| 1. |
- Andersson, Hans, 1962-, et al.
(författare)
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Utvärdering av användningen av arbetstidsmodellen 3-3 på akutmottagningen och LAH
- 2005
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den här rapporten innehåller resultat från en utvärdering som har gjorts av användningen avarbetstidsmodellen 3-3 vid akutmottagningen och LAH inom Närsjukvården i centrala Östergötland.Utvärderingen har gjorts på uppdrag av Landstinget i Östergötland.Utvärderingen har inte skett inom ramen för något särskilt forskningsmässigt sammanhangoch präglas därför inte av några medvetet valda teoretiska perspektiv. Rapporten torde dockkunna användas som underlag för forskningsmässiga ambitioner. För sådana ändamål avslutasrapporten med några forskningsmässiga reflektioner.Utvärderingen visar att positiva effekter har uppnåtts med hjälp av 3-3-systemet. Det sätt attförlägga arbetstid som systemet innebär har inneburit goda möjligheter för personalen attåterhämta sig både fysiskt och mentalt. Med hjälp av återhämtningsmöjligheterna har personalenhälsa förbättrats liksom trivsel och motivation. Både långtids- och korttidssjukfrånvarohar minskat. Arbetsglädjen har tilltagit. Dessa effekter är högst påtagliga. De har i sin turmedfört ett ökat intresse för lärande vilket har kommit verksamhet och patienter till goda. Denmer utvilade personalen har också inneburit ett bättre omhändertagande och bemötande avpatienter.Användningen av arbetstidsmodellen 3-3 har medfört ökade lönekostnader, dock i en lägreomfattning än den arbetstidsförkortning som systemet innebär för enskilda arbetstagare. Gjordaberäkningar visar att lönekostnadsökningen kan kompenseras av minskade kostnader försjukfrånvaro och övertid.Vid utvärderingen har det framkommit att 3-3-system tycks passa för verksamheter som pågårdygnet runt veckans alla dagar och som ställer krav på fysisk och mental återhämtning. För attkunna uppnå positiva effekter med denna arbetstidsmodell måste personalen vilja förlägga sinarbetstid på det sätt som modellen innebär.Utvärderingen har också pekat på vikten att uppmärksamma och arbeta med frågor om arbetstidsförläggningi stort och inte bara i samband med användning av arbetstidsmodeller av dettaslag. Frågor av detta slag behöver också uppmärksammas i förhållande till verksamhetsmässigaaspekter. Inom arbetstidsområdet tycks det finnas möjligheter till att utveckla tänkande ochhandlande med vars hjälp effektiviseringar torde kunna göras.
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| 2. |
- Andresen Bergström, Moa, 1978, et al.
(författare)
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A skin-like cytochrome P450 cocktail activates prohaptens to contact allergenic metabolites.
- 2007
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Ingår i: The Journal of investigative dermatology. - : Elsevier BV. - 1523-1747 .- 0022-202X. ; 127:5, s. 1145-53
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Tidskriftsartikel (refereegranskat)abstract
- Allergic contact dermatitis is a complex syndrome representing immunological responses to cutaneous exposure to protein-reactive chemicals. Although many contact sensitizers directly can elicit this disorder, others (prohaptens) require activation. Knowledge regarding the activating mechanisms remains limited, but one possibility is metabolic activation by cytochrome P450 (CYP) enzymes in the skin. We have, after quantitative reverse transcriptase-PCR studies of the CYP content in 18 human skin samples, developed an enriched skin-like recombinant human (rh) CYP cocktail using CYP1A1, 1B1, 2B6, 2E1, and 3A5. To validate the rhCYP cocktail, a prohaptenic conjugated diene ((5R)-5-isopropenyl-2-methyl-1-methylene-2-cyclohexene) was investigated using: the skin-like rhCYP cocktail, a liver-like rhCYP cocktail, single rhCYP enzymes, liver microsomes, keratinocytes, and a dendritic cell (DC) assay. The diene was activated to sensitizing epoxides in all non-cell-based incubations including the skin-like rhCYP cocktail. An exocyclic epoxide metabolite ((7R)-7-isopropenyl-4-methyl-1-oxaspiro[2.5]oct-4-ene) was found to be mainly responsible for the allergenic activity of the diene. This epoxide also induced pronounced DC activation indicated by upregulation of IL-8. The skin-like rhCYP cocktail provides a simplified alternative to using skin tissue preparations in mechanistic studies of CYP-mediated skin metabolism of prohaptens and offers the future possibility of designing in vitro predictive assays for assessment of allergenic activity of prohaptens.
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| 3. |
- Anton, R., et al.
(författare)
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Refrigerating Cycle Simulator : System Modelling, Educational Implementation and Assessment
- 2009
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Ingår i: International journal of engineering education. - 0949-149X. ; 25:2, s. 324-332
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Tidskriftsartikel (refereegranskat)abstract
- To leach and explain system modelling in a Thermal-Fluid application is a challenge: learning how one component or even the surrounding conditions can influence the performance of the rest of the components of the system and the system itself is not all easy task. However a suitable educational implementation may help students gain a deeper understanding not only of the system itself bill of the existing interrelation between the Thermal-Fluid fields: Thermodynamics, Heat Transfer and Fluid Mechanics. In this study a refrigerating cycle simulator is used. The simulator is' prepared in such a way that the interrelation between each component, the system and the surroundings call be analysed by the students. This case study is found to be very useful due of its ability to study system performance. A three-step educational implementation, the simulator being the third step, has been used and found to he enriching both for students and instructors.
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| 4. |
- Anton Remirez, Raul, et al.
(författare)
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Compact CFD modeling of EMC screen for radio base stations : A porous media approach and a correlation for the directional loss coefficients
- 2007
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Ingår i: IEEE transactions on components and packaging technologies. - : IEEE Press. - 1521-3331 .- 1557-9972. ; 30:4, s. 875-885
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Tidskriftsartikel (refereegranskat)abstract
- A methodology to obtain the directional pressure loss coefficients in a porous media model of an electromagnetically compatible screen of a radio base station model is presented. The directional loss coefficients of this compact model are validated against a detailed computational fluid dynamics model not only by comparing the total pressure drop, but also by evaluating the flow pattern after the screen. The detailed model was validated in an earlier article by the authors. A parametric study is conducted for 174 cases. Seven parameters were investigated: velocity, inlet height, screen porosity, printed circuit board (PCB) thickness, inlet-screen gap, distance between two PCBs and screen thickness. Based on the compact model parametric study, two correlations for the directional loss coefficients are developed as a function of the Reynolds number and the above geometrical parameters. The average disagreement between the compact model that uses the directional loss coefficients from the correlations and the detailed model was of 3% for the prediction of the total pressure drop and less than 6.5% and 9.5% for two coefficients that accurately characterize the flow pattern. © 2007 IEEE.
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| 5. |
- Anton Remirez, Raul, et al.
(författare)
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Detailed CFD Modelling of EMC Screen for Radio Base Stations : A Conjugate Heat Transfer Problem
- 2007
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Ingår i: International Journal of Heat Exchangers. - : R.T Edwards Inc.. - 1524-5608. ; 8:1, s. 95-116
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this paper is to perform an experimental as well as CFD investigations of the conjugate heat transfer problem in a sub-rack slot model. A steady-state three-dimensional detailed model, which serves as the most accurate representation of the model, was used in order to evaluate the details of the airflow paths and temperature field. A general model that covers a considerable range of velocities, screen porosities and heat fluxes was validated experimentally by wind tunnel measurements. The result shows that the RNG k-ε model used with correct y+ and mesh strategy accurately predicts the temperature field. The average temperature deviation at several locations is less than 4% compared to experimental data. The influence of the velocity, screen porosity, heat flux and presence of the EMC screen on the PCB temperature field is commented.
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| 6. |
- Anton Remirez, Raul, et al.
(författare)
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Detailed CFD modelling of EMC screen for radio base stations : a parametric study
- 2009
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Ingår i: IEEE transactions on components and packaging technologies. - 1521-3331 .- 1557-9972. ; 32:1, s. 145-155
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this paper is to make a parametric study of the hydraulic resistance and flow pattern of the flow after an electromagnetic compatibility screen and between two printed circuit boards (PCBs) in a model of a 90° subrack cooling architecture. The parametric study is carried out using a detailed 3-D model of a PCB slot. The detailed model was experimentally validated in a previous paper by the authors. Seven parameters were investigated: velocity, inlet height, screen porosity, PCB thickness, distance between two PCBs, inlet-screen gap and screen thickness. A correlation for the static anddynamic pressure drop, the percentage of dimensionless wetted area, Aw*, and the RMS* factor (a function of the flow uniformity along the PCB) after the screen is reported as a function of six geometrical dimensionless parameters and the Reynolds number. The correlations, that are based on 174 three dimensional simulations, yield good results for the total pressure drop, in which the values are predicted within the interval of ±15%. For the, Aw* all the predicted values are within the interval of ±22% of the observed values. Finally, for the RMS* factor, the majority of the values also have a disagreement of less than 20% of the observed values. These last two parameters are believed to provide a correct insight about the flow pattern after the screen.
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| 7. |
- Anton Remirez, Raul, et al.
(författare)
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Detailed CFD modelling of EMC screen for radio base stations : a benchmark study
- 2007
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Ingår i: IEEE transactions on components and packaging technologies. - 1521-3331 .- 1557-9972. ; 30:4, s. 754-763
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this paper is to investigate the performance of five well-known turbulence models, in order to find a model that predicts the details of the flow patterns through an electromagnetic compatibility (EMC) screen. The turbulence models investigated in the present study are five different eddy-viscosity models; the standard k-ε model, the renormalization group (RNG) k-ε model, the realizable k-ε model, the standard k-ω model, as well as the shear stress transport k-ω model. A steady-state 3-D detailed model, which serves as the most accurate representation of the model, was used in order to evaluate the details of the airflow paths and pressure field. The flow was assumed to be isothermal, turbulent and incompressible. A general model that covers a considerable range of velocities and geometries was validated experimentally by wind tunnel measurements. The result shows that for most of the k-ε models used with correct y+ and mesh strategy, the pressure drop and the velocity field deviation is small compared to experimental data. The k-ω models overpredict the overall pressure drop. When using the RNG k-ε model, the total static pressure drop predicted differs around 5%-10% and the average velocity deviation at several locations before and after the screen is around 5%.
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| 8. |
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| 9. |
- Bergström, Ulrica, 1970-, et al.
(författare)
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Fracture mechanisms and fracture pattern in men and women aged 50 years and older : a study of a 12-year population-based injury register, Umeå, Sweden
- 2008
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Ingår i: Osteoporosis International. - London : Springer International. - 0937-941X .- 1433-2965. ; 19:9, s. 1267-1273
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Tidskriftsartikel (refereegranskat)abstract
- Summary: In a study of a 12-year population-based injury register, Umeå, Sweden, we analyzed the fracture mechanisms and fracture pattern in men and women 50 years and older. Low-energy trauma was responsible for the major and costliest part of the fracture panorama, but the pattern differs between age groups. Introduction: Osteoporosis-related fracture is a major health problem: the number of hip fractures is expected to double to 2030. While osteoporosis is one of many risk factors, trauma is almost always involved. Therefore, we analyzed injury mechanisms in patients aged over 50. Methods: We registered injury mechanism, cause, diagnosis in all trauma patients at Umeå University hospital, Sweden. This population-based register (1993–2004) comprises a total of 113,668 injuries (29,189 fractures). Patients ≥50 years contributed to 13,279 fractures. Results: Low-energy trauma (fall <1 m) caused 53% of all fractures ≥50 years and older. In those over 75 low-energy trauma caused >80%. The seasonal variation of fractures was maximally 25%. With increasing age, proximal fractures became more common, in both upper and lower extremities. Proximal locations predominate in older age groups. Conclusions: Low-energy trauma was responsible for the largest and costliest part of the fracture panorama. In fact, almost all fractures in middle-aged and old people were caused by low-energy mechanisms; thus, most fractures in these patients have a fragility component, and the contribution of osteoporosis-related fractures is more important than previously thought. A better understanding of injury mechanisms also in low-energy trauma is a prerequisite for preventive interventions.
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| 10. |
- Bergström, Ulrica, 1970-
(författare)
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Fragility fractures in fragile people : epidemiology of the age quake
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Osteoporosis-related fracture is already today a major public health problem and the number of hip fractures is expected to double to 2030. Sweden has one of the highest hip fracture incidences worldwide. This may be explained by several factors: e.g. age, genetic, climatologic, geographic and a relative vitamin D deficiency, secondary to the limited sunlight exposure especially during winter months. Intrinsic and extrinsic factors contribute to a fracture, although a prior low energy fracture is one of the strongest predictors for a subsequent one and this should be a target for secondary fracture prevention in an orthopaedic setting. Since 1993 all injured patients admitted to the emergency floor and all in-hospital fractures at Umeå University Hospital, Sweden, were registered according to the Injury Data Base, former EHLASS. There were 31,173 fracture events (one or more fractures at the same time), of which 13,931 were in patients’ ≥ 50 years old. The fracture database was co analyzed with the Northern Sweden Health and Disease Study cohort in a nested case-control study for investigations of associations between osteoporotic fracture and serum markers, lifestyle data, nutrition etc. We found that there were differences in fracture pattern depending on age and sex. Both injury mechanism and fracture site were strongly dependent of age. The most severe fragility fracture, hip fracture, had a decreasing incidence. However, the incidence curve was right-shifting leading to an increase, both in numbers and in incidence of hip fractures among the oldest female. To identify people at high risk for fractures, re-fracture patients are useful. No less than 21% of the fracture patients had suffered more than one fracture event, accounting for 38% of all fracture events. The total risk ratio for a subsequent fracture was 2.2 (2.1-2.3 95% CI). In males the highest risk for re fracture was in the age cohort 70-79 years (RR 2.7, 2.3-3.2 95% CI), in females > 90 years (RR 3.9, 3.2-4.8 95% CI). Another possible risk factor in this subarctic population is the lack of sunlight, leading to a vitamin D deficit. The overall adjusted risk of sustaining a hip fracture in this population was 2.7 (95%CI:1.3-5.4) in subjects with a serum 25 hydroxyvitamin D below 50 nmol/l. The association was, however, different according to age at baseline. Thus in subjects aged 60 years and above at baseline, the adjusted odds ratio of sustaining a hip fracture was 6.2 (1.2-32.5 95%CI) for the group of individuals with a serum 25OHD below 50 nmol/l, whereas no significant association was found in the youngest age group. In the next 30 years the ongoing demographic changes will accelerate. The World War II baby boomers will cause an age quake. We can already see signs heralding a new fracture pattern: an increasing cohort of mobile but fragile elderly, with considerable co-morbidity is now at risk for fragility fractures. In fracture patients, clinical information is sufficient to pinpoint patients with a high risk for re-fractures. It is therefore clinically important to use the information provided by the fracture event. We suggest that trauma units and primary care units should screen for risk factors and inform patients about the treatment options, and to organize fracture liaison services. This seems to be especially cost-efficient for our oldest and frailest patients. Secondary prophylaxis and follow-up treatment after cardiovascular disorders are now a matter of course worldwide, but the screening for risk factors, in order to prevent a second fracture, is often neglected. This is one of the most important issues of fracture care in the future in order to improve general health.
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| 11. |
- Bergström, Ulrica, 1970-, et al.
(författare)
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The hip fracture incidence curve is shifting to the right : a forecast of the age-quake
- 2009
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 80:5, s. 520-524
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Tidskriftsartikel (refereegranskat)abstract
- Background The number of hip fractures has doubled in the last 30–40 years in many countries. Age-adjusted incidence has been reported to be decreasing in Europe and North America, but is there a decreasing trend in all age groups? Patients and methods This population-based study included all hip-fracture patients over 50 years of age (a total of 2,919 individuals, 31% of whom were men) admitted to Umeå University Hospital, Sweden, from 1993 through 2005. Results The incidence of hip fracture declined between the periods 1993–1996 and 2001–2005: from 706 to 625 hip fractures per 105 women and from 390 to 317 hip fractures per 105 men. However, there was a 114% increase in the number of fractures in women aged 90 or older (12 and 25 hip fractures/year, respectively, in the two time periods). For the period 2001–05, women ≥ 90 years of age accounted for almost the same numbers of hip fractures as women aged 75–79 (27 fractures/year). The rate increased during this period, from 2,700 per 105 women to 3,900 per 105 women > 90 years. In men there were declining trends for both relative and absolute numbers. Interpretation Although age-adjusted incidence declined in the population > 50 years of age, absolute fracture rate and incidence increased in the very old. Women over 90 now have the same absolute number of hip fractures every year as women aged 75–79 years. There was a right-shift in hip fracture distribution towards the oldest old, probably due to an increased number of octo/nonagenarians, a new population of particularly frail old people that hardly existed earlier. Better health among septuagenarians may also have delayed the age at which fractures occurred. This changing pattern will strain orthopedic and geriatric resources even more.
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| 12. |
- Bjarnegård, Niclas, et al.
(författare)
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Long-term hyperglycaemia impairs vascular smooth muscle cell function in women with type 1 diabetes mellitus
- 2009
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Ingår i: DIABETES and VASCULAR DISEASE RESEARCH. - : SAGE Publications. - 1479-1641 .- 1752-8984. ; 6:1, s. 25-31
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Tidskriftsartikel (refereegranskat)abstract
- Observations of increased stiffness in the elastic aorta in women with diabetes, but not men, emphasise the need for further analysis regarding early abnormalities in arterial wall properties of women with type 1 diabetes mellitus (DM).Ultrasound was used to study the wall properties of the distal brachial artery (BA) in 37 type 1 diabetic women (aged 22-45 years) without evident complications and in 53 controls (C). Blood samples were drawn for later analysis.Flow-mediated dilatation (FMD) was slightly lower in DM than C, 8.1 +/- 4.3% vs. 10.3 +/- 4.9% (p<0.05), and nitrate-mediated dilatation (NMD) was markedly lower, 21.7 +/- 6.6% vs. 31.4 +/- 5.7% (p<0.001). Lumen diameter, intima-media thickness and distensibility were similar in DM and C. Insulin-like growth factor (IGF-1) was lower in DM than C, 231 +/- 65 vs. 349 +/- 68 ng/ml (p<0.001). Glycosylated haemoglobin (HbA(1C)) and matrix metalloproteinase (MMP-9) were independent predictors of the reduced NMD in the DM.Brachial artery responsiveness to an exogenous donor of nitric oxide (NO) was markedly reduced in type 1 diabetic women despite only limited reduction in endothelium-dependent dilatation. The negative association between NMD and HbA(1C) suggests that long-term hyperglycaemia impairs vascular smooth muscle cell function in DM.
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| 13. |
- Borena, Wegene, et al.
(författare)
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Long-term temporal trends in cardiovascular and metabolic risk factors
- 2009
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Ingår i: Wiener Klinische Wochenschrift. - : Springer Science and Business Media LLC. - 0043-5325 .- 1613-7671. ; 121:19-20, s. 623-630
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Metabolic factors such as obesity, hypertension, dyslipidemia and hyperglycemia have consistently been associated with increased risk of cardiovascular disease. There is also growing evidence that these factors are linked to cancer incidence and mortality. The aim of this study was to investigate long-term trends in major metabolic risk factors in three large cohorts. MATERIALS AND METHODS: Data from 239,602 individuals aged 25-64 years participating in health examinations between 1976 and 2005 were used to estimate prevalence and trends in five risk factors. RESULTS: Irrespective of geographic location, individual metabolic risk factors showed divergent trends across the observation period. Whereas obesity and hyperglycemia in men increased by a per decade ratio of 1.54 (95% CI: 1.42-1.66) and 1.62 (95% CI: 1.49-1.76), respectively, and in women by 1.48 (95% CI: 1.41-1.56) and 1.66 (95% CI: 1.57-1.75), hypertension decreased by 0.71 (95% CI: 0.68-0.74) in men and 0.83 (95% CI: 0.79-0.86) in women. Dyslipidemia increased from the 1970s to the 1980s but declined in the succeeding decade. A combination of three or more of these risk factors increased significantly in men by a ratio of 1.15 (95% CI: 1.08-1.22) per decade and in women by 1.20 (95% CI: 1.15-1.27). CONCLUSION: The study shows that individual metabolic risk factors followed divergent trends over the period of three decades even though the combination of three or more risk factors used as a proxy for the metabolic syndrome appeared to be stable over the last two of the decades. The two key components of the syndrome, namely BMI and glucose levels, increased significantly and deserve professional attention.
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| 14. |
- Cornelissen, Gerard, et al.
(författare)
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Freely Dissolved Concentrations and Sediment-Water Activity Ratios of PCDD/Fs and PCBs in the Open Baltic Sea
- 2008
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 42:23, s. 8733-8739
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Tidskriftsartikel (refereegranskat)abstract
- Aqueous concentrations of polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs) as well as polychlorinated biphenyls (PCBs) in the open sea have heretofore been measured by filtering. and extracting large amounts of water. Measurement of freely dissolved concentrations with this technique is difficult because of corrections for sorption to dissolved organic matter. In this study we use a novel, more economic technique using equilibrium passive samplers consisting of 17-mu m thin polyoxymethylene (POM-17), capable of measuring freely dissolved aqueous concentrations (C-W) in pristine (i.e., background) locations. POM-17 was employed in an extensive field campaign at five stations in the open Baltic sea to obtain C-W at two depths (1 m above the seafloor and 25 m below the surface). Median C-W in the overlying water was 2.3 pg toxic equivalents (TEQ)/m(3) PCDD/Fs and 15 pg/L sum 7-PCB, with generally less than a factor two variation among sites and depths. Also freely dissolved concentrations of native compounds in the surface sediment porewater (C-PW) were determined in laboratory batch experiments. The data were used to derive sediment-water activity ratios, which indicate the diffusive flux direction. It was found that the PCDD/Fs and PCBs were in close equilibrium between the sediment porewater and the overlying water. Comparison of C-PW with total sediment concentrations indicated that more than 90% of the compounds were sorbed to sedimentary black carbon.
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| 15. |
- Dahlström, Mia, et al.
(författare)
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Evidence for different pharmacological targets for imidazoline compounds inhibiting settlement of the barnacle Balanus improvisus
- 2005
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Ingår i: Journal of Experimental Zoology. - : Wiley. - 0022-104X .- 1097-010X. ; 303A:7, s. 551-562
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Tidskriftsartikel (refereegranskat)abstract
- We describe the effect of eight different imidazoline/guanidinium compounds on the settlement and metamorphosis of larvae of the barnacle Balanus improvisus. These agents were chosen on the basis of their similar pharmacological classification in vertebrates and their chemical similarity to medetomidine and clonidine, previously described as highly potent settlement inhibitors (nanomolar range). Seven of the tested compounds were found to inhibit settlement in a dose-dependent manner in concentrations ranging from 100 nM to 10 microM without any significant lethal effects. In vertebrate systems these substances have overlapping functions and interact with both alpha-adrenoceptors as well as imidazoline binding sites. Antagonizing experiments using the highly specific alpha(2)-antagonist methoxy-idazoxan or agmatine (the putative endogenous ligand at imidazoline receptors) were performed to discriminate between putative pharmacological mechanisms involved in the inhibition of cyprid settlement. Agmatine was not able to reverse the effect of any of the tested compounds. However, methoxy-idazoxan almost completely abolished the settlement inhibition mediated by guanabenz (alpha(2)-agonist, I(2) ligand), moxonidine (alpha(2)-agonist, I(1) ligand) and tetrahydrozoline (alpha-agonist, I(2) ligand). The actions of cirazoline (alpha(1)-agonist, I(2) ligand) BU 224 (I(2) ligand) and metrazoline (I(2) ligand) were not reversed by treatment with methoxy-idazoxan. These results suggest that the settlement inhibition evoked by the I(2) ligands and alpha(2)-agonists used in this study of the neurologically simple but well-organized barnacle larva is mediated through different physiological targets important in the overall settlement process.
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| 16. |
- Ekbladh, Elin, 1974-
(författare)
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Return to Work : Assessment of Subjective Psychosocial and Environmental Factors
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduktion: Sjukfrånvaron i Sverige är hög och kunskap om vad som påverkar återgång i arbete efter sjukskrivning behöver utvecklas. I processen kring återgång i arbete är bedömning av arbetsförmåga en viktig del. Bristen på valida, reliabla och teoretiskt förankrade bedömningsinstrument inom området är dock ett bekymmer eftersom tillförlitliga bedömningar av arbetsförmåga är en förutsättning för utformning och genomförande av interventioner för att stödja återgång i arbete. Denna typ av interventioner kräver multidisciplinär kompetens där arbetsterapeuter utgör en viktig funktion. Vid bedömning av arbetsförmåga bör personens subjektiva uppfattning om sin situation beaktas, då den har betydelse för utfallet av återgång i arbete. Worker Role Interview (WRI) och Work Environment Impact Scale (WEIS) är två arbetsrelaterade intervjuinstrument, som har utvecklats i syfte att bedöma subjektiva psykosociala och miljömässiga faktorers påverkan på arbetsförmåga. Den teoretiska grunden till WRI och WEIS är Model of Human Occupation, som är en modell med fokus på aktivitetsutförande i relation till psykosociala faktorer. Inledande prövningar av WRI och WEIS reliabilitet och validitet har genomförts. Bedömningsinstrumenten har bearbetats och översatts till svenska och används främst av arbetsterapeuter, som arbetar med personer med arbetsrelaterad problematik.Syfte: Det övergripande syftet med avhandlingen är att undersöka användbarheten av bedömningsinstrumenten Worker Role Interview och Work Environment Impact Scale för identifiering av psykosociala och miljömässiga rehabiliteringsbehov av betydelse för återgång i arbete.Metod: Avhandlingen består av fem empiriska studier. I samtliga studier har erhållen information bearbetats kvantitativt. I studie IV har även kvalitativ bearbetning genomförts. Studie I, II och IV är tvärsnittsstudier och studie II och V är två års longitudinella studier. I studie I samlades information in via enkät. I studie II, III och V bestod den huvudsakliga informationen av skattningar utifrån WRI variabler och i studie IV var bedömningar utifrån WEIS i form av skattningar och nedskrivna kommentarer till skattningarna den huvudsakliga informationen.Resultat: I studie I undersöktes vilka teoretiska utgångspunkter och professionsspecifika modeller arbetsterapeuter i Sverige ansåg påverka den psykiatriska vården och den psykiatriska arbetsterapin. Det psykosociala perspektivet var den teoretiska utgångspunkt som hade störst påverkan både på psykiatrisk vård och på psykiatrisk arbetsterapi. Den arbetsterapeutiska modell som flest identifierade var Model of Human Occupation. Detta resultat indikerar att Model of Human Occupation verkar vara användbar inom arbetsterapi och motiverade vidare användning av modellen i denna avhandling. Det som dock också framkom i studie I var att arbetsterapeuter inom psykiatrisk vård använde professionsspecifika modeller i en relativt liten utsträckning. Ett sätt att öka tillämpningen av teori i praktik är att använda teoretiskt grundade bedömningsinstrument. I studie II, III, IV och V har endera av de Model of Human Occupation- baserade bedömningsinstrumenten WRI och WEIS använts och värderats.I studie II och V prövades WRI:s förmåga att predicera återgång i arbete efter långvarig sjukskrivning. Det område i WRI som uppvisade bäst prediktivitet var området ”Självuppfattning” vars variabler beaktar personens motivation för återgång i arbete i form av personens upplevelse av kompetens och effektivitet för att utföra arbetsuppgifter och hantera utmaningar i arbetet. De två WRI variabler som bäst kunde predicera vilka som skulle återgå respektive inte återgå i arbete vid uppföljning efter två år var: ”Tro på sin arbetsförmåga”, och ”Dagliga vanor och rutiner”. Resultaten tyder på att kunskap om hur tro på den egna förmågan stärks och kunskap om dagliga vanor och rutiners påverkan på utförande av arbete är central vid genomförande av interventioner i syfte att stödja personer att återgå till arbete efter sjukskrivning.I studie III prövades WRI:s konstrukturella validitet i en internationell studie. Samtliga variabler i WRI, förutom de som tillhör miljöområdet, uppvisade en god konstrukturell validitet dvs mätte psykosociala faktorers påverkan på arbetsförmågan. WRI:s skattningsskala verkar stabil och valid mellan olika länder och för personer med olika diagnoser. I analysen framkom att WRI kunde särskilja mellan personers psykosociala arbetsförmåga på tre olika nivåer.I studie IV undersöktes hur personer med erfarenhet av långtidssjukskrivning uppfattar att faktorer i arbetsmiljön stödjer respektive hindrar personens utförande av arbete och välbefinnande genom bedömningar utifrån WEIS. De faktorer som uppfattades som meststödjande var olika former av sociala interaktioner på arbetet samt uppfattningen om arbetets värde och mening. De faktorer som uppfattades som mest hindrande var olika krav i relation till arbetsgenomförandet samt den belöning som erhålls för arbetet.Konklusion: Sammanfattningsvis så kan WRI användas för bedömning av psykosociala faktorers påverkan på arbetsförmågan. I WRI ingår variabler som kan predicera återgång till arbete upp till två år efter genomförd bedömning. WEIS verkar användbart för att identifiera arbetsmiljöfaktorer som stödjer respektive hindrar personers välbefinnande och utförande av arbete. Att komplettera olika datainsamlingsmetoder är en förutsättning för att uppnå en så god bedömning av arbetsförmåga som möjligt. Den information som WRI- och WEISintervjuer genererar är värdefull, då den kan utgöra en viktig grund för planering av individspecifika rehabiliteringsinsatser. Bedömningsinstrumenten WRI och WEIS med sin teoretiska förankring i Model of Human Occupation kan anses vara användbara för att identifiera psykosociala och miljömässiga rehabiliteringsbehov i syfte att stödja personer i processen åter till arbete efter sjukskrivning.
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| 17. |
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| 18. |
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| 19. |
- Entesarian, Miriam, et al.
(författare)
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Mutations in the gene encoding fibroblast growth factor 10 are associated with
- 2005
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Ingår i: Nat Genet. - 1061-4036. ; 37:2, s. 125-7
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Tidskriftsartikel (refereegranskat)abstract
- Autosomal dominant aplasia of lacrimal and salivary glands (ALSG; OMIM 180920 and OMIM 103420) is a rare condition characterized by irritable eyes and dryness of the mouth. We mapped ALSG to 5p13.2-5q13.1, which coincides with the gene fibroblast growth factor 10 (FGF10). In two extended pedigrees, we identified heterozygous mutations in FGF10 in all individuals with ALSG. Fgf10(+/-) mice have a phenotype similar to ALSG, providing a model for this disorder. We suggest that haploinsufficiency for FGF10 during a crucial stage of development results in ALSG.
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| 20. |
- Entesarian, Miriam, et al.
(författare)
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Mutations in the gene encoding fibroblast growth factor 10 are associated with aplasia of lacrimal and salivary glands.
- 2005
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Ingår i: Nat Genet. ; 37:2, s. 125-7
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Tidskriftsartikel (refereegranskat)abstract
- Autosomal dominant aplasia of lacrimal and salivary glands (ALSG; OMIM 180920 and OMIM 103420) is a rare condition characterized by irritable eyes and dryness of the mouth. We mapped ALSG to 5p13.2-5q13.1, which coincides with the gene fibroblast growth factor 10 (FGF10). In two extended pedigrees, we identified heterozygous mutations in FGF10 in all individuals with ALSG. Fgf10(+/-) mice have a phenotype similar to ALSG, providing a model for this disorder. We suggest that haploinsufficiency for FGF10 during a crucial stage of development results in ALSG.
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| 21. |
- Fava, Cristiano, et al.
(författare)
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Novel mutations in the SLC12A3 gene causing Gitelman's syndrome in Swedes
- 2007
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Ingår i: DNA Sequence. - : Informa UK Limited. - 1029-2365 .- 1042-5179. ; 18:5, s. 395-399
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Gitelman's syndrome (GS) is an inherited autosomal recessive disorder due to loss of function mutations in the SLC12A3 gene encoding the Na-Cl co-transporter (NCCT), the target of thiazide diuretics. The defective function of the NCCT, which normally is expressed in the apical membrane of the distal convolute tubule in the kidney, leads to mild hypotension, hypokalemia, hyperreninemic hyperaldosteronism, mild metabolic alkalosis, hypomagnesemia and hypocalciuria. Up to now, more than 100 mutations of the SLC12A3 gene have been described in GS patients. METHODS: We have collected 30 patients from Sweden with a clinical diagnosis of GS and undertaken a mutation screening by SSCP and successive sequencing of the 26 exons and intronic boundaries. Both mutations were identified in most (n = 28, 93%) and at least one mutation was identified in all patients. RESULTS: We found 22 different mutations evenly distributed throughout the gene, 11 of which have not been described previously. The new variants include 8 missense mutations (Glu68Lys, His69Asn, Argl45His, Vall53Met, Gly230Asp, Gly342Ala, Val677Leu and Gly867Ser), 1 insertion (c.834_835insG on exon 6) and 2 splice-site mutations (c.2667 + lT>G substitution in splicing donor site after exon 22, c.1569-1G>A substitution in the splicing acceptor site before exon 13). CONCLUSION: In Swedish patients with the clinical features of GS, disease-causing mutations in the SLC12A3 gene were identified in most patients. The spectrum of GS mutations is wide making full mutation screening of the SLC12A3 gene necessary to confirm the diagnosis.
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| 22. |
- Folkesson, Joakim, et al.
(författare)
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Rectal cancer survival in the Nordic countries and Scotland
- 2009
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; 125:10, s. 2406-12
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to present detailed population-based survival estimates for patients with a rectal adenocarcinoma, using cancer register data supplemented with clinical data. Based on cancer register data, differences in rectal cancer survival have been reported between countries in Europe. Variation in the distribution of stage at diagnosis, initial therapy including surgical technique, and comorbidity are possible explanatory factors. Adenocarcinomas in the rectum, diagnosed in 1997 and identified in the national cancer registries in the Nordic countries and Scotland were included. Age standardized 5-year relative survival and multiplicative regression models for the relative excess mortality were calculated. 3888 patients were included in the survival study. Men in Denmark, Finland and Iceland had lower 5-year relative survival and poorer stage distribution compared to Norway, Sweden and Scotland. Danish men had the highest rate of excess deaths in the first six months after diagnosis. Stage adjusted, the elevated relative excess mortality decreased and after six months the excess mortality rates were the same in all countries. The poor 5-year relative survival in Danish men was mainly due to a high excess rate of death during the first six months after diagnosis. The low survival in Finland and Iceland was not in accordance with other periods. For both countries this may be explained by random variation due to small numbers. The study emphasizes the need for high quality and detailed data in order to understand international survival differences, and cautions comparisons between large national samples and those of smaller areas.
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| 23. |
- Gabrielsson, Jon, et al.
(författare)
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Combining process and spectroscopic data to improve batch modeling
- 2006
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Ingår i: AIChE Journal. - : Wiley. - 0001-1541 .- 1547-5905. ; 52:9, s. 3164-72
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Tidskriftsartikel (refereegranskat)abstract
- Pharmaceutical production is at present characterized by static processes where quality is guaranteed by controlling the purity of the final product. Achieving better control throughout the process, as a means for improving product quality, is one of the objectives of the PAT initiative by the FDA. A data set consisting of 11 batches characterized by UV spectroscopy together with process data was used in this study. Design of experiments was used to introduce controlled process variation in test batches. The objective was to investigate possible advantages of MSPC using a combined data set, compared to separate models of the respective data sets. Individual models for the separate data sets show that they contain complementary information. A major advantage of combining spectroscopic and process data is that deviations that would go unnoticed using just an individual model can be detected and interpreted. All process manipulations were detected by the combined data set model. Implementation of these methods to batch processes in primary and secondary pharmaceutical production is feasible. An enhanced understanding of the process together with control tools should lead to a well-understood process and, ultimately, real time release. © 2006 American Institute of Chemical Engineers AIChE J, 2006
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| 24. |
- Gabrielsson, Jon, et al.
(författare)
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OPLS methodology for analysis of pre-processing effects on spectroscopic data
- 2006
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Ingår i: Chemometrics and Intelligent Laboratory Systems. - : Elsevier BV. - 0169-7439. ; 84:1-2, s. 153-8
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Tidskriftsartikel (refereegranskat)abstract
- Pre-processing of spectroscopic data is commonly applied to remove unwanted systematic variation. Possible loss of information and ambiguity regarding discarded variation are issues that complicate pre-treatment of data. In this paper, OPLS methodology is applied to evaluate different techniques for pre-processing of spectroscopic data gathered from a batch process. The objective is to present a rational scheme for analysis of pre-processing in order to understand the influence and effect of pre-treatment.O2PLS uses linear regression to divide the systematic variation in X and Y into three parts; one part with joint X–Y covariation, i.e. related to both X and Y, one part of X with Y-orthogonal variation and one part of Y with X-orthogonal variation.All of the investigated pre-treatment methods removed an additive baseline as expected. In the analysis of raw and differentiated data variation associated with the baseline was found in the Y-orthogonal part of X. Orthogonal information was also found in Y, which suggests that this pre-processing procedure not only removed variation. This would have been more difficult to detect without the O2PLS model since both raw and differentiated data must be analysed simultaneously.Development of a knowledge based strategy with OPLS methodology is an important step towards eliminating trial and error approaches to pre-processing.
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| 25. |
- Gabrielsson, Jon, et al.
(författare)
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The OPLS methodology for analysis of multi-block batch process data
- 2006
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Ingår i: Journal of Chemometrics. - : Wiley. - 0886-9383 .- 1099-128X. ; 20:8-10, s. 362-9
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Tidskriftsartikel (refereegranskat)abstract
- With increasing availability of different process analysers multiple data sources are commonly available and this will impose new challenges and enable new types of investigations. The ability to separate joint, complementary and redundant information in multiple block data will be of increasing importance. In this study data from a batch mini plant were collected and O2PLS was implemented to facilitate a combined analysis of spectroscopic and process data. This enables assessment of both the joint and complementary variations in the respective data sets. The different types of variation that were separated were then modelled together to evaluate their individual correlation to a time response. By combining data of different origin an uncomplicated summary of the variation was accomplished and a deeper understanding of process interactions was gained. The analysis of separated variation with a response variable proved useful for verifying the supposed correlation between the joint variation and time.
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| 26. |
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| 27. |
- Haugen, Susanne, 1968-
(författare)
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Från bautasten till bautastor : studier över fornvästnordiska bautasteinn och svenska ord bildade med bauta(-)
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingen tar sin utgångspunkt i två uppslagsord i Svenska Akademiens Ordlista 2006: bautasten och bauta-. Övergripande syfte är att beskriva och förklara lexikala förändringar hos ord bildade med bauta(-) i svenskan under perioden 1664–2006, med särskild hänsyn till dessa förändringars relation till ordens etableringsgrad. Materialet består av 838 belägg för ord bildade med baut- eller böt-, och därutöver undersöks 30 ordböcker. Ordet bautasten är ett isländskt lånord i svenskan. Undersökningen av fornvästnordiska ord visar att bautasteinn kan vara ’sten som är slagen ned i jorden’ eller ’sten rest över en fallen krigare’, två betydelser som kan sammanföras i betydelsen ’minnessten’. Denna betydelse framträder också tydligt i samtliga texter. Historiens höga status under stormaktstiden har haft stor betydelse för att ordet bautasten lånades in i svenskan år 1664. Språkstrukturella faktorer har sannolikt lett till att ordet har uppmärksammats och att det har kunnat användas i svenskan. Under perioden 1664–1790 har etableringsgraden hos bautasten inte har varit hög, men vissa tecken tyder på att den höjs under perioden. Fram till ca 1900 stiger etableringsgraden hos bautasten, men den avtar sedan fram till 1973. I avhandlingen antas att ordets växlande etableringsgrad har varit beroende av synen på historien. I början av 1970-talet stiger etableringsgraden åter hos bautasten och 1985 finns första belägget för bauta- som förstärkande förled, vilket med stor sannolikhet har sin orsak att söka hos den stora populariteten hos och spridningen av seriealbumet Asterix. Förleden bauta- har visat sig vara mycket användbar som förstärkande förled. I materialet finns 3 ord bildade med bauta(-) som inte är etablerade i språksamfundet.
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| 28. |
- Hemmingsson, Helena, 1940-, et al.
(författare)
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An occupational perspective on the concept of participation in the International Classification of Functioning, Disability and Health--some critical remarks
- 2005
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Ingår i: American Journal of Occupational Therapy. - : Aota Press. - 0272-9490 .- 1943-7676. ; 59:5, s. 569-76
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Tidskriftsartikel (refereegranskat)abstract
- The International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2001) provides an international and interprofessional scientific basis for understanding and studying health. The concept of participation plays an important role in the classification and has become a central construct in health care, rehabilitation, and in occupational therapy. The aim of this paper is to provide a critical analysis of the concept of participation in the ICF. As background, the origins and current presentation of the ICF are presented. The use and function of the ICF and the contemporary discussions regarding the classification are reviewed. An occupational perspective on participation in the ICF reveals major shortcomings regarding the subjective experience of meaning and autonomy. Furthermore, the ICF has limitations in capturing different kinds of participation in a single life situation. Following these analyses we discuss the advantages and shortcomings of using the ICF, and how an occupational perspective can contribute to an ongoing discussion about the development of the ICF.
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| 29. |
- Jansik, B., et al.
(författare)
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Cubic response functions in time-dependent density functional theory
- 2005
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Ingår i: Journal of Chemical Physics. - : AIP Publishing. - 0021-9606 .- 1089-7690. ; 122:5
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Tidskriftsartikel (refereegranskat)abstract
- We present density-functional theory for time-dependent response functions up to and including cubic response. The working expressions are derived from an explicit exponential parametrization of the density operator and the Ehrenfest principle, alternatively, the quasienergy ansatz. While the theory retains the adiabatic approximation, implying that the time-dependency of the functional is obtained only implicitly-through the time dependence of the density itself rather than through the form of the exchange-correlation functionals-it generalizes previous time-dependent implementations in that arbitrary functionals can be chosen for the perturbed densities (energy derivatives or response functions). In particular, general density functionals beyond the local density approximation can be applied, such as hybrid functionals with exchange correlation at the generalized-gradient approximation level and fractional exact Hartree-Fock exchange. With our implementation the response of the density can always be obtained using the stated density functional, or optionally different functionals can be applied for the unperturbed and perturbed densities, even different functionals for different response order. As illustration we explore the use of various combinations of functionals for applications of nonlinear optical hyperpolarizabilities of a few centrosymmetric systems; molecular nitrogen, benzene, and the C-60 fullerene. Considering that vibrational, solvent, and local field factors effects are left out, we find in general that very good experimental agreement can be obtained for the second dynamic hyperpolarizability of these systems. It is shown that a treatment of the response of the density beyond the local density approximation gives a significant effect. The use of different functional combinations are motivated and discussed, and it is concluded that the choice of higher order kernels can be of similar importance as the choice of the potential which governs the Kohn-Sham orbitals.
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| 30. |
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| 31. |
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| 32. |
- Jonsson, Bertil, et al.
(författare)
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Backset-stationary and during car driving.
- 2008
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Ingår i: Traffic injury prevention. - : Informa UK Limited. - 1538-957X .- 1538-9588. ; 9:6, s. 568-573
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the study was to measure and analyze backset, defined as the horizontal distance between the back of the occupant's head and a point located on the ventral/top aspect of the sewn rim of the head restraint, with the car stationary and during driving, in the driver's position in a modern car. METHODS: A population of 65 subjects, 35 males and 30 females, was studied in a Volvo V70 car, model year 2007. The subjects were studied in the driver's position, in a self-selected posture. Stationary backset was measured with the technique described by Jonsson et al. (2007) and backset during driving with video analysis. Descriptive data were calculated, and variability and correlation analyses were performed. A t-test was used to test differences of means. Significance level was set to 0.05. RESULTS: In comparison to stationary backset, mean backset during driving was 43 mm greater in males and 41 mm greater in females. Driving backset was 44 mm larger in males than in females. Driving backset was moderately correlated (0.37-0.43) to stature, seated height, and seat back angle in males and moderately correlated (0.44-0.52) to hip width, waist circumference, and weight in females. The overall intraclass correlation coefficient for backset during driving was 0.81 (CI: 0.75-0.86). CONCLUSIONS: These results may be of use in designing future updates of test protocols/routines for geometric backset, such as RCAR and RCAR-IIWPG.
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| 33. |
- Jonsson, Bertil, et al.
(författare)
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Seat adjustment : capacity and repeatability among occupants in a modern car
- 2008
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Ingår i: Ergonomics. - : Taylor & Francis. - 0014-0139 .- 1366-5847. ; 51:2, s. 232-241
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Tidskriftsartikel (refereegranskat)abstract
- Families in the Western world have a car and several family members share the same car. In this study, 154 participants have adjusted a driver's seat three times. The primary objective was to study intrapersonal repeatability and intraclass correlation (ICC) on seat; length adjustment, backrest angle, seat front edge and seat rear edge adjustment, related to participant age, sex, stature and weight. Length adjustment has the best intrapersonal repeatability within two repetitions, 49 mm and ICC-value 0.87. Females and younger participants (age < 40 years) adjust seats generally more accurately. Females adjust the seat 41 mm more forward, 120 mm compared to men 79 mm counted from 0-starting position. Females sit with more upright seat backrests, 46 degree compared to 43 degrees for males counted from 0-starting position. Females sit higher than males in both the frontal and rear part of the seat cushion.
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| 34. |
- Jonsson, Dan, et al.
(författare)
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Kohn–Sham Time-Dependent Density Functional Theory with Applications to Linear and Nonlinear Properties
- 2006
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Ingår i: Nonlinear optical properties of matter. - Dordrecht : Springer Netherlands. - 9781402048500 ; , s. 151-209
-
Bokkapitel (refereegranskat)abstract
- We review Kohn–Sham density-functional theory for time-dependent response functionsup to and including cubic response. The working expressions are derived from anexplicit exponential parametrization of the density operator and the Ehrenfest principle,alternatively the quasi-energy ansatz. While the theory retains the adiabatic approximation,implying that the time-dependency of the functional is obtained only implicitly—through the time-dependency of the density itself rather than through the form ofthe exchange-correlation functionals—our implementation generalizes previous timedependentapproaches in that arbitrary functionals can be chosen for the perturbed densities(energy derivatives or response functions). Thus, the response of the density canalways be obtained using the stated density functional, or optionally different functionalscan be applied for the unperturbed and perturbed densities, even different functionals fordifferent response order. In particular, general density functionals beyond the local densityapproximation can be applied, such as hybrid functionals with exchange–correlation atthe generalized gradient-approximation level and fractional exact Hartree–Fock exchange.We also review some recent progress in time-dependent density functional theory foropen-shell systems, in particular spin-restricted and spin restricted-unrestricted formalismsfor property calculations. We highlight a sample of applications of the theory
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| 35. |
- Jonsson, Hans, et al.
(författare)
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Evaluation of Preprocessing Methods
- 2009
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Ingår i: Comprehensive Chemometrics. - AMSTERDAM : Elsevier. - 9780444527028 ; , s. A199-A206
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 36. |
- Jonsson, Håkan, et al.
(författare)
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Service screening with mammography in Northern Sweden : effects on breast cancer mortality - an update.
- 2007
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Ingår i: Journal of Medical Screening. - : SAGE Publications. - 0969-1413 .- 1475-5793. ; 14:2, s. 87-93
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To study the effectiveness of service screening with mammography in Northern Sweden. SETTING: Two counties which invited women aged 40-74 years to service screening with mammography were compared with two counties where service screening started 5-7 years later. There were 109,000 and 77,000 women in the study and control counties, respectively. METHODS: Cohorts in the study group were defined to include only breast cancer cases diagnosed after their first invitation to screening. Two outcome measures for breast cancer mortality were used; excess mortality and underlying cause of death (UCD). Detection mode was used to estimate the efficacy of screening for those women who actually attended screening. The cohorts were followed for 11 years. RESULTS: The relative rate (RR) of breast cancer death as excess mortality and UCD for women aged 40-74 years invited to screening, compared with women not yet invited, was 0.70 (95% confidence interval [CI] 0.56-0.87) and 0.74 (95% CI 0.62-0.88), respectively. The largest effect was seen in women aged 40-49 years (RR = 0.64 and RR = 0.62 for excess mortality and UCD, respectively). RR in age 40-74 years for women actually screened was 0.65 (95% CI 0.51-0.84) and 0.70 (95% CI 0.57-0.86) for excess mortality and UCD, respectively. The number of women needed to screen to save one life was 912 after 11 years of follow-up. CONCLUSIONS: This study confirms previous findings in the earlier follow-up and indicates a long-term reduction of breast cancer mortality by 26-30%. The efficacy among those who actually attended screening was about 5% larger.
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| 37. |
- Jonsson, Ing-Marie, 1949, et al.
(författare)
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Ethanol prevents development of destructive arthritis
- 2007
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Ingår i: Proc Natl Acad Sci U S A. - Washington, DC : Proceedings of the National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 104:1, s. 258-63
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Tidskriftsartikel (refereegranskat)abstract
- Environmental factors are thought to play a major role in the development of rheumatoid arthritis. Because the use of ethanol is widespread, we assessed the role of ethanol intake on the propensity to develop chronic arthritis. Collagen type II-immunized mice were given water or water containing 10% (vol/vol) ethanol or its metabolite acetaldehyde. Their development of arthritis was assessed, as well as the impact of ethanol on leukocyte migration and activation of intracellular transcription factors. Mice exposed daily to this dose of ethanol did not display any liver toxicity, and the development of erosive arthritis was almost totally abrogated. In contrast, the antibody-mediated effector phase of collagen-induced arthritis was not influenced by ethanol exposure. Also, the major ethanol metabolite, acetaldehyde, prevented the development of arthritis. This antiinflammatory and antidestructive property of ethanol was mediated by (i) down-regulation of leukocyte migration and (ii) up-regulation of testosterone secretion, with the latter leading to decreased NF-kappaB activation. We conclude that low but persistent ethanol consumption delays the onset and halts the progression of collagen-induced arthritis by interaction with innate immune responsiveness.
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| 38. |
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| 39. |
- Jonsson, Mattias, et al.
(författare)
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Cost-effectiveness of silvicultural measures to increase substrate availability for red-listed wood-living organisms in Norway spruce forests
- 2006
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Ingår i: Biological Conservation. - : Elsevier. - 0006-3207 .- 1873-2917. ; 127:4, s. 443-467
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Tidskriftsartikel (refereegranskat)abstract
- It is important that measures to maintain biodiversity are taken in a way that is cost-effective for the landowner. We analyzed the cost-effectiveness of silvicultural measures that aim at increasing the substrate availability for red-listed (species that are threatened, near threatened or where species probably are threatened but data is deficient) saproxylic (wood-inhabiting) organisms. We modelled stands of Norway spruce (Picea abies) in three regions of Sweden by using computer simulations and a database with substrate requirements of saproxylic beetles and cryptogams on the Swedish Red-List. Conclusions concerning cost-effectiveness of silvicultural measures depend on the extinction thresholds of the species they are intended to conserve; measures that generate only small amounts of coarse woody debris (CWD) may provide too little substrate to be useful for species with high extinction thresholds. In northern Sweden, forestland is relatively inexpensive, so a cost-effective strategy to increase the amount of spruce CWD was to set aside more forests as reserves. In central and southern Sweden, more emphasis should instead be given to increasing the amount of CWD in the managed forest. The regulations by the Forest Stewardship Council (FSC) could be made more cost-effective by prescribing creation of more high stumps and retention of larger amounts of naturally dying trees. Large-sized CWD, CWD from slow-growing trees, and CWD in late decay stages are substrate types that were particularly rare in managed forest in relation to unmanaged forests. Manual soil scarification and retention of living trees are measures that can increase the proportion of these underrepresented CWD types.
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| 40. |
- Jonsson, Olof, 1941, et al.
(författare)
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Prophylaxis against bone loss in kock reservoir patients with reduced glomerular filtration rate.
- 2005
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Ingår i: Scand J Urol Nephrol. - : Informa UK Limited. ; 39:3, s. 200-205
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Tidskriftsartikel (refereegranskat)abstract
- Objective We investigated whether treatment with calcium carbonate and vitamin D3 can improve the bone mineral content of patients with ileal reservoirs for continent urinary diversion and a reduced glomerular filtration rate (GFR). Material and methods Twenty-six patients with Kock reservoirs were included in the study. Bone mineralization was determined using dual-energy X-ray absorptiometry. Kidney function was estimated from Cr-EDTA clearance and serum cystatin C concentration. Osteocalcin and parathyroid hormone in serum were also measured. Patients with reduced GFR were treated with calcium carbonate and vitamin D3 perorally. Results Bone mineral density in the femur neck and hip increased in the treatment group, as reflected by an improved T score. Conclusion Patients with ileal reservoirs for continent urinary diversion and reduced kidney function should be supplemented with calcium carbonate and vitamin D3 in order to reduce the long-term risk of osteoporosis.
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| 41. |
- Jonsson, Pär, et al.
(författare)
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A strategy for modelling dynamic responses in metabolic samples characterized by GC/MS
- 2006
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Ingår i: Metabolomics. - : Springer Science and Business Media LLC. - 1573-3882 .- 1573-3890. ; 2:3, s. 135-143
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Tidskriftsartikel (refereegranskat)abstract
- A multivariate strategy for studying the metabolic response over time in urinary GC/MS data is presented and exemplified by a study of drug-induced liver toxicity in the rat. The strategy includes the generation of representative data through hierarchical multivariate curve resolution (H-MCR), highlighting the importance of obtaining resolved metabolite profiles for quantification and identification of exogenous (drug related) and endogenous compounds (potential biomarkers) and for allowing reliable comparisons of multiple samples through multivariate projections. Batch modelling was used to monitor and characterize the normal (control) metabolic variation over time as well as to map the dynamic response of the drug treated animals in relation to the control. In this way treatment related metabolic responses over time could be detected and classified as being drug related or being potential biomarkers. In summary the proposed strategy uses the relatively high sensitivity and reproducibility of GC/MS in combination with efficient multivariate curve resolution and data analysis to discover individual markers of drug metabolism and drug toxicity. The presented results imply that the strategy can be of great value in drug toxicity studies for classifying metabolic markers in relation to their dynamic responses as well as for biomarker identification.
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| 42. |
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| 43. |
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| 44. |
- Jonsson, Per
(författare)
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Safety and biological aspects of present techniques of haemodialysis
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Haemodialysis (HD) is a treatment in which blood from the patient is lead through a tubing system into a dialysis device in a extracorporeal circuit. This circuit contains semipermeable membranes (dialyzer). Blood with uraemic toxins flows on one side, and a salt solution flows on the other side. The salt solution flushes away waste products that have passed the membrane by diffusion or convection through small pores. From there the blood returns to the patient through a tubing system that contains an air-trap and a sensor to avoid air contamination in the blood. Besides air contamination, this treatment is burdened with safety problems such as biocompatibility, electrical safety and mechanical safety. The aim of this thesis was to investigate the safety issues in haemodialysis devices regarding leakage current and air contamination during standard procedures and simulated fault conditions. Does the dialysis device constitute a risk for the patient?Methods: To determine the extent of leakage current in HD machines, measurements at the filter-coupling site were performed in vitro according to the safety standard, IEC 601-1, in 5 types of dialysis machines. To determine, in vitro, to what extent blood and priming fluid allowed leakage current to pass to the patient, leakage current were also measured in the blood lines. The blood line was filled with blood from donors or priming fluid in eight different runs. To determine if leakage current could influence biocompatibility, a Fresenius 2008C dialysis machine and 8 hemophan dialyzers were used. Blood lines contained about 400 ml heparinized blood from each of 8 different donors (in vitro). C3d was measured, in vitro, before start of a simulated dialysis and at 15, 30, 45 and 60 min. during standard dialysis procedure. Then 1.5 mA current was switched on and additional samples were drawn at 75 and 90 min. Some patients need a central dialysis catheter (CDC) for access, placed close to or within the heart. To analyze if leakage current during standard HD would influence the ECG, patients with CDC or with AV-fistula as access were investigated. To analyse if air contamination could occur without activating security alarms in the dialysis device, various modes of in vitro dialysis settings were studied, some using a dextran solution to mimic blood viscosity. Besides visual inspection an ultrasound detector for microemboli and microbubbles was also used.Results: The data showed leakage current at the filter coupling site that was significantly higher for some devices than for others. The leakage current could pass through blood and priming fluid. It exceeded the cardiac floating (CF)-safety limit (<50μA) at the top of the CDC using the test mains on applied part for saline (median 1008μA), for blood (median 610μA) and for a single fault condition using saline (median 68 μA) or blood (47 μA). The leakage current experiments showed that complement activation worsened as the leakage current increased. During standard dialysis arrhythmia could occur. Microbubbles were visible at the bottom of the air-trap and bubbles could pass the air-trap towards the venous line without triggering the alarm. During recirculation, several ml of air could be collected in an intermediate bag after the venous line. Ultrasound showed the presence of bubbles of sizes 2.5-50 μm as well as more than 50 μm silently passing to the venous line in all runs performed.In conclusion, the data showed that a leakage current in HD devices can be high enough to be a safety risk for the patient. This risk is greater if a single fault arises in the dialysis machine or another device connected to the same patient, or during mains contact to the patient. Then the current flow may be high enough to cause arrhythmia for the patient, especially when using a CDC. There is also reason for concern that micro bubble transmission may occur without inducing an alarm. These factors need to be looked over to improve safety regulations and optimize HD treatment and service schedules.
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| 45. |
- Lind, Helena, et al.
(författare)
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Antifungal effect of dairy propionibacteria - contribution of organic acids
- 2005
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Ingår i: International Journal of Food Microbiology. - : Elsevier. - 0168-1605 .- 1879-3460. ; 98:2, s. 157-165
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Tidskriftsartikel (refereegranskat)abstract
- Large amounts of food and feed are lost every year due to spoilage by moulds and yeasts. Biopreservation, i.e. the use of microorganisms as preservatives instead of chemicals, has gained increased interest. Lactic acid bacteria and propionibacteria might be particularly useful due to their important role in many food fermentations. Knowledge of the antifungal effects of the organic acids produced by these bacteria is necessary to understand their inhibitory activity. We evaluated the antifungal activity of the type strains of five dairy propionibacteria, Propionibacterium acidipropionici, P. jensenii, P. thoenii, P. freudenreichii subsp. freu denreichii and P. freudenreichii subsp. shermanii against eight food- and feedborne moulds and yeasts. A dual culture system assayed the inhibitory activity on three different agar media, sodium lactate (SL), de Man Rogosa Sharp (MRS) and MRS without acetate (MRS-ac). The amounts of organic acids produced during growth of propionibacteria in liquid SL, MRS and MRS-ac were also determined. The minimal inhibitory concentration (MIC) values of propionic, acetic and lactic acid were established for all fungi at pH 3, 5 and 7. Propionic acid, followed by acetic acid, was the most potent antifungal acid. Inhibition at pH 7 generally required concentrations above 500 mM for all three acids, at pH 5 the MIC values for propionic and acetic acids were 20-120 mM and above 500 mM for lactic acid. At pH 3, the MIC values were, with one exception, below 10 mM for both propionic and acetic acid and above 160 mM for lactic acid. The yeast Pichia anomala was the fungus most resistant to organic acids. The propionibacteria exhibited a pronounced species variation in antifungal activity on MRS (+/- acetate) agar, with P. thoenii being the most potent. Four of the five propionibacteria species produced more propionic and acetic acid in liquid SL medium than in MRS (+/- acetate) broth. However, when SL agar was used as the growth medium, none of the propionibacteria inhibited fungal growth.
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| 46. |
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| 47. |
- Lindström, Sara, et al.
(författare)
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Systematic replication study of reported genetic associations in prostate cancer : Strong support for genetic variation in the androgen pathway
- 2006
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Ingår i: The Prostate. - Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden. Umea Univ, Dept Radiat Sci Oncol, Umea, Sweden. Wake Forest Univ, Sch Med, Ctr Human Genome, Winston Salem, NC USA. Karolinska Inst, Ctr Genome & Bioinformat, Stockholm, Sweden. Univ Leicester, Dept Genet, Leicester, Leics, England. Johns Hopkins Med Inst, Dept Urol, Baltimore, MD USA. Karolinska Inst, CLINTEC, Ctr Oncol, Stockholm, Sweden. : WILEY-LISS. - 0270-4137 .- 1097-0045. ; 66:16, s. 1729-1743
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND. Association studies have become a common and popular method to identify genetic variants predisposing to complex diseases. Despite considerable efforts and initial promising findings, the field of prostate cancer genetics is characterized by inconclusive reports and no prostate cancer gene has yet been established. METHODS. We performed a literature review and identified 79 different polymorphisms reported to influence prostate cancer risk. Of these, 46 were selected and tested for association in a large Swedish population-based case-control prostate cancer population. RESULTS. We observed significant (P < 0.05) confirmation for six polymorphisms located in five different genes. Three of them coded for key enzymes in the androgen biosynthesis and response pathway; the CAG repeat in the androgen receptor (AR) gene (P = 0.03), one SNP in the CYP17 gene (P = 0.04), two SNPs in the SRD5A2 gene (P = 0.02 and 0.02, respectively), a deletion of the GSTT1. gene (P = 0.006), and one SNP in the MSR1 gene, IVS5-59C > A, (P = 0.009). CONCLUSIONS. Notwithstanding the difficulties to replicate findings in genetic association studies, our results strongly support the importance of androgen pathway genes in prostate cancer etiology.
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| 48. |
- Marsell, Richard, et al.
(författare)
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Fibroblast growth factor-23 is associated with parathyroid hormone and renal function in a population-based cohort of elderly men.
- 2008
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Ingår i: European journal of endocrinology / European Federation of Endocrine Societies. - 1479-683X .- 0804-4643. ; 158:1, s. 125-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Fibroblast growth factor-23 (FGF23) is a circulating factor involved in phosphate (Pi) and vitamin D metabolism. Serum FGF23 is increased at later stages of chronic kidney disease due to chronic hyperphosphatemia and decreased renal clearance. Recent studies also indicate that FGF23 may directly regulate the expression of parathyroid hormone (PTH) in vitro. Therefore, the objective of the current study was to determine the relationship between FGF23, PTH, and other biochemistries in vivo in subjects with no history of renal disease. DESIGN: Serum biochemistries were measured in a subsample of the population-based Swedish part of the MrOS study. In total, 1000 Caucasian men aged 70-80 years were randomly selected from the population. METHODS: Intact FGF23, Pi, calcium, albumin, estimated glomerular filtration rate (eGFR, calculated from cystatin C), PTH, and 25(OH)D3 were measured. Association studies were performed using linear univariate and multivariate regression analyses. RESULTS: The median FGF23 level was 36.6 pg/ml, ranging from 0.63 to 957 pg/ml. There was a significant correlation between log FGF23 and eGFR (r=-0.21; P<0.00001) and log PTH (r=0.13; P<0.001). These variables remained as independent predictors of FGF23 in multivariate analysis. In addition, log PTH (beta=0.082; P<0.05) and eGFR (beta=-0.090; P<0.05) were associated with log FGF23 in subjects with eGFR>60 ml/min. Only eGFR (beta=-0.35; P<0.0001) remained as a predictor of log FGF23 in subjects with eGFR<60 ml/min. CONCLUSIONS: Serum FGF23 and PTH are associated in vivo, supporting recent findings that FGF23 directly regulates PTH expression in vitro. Additionally, eGFR is associated with FGF23 in subjects with normal or mildly impaired renal function, indicating that GFR may modulate FGF23 levels independent of serum Pi.
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| 49. |
- Marsell, Richard, et al.
(författare)
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Relation between fibroblast growth factor-23, body weight and bone mineral density in elderly men
- 2009
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Ingår i: Osteoporosis International. - : Springer Science and Business Media LLC. - 0937-941X .- 1433-2965. ; 20:7, s. 1167-1173
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated the relation between serum FGF23 and bone mineral density (BMD) in a community-based cohort of elderly men. There was a weak correlation between FGF23 and BMD, which was primarily dependent on body weight.INTRODUCTION: FGF23 is a hormonal factor produced in bone and regulates serum levels of phosphate (Pi) and vitamin D. FGF23 over-expression is associated with skeletal abnormalities, including rickets/osteomalacia. The relation between FGF23 and Bone Mineral Density (BMD) in the community remains unexplored.METHODS: We employed a large, population-based cohort of 3014 Swedish men aged 69-80 years, without known renal disease. BMD was measured with dual X-ray absorptiometry (DXA) in the hip and lumbar spine. Serum intact FGF23 was analyzed with a two-site monoclonal ELISA.RESULTS: There was a weak but significant correlation between FGF23 and BMD in femoral neck (r = 0.04, p < 0.05), femoral trochanter (r = 0.05, p = 0.004), total hip (r = 0.06, p = 0.0015) and lumbar spine (r = 0.07, p = 0.0004). The correlations remained significant when adjusting for biochemical covariates (Pi, calcium, PTH, 25(OH)D and renal function). However, the association became insignificant in all regions when adjusting for established confounding variables including age, height, weight and smoking. Further analysis confirmed a significant correlation between FGF23 and body weight (r = 0.13, p < 0.0001).CONCLUSIONS: The weak correlation between FGF23 and BMD in elderly male subjects is mainly due to an association between FGF23 and body weight. Therefore, FGF23 may not play a significant role in the hormonal regulation of BMD.
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| 50. |
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