| 1. |
- Kukkonen, J., et al.
(author)
-
Towards a Comprehensive Evaluation of the Environmental and Health Impacts of Shipping Emissions
- 2022
-
In: Springer Proceedings in Complexity. - Cham : Springer International Publishing. - 2213-8684 .- 2213-8692. ; , s. 329-336
-
Conference paper (peer-reviewed)abstract
- We present a new concept for marine research, applied in the EU-funded project EMERGE, “Evaluation, control and Mitigation of the EnviRonmental impacts of shippinG Emissions” (2020–2024; https://emerge-h2020.eu/ ). For the first time, both the various marine and atmospheric impacts of the shipping sector have been and will be comprehensively analyzed, using a concerted modelling and measurements framework. The experimental part of the project focuses on five European geographical case studies in different ecologically vulnerable regions, and a mobile onboard case study. The EMERGE consortium has also developed a harmonised and integrated modelling framework to assess the combined impacts of shipping emissions, both (i) on the marine ecosystems and (ii) the atmospheric environment. The first results include substantial refinements of a range of models to be applied, especially those for the STEAM and OpenDrift models. In particular, the STEAM (Ship Traffic Emission Assessment Model) model has been extended to allow for the effects of atmospheric and oceanographic factors on the fuel consumption and emissions of the ships. The OpenDrift model has been improved to take into account the partitioning, degradation, and volatilization of pollutants in water. The predicted emission and discharge values have been used as input for both regional scale atmospheric dispersion models, such as WRF-CMAQ (Weather Research and Forecasting—Community Multiscale Air Quality Model) and SILAM (System for Integrated modeLling of Atmospheric composition), and water quality and circulation models, such as OpenDrift (Open source model for the drifting of substances in the ocean) and Delft3D (oceanographic model). The case study regions are Eastern Mediterranean, Northern Adriatic Sea, the Lagoon of Aveiro, the Solent Strait and the Öresund Strait. We have also conducted a substantial part of the experimental campaigns scheduled in the project. The final assessment will include the benefits and costs of control and mitigation options affecting water quality, air pollution exposure, health impacts, climate forcing, and ecotoxicological effects and bioaccumulation of pollutants in marine biota.
|
|
| 2. |
- Moldanova, Jana, et al.
(author)
-
The impact of ship emissions on air quality and human health in the Gothenburg area – Part II: Scenarios for 2040
- 2020
-
In: Atmospheric Chemistry And Physics. - : Copernicus GmbH. - 1680-7316 .- 1680-7324. ; 20:10, s. 667-10686
-
Journal article (peer-reviewed)abstract
- Shipping is an important source of air pollutants, from the global to the local scale. Ships emit substantial amounts of sulfur dioxides, nitrogen dioxides, and particulate matter in the vicinity of coasts, threatening the health of the coastal population, especially in harbour cities. Reductions in emissions due to shipping have been targeted by several regulations. Nevertheless, effects of these regulations come into force with temporal delays, global ship traffic is expected to grow in the future, and other land-based anthropogenic emissions might decrease. Thus, it is necessary to investigate combined impacts to identify the impact of shipping activities on air quality, population exposure, and health effects in the future. We investigated the future effect of shipping emissions on air quality and related health effects considering different scenarios of the development of shipping under current regional trends of economic growth and already decided regulations in the Gothenburg urban area in 2040. Additionally, we investigated the impact of a large-scale implementation of shore electricity in the Port of Gothenburg. For this purpose, we established a one-way nested chemistry transport modelling (CTM) system from the global to the urban scale, to calculate pollutant concentrations, population-weighted concentrations, and health effects related to NO2, PM2.5, and O3. The simulated concentrations of NO2 and PM2.5 in future scenarios for the year 2040 are in general very low with up to 4 ppb for NO2 and up to 3.5 µg m−3 PM2.5 in the urban areas which are not close to the port area. From 2012 the simulated overall exposure to PM2.5 decreased by approximately 30 % in simulated future scenarios; for NO2 the decrease was over 60 %. The simulated concentrations of O3 increased from the year 2012 to 2040 by about 20 %. In general, the contributions of local shipping emissions in 2040 focus on the harbour area but to some extent also influence the rest of the city domain. The simulated impact of onshore electricity implementation for shipping in 2040 shows reductions for NO2 in the port of up to 30 %, while increasing O3 of up to 3 %. Implementation of onshore electricity for ships at berth leads to additional local reduction potentials of up to 3 % for PM2.5 and 12 % for SO2 in the port area. All future scenarios show substantial decreases in population-weighted exposure and health-effect impacts.
|
|
| 3. |
- Afsharnejad, Bahareh, et al.
(author)
-
Cross-cultural adaptation to Australia of the KONTAKT© Social Skills Group Training Program for Youth with Autism Spectrum Disorder : A feasibility study
- 2020
-
In: Journal of autism and developmental disorders. - : Springer. - 0162-3257 .- 1573-3432. ; 50, s. 4297-4316
-
Journal article (peer-reviewed)abstract
- This study investigated the feasibility and cultural validity of KONTAKT©, a manualised social skills group training, in improving the social functioning of adolescents with autism spectrum disorder (ASD). KONTAKT© was delivered to 17 adolescents (mage = 14.09, SDage = 1.43; 70% male) with ASD over sixteen 90 min sessions. A pre-test post-test design evaluated changes in personally meaningful social goals, symptom severity, quality of life, interpersonal efficacy, social anxiety, loneliness, and facial emotion recognition at pre, post and 3 months follow-up. Focus groups were conducted post intervention. Findings indicate that KONTAKT© may support Australian adolescents with ASD in achieving their personally meaningful social goals. This study resulted in finalisation of KONTAKT© in preparation for evaluation of its efficacy in a randomised controlled trial (Australian New Zealand Clinical Registry (ANZCTR): ACTRN12617001117303, ClinicalTrials.gov: NCT03294668).
|
|
| 4. |
- Afsharnejad, B., et al.
(author)
-
“I Met Someone Like Me!” : Autistic Adolescents and Their Parents’ Experience of the KONTAKT® Social Skills Group Training
- 2022
-
In: Journal of autism and developmental disorders. - : Springer. - 0162-3257 .- 1573-3432. ; 52, s. 1458-1477
-
Journal article (peer-reviewed)abstract
- This study captured the experiences of 35 autistic adolescents and their parents after completing a 16-session variant of social skills group training KONTAKT® (ACTRN12617001117303). Semi-structured interviews explored participants' and relatives' perceptions of KONTAKT® and associated social outcomes. Adolescents were classified as either high (HR, n = 23) or low (LR, n = 12) responders based on the primary outcome effects during the previous trial. Thematic analysis revealed that both HR and LR participants their parents were satisfied with KONTAKT®, noting consistent patterns of improvement in adolescents' social understanding, communication, relationships, and empowerment, although positive reports were more frequent among HR than LR groups. This study enhances the understanding of the impact of SSGT, which is key in improving their content, principles, and administration.
|
|
| 5. |
- Afsharnejad, Bahareh, et al.
(author)
-
KONTAKT© for Australian adolescents on the autism spectrum : Protocol of a randomized control trial
- 2019
-
In: Trials. - : BioMed Central. - 1745-6215. ; 20:1
-
Journal article (peer-reviewed)abstract
- BACKGROUND:Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes.METHOD/DESIGN:With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs.DISCUSSION:The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.
|
|
| 6. |
- Anderson, Maria, 1983, et al.
(author)
-
Characterization of particles from a marine engine operating at low loads
- 2015
-
In: Atmospheric Environment. - : Elsevier BV. - 1873-2844 .- 1352-2310. ; 101, s. 65-71
-
Journal article (peer-reviewed)abstract
- Particle emissions from a marine diesel engine operating at low loads with four different fuels were characterized with respect to particle number (PN) and particle mass (PM), size distribution, volatility and chemical composition. The four different fuels used were Swedish Environmental class 1 (MK1) and class 3 diesel (MK3), heavy fuel oil (HFO, 0.12 wt% S) and marine diesel oil (MDO, 0.52 wt% S). The measurements were performed for a marine diesel engine in a test-bed engine lab and the particle emissions were measured with an Engine Exhaust Particle Sizer and a Dust Monitor, giving the number concentrations in the size range of 5.6-560 nm and 300 nm to 20 gm, respectively. To quantify the amount of solid particles a thermodenuder was used. Additionally, filter samples were taken for gravimetric, black carbon (BC) and elemental analysis. The particle emissions showed a bimodal size distribution by number and the number concentrations were dominated by nanoparticles (diameter (Dp) 50 nm generally were solid primary particles. Combustion of HFO resulted in the highest PN and PM concentrations. Emission factors (EFs) for PM and PN for both the total particle emissions and the fraction of primary, solid particles are presented for different fuels and loads. EFs for nitrogen oxides (NOx), BC and some elements (Ca, Fe, V, Ni, Zn) are presented as well. This study contributes to understanding particle emissions from potential future fuels as well as emissions in ports and coastal areas where lower engine loads are common.
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Fridell, M, et al.
(author)
-
Health System Resilience: What Are We Talking About? A Scoping Review Mapping Characteristics and Keywords
- 2020
-
In: International journal of health policy and management. - : Maad Rayan Publishing Company. - 2322-5939. ; 9:1, s. 6-16
-
Journal article (peer-reviewed)abstract
- Background: Health systems are based on 6 functions that need to work together at all times to effectively deliver safe and quality health services. These functions are vulnerable to shocks and changes; if a health system is unable to withstand the pressure from a shock, it may cease to function or collapse. The concept of resilience has been introduced with the goal of strengthening health systems to avoid disruption or collapse. The concept is new within health systems research, and no common description exists to describe its meaning. The aim of this study is to summarize and characterize the existing descriptions of health system resilience to improve understanding of the concept. Methods and Analysis: A scoping review was undertaken to identify the descriptions and characteristics of health system resilience. Four databases and gray literature were searched using the keywords "health system" and "resilience" for published documents that included descriptions, frameworks or characteristics of health system resilience. Additional documents were identified from reference lists. Four expert consultations were conducted to gain a broader perspective. Descriptions were analysed by studying the frequency of key terms and were characterized by using the World Health Organization (WHO) health system framework. The scoping review identified eleven sources with descriptions and 24 sources that presented characteristics of health system resilience. Frequently used terms that were identified in the literature were shock, adapt, maintain, absorb and respond. Change and learning were also identified when combining the findings from the descriptions, characteristics and expert consultations. Leadership and governance were recognized as the most important building block for creating health system resilience. Discussion: No single description of health system resilience was used consistently. A variation was observed on how resilience is described and to what depth it was explained in the existing literature. The descriptions of health system resilience primarily focus on major shocks. Adjustments to long-term changes and the element of learning should be considered for a better understating of health system resilience.
|
|
| 10. |
|
|
| 11. |
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
- Hallert, Claes, 1945-, et al.
(author)
-
Må bra med glutenintolerans : fakta, råd, recept
- 2009. - 1
-
Book (other academic/artistic)abstract
- Må bra med glutenintolerans är för dig som inte tål gluten, oavsett om du varit glutenintolerant under en lång tid eller om du nyligen fått diagnosen celiaki. Skriften är författad av docent Claes Hallert som är en av Sveriges mest namnkunniga läkare inom området. Claes ger en pedagogisk förklaring av sjukdomen, orsak, symtom och behandling samt aktuell forskning.Aukt socionom Annette Sverker, verksam på Nordiska folkhälsohögskolan i Göteborg, ger tips och råd hur du kan hantera vardagen som glutenintolerant, när du ska handla glutenfritt, äta på restaurang, fika på arbetet, äta middag hos vänner eller åka på utlandssemester.Dietisten Karin Fridell berättar vad man kan äta och vad man måste undvika som glutenintolerant. Karin redogör även för de nya EU-reglerna kring livsmedelsmärkning, ger baktips och en rad nya glutenfria recept.Skriften är rikligt illustrerad med inspirerande foton. Den är faktagranskad av leg. dietist Carina Lunneryd, Lunds universitetssjukhus, Iréne Jonson, Svenska celiakiförbundet och leg. läkare Ann Österman som själv är
|
|
| 16. |
- Olsson, Tina M., et al.
(author)
-
The five-year costs and benefits of extended psychological and psychiatric assessment versus standard intake interview for women with comorbid substance use disorders treated in compulsory care in Sweden
- 2018
-
In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 18:1
-
Journal article (peer-reviewed)abstract
- Background: Women with comorbid substance use disorders are an extremely vulnerable group having an increased relative risk of negative outcomes such as incarceration, morbidity and mortality. In Sweden, women with comorbid substance use disorders may be placed in compulsory care for substance abuse treatment. Clinical intake assessment procedures are a distinct aspect of clinical practice and are a foundation upon which client motivation and continued treatment occurs.Method: The current study is a naturalistic quasi-experiment and aims to assess the five-year costs and benefits of a standard intake interview versus an extended psychological and psychiatric assessment for a group of chronic substance abusing women placed in compulsory care in Sweden between 1997 and 2000. Official register data on criminal activity, healthcare use, compulsory care stays and other services was retrieved and all resources used by study participants from date of index care episode was valued. In addition, the cost of providing the intake assessment was estimated.Results: Results show that the extended assessment resulted in higher net costs over five years of between 256,000 and 557,000 SEK per person for women placed in care via the Law on Compulsory Care for Substance Abusers (LVM). Higher assessment costs made up a portion of this cost. The majority of this cost (47-57%) falls on the local municipality (social welfare) and 11.6-13.7% falls on the individual patient.Conclusions: Solid evidence supporting the clinical utility or incremental validity of assessment for improving treatment outcomes in this setting was not confirmed.
|
|
| 17. |
- Olsson, Tina M., et al.
(author)
-
Women with co-occurring substance abuse and mental disorders in Sweden : a longitudinal study of criminal justice system involvement and costs
- 2013
-
In: Mental Health and Substance Use. - London : Taylor & Francis. - 1752-3281 .- 1752-3273. ; 6:3, s. 219-236
-
Journal article (peer-reviewed)abstract
- This study aimed to estimate the cumulative direct criminal justice system costs incurred by age and offending year between 1975 and 2004 by a cohort of women with a co-occurring substance abuse and mental disorder (COD) placed in a compulsory treatment facility for substance abuse between 1997 and 2000. Official register data were obtained for the period 1975–2004 on criminal charges, prosecutions, judgments and sentences by a consecutive sample of 227 women. The 2010 unit price data were applied to resource use and total costs were calculated and reported by age and offending year. A total of 211 women (92.9%) were charged for at least one crime during the period under review. The mean length of criminal career was 8.58 years. Theft and narcotics offenses were the crime categories with the highest number of crimes committed and charges made. The total criminal justice system costs per person averaged 834,897 Swedish crowns (SEK, 2010) over the entire sample. This study provides cost data on the real criminal careers of women with COD which can be used to estimate the potential benefit of targeted interventions at various stages in an individual's criminal career. The results indicate that early, targeted, effective intervention can have substantial benefits.
|
|
| 18. |
|
|
