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1.	af Winklerfelt Hammarberg, Sandra, et al. (author) Clinical effectiveness of care managers in collaborative primary health care for patients with depression : 12-and 24-month follow-up of a pragmatic cluster randomized controlled trial 2022 In: BMC Primary Care. - : Springer Nature. - 2731-4553. ; 23:1 Journal article (peer-reviewed)abstract Background In previous studies, we investigated the effects of a care manager intervention for patients with depression treated in primary health care. At 6 months, care management improved depressive symptoms, remission, return to work, and adherence to anti-depressive medication more than care as usual. The aim of this study was to compare the long-term effectiveness of care management and usual care for primary care patients with depression on depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and 24 months after the start of the intervention. Methods Cluster randomized controlled trial that included 23 primary care centers (11 intervention, 12 control) in the regions of Vastra Gotaland and Dalarna, Sweden. Patients >= 18 years with newly diagnosed mild to moderate depression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed a structured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care manager followed up symptoms and treatment, encouraged behavioral activation, provided education, and communicated with the patient's general practitioner as needed. Patients at control centers received usual care. Adjusted mixed model repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptoms and remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specific questionnaire). Results The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) but not 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differences in remission and self-efficacy were not significant, but patients in the intervention group were more confident that they could get information (53% vs 38%; P = 0.02) and professional emotional support (51% vs 40%; P = 0.05) from the primary care center. Conclusions Patients with depression who had a care manager maintained their 6-month improvements in symptoms at the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients with care managers also had significantly more confidence in primary care and belief in future support than controls.
2.	Andersson-Hange, Dominique, 1963, et al. (author) Experiences and perceptions of Primary Health Care staff participating in scientific research in the workplace 2012 In: “Crossing Borders in Primary Care”. The Future of Primary health Care in Europe IV. Gothenburg 3-4 September, 2012. Conference paper (other academic/artistic)
3.	Appelgren, Alva, et al. (author) Läxor och likvärdiga förutsättningar för lärande : – lärares arbetssätt inför, under och efter läxan 2022 Reports (other academic/artistic)abstract I denna systematiska översikt sammanställs forskning om hur lärares arbete med läxor kan bidra till likvärdiga förutsättningar för elevers lärande. Översikten utgår från följande frågeställning:Vad kännetecknar lärares arbete med läxor som kan bidra till likvärdiga förutsättningar för elevers lärande?Resultaten från de studier som ingår i översikten är sammanställda med fokus på lärares arbete med läxor inför, under och efter läxan. Sammantaget visar resultaten att lärare kan bidra till likvärdiga förutsättningar för elevers lärande genom att planera utformningen av läxan, ta hänsyn till elevers situation i hemmet samt genom att följa upp läxarbetet i undervisningen.Översiktens resultat bygger på 15 forskningsstudier från olika länder som systematiskt har valts ut efter omfattande litteratursökningar i internationella referensdatabaser.
4.	Ara, Mostarin, et al. (author) Pre-commercial thinning in Norway spruce-birch mixed stands can provide abundant forage for ungulates without losing volume production 2022 In: Forest Ecology and Management. - : Elsevier BV. - 0378-1127 .- 1872-7042. ; 520 Journal article (peer-reviewed)abstract Mixed stands of Norway spruce and birch have the potential to simultaneously produce timber and provide large ungulates with a significant amount of forage during the regeneration phase. While the growth and yield of such mixtures are well studied, little is known about potential trade-offs between timber and forage production and which management techniques are suitable for meeting both goals. In this study, four different pre-commercial thinning (PCT) strategies were used to study the trade-offs between production and available forage for free-ranging ungulates in a Norway spruce-birch mixture. The four PCT strategies were: 1) retaining 2000 birch stems ha(-1) with 2000 Norway spruce ha(-1), 2) removing all birches within a 0.75 m radius around Norway spruce stems, 3) removing all birches and other broadleaves, and 4) no PCT (control). Growth of Norway spruce was higher in the 2000 birch ha(-1) and full removal treatments compared to the untreated control, but these two treatments did not differ from one another in volume production of Norway spruce. We found a negative effect of PCT on forage availability but no effect on ungulate browsing. Therefore, PCT strategies that provide both sufficient birch forage and maximize volume production of Norway spruce can be implemented.
5.	Augustsson, Pia, 1967, et al. (author) Implementation of care managers for patients with depression: A cross-sectional study in Swedish primary care 2020 In: BMJ Open. - : BMJ. - 2044-6055. ; 10:5 Journal article (peer-reviewed)abstract Objectives To perform an analysis of collaborative care with a care manager implementation in a primary healthcare setting. The study has a twofold aim: (1) to examine clinicians' and directors' perceptions of implementing collaborative care with a care manager for patients with depression at the primary care centre (PCC), and (2) to identify barriers and facilitators that influenced this implementation. Design A cross-sectional study was performed in 2016-2017 in parallel with a cluster-randomised controlled trial. Setting 36 PCCs in south-west Sweden. Participants PCCs' directors and clinicians. Outcome Data regarding the study's aims were collected by two web-based questionnaires (directors, clinicians). Descriptive statistics and qualitative content analysis were used for analysis. Results Among the 36 PCCs, 461 (59%) clinicians and 36 (100%) directors participated. Fifty-two per cent of clinicians could cooperate with the care manager without problems. Forty per cent regarded to their knowledge of the care manager assignment as insufficient. Around two-thirds perceived that collaborating with the care manager was part of their duty as PCC staff. Almost 90% of the PCCs' directors considered that the assignment of the care manager was clearly designed, around 70% considered the priority of the implementation to be high and around 90% were positive to the implementation. Facilitators consisted of support from colleagues and directors, cooperative skills and positive attitudes. Barriers were high workload, shortage of staff and extensive requirements and demands from healthcare management. Conclusions Our study confirms that the care manager puts collaborative care into practice. Facilitators and barriers of the implementation, such as time, information, soft values and attitudes, financial structure need to be considered when implementing care managers at PCCs. © © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
6.	Bertilsson, Monica, et al. (author) Capacity to work while depressed and anxious - a phenomenological study 2013 In: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 35:20, s. 1705-1711 Journal article (peer-reviewed)abstract Purpose: The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work. Method: Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed. Results: The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with ones ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost "refueling and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome. Conclusions: A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individuals capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence.
7.	Björck, Viveka, et al. (author) Morbidity and mortality in critically ill patients with invasive group A streptococcus infection : an observational study 2020 In: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535. ; 24:1 Journal article (peer-reviewed)abstract BACKGROUND: Group A streptococci (GAS) are known to cause serious invasive infections, but little is known about outcomes when patients with these infections are admitted to intensive care. We wanted to describe critically ill patients with severe sepsis or septic shock due to invasive GAS (iGAS) and compare them with other patients with severe sepsis or septic shock. METHODS: Adult patients admitted to a general intensive care unit (ICU) in Sweden (2007-2019) were screened for severe sepsis or septic shock according to Sepsis 2 definition. Individuals with iGAS infection were identified. The outcome variables were mortality, days alive and free of vasopressors and invasive mechanical ventilation, maximum acute kidney injury score for creatinine, use of continuous renal replacement therapy and maximum Sequential Organ Failure Assessment score during the ICU stay. Age, Simplified Acute Physiology Score (SAPS 3) and iGAS were used as independent, explanatory variables in regression analysis. Cox regression was used for survival analyses. RESULTS: iGAS was identified in 53 of 1021 (5.2%) patients. Patients with iGAS presented a lower median SAPS 3 score (62 [56-72]) vs 71 [61-81]), p < 0.001), had a higher frequency of cardiovascular cause of admission to the ICU (38 [72%] vs 145 [15%], p < 0.001) and had a higher median creatinine score (173 [100-311] vs 133 [86-208] μmol/L, p < 0.019). Of the GAS isolates, 50% were serotyped emm1/T1 and this group showed signs of more pronounced circulatory and renal failure than patients with non-emm1/T1 (p = 0.036 and p = 0.007, respectively). After correction for severity of illness (SAPS 3) and age, iGAS infection was associated with lower mortality risk (95% confidence interval (CI) of hazard ratio (HR) 0.204-0.746, p < 0.001). Morbidity analyses demonstrated that iGAS patients were more likely to develop renal failure. CONCLUSION: Critically ill patients with iGAS infection had a lower mortality risk but a higher degree of renal failure compared to similarly ill sepsis patients. emm1/T1 was found to be the most dominant serotype, and patients with emm1/T1 demonstrated more circulatory and renal failure than patients with other serotypes of iGAS.
8.	Björkelund, Cecilia, 1948, et al. (author) Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial 2018 In: Bmc Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 19:1 Journal article (peer-reviewed)abstract Background: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden. Methods: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged >= 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU). Outcome measures: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle. Results: One hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [-0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group. Conclusions: Care managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients.
9.	Björkelund, Cecilia, 1948, et al. (author) [Effects of a care manager organization for care of people with mild-moderate depression in Swedish primary care]. : Vårdsamordnare för depression – effektivt grepp i primärvården - Gav friskare patienter och hälsoekonomiska vinster. 2019 In: Lakartidningen. - 1652-7518. ; 116 Journal article (other academic/artistic)abstract By strengthening accessibility and continuity and support via a care manager for primary care patients with depression corresponding to 20-30% of a nursing service, patients recovered significantly faster and to a greater extent than in primary care-as-usual. Return to work occurred significantly earlier in the first three months, and net sick leave period was significantly shorter during the following 4-6 months. To introduce a collaborative care organizational change where the care manager is the hub and coordinates care for the patient and makes it possible to adapt the care according to the patient's needs throughout the care process, is thus the individual effort shown to have the greatest efficiency in Swedish primary care to increase the quality of care of depression. This approach, where the clinic and academy work closely and continuously in the development and evaluation phases, makes it possible to rapidly develop new ways of working where consideration is given to the complexity of primary care and the complexity of care needs and care efforts.
10.	Björkelund, Cecilia, 1948, et al. (author) Effects of adding early cooperation and a work-place dialogue meeting to primary care management for sick-listed patients with stress-related disorders: CO-WORK-CARE-Stress - a pragmatic cluster randomised controlled trial. 2024 In: Scandinavian journal of primary health care. - 1502-7724. ; , s. 1-15 Journal article (peer-reviewed)abstract To investigate whether intensified cooperation between general practitioner (GP), care manager and rehabilitation coordinator (RC) for patients sick-listed for stress-related mental disorder, combined with a person-centred dialogue meeting with employer, could reduce sick-leave days compared with usual care manager contact.Pragmatic cluster-randomised controlled trial, randomisation at primary care centre (PCC) level.PCCs in Region Västra Götaland, Sweden, with care manager organisation.Of 30 invited PCCs, 28 (93%) accepted the invitation and recruited 258 patients newly sick-listed due to stress-related mental disorder (n=142 intervention, n=116 control PCCs).Cooperation between GP, care manager and rehabilitation coordinator from start of illness notification plus a person-centred dialogue meeting between patient and employer within 3months. Regular contact with care manager was continued at the control PCCs.12-months net and gross number of sick-leave days. Secondary outcomes: Symptoms of stress, depression, anxiety; work ability and health related quality of life (EQ-5D) over 12months.There were no significant differences between intervention and control groups after 12months: days on sick-leave (12-months net sick-leave days, intervention, mean = 110.7days (95% confidence interval (CI) 82.6-138.8); control, mean = 99.1days (95% CI 73.9-124.3)), stress, depression, or anxiety symptoms, work ability or EQ-5D. There were no significant differences between intervention and control groups concerning proportion on sick-leave after 3, 6, 12months. At 3months 64.8% were on sick-leave in intervention group vs 54.3% in control group; 6months 38% vs 32.8%, and12 months 16.9% vs 15.5%.Increased cooperation at the PCC between GP, care manager and RC for stress-related mental disorder coupled with an early workplace contact in the form of a person-centred dialogue meeting does not reduce days of sick-leave or speed up rehabilitation.Trial registration: ClinicalTrials.gov Identifier: NCT03250026 https://clinicaltrials.gov/study/NCT03250026?tab=results#publicationsCO-WORK-CAREFirst Posted: August 15, 2017. Recruitment of PCCs: September 2017. Inclusion of patients from December 2017.
11.	Björkelund, Cecilia, 1948, et al. (author) Rehabilitation cooperation and person-centred dialogue meeting for patients sick-listed for common mental disorders: 12 months follow-up of sick leave days, symptoms of depression, anxiety, stress and work ability - a pragmatic cluster randomised controlled trial from the CO-WORK-CARE project. 2023 In: BMJ open. - 2044-6055. ; 13:6 Journal article (peer-reviewed)abstract To study whether early and enhanced cooperation within the primary care centres (PCC) combined with workplace cooperation via a person-centred employer dialogue meeting can reduce days on sick leave compared with usual care manager contact for patients on sick leave because of common mental disorders (CMD). Secondary aim: to study lapse of CMD symptoms, perceived Work Ability Index (WAI) and quality of life (QoL) during 12 months.Pragmatic cluster randomised controlled trial, randomisation at PCC level.28 PCCs in Region Västra Götaland, Sweden, with care manager organisation.30 PCCs were invited, 28 (93%) accepted invitation (14 intervention, 14 control) and recruited 341 patients newly sick-listed because of CMD (n=185 at intervention, n=156 at control PCCs).Complex intervention consisting of (1) early cooperation among general practitioner (GP), care manager and a rehabilitation coordinator, plus (2) a person-centred dialogue meeting between patient and employer within 3 months.regular contact with care manager.12 months net and gross number of sick leave days at group level.12 months depression, anxiety, stress symptoms, perceived WAI and QoL (EuroQoL-5 Dimensional, EQ-5D).No significant differences were found between intervention and control groups concerning days of sick leave (intervention net days of sick leave mean 102.48 (SE 13.76) vs control 96.29 (SE 12.38) p=0.73), return to work (HR 0.881, 95%CI 0.688 to 1.128), or CMD symptoms, WAI or EQ-5D after 12 months.It is not possible to speed up CMD patients' return to work or to reduce sick leave time by early and enhanced coordination among GP, care manager and a rehabilitation coordinator, combined with early workplace contact over and above what 'usual' care manager contact during 3 months provides.NCT03250026.
12.	Björkelund, Cecilia, et al. (author) Vårdsamordnare för depression : effektivt grepp i primärvården 2019 In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 116 Journal article (peer-reviewed)
13.	Björkelund, Cecilia, 1948, et al. (author) Vårdsamordnare för depression – effektivt grepp i primärvården. Gav friskare patienter och hälsoekonomiska vinster : Effects of a care manager organization for care of people with mild-moderate depression in Swedish primary care 2019 In: Läkartidningen. - 0023-7205. ; 116 Journal article (peer-reviewed)
14.	Björkelund, Cecilia, 1948, et al. (author) Vårdsamordnare vid psykisk ohälsa i primärvården 2020 Book (other academic/artistic)
15.	Brink, Magnus, et al. (author) Nu gäller Sepsis-3 för definitioner och diagnostiska kriterier : [New definition of and diagnostic criteria for sepsis – Swedish use of Sepsis-3] 2018 In: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 115 Research review (peer-reviewed)abstract A working group representing the Swedish Society for Infectious Diseases, the Swedish Society for Anaesthesiology and Intensive Care, the Swedish Society for Emergency Medicine, and the Swedish Intensive Care Registry have reached consensus on how to adopt the new sepsis definition, Sepsis-3, in Sweden. The recommendation is to implement the new definitions and diagnostic criteria for sepsis and septic shock, but not the use of the new screening tool for sepsis, quick-SOFA, as it needs prospective validation and since it is not clear if quick-SOFA is more useful than the currently used general triage and early warning score systems. The group recommends the use of the sfollowing ICD-10 codes: R65.1 for sepsis and R57.2 for septic shock.
16.	Brink, Magnus, et al. (author) Nu gäller Sepsis-3 för definitioner och diagnostiska kriterier [New definition of and diagnostic criteria for sepsis: Swedish use of Sepsis-3] 2018 In: Läkartidningen. - Stockholm, Sweden : Läkartidningen Förlag AB. - 0023-7205 .- 1652-7518. ; 115:15, s. 660-667 Journal article (peer-reviewed)
17.	Börjesson, Lisa, et al. (author) A Neo-Documentalist Lens for Exploring the Premises of Disciplinary Knowledge Making 2016 In: Proceedings from the Document Academy. - 2376-8908. ; 3:1, s. 1-23 Journal article (peer-reviewed)abstract This article applies a neo-documentalist approach to explore disciplinary documentation and document practices, assumed to condition disciplinary knowledge-making. The aim is to show how conceptions and materialities of what counts as documentation and documents are intertwined with changing and persisting disciplinary and sub-disciplinary practices of producing information and knowledge, of knowing, and informing. A collective, multivocal autoethnographic method is used to obtain vignettes from five areas of activity in or related to archaeology. The ongoing digitization of archaeological investigation and documentation methods, and of archaeological materials, is used as a shared departure point in the vignettes, explaining how digitization influences documents in each area of archaeology. The vignettes illustrate a multitude of conceptions and materialities of documentation and reveal frictions, both within and between sub-disciplinary areas. In light of the exploration of documentation practices in archaeology, we posit that a neo-documentalist perspective functions as a useful analytical tool for deconstructing habitual and canonical conceptions of documentation in disciplines and practices. The approach is especially powerful for pinpointing and explicating frictions between conceptions of documentation that can cause problems in information sharing and communication. We discuss the potential of the neo-documentalist approach as a practical tool to plan for and implement change in documentation and document practices.
18.	Börjesson, Lisa, et al. (author) A neo-documentalist lens for exploring the premises of disciplinary knowledge making 2016 In: Proceedings from the annual meeting of the Document Academy. - 2376-8908. ; 3:1, s. 1-23 Journal article (peer-reviewed)abstract This article applies a neo-documentalist approach to explore disciplinary information and knowledge making practices. The aim is to show how conceptions and materialities of what counts as documentation and documents are intertwined with changing and persisting disciplinary and sub-disciplinary practices of producing information and knowledge, of knowing, and informing. A collective, multivocal autoethnographic method is used to obtain vignettes from five areas of activity in or related to the discipline archaeology. The ongoing digitization of archaeology is used as a shared point of departure in the vignettes, explaining how digitization influences documentation and documents in each area of archaeological practice. The vignettes illustrate a multitude of conceptions and materialities of documentation, and reveal frictions in-between, both between and within sub-disciplinary areas. In the light of the exploration of information and knowledge making practices in archaeology, we posit that a neo-documentalist perspective functions as a useful analytical tool for deconstructing canonical and habitual conceptions of documentation in disciplines and practices. The approach is especially powerful in pinpointing and explicating frictions between conceptions of documentation as potential sources of problems in information sharing. Moreover, we discuss the potential of the neo-documentalist approach as a practical tool to plan for and implement change in documents and documentation practices.
19.	Börjesson, Lisa, et al. (author) A Neo-Documentalist Lens for Exploring the Premises of Disciplinary Knowledge Making 2016 In: Proceedings from the Document Academy. - 2473-215X. ; 3:1, s. 1-23 Journal article (peer-reviewed)abstract The aim of this article is to demonstrate how documentation analysis with a neo-documentalist lens can help us explore variations (and stabilities) in conceptions and materialities of documents, as intertwined with disciplinary and sub-disciplinary practices of informing and knowing. Drawing on documentation theory, and with previous research on archaeological documentation as a background, by means of autoethnographic vignettes we explore contemporary conceptions of documentation in five areas in or related to archaeology (Intra-site 3D documentation, Development-led archaeology, Aggregating documentation for use outside the organization, Mediating documentation – or documentation mediation, and Documenting and displaying archaeology in a changing environment). Digitization, and how digitization has spurred renegotiations of what counts as documentation, functions as a common denominator discussed in all of the vignettes. The analysis highlights simultaneously ongoing renegotiations of documentation serving each area’s unique epistemic purposes, and pushing document materialities in different directions. This operationalization of documentation analysis creates an understanding for intra-disciplinary variations in documentation but is importantly also a practical tool to uncover documentation-related premises of disciplinary knowledge-making. This tool can be applied for example in processes of information policy development (regulating what purposes documentation should serve, and what it should be like), information systems design (e.g. for creation and communication of documentation), and infrastructure development (e.g. for preservation and accessibility of documentation).
20.	Börjesson, Lisa, et al. (author) Information Policy for (Digital) Information in Archaeology : current state and suggestions for development 2015 In: Internet Archaeology. - York : University of York. - 1363-5387. ; 40 Journal article (peer-reviewed)abstract The introduction of digital data capturing and management technologies has transformed information practices in archaeology. Digital documentation and digital infrastructures are integrated in archaeologists' daily work now more than ever. International and national institutions and projects have contributed to the development of digital archiving and curation practices. Because knowledge production in archaeology depends heavily on documentation and information dissemination, and on retrieval of past documentation, the question of how information is managed is profoundly intertwined with the possibilities for knowledge production. Regulations at different levels articulate demands and expectations from the emerging digital information practices, but how are these different regulations coordinated, and do they support archaeological knowledge production?In this article we look into the state of information policy - the sum of principles guiding decisions about information - in archaeology and related areas. The aim of the article is to shed light on how information policy directs practice in archaeology, and to show that analysis of such policies is therefore vital. Information policy in legislation and guidelines in Swedish archaeology serves as a case study, and examples from development-led archaeology and the museum sector illustrate how information policies have varied roles across different heritage sectors. There are historical and local trajectories in the policy documents specific to Sweden, but the discussion shows that the emergence of Swedish policies have many parallels with processes in other countries. The article provides recommendations for information policy development for archaeology and related areas.
21.	Cabak, Andrea, et al. (author) Activity of airway antimicrobial peptides against cystic fibrosis pathogens 2020 In: Pathogens and Disease. - : Oxford University Press. - 2049-632X. ; 78:7 Journal article (peer-reviewed)abstract Antimicrobial peptides are important players of the innate host defence against invading microorganisms. The aim of this study was to evaluate the activity of airway antimicrobial peptides against the common cystic fibrosis (CF) pathogen Pseudomonas aeruginosa, and to compare it to the emerging multi-drug resistant CF pathogens Achromobacter xylosoxidans and Stenotrophomonas maltophilia. Clinical bacterial isolates from CF patients were used, and the antimicrobial activity of human beta-defensin 2 and 3, LL37 and lysozyme was evaluated using radial diffusion assay and viable counts. The cell surface zeta potential was analysed to estimate the net charge at the bacterial surface. Of the bacterial species included in the study, A. xylosoxidans was the most resistant to antimicrobial peptides, whereas P. aeruginosa was the most susceptible. The net charge of the bacterial surface was significantly more negative for P. aeruginosa compared to A. xylosoxidans, which may in part explain the differences in susceptibility.
22.	Carlsson, Martin, et al. (author) Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden 2016 In: Nutrients. - : MDPI AG. - 2072-6643. ; 8:11 Journal article (peer-reviewed)abstract Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH) D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH) D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people >= 75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH) D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n = 133), 31% of stroke patients (n = 122), 39% of patients visiting the hospital's emergency department >= 4 times a year (n = 81), and 75% of homebound adult residents in long-term care nursing homes (n = 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (< 50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.
23.	Danielsson, Louise, 1979, et al. (author) Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study 2014 In: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 168, s. 98-106 Journal article (peer-reviewed)abstract Background: While physical exercise as adjunctive treatment for major depression has received considerable attention in recent years, the evidence is conflicting. This study evaluates the effects of two different add-on treatments: exercise and basic body awareness therapy. Methods: Randomized controlled trial with two intervention groups and one control, including 62 adults on antidepressant medication, who fulfilled criteria for current major depression as determined by the Mini International Neuropsychiatric Interview. Interventions (10 weeks) were aerobic exercise or basic body awareness therapy (BBAT), compared to a single consultation with advice on physical activity. Primary outcome was depression severity, rated by a blinded assessor using the Montgomery Asberg Rating Scale (MADRS). Secondary outcomes were global function, cardiovascular fitness, self-rated depression, anxiety and body awareness. Results: Improvements in MADRS score (mean change= -10.3, 95% CI (-13.5 to -7.1), p=0.038) and cardiovascular fitness (mean change=2.4 ml oxygen/kg/min, 95% Cl (1.5 to 3.3), p=0.017) were observed in the exercise group. Per-protocol analysis confirmed the effects of exercise, and indicated that BBAT has an effect on self-rated depression. Limitations: The small sample size and the challenge of missing data. Participants' positive expectations regarding the exercise intervention need to be considered. Conclusions: Exercise in a physical therapy setting seems to have effect on depression severity and fitness, in major depression. Our findings suggest that physical therapy can be a viable clinical strategy to inspire and guide persons with major depression to exercise. More research is needed to clarify the effects of basic body awareness therapy.
24.	Dellmuth, Lisa, et al. (author) Empowering NGOs? Long-Term Effects of Ecological and Institutional Change on Regional Fisheries Management Organizations Other publication (other academic/artistic)abstract The participation of environmental non-governmental organizations (NGOs) in regional fisheries management organizations has inspired optimism among many observers and researchers about increasing the effectiveness of these regional organizations in managing highly migratory and straddling fish stocks sustainably. Others claim that the attendance of NGOs in meetings of regional fisheries management organizations as accredited observers or as part of member state or cooperating non-member state delegations, could make decision-making complex, long, and inefficient. NGO participation has attracted broad scholarly interest in the study of interest groups and transnational advocacy in political science. Yet, we know little about the determinants of NGO participation in meetings of regional fisheries management organizations in the first place. To fill this gap, this article develops a theoretical framework conceptualizing NGO participation and developing expectations about how ecological and institutional change shapes NGO participation. The framework deals with structural determinants of NGO participation, as existing literature primarily has been preoccupied with the study of actor-specific explanations of specific NGOs’ impact in specific political processes. By contrast, we examine how ecological change – such as target fish stock health and biomass status – and institutional change – such as financial resources and membership composition of regional fisheries management organizations and participation by other non-state actors such as experts and industry associations – shape NGO participation. We empirically explore this framework in the context of seven regional fisheries management organizations. A dataset comprising yearly fish stock-level data on participation, institutional, and ecological factors, for 1980-2014, was compiled for our quantitative inquiry into the determinants of NGO participation. We find robust evidence that institutional change shapes NGO participation, but not ecological factors related to target fish stock health. We discuss our findings against the backdrop of ongoing debates about NGOs in political science, and spell out broader implications for future research on NGOs in regional fisheries management organizations.
25.	Dellmuth, Lisa M., et al. (author) Dataset on non-state actor participation in regional fisheries management organizations 2021 In: Data in Brief. - : Elsevier BV. - 2352-3409. ; 34 Research review (peer-reviewed)abstract In this article, we present and describe a new dataset of non-state actor participation in seven regional fisheries management organizations (RFMOs). The dataset contains institutional, economic and ecological variables relevant for non-state actor participation in RFMOs and for RFMO effectiveness. To code non-state actor participation and institutional factors, we quantify information from publicly available RFMO reports as well as data from the Policy IV dataset. We pair these data with existing datasets on ecological and economic factors from the RAM Legacy and the Sea Around Us databases. This article describes the data collection process and the coded variables in detail.
26.	Dellmuth, Lisa M., et al. (author) Empowering NGOs? Long-term effects of ecological and institutional change on regional fisheries management organizations 2020 In: Global Environmental Change. - : Elsevier BV. - 0959-3780 .- 1872-9495. ; 65 Journal article (peer-reviewed)abstract The participation of environmental non-governmental organizations (ENGOs) in regional fisheries management organizations has inspired optimism among many observers and researchers about increasing the effectiveness of these regional organizations in managing highly migratory and straddling fish stocks sustainably. Others claim that the attendance of ENGOs in meetings of regional fisheries management organizations as accredited observers or as part of member state or cooperating non-member state delegations, could make decision-making complex, long, and inefficient. More generally, NGO participation has attracted broad scholarly interest in the study of interest groups and transnational advocacy in political science. Yet, we know little about the determinants of ENGO participation in meetings of regional fisheries management organizations in the first place. To fill this gap, this article develops a theoretical framework conceptualizing ENGO participation and developing expectations about how ecological and institutional change shapes ENGO participation. The framework deals with structural determinants of ENGO participation, as existing literature primarily has been preoccupied with the study of actor-specific explanations of specific NGOs' impact in specific political processes. By contrast, we examine how ecological change - such as target fish stock health and biomass status - and institutional change - such as financial resources, membership composition of regional fisheries management organizations and participation by other non-state actors, such as experts and fishing industry representatives - shape ENGO participation. We empirically explore this framework in the context of seven regional fisheries management organizations. A dataset comprising yearly fish stock-level data on participation, institutional, and ecological factors, for 1980-2014, was compiled for our quantitative inquiry into the determinants of ENGO participation. We find robust evidence that institutional change shapes ENGO participation, but not ecological factors related to target fish stock health. We discuss our findings against the backdrop of ongoing debates about NGOs in political science, and spell out broader implications for future research on NGOs in regional fisheries management organizations.
27.	Dotevall, Hans, 1958, et al. (author) Treatment with head-lift exercise in head and neck cancer patients with dysphagia: results from a randomized, controlled trial with flexible endoscopic evaluation of swallowing (FEES) 2023 In: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 31:1 Journal article (peer-reviewed)abstract Background: This randomized study aimed to evaluate the effects of the Shaker head-lift exercise (HLE) to improve dysphagia following oncologic treatment for head and neck cancer (HNC). Methods: Patients with dysphagia following oncologic treatment for HNC were randomly assigned to intervention (n = 23) or control (standard dysphagia management, n = 24) groups. Swallowing was evaluated at baseline and at 8-week follow-up using flexible endoscopic evaluation of swallowing (FEES) and self-perceived swallowing with the Eating Assessment Tool (EAT-10). Analysis was performed regarding secretion, initiation of swallow, residue after swallowing, and penetration/aspiration. Results: Few statistically significant differences were found in the FEES analysis. Some improvement of self-perceived swallowing function was found in both groups. Adherence to training was high. Conclusions: This randomized study regarding the effect of the HLE demonstrated that swallowing outcome measures used in assessment of FEES did not improve in patients treated with radiotherapy for patients with dysphagia following HNC.
28.	Edvardsson, David, et al. (author) Everyday activities for people with dementia in residential aged care : associations with person-centredness and quality of life. 2014 In: International journal of older people nursing. - : Blackwell Publishing. - 1748-3743 .- 1748-3735. ; 9, s. 269-276 Journal article (peer-reviewed)abstract BACKGROUND: Providing everyday activities is central to high quality residential aged care, but further research is needed on the association between activity participation, person-centred care and quality of life. AIMS AND OBJECTIVES: To explore the point-prevalence of participation in everyday activities for residents with dementia within a national sample of Swedish residential aged care units and to explore if residents participating in everyday activities lived in more person-centred units and/or had higher quality of life as compared to residents not participating in everyday activities. DESIGN AND METHODS: A cross-sectional design was used to collect valid and reliable questionnaire data on activity participation, unit person-centredness and quality of life in a sample of residents in residential aged care (n = 1266). RESULTS: Only 18% of residents participated in everyday activities such as making coffee, setting or clearing the table, cleaning or watering plants, 62% participated in outdoor walks, 27% participated in parlour games, and 14% and 13% participated in excursions and church visits, respectively. Those residents who had participated in everyday activities lived in more person-centred units, had significantly higher quality of life and higher cognitive scores as compared to those residents who had not participated in everyday activities. CONCLUSIONS: Even though the prevalence of resident participation in everyday activities was low, resident participation was significantly associated with unit person-centredness and resident quality of life. It seems that everyday activities that are routine and commonplace to residential aged care can be potent nursing interventions for promoting resident quality of life. IMPLICATIONS FOR PRACTICE: The study indicates that residents can benefit from participation in everyday activities that are commonly occurring in aged care practice. It seems that such everyday tasks and procedures can provide fruitful ways to make person-centred care happen in clinical practice, and ways to increasingly involve residents with cognitive impairment need to be further developed.
29.	Ericson, Lisa, et al. (author) A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements 2017 In: Journal of Aging Research and Healthcare. - Valley Cottage, NY : Open Access Pub. - 2474-7785. ; 2:2, s. 13-22 Journal article (peer-reviewed)abstract Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.
30.	Ericson, Lisa, et al. (author) Klinisk utvärdering av medicinska informationssystem : Fokus på elektroniska patientjournalsystem 2014 Reports (other academic/artistic)abstract Vården blir allt mer beroende av effektiva och ändamålsenliga informationssystem. Många system har införts utan närmare prövning och kontroll av den kliniska nyttan till skillnad mot införande av nya läkemedel. Medicinska informationssystem är en medicinteknisk produkt och ska följa dess regelverk, till exempel ha en uttalad avsedd användning som inbegriper patientnyttan. Att regelverket för medicintekniska produkter även gäller för medicinska informationssystem har dock i vissa delar haft svårt att slå igenom hos tillverkarna som, bland annat, har skyldighet att genomföra kliniska utvärderingar. För att förbättra genomslagskraften av regelverket uppdrog Läkemedelsverket åt eHälsoinstitutet att kartlägga kunskapen om och följsamheten till regelverket avseende klinisk utvärdering.Syftet med föreliggande studie var primärt att ta fram ett beslutsunderlag för hur klinisk utvärdering av medicinska informationssystem bör gå till, med fokus på elektroniska patientjournalsystem, och sekundärt att konkretisera de krav som ska vara uppfyllda för systemen och att undersöka vilken information som är lämplig i en framtida vägledning. För att lösa detta preciserades flera målfrågeställningar vilka berörde vad klinisk utvärdering av patientjournalsystem innebär och syftar till, varför det är nödvändigt, hur de genomförs, om de överensstämmer med regelverket och hur de bör genomföras.Totalt 28 semistrukturerade intervjuer genomfördes med tillverkare, IT-förvaltare, användare och nationella företrädare, med kommentarer från en referensgrupp.Respondenterna var positiva till att diskutera klinisk utvärdering och till att frågan belystes, men tyckte att frågeställningarna var komplexa och svåra att besvara samt att termer och begrepp uppfattades svåra att förstå. Det kunde upplevas abstrakt och svårt att kliniskt utvärdera ett medicinskt informationssystem jämfört med mer hårdvarubaserad medicinteknisk apparatur.Det medicinska syftet och den avsedda användningen med journalsystemet ska definieras av tillverkaren, vilka också var tydliga med att beskriva detta, medan IT-förvaltarna och användarna inte visste vad tillverkarna angivit för medicinskt syfte. Trots att IT-förvaltarna och användarna var osäkra på tillverkarnas beskrivning av det medicinska syftet hade de ändå en ganska tydlig uppfattning om vad det medicinska syftet med systemen är eller kanske snararare vilket/vilka behov de borde uppfylla enligt användaren. Syfte och behov upplevdes gå i vartannat och beskrevs bland annat med orden tillgänglighet, överblick, dokumentation, patientsäkerhet, effektivitet, beslutsstöd, arbetsverktyg, kommunikation och uppföljning.Flera av tillverkarna hade svårt att koppla begreppet klinisk utvärdering till patientjournalsystem och hade svårt att sätta begreppet i ett sammanhang. Tillverkarna förknippade istället sina svar till vad man faktiskt använder sig av såsom litteraturstudier, riskanalys, riskhanteringsprocess, acceptanstest, testmiljö, pilottest och beprövad erfarenhet.Till skillnad från vad som gäller för läkemedel har införandet av medicinska informationssystem inga tydligt definierade faser. Ett sätt att förtydliga och förenkla klinisk utvärdering av medicinska informationssystem skulle vara att göra en tydlig fasindelning, som blir lätt att kontrollera. Utifrån våra intervjuer skulle faserna kunna innehålla följande steg:Teoretisk del – litteraturstudier, intervjuformUtvecklingsfasen – riskanalys, riskhanteringsprocess, acceptanstestTestmiljö – standardiserade användningsfall/testfallPilottest – skarp miljö i liten skala under översiktBreddinförandeUppföljningBeprövad erfarenhetSammanfattningsvis har vi funnit stora variationer i tolkningen av klinisk utvärdering av medicinska informationssystem och ett stort behov av förslag till att stärka den kliniska utvärderingen. Våra rekommendationer i det framtida arbetet med klinisk utvärdering av medicinska informationssystem är att ta fram:Enhetliga definitioner av termer och begreppGemensamt regelverk med tydliga riktlinjerFörenklad vägledning anpassad till svenska förhållandenSpecifik utbildning kring avsedd användning och regelverkens tillämpningBranschöverenskommelserTydliga krav vid tillsynFöreliggande rapport avser att bidra till att både förtydliga tolkningen av regelverket och underlätta följsamheten och förhoppningen är att rapporten ska kunna användas i en framtida vägledning avseende klinisk utvärdering av medicinska informationssystem.
31.	Ericson, Lisa, et al. (author) Stakeholder consensus on the purpose of clinical evaluation of electronic health records is required 2017 In: Health Policy and Technology. - : Elsevier. - 2211-8837 .- 2211-8845. ; 6:2, s. 152-160 Journal article (peer-reviewed)abstract ObjectiveTo explore the purpose and performance of clinical evaluation of electronic health records (EHRs) among stakeholders in order to identify any need for regulatory actions or guidelines.MethodsThis was a qualitative study of information collected in semi-structured interviews (n=28) of representatives of the five largest EHR vendors in Sweden, healthcare provider IT managers, users, and representatives of national authorities.ResultsWe found a difference between the stated purpose of clinical evaluation of EHRs by the authorities and the perception of the purpose by the vendors, IT managers, and the users. The respondents gave divergent answers about the medical purpose of the application: e.g. availability of data, overview and documentation, patient safety, process efficiency, decision support, a working tool, and an aid to communication and follow-up. Several vendors found it difficult to put the term clinical evaluation in its specific context, instead referring to literature reviews, risk analyses, risk-management processes, acceptance tests, test facilities, pilot tests, and proven experience.ConclusionsStakeholders need to agree on a mutually acceptable, consistent method to guide regulatory decisions. The lack of consensus regarding the purpose and performance of clinical evaluation of EHRs could impact negatively on a safe and efficient documentation in healthcare. Thus, there is a need for more consistent use of terms and concepts in, and a more systematic approach to, clinical evaluation of EHRs. To ensure that the implementation of IT in healthcare meets expectations, delivers the desired outcome, and does not create new problems, it should be evaluated.
32.	Eriksson, Maria Christina, 1981, et al. (author) Long-term effects of Internet-delivered cognitive behavioral therapy for depression in primary care - the PRIM-NET controlled trial. 2017 In: Scandinavian journal of primary health care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 35:2, s. 126-136 Journal article (peer-reviewed)abstract Internet-delivered cognitive behavioral therapy (ICBT) is recommended as an efficient treatment alternative for depression in primary care. However, only few previous studies have been conducted at primary care centers (PCCs). We evaluated long-term effects of ICBT treatment for depression compared to treatment as usual (TAU) in primary care settings.Randomized controlled trial.Patients were enrolled at16 PCCs in south-west Sweden.Patients attending PCCs and diagnosed with depression (n=90).Patients were assessed by a primary care psychologist/psychotherapist and randomized to ICBT or TAU. The ICBT included an ICBT program consisting of seven modules and weekly therapist e-mail or telephone support during the 3-month treatment period.Questionnaires on depressive symptoms (BDI-II), quality of life (EQ-5D) and psychological distress (GHQ-12) were administered at baseline, with follow-ups at 3, 6 and 12 months. Antidepressants and sedatives use, sick leave and PCC contacts were registered.Intra-individual change in depressive symptoms did not differ between the ICBT group and the TAU group during the treatment period or across the follow-up periods. At 3-month follow-up, significantly fewer patients in ICBT were on antidepressants. However, the difference leveled out at later follow-ups. There were no differences between the groups concerning psychological distress, sick leave or quality of life, except for a larger improvement in quality of life in the TAU group during the 0- to 6-month period.ICBT with weekly minimal therapist support in primary care can be equally effective as TAU among depressed patients also over a 12-month period.The trial was registered in the Swedish Registry, researchweb.org, ID number 30511.
33.	Esperi, Benedikte, 1969, et al. (author) 10-21 WING IT 2021 In: Turné i Göteborg och Västra Götalandsregionen. Utomhus i Södra Änggården, Galleri PS, Stationen Svenshögen, Galleri 3 Vänersborg, VULKANO Södra Änggården, Vegby x-sites Ulricehamn, Finnekumla kyrka Ulricehamn, Centralen Tranemo, Biblioteket Tranemo. Artistic work (other academic/artistic)abstract Solo och duettföreställningar där ögonblick och personlighet vävs samman till färgstark komposition. Av och med scenkonstnärerna Benedikte Esperi och Lisa Larsdotter Petersson med gästande musiker.
34.	Felton, Adam, et al. (author) Forest biodiversity and ecosystem services from spruce-birch mixtures : The potential importance of tree spatial arrangement 2022 In: Environmental Challenges. - : Elsevier BV. - 2667-0100. ; 6 Research review (peer-reviewed)abstract There is increasing empirical support for the biodiversity and ecosystem service (ES) benefits of mixed-species production forests. However, few studies control for the spatial arrangement of the trees within mixtures to determine the influence that clustering the tree species (patch scale mixtures), versus evenly dispersing them (intimate scale mixtures), may have for biodiversity and ES outcomes. To highlight the potential implications of altering tree spatial arrangement in mixtures, and the need to fill related knowledge gaps, here we provide a qualitative multi-disciplinary overview of ecological and socio-economic drivers with the potential to alter biodiversity, ecosystem services, and management-related outcomes from patch versus intimate scale mixtures. We focused our overview on even-aged mixtures of Norway spruce (Picea abies) and birch (Betula pendula or B. pubescens) in Sweden, which enabled us to contrast findings within a biogeographical and silvicultural setting. Specifically, we targeted implications for biodiversity (understory vascular plants, epiphytic lichens, saproxylic beetles, birds), biomass production, harvesting costs, management ease, recreation and aesthetics, cervid game, as well as abiotic and biotic risks (wind, fire, pathogens, pests, browsing damage). In the absence of direct empirical evidence, we primarily relied on expert inference from theory and relevant empirical studies sourced from the Fennoscandian region, and further afield if needed. Collectively these efforts allowed us to develop a number of informed hypotheses indicating that for spruce-birch mixtures in this region, patch scale mixtures may have the potential to favour the diversity of several forest dependant taxonomic groups, cervid game and reduce harvesting costs, whereas intimate mixtures may have the potential to reduce pathogen and pest damage, and likewise, potentially benefit production outcomes. Current knowledge was too limited, inconsistent or context dependant to even tentatively infer outcomes for fire risk, wind damage, browsing damage, management ease, recreational and aesthetic outcomes. We emphasize that our hypotheses require testing, but are sufficient to (1) highlight the likely importance of spatial-scale to biodiversity and ecosystem services outcomes in mixed-species production forests, (2) caution against generalization from mixture studies that lack scale considerations, and (3) motivate the targeted consideration of spatial grain in future mixture studies.
35.	Felton, Adam, et al. (author) The tree species matters : Biodiversity and ecosystem service implications of replacing Scots pine production stands with Norway spruce. 2020 In: Ambio. - : Springer. - 0044-7447 .- 1654-7209. ; 49:5, s. 1035-1049 Research review (peer-reviewed)abstract The choice of tree species used in production forests matters for biodiversity and ecosystem services. In Sweden, damage to young production forests by large browsing herbivores is helping to drive a development where sites traditionally regenerated with Scots pine (Pinus sylvestris) are instead being regenerated with Norway spruce (Picea abies). We provide a condensed synthesis of the available evidence regarding the likely resultant implications for forest biodiversity and ecosystem services from this change in tree species. Apart from some benefits (e.g. reduced stand-level browsing damage), we identified a range of negative outcomes for biodiversity, production, esthetic and recreational values, as well as increased stand vulnerability to storm, frost, and drought damage, and potentially higher risks of pest and pathogen outbreak. Our results are directly relevant to forest owners and policy-makers seeking information regarding the uncertainties, risks, and trade-offs likely to result from changing the tree species in production forests.
36.	Gallo, Valentina, et al. (author) Parkinson's Disease Case Ascertainment in the EPIC Cohort : The NeuroEPIC4PD Study 2015 In: Neurodegenerative Diseases. - : S. Karger. - 1660-2854 .- 1660-2862. ; 15:6, s. 331-338 Journal article (peer-reviewed)abstract Background/Aims: Large epidemiological prospective studies represent an important opportunity for investigating risk factors for rare diseases such as Parkinson's disease (PD). Here we describe the procedures we used for ascertaining PD cases in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. Methods: The following three-phase procedure was used: (1) elaboration of a NeuroEPIC4PD template for clinical data collection, (2) identification of all potential PD cases via record linkage and (3) validation of the diagnosis through clinical record revision, in a population of 220,494 subjects recruited in 7 European countries. All cases were labelled with the NeuroEPIC4PD diagnoses of 'definite', 'very likely', 'probable', or 'possible' PD. Results: A total of 881 PD cases were identified, with over 2,741,780 person-years of follow-up (199 definite, 275 very likely, 146 probable, and 261 possible). Of these, 734 were incident cases. The mean age at diagnosis was 67.9 years (SD 9.2) and 458 patients (52.0%) were men. Bradykinesia was the most frequent presenting motor sign (76.5%). Tremor-dominant and akinetic rigid forms of PD were the most common types of PD. A total of 289 patients (32.8%) were dead at the time of the last follow-up. Conclusions: This exercise proved that it is feasible to ascertain PD in large population-based cohort studies and offers a potential framework to be replicated in similar studies.
37.	Hajdu, Flora, et al. (author) Sveriges utsläpp måste minska nu, regeringen 2023 In: Aftonbladet. - 1103-9000. Journal article (pop. science, debate, etc.)
38.	Hammarberg, Sandra af Winklerfelt, et al. (author) Care managers can be useful for patients with depression but their role must be clear : a qualitative study of GPs' experiences 2019 In: Scandinavian Journal of Primary Health Care. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724. ; 37:3, s. 273-282 Journal article (peer-reviewed)abstract Objective: Explore general practitioners' (GPs') views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases. Design: Qualitative content analysis of five focus-group discussions. Setting: Primary health care centers in the Region of Vastra Gotaland and Dalarna County, Sweden. Subjects: 29 GPs. Main outcome measures: GPs' views and experiences of care managers for patients with depression. Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases. Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members' roles must be clear.
39.	Hange, Dominique, 1963, et al. (author) Associations between antidepressant therapy, work ability, and sick leave for patients with common mental disorders within a two-year perspective A longitudinal observational cohort study in Swedish primary care 2021 In: Heliyon. - : Elsevier BV. - 2405-8440. ; 7:5 Journal article (peer-reviewed)abstract Background: An increasing number of patients are on sick leave because of common mental disorders (CMD), with or without antidepressant therapy. There is a lack of long-term follow-up studies in the primary care context, where most of the patients are treated. The importance of identifying potential factors associated with work ability for CMD patients is increasingly in focus. Objective: To investigate the associations between using antidepressants, sick leave duration, reported work ability and psychological symptoms among patients with CMD during a two-year observation period in the primary care context. Methods: Longitudinal observational cohort study at 28 Primary Care Centers in Region Vastra Gotaland, Sweden, including 182 patients with an employment and on sick leave for CMD. The following outcomes were assessed: work ability measured with WAI, depressive symptoms with MADRS-S, anxiety symptoms with BAI, fatigue symptoms with KEDS, quality of life with EQ-5D, and days of sick leave. The data were compared between the groups that used and did not use antidepressants, during the 24-months observation period. Results: Work ability and health-related quality of life increased over time in both groups. A steeper decrease of depressive symptoms, anxiety symptoms as well as an increased health-related quality of life at 3, 6 and 12 months was found in the group without antidepressants, although both groups levelled off at 24 months. In both groups, a higher work ability at baseline was associated with less two-year sick leave. Conclusion: Our study indicates that a high work ability at baseline has a strong association with a lower total net and gross sick leave duration during the entire two-year follow-up period for patients with CMD in primary health care, irrespective of use of antidepressants. Using WAI in primary health care could therefore be helpful in predicting return to work. Use of antidepressants during the CMD episode could indicate initially a more pronounced overall symptom pattern, motivating introduction of antidepressants, rather than prolonging the sick leave period.
40.	Hange, Dominique, 1963, et al. (author) Experiences of staff members participating in primary care research activities: a qualitative study 2015 In: International Journal of General Medicine. - 1178-7074. ; 8, s. 143-8 Journal article (peer-reviewed)abstract BACKGROUND: The aim of this paper was to study primary care staff members' experiences and perceptions of participating in a randomized controlled trial concerning Internet therapy. METHODS: Data were collected via five focus groups, each containing four to eight nurses or general practitioners. The systematic text condensation method described by Malterud was used for thematic analysis of meaning and content of data across cases. RESULTS: The informants believed it was important to conduct research within the primary care setting, but it was difficult to combine clinical work and research. They stressed also that there was a need for continuous information and communication between primary care centers and researchers as well as internally at each primary care center. CONCLUSION: Staff members' experiences of participating in a research study were positive, although associated with various difficulties. It is important to include staff members when designing clinical studies; information should be given continuously during the study and communication facilitated between different occupational groups working at the primary care center.
41.	Hange, Dominique, 1963, et al. (author) The impact of internet-based cognitive behavior therapy on work ability in patients with depression - a randomized controlled study. 2017 In: International Journal of General Medicine. - 1178-7074. ; 10, s. 151-159 Journal article (peer-reviewed)abstract The aim of this randomized controlled trial (RCT) was to investigate the effects of internet-based cognitive behavior therapy (ICBT) treatment for depression compared to treatment-as-usual (TAU) on improving work ability and quality of life in patients with mild-to-moderate depression. We also examined whether patients treated with ICBT returned to work more rapidly, that is, had fewer days of sick leave, than patients treated with TAU.This study is based on material from the PRIM-NET RCT that took place between 2010 and 2013.Primary care centers in Region Vastra Gotaland, Sweden, population about 1.6 million.A total of 77 patients with depression randomized to either ICBT (46 patients) or TAU (31 patients). Mean age of participants was 35.8 years, and 67.5% were women.Work ability was measured with the Work Ability Index, depressive symptoms with Montgomery Asberg Depression Rating Scale - self-rating version (MADRS-S), quality of life with EuroQoL-5D (EQ-5D), and number of sick leave days.Both groups showed an association between improved work ability and reduction of depressive symptoms and between improved work ability and better quality of life. ICBT could not be shown to improve work ability more than TAU among patients with mild-to-moderate depression. There were no differences between the groups concerning number of patients with sick leave or number of sick leave days.Our study indicates that a high level of work ability has an association with high health-related quality of life in patients with mild-to-moderate depression, whether they are treated with ICBT or TAU. ICBT has previously been found to be cost-effective and can be seen as a good alternative to TAU. In addition to the ICBT, an intervention oriented toward the work place might improve work ability and reduce the number of sick leave days among patients with depression.
42.	Hange, Dominique, 1963, et al. (author) Use of antidepressants among depressed treated with internet-based Cognitive Behavior Therapy (CBT) 2013 In: International Journal of Integrated Care (IJIC). ; 13:EFPC Conference Supplemen Conference paper (other academic/artistic)
43.	Hensing, Gunnel, 1956-, et al. (author) Alkoholkonsumtion, alkoholproblem och sjukfrånvaro - vilka är sambanden? : en systematisk litteraturöversikt : en rapport 2010 Book (other academic/artistic)abstract Presenterar resultat från en systematisk litteraturöversikt om samband mellan alkoholkonsumtion respektive alkoholproblem och sjukfrånvaro.
44.	Hensing, Gunnel, et al. (author) Alkoholkonsumtion, alkoholproblem och sjukfrånvaro - vilka är sambanden? : En systematisk litteraturöversikt 2010 Reports (other academic/artistic)
45.	Hensing, Gunnel, 1956-, et al. (author) The impact of health problems in sickness absence might be underestimated in Sweden 2010 In: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 20:Suppl. 1, s. 228-228 Journal article (peer-reviewed)abstract Changes in the welfare systems including the sickness insurance scheme are ongoing in several countries, and better knowledge on the extent of health problems in sickness absence seems needed. The overall aim of this cross sectional study was to assess and compare self-rated health, common symptoms and mental well-being in two samples of incident sick-leave cases with the general population. The study was performed in Sweden, 2008, and three samples of individuals aged 19–64 years were selected. The final study populations consisted of 3310 consecutive new employer reported sick-leave cases, 498 consecutive new self-reported sick-leave cases and 4027 individuals from a random general population sample. A mailed questionnaire was distributed. Validated questions and instruments on health and demographic data was analysed in bivariate and multivariate analyses. Poor self-rated health, high levels of symptoms and low mental well-being was reported by a significantly higher proportion in the two sick-leave samples compared with the general population. In logistic regressions with the generalpopulation as reference we adjusted for age, income, occupational class and current sick-leave. The fully adjusted OR for poor self-rated health, high levels of symptoms and low mental well-being respectively were 1.54 (95% confidence intervals 1.24–1.91), 1.95 (1.54–2.48) and 1.41 (1.11–1.79) among the employer reported male sick-leave cases and 1.94 (1.34–2.82), 1.76 (1.14–2.70) and 2.11 (1.40–3.17) among self reported male sick-leave cases. Corresponding figures for women were 1.80 (1.56–2.08), 1.42 (1.22–1.66) and 1.21 (1.03–1.43) and 2.10 (1.60–2.75), 1.97 (1.1–2.57) and 1.78 (1.35–2.36). Differences in health problems between the groups remained significant in the fully adjusted model. We conclude that sick-listed individuals have a higher burden of illness also after control for current sick leave than the general population. Consequence analyses of more rigorous legislation and increased demands need to take this into account.
46.	Holst, Anna, et al. (author) Cost-effectiveness analysis of internet-mediated cognitive behavioural therapy for depression in the primary care setting : results based on a controlled trial 2018 In: BMJ Open. - : BMJ. - 2044-6055. ; 8:6 Journal article (peer-reviewed)abstract Objective To perform a cost-effectiveness analysis of a randomised controlled trial of internet-mediated cognitive behavioural therapy (ICBT) compared with treatment as usual (Tall) for patients with mild to moderate depression in the Swedish primary care setting. In particular, the objective was to assess from a healthcare and societal perspective the incremental cost-effectiveness ratio (ICER) of ICBT versus TaU at 12 months follow-up. Design A cost-effectiveness analysis alongside a pragmatic effectiveness trial. Setting Sixteen primary care centres (PCCs) in south-west Sweden. Participants Ninety patients diagnosed with mild to moderate depression at the PCCs. Main outcome measure ICERs calculated as (Cost(ICBT)-Cost(TaU))/(Health outcome(ICBT)-Health outcome(TaU))=Delta Cost/Delta Health outcomes, the health outcomes being changes in the Beck Depression Inventory-II (BDI-II) score and quality-adjusted life-years (QALYs). Results The total cost per patient for ICBT was 4044 Swedish kronor (SEK) ((sic)426) (healthcare perspective) and SEK47679 ((sic)5028) (societal perspective). The total cost per patient for TaU was SEK4434 ((sic)468) and SEK50 343 ((sic)5308). In both groups, the largest cost was associated with productivity loss. The differences in cost per patient were not statistically significant. The mean reduction in BDI-ll score was 13.4 and 13.8 units in the ICBT and Tall groups, respectively. The mean QALYs per patient was 0.74 and 0.79 in the ICBT and TaU groups, respectively. The differences in BDI-11 score reduction and mean QALYs were not statistically significant. The uncertainty of the study estimates when assessed by bootstrapping indicated that no firm conclusion could be drawn as to whether ICBT treatment compared with Tall was the most cost-effective use of resources. Conclusions ICBT was regarded to be as cost-effective as TaU as costs, health outcomes and cost-effectiveness were similar for ICBT and TaU, both from a healthcare and societal perspective.
47.	Holst, Anna, et al. (author) Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care : economic evaluation of a pragmatic randomised controlled study 2018 In: BMJ Open. - : BMJ. - 2044-6055. ; 8:11 Journal article (peer-reviewed)abstract Objective: To evaluate the cost-effectiveness of a care manager (CM) programme compared with care as usual (CAU) for treatment of depression at primary care centres (PCCs) from a healthcare as well as societal perspective.Design: Cost-effectiveness analysis.Setting: 23 PCCs in two Swedish regions.Participants: Patients with depression (n=342).Main outcome measures: A cost-effectiveness analysis was applied on a cluster randomised trial at PCC level where patients with depression had 3 months of contact with a CM (11 intervention PCCs, n=163) or CAU (12 control PCCs, n=179), with follow-up 3 and 6 months. Effectiveness measures were based on the number of depression-free days (DFDs) calculated from the Montgomery-angstrom sberg Depression Rating Scale-Self and quality-adjusted life years (QALYs).Results were expressed as the incremental cost-effectiveness ratio: Cost/QALY and Cost/DFD. Sampling uncertainty was assessed based on non-parametric bootstrapping.Results: Health benefits were higher in intervention group compared with CAU group: QALYs (0.357 vs 0.333, p<0.001) and DFD reduction of depressive symptom score (79.43 vs 60.14, p<0.001). The mean costs per patient for the 6-month period were Euro368 (healthcare perspective) and Euro6217 (societal perspective) for the intervention patients and Euro246 (healthcare perspective) and Euro7371 (societal perspective) for the control patients (n.s.). The cost per QALY gained was Euro6773 (healthcare perspective) and from a societal perspective the CM programme was dominant.Discussion: The CM programme was associated with a gain in QALYs as well as in DFD, while also being cost saving compared with CAU from a societal perspective. This result is of high relevance for decision-makers on a national level, but it must be observed that a CM programme for depression implies increased costs at the primary care level.
48.	Holst, Anna, et al. (author) Cost-effectiveness of a care manager collaborative care programme for patients with depression in primary care: 12-month economic evaluation of a pragmatic randomised controlled trial 2021 In: Cost Effectiveness and Resource Allocation. - : Springer Science and Business Media LLC. - 1478-7547. ; 19 Journal article (peer-reviewed)abstract Objectives: To study the cost-effectiveness of a care manager organization for patients with mild to moderate depression in Swedish primary care in a 12-month perspective. Methods: Cost-effectiveness analysis of the care manager organization compared to care as usual (CAU) in a pragmatic cluster randomised controlled trial including 192 individuals in the care manager group and 184 in the CAU group. Cost-effectiveness was assessed from a health care and societal perspectives. Costs were assessed in relation to two different health outcome measures: depression free days (DFDs) and quality adjusted life years (QALYs). Results: At the 12-month follow-up, patients treated at the intervention Primary Care Centres (PCCs) with a care manager organization had larger health benefits than the group receiving usual care only at control PCCs. Mean QALY per patient was 0.73 (95% CI 0.7; 0.75) in the care manager group compared to 0.70 (95% CI 0.66; 0.73) in the CAU group. Mean DFDs was 203 (95% CI 178; 229) in the care manager group and 155 (95% CI 131; 179) in the CAU group. Further, from a societal perspective, care manager care was associated with a lower cost than care as usual, resulting in a dominant incremental cost-effectiveness ratio (ICER) for both QALYs and DFDs. From a health care perspective care manager care was related to a low cost per QALY (36,500 SEK / €3,379) and DFD (31 SEK/€3). Limitations: A limitation is the fact that QALY data was impaired by insufficient EQ-5D data for some patients. Conclusions: A care manager organization at the PCC to increase quality of care for patients with mild-moderate depression shows high health benefits, with no decay over time, and high cost-effectiveness both from a health care and a societal perspective. Trial registration details: The trial was registered in ClinicalTrials.com (https://clinicaltrials.gov/ct2/show/NCT02378272) in 02/02/2015 with the registration number NCT02378272. The first patient was enrolled in 11/20/2014.
49.	Holst, Anna, et al. (author) Patients' experiences of a computerised self-help program for treating depression - a qualitative study of Internet mediated cognitive behavioural therapy in primary care. 2017 In: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 35:1, s. 46-53 Journal article (peer-reviewed)abstract The objective of this study was to explore primary care patients' experiences of Internet mediated cognitive behavioural therapy (iCBT) depression treatment.Qualitative study. Data were collected from focus group discussions and individual interviews.Primary care.Data were analysed by systematic text condensation by Malterud.Thirteen patients having received iCBT for depression within the PRIM-NET study.Analysis presented different aspects of patients' experiences of iCBT.The informants described a need for face-to-face meetings with a therapist. A therapist who performed check-ups and supported the iCBT process seemed important. iCBT implies that a responsibility for the treatment is taken by the patient, and some patients felt left alone, while others felt well and secure. This was a way to work in privacy and freedom with a smoothly working technology although there was a lack of confidence and a feeling of risk regarding iCBT.iCBT is an attractive alternative to some patients with depression in primary care, but not to all. An individual treatment design seems to be preferred, and elements of iCBT could be included as a complement when treating depression in primary care. Such a procedure could relieve the overall treatment burden of depression. Key points Internet mediated cognitive behavioural therapy (iCBT) can be effective in treating depression in primary care, but patients' experiences of iCBT are rarely studied •Most patients express a need for human contact, real-time interaction, dialogue and guidance when treated for depression. •The patient's opportunity to influence the practical circumstances about iCBT is a success factor, though this freedom brings a large responsibility upon the receiver. •An individual treatment design seems to be crucial, and elements of iCBT could be included as a complement to face-to-face meetings.
50.	Hovstadius, Bo, et al. (author) Trends in Inappropriate Drug Therapy Prescription in the Elderly in Sweden from 2006 to 2013 : Assessment Using National Indicators 2014 In: Drugs & Aging. - : Springer Science and Business Media LLC. - 1170-229X .- 1179-1969. ; 31:5, s. 379-386 Journal article (peer-reviewed)abstract Background Medication for elderly patients is often complex and problematic. Several criteria for classifying inappropriate prescribing exist. In 2010, the Swedish National Board of Health and Welfare published the document "Indicators of appropriate drug therapy in the elderly" as a guideline for improving prescribing for the elderly. Objective The aim of this study was to assess trends in the prescription of inappropriate drug therapy in the elderly in Sweden from 2006 to 2013 using national quality indicators for drug treatment. Methods Individual-based data on dispensed prescription drugs for the entire Swedish population aged >= 65 years during eight 3-month periods from 2006 to 2013 were accumulated. The data were extracted from the Swedish Prescribed Drug Register. Eight drug-specific quality indicators were monitored. Results For the entire population studied (n = 1,828,283 in 2013), six of the eight indicators showed an improvement according to the guidelines; the remaining two indicators (drugs with anticholinergic effects and excessive polypharmacy) remained relatively unchanged. For the subgroup aged 65-74 years, three indicators showed an improvement, four indicators remained relatively unchanged (e.g. propiomazine, and oxazepam) and one showed an undesirable trend (anticholinergic drugs) according to guidelines. For the older group (aged >= 75 years), all indicators except excessive polypharmacy showed improvement. Conclusion According to the quality indicators used, the extent of inappropriate drug therapy in the elderly decreased from 2006 to 2013 in Sweden. Thus, prescribers appear to be more likely to change their prescribing patterns for the elderly than previously assumed.

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