| 1. |
- Angelstam, Per, et al.
(author)
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Knowledge production and learning for sustainable forest landscapes: the European continent's west and east as a laboratory
- 2019
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In: Lesnoy zhurnal. - : M.V. Lomonosov Northern (Arctic) Federal University. - 0536-1036. ; , s. 9-31
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Research review (peer-reviewed)abstract
- To support human well-being, green (or ecological) infrastructure policy stresses the need to sustain functional networks of representative terrestrial and aquatic ecosystems for the sus- tainable provision of multiple ecosystem services. Implementing this means that the com- plexity of interactions between social and ecological systems at multiple spatial scales and levels of governance needs to be understood. Place-based knowledge production and learn- ing through integration of different research disciplines in collaboration with actors and stakeholders (i.e. transdisciplinary research) is a key feature to achieve this goal. Using a suite of local landscapes and regions on the European continent’s West and East as a labora- tory, we developed and applied a step-wise approach to produce knowledge and encourage learning towards functional green infrastructures. Our diagnoses of forest landscapes show that the functionality for wood production and biodiversity conservation was inversely relat- ed in the gradient from long to short forest management histories. In Europe’s West there is a need for increased quantity of, and more functional, protected areas; diversification of management methods; and landscape restoration. In NW Russia there are opportunities to intensify forest management, and to continue the land-sparing approach with zoning for different functions, thus reducing biodiversity loss. Examples of diagnoses of social systems included the evaluation of comprehensive planning in Sweden, outcomes for biodiversity conservation of forest certification in Lithuania, and learning from environmental managers. We conclude that the main challenge for securing functional green infrastructure is poor cross-sectoral integration. Treatment of social-ecological systems requires knowledge-based collaboration and learning. The diversity of landscape histories and governance legacies on the European continent’s West and East, including Russia, offers grand opportunities for both knowledge production about performance targets for green infrastructure functionality, as well as learning to adapt governance and management to regional contexts. Integrating project funding for both researchers and stakeholder collaboration is a necessary strategy to fill the transdisciplinary research agenda. However, formal and informal disciplinary and administrative barriers can limit team building despite self-reflection and experience.
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| 2. |
- Angelstam, Per, et al.
(author)
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LTSER platforms as a place-based transdisciplinary research infrastructure: learning landscape approach through evaluation
- 2019
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In: Landscape Ecology. - : Springer Science and Business Media LLC. - 0921-2973 .- 1572-9761. ; 34, s. 1461-1484
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Journal article (peer-reviewed)abstract
- Context Place-based transdisciplinary research involves multiple academic disciplines and non-academic actors. Long-Term Socio-Ecological Research (LTSER) platform is one concept with similar to 80 initiatives globally.Objectives As an exercise in learning through evaluation we audited (1) the siting, construction and maintenance of individual LTSER platforms, and (2) them as a distributed infrastructure for place-based transdisciplinary research with focus on the European continent.MethodsFirst, we defined a normative model for ideal performance at both platform and network levels. Second, four surveys were sent out to the 67 self-reported LTSER platforms officially listed at the end of 2016. Third, with a focus on the network level, we analyzed the spatial distribution of both long-term ecological monitoring sites within LTSER platforms, and LTSER platforms across the European continent. Fourth, narrative biographies of 18 platforms in different stages of development were analyzed.ResultsWhile the siting of LTSER platforms represented biogeographical regions well, variations in land use history and democratic governance were not well represented. Platform construction was based on 2.1 ecological monitoring sites, with 72% ecosystem and 28% social system research. Maintenance of a platform required three to five staff members, focused mostly on ecosystem research, was based mainly on national funding, and had 1-2years of future funding secured. Networking with other landscape approach concepts was common.ConclusionsIndividually, and as a network, LTSER platforms have good potential for transdisciplinary knowledge production and learning about sustainability challenges. To improve the range of variation of Pan-European social-ecological systems we encourage interfacing with other landscape approach concepts.
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| 3. |
- Axelsson, Robert, et al.
(author)
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The Challenge of Transdisciplinary Research : A Case Study of Learning by Evaluation for Sustainable Transport Infrastructures
- 2020
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In: Sustainability. - : MDPI. - 2071-1050. ; 12:17, s. 1-24
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Journal article (peer-reviewed)abstract
- While transdisciplinary (TD) research is desired in order to solve real world sustainability issues, this may be challenging for both academic and non-academic participants. Supporting learning through evaluation, we analyzed a project aiming at sustainable transport infrastructures. After developing a TD research framework as a benchmark, two external independent evaluators interviewed all project researchers, representatives for end-users, and donors. The evaluators compared results with the framework, and evaluators and participants critically reflected on the results together. There were three inconsistencies relative to the framework: (1) limited understanding of TD research among project management, end-users, and most of the researchers; (2) no structured learning process among end-users; instead, they expressed very diverse opinions about what they expected from the project; (3) project leaders had limited understanding of the special challenges of TD research, did not fully understand the status of the project's social system, and thus did not act as facilitators of the required collaborative learning process. Non-academic participants saw themselves as customers and not as partners in the knowledge production process. We conclude that TD problem-solving research requires much time and needs facilitation and training. A preparatory phase with a lower level of funding would be helpful in preparing for TD processes.
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| 4. |
- Boman, Kurt, et al.
(author)
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Healthcare resource utilisation and costs associated with a heart failure diagnosis : A retrospective, population-based cohort study in Sweden
- 2021
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:10
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Journal article (peer-reviewed)abstract
- Objectives: To examine healthcare resource use (HRU) and costs among heart failure (HF) patients using population data from Sweden.Design: Retrospective, non-interventional cohort study.Setting: Two cohorts were identified from linked national health registers (cohort 1, 2005-2014) and electronic medical records (cohort 2, 2010-2012; primary/secondary care patients from Uppsala and Västerbotten).Participants: Patients (aged ≥18 years) with primary or secondary diagnoses of HF (≥2 International Classification of Diseases and Related Health Problems, 10th revision classification) during the identification period of January 2005 to March 2015 were included.Outcome measures: HRU across the HF phenotypes was assessed with logistic regression. Costs were estimated based on diagnosis-related group codes and general price lists.Results: Total annual costs of secondary care of prevalent HF increased from SEK 6.23 (€0.60) to 8.86 (€0.85) billion between 2005 and 2014. Of 4648 incident patients, HF phenotype was known for 1715: reduced ejection fraction (HFrEF): 64.5%, preserved ejection fraction (HFpEF): 35.5%. Within 1 year of HF diagnosis, the proportion of patients hospitalised was only marginally higher for HFrEF versus HFpEF (all-cause (95% CI): 64.7% (60.8 to 68.4) vs 63.7% (60.8 to 66.5), HR 0.91, p=0.14; cardiovascular disease related (95% CI): 61.1% (57.1 to 64.8) vs 60.9% (58.0 to 63.7), HR 0.93, p=0.28). Frequency of hospitalisations and outpatient visits per patient declined after the first year. All-cause secondary care costs in the first year were SEK 122 758 (€12 890)/patient/year, with HF-specific care accounting for 69% of the costs. Overall, 10% of the most expensive population (younger; predominantly male; more likely to have comorbidities) incurred ~40% of total secondary care costs.Conclusions: HF-associated costs and HRU are high, especially during the first year of diagnosis. This is driven by high hospitalisations rates. Understanding the profile of resource-intensive patients being at younger age, male sex and high Charlson comorbidity index scores at the time of the HF diagnosis is most likely a sign of more severe disease.
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| 5. |
- Dorsch, Michael J., et al.
(author)
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A Review of Resource Theories and Their Implications for Understanding Consumer Behavior
- 2017
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In: Journal of the Association for Consumer Research. - : University of Chicago Press. - 2378-1815 .- 2378-1823. ; 2:1, s. 5-25
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Journal article (peer-reviewed)abstract
- The shift to consumer-centric marketing accentuates the need for a more comprehensive understanding of consumer desires, including how consumers manage their resources to satisfy these desires. However, the complexity of the resource concept combined with a fragmented research stream thus far provides a limited understanding of consumer resources and their effect on consumer well-being. The purpose of this article is to encourage continued research into consumer resources, including resource exchange, to gain a more complete understanding of the concept and to facilitate the development of a unified theory of consumer resources. To accomplish our objective, resource theories proposed in different disciplines (economics, management/marketing, psychology, and social psychology) are summarized and used to provide research direction into a wide variety of consumer behavior issues related to consumer resource management and resource exchange behavior.
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| 6. |
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| 7. |
- Elbakidze, Marine, et al.
(author)
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Hållbar landsbygdsutveckling : samverkan för kunskapsproduktion och lärande
- 2017
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In: Fakta. Skog. - 1400-7789.
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Other publication (pop. science, debate, etc.)abstract
- Landsbygdens naturresurser och andra värden är viktiga för att vidareutveckla en biobaserad ekonomi och att stärka Sverige som besöksnation. Därför är det viktigt med befolkade, aktiva och växande landsbygder. Landsbygden står dock inför stora utmaningar. Hur skapas attraktiva bygder? Hur bevaras gamla jobb, och skapas nya? Hur bevaras ekologiska, sociala och kulturella värden? Genom tvärvetenskaplig forskning tillsammans med aktörer på olika samhällsnivåer verkar vi för en hållbar landsbygd genom att generera kunskap och bidra till lärande. Vårt internationella arbetssätt ger nya perspektiv på kunskapsproduktion och lärande tillsammans med praktiker, och skapar förutsättningar för problembaserad utbildning för hållbar landsbygdsutveckling. Här presenteras huvudinriktningarna för vår forskning för hållbar landsbygdsutveckling.
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| 8. |
- Jansson, Christer, et al.
(author)
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Real-world evidence effect of budesonide+formoterol Spiromax on patients with asthma and chronic obstructive pulmonary disease in Sweden
- 2019
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In: European Clinical Respiratory Journal. - : Informa UK Limited. - 2001-8525. ; 6:1
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Journal article (peer-reviewed)abstract
- Background and Objective: Despite improved asthma and chronic obstructive pulmonary disease (COPD) management, treatment remains inadequate in many patients. Understanding the impact of current treatment in settings outside of controlled trials would add important clinical decision-making information. This study evaluated costs and outcomes associated with budesonide+formoterol (BF) Spiromax® initiation among real-world Swedish patients with asthma and/or COPD.Methods:In this retrospective observational analysis of Swedish patients with asthma and/or COPD, data were collected from the National Patient Register, National Dispensed Drug Register, and Cause of Death Register 1 year before and after initiating BF Spiromax (index date). Outcomes included exacerbation occurrence, treatment patterns, inpatient care, and healthcare costs.Results: The study included 576 patients (asthma: 51.6%; COPD: 32.8%; and asthma and COPD: 15.6%). Following BF Spiromax initiation in asthma patients, there were significant decreases in exacerbations (41.1% to 30.0%; P < 0.001), mean comorbidity-related inpatient visits (0.5 to 0.2; P < 0.001), and inpatient days (1.9 to 0.6; P = 0.006), and a trend toward fewer asthma-related inpatient visits (mean, 0.2 to 0.1; P = 0.056) and asthma-related inpatient days (mean, 0.7 to 0.3; P = 0.060). Increased inpatient utilization was observed in patients with COPD or both diagnoses. All-cause and asthma-/COPD-related medication costs decreased in all groups.Conclusions: After switching to BF Spiromax, asthma patients had fewer exacerbations and hospital visits versus the prior year and COPD patients showed an increase in all-cause and COPD-related healthcare resource utilization. All-cause and asthma-/COPD-related medication costs decreased in all groups after switching to BF Spiromax.
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| 9. |
- Lindmark, Krister, et al.
(author)
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Epidemiology of heart failure and trends in diagnostic work-up : a retrospective, population-based cohort study in Sweden
- 2019
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In: Clinical Epidemiology. - : Dove medical press. - 1179-1349. ; 11, s. 231-244
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Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study was to examine the trends in heart failure (HF) epidemiology and diagnostic work-up in Sweden.Methods: Adults with incident HF (>= 2 ICD-10 diagnostic codes) were identified from linked national health registers (cohort 1, 2005-2013) and electronic medical records (cohort 2, 2010-2015; primary/secondary care patients from Uppsala and Vasterbotten). Trends in annual HF incidence rate and prevalence, risk of all-cause and cardiovascular disease (CVD)-related 1-year mortality and use of diagnostic tests 6 months before and after first HF diagnosis (cohort 2) were assessed.Results: Baseline demographic and clinical characteristics were similar for cohort 1 (N=174,537) and 2 (N=8,702), with mean ages of 77.4 and 76.6 years, respectively; almost 30% of patients were aged >= 85 years. From 2010 to 2014, age-adjusted annual incidence rate of HF/1,000 inhabitants decreased (from 3.20 to 2.91, cohort 1; from 4.34 to 3.33, cohort 2), while age-adjusted prevalence increased (from 1.61% to 1.72% and from 2.15% to 2.18%, respectively). Age-adjusted 1-year all-cause and CVD-related mortality was higher in men than in women among patients in cohort 1 (all-cause mortality hazard ratio [HR] men vs women 1.07 [95% CI 1.06-1.09] and CVD-related mortality subdistribution HR for men vs women 1.04 [95% CI 1.02-1.07], respectively). While 83.5% of patients underwent N-terminal pro-B-type natriuretic peptide testing, only 36.4% of patients had an echocardiogram at the time of diagnosis, although this increased overtime. In the national prevalent HF population (patients with a diagnosis in 1997-2004 who survived into the analysis period; N=273,999), death from ischemic heart disease and myocardial infarction declined between 2005 and 2013, while death from HF and atrial fibrillation/flutter increased (P<0.0001 for trends over time).Conclusion: The annual incidence rate of HF declined over time, while prevalence of HF has increased, suggesting that patients with HF were surviving longer over time. Our study confirms that previously reported epidemiological trends persist and remain to ensure proper diagnostic evaluation and management of patients with HF.
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| 10. |
- Lindmark, Krister, et al.
(author)
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Recurrent heart failure hospitalizations increase the risk of cardiovascular and all-cause mortality in patients with heart failure in Sweden: a real-world study
- 2021
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In: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 8:3, s. 2144-2153
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Journal article (peer-reviewed)abstract
- Aims: Heart failure (HF) is a leading cause of hospitalization and is associated with high morbidity and mortality. We examined the impact of recurrent HF hospitalizations (HFHs) on cardiovascular (CV) mortality among patients with HF in Sweden.Methods and results: Adults with incident HF were identified from linked national health registers and electronic medical records from 01 January 2005 to 31 December 2013 for Uppsala and until 31 December 2014 for Västerbotten. CV mortality and all-cause mortality were evaluated. A time-dependent Cox regression model was used to estimate relative CV mortality rates for recurrent HFHs. Assessment was also done for ejection fraction-based HF phenotypes and for comorbid atrial fibrillation, diabetes, or chronic renal impairment. Overall, 3878 patients with HF having an index hospitalization were included, providing 9691.9 patient-years of follow-up. Patients were relatively old (median age: 80 years) and were more frequently male (55.5%). Compared with patients without recurrent HFHs, the adjusted hazard ratio (HR [95% confidence interval; CI]) for CV mortality and all-cause mortality were statistically significant for patients with one, two, three, and four or more recurrent HFHs. The risk of CV mortality and all-cause mortality increased approximately six-fold in patients with four or more recurrent HFHs vs. those without any HFHs (HR [95% CI]: 6.26 [5.24–7.48] and 5.59 [4.70–6.64], respectively). Similar patterns were observed across the HF phenotypes and patients with comorbidities.Conclusions: There is a strong association between recurrent HFHs and CV and all-cause mortality, with the risk increasing progressively with each recurrent HFH.
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