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1.	Bardel, Annika, 1952-, et al. (författare) Age and sex related self-reported symptoms in a general population across 30 years: Patterns of reporting and secular trend 2019 Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 14:2 Tidskriftsartikel (refereegranskat)abstract Objective :To study age and sex specific prevalence of 30 symptoms in random samples from the general population and to analyze possible secular trends across time. Study population: The study was based on data from eight on-going Swedish cohort studies, with baseline investigations performed between 1973 and 2003. Samples were drawn from the general population of the cities of Gothenburg and Eskilstuna, and of Uppsala County. Overall, 20,160 subjects were sampled, 14,470 (71.8%) responded, of whom 12.000 were unique subjects, and 2548 were part of more than one sample. Methods: The Complaint score sub-scale of the Gothenburg Quality of Life instrument, listing 30 general symptoms was used. Responders were asked to indicate which symptoms they had experienced during the last three months. Results: Women reported on average 7.8 symptoms, and men 5.3 (p<0.0001). Women reported higher prevalence than men for 24 of the 30 symptoms. In multivariate analyses four patterns of prevalence across age were identified in both men and women; increasing prevalence, decreasing, stable and biphasic prevalence. The symptoms in the various pattern groups differed somewhat between men and women. However, symptoms related to strain were prominent among symptoms decreasing with age. Moreover, there were secular trends. Across all symptoms reporting prevalence increased over time in men (p<0.001) as well as in women (p<0.0001). Conclusions: Women reported higher total symptom prevalence than men. Symptoms related to health generally increased with age, while symptoms related to stress decreased markedly. Significant secular trends across time regarding symptom prevalence were found. © 2019 Bardel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
2.	Dewi, Nikmah Utami, et al. (författare) Anthropometry and the risk of lung cancer in EPIC 2016 Ingår i: American Journal of Epidemiology. - : Oxford University Press (OUP). - 0002-9262 .- 1476-6256. ; 184:2, s. 129-139 Tidskriftsartikel (refereegranskat)abstract The associations of body mass index (BMI) and other anthropometric measurements with lung cancer were examined in 348,108 participants in the European Investigation Into Cancer and Nutrition (EPIC) between 1992 and 2010. The study population included 2,400 case patients with incident lung cancer, and the average length of follow-up was 11 years. Hazard ratios were calculated using Cox proportional hazard models in which we modeled smoking variables with cubic splines. Overall, there was a significant inverse association between BMI (weight (kg)/height (m)2) and the risk of lung cancer after adjustment for smoking and other confounders (for BMI of 30.0-34.9 versus 18.5-25.0, hazard ratio = 0.72, 95% confidence interval: 0.62, 0.84). The strength of the association declined with increasing follow-up time. Conversely, after adjustment for BMI, waist circumference and waist-to-height ratio were significantly positively associated with lung cancer risk (for the highest category of waist circumference vs. the lowest, hazard ratio = 1.25, 95% confidence interval: 1.05, 1.50). Given the decline of the inverse association between BMI and lung cancer over time, the association is likely at least partly due to weight loss resulting from preclinical lung cancer that was present at baseline. Residual confounding by smoking could also have influenced our findings.
3.	Fanidi, Anouar, et al. (författare) Circulating vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort 2016 Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6 Tidskriftsartikel (refereegranskat)abstract Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747 participants with blood samples between 1992 and 2000. This analysis includes 497 case-control pairs of the head and neck and oesophagus, as well as 443 additional controls. Circulating 25(OH)D3 were measured in pre-diagnostic samples and evaluated in relation to HNC and oesophagus cancer risk and post-diagnosis all-cause mortality. After controlling for risk factors, a doubling of 25(OH)D3 was associated with 30% lower odds of HNC (OR 0.70, 95% confidence interval [95% CI] 0.56-0.88, Ptrend = 0.001). Subsequent analyses by anatomical sub-site indicated clear inverse associations with risk of larynx and hypopharynx cancer combined (OR 0.55, 95CI% 0.39-0.78) and oral cavity cancer (OR 0.60, 95CI% 0.42-0.87). Low 25(OH)D3 concentrations were also associated with higher risk of death from any cause among HNC cases. No clear association was seen with risk or survival for oesophageal cancer. Study participants with elevated circulating concentrations of 25(OH)D3 had decreased risk of HNC, as well as improved survival following diagnosis.
4.	Fredén, Annika, et al. (författare) Skäl att rösta strategiskt i riksdagsval 2015 Ingår i: Fragment: SOM-undersökningen 2014. - Göteborg : University of Gothenburg. - 0284-4788. - 9789189673328 ; 63, s. 377-386 Bokkapitel (refereegranskat)
5.	Guida, Florence, et al. (författare) Assessment of Lung Cancer Risk on the Basis of a Biomarker Panel of Circulating Proteins 2018 Ingår i: JAMA Oncology. - : American Medical Association (AMA). - 2374-2437 .- 2374-2445. ; 4:10 Tidskriftsartikel (refereegranskat)abstract Importance There is an urgent need to improve lung cancer risk assessment because current screening criteria miss a large proportion of cases.Objective To investigate whether a lung cancer risk prediction model based on a panel of selected circulating protein biomarkers can outperform a traditional risk prediction model and current US screening criteria.Design, Setting, and Participants Prediagnostic samples from 108 ever-smoking patients with lung cancer diagnosed within 1 year after blood collection and samples from 216 smoking-matched controls from the Carotene and Retinol Efficacy Trial (CARET) cohort were used to develop a biomarker risk score based on 4 proteins (cancer antigen 125 [CA125], carcinoembryonic antigen [CEA], cytokeratin-19 fragment [CYFRA 21-1], and the precursor form of surfactant protein B [Pro-SFTPB]). The biomarker score was subsequently validated blindly using absolute risk estimates among 63 ever-smoking patients with lung cancer diagnosed within 1 year after blood collection and 90 matched controls from 2 large European population-based cohorts, the European Prospective Investigation into Cancer and Nutrition (EPIC) and the Northern Sweden Health and Disease Study (NSHDS).Main Outcomes and Measures Model validity in discriminating between future lung cancer cases and controls. Discrimination estimates were weighted to reflect the background populations of EPIC and NSHDS validation studies (area under the receiver-operating characteristics curve [AUC], sensitivity, and specificity).Results In the validation study of 63 ever-smoking patients with lung cancer and 90 matched controls (mean [SD] age, 57.7 [8.7] years; 68.6% men) from EPIC and NSHDS, an integrated risk prediction model that combined smoking exposure with the biomarker score yielded an AUC of 0.83 (95% CI, 0.76-0.90) compared with 0.73 (95% CI, 0.64-0.82) for a model based on smoking exposure alone (P = .003 for difference in AUC). At an overall specificity of 0.83, based on the US Preventive Services Task Force screening criteria, the sensitivity of the integrated risk prediction (biomarker) model was 0.63 compared with 0.43 for the smoking model. Conversely, at an overall sensitivity of 0.42, based on the US Preventive Services Task Force screening criteria, the integrated risk prediction model yielded a specificity of 0.95 compared with 0.86 for the smoking model.Conclusions and Relevance This study provided a proof of principle in showing that a panel of circulating protein biomarkers may improve lung cancer risk assessment and may be used to define eligibility for computed tomography screening.
6.	Ivarsson, Anneli, et al. (författare) Healing the health system after civil unrest 2015 Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 8:1, s. 1-4 Tidskriftsartikel (refereegranskat)
7.	Johansson, Henrik J., et al. (författare) Extracellular nanovesicles released from the commensal yeast Malassezia sympodialis are enriched in allergens and interact with cells in human skin 2018 Ingår i: Scientific Reports. - : NATURE PUBLISHING GROUP. - 2045-2322. ; 8 Tidskriftsartikel (refereegranskat)abstract Malassezia sympodialis is a dominant commensal fungi in the human skin mycobiome but is also associated with common skin disorders including atopic eczema (AE). M. sympodialis releases extracellular vesicles, designated MalaEx, which are carriers of small RNAs and allergens, and they can induce inflammatory cytokine responses. Here we explored how MalaEx are involved in hostmicrobe interactions by comparing protein content of MalaEx with that of the parental yeast cells, and by investigating interactions of MalaEx with cells in the skin. Cryo-electron tomography revealed a heterogeneous population of MalaEx. iTRAQ based quantitative proteomics identified in total 2439 proteins in all replicates of which 110 were enriched in MalaEx compared to the yeast cells. Among the MalaEx enriched proteins were two of the M. sympodialis allergens, Mala s 1 and s 7. Functional experiments indicated an active binding and internalization of MalaEx into human keratinocytes and monocytes, and MalaEx were found in close proximity of the nuclei using super-resolution fluorescence 3D-SIM imaging. Our results provides new insights into host-microbe interactions, supporting that MalaEx may have a role in the sensitization and maintenance of inflammation in AE by containing enriched amounts of allergens and with their ability to interact with skin cells.
8.	Mårald, Erland, 1970-, et al. (författare) Forest governance and management across time : developing a new forest social contract 2017 Bok (refereegranskat)abstract The influence of the past, and of the future on current-time tradeoffs in the forest arena are particularly relevant given the long-term successions in forest landscapes and the hundred years' rotations in forestry. Historically established path dependencies and conflicts determine our present situation and delimit what is possible to achieve. Similarly, future trends and desires have a large influence on decision making. Nevertheless, decisions about forest governance and management are always made in the present – in the present-time appraisal of the developed situation, future alternatives and in negotiation between different perspectives, interests, and actors.This book explores historic and future outlooks as well as current tradeoffs and methods in forest governance and management. It emphasizes the generality and complexity with empirical data from Sweden and internationally. It first investigates, from a historical perspective, how previous forest policies and discourses have influenced current forest governance and management. Second, it considers methods to explore alternative forest futures and how the results from such investigations may influence the present. Third, it examines current methods of balancing tradeoffs in decision-making among ecosystem services. Based on the findings the authors develop an integrated approach – Reflexive Forestry – to support exchange of knowledge and understandings to enable capacity building and the establishment of common ground. Such societal agreements, or what the authors elaborate as forest social contracts, are sets of relational commitment between involved actors that may generate mutual action and a common directionality to meet contemporary challenges.
9.	Ward, Heather A., et al. (författare) Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition 2017 Ingår i: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. - : AMER ASSOC CANCER RESEARCH. - 1538-7755 .- 1055-9965. ; 26:6, s. 895-904 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer (HNC). However, most studies have used self-reported anthropometry which is prone to error.METHODS: Among 363 094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of HNC. HNC risk was examined in relation to body mass index (BMI) [lean: < 22.5 kg/m2, normal weight (reference): 22.5-24.9 kg/m2, overweight 25-29.9 kg/m2, obese: > 30 kg/m2], waist circumference (WC), hip circumference (HC) and waist to hip ratio (WHR) using Cox proportional hazards models.RESULTS: Among men, a BMI < 22.5 kg/m2 was associated with higher HNC risk [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.23 - 2.12)]; BMI was not associated with HNC among women. WC and WHR were associated with greater risk of HNC among women, (WC per 5 cm: HR 1.08, 95% CI 1.02 - 1.15; WHR per 0.1 unit: HR 1.64, 95% CI 1.38 - 1.93). After stratification by smoking status, the association for WHR was present only among smokers (p interaction 0.004). Among men, WC and WHR were associated with HNC only upon additional adjustment for BMI (WC per 5 cm: HR 1.16, 95% CI 1.07 - 1.26; WHR per 0.1 unit: HR 1.42, 95% CI 1.21 - 1.65).CONCLUSION: Central adiposity, particularly among women, may have a stronger association with HNC risk than previously estimated.IMPACT: Strategies to reduce obesity may beneficially impact HNC incidence.
10.	Adman, Per, et al. (författare) 171 forskare: ”Vi vuxna bör också klimatprotestera” 2019 Ingår i: Dagens nyheter (DN debatt). - Stockholm. - 1101-2447. Tidskriftsartikel (populärvet., debatt m.m.)abstract DN DEBATT 26/9. Vuxna bör följa uppmaningen från ungdomarna i Fridays for future-rörelsen och protestera eftersom det politiska ledarskapet är otillräckligt. Omfattande och långvariga påtryckningar från hela samhället behövs för att få de politiskt ansvariga att utöva det ledarskap som klimatkrisen kräver, skriver 171 forskare i samhällsvetenskap och humaniora.
11.	Alenius Dahlqvist, Jenny, 1972-, et al. (författare) Pacemaker treatment after Fontan surgery-A Swedish national study 2019 Ingår i: Congenital Heart Disease. - : Computers, Materials and Continua (Tech Science Press). - 1747-079X .- 1747-0803. ; 14:4, s. 582-589 Tidskriftsartikel (refereegranskat)abstract ObjectiveFontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indications in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden. MethodsWe retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n=599). ResultsAfter a mean follow-up of 12.2years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total cavopulmonary connection had a significantly lower prevalence of pacemaker implantation (6%) than patients with lateral tunnel (LT; 17%). Mortality did not differ between patients with (8%) and without pacemaker (5%). The most common pacemaker indication was sinus node dysfunction (SND) (64%). Pacemaker implantation due to SND was less common among patients with EC. Pacemaker implantation was significantly more common in patients with mitral atresia (MA; 44%), double outlet right ventricle (DORV; 24%) and double inlet left ventricle (DILV; 20%). In contrast, patients with pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome were significantly less likely to receive a pacemaker (3% and 6%, respectively). ConclusionsThirteen percent of Fontan patients received a permanent pacemaker, most frequently due to SND. EC was associated with a significantly lower prevalence of pacemaker than LT. Permanent pacemaker was more common in patients with MA, DORV, and DILV.
12.	Andersson, Staffan, et al. (författare) Effect of storage time and temperature on stability of bioactive compounds in aseptically packed beverages prepared from rose hips and sea buckthorn berries 2015 Ingår i: Agricultural and Food Science. - 1795-1895 .- 1459-6067. ; 24:4, s. 273-288 Tidskriftsartikel (refereegranskat)abstract Rose hips and sea buckthorn berries contain high amounts of beneficial bioactive compounds. In this study the content and stability of natural vitamins and antioxidants were investigated in two fruit beverages made from rose hip powder, sea buckthorn berry puree and white grape juice concentrate, and wheat germ oil in one of the beverages. Beverages were formulated, pasteurised and filled aseptically in Tetra Brik packages and stored up to 35 days at 4 degrees C or 22 degrees C. Samples were analysed for the content of ascorbic acid, carotenoids, major phenolics, tocochromanols, total phenols and total antioxidant capacity as ferric reducing ability. The largest changes occurred during the first 5 days of storage, thereafter mainly ascorbic acid decreased. In the wheat germ oil supplemented beverage, alpha-tocopherol was more rapidly degraded. Negative correlations between the decrease of some carotenoids and tocochromanols, and the increase of some phenolics, suggest relationships of redox reactions specific to the amount of oil supplemented. From the present study we can conclude that additions of oil to beverages should be carefully selected to avoid oxidations of bioactive compounds. Furthermore, packaging of the beverages should be carried out at higher temperatures and thereafter it should be stored at low temperatures (4 degrees C), which decreased oxidation of all bioactive compounds except ascorbic acid.
13.	Andersson, Åsa, et al. (författare) Översyn av förordning om miljökvalitetsnormer för fisk- och musselvatten : Redovisning av regeringsuppdrag med Havs- och vattenmyndighetens analys av normerna och förslag till ändrad lagstiftning 2016 Rapport (övrigt vetenskapligt/konstnärligt)abstract Regeringen gav genom ett beslut den 22 oktober 2015 Havs- och vattenmyndigheten i uppdrag att göra en översyn av förordningen (2001:554) om miljökvalitetsnormer för fisk- och musselvatten (fisk- och musselvattenförordningen). Behovet av att göra denna översyn har framförts av Havs- och vattenmyndigheten, Naturvårdsverket och Länsstyrelsen i Västra Götalands län. I rapporten görs en översyn av miljökvalitetsnormerna i förordningen (2001:554) om miljökvalitetsnormer för fisk- och musselvatten och en bedömning av om det finns normer som bör ändras, tas bort eller om samma skyddsnivå kan uppnås på annat sätt. Havs- och vattenmyndigheten föreslår att fisk- och musselvattenförordningen upphävs. Som en följd av detta behöver ett antal föreskrifter upphävas eller ändras. Därutöver behöver viss vägledning tas fram för att täcka återstående skyddsbehov.Det är svårt att få en överblick av i vilken utsträckning fisk- och musselvattenförordningen har påverkat den övervakning som bedrivs och hur mycket övervakning som bedrivs enbart utifrån förordningens krav. Havs- och vattenmyndighetens bedömning är dock att ett upphävande av förordningen inte kommer att påverka den övervakning som utförs på ett betydande sätt. Konsekvensutredningen visar att fisk- och musselvattenförordningen kan upphävas och att detta medför i huvudsak positiva effekter för såväl miljön som berörda myndigheter och verksamhetsutövare.
14.	Annika, Johansson, et al. (författare) Obstetric brachial plexus palsy - A prospective, population-based study of incidence, recovery and long-term residual impairment at 10 to 12 years of age. 2019 Ingår i: European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. - : Elsevier BV. - 1532-2130. ; 23:1, s. 87-93 Tidskriftsartikel (refereegranskat)abstract To assess the long-term outcome and evaluate prognostic factors in obstetric brachial plexus palsy (OBPP).Of all 114 children with OBPP born in western Sweden in 1999-2001, 98 (61 males, 37 females) were invited to participate. A questionnaire on the symptoms of the OBPP was sent out and those with persisting symptoms were examined in terms of muscle strength, range of motion (ROM), activities of daily living (ADL), pain and sensibility at the age of 10-12years. Contact was made by 87 children.The incidence of persisting OBPP at 10-12 years of age was calculated as 19 per 38,749 live births or 0.49 per 1000. Symptoms were reduced muscle strength and ROM in the arm. Eight children reported pain, four had impaired sensibility and ten children described some difficulties in ADL. Muscle strength in forearm supination, shoulder external rotation and elbow flexion at three months of age can be used to predict outcome.Most children with an OBPP recover completely, but one in five has symptoms of the injury at 10-12 years of age. Muscle strength in the arm at three months of age can be used to predict outcome.
15.	Argento, Daniela, et al. (författare) Reliance on the internal auditors’ work : experiences of Swedish external auditors 2018 Ingår i: Journal of Management Control. - : Springer. - 2191-4761 .- 2191-477X. ; 29:3-4, s. 295-325 Tidskriftsartikel (refereegranskat)abstract The purpose of this study is to explore how external auditors experience their decision to rely on internal auditors’ work. This study employs both qualitative and quantitative methods consisting of semi-structured interviews and questionnaires administered to external auditors in Sweden. Semi-structured interviews were conducted with external auditors who are working in Big 4 audit firms in Sweden and have engagements with internal audit functions. A questionnaire was administered to authorized/approved auditors, members of the Swedish Association of Certified Public Accountants (FAR). Findings indicate that external auditors use the work of internal auditors as they gain efficiency in performing their work. Nevertheless, external auditors may compromise their independence and professionalism through closer involvement with internal auditors, which may lead to uncritical evaluation and use of the reports prepared by internal auditors. At the same time, while relying on the internal auditors’ reports, external auditors appear to be conscious of the consequences for the audit quality they deliver. The study highlights the dilemma faced by external auditors in their cooperative work with internal auditors and the balance/imbalance in their opinions concerning efficiency gains, independence, professionalism and audit quality. © 2018, The Author(s).
16.	Batingan Paredes, Karla Marie, et al. (författare) Organizational climate for innovation and creativity—a study in Swedish retail organizations 2018 Konferensbidrag (refereegranskat)abstract Innovation in retailing is under-investigated in academia and yet highly relevant in practice given the current changes in the retail landscape. Although retailing is often characterised by a dynamic and highly competitive environment, retail organizations are not often considered as “innovative,” at least when compared with manufacturing industries or when using existing innovation frameworks in academic literature. There is a need to consider other ways of looking into retailing’s innovativeness—such as looking into the organizational climate— which may help explain how innovation is enabled in service organizations such as retailers. We applied a mixed-methods approach using an organizational climate survey based on Ekvall’s (1996) work, and semi-structured, one-on-one interviews regarding the creative climate and other aspects of innovation management in the companies. The study shows that despite retail organizations still struggling to incorporate innovation on a strategic level and move beyond incremental developments in their operations, retail organizations score positively on being innovative regarding certain dimensions of the creative climate survey. This indicates that retailers (especially conventional ones) could benefit from challenging current practices and moving towards becoming more active innovators, since the creative climate to a certain extent seems to allow for it. Respondents within the organisations also express a need for better innovation support, whether it is through integrated, formalised structures and processes, or an improvement in the current conditions of the organizational climate. How retailers could enable themselves to become more active innovators—based on what we know that retailers look more towards entrepreneurship and continuous development as a driving force rather than institutionalized innovation practices per se—is a potential avenue for further research.
17.	Batingan Paredes, Karla Marie, et al. (författare) Retail Innovation: perceptions. management, and challenges of a systematic approach 2018 Ingår i: The ISPIM Innovation Conference. - Åkersberga. Konferensbidrag (refereegranskat)abstract The retail industry is looking for new ways to compete as digitalization and non-traditional actors are changing the game. In an industry where constant improvements are key and studies of innovation management are scarce - this qualitative study of four retail firms addresses how innovation is currently perceived and managed. As a result, we have found that innovation is an uncommon theme and there is no systematic approach to innovation management. Furthermore, despite retailers{\textquoteright} proximity to end users, the customer perspective is surprisingly limited, idea development is present but without clear criteria for selection and prioritization from an innovation point of view. For future research, we point to an interesting avenue for retailers as a “hub” for innovation, given their position in the value chain, acknowledging the need for a more strategic and systematic approach.
18.	Bay, Annika, 1970- (författare) Being physically active as an adult with congenital heart disease 2018 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Background: Due to advances in medical and surgical care adults with congenital heart disease (CHD) is a growing and aging population, that now outnumbers the children with CHD. In general, adults with CHD have reduced aerobic exercise capacity and nearly half of the patients do not reach current recommendations on physical activity. It is known that a low level of physical activity is associated with an increased risk for acquired cardiovascular disease. Studies has shown that adults with CHD are at the same, or even higher risk as the general population, for developing acquired cardiovascular disease.Aim: The overall aim was to explore physical activity in adults with CHD with respect to associated factors, exercise self-efficacy and their own experiences.Methods: This thesis is based on four papers. Paper I included 471 adults with CHD from three tertiary care centres in Sweden. The participants completed questionnaires measuring patient reported outcomes (e.g. SF-12) including physical activity level. Paper II was based on data from 79 adults with CHD from two tertiary care centers in Sweden and 42 matched controls. All participants completed questionnaires on exercise self-efficacy and quality of life, wore an activity monitor during four consecutive days and performed muscle endurance tests. Paper I and II were of cross-sectional design and analyses were done using logistic regression. In paper III and IV data were collected through structured interviews for 14 participants. They were asked about their experiences of being physically active (paper III), what they considered as physical activities, and their experiences of enablers and barriers to physical activity (paper IV). Qualitative content analysis was used in papers III and IV.Results: Physical activity level (paper I) and exercise self-efficacy (paper II) were strongly associated with age where those over 40 years had a lower level of physical activity and lower exercise self-efficacy. Further, in paper I, it appeared that patient reported outcomes from SF-12 were strongly associated with physical activity level. In paper II, exercise self-efficacy was associated with performance in a muscle endurance tests. Paper III revealed an overall theme – It´s like balancing on a slackline that illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four themes: (1) Being an adventurer – enjoying the challenges of physical activity; (2) Being a realist – adapting to physical ability; (3) Being a non-doer – lacking prerequisites for physical activity and (4) Being an outsider – feeling excluded depending on physical ability. In paper IV, the analysis revealed a description of what adults with CHD consider to be physical activity and considered as enablers and barriers for physical activity. Four categories appeared; physical aspects, psychological aspects, psychosocial aspects and environmental aspects. In the psychosocial aspect, social support and encouragement in childhood to be physically active and no restrictions from e.g. parents, teachers and health care increased physical activity in adulthood.Conclusions: Age, social support and accepting physical limitations seem to have an important impact regarding physical activity level and exercise self-efficacy. In contrast, the complexity of CHD and other medical factors appear to be of less importance for adults with CHD in relation to physical activity. In order to support adults with CHD to increase their physical activity and reach their full potential, it is important to explore and consider the various aspects that may affect physical activity in this population.
19.	Bay, Annika, 1970-, et al. (författare) Enablers and barriers for physical activity in adults with congenital heart disease 2019 Konferensbidrag (refereegranskat)
20.	Bay, Annika, 1970-, et al. (författare) Exercise self-efficacy (ESE) in adults with congential heart disease 2017 Ingår i: European Heart Journal. - 0195-668X .- 1522-9645. ; 38:Suppl. 1 Tidskriftsartikel (refereegranskat)abstract Background: Many adults with congenital heart disease (CHD) have reduced aerobic exercise capacity and impaired muscle function. However, it is largely unknown which factors have influence on the confidence to perform exercise training, i.e. Exercise Self-Efficacy (ESE).Aims: To identify factors related to low ESE, and thus identify potential targets for rehabilitation and thereby enhance the potential for being physically active.Methods: Seventy-nine adults with CHD; simple lesions n=38 (women n=16), complex lesions n=41 (women n=17) (mean age 36.7±14.6 years) and 42 age and sex matched controls were recruited. All participants completed questionnaires on ESE, quality of life (EQ-5D), and physical activity (international physical activity questionnaire, IPAQ), and performed muscle endurance tests.Results: ESE was categorised into low (<26 points, n=24) and high (≥26 points, n=55). Patients with low ESE were older (45.2±15.4 vs. 32.6±12.5 years, p=0.002), more often had prescribed medication (67% vs. 44%, p=0.06), higher New York Heart Association functional class (NYHA) (≥ III) (25% vs. 7%, p=0.03) and performed fewer shoulder flexions (30.9±16.1 vs. 45.9±23.9, p=0.01) compared with those with high ESE. In the high ESE group, ESE did not differ from controls (33.8±3.9 vs. 33.4±6.1, p=0.74). In linear multivariate analysis age (B;-0.18, 95% CI -0.28- -0.08), smoking (B;-3.73, 95% CI -7.17- -0.28), EQ-5Dindex <1 (B;-3.33, 95% CI -6.08- -0.57) and number of shoulder flexions (B; 0.09, 95% CI 0.03–0.16) were independently associated with ESE.Conclusion: Many adults with CHD have low ESE. Rehabilitation targeting quality of life, smoking cessation and muscle training may improve ESE, and thus enhance the potential for being physically active in this population.
21.	Bay, Annika, et al. (författare) Exercise self-efficacy in adults with congenital heart disease 2018 Ingår i: International Journal of Cardiology: Heart and vasculature. - : Elsevier. - 2352-9067. ; 18, s. 7-11 Tidskriftsartikel (refereegranskat)abstract Background: Physical activity improves health, exercise tolerance and quality of life in adults with congenital heart disease (CHD), and exercise training is in most patients a high-benefit low risk intervention. However, factors that influence the confidence to perform exercise training, i.e. exercise self-efficacy (ESE), in CHD patients are virtually unknown. We aimed to identify factors related to low ESE in adults with CHD, and potential strategies for being physically active.Methods: Seventy-nine adults with CHD; 38 with simple lesions (16 women) and 41 with complex lesions (17 women) with mean age 36.7 ± 14.6 years and 42 matched controls were recruited. All participants completed questionnaires on ESE and quality of life, carried an activity monitor (Actiheart) during four consecutive days and performed muscle endurance tests.Results: ESE in patients was categorised into low, based on the lowest quartile within controls, (≤ 29 points, n = 34) and high (> 29 points, n = 45). Patients with low ESE were older (42.9 ± 15.1 vs. 32.0 ± 12.4 years, p = 0.001), had more complex lesions (65% vs. 42%, p = 0.05) more often had New York Heart Association functional class III (24% vs. 4%, p = 0.01) and performed fewer shoulder flexions (32.5 ± 15.5 vs. 47.7 ± 25.0, p = 0.001) compared with those with high ESE. In a logistic multivariate model age (OR; 1.06, 95% CI 1.02-1.10), and number of shoulder flexions (OR; 0.96, 95% CI 0.93-0.99) were associated with ESE.Conclusion: In this study we show that many adults with CHD have low ESE. Age is an important predictor of low ESE and should, therefore, be considered in counselling patients with CHD. In addition, muscle endurance training may improve ESE, and thus enhance the potential for being physically active in this population.
22.	Bay, Annika, 1970-, et al. (författare) Facilitators and barriers for physical activity in adults with congenital heart disease 2018 Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 39:suppl_1, s. 1120-1121 Tidskriftsartikel (refereegranskat)abstract Background: A majority of adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and counteract acquired cardiovascular disease. This study illuminates aspects that may be relevant for performing physical activity.Purpose: To describe facilitators and barriers for physical activity in adults with CHD.Methods: Semi-structured interviews were performed individually with fourteen adults (age 19–68 years, women=7) with complex CHD. The interviews were analyzed using qualitative content analysis.Results: Aspects that may enable or inhibit physical activity were found in two domains; Facilitators and Barriers, which both consisted of four categories physical, psychological, psychosocial and environmental aspects (Table 1).
23.	Bay, Annika, 1970-, et al. (författare) It ́s like balancing on a slackline : A description from adults living with congenital heart disease 2018 Ingår i: Cardiology in the Young. - : Cambridge University Press. - 1047-9511 .- 1467-1107. ; 28:Suppl. S1, s. S37-S37 Tidskriftsartikel (refereegranskat)abstract Introduction: Several studies have shown that adults with congenital heart disease have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of great importance to investigate how this population experiences physical activity. The aim of the study is to illuminate how adults with congenital heart disease describes themselves in relation to physical activity.Methods: Semi-structured interviews with fourteen adults with complex congenital heart disease were performed. Patients were recruited from the clinic waiting list, based on their scheduled follow up and diagnosis. Interviews were analysed by qualitative content analysis.Results: The overall theme It´s like balancing on a slackline illustrates how adults with congenital heart disease described themselves in relation to physical activity. The overall theme consists of four themes: Being an adventurer- enjoying the challenges of physical activity, Being a realist- adapting to physical ability, Beinga non-doer- lacking prerequisites for physical activity and Being an outsider- feeling excluded depending on physical ability.Conclusions: The descriptions on themselves as a physically active were not constant or one-dimensional and the descriptions varied during the interviews, related to different time periods in life. It meant that they could described themselves as being an adventurer liking tough challenges, but at the same time describing themselves as being a non-doer with uncertainty over their physical strength. The findings point out specific factors for adults with CHD that might constitute as obstacles, but also possibilities for being physically active.
24.	Bay, Annika, et al. (författare) It's like balancing on a slackline : A description of how adults with congenital heart disease describe themselves in relation to physical activity 2018 Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 27:15-16, s. 3131-3138 Tidskriftsartikel (refereegranskat)abstract AIMS AND OBJECTIVES: To illuminate how adults with CHD describe themselves in relation to physical activity.BACKGROUND: Several studies have shown that adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.DESIGN: Qualitative study with semi-structured interviews analysed with qualitative content analysis.METHODS: Semi-structured interviews were individually performed with fourteen adults (women=7, age 19-68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow-up and diagnosis.RESULTS: The overall theme, It's like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (1) Being an adventurer- enjoying the challenges of physical activity; (2) Being a realist- adapting to physical ability; (3) Being a non-doer- lacking prerequisites for physical activity; and (4) Being an outsider- feeling excluded depending on physical ability.CONCLUSIONS: Adults with CHD seem to have a diverse relationship to physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active in order to get a deeper understanding of how to support adults with CHD to be physically active.RELEVANCE TO CLINICAL PRACTICE: Given the diverse relationship to physical activity, nurses have to further investigate the patients' relationship to physical activity, in order to support a healthy lifestyle. Nurses and allied health professionals should offer individualized exercise prescriptions and education about suitable physical activities in relation to physical ability. This article is protected by copyright. All rights reserved.
25.	Bay, Annika, et al. (författare) Patient reported outcomes are associated with physical activity level in adults with congenital heart disease. 2017 Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 243, s. 174-179 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO).METHODS: Patients with CHD (n=471) were randomly selected from the national register on CHD and categorized according to complexity of lesions - simple (n=172, 39.1±14.6years), moderate (n=212, 39±14.1years), and severe (n=87, 31.7±10.7years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression.RESULTS: PAL was categorized into high (≥3 METs ≥2.5h/week, n=192) and low (≥3 METs <2.5h/week, n=279). Patients with low PAL were older (42.6 vs. 35.8years, p≤0.001), had more prescribed medications (51% vs. 39%, p=0.009), more symptoms (25% vs. 16%, p=0.02) and comorbidity (45% vs. 34% p=0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p<0.001), satisfaction with life (25.6 vs. 27.3, p=0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p<0.001) and Mental Component Summary score (MCS) (73.5 vs. 79.5, p<0.001). Complexity of heart lesion was not associated with PAL. The included PROs - separately tested in the model, together with age were associated with PAL.CONCLUSIONS: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.
26.	Bay, Annika, et al. (författare) Patient-reported outcomes are associated with physical activity level in adults with congenital heart disease 2017 Ingår i: Swedish Cardiovascular Spring Meeting – Vårmöte 2017, Malmö, Sweden (26-28 April 2017). Konferensbidrag (övrigt vetenskapligt/konstnärligt)
27.	Bentham, James, et al. (författare) A century of trends in adult human height 2016 Ingår i: eLIFE. - 2050-084X. ; 5 Tidskriftsartikel (refereegranskat)abstract Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
28.	Bentham, James, et al. (författare) A century of trends in adult human height 2016 Ingår i: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5 Tidskriftsartikel (refereegranskat)abstract Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
29.	Bernes, Gun, et al. (författare) Forskning pågår - från foder till ost 2018 Ingår i: Nytt / Sveriges lantbruksuniversitet, Institutionen för norrländsk jordbruksvetenskap. Annan publikation (populärvet., debatt m.m.)abstract I ett samarbete mellan Norrmejerier, Växa Sverige och institutioner vid SLU i Umeå och i Uppsala pågår tre sammanlänkade projekt där vi studerar hur ostens kvalitet påverkas av olika faktorer, från gård till mejeri. De bakterier och andra mikroorganismer som finns i foder, mjölk och ost studeras särskilt noga. Vi vill bland annat veta vad mikrofloran har för inverkan på ostens lagringstid och på dess smak och konsistens.
30.	Bernes, Gun, et al. (författare) Från vallfoder till ost 2019 Ingår i: Svenska vallbrev. - 1653-8064. ; , s. 3-5 Tidskriftsartikel (populärvet., debatt m.m.)
31.	Bernes, Gun, et al. (författare) Vad påverkar mikrofloran i mjölken på gård och mejeri? 2019 Rapport (övrigt vetenskapligt/konstnärligt)abstract När man producerar långtidslagrad ost är det viktigt att kunna förutsäga lagringstiden och minimera förlusterna i produktionen från ystning till lagring och leverans av färdigt produkt. Mejeriet kan styra över processer och lagring men kan bara i begränsad omfattning påverka mjölkråvarans sammansättning. Projektet har syftat till att undersöka sambandet mellan olika gårdsfaktorer och sammansättning och mikroflora i mjölkråvaran på gården (gårdsmjölken). Dessutom undersöktes sambandet mellan mjölkråvaran på mejeriet (silomjölken) och kvaliteten och mognadstiden hos långtidslagrade ostar. Vi ville också studera säsongsvariationen hos mjölkråvarans kvalitet med fokus på mikrofloran. Studien inleddes med att dokumentera produktionen av mjölk på gårdar som levererar mjölk till mejeriet i Burträsk och dessutom några ekologiska gårdar som jämförelse. Totalt omfattande studien 43 gårdar. Dokumentationen inleddes med en enkät rörande gårdarnas storlek, inhysning, vallproduktion, fodermedel, mjölkningsrutiner mm. Enkätsvaren har kompletterats med data från Växa Sverige (Kokontrollen). Gårdarna har besökts vid två tillfällen då grovfoderprover tagits som analyserats för fermentationskvalitet. För att studera säsongsvariationen i mjölkråvarans kvalitet under ett år har prov från gårdarnas mjölktankar samlats in månadsvis av tankbilschaufförerna (utöver ordinarie provtagning). Proverna har analyserats för traditionella parametrar, inklusive totalantal bakterier och termoresistenta bakterier, men även för aktiviteten av plasmin, ett enzym som bryter ned mjölkens protein. För att få information om vilka bakterier som förekommer i gårds- och silomjölk, dvs sammansättningen av mjölkens mikroflora, har prover analyserats med molekylär teknik, s.k. DNA-sekvensering. Resultaten beskriver bakteriernas fördelning i procent men anger inte hur många de är i absoluta tal eller vilken betydelse de har. För att studera sambanden mellan gårdsdata, mjölkkvalitet inklusive mikroflorans sammansättning, och säsong har vi skapat ett antal matriser som länkar olika typer av information till varandra och bearbetat data med multivariata statistiska metoder. Vi har utifrån detta försökt utvärdera vilka faktorer på gården som påverkar gårdsmjölkens kvalitet, mikroflora och plasminaktivitet. Den viktigaste faktorn för totalantal bakterier och mikroflorans sammansättning visade sig vara vilket mjölkningssystem som fanns på gården, dvs bås, grop eller robot. Gårdar med robotmjölkning hade högre antal bakterier och fler termoresistenta bakterier i mjölken jämfört med de andra systemen. De hade även en annan sammansättning av mikrofloran jämfört med gårdar med mjölkning på bås. Mjölkning i grop visade sig vara ett mellanting mellan bås- och robotsystem när det gäller bakterier. Vi kunde även se att mjölknings- och diskrutiner hade betydelse för mikroflorans sammansättning och mjölkkvalitet, liksom hygienen på båspallen, användning av gummimatta och att korna inte klövverkas för sällan. I projektets andra del studerades kopplingen mellan silomjölkens sammansättning och produktion och lagring av långtidslagrad ost. Vi tog prover från mjölksilos innan pastörisering av mjölken och analyserade dessa för samma parametrar som för gårdsmjölken i den första delen av projekt, inklusive DNA-analyser av mikrofloran. Vid mejeriet i Burträsk tillverkas ost i stor skala och varje mjölksilo innehåller mjölk från ett stort antal gårdar. Mjölken som provtogs och analyserades i den här delen av studien kom i huvudsak från de gårdar som ingick i projektet men även från ett antal gårdar som inte deltog i projektet. Silomjölken provtogs från februari 2016 till februari 2017. Vid varje tillfälle togs prov från två eller tre silos. Ostar som producerades av mjölken provtogs och analyserades på alla traditionella parametrar inklusive sensoriska analyser. Detta gjordes efter 14 månaders mognadstid och därefter fram till att de bedömts som färdiga. För att förstå sambanden mellan silomjölk och ostproduktion analyserades data med multivariata statistiska metoder. Det fanns endast svaga samband mellan silomjölkens mikroflora före pastörisering och den resulterande ostens kvalitet och lagringstid. Det fanns dock viss koppling mellan mjölkens kvalitet och utbytet av ystningen, dvs hur mycket mjölk 4 som går åt för att göra ett kilo ostmassa; förhöjda värden för celltal, fria fettsyror, totalantal bakterier och pH var kopplat till minskat utbyte, medan högre fett- och proteinhalt var kopplat till ett högre utbyte. Orsaken till att vi bara ser svaga samband mellan silomjölkens sammansättning inklusive mikroflora, och ostens kvalitet, beror främst på att silomjölken är en blandning av mjölk från många gårdar, vilket gör att vi inte ser den tydliga variation som finns mellan enskilda gårdar.
32.	Bilén, Anna-Karin, et al. (författare) Miljökvalitetsmålen 2016 : Årlig uppföljning av miljökvalitetsmålen 2016 Rapport (övrigt vetenskapligt/konstnärligt)abstract I Blekinge bedöms inte något miljökvalitetsmål vara möjligt att nå till år 2020. För att kunna lämna över ett hållbart samhälle till nästa generation krävs förebyggande arbete, ef?????????????????r. Ambitionerna måste öka och miljöfrågorna prioriteras högre på den politiska agendan.De mål som rör biologisk mångfald och bevarande av kulturmiljö följer enneutral eller negativ trend. I odlingslandskapet leder färre lantbrukare ochbrist på betesdjur till igenväxning av hagmarker. Livsmiljöer försvinner och????????????????????????????????????????,främst möte insekter.För att god ekologisk status ska uppnås i vattendragen behövs ny vattenlagstiftning och mer resurser för tillsyn. I Blekinges kustvatten är övergödning ett stort miljöproblem och det krävs kraftfulla åtgärder för att minska näringsläckaget. Arbetet med vattenförsörjningsplaner behöver fortsätta för att trygga framtida dricksvattenförsörjning. De senaste årens fynd av PFAS i dricksvatten visar på vikten av att skydda vattentäkter, genomföra riskbedömningar och undersöka förekomst av föroreningar.Obalans mellan den tätbefolkade kusten och den glesbyggda landsbygden är en utmaning i länet. Byggandet vid kusten ställer krav på en hänsynsfull bebyggelseutveckling som tydligt beaktar miljökvalitetsmålen.Internationella överenskommelser om kemikalier och minskade utsläpp till luft och vatten är nödvändigt för att uppnå uppsatta mål. Dessutom behövs en omställning till ett samhälle som baseras på förnybar energi. För att skapa en hållbar framtid måste vi förändra vår livsstil och vår attityd till konsumtion. Lokala och regionala åtgärder såsom arbete för en giftfri förskola och minskade utsläpp av mikroplaster är steg i rätt riktning.Minskad biologisk mångfald påverkar tillsammans med klimatförändringar, övergödning och miljögifter många av de ekosystemtjänster som vi är beroende av för mänsklig välfärd och en hållbar samhällsutveckling. Det pågår insatser som förbättrar tillståndet i miljön, men det går för långsamt. Det krävs mer resurser och modiga politiska beslut för att möjliggöra en hållbar framtid, den framtid som vi är skyldiga våra barn!
33.	Bixby, H., et al. (författare) Rising rural body-mass index is the main driver of the global obesity epidemic in adults 2019 Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4 Tidskriftsartikel (refereegranskat)abstract Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
34.	Björck, Lena, 1959, et al. (författare) Changes in Dietary Fat Intake and Projections for Coronary Heart Disease Mortality in Sweden: A Simulation Study 2016 Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 11:8 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: In Sweden, previous favourable trends in blood cholesterol levels have recently levelled off or even increased in some age groups since 2003, potentially reflecting changing fashions and attitudes towards dietary saturated fatty acids (SFA). We aimed to examine the potential effect of different SFA intake on future coronary heart disease (CHD) mortality in 2025. METHODS: We compared the effect on future CHD mortality of two different scenarios for fat intake a) daily SFA intake decreasing to 10 energy percent (E%), and b) daily SFA intake rising to 20 E%. We assumed that there would be moderate improvements in smoking (5%), salt intake (1g/day) and physical inactivity (5% decrease) to continue recent, positive trends. RESULTS: In the baseline scenario which assumed that recent mortality declines continue, approximately 5,975 CHD deaths might occur in year 2025. Anticipated improvements in smoking, dietary salt intake and physical activity, would result in some 380 (-6.4%) fewer deaths (235 in men and 145 in women). In combination with a mean SFA daily intake of 10 E%, a total of 810 (-14%) fewer deaths would occur in 2025 (535 in men and 275 in women). If the overall consumption of SFA rose to 20 E%, the expected mortality decline would be wiped out and approximately 20 (0.3%) additional deaths might occur. CONCLUSION: CHD mortality may increase as a result of unfavourable trends in diets rich in saturated fats resulting in increases in blood cholesterol levels. These could cancel out the favourable trends in salt intake, smoking and physical activity.
35.	Bratt, Ewa-Lena, 1970, et al. (författare) Unraveling the role of healthcare system factors for continuing care of adolescents with congenital or rheumatic heart disease: Rationale and methods of the international Adole7C-project 2019 Ingår i: Abstract book of the 99th Berzelius conference, 21-22 February 2019, Stockholm, Sweden, p31-32.. Konferensbidrag (övrigt vetenskapligt/konstnärligt)
36.	Brunnström, Hans, et al. (författare) PD-L1 immunohistochemistry in clinical diagnostics of lung cancer : inter-pathologist variability is higher than assay variability 2017 Ingår i: Modern Pathology. - : NATURE PUBLISHING GROUP. - 0893-3952 .- 1530-0285. ; 30:10, s. 1411-1421 Tidskriftsartikel (refereegranskat)abstract Assessment of programmed cell death ligand 1 (PD-L1) immunohistochemical staining is used for decision on treatment with programmed cell death 1 and PD-L1 checkpoint inhibitors in lung adenocarcinomas and squamous cell carcinomas. This study aimed to compare the staining properties of tumor cells between the antibody clones 28-8, 22C3, SP142, and SP263 and investigate interrater variation between pathologists to see if these stainings can be safely evaluated in the clinical setting. Using consecutive sections from a tissue microarray with tumor tissue from 55 resected lung cancer cases, staining with five PD-L1 assays (28-8 from two different vendors, 22C3, SP142, and SP263) was performed. Seven pathologists individually evaluated the percentage of positive tumor cells, scoring each sample applying cutoff levels used in clinical studies: < 1% positive tumor cells (score 0), 1-4% (score 1), 5-9% (score 2), 10-24% (score 3), 25-49% (score 4), and > 50% positive tumor cells (score 5). Pairwise analysis of antibody clones showed weighted kappa values in the range of 0.45-0.91 with the highest values for comparisons with 22C3 and 28-8 and the lowest involving SP142. Excluding SP142 resulted in kappa 0.75-0.91. Weighted kappa for interobserver variation between pathologists was 0.71-0.96. Up to 20% of the cases were differently classified as positive or negative by any pathologist compared with consensus score using >= 1% positive tumor cells as cutoff. A significantly better agreement between pathologists was seen using >= 50% as cutoff (0-5% of cases). In conclusion, the concordance between the PD-L1 antibodies 22C3, 28-8 and SP263 is relatively good when evaluating lung cancers and suggests that any one of these assays may be sufficient as basis for decision on treatment with nivolumab, pembrolizumab, and durvalumab. The scoring of the pathologist presents an intrinsic source of error that should be considered especially at low PD-L1 scores.
37.	Catharina, Johansson, et al. (författare) Profiling the autoantibody repertoire in atopic dermatitis identifies four associated autoantigens 2017 Ingår i: Scandinavian Journal of Immunology. - : WILEY. - 0300-9475 .- 1365-3083. ; 86:4, s. 322-322 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
38.	Celec, Ulrica, et al. (författare) Bättre ljus i skolan minskar barnens stress 2015 Ingår i: NyTeknik, Debatt.. - 0550-8754. ; :23 juni 2015 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
39.	Cerdas, Sara, et al. (författare) Development of job demands, decision authority and social support in industries with different gender composition - Sweden, 1991-2013 2019 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19 Tidskriftsartikel (refereegranskat)abstract BackgroundThis study aims to explore the development of job demands, decision authority and social support within and between industries with different gender composition in Sweden between 1991 and 2013.MethodsCross-sectional data from 12 waves of the Swedish Work Environment Surveys (1991 to 2013), comprising in total 109,698 respondents, were used. Industries were classified in 7 categories according to its gender composition and main activity, comprising two female-dominated, three gender-mixed and two male-dominated industries. Proportions of workers reporting high job demands, low decision authority and poor social support between 1991 and 2013 were calculated. Logistic regression analyses were performed to estimate variation across time, using 1991 as the reference category, and between industries, using knowledge intensive services as the reference category. Estimates for high job demands, low decision authority and poor social support were presented as average marginal effects (AMEs).ResultsThe probabilities of reporting low decision authority were higher in education and health and social care during the whole study period, for both genders, compared with the reference category of knowledge intensive services. The probability of having high job demands were higher for men and women in education, and women in health and social care, compared with the reference category. Men in the male dominated industries had increased job demands over time, compared to the beginning of the study period (1991). The probability of reporting poor social support was higher in the later than in the earliest time period for women in the female-dominated industry health and social care as well as in the gender-mixed labour intensive services industry.ConclusionsThere has been a negative development of job demands and decision authority in the female-dominated industries education and health and social care in Sweden, whereas social support has developed more negatively for women in health and social care and in labour intensive services.
40.	Cerdas, Sara, et al. (författare) Development of Organisational and Psychosocial Work Factors Across Industries with Different Gender Composition in Sweden, 2003-2013 2018 Ingår i: Book of proceedings: 13th Conference of the European Academy of Occupational Health Psychology. - Nottingham : European Academy of Occupational Health Psychology. - 9780992878641 ; , s. 34-35 Konferensbidrag (refereegranskat)abstract Background: In Sweden, the development of mental ill-health and sickness absence has been poorer in female-dominated industries compared to others. One possible explanation is the different developments of psychosocial working conditions across industries. Men and women appear to react similarly to the same psychosocial exposures at work, but differences in exposure patterns may prevail. There is to date a lack of studies on the extent to which psychosocial work exposures are associated with the gender segregation on the Swedish labour market at the industry level. This study aims to investigate how organisational and psychosocial work factors have developed over time across industries with different gender composition in Sweden from 2003 to 2013, and to what extent these factors differ between industries.Methods: The present study is based on repeated cross-sectional data from the Swedish Work Environment Survey (SWES). SWES is conducted biennially by Statistics Sweden (SCB) and includes Swedish workers aged 16-64 years. Six waves from 2003 to 2013, comprising a study sample of 45,631 subjects, were analysed, Industries were categorised according to gender composition and divided into seven categories: 1) Goods and energy production; 2) Machine handling; 3) Manual services; 4) Public administration; 5) Knowledge intensive services; 6) Education; 7) Health and social care. Proportions of men and women in each industry who were exposed to adverse or positive organisational and psychosocial work factors were calculated for each of the six waves. Logistic regression analyses, adjusted for age, educational level and year of response to SWES were performed on the full sample (all six waves), in order to estimate the odds of being exposed to organisational and psychosocial work factors in each industry using the knowledge intensive service industry as the reference category.Results: Preliminary results show that in female dominated industries (Education and Health and social care), many organisational and psychosocial work factors developed poorly over the study period. Higher odds of exposure to adverse or positive organisational and psychosocial work factors were found for several industries when using the industry of Knowledge intensive services as the reference category.Conclusion: This study is one of the first of its kind analysing the development of organisational and psychosocial work factors, as well as differences in these factors between industries with different gender compositions in Sweden.
41.	Chang, Ya-Ting, et al. (författare) Versican accumulates in vascular lesions in pulmonary arterial hypertension 2016 Ingår i: PULMONARY CIRCULATION. - : Wiley. - 2045-8932 .- 2045-8940. ; 6:3, s. 347-359 Tidskriftsartikel (refereegranskat)abstract Pulmonary arterial hypertension (PAH) is a lethal condition for which there is no effective curative pharmacotherapy. PAH is characterized by vasoconstriction, wall thickening of pulmonary arteries, and increased vascular resistance. Versican is a chondroitin sulfate proteoglycan in the vascular extracellular matrix that accumulates following vascular injury and promotes smooth-muscle cell proliferation in systemic arteries. Here, we investigated whether versican may play a similar role in PAH. Paraffin-embedded lung sections from patients who underwent lung transplantation to treat PAH were used for immunohistochemistry. The etiologies of PAH in the subjects involved in this study were idiopathic PAH, scleroderma, and congenital heart disease (atrial septal defect) with left-to-right shunt. Independent of the underlying etiology, increased versican immunostaining was observed in areas of medial thickening, in neointima, and in plexiform lesions. Western blot of lung tissue lysates confirmed accumulation of versican in patients with PAH. Double staining for versican and CD45 showed only occasional colocalization in neointima of high-grade lesions and plexiform lesions. In vitro, metabolic labeling with [S-35] sulfate showed that human pulmonary artery smooth-muscle cells (hPASMCs) produce mainly chondroitin sulfate glycosaminoglycans. In addition, hypoxia, but not cyclic stretch, was demonstrated to increase both versican messenger RNA expression and protein synthesis by hPASMCs. Versican accumulates in vascular lesions of PAH, and the amount of versican correlates more with lesion severity than with underlying etiology or inflammation. Hypoxia is a possible regulator of versican accumulation, which may promote proliferation of pulmonary smooth-muscle cells and vascular remodeling in PAH.
42.	Claeson, Anna-Sara, 1974-, et al. (författare) A standardized protocol for comparable analysis of GSH/GSSG by UHPLC-ESI-MSMS for human plasma 2019 Ingår i: Journal of chromatography. B. - : Elsevier. - 1570-0232 .- 1873-376X. ; 1104, s. 67-72 Tidskriftsartikel (refereegranskat)abstract Variability in the levels of GSH and GSSG in plasma is suggested to derive from inadequate pre-processing methods. The aim of this study was to develop a protocol for comparable and reliable measurements of GSH/GSSG. Venous blood from 8 healthy individuals were collected and divided into 7 different pre-processing procedures. For three of the samples an extraction mixture was added after 0 (baseline), 4 and 8 min and for three of the samples the extraction mixture was added at different times during defrost. A worst case scenario where a sample was left in a cool box during 6 h was also included. The samples were analyzed with UHPLC-ESIMSMS. A large difference in the levels of GSH and GSSG were identified and it was clearly associated with the sample handling procedures. A sample left untreated for 4 min will have significantly reduced amount of GSH. Stability tests showed that the level of GSH was reduced after 3 months in -80 degrees C.
43.	Dalmar, Abdirisak Ahmed, et al. (författare) Rebuilding research capacity in fragile states : the case of a Somali-Swedish global health initiative 2017 Ingår i: Global Health Action. - Abingdon : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1 Tidskriftsartikel (refereegranskat)abstract This paper presents an initiative to revive the previous Somali-Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.
44.	Davoodi, Anahita, 1979- (författare) Lighting simulation for a more value-driven building design process 2016 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract Concerns about global warming are increasing, hence, the urgency to cut carbon emissions. Reducing energy consumption, including lighting energy, is seen as the primary solution. Yet, solving the environmental factor should not come at the cost of other pillars of sustainable development. Rather, maximizing the total value of the building should be the focus. Maximizing value in the context of lighting entails improving the quality of the lighting. This study has investigated how lighting simulation could help in achieving better lighting quality. The aim of the thesis was defined as to understand the underlying architecture of lighting simulation and obtain an overview of its characteristics and applications as well as to study the use of current simulation tools.The theoretical background of lighting simulation (in the domain of Systems Engineering) was reviewed from the literature. This revealed the missing and imperfect links in the solution-to-value chain. The thesis suggests the use of a new base metric, Retinal Illuminance Map, as a solution, which in combination with black box simulation of a visual system can help repair this incomplete chain.The study of the current lighting simulation tools (Paper 1) revealed that illuminance-based metrics, luminance-based metrics, daylight availability metrics, and glare indexes are the most available performance metrics in existing lighting simulation tools. Based on usability, acceptability, availability, and previous references in the literature six software programs (Radiance, DAYSIM, Evalglare, DIALux, VELUX, and VISSLA) were selected and compared. It was found that no single tool could meet all the needs of a designer, hence, simulation tool(s) should be selected (or combined) according to the requirements of project goals and the stage of design.Building on these studies, applications of lighting simulation were identified and compiled in relation to different aspects, including performance metrics, stages of design, optimization, model integration, BIM, and parametric modeling.To obtain first-hand information about lighting designers’ experience, an online survey was conducted in Sweden (Paper 2). The results showed that lighting simulation programs were widely (90%) used in Sweden for analysis and/or rendering purposes. The majority of lighting designers considered both daylight and artificial light in their design. Factors such as ease-of use, simulation time and training had more weight than accuracy and the diversity of metrics in practitioner’s eyes. Surrogate modeling was identified as a solution for speeding up simulation time, which would also enable exploration of design solution space especially in the early design stage.
45.	Di Cesare, Mariachiara, et al. (författare) Trends in adult body-mass index in 200 countries from 1975 to 2014: A pooled analysis of 1698 population-based measurement studies with 19.2 million participants 2016 Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 387:10026, s. 1377-1396 Tidskriftsartikel (refereegranskat)
46.	Drevinge, Christina, 1983, et al. (författare) Perilipin 5 is protective in the ischemic heart 2016 Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 219, s. 446-454 Tidskriftsartikel (refereegranskat)abstract Background: Myocardial ischemia is associated with alterations in cardiac metabolism, resulting in decreased fatty acid oxidation and increased lipid accumulation. Here we investigate how myocardial lipid content and dynamics affect the function of the ischemic heart, and focus on the role of the lipid droplet protein perilipin 5 (Plin5) in the pathophysiology of myocardial ischemia. Methods and results: We generated Plin5(-/-) mice and found that Plin5 deficiency dramatically reduced the triglyceride content in the heart. Under normal conditions, Plin5(-/-) mice maintained a close to normal heart function by decreasing fatty acid uptake and increasing glucose uptake, thus preserving the energy balance. However, during stress or myocardial ischemia, Plin5 deficiency resulted in myocardial reduced substrate availability, severely reduced heart function and increased mortality. Importantly, analysis of a human cohort with suspected coronary artery disease showed that a common noncoding polymorphism, rs884164, decreases the cardiac expression of PLIN5 and is associated with reduced heart function following myocardial ischemia, indicating a role for Plin5 in cardiac dysfunction. Conclusion: Our findings indicate that Plin5 deficiency alters cardiac lipid metabolism and associates with reduced survival following myocardial ischemia, suggesting that Plin5 plays a beneficial role in the heart following ischemia. (C) 2016 The Authors. Published by Elsevier Ireland Ltd.
47.	Edin, Alicia, et al. (författare) Development and Laboratory Evaluation of a Real-Time PCR Assay for Detecting Viruses and Bacteria of Relevance for Community-Acquired Pneumonia 2015 Ingår i: Journal of Molecular Diagnostics. - : Elsevier BV. - 1525-1578 .- 1943-7811. ; 17:3, s. 315-324 Tidskriftsartikel (refereegranskat)abstract Community-acquired pneumonia may present with similar clinical symptoms, regardless of viral or bacterial cause. Diagnostic assays are needed to rapidly discriminate between causes, because this will guide decisions on appropriate treatment. Therefore, a quantitative real-time PCR (qPCR) assay with duplex reactions targeting eight bacteria and six viruses was developed. Technical performance was examined with linear plasmids. Upper and Lower respiratory tract specimens were used to compare the qPCR assay with standard microbiological methods. The limit of detection was 5 to 20 DNA template copies with approximately 1000-fold differences in concentrations of the two competing templates. SDs for positive controls were <5%. The use of the qPCR assay resulted in 113 positive identifications in 94 respiratory specimens compared with 38 by using standard diagnostics. Diagnostic accuracy of the qPCR assay varied between 60% positive agreement with standard tests for Streptococcus pneumoniae and 100% for Mycoplasma pneumoniae, Moraxella catarrhalis, and Staphylococcus aureus. Negative percentage of agreement was >95% for M. pneumoniae, Streptococcus pyogenes, respiratory syncytial virus, and influenza A virus; whereas it was only 56% for Haemophilus influenzae. Multiple microbial agents were identified in 19 of 44 sputum and 19 of 50 nasopharynx specimens. We conclude that in parallel qPCR detection of the targeted respiratory bacteria and viruses is feasible. The results indicate good technical performance of the assay in clinical specimens.
48.	Edin, Alicia, 1985- (författare) Improved diagnosis and prediction of community-acquired pneumonia 2018 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. Although there is wide variation in the microbial etiology, CAP may manifest with similar symptoms, making institution of proper treatment challenging. Therefore, etiological diagnosis is important to ensure that correct treatment and necessary infection control measures are instituted. This provides a challenge for conventional microbial diagnostic methods, typically based on culture and direct antigen tests. Moreover, existing molecular biomarkers have poor prognostic value. Few studies have investigated the global metabolic response during infection and virtually nothing is known about early responses after the start of antimicrobial treatment. The aim of this work was to improve diagnostic and predictive methods for CAP.In paper I, a qPCR panel targeting 15 pathogens known to cause CAP was developed and evaluated. It combined identification of bacterial pathogens and viruses in the same diagnostic platform. The method proved to be robust and the results consistent with those obtained by standard methods. The panel approach, compared to conventional, selective diagnostics, detected a larger number of pathogens. In Paper II, whole blood samples from 65 patients with bacteremic sepsis were analyzed for metabolite profiles. Forty-nine patients with symptoms of sepsis, but later attributed to other diagnoses, were matched according to age and sex and served as a control group. Six metabolites were identified, all of which predicted growth of bacteria in blood culture. One of the metabolites, myristic acid, alone predicted bacteremic sepsis with a sensitivity of 100% and a specificity of 95%. Paper III and IV were based on a clinical study enrolling 35 patients with suspected CAP in need of hospital care. The aim was to study the metabolic response during the early phase of acute infection. The qPCR panel developed in Paper I was used to obtain the microbial etiological diagnosis. Paper IV focused on the global metabolic response and highlighted the dynamics of changes in major metabolic pathways during early recovery. A specific metabolite pattern for M. pneumoniae etiology was found. Four metabolites accurately predicted all but one patient as either M. pneumoniae etiology or not. Paper III looked at phospholipid levels during the first 48 hours after hospital admission. It was found that all major phospholipid species, especially the lysophosphatidyl-cholines, were pronouncedly decreased during acute infection. Levels started to increase the day after admission, reaching statistical significance at 48 hours. Paper II-IV showed that metabolomics might be used to study a number of different aspects of infection, such as etiology, disease progress and recovery. Knowledge of the metabolic profiles of patients may not only be utilized for biomarker discovery, as proposed in this work, but also for the future development of targeted therapies and supportive treatment.
49.	Eliasson, Inger, et al. (författare) Organisation and leadership changes reasons for teenage girls to drop to out from sport 2015 Ingår i: 20th Annual Congress of the European college of Sport Science, 24-27 June 2015, Malmö - Sweden. - : European College of Sport Science. - 9789171045676 ; , s. 440-441 Konferensbidrag (refereegranskat)abstract Introduction: Many girls and boys quit sport in their teens and the reasons for this has eluded scientist and sport organisations for many years. This study was initiated by the Swedish Floorball Association with the aim to understand why many teenage girls quit floorball and to increase knowledge about what sportclubs can do to prevent girls from dropping out. A special research focus was directed towards the disengagement process which the girls undergoes when they take the decision to quit their sport.Methods: The study is based on data from 24 semi-structured interviews with 12 girls aged 13-18 years (n=12) and with one parent from each of the girls (n=12). The girls belonged to three different floorball clubs geographically spread in Sweden and had quit floorball from 6 months to 2,5 years ago. The study draws on Ebaughs (1988) theory of the disengagement process.Results: The results showed that the disengagement process can take from a few months up to two yearsbefore the girl takes the final decision to quit. The process was described by four different phases 1) First doubts 2) Seeking alternatives 3) The Turning point 4) After the decision. While the parents were involved in the process representatives from the sport clubs were almost absent. The longer into the process the girls where the more final their decision became. Six factors were identified asthe main reasons for the girls to quit their sport, often a girl quit due to a combination of three to four of these factors. The most salient factors were an increased focus on sport performance andresults, changes in the team's formation, new coaches and changes in the coach attitudes, interest inother activities or sports, lack of time and high demands on themselves. No one of the girls in this study had been contacted from the sport organisations after they quit.Discussion: The results points out the impact different changes had for the girls’ decision to quit and the importance for the clubs to be aware of this. It also highlights how the absence of there presentatives from the sport clubs in the girls’ disengagement process led to limited knowledge about the girls’ feelings and thought processes which means they were less able to adopt accurate strategies or to implement appropriate interventions to reduce the dropout rate. One message tothe sport organisations is therefore to develop strategies for how to gather knowledge of their members’ thoughts and feelings about their sport participation and be proactive in their work concerning how to handle changes, group cohesion and coach education. Organisation and leadership in the sport organisations were seen as key areas to develop when the ambition is to lower dropout rates.
50.	Engström, Annika, et al. (författare) Effectual learning in SME’s to promote transformation instead of frustration : Towards a design of an intervention study 2016 Ingår i: The 4th Effectuation Conference, Bodø, June 5-7, 2016.. - : The Society for Effectual Action. Konferensbidrag (refereegranskat)

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