards T. gondii infection and that the two parasite lineages distinctly manipulate subpopulations of infected BMDCs. Co-expression networks define host and parasite genes, with implications for modulation of host immunity. Integrative analysis validates previously established immune pathways and additionally, suggests novel candidate genes involved in host-pathogen interactions. Altogether, this study provides a comprehensive resource for characterizing host-pathogen interplay at high-resolution.
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28.
  • Holmgren Troy, Maria, 1962-, et al. (författare)
  • Making Home : Orphanhood, kinship and cultural memory in contemporary American novels
  • 2021. - 1st paperback
  • Bok (refereegranskat)abstract
    • Making home explores the orphan child as a trope in contemporary US fiction, arguing that in the times of perceived national crisis, concerns about American identity, family and literary history are articulated around this literary figure.The book focuses on orphan figures in a broad, multi-ethnic range of contemporary fiction by Barbara Kingsolver, Marilynne Robinson, Michael Cunningham, Jonathan Safran Foer, John Irving, Octavia Butler and Toni Morrison among others, and investigates genres as carriers of cultural memory, looking particularly at the captivity narrative, historical fiction, speculative fiction, the sentimental novel and the bildungsroman. From a decisively literary perspective, Making home engages socio-political concerns such as mixed-race families, child welfare, and racial and national identity, as well as shifting definitions of familial, national and literary home.By analysing how contemporary novels both incorporate and resist gendered and raced literary conventions, how they elaborate on symbolic and factual meanings of orphanhood, and how they explore kinship beyond the nuclear and/or adoptive family, this book offers something distinctly new in American literary studies. It is a crucial study for students and scholars interested in the links between literature and identity, questions of inclusion and exclusion in national ideology, and definitions of family and childhood.
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29.
  • Kinhult, Sara, et al. (författare)
  • Regional variation i användningen av TTF vid glioblastombehandling : [Regional variation in usage of TTF (Optune)]
  • 2023
  • Ingår i: Läkartidningen. - : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 120:120
  • Tidskriftsartikel (refereegranskat)abstract
    • The standard treatment of glioblastoma, an aggressive brain tumour, includes radiotherapy combined with temozolomide. Based on a randomised trial, showing five months increased survival, TTF has been introduced in the management of patients with good performance status. Data from the Swedish national quality registry for CNS tumours have been analysed for TTF usage. The results demonstrate that 65 percent of the patients accepted treatment with TTF. More than half of the treated patients interrupted treatment due to low compliance or their own wish. Median treatment time was 164 days, with a range from 0 to 774 days. There was a large variation between different regions in how many patients were offered TTF treatment. A non-significant trend to better survival was seen for the group of TTF-treated patients compared to individually matched controls. In summary, TTF is a new treatment for glioblastoma, with potential to prolong survival also in real world patients. Today, the treatment is not offered equally to all patients, despite national guidelines.
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30.
  • Kinhult, Sara, et al. (författare)
  • Regional variation i användningen av TTF vid glioblastombehandling
  • 2023
  • Ingår i: Lakartidningen. - 0023-7205. ; 120
  • Tidskriftsartikel (refereegranskat)abstract
    • The standard treatment of glioblastoma, an aggressive brain tumour, includes radiotherapy combined with temozolomide. Based on a randomised trial, showing five months increased survival, TTF has been introduced in the management of patients with good performance status. Data from the Swedish national quality registry for CNS tumours have been analysed for TTF usage. The results demonstrate that 65 percent of the patients accepted treatment with TTF. More than half of the treated patients interrupted treatment due to low compliance or their own wish. Median treatment time was 164 days, with a range from 0 to 774 days. There was a large variation between different regions in how many patients were offered TTF treatment. A non-significant trend to better survival was seen for the group of TTF-treated patients compared to individually matched controls. In summary, TTF is a new treatment for glioblastoma, with potential to prolong survival also in real world patients. Today, the treatment is not offered equally to all patients, despite national guidelines.
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31.
  • Kinhult, Sara, et al. (författare)
  • Regional variation in usage of TTF (Optune) Regional variation i användningen av TTF vid glioblastombehandling : [Regional variation in usage of TTF (Optune)]
  • 2023
  • Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 120
  • Tidskriftsartikel (refereegranskat)abstract
    • The standard treatment of glioblastoma, an aggressive brain tumour, includes radiotherapy combined with temozolomide. Based on a randomised trial, showing five months increased survival, TTF has been introduced in the management of patients with good performance status. Data from the Swedish national quality registry for CNS tumours have been analysed for TTF usage. The results demonstrate that 65 percent of the patients accepted treatment with TTF. More than half of the treated patients interrupted treatment due to low compliance or their own wish. Median treatment time was 164 days, with a range from 0 to 774 days. There was a large variation between different regions in how many patients were offered TTF treatment. A non-significant trend to better survival was seen for the group of TTF-treated patients compared to individually matched controls. In summary, TTF is a new treatment for glioblastoma, with potential to prolong survival also in real world patients. Today, the treatment is not offered equally to all patients, despite national guidelines.
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32.
  • Lundgren, Oskar, et al. (författare)
  • Hyperactivity in preschool age is associated with higher fat-free mass and healthy lifestyle behaviours five years later: A longitudinal study of Swedish children
  • 2023
  • Ingår i: Pediatric Obesity. - : WILEY. - 2047-6302 .- 2047-6310.
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThere is evidence for a link between hyperactivity and obesity, especially among older children. Both conditions seem to be multifactorial in origin and hypotheses of common underlying issues, such as emotional dysregulation, have been suggested. However, studies of the co-occurrence of the two conditions in younger age groups have been inconclusive.ObjectivesWe aimed to study the longitudinal associations of psychological strengths and difficulties at 4 years of age with health behaviours, body composition, physical fitness, and cardiovascular disease (CVD) risk factors 5 years later.MethodsParents of 226 4-year-old children filled out the Strengths and Difficulties Questionnaire (SDQ). At 9 years of age, we assessed health behaviours, physical fitness, body composition, and CVD risk factors. Associations were examined with linear regression models that were adjusted for sex, age of the child at 9, and maternal education.ResultsIn the adjusted models, hyperactivity at 4 was associated with higher fat-free mass (beta = 0.18, p = 0.007) and lower levels of sedentary behaviour (beta -0.14, p = 0.043) at 9 years. Furthermore, greater emotional problems at 4 were associated with lower intake of fruit and vegetables (beta -0.14, p = 0.038) at 9 years. However, there were no statistically significant associations between psychological difficulties and fat-mass index.ConclusionsOur novel data provide no evidence of an association between hyperactivity in preschool age and obesity or obesity-related behaviours in school age. Future studies examining how psychological factors relate to obesity development should consider a developmental perspective.
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33.
  • Magnusson, Maria, 1961-, et al. (författare)
  • ACCURACY OF CT NUMBERS OBTAINED BY DIRA AND MONOENERGETIC PLUS ALGORITHMS IN DUAL-ENERGY COMPUTED TOMOGRAPHY
  • 2021
  • Ingår i: Radiation Protection Dosimetry. - : Oxford University Press. - 0144-8420 .- 1742-3406. ; 195:3-4, s. 212-217
  • Tidskriftsartikel (refereegranskat)abstract
    • Dual-energy computed tomography (CT) can be used in radiotherapy treatment planning for the calculation of absorbed dose distributions. The aim of this work is to evaluate whether there is room for improvement in the accuracy of the Monoenergetic Plus algorithm by Siemens Healthineers. A Siemens SOMATOM Force scanner was used to scan a cylindrical polymethyl methacrylate phantom with four rod-inserts made of different materials. Images were reconstructed using ADMIRE and processed with Monoenergetic Plus. The resulting CT numbers were compared with tabulated values and values simulated by the proof-of-a-concept algorithm DIRA developed by the authors. Both the Monoenergetic Plus and DIRA algorithms performed well; the accuracy of attenuation coefficients was better than about ±1% at the energy of 70 keV. Compared with DIRA, the worse performance of Monoenergetic Plus was caused by its (i) two-material decomposition to iodine and water and (ii) imperfect suppression of the beam hardening artifact in ADMIRE.
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34.
  • Michelsen, Halldora Ögmundsdottir, et al. (författare)
  • Organizational and patient-level predictors for attaining key risk factor targets in cardiac rehabilitation after myocardial infarction: The Perfect-CR study.
  • 2023
  • Ingår i: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 371, s. 40-48
  • Tidskriftsartikel (refereegranskat)abstract
    • Benefits of cardiac rehabilitation (CR) programme components on attaining risk factor targets post-myocardial infarction (MI) and their predictive strength relative to patient characteristics remain unclear. We aimed to identify organizational and patient-level predictors of risk factor target attainment at one-year post-MI.In this observational study data on CR organization at 78 Swedish CR centres was collected and merged with patient-level registry data (n=7549). Orthogonal partial least squares discriminant analysis identified predictors (Variables of Importance for the Projection (VIP) values >0.8) of attaining low-density lipoprotein-cholesterol (LDL-C) <1.8mmol/L, blood pressure (BP) <140/90mmHg and smoking abstinence.The strongest predictors (VIP [95% CI]) for attaining LDL-C and BP targets were offering psychosocial management (2.14 [1.78-2.50]; 2.45 [1.91-2.99]), having a psychologist in the CR team (1.62 [1.36-1.87]; 2.05 [1.67-2.44]), extended opening hours (2.13 [2.00-2.27]; 1.50 [0.91-2.10]), adequate facilities (1.54 [0.91-2.18]; 1.89 [1.38-2.40]), and having a medical director (1.70 [0.91-2.48]; 1.46 [1.04-1.88]). The strongest patient-level predictors of attaining LDL-C and/or BP targets were low baseline LDL-C (3.95 [3.39-4.51]) and having no history of hypertension (2.93 [2.60-3.26]), respectively, followed by exercise-based CR participation (1.38 [0.66-2.10]; 1.46 [1.14-1.78]). For smoking abstinence, the strongest organizational predictor was varenicline being prescribed by CR physicians (1.88 [0.95-2.80]) and patient-level predictors were participation in exercise-based CR (2.47 [2.07-2.88]) and group education (1.92 [1.43-2-42]), and no cardiovascular disease history (2.13 [1.78-2.48]).We identified multiple CR organizational and patient-level predictors of attaining risk factor targets post-MI. These results may influence the future design of comprehensive CR programmes.
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35.
  • Mörtzell Henriksson, Monica, et al. (författare)
  • Analyses of registry data of patients with anti-GBM and antineutrophil cytoplasmatic antibody-associated (ANCA) vasculitis treated with or without therapeutic apheresis
  • 2021
  • Ingår i: Transfusion and Apheresis Science. - : Elsevier BV. - 1473-0502 .- 1878-1683. ; 60:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Therapeutic apheresis (TA) as a treatment for antibody-associated vasculitis (AAV) was questioned by the PEXIVAS although the MEPEX study favored TA. The aim of this study was to evaluate the efficacy of TA to improve renal function in patients consecutively included in the WAA-apheresis registry versus patients not treated with TA. Materials and methods: Included were 192 patients that suffered from anti-glomerular basement membrane disease (anti-GBM, n = 28) and antineutrophil cytoplasmic antibody-associated vasculitis of MPO or PR3 origin. Of these 119 had performed TA and the other 73 had not performed TA for theses diagnoses (CTRL). Results: Elderly had an increased risk to die within 12 months (p = 0.002). All 28 anti-GBM had renal involvement, 21 dialysis dependent. At 3 month nine (36 %) did not need dialysis. Baseline data regarding renal function of AAV patients, subtype MPO and PR3, were worse in the TA groups than in CTRL. Recovery out of dialysis was better for the PR3-TA group compared with 1) the controls of MEPEX (RR 0.59, CI 0.43−0.80) and 2) the MPO-TA patients (RR 0.28, CI 0.12−0.68). The MPO-TA recovered similarly as the MEPEX-CTRL. Renal function improved most for TA-patients from baseline during the first 3 months (MPO-TA and PR3-TA) and stabilized thereafter and less for MPO-CTRL and PR3-CTRL. Conclusion: PR3-TA patients seem to have best chances to get out of dialysis. PR3-TA and MPO-TA improved residual renal function better than CTRL. The present study recommends reconsiderations to use TA for AAV especially those with PR3-vasculitis with severe renal vasculitis.
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36.
  • Planting-Bergloo, Sara, 1978-, et al. (författare)
  • Att utveckla elevers förmåga att formulera undersökningsbara frågor i naturvetenskap : Mangling av en didaktisk modell
  • 2021
  • Ingår i: LUMAT. - : LUMA Centre Finland. - 2323-7112. ; 9:1, s. 774-803
  • Tidskriftsartikel (refereegranskat)abstract
    • En viktig målsättning för naturvetenskaplig undervisning är att utveckla förmågan att formulera undersökningsbara frågor. Syftet med den här studien är att undersöka hur undervisning som utformats med hjälp av metoden Question Formulation Technique (QFT) kan stödja utveckling av elevers förmåga att formulera naturvetenskapligt undersökningsbara frågor.  QFT är en modell för att utveckla elevers förmåga att formulera och värdera sina egna frågor i allmänhet. I studien prövas QFT i en svensk skolkontext och inom ramen för naturvetenskaplig undervisning. Studien genomfördes som en interventionsstudie i gymnasieskolan och inom ramen för kursen Gymnasiearbete. I kursen ska eleverna genomföra en egen naturvetenskaplig undersökning. QFT användes för att utforma undervisning som del av introduktionen till kursen. Data består av videoinspelningar av elevsamtal från undervisning som har analyserats utifrån ett pragmatiskt ramverk med organiserande syften och praktisk epistemologisk analys. Resultaten visar vilka närliggande syften som etableras i elevernas samtal om undersökningsbara frågor i undervisningen: (A) att producera så många frågor som möjligt, (B) att bedöma vilka frågor som är mest relevanta, (C) att kategorisera frågor, (D) att hitta och specificera ett undersökningsobjekt och (E) att planera för att genomföra en undersökning. Slutsatsen är att QFT kan fungera som stöd för lärares planering av undervisning om naturvetenskapligt undersökningsbara frågor under förutsättning att läraren aktivt stödjer eleverna i att uppmärksamma centrala kvaliteter avseende undersökningsbarhet och genom att binda samman närliggande syften med det övergripande syftet. 
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37.
  • Ruiz-Pérez, María Victoria, et al. (författare)
  • Inhibition of fatty acid synthesis induces differentiation and reduces tumor burden in childhood neuroblastoma
  • 2021
  • Ingår i: iScience. - : Elsevier BV. - 2589-0042. ; 24:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Many metabolic pathways, including lipid metabolism, are rewired in tumors to support energy and biomass production and to allow adaptation to stressful environments. Neuroblastoma is the second deadliest solid tumor in children. Genetic aberrations, as the amplification of the MYCN-oncogene, correlate strongly with disease progression. Yet, there are only a few molecular targets successfully exploited in the clinic. Here we show that inhibition of fatty acid synthesis led to increased neural differentiation and reduced tumor burden in neuroblastoma xenograft experiments independently of MYCN-status. This was accompanied by reduced levels of the MYCN or c-MYC oncoproteins and activation of ERK signaling. Importantly, the expression levels of genes involved in de novo fatty acid synthesis showed prognostic value for neuroblastoma patients. Our findings demonstrate that inhibition of de novo fatty acid synthesis is a promising pharmacological intervention strategy for the treatment of neuroblastoma independently of MYCN-status.
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38.
  • Sainero-Alcolado, Lourdes, et al. (författare)
  • Targeting MYC induces lipid droplet accumulation by upregulation of HILPDA in clear cell renal cell carcinoma
  • 2024
  • Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : Proceedings of the National Academy of Sciences (PNAS). - 1091-6490 .- 0027-8424. ; 121:7, s. 2310479121-2310479121
  • Tidskriftsartikel (refereegranskat)abstract
    • Metabolic reprogramming is critical during clear cell renal cell carcinoma (ccRCC) tumorigenesis, manifested by accumulation of lipid droplets (LDs), organelles that have emerged as new hallmarks of cancer. Yet, regulation of their biogenesis is still poorly understood. Here, we demonstrate that MYC inhibition in ccRCC cells lacking the von Hippel Lindau (VHL) gene leads to increased triglyceride content potentiating LD formation in a glutamine-dependent manner. Importantly, the concurrent inhibition of MYC signaling and glutamine metabolism prevented LD accumulation and reduced tumor burden in vivo. Furthermore, we identified the hypoxia-inducible lipid droplet-associated protein (HILPDA) as the key driver for induction of MYC-driven LD accumulation and demonstrated that conversely, proliferation, LD formation, and tumor growth are impaired upon its downregulation. Finally, analysis of ccRCC tissue as well as healthy renal control samples postulated HILPDA as a specific ccRCC biomarker. Together, these results provide an attractive approach for development of alternative therapeutic interventions for the treatment of this type of renal cancer.
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39.
  • Sandborg, Johanna, et al. (författare)
  • Effectiveness of a Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms) : Randomized Controlled Trial
  • 2021
  • Ingår i: JMIR mhealth and uhealth. - : JMIR Publications Inc. - 2291-5222. ; 9:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Excessive gestational weight gain (GWG) during pregnancy is a major public health concern associated with negative health outcomes for both mother and child. Scalable interventions are needed, and digital interventions have the potential to reach many women and promote healthy GWG. Most previous studies of digital interventions have been small pilot studies or have not included women from all BMI categories. We therefore examined the effectiveness of a smartphone app in a large sample (n=305) covering all BMI categories. Objective: To investigate the effectiveness of a 6-month intervention (the HealthyMoms app) on GWG, body fatness, dietary habits, moderate-to-vigorous physical activity (MVPA), glycemia, and insulin resistance in comparison to standard maternity care. Methods: A 2-arm parallel randomized controlled trial was conducted. Women in early pregnancy at maternity clinics in Ostergotland, Sweden, were recruited. Eligible women who provided written informed consent completed baseline measures, before being randomized in a 1:1 ratio to either an intervention (n=152) or control group (n=153). The control group received standard maternity care while the intervention group received the HealthyMoms smartphone app for 6 months (which includes multiple features, eg, information; push notifications; self-monitoring; and feedback features for GWG, diet, and physical activity) in addition to standard care. Outcome measures were assessed at Linkoping University Hospital at baseline (mean 13.9 [SD 0.7] gestational weeks) and follow-up (mean 36.4 [SD 0.4] gestational weeks). The primary outcome was GWG and secondary outcomes were body fatness (Bod Pod), dietary habits (Swedish Healthy Eating Index) using the web-based 3-day dietary record Riksmaten FLEX, MVPA using the ActiGraph wGT3x-BT accelerometer, glycemia, and insulin resistance. Results: Overall, we found no statistically significant effect on GWG (P=.62); however, the data indicate that the effect of the intervention differed by pre-pregnancy BMI, as women with overweight and obesity before pregnancy gained less weight in the intervention group as compared with the control group in the imputed analyses (-1.33 kg; 95% CI -2.92 to 0.26; P=.10) and completers-only analyses (-1.67 kg; 95% CI -3.26 to -0.09; P=.031]). Bayesian analyses showed that there was a 99% probability of any intervention effect on GWG among women with overweight and obesity, and an 81% probability that this effect was over 1 kg. The intervention group had higher scores for the Swedish Healthy Eating Index at follow-up than the control group (0.27; 95% CI 0.05-0.50; P=.017). We observed no statistically significant differences in body fatness, MVPA, glycemia, and insulin resistance between the intervention and control group at follow up (P=.21). Conclusions: Although we found no overall effect on GWG, our results demonstrate the potential of a smartphone app (HealthyMoms) to promote healthy dietary behaviors as well as to decrease weight gain during pregnancy in women with overweight and obesity.
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40.
  • Vegunta, Vijaya Lakshmi, et al. (författare)
  • Addition of Green and Black Liquor in Kraft Pulping of Eucalyptus dunnii wood : Possible Solutions for the Problems with Kraft Pulping Caused by High Calcium Content.
  • 2023
  • Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
    • Samples of Eucalyptus dunnii with high calcium content have less good pulping properties regarding delignification and polysaccharide degradation, as it was shown by us earlier. In this work, we tested the addition of black liquor and green liquor to the Eucalyptus dunnii chips before kraft pulping, Specific improvements were obtained with both liquors, but the most substantial effect was observed with the green liquor, where even wood with the highest calcium content was pulped with a good result. Delignification was faster, and viscosity losses (degree of polymerization of cellulose) were higher for samples treated with green liquor prior to kraft pulping. Bleaching experiments showed that the bleachability of the green liquor-treated pulp was virtually the same as for a control pulp and that the higher viscosity of the bleached pulp was maintained. Possible chemical explanations for the results obtained are discussed.
  •  
41.
  • Wall, Alexander, et al. (författare)
  • Exercise and health-related quality of life and work-related outcomes in primary care patients with anxiety disorders - A randomized controlled study
  • 2024
  • Ingår i: JOURNAL OF AFFECTIVE DISORDERS. - 0165-0327 .- 1573-2517. ; 360, s. 5-14
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Exercise interventions show promise in the treatment of anxiety disorders, but effects on healthrelated quality of life (HR-QoL), work ability, and sick leave are little studied. We investigated these outcomes in a 12-week randomized controlled trial with a 1-year follow-up. Methods: Patients aged 18-65 (n = 222) with anxiety disorders from primary care centers in Gothenburg were randomized to a control group or one of two 12-week exercise intervention groups (low-intensity, [LI] and moderate/high-intensity, [HI]); 148 were evaluated at 12-weeks and 113 completed the 1-year follow-up. The EuroQol 5D (EQ5D; index and the visual analogue scale [VAS]), work ability score (WAS), presenteeism, and selfreported sick leave were assessed at baseline, 12 weeks, and 1 year. Improvements were defined by binary cutoffs for each scale. Binary logistic regression with odds ratios (OR) and 95 % confidence intervals (CI) were reported. Results: There were improved scores for EQ5D and WAS in the HI group compared to controls after 12 weeks (EQ5D index: 4.74 [1.91-11.7], EQ5D-VAS 4.00, [1.65-9.72], WAS 3.41 [1.24-7.37]) and 1 year (EQ5D index: 3.05 [1.05-8.81], EQ5D-VAS 3.20 [1.16-8.84], WAS 5.50 [1.85-16.3]). Post-hoc analysis showed higher ORs in participants on antidepressants (n = 75) (12-week EQ5D index: OR 9.95 [2.85-34.8]) and significant improvements in EQ5D scores for both intervention groups after 1 year. There were no between-group differences for presenteeism or sick leave. Limitations: Discontinuation was high, mostly early after randomization (n = 74), as is common for anxiety interventions. Conclusions: HI Exercise improves HR-QoL and work ability in anxiety patients, especially when combined with antidepressants.
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42.
  • Wannberg, Johan, et al. (författare)
  • N-(Heteroaryl)thiophene sulfonamides as angiotensin AT2 receptor ligands
  • 2024
  • Ingår i: European Journal of Medicinal Chemistry. - : Elsevier. - 0223-5234 .- 1768-3254. ; 265
  • Tidskriftsartikel (refereegranskat)abstract
    • Two series of N-(heteroaryl)thiophene sulfonamides, encompassing either a methylene imidazole group or a tertbutylimidazolylacetyl group in the meta position of the benzene ring, have been synthesized. An AT(2)R selective ligand with a Ki of 42 nM was identified in the first series and in the second series, six AT(2)R selective ligands with significantly improved binding affinities and Ki values of <5 nM were discovered. The binding modes to AT(2)R were explored by docking calculations combined with molecular dynamics simulations. Although some of the high affinity ligands exhibited fair stability in human liver microsomes, comparable to that observed with C21 undergoing clinical trials, most ligands displayed a very low metabolic stability with t(1/2) of less than 10 min in human liver microsomes. The most promising ligand, with an AT(2)R K-i value of 4.9 nM and with intermediate stability in human hepatocytes (t(1/2) = 77 min) caused a concentration-dependent vasorelaxation of pre-contracted mouse aorta.
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43.
  • Witzell, Jacob, 1981- (författare)
  • Approaching transformative futures : Discourse and practice in Swedish national transport policy and planning
  • 2021
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis concerns the need to transform the transport system to meet climate mitigation objectives. It provides insights into how specific approaches and practices in transport policy and planning affect prospects for transformation. It focuses on specific practices and knowledge perspectives in policy and planning, exploration of future uncertainty, and the scope and agency attributed to planning for influencing the future development of the transport system. The empirical interest is directed towards contemporary Swedish national transport policy and planning, analyzed in four articles: organization and procurement of physical planning of road and rail investments (Article 1), an emerging discursive framing of digitalized, 'smart' accessibility (Article 2), the approach to future uncertainty in the national investment plan for transport infrastructure 2018-2029 (Article 3), and an inter-agency collaboration on a plan for a fossil-free transformation of the transport system (Article 4).The thesis follows a qualitative research approach based on a social constructivist and poststructuralist understanding of knowledge as socially constructed and sustained. To highlight the influence of practice and knowledge perspectives on understandings of the future development of the transport system and conditions for transformation, a Foucauldian discursive approach is applied. This approach emphasizes reciprocal dependency between discourse and practice.Results make evident that Swedish national transport planning and policy is largely characterized by a ‘conventional’ approach with dominant quantitative practices and knowledge perspectives, through which the future is mainly portrayed as a continuation of the historical development. The studies show that this approach strongly influence how the transport system and prospects for transformation are understood and described. The thesis illustrates tendencies to avoid issues of future uncertainty, and how this is taken as an argument for not exploring alternative development directions. Consequently, opportunities to influence future development are portrayed as limited. This has a restrictive effect on the conditions for transformation. However, the thesis also shows contexts where future uncertainty is considered as a basic planning condition, which justifies exploration of opportunities for transformation by broader practices and knowledge perspectives.Overall, the thesis makes visible ways in which specific practices and knowledge perspectives exert significant influence over which choices regarding future pathways that are presented to the public and decision makers. A central conclusion regards a need for a more politically oriented discussion on what knowledge and practices in transport policy and practice that are relevant and fit for purpose in the light of the climate mitigation challenge as well as other societal objectives.
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44.
  • Witzell, Jacob, 1981-, et al. (författare)
  • Transformative capacity for climate mitigation in strategic transport planning–principles and practices in cross-sectoral collaboration
  • 2022
  • Ingår i: Journal of Environmental Policy and Planning. - : Informa UK Limited. - 1523-908X .- 1522-7200.
  • Tidskriftsartikel (refereegranskat)abstract
    • This article presents findings from a qualitative in-depth analysis of a four-year Swedish national policy initiative where six public agencies were commissioned to produce a strategic plan for a transition towards a fossil-free transport sector. The aim of the article is to provide empirically grounded insights on principles and practices of importance for building transformative capacity in strategic, long-term transport planning. In the analysis, the concepts stewarding, unlocking, transforming and orchestrating are applied to explore and discuss transformative features of the policy initiative. Altogether, several elements of transformative capacity were developed through the process. Of specific importance was the establishment of an open and explorative approach to carrying out the commission, and ways in which the organizations involved started to challenge dominant perspectives and analytical practices in conventional transport planning. Shared principles and practices for analysis and assessment were developed, which allowed for a broadened consideration of climate mitigation measures. However, due to a lack of coordination with formalized planning settings and a lack of political decisions to sustain the commission, there are yet no signs of the work influencing conventional transport planning. Even so, gained experience and insights from this case can inform future change-oriented initiatives. 
  •  
45.
  • Ögmundsdottir Michelsen, Halldora, et al. (författare)
  • Cardiac rehabilitation after acute myocardial infarction in Sweden : evaluation of programme characteristics and adherence to European guidelines: The Perfect Cardiac Rehabilitation (Perfect-CR) study
  • 2020
  • Ingår i: European Journal of Preventive Cardiology. - : Oxford University Press (OUP). - 2047-4873 .- 2047-4881. ; 27:1, s. 18-27
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: While patient performance after participating in cardiac rehabilitation programmes after acute myocardial infarction is regularly reported through registry and survey data, information on cardiac rehabilitation programme characteristics is less well described.AIM: The aim of this study was to evaluate Swedish cardiac rehabilitation programme characteristics and adherence to European Guidelines on Cardiovascular Disease Prevention.METHOD: Cardiac rehabilitation programme characteristics at all 78 cardiac rehabilitation centres in Sweden in 2016 were surveyed using a web-based questionnaire (100% response rate). The questions were based on core components of cardiac rehabilitation as recommended by European Guidelines.RESULTS: There was a wide variation in programme duration (2-14 months). All programmes reported offering an individual post-discharge visit with a nurse, and 90% (n = 70) did so within three weeks from discharge. Most programmes offered centre-based exercise training (n = 76, 97%) and group educational sessions (n = 61, 78%). All programmes reported to the national audit, SWEDEHEART, and 60% (n = 47) reported that performance was regularly assessed using audit data, to improve quality of care. Ninety-six per cent (n = 75) had a core team consisting of a cardiologist, a physiotherapist and a nurse and 76% (n = 59) reported having a medical director. Having other allied healthcare professionals included in the cardiac rehabilitation team varied. Forty per cent (n = 31) reported having regular team meetings where nurses, physiotherapists and cardiologist could discuss patient cases.CONCLUSION: The overall quality of cardiac rehabilitation programmes provided in Sweden is high. Still, there are several areas of potential improvement. Monitoring programme characteristics as well as patient outcomes might improve programme quality and patient outcomes both at a local and a national level.
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