1. |
- Ballin, Marcel, et al.
(author)
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Effects of interval training on quality of life and cardiometabolic risk markers in older adults : a randomized controlled trial
- 2019
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In: Clinical Interventions in Aging. - : Dove Press. - 1176-9092 .- 1178-1998. ; 14, s. 1589-1599
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Journal article (peer-reviewed)abstract
- Purpose: To explore the effects of 10 weeks of progressive vigorous interval training as a single intervention on health-related quality of life (HRQoL) and cardiometabolic risk markers in centrally obese 70-year-old individuals.Participants and methods: A randomized controlled trial (ClinicalTrials.gov registration no. NCT03450655) including seventy-seven community-dwelling 70-year-old men and women with central obesity defined as > 1 kg visceral adipose tissue for women and > 2 kg for men. Participants randomized to the intervention group were offered a 10-week progressive vigorous interval training program performed three times per week. Control subjects were asked to maintain their daily living and routines throughout the trial. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation. Prespecified outcome measures included: changes in HRQoL using the Short Form Health Survey Questionnaire (SF-36), blood pressure; resting heart rate (HR) and blood lipids. All analyses were conducted on an intention-to-treat basis.Results: The intervention resulted in significant effects on the SF-36 mental component summary (MCS) score and the mental health (MH) subscale (P< 0.05 for both), when compared to the control group. Specifically, the intervention group increased their MCS score by 6.3 points (95% confidence interval [CI] = 0.3–12.3) and their MH score by 6.0 points (95% CI = 1.7–10.4) compared to the control group. Moreover, significant effects were seen on resting HR, total cholesterol and LDL-cholesterol (P<0.05 for all).Conclusion: It was shown that 10 weeks of vigorous interval training as a single intervention was sufficient to improve mental aspects of HRQoL in older individuals with central obesity, which is a critical aspect of healthy ageing. Positive effects were seen also on cardiometabolic risk markers.
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2. |
- Ballin, Marcel, et al.
(author)
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Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70-Year-Old Individuals : A Randomized Controlled Trial
- 2019
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In: Journal of The American Geriatrics Society. - : John Wiley & Sons. - 0002-8614 .- 1532-5415. ; 67:8, s. 1625-1631
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the effects of 10 weeks of progressive vigorous-intensity interval training as a single intervention on body composition among 70-year-old individuals with central obesity.DESIGN: Randomized controlled trial (ClinicalTrials.gov registration No. NCT03450655).SETTING: Community-dwelling 70-year-old men and women living in the Umeå municipality in Sweden.PARTICIPANTS: Seventy-seven 70-year-old men and women with central obesity (greater than 1 kg visceral adipose tissue [VAT] for women and greater than 2 kg VAT for men).INTERVENTION: Participants allocated to the intervention group were offered a 10-week progressive concurrent exercise program performed three times per week. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation.MEASUREMENTS: The primary outcome was changes in VAT, and secondary outcomes included changes in total fat mass (FM), total lean body mass (LBM), and body mass index.RESULTS: Comparing the groups, there were no significant differences in decrease of VAT mass (P = .10), although the intervention group significantly decreased FM by 716 g (P = .01) and gained LBM by 508 g (P = .03), compared to the control group. Furthermore, the effects of the training were significantly greater in the male subcohort (P < .05 for interaction), with positive effects also on VAT and FM, where men in the intervention group decreased VAT by 175 g (P < .05) and FM by 1364 g (P = .004), compared to the male controls.CONCLUSIONS: The present trial demonstrates that 10 weeks of progressive vigorous interval training is sufficient to significantly decrease FM in older adults with central obesity, with positive effects also on LBM.
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3. |
- Ballin, Marcel, et al.
(author)
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Web-based exercise versus supervised exercise for decreasing visceral adipose tissue in older adults with central obesity : a randomized controlled trial
- 2020
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In: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 20:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: Visceral adipose tissue (VAT) is a strong risk factor for cardiovascular disease and increases with age. While supervised exercise (SE) may be an effective approach, web-based exercise (WE) have other advantages such as being more readily accessible. Therefore, we evaluated the effects of WE on VAT, body composition and cardiometabolic risk markers in centrally obese older adults and compared the effects of WE to SE. We also explored the feasibility of WE.METHODS: In a randomized controlled trial conducted in Umeå, Sweden during January 2018 - November 2018, N = 77, 70-year-old men and women with central obesity (> 1 kg VAT for women, > 2 kg for men) were randomized to an intervention group (n = 38) and a wait-list control group (n = 39). The intervention group received 10 weeks of SE while the wait-list control group lived as usual. Following a 10-week wash-out-period, the wait-list control group received 10 weeks of WE. The primary outcome was changes in VAT. Secondary outcomes included changes in fat mass (FM), lean body mass (LBM), blood lipids, fasting blood glucose. Additionally, we explored the feasibility of WE defined as adherence and participant experiences.RESULTS: WE had no significant effect on VAT (P = 0.5), although it decreased FM by 450 g (95% confidence interval [CI], 37 to 836, P < 0.05). The adherence to WE was 85% and 87-97% of the participants rated aspects of the WE intervention > 4 on a scale of 1-5. Comparing SE to WE, there was no significant difference in decrease of VAT (Cohen's δ effect size [ES], 0.5, 95% CI, - 24 to 223, P = 0.11), although SE decreased FM by 619 g (ES, 0.5, 95% CI, 22 to 1215, P < 0.05) compared to WE.CONCLUSIONS: Ten weeks of vigorous WE is insufficient to decrease VAT in centrally obese older adults, but sufficient to decrease FM while preserving LBM. The high adherence and positive experiences of the WE intervention implies that it could serve as an alternative exercise strategy for older adults with central obesity, with increased availability for a larger population.TRIAL REGISTRATION: ClinicalTrials.gov (NCT03450655), retrospectively registered February 28, 2018.
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4. |
- Bianchi, Matteo, et al.
(author)
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Contribution of rare genetic variation to disease susceptibility in a large Scandinavian myositis cohort
- 2022
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In: Arthritis & Rheumatology. - : John Wiley & Sons. - 2326-5191 .- 2326-5205. ; 74:2, s. 342-352
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Journal article (peer-reviewed)abstract
- Objective Idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of complex autoimmune conditions characterized by inflammation in skeletal muscle and extramuscular compartments, and interferon (IFN) system activation. We undertook this study to examine the contribution of genetic variation to disease susceptibility and to identify novel avenues for research in IIMs.Methods Targeted DNA sequencing was used to mine coding and potentially regulatory single nucleotide variants from ~1,900 immune-related genes in a Scandinavian case–control cohort of 454 IIM patients and 1,024 healthy controls. Gene-based aggregate testing, together with rare variant– and gene-level enrichment analyses, was implemented to explore genotype–phenotype relations.Results Gene-based aggregate tests of all variants, including rare variants, identified IFI35 as a potential genetic risk locus for IIMs, suggesting a genetic signature of type I IFN pathway activation. Functional annotation of the IFI35 locus highlighted a regulatory network linked to the skeletal muscle–specific gene PTGES3L, as a potential candidate for IIM pathogenesis. Aggregate genetic associations with AGER and PSMB8 in the major histocompatibility complex locus were detected in the antisynthetase syndrome subgroup, which also showed a less marked genetic signature of the type I IFN pathway. Enrichment analyses indicated a burden of synonymous and noncoding rare variants in IIM patients, suggesting increased disease predisposition associated with these classes of rare variants.Conclusion Our study suggests the contribution of rare genetic variation to disease susceptibility in IIM and specific patient subgroups, and pinpoints genetic associations consistent with previous findings by gene expression profiling. These features highlight genetic profiles that are potentially relevant to disease pathogenesis.
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5. |
- Jönsson, Simon, 1983-
(author)
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Leukocyte-derived matrix metalloproteinase-9 in patients with coronary artery disease : Associations with psychological stress and glucocorticoid sensitivity
- 2015
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Doctoral thesis (other academic/artistic)abstract
- Inflammation is closely associated with development of atherosclerosis. The proteolytic enzyme matrix metalloproteinase (MMP)-9 is considered to play a prominent role in this process. MMP-9 has also been introduced as a marker for plaque vulnerability. Still, the possible mechanisms behind altered levels of MMP-9 and its tissue inhibitors (TIMPs) in patients with atherosclerotic disease remain unclear. The general aim of this thesis was to compare leukocyte-derived MMP-9 and TIMPs in patients with coronary artery disease (CAD) and healthy controls and to further relate the findings to psychological stress and glucocorticoid sensitivity.Levels of leukocyte-derived MMP-9 and TIMP-1 showed a significant difference between CAD patients and controls. Neutrophils in CAD patients were more prone to release MMP-9 and furthermore, PBMCs in patients expressed higher levels of MMP-9 and TIMP-1 and -2 mRNA than PBMCs in controls while there were no differences in plasma or serum levels. The increase in leukocyte-derived levels of MMP-9 and TIMPs indicate the presence of preactivated leukocytes in CAD.Inflammation has been proposed as a mechanistic link between cardiovascular risk and depressive symptoms. We investigated whether the overexpression of leukocyte-derived MMP-9 and TIMPs in CAD patients was associated with psychological factors. Patients exhibited sustained elevations in depressive symptoms, however, these symptoms were not related to any MMP-9 or TIMP variables. The findings suggest that overexpression of leukocyte-derived MMP-9 and TIMPs and elevated depressive scores represent two parallel phenomena in CAD.Chronic inflammation may be associated with reduced glucocorticoid sensitivity. We found that PBMCs in CAD patient expressed significantly increased levels of glucocorticoid receptor (GR)-α mRNA, whereas GR-β mRNA levels did not differ between patients and controls. Moreover, in ex vivo assays, dexamethasone efficiently suppressed MMP-9 and TIMPs equally or even more in patients compared to controls. The findings provide evidence for enhanced glucocorticoid sensitivity in CAD patients and also suggest that a state of relative hypocortisolism may contribute to the overexpression of leukocyte-derived MMP-9 and TIMPs.Lastly, we explored the release of MMP-9, TIMPs and cortisol in response to acute mental stress in CAD patients. Patients who exhibited a significant stress-induced increase in serum MMP-9 also exhibited an altered cortisol response. Moreover, the susceptibility to stressinduced increase in serum MMP-9 was associated with shorter leukocyte telomere length and atherosclerotic plaque burden. The findings highlight the existence of a high-risk group which may be in need of improved diagnostic and therapeutic strategies.
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6. |
- Ljungcrantz, Desireé, 1982-
(author)
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Skrubbsår : Berättelser om ur hiv föreställs och erfars i samtida Sverige
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Avhandlingen är en tvärvetenskaplig kulturstudie som utforskar föreställningar om och erfarenheter av hiv som kronisk sjukdom i Sverige under 2005–2014. Analysen av ett antal hiv-berättelser sker tillsammans med en teoretisk sammanflätning i form av den queera sårbarhetens och sjukdomens fenomenologi, samt genom de feministiska figurationerna hiv-tröskeln, skrubbsår, plåster och gruskorn. Materialet utgörs av djupintervjuer, autofiktiva texter och populärkulturella representationer. I djupintervjuer med personer som har hiv och i autofiktiva texter undersöks när och hur hiv görs och blir påtagligt i vardagslivet. Genom läsningar av de populärkulturella berättelserna Hur kunde hon?, Ophelias resa, Mitt positiva liv och Positiv undersöker avhandlingen hur protagonisterna och hiv gestaltas, vad som bygger dramaturgin samt hur normaliserande skildringar riskerar att (åter)skapa normativa gränser. Förhandlingar med normlinjer berör återkommande respektabilitet och begäret att framstå som en lyckad och lycklig individ, men även att ha ett levbart liv. Hiv-berättelser innehåller återkommande känslor som rädsla, skam och mononormativ melankoli. De utgör skrubbsår skapade i mötet med andra personer, samhällsinstitutioner och de föreställningar om hiv som finns i samhället. Likt gruskorn skrubbar föreställningarna oss. Det medför olika former av undvikande och ensamhetsorienteringar. Plåster, det vill säga individuella strategier av att exponera hiv och att distansera sig från den yttre blicken på självet görs tillsammans med och skapar känslor såsom lättnad, stolthet och ilska. Skrubbsår erbjuder en diskussion kring vardagligt hiv-görande, hur vi blir med hiv tillsammans med andra personer, normer, institutioner och samhällets skam- och kontrollmekanismer, samt hur känslor samskapar hiv. Genom ett poetiskt och skönlitterärt skrivande utgör scener och fiktiva karaktärer, baserade på intervjuer, och den autofiktiva alter-egoberättaren Desideria ett icke-distanserat och kännbart gestaltande av det relationella hiv-blivandet.
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7. |
- Lundberg, Anna, 1977-
(author)
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Immune responses to lipopolysaccharide in relation to allergic disease : a TLR4 gene polymorphism and endotoxin exposure
- 2009
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Doctoral thesis (other academic/artistic)abstract
- Background: Allergic diseases have increased during the last decades, particularly in affluent countries, possibly due to a reduced and/or altered microbial exposure during infancy. Activation of the immune system by microbes early in life is probably required for accurate maturation of the immune system and tolerance development. It is not fully understood how microbial exposure is associated with the development of allergic diseases, however. Genetic factors may influence microbial induced immune responses. A certain polymorphism, in the gene coding for the Toll-like receptor 4, i.e. (TLR4 Asp299Gly), has been suggested to alter the immunological responsiveness to bacterial lipopolysaccharide (LPS).Aim: The aim of this thesis was to study the interplay between LPS induced immune responses, LPS signalling related genetic polymorphisms, allergic disease and endotoxin exposure.Subjects: The thesis is based on the results obtained from individuals in three different study groups, i.e. Estonian and Swedish children followed prospectively from birth up to five years of age, Swedish school-children eight and 14 years of age and young adults.Methods: The study subjects were clinically evaluated regarding allergic diseases with skin prick tests, circulating IgE levels, validated questionnaires and clinical examinations by paediatricians or research nurses. The gene polymorphisms TLR4 Asp299Gly and CD14/-159 were analysed. Peripheral blood mononuclear cells were isolated from blood and cultured with LPS from two Gram negative bacterial strains, i.e. Salmonella enterica serotype Typhimurium (Serotype Typhimurium) and Escherichia coli (E. coli). Cytokine and chemokine secretions were analysed with Luminex or ELISA technique. Receptor expression of circulating peripheral blood monocytes was analysed with flow cytometry. The phosphorylation of intracellular proteins involved in LPS signalling pathways was analysed with Luminex technique. mRNA expression of proteins involved in LPS signalling pathways and of markers for T regulatory cells were analysed with realtime-PCR.Results: In school-children and young adults, the TLR4 Asp299Gly gene polymorphism was associated with reduced LPS induced IκBα phosphorylation, IL-10 and IL-12 cytokine secretion. Interestingly, these findings were observed only when the cells were cultured with LPS from Serotype Typhimurium but not with LPS from E. coli. The polymorphism was positively associated with asthma, especially atopic asthma.Several differences in immunological responses to LPS were observed between allergic and non-allergic individuals. Asthma in school-children was associated with reduced LPS induced cytokine production of IL-10 and IL-12. The phosphorylation of IκBα was lower in adult allergic compared to non-allergic individuals. Swedish children who had developed allergic disease at five years of age had lower TLR2 mRNA expression at birth compared to children who remained healthy.Estonian children displayed generally lower LPS induced cytokine and chemokine production as compared to Swedish children both at birth and at 3 and 6 months of age. The mRNA expression of the T regulatory associated markers Foxp3 and Ebi3 were higher in the Estonian compared to the Swedish children at birth.Conclusion: Polymorphisms in genes coding for pattern recognition receptors can alter the immune responsiveness of the host to microbial components and may be of importance for the development of asthma. Lower LPS induced cytokine response and higher expression of T regulatory associated markers were seen in children from Estonia as compared to Sweden, suggesting an increased capacity for early immune regulation among infants from a country with a low prevalence of allergic disease.
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8. |
- Lundberg, Anna, L., V.
(author)
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Proportionalitetsbegreppet i den svenska gymnasiematematiken : en studie om läromedel och nationella prov
- 2011
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Licentiate thesis (other academic/artistic)abstract
- Proportionalitet är ett centralt begrepp i skolmatematiken. Begreppet introduceras i de lägre stadierna och återkommer i så gott som samtliga kurser från årskurs 9 tillsista kursen på gymnasiet. Det övergripande syftet med denna studie är att undersöka hur det matematiska begreppet proportionalitet hanteras i den svenska gymnasieskolan. En generell problematik kopplad till detta syfte är hur skolans styrdokument realiseras i läromedel och nationella prov. Fokus för denna avhandling har varit hur proportionalitet hanteras i det svenska gymnasiet i kursen Matematik A i några läromedel och nationella prov. För att undersöka detta utvecklades ett analysverktyg utifrån det teoretiska ramverket i ATD (Anthropological Theory of the Didactic). Av intresse är här relationer mellan de olika nivåerna i den didaktiska transpositionen, som berör just hur skolans styrdokument realiseras i läromedel och nationella prov. För det empiriska studiet av materialet användes från ATD begreppet matematisk organisation, genom att använda ett analysverktyg för att granska typer av uppgifter om proportionalitet, lösningstekniker och teoretiska modeller för proportionalitetsbegreppet.De data som presenterats i denna studie ger en ganska ostrukturerad bild av de matematiska organisationer av begreppsområdet proportionalitet som presenteras i läromedel och i nationella prov och de ser även olika ut när det gäller hur proportionalitet hanteras i läromedlen respektive det nationella provet för Matematik A. Resultatet visar att ungefär var fjärde uppgift i de studerade kapitlen och de nationella proven berör proportionalitet men att begreppet hanteras ensidigt vad avser uppgiftstyp. Skillnader observerades mellan läromedel och nationella prov när det gäller hur lösningstekniker rekommenderas för olika typer av proportionalitetsuppgifter. De två teoretiska modeller för proportionalitet som har undersökts, dvs. statisk och dynamisk proportionalitet, finns representerade i ungefär lika omfattning i både läromedel och nationella prov. Vid uppgifter inom geometri handlar det dock ofta om statisk proportionalitet medan det inomområdet funktioner är vanligare att använda dynamisk proportionalitet.Lärare bör få kunskap om skillnader mellan läromedel och läroplaner, och hur dessa tolkas i nationella prov, så att de i sin verksamhet kan välja det undervisningsinnehåll, inklusive övningsuppgifter, som ger en god variation för eleven kopplat till kursplanernas mål
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9. |
- Lundtoft, Christian, et al.
(author)
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Complement C4 Copy Number Variation is Linked to SSA/Ro and SSB/La Autoantibodies in Systemic Inflammatory Autoimmune Diseases
- 2022
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In: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 74:8, s. 1440-1450
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Journal article (peer-reviewed)abstract
- Objective Copy number variation of the C4 complement components, C4A and C4B, has been associated with systemic inflammatory autoimmune diseases. This study was undertaken to investigate whether C4 copy number variation is connected to the autoimmune repertoire in systemic lupus erythematosus (SLE), primary Sjogrens syndrome (SS), or myositis. Methods Using targeted DNA sequencing, we determined the copy number and genetic variants of C4 in 2,290 well-characterized Scandinavian patients with SLE, primary SS, or myositis and 1,251 healthy controls. Results A prominent relationship was observed between C4A copy number and the presence of SSA/SSB autoantibodies, which was shared between the 3 diseases. The strongest association was detected in patients with autoantibodies against both SSA and SSB and 0 C4A copies when compared to healthy controls (odds ratio [OR] 18.0 [95% confidence interval (95% CI) 10.2-33.3]), whereas a weaker association was seen in patients without SSA/SSB autoantibodies (OR 3.1 [95% CI 1.7-5.5]). The copy number of C4 correlated positively with C4 plasma levels. Further, a common loss-of-function variant in C4A leading to reduced plasma C4 was more prevalent in SLE patients with a low copy number of C4A. Functionally, we showed that absence of C4A reduced the individuals capacity to deposit C4b on immune complexes. Conclusion We show that a low C4A copy number is more strongly associated with the autoantibody repertoire than with the clinically defined disease entities. These findings may have implications for understanding the etiopathogenetic mechanisms of systemic inflammatory autoimmune diseases and for patient stratification when taking the genetic profile into account.
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10. |
- Sarstrand, Anna-Maria, 1976-
(author)
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De första invandrarbyråerna : Om invandrares inkorporering på kommunal nivå åren 1965-1984
- 2007
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Licentiate thesis (other academic/artistic)abstract
- Immigration to Sweden increased during and after the Second World War. Initially the in-crease consisted of refugees, but after the war labour migration became the dominant form of migration to Sweden. The immigrants were expected to manage the adaptation to the Swedish society on their own, possibly with the help of voluntary organizations or the company they worked for. This situation began to change in the 1960s. The immigrants’ situation received public attention and different actions were taken to reduce the risk of marginalizing the immi-grants. Many of these actions started on a local level, in the municipalities, prior to the devel-opment of the first national immigrant policy in 1975. The first local public administrations for handling immigrant incorporation developed approximately ten years before. These or-ganizations, soon to be called Immigrant bureaus, were among the first public initiatives, on both state and local level, to actively take measures to incorporate the immigrants. The licen-tiate thesis is a comparative case study of five Swedish municipalities which started Immi-grant bureaus in the middle of the 1960s. The objective of the thesis is to study the creation and development of these organizations up until 1984. Thereby, the study gives an image of the creation and development of a specific local public administration for immigrant incorpo-ration. It describes and analyzes the common features of the bureaus as well as the unique character of each individual bureau. Accordingly, a theoretical perspective which stresses the early development in an organization’s history and accentuates the importance of specific contexts for understanding different organizational developments has been used. The result shows that the immigrant bureaus were initiated by different local actors, such as the public administration, labour unions and educational associations which meant that the purposes were somewhat divergent. Yet another consequence was not only variation in development between different bureaus, but also within each of them over time.
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