| 1. |
- Nilsson, Maria, 1957-
(author)
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Promoting health in adolescents : preventing the use of tobacco
- 2009
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Doctoral thesis (other academic/artistic)abstract
- There is a robust evidence base for the negative health effects from smoking. Smoking is linked to severe morbidity and to mortality, and kills up to half of its regular users. Tobacco use and production also bring other negative consequences such as economic loss for countries, poverty for individuals, child labour, deforestation and other environmental problems in tobacco growing countries. A combination of comprehensive interventions at different levels is needed to curb the tobacco epidemic. Tobacco control strategies at national levels in the western world often include components of information/education, taxation, legislative measures and influencing public opinion. Two approaches have dominated at the meso and micro levels: cessation support for tobacco users and prevention activities to support young people refraining from tobacco use. Smoking uptake is a complex process that includes factors at the societal level as well as social and individual characteristics. At national level, taxation and legislation can contribute to a societal norm opposing tobacco and creating a context for primary prevention aimed at tobacco free youth. There is no magic bullet in primary prevention. At the meso and micro levels, a continued development of knowledge on the underlying mechanisms and primary prevention methods is essential to prevent young people from starting to use tobacco. The overall aim of this thesis was to gain knowledge about factors that influence young people’s use of tobacco and of preventive mechanisms. The specific aims included to study the relation between Tobacco Free Duo, an intervention program targeting youth in Västerbotten County, and tobacco use prevalence. A specific interest was to explore the role adults can play in supporting young people to refrain from tobacco use. The thesis is based on four studies with three separate sets of data, two were quantitative and one was qualitative. The studies were conducted among adolescents (aged 13-15 yr) in Västerbotten County and on national level in Sweden (aged 13, 15 and 17 yr). Tobacco Free Duo is a school-based community intervention that started in 1993. An essential component of the intervention was to involve adults in supporting adolescents to stay tobacco free. Results showed decreased smoking in adolescents among both boys and girls in the intervention area during the study period of seven years. There was no change in a national reference group during the same time period. A bonus effect was a decrease in adult tobacco use in the intervention area. One out of four adults who supported a young person taking part in the intervention stopped using tobacco. In a qualitative assessment of young smokers, starting to smoke was described as a means of gaining control of their feelings and their situation during early adolescence. They expected adults to intervene against their smoking and claimed that close relations with caring adults could be a reason for smoking less or trying to quit smoking. In a quantitative study that used three decades of national data, over time adolescents became more positive toward parental action on children’s smoking. The adolescents strongly supported the idea of parental action, regardless of whether or not they themselves smoked. Adolescents preferred that actions from parents were dissuading their children from smoking, not smoking themselves, and not allowing their children to smoke at home. These results suggest that the Tobacco Free Duo program contributed to a reduction in adolescent smoking among both boys and girls. Using a multi-faceted intervention that includes an adolescent-adult partnership can decrease adolescent smoking uptake. Engaging adults as partners in tobacco prevention interventions that target adolescents has an important tobacco reducing bonus effect in the adults. The intervention has proven sustainable within communities. A growing majority of adolescents support parental interventions to help them refrain from tobacco. The findings dismiss the notion that adolescents ignore or even disdain parental practices concerning tobacco. A common and consequent norm against tobacco from both schools and parents using a supportive attitude can prevent tobacco use in young people.
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| 2. |
- Folkersen, Lasse, et al.
(author)
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Genomic and drug target evaluation of 90 cardiovascular proteins in 30,931 individuals.
- 2020
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In: Nature metabolism. - : Springer Science and Business Media LLC. - 2522-5812. ; 2:10, s. 1135-1148
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Journal article (peer-reviewed)abstract
- Circulating proteins are vital in human health and disease and are frequently used as biomarkers for clinical decision-making or as targets for pharmacological intervention. Here, we map and replicate protein quantitative trait loci (pQTL) for 90 cardiovascular proteins in over 30,000 individuals, resulting in 451 pQTLs for 85 proteins. For each protein, we further perform pathway mapping to obtain trans-pQTL gene and regulatory designations. We substantiate these regulatory findings with orthogonal evidence for trans-pQTLs using mouse knockdown experiments (ABCA1 and TRIB1) and clinical trial results (chemokine receptors CCR2 and CCR5), with consistent regulation. Finally, we evaluate known drug targets, and suggest new target candidates or repositioning opportunities using Mendelian randomization. This identifies 11 proteins with causal evidence of involvement in human disease that have not previously been targeted, including EGF, IL-16, PAPPA, SPON1, F3, ADM, CASP-8, CHI3L1, CXCL16, GDF15 and MMP-12. Taken together, these findings demonstrate the utility of large-scale mapping of the genetics of the proteome and provide a resource for future precision studies of circulating proteins in human health.
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| 3. |
- Jerdén, Lars
(author)
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Health-promoting health services : personal health documents and empowerment
- 2007
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Doctoral thesis (other academic/artistic)abstract
- In 2003, the Swedish Parliament adopted a national public health policy that included the domain - “A more health-promoting health service”. Strategies and tools are needed in the work to reorient health services. Personal health documents are documents concerning a person’s health, and are owned by the individual. Several studies that have evaluated such documents indicate that they could be of interest in health-promotion work. However, there is insufficient knowledge concerning personal health documents that target adolescents, and little is known about the feasibility of such documents in a Swedish cultural context. The concept of empowerment is gaining increased interest for health services, but the associations between empowerment, self-rated health and health behaviour are sparsely studied. The overall aim of the thesis is to explore a strategy - empowerment - and a tool - personal health documents - that might facilitate the work of the public health goal of a health-promoting health service. Specific aims are to examine the feasibility of using personal health documents in health promotion; to examine professionals’ experiences of working with health promotion and personal health documents; to examine the association between personal health documents and self-reported health behaviour change; and to examine the perception of empowerment in relation to self-rated health and health behaviour among adolescents. Two personal health documents that targeted adults and adolescents were developed and evaluated. Distribution to adults in different settings was compared in a cross-sectional study (n = 1 306). Adolescents received the document in school, and surveys were performed at baseline and after one year (n = 339). Practical use and attitudes by document owners were studied by questionnaires. Teachers (n = 69) answered a questionnaire, and community health nurses were interviewed (n = 12). The interviews also explored nurses’ experiences of working with health promotion in general, and were analysed by qualitative methodology. Adolescents’ empowerment was examined by a questionnaire (n = 1 046). Most participants reported reading in the documents; writing in the documents varied between 16% (distribution in occupational health) and 87% (adolescents). The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a non-smoker and having a positive school experience. Community health nurses were striving for a balance of being a doer of practical, disease-oriented tasks and a health-promotion communicator. The structural organisation in health care centres was important for their work with health promotion and the health document. Teachers were generally in favour of continued work with the document. In different settings, between 10% and 26% of adults reported changes in their health situations as a result of reading the booklet. Self-reported changes in health situations were less likely using postal distribution, and there were no significant differences between the other types of distribution. Adolescents with low empowerment scores reported poorer self-rated health and more risk-taking behaviours such as smoking and binge drinking. To conclude, personal health documents are feasible to use in different settings. Health promotion in health services needs active support from leaders as well as adequate support systems. Findings suggest that personal health documents can be tools for promoting self-reported lifestyle changes among adults in different settings. There is a close relation among adolescents between low empowerment in the domain of health, low self-rated health and health behaviours such as binge drinking and smoking.
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| 6. |
- Sjölie, Daniel, 1977-
(author)
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Human brains and virtual realities : Computer-generated presence in theory and practice
- 2013
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Doctoral thesis (other academic/artistic)abstract
- A combined view of the human brain and computer-generated virtual realities is motivated by recent developments in cognitive neuroscience and human-computer interaction (HCI). The emergence of new theories of human brain function, together with an increasing use of realistic human-computer interaction, give reason to believe that a better understanding of the relationship between human brains and virtual realities is both possible and valuable. The concept of “presence”, described as the subjective feeling of being in a place that feels real, can serve as a cornerstone concept in the development of such an understanding, as computer-generated presence is tightly related to how human brains work in virtual realities.In this thesis, presence is related both to theoretical discussions rooted in theories of human brain function, and to measurements of brain activity during realistic interaction. The practical implications of such results are further developed by considering potential applications. This includes the development and evaluation of a prototype application, motivated by presented principles.The theoretical conception of presence in this thesis relies on general principles of brain function, and describes presence as a general cognitive function, not specifically related to virtual realities. Virtual reality (VR) is an excellent technology for investigating and taking advantage of all aspects of presence, but a more general interpretation allows the same principles to be applied to a wide range of applications.Functional magnetic resonance imaging (fMRI) was used to study the working human brain in VR. Such data can inform and constrain further discussion about presence. Using two different experimental designs we have investigated both the effect of basic aspects of VR interaction, as well as the neural correlates of disrupted presence in a naturalistic environment.Reality-based brain-computer interaction (RBBCI) is suggested as a concept for summarizing the motivations for, and the context of, applications building on an understanding of human brains in virtual realities. The RBBCI prototype application we developed did not achieve the set goals, but much remains to be investigated and lessons from our evaluation point to possible ways forward. A developed use of methods and techniques from computer gaming is of particular interest.
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| 7. |
- Wikstrand, Greger, 1972-
(author)
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Human factors and wireless network applications : more bits and better bits
- 2006
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Doctoral thesis (other academic/artistic)abstract
- I avhandlingen beskrivs ett hypotetiskt system som kan användas av mobila användare, bland andra taxichaufförer, som exempelvis vill följa en viktig fotbollsmatch. Flera faktorer ställer till problem: Ibland står bilen still och föraren har inget annat att tänka på än matchen. Ibland kör denne runt med en kund som inte vill bli störd av matchen. Dessutom kan det vara svårt att titta på rörliga bilder och köra bil samtidigt. I och med att bilen körs runt har man också olika bra anslutning till Internet vid olika tillfällen – det kan variera mellan inget alls, en dålig GSM/GPRS förbindelse (8 kbps) och en snabb WLAN anslutning (100 Mbps). I avhandlingen presenteras en tre-lagers modell som kan användas för att beskriva den här typen av applikationers kvalitet. Modellen delas in i tre lager: nätverk, applikation och användare/använding. Det sistnämnda lagret ligger utanför det tekniska systemet och definieras av att det är där de verkliga informationsutbytet sker. På applikationsnivån samlas data in, packas och packas upp i samband med nätverkstransport och visas sedan för användaren. Det är också här som eventuell interaktion sker med användaren. Nätverkslagret är ansvarigt för ändamålsenlig transport av data. De tre lagren är ömsesidigt beroende av varandra. Dålig prestanda på ettlager påverkar de andra lagren och tvärtom. Tre studier har genomförts av hur problem på nätverkslagret i form av begränsad bandbredd och hög fördöjning påverkar användarna. Låg bandbredd ger låg videokvalitet vilket inte uppskattas av användarnamnen genom att skifta till animeringar som fungerar med lägre bandbredd kan man ändå få användarna nöjda. Om användarna måste välja mellandålig videokvalitet och animeringar väljer de som ser sig som fotbollskunniga det förstnämnda och de som ser sig som okunniga men dock fotbollsfans väljer det sistnämnda. Men i en annan studie där användarna spelade bluffstopp mot varandra över ett datanätverk fick vi ett annat resultat. Där var det negativt med högre videokvalitet (bilder per sekund). En förklaring kan vara att användarna distraherades mer av högre bildfrekvens. I den tredje studien studerades vad som händer i Pong om man läggerin fördröjningar i spelet. Sedan tidigare visste man att det blir svårare attspela med fördröjningar – särskilt om man inte märker dem. Vi ställde ossfrågan om man kan kompensera för dem genom att informera användarna om dem. Det visade sig att användare som får information med i vårtfall en prediktiv visning lättare anpassar sin mentala insats till uppgiftens svårighetsgrad. Det är alltså inte bara möjligt utan ibland också önskvärt att utnyttja en lägre bandbredd från användarens perspektiv. Med det sagt finns det ändå i långt fler situationer där det är bättre med bättre nätverksprestanda. Pongspelet var roligare med lägre delay. Videon uppfattades som bättre medhögre bandbredd i den förstnämnda studien. Multicast, där ett paket skickas till flera användare i stället för att de skafå varsin, identiska paket, är ett viktigt verktyg för att få bättre prestanda i videoapplikationer. Tyvärr är det inbyggda stödet för multicast i den viktiga IEEE 802.11 standardfamiljen för trådlösa nätverk mycket outvecklat. Ettstort problem är att det inte går att veta om ett paket har kommit fram eller om det har försvunnit i en, mycket trolig, krock. Vi har vidareutvecklat och anpassat en föga känd krockdetektionsmekanism från 80-talet för använding i IEEE 802.11 nätverk. Den anpassade algoritmen kallar vi EMCD vilket är en förkortning för ‘‘Early Multicast Collision Detection’’ eller tidig krockupptäckt för multicast. Vi har presenterat en nysannolikhetsbaserad modell för att beräkna algoritmens prestanda undermaximal belastning. Modellen som har verifierats genom simuleringar kanäven användas för att beräkna optimala parametrar för algoritmen. Algoritmen har visats kraftigt reducera risken för oupptäckta kollisioner och reducerar den tid som går åt för dem. EMCD-algoritmen inspirerade till att utveckla en ytterligare algoritm som inte bara kan upptäcka utan också undvika kollisioner: PREMA som står för ‘‘Prioritized Repeated Eliminations Multiple Access’’ eller prioriterad kanal-åtkomst med upprepade eliminationer. Det finns två viktiga skillnader mellanhur de fungerar. I EMCD bygger kollisionsdetektionen på rektangelfördelade slumptal och en enda upptäcktsomgång. I PREMA används i stället geometriskt fördelade slumptal och upprepade omgångar. Effekten blir att man med stor säkerhet får en enda vinnare. även för PREMA presenteras en sannolikhetskalkylsbaserad prestandaanalys för maxlastfallet vilken stöds av simuleringar. Samma formler kan användas för att approximativt skatta prestanda i EY-NPMA som är en närliggande algoritm. Den var tänkt att använda i Hiperlan/1; en standard som aldrig fick något kommersiellt genombrott. Använder man den modell som vi presenterar i avhandlingens sista studiekan man med ganska god noggrannhet beräkna optimala parametrar för EY-NPMA med en beräkningsinsats O(mY S) mot O(mES×mY S) för tidigare kända algoritmer.
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| 8. |
- Ahlman, Daniel, 1978-
(author)
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A study of turbulence and scalar mixing in a wall-jet using direct numerical simulation
- 2006
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Licentiate thesis (other academic/artistic)abstract
- Direct numerical simulation is used to study the dynamics and mixing in a turbulent plane wall-jet. The investigation is undertaken in order to extend the knowledge base of the influence of the wall on turbulent dynamics and mixing. The mixing statistics produced can also be used to evaluate and develop models for mixing and combustion. In order to perform the simulations, a numerical code was developed. The code employs compact finite difference schemes, of high order, for spatial integration, and a low-storage Runge-Kutta method for the temporal integration. In the simulations performed the inlet based Reynolds and Mach numbers of the wall jet were Re = 2000 and M=0.5, respectively. Above the jet a constant coflow of 10% of the inlet jet velocity was applied. A passive scalar was added at the inlet of the jet, in a non-premixed manner, enabling an investigation of the wall-jet mixing as well as the dynamics. The mean development and the respective self-similarity of the inner and outer shear layers were studied. Comparisons of properties in the shear layers of different character were performed by applying inner and outer scaling. The characteristics of the wall-jet was compared to what has been observed in other canonical shear flows. In the inner part of the jet, 0 ≤ y+ ≤ 13, the wall-jet was found to closely resemble a zero pressure gradient boundary layer. The outer layer was found to resemble a free plane jet. The downstream growth rate of the scalar was approximately equal to that of the streamwise velocity, in terms of the growth rate of the half-width. The scalar fluxes in the streamwise and wall-normal direction were found to be of comparable magnitude.
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| 9. |
- Bergström, Göran, 1964, et al.
(author)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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In: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Journal article (peer-reviewed)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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| 10. |
- Blomberg, Karin, 1970-, et al.
(author)
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Fifty-year follow-up of childhood epilepsy : Social, psychometric, and occupational outcome
- 2019
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In: Epilepsy & Behavior. - : Elsevier. - 1525-5050 .- 1525-5069. ; 96, s. 224-228
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The objective of this study was to explore and describe the experience of a childhood diagnosis of epilepsy and its consequences for the experiences of daily life over a span of 50 years.METHODS: A descriptive mixed method design was chosen. Data were collected through a survey returned by 86 persons (59% response rate) who had received diagnoses of epilepsy as children. The survey contained questions about education, vocation, family status, and included the 14-item Hospital Anxiety and Depression Scale (HAD). Additionally, interviews (n = 11) were conducted and analyzed by interpretative description.RESULTS: Few persons reported that the childhood diagnosis of epilepsy had affected their choice of education, work, or leisure activities. However, 20% reported that the diagnosis had caused problems in school or at work and had restricted their activities of daily living. Sixty-six percent of the participants were married, and 68% had children; of those, 12 (20%) reported that one or more of the children had also had seizures. Almost all reported no anxiety (82%) and no depression (90%). The results of the interviews revealed a balancing act between 'Controlling and managing the situation' and 'Not being restricted by the condition'.SIGNIFICANCE: This long-term follow-up over a 50-year life-span of persons who received childhood diagnoses of epilepsy suggests that the consequences for education, work, and leisure activities were few. Most of the participants had developed strategies to manage their situation.
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