| 1. |
- Montelius, Elin, 1983-
(författare)
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Att göra det materiella virtuellt : Subjektifiering, moral och motstånd i konstruktionen av den riskfyllda mathållningen
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Den här avhandlingen syftar till att bidra till förståelsen av hur risk konstrueras och förändras i diskussioner om mathållning på nätforum och vilka subjektspositioner som görs möjliga då risk uttrycks i relation till klass och kön. Mat har kommit att få stor uppmärksamhet i samhällsdiskussionen, men i det moderna samhället är det inte bristen på mat som står i fokus, utan snarare de val människor måste göra relaterade till mat. Vad vi äter har kommit att bli en signal om vem vi är och vem vi vill vara, men diskussioner kring mat handlar också om vad som betraktas som riskfyllt eller inte. Därtill har mat länge använts för att göra distinktioner mellan människor baserat på maktstrukturer som klass och kön. Avhandlingen är inspirerad av en feministisk poststrukturalistisk ansats vilken används för att undersöka hur maktrelationer och subjektifieringsprocesser uttrycks i konversationer på nätbaserade diskussionsforum.Genom att ta avstamp i den kritiska riskforskningen samt i genusvetenskaplig forskning visar avhandlingen hur risk konstrueras genom riskperformativ. Riskperformativ, uttryckta i det virtuella rummet, medför att olika ”sanningar” konstrueras runt mathållningar vilket får konsekvenser får vilka subjektspositioner som möjliggörs. Genom riskperformativen konstruerats olika förväntningar om vad som kan och bör sägas för att konstituera sig som ett ansvarsfullt och moraliskt subjekt. Därigenom görs olika riskpositioner, det vill säga klass- och könskodade subjektspositioner som konstitueras i relation till riskkonstruktioner, tillgängliga. Analysen visar också hur utrymme för betydelseförskjutningar och motstånd mot riskkonstruktioner skapas i diskussionerna, vilket sker genom dels bekännelsen som teknik och dels genom en teknik som här kallas en responsibiliserad paternalism varigenom det individualiserade ansvaret för upprätthållandet av självreglering inför risk uttrycks i samverkan med kollektivt upprätthållna klass- och könsnormer. I avhandlingen analyseras därigenom hur kön och klass görs i samverkan med riskkonstruktioner på sätt där dessa förstärker varandra.
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| 2. |
- Claesson Lingehall, Helena, 1965-
(författare)
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Delirium in older people after cardiac surgery : risk factors, dementia, patients’ experiences and assessments
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background:Delirium is common in older people undergoing cardiac surgery. Delirium is an acute or subacute neuro-psychiatric syndrome, characterized by a change in cognition, disturbances in consciousness; it fluctuates, develops over a short period of time and always has an underlying cause. It is associated with a disturbance in psychomotor activity, and is classified according to different clinical profiles such as hypoactive, hyperactive and mixed delirium. Delirium after cardiac surgery is not harmless, it increases the risk of complications such as prolonged stay in hospital, falls, reduced quality of life, reduced cognitive function and increased mortality.Aim:The overall aim of this thesis was to investigate postoperative delirium in older people undergoing cardiac surgery with Cardiopulmonary Bypass (CPB), focusing on risk factors, dementia and patients’ experiences; and to evaluate an assessment for screening delirium.Methods:This thesis compromises four studies. All participants (n=142) were scheduled for cardiac surgery with use of CPB at the Cardiothoracic Surgery Department, Heart Centre, Umeå University Hospital, Sweden, between February and October 2009. Six structured interviews were conducted preoperatively, day one and day four postoperatively, and in home visits, one, three and five years after surgery (2010, 2012 and 2014). The assessment scales used in Studies I, II and IV were: the Mini-Mental State Examination (MMSE) for cognition, the Organic Brain Syndrome Scale (OBS) for delirium, Geriatric Depression Scale 15 (GDS-15) for depression, Katz staircase with Activities of Daily Living (ADL) for participants’ functional status and the Numerical Rating Scale (NRS) for pain. During the hospital stay, nursing staff used the Swedish version of the Nursing Delirium Screening Scale (Nu-DESC) to assess delirium. Semi-structured interviews were also carried out (III) in the one-year follow up. Delirium, dementia and depression were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR).Results: Out of 142 participants 54.9% (78/142) developed delirium after cardiac surgery (I). Independent risk factors, predisposing and precipitating, associated with delirium were: age, diabetes, gastritis/peptic ulcer, volume load during operation, longer time on ventilator in intensive care, increased temperature and plasma sodium concentration in the intensive care unit. Out of 114 participants thirty (26.3%) developed dementia within the five years of follow-up. It was shown that a lower preoperative MMSE score and postoperative delirium were factors independently associated with development of dementia (II). One year after cardiac surgery, participants diagnosed with postoperative delirium described in detail feelings of extreme vulnerability and frailty. Despite this, the participants were grateful for the care they had received (III). Hypoactive was the most common symptom profile for delirium. The Swedish version of Nu-DESC showed high sensitivity in detecting hyperactive delirium, but low sensitivity in detecting hypoactive delirium (IV).Conclusion:Delirium was common among older patients undergoing cardiac surgery. Both predisposing and precipitating factors contributed to postoperative delirium. Preventive strategies should be considered in future randomized studies. It might also be suggested that cognitive function should be screened for preoperatively and patients who develop delirium should be followed up to enable early detection of symptoms of dementia. Whether prevention of postoperative delirium can reduce the risk of future dementia remains to be studied. To minimise unnecessary suffering, patients and next of kin should be informed about and prepared for the risk of delirium developing during hospitalization. The Swedish version of Nu-DESC should be combined with cognitive testing to improve detection of hypoactive delirium, but further research is needed. Healthcare professionals need knowledge concerning postoperative delirium in order to prevent, detect and treat delirium so as to avoid and relieve the suffering it might cause.
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| 3. |
- Hober, Sophia, Professor, 1965-, et al.
(författare)
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Systematic evaluation of SARS-CoV-2 antigens enables a highly specific and sensitive multiplex serological COVID-19 assay
- 2021
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Ingår i: Clinical & Translational Immunology. - : Wiley. - 2050-0068. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The COVID-19 pandemic poses an immense need for accurate, sensitive and high-throughput clinical tests, and serological assays are needed for both overarching epidemiological studies and evaluating vaccines. Here, we present the development and validation of a high-throughput multiplex bead-based serological assay. Methods. More than 100 representations of SARS-CoV-2 proteins were included for initial evaluation, including antigens produced in bacterial and mammalian hosts as well as synthetic peptides. The five best-performing antigens, three representing the spike glycoprotein and two representing the nucleocapsid protein, were further evaluated for detection of IgG antibodies in samples from 331 COVID-19 patients and convalescents, and in 2090 negative controls sampled before 2020. Results. Three antigens were finally selected, represented by a soluble trimeric form and the S1-domain of the spike glycoprotein as well as by the C-terminal domain of the nucleocapsid. The sensitivity for these three antigens individually was found to be 99.7%, 99.1% and 99.7%, and the specificity was found to be 98.1%, 98.7% and 95.7%. The best assay performance was although achieved when utilising two antigens in combination, enabling a sensitivity of up to 99.7% combined with a specificity of 100%. Requiring any two of the three antigens resulted in a sensitivity of 99.7% and a specificity of 99.4%. Conclusion. These observations demonstrate that a serological test based on a combination of several SARS-CoV-2 antigens enables a highly specific and sensitive multiplex serological COVID-19 assay.
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| 4. |
- Holm, Anna M., 1989-
(författare)
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Human papillomavirus in sinonasal inverted papilloma, recurrent respiratory papilloma and non-malignant tonsils
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Human papillomavirus (HPV) is known to cause recurrent respiratory papilloma (RRP) and certain types of oropharyngeal cancer. HPV has also been associated with sinonasal inverted papilloma (SIP). HPV transmission routes are under investigation and the conviction is that the infection occurs sexually at an adult stage, however, vertical transmission at birth with a dormant viral condition until disease eruption/co-activation has been stated as a possibility.Purpose: The purpose of this work was to contribute to the understanding of HPV related chronic diseases in the airway. Specific aims were: 1. To increase understanding regarding changes in the immune system as well as of the glycosaminoglycan hyaluronan in patients with RRP. 2. To evaluate prevalence of HPV and its surrogate marker p16 in SIP as well as HPV, p16 and Epstein-Barr virus (EBV) in benign tonsillar disease. HPV and EBV in non-malignant tonsillar disease were studied due to the fact that incidence of HPV positive tonsillar cancer is increasing and the time of viral infection is unknown.Methods: A phenotypic characterization of peripheral blood from 16 RRP patients and 12 age-matched controls, using immunoflow cytometry, and monoclonal antibodies against differentiation and activation markers, was performed. The cytokine mRNA profile of monocytes, T helper-, T cytotoxic-, and NK cells was assessed using RT-qPCR. 54 SIP samples were studied of which 53 were available for analyzation with PCR. Genotype screening for 18 high risk and six low risk HPV types was performed using the PapilloCheck® HPV-screening test (a PCR method). 54 samples were immunohistochemically (IHC) stained for p16. Biopsies from vocal folds (VFs) and false vocal folds (FVFs) were collected from 24 patients with RRP, 12 were randomly selected to histochemistry for Hyaluronan (HA) and IHC staining for CD44 in the epithelium, stroma and RRP lesions. The remaining 12 patients were analyzed for HA molecular mass distribution with a gas-phase electrophoretic molecular mobility analyzer (GEMMA). Eight VF samples and four FVF samples were successfully analyzed. Biopsies from 40 non-malignant tonsils were analyzed using Papillocheck® for HPV, IHC for p16 and EBER analysis for EBV.Results: We found a dominance of cytotoxic T cells, activated NK cells, and high numbers of stressed MIC A/B (MHC class I chain-related molecule A/B) expressing lymphocytes. The HPV analysis was successful for 38 SIP samples and two (5%) were positive for HPV 11. Notably, p16 was present in the epithelia of all samples and in the papilloma portions in 37 of 38 samples. We found extensive HA staining in the stroma of both VFs and FVFs. CD44 was expressed throughout the epithelium, stroma, and RRP lesions in both FVFs and VFs, it did however, not concur with the expression of HA. Very high mass HA was found in both VFs and FVFs, though more variation regarding amounts of HA was seen in the VFs compared to FVFs. No HPV was found in non-malignant tonsils, the p16 levels were low and the counted EBER positive cells showed great variation in numbers.Conclusions: Our findings demonstrate an immune dysregulation with inverted CD4+/CD8+ ratio and aberrant cytokine mRNA production in RRP patients, compared to healthy controls. We concluded that p16 cannot be used as a surrogate marker for high-risk HPV-infection in SIP and that HPV incidence was low (5%). CD44 does not seem to bind to HA, which might explain the noninflammatory response previously described in RRP. Very high mass HA possibly crosslinked was seen in both VFs and FVFs. A possibility to counteract inflammatory crosslinking of HA may be found for medical treatment options in RRP.
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| 5. |
- Karlsson, Åsa, 1972-
(författare)
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Team-based home rehabilitation after hip fracture in older adults : effects, experiences and impact of dementia
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: For an older adult a hip fracture may be a traumatic and life-changing event and has shown to be associated with reduced health-related quality of life, disability and increased mortality. Previous rehabilitation studies have often excluded older adults with cognitive impairment and those living in residential care facilities, groups with an additional risk of poor outcome. Moreover, there are few randomized controlled trials that have evaluated interdisciplinary home rehabilitation after hip fracture. These studies did not include older adults with severe cognitive impairment or dementia, those with serious medical conditions, or those living in residential care.OBJECTIVE: The aim of the thesis was to investigate the effects of early discharge followed by geriatric interdisciplinary home rehabilitation (GIHR) for older adults with hip fracture, and specifically among those with dementia, compared to in-hospital geriatric care according to a multifactorial rehabilitation program. An additional aim was to explore how older adults experienced their rehabilitation and recovery during the year following the fracture.METHODS: The thesis evaluated a randomized controlled trial that included 205 participants with hip fracture, 70 years or older, living in ordinary housing or residential care facilities. In hospital, both the GIHR and control groups received care and rehabilitation according to a multifactorial rehabilitation program, but with the aim of early discharge for the GIHR group. The individually designed GIHR intervention focused on walking ability indoors and outdoors, independence in activities of daily living (ADL), and multifactorial fall prevention during a maximum period of 10 weeks. Participants were assessed in-hospital and at 3- and 12-month follow-up visits. Independence in walking and use of walking aids was assessed via an interview along with gait speed tests. Independence in ADL was measured using the Barthel ADL Index, and the ADL Staircase including the Katz ADL Index, and hospital length of stay (LOS) was recorded from medical charts. The effects of GIHR intervention among participants with dementia were investigated in a post hoc subgroup analysis where additional outcomes were falls, mortality and readmissions between discharge and 12 months. Individual interviews were conducted with 20 selected participants just after the 12-month follow-up. Data were analysed using qualitative content analysis.RESULTS: The postoperative hospital LOS was significantly reduced by a median of six days in the GIHR group compared to the control group, although not significantly reduced in the GIHR group for participants with dementia. Binary logistic regression analyses revealed no significant differences between the GIHR and control groups regarding independent walking ability, the ability to walk without a walking device, or independence in ADL at 3 and 12 months. Gait speed was comparable between the two groups at 3 and 12 months. At 12 months, 56% in the GIHR group and 58% in the control group had recovered their prefracture walking ability, and 41% vs. 42% in GIHR and control groups, respectively, had regained their prefracture Barthel ADL Index score. Interaction analyses showed that the GIHR group vs. the control group had comparable effects on walking ability and ADL at 3 and 12 months, and on falls and mortality between discharge and 12 months, regardless of whether the participants had dementia or not (P≥0.05 for all). The number of readmissions and hospital days after discharge was comparable between GIHR and control groups for participants with dementia. Overall, dementia was associated with significantly impaired walking ability and greater dependence in ADL at 3 and 12 months and with increased risk of falling and increased mortality between discharge and 12 months compared to participants without dementia. The interviews revealed that access to rehabilitation, provided by skilled staff, and support from others were important for participants’ well-being and recovery. Participants experienced a fundamental change in their self-image after the fracture, and faced a number of difficulties, but strove for independence and used adaptive strategies to find contentment in their lives.CONCLUSIONS: In older adults with hip fracture, early discharge followed by interdisciplinary home rehabilitation significantly reduced postoperative hospital LOS. Functional recovery during the year following the fracture was nevertheless comparable to in-hospital geriatric care according to a multifactorial rehabilitation program. The GIHR intervention seems to be appropriate also for older adults with dementia since the effects were not different in this subgroup, except for postoperative hospital LOS, which was not significantly reduced in the GIHR group for participants with dementia. Further studies with larger samples are needed to validate these results. Overall, dementia was associated with a substantial negative impact on the outcomes. According to participants’ experiences, receiving rehabilitation and support after the hip fracture seems crucial for successful recovery. Negative psychological reactions were common, suggesting that future interventions should consider both physical and psychological aspects. Different rehabilitation alternatives were appreciated by the participants. Rehabilitation should thus be customised to suit wishes and needs of older adults and may accordingly be carried out in different settings, where rehabilitation in the home can be one suitable alternative. The findings of this thesis indicate that geriatric interdisciplinary home rehabilitation after hip fracture can be an alternative and a complement to in-hospital care and rehabilitation for older adults with and without dementia.
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| 6. |
- Löfmarck, Erik, 1974-
(författare)
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Den hand som föder dig : En studie av risk, mat och moderskap i Sverige och Polen
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This is a study of how mothers of young children relate to risk in everyday life, with an emphasis on the invisible risks associated with modernity in general, and with food in particular. It explores variations and similarities in how mothers deal with risk in two cultural contexts: Sweden and Poland. The study is based on twenty qualitative interviews with university educated mothers of small children in Stockholm and Warsaw. While risks more generally challenge how we “get on” with our lives, mothers of young children in particular have a special relationship to risk. During pregnancy and breastfeeding they are subject to all kinds of risk minimization efforts, and mothers are ultimately held "infinitely responsible" for their children's welfare by society. Women's transition to parenthood then makes for a particularly interesting case as to how risks manifest in everyday life. The theoretical framework draws on modernization theory, combined with insights from cultural theory. In addition, various contributions from sociological and psychological risk research, family sociology and research on parenting and motherhood are used to highlight contextual aspects and to interpret the empirical results. Two aspects of the mothers’ relationship to risk and food are examined in this study: firstly, their risk constructs, i.e. what they perceive as ‘risky’ with regards to food; and, secondly, their risk management strategies, i.e. how they deal with identified risks on a practical and cognitive level. The overall risk management depicted in this study is characterized by reflexivity, critical thinking, information retrieval, attention to scientific evidence, purposely transferred trust, confidence and the ability to make fairly sophisticated tradeoffs between risks and other aspects of life. Neither the Swedish nor the Polish mothers then conform to popular notions of ‘security junkies’ or ‘paranoid parenting’. Nonetheless, the comparative approach demonstrates how contextual differences, such as general trust levels and family policy, influence both the risk constructs and the employment of different risk management strategies.
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| 7. |
- Dillner, Joakim, et al.
(författare)
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Antibodies to SARS-CoV-2 and risk of past or future sick leave
- 2021
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- The extent that antibodies to SARS-CoV-2 may protect against future virus-associated disease is unknown. We invited all employees (n=15,300) at work at the Karolinska University Hospital, Stockholm, Sweden to participate in a study examining SARS-Cov-2 antibodies in relation to registered sick leave. For consenting 12,928 healthy hospital employees antibodies to SARS-CoV-2 could be determined and compared to participant sick leave records. Subjects with viral serum antibodies were not at excess risk for future sick leave (adjusted odds ratio (OR) controlling for age and sex: 0.85 [95% confidence interval (CI) (0.85 (0.43-1.68)]. By contrast, subjects with antibodies had an excess risk for sick leave in the weeks prior to testing [adjusted OR in multivariate analysis: 3.34 (2.98-3.74)]. Thus, presence of viral antibodies marks past disease and protection against excess risk of future disease. Knowledge of whether exposed subjects have had disease in the past or are at risk for future disease is essential for planning of control measures.Trial registration: First registered on 02/06/20, ClinicalTrials.gov NCT04411576.
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| 8. |
- Havervall, Sebastian, et al.
(författare)
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Robust humoral and cellular immune responses and low risk for reinfection at least 8 months following asymptomatic to mild COVID-19
- 2022
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Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 0954-6820 .- 1365-2796. ; 291:1, s. 72-80
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emerging data support detectable immune responses for months after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination, but it is not yet established to what degree and for how long protection against reinfection lasts.Methods: We investigated SARS-CoV-2-specific humoral and cellular immune responses more than 8 months post-asymptomatic, mild and severe infection in a cohort of 1884 healthcare workers (HCW) and 51 hospitalized COVID-19 patients. Possible protection against SARS-CoV-2 reinfection was analyzed by a weekly 3-month polymerase chain reaction (PCR) screening of 252 HCW that had seroconverted 7 months prior to start of screening and 48 HCW that had remained seronegative at multiple time points.Results: All COVID-19 patients and 96% (355/370) of HCW who were anti-spike IgG positive at inclusion remained anti-spike IgG positive at the 8-month follow-up. Circulating SARS-CoV-2-specific memory T cell responses were detected in 88% (45/51) of COVID-19 patients and in 63% (233/370) of seropositive HCW. The cumulative incidence of PCR-confirmed SARS-CoV-2 infection was 1% (3/252) among anti-spike IgG positive HCW (0.13 cases per 100 weeks at risk) compared to 23% (11/48) among anti-spike IgG negative HCW (2.78 cases per 100 weeks at risk), resulting in a protective effect of 95.2% (95% CI 81.9%-99.1%).Conclusions: The vast majority of anti-spike IgG positive individuals remain anti-spike IgG positive for at least 8 months regardless of initial COVID-19 disease severity. The presence of anti-spike IgG antibodies is associated with a substantially reduced risk of reinfection up to 9 months following asymptomatic to mild COVID-19.
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| 9. |
- Havervall, Sebastian, et al.
(författare)
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SARS-CoV-2 induces a durable and antigen specific humoral immunity after asymptomatic to mild COVID-19 infection
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:1, s. e0262169-e0262169
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Tidskriftsartikel (refereegranskat)abstract
- Current SARS-CoV-2 serological assays generate discrepant results, and the longitudinal characteristics of antibodies targeting various antigens after asymptomatic to mild COVID-19 are yet to be established. This longitudinal cohort study including 1965 healthcare workers, of which 381 participants exhibited antibodies against the SARS-CoV-2 spike antigen at study inclusion, reveal that these antibodies remain detectable in most participants, 96%, at least four months post infection, despite having had no or mild symptoms. Virus neutralization capacity was confirmed by microneutralization assay in 91% of study participants at least four months post infection. Contrary to antibodies targeting the spike protein, antibodies against the nucleocapsid protein were only detected in 80% of previously anti-nucleocapsid IgG positive healthcare workers. Both anti-spike and anti-nucleocapsid IgG levels were significantly higher in previously hospitalized COVID-19 patients four months post infection than in healthcare workers four months post infection (p = 2*10−23 and 2*10−13 respectively). Although the magnitude of humoral response was associated with disease severity, our findings support a durable and functional humoral response after SARS-CoV-2 infection even after no or mild symptoms. We further demonstrate differences in antibody kinetics depending on the antigen, arguing against the use of the nucleocapsid protein as target antigen in population-based SARS-CoV-2 serological surveys
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| 10. |
- Lundgren, Minna
(författare)
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Boundaries of displacement : Belonging and Return among Forcibly Displaced Young Georgians from Abkhazia
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This dissertation explores the implications of borders and boundaries for how forcibly displaced young Georgians from Abkhazia understand issues of belonging and return. My theoretical framework draws from theories on home and belonging as well as theories on border and boundary making, and locates them in geographies of uncertainty – or riskscapes – areas characterized by conflict and/or inequality. Empirical data was collected through two sets of interviews in Zugdidi near the border to Abkhazia and a questionnaire survey in Zugdidi and the capital Tbilisi. These data have been analysed through both qualitative and quantitative methods. The young respondents providing material for this research do not constitute a homogenous group. Some of the respondents have family still living in Abkhazia or even partly grew up in the area; others have never been there. The primary goal of the Georgian government has been that the displaced population should return to their homes, and the government’s efforts for local integration has long been insufficient. Since no peace accords have been signed, a lack of security prevents a large-scale return. Notwithstanding increased border controls that have made it difficult to visit former homes, some young people still cross the de facto border. By doing this they contest both the Abkhazian de facto authorities and the border as a symbol of separation and differentiation, while claiming a right to belong in Abkhazia. Property and social relations in Abkhazia contribute to stronger connections and an imperative to return. On the other hand, experience of hardship in contemporary Abkhazia has resulted in some young people not considering return as a viable option. Youth who never visited Abkhazia depend mainly on other peoples’ memories and political discourse to create emotional bonds to the area their parents fled and to form their ideas of return. Results from the quantitative survey indicate that youth living in Tbilisi, closer to the political centre, to a higher extent intend to return than their peers in Zugdidi. Meanwhile young people’s experiences of everyday life in current dwellings in relative stability create emotional bonds to their present place of living. These experiences challenge both collective processes and experiences from Abkhazia when it comes to maintaining the desire to return. This research offers insights into the human consequences of war and conflict. More specifically, this dissertation sheds light on how young internally displaced persons (IDPs) are living in a borderland (in both temporal and spatial terms) characterized by uncertainty-- between the past and the future as well as between Georgia and Abkhazia. Practices of exclusion and segregation are constitutive of the borders and boundaries that permeate life experiences of the forcibly displaced youth. Furthermore, these borders and boundaries are situated in riskscapes of disputed belongings, which makes this borderland more or less stable for different groups of IDPs. This dissertation contributes to an increased understanding of how political aspirations and personal desire to return preserves instability and uncertainty as long as return is not possible.
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| 11. |
- Olofsson, Birgitta, 1963-
(författare)
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Old people with femoral neck fracture : delirium, malnutrition and surgical methods - an intervention program
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Hip fracture is a global and a growing public health problem. More women than men sustain hip fractures, the incidence increases exponentially with age and mean age is above 80. About one third of hip-fracture patients suffer from dementia and are prone to develop acute confusional state (delirium). Delirium is one of the most common complications after hip-fracture surgery, and seriously impacts on morbidity and mortality. Malnutrition is also common in hip-fracture patients and is associated with postoperative complications, such as delayed healing of the wound, infections and decubitus ulcers. Arthroplasty is usually preferred procedure in displaced femoral neck fractures but is, however, controversial in patients with dementia due to the fear of dislocation of the prosthesis. The aims of this thesis are to identify risk factors for delirium and the impact of delirium on rehabilitation outcome, to evaluate whether a postoperative multi-factorial intervention program could reduce delirium, to investigate the effect of a nutritional intervention and to evaluate complications, functional outcome and mortality regarding two surgical methods, hemiarthroplasty (HAP) and internal fixation (IF), in old patients with femoral neck fracture. Thirty-eight out of 61 consecutive patients (62%) were delirious on admission to hospital or developed postoperative delirium. An increased risk of postoperative delirium was found among hip-fracture patients with dementia and/or depression. Delirious patients were hospitalized longer, were more dependent in their activities of daily living, had poorer psychological well-being and suffered more complications than non-delirious patients. A postoperative multi-factorial and multidisciplinary intervention program reduced the incidence, at 55% vs 75% (p=0.003), and number of days with delirium, 5 vs 10 days (p=0.009). Postoperative complications were also reduced; decubitus ulcers 9% vs 22% (p= 0.010), urinary tract infections 31% vs 51% (p=0.005), falls 12% vs 27% (p=0.007), and the mean hospitalization period was 10 days shorter in the intervention group (p=0.030). Malnutrition was common among all these patients (53 %) and associated with postoperative complications such as decubitus ulcers and delirium. However, the nutritional intervention had no effect on nutritional parameters at four months, nevertheless men had better nutritional outcomes than women. A higher proportion of patients with dementia operated on using HAP had regained their pre-fracture ability to walk independently at the one-year follow up compared with those operated on using IF. Six of 83 patients dislocated their HAP during hospitalization and during an episode of delirium, none had dementia. No difference in mortality between the surgical methods was seen. Dementia per se should not be a reason to disqualify patients from being treated with the most appropriate surgical method. It is clinically important to discriminate between dementia and delirium, since delirium can be prevented and treated even in patients with dementia. Old patients undergoing surgery have special needs that are not always catered for in ordinary orthopaedic or surgical wards. The special care for these patients should include: a combined nursing and medical care based on comprehensive geriatric assessments, systematic prevention, detection and treatment of postoperative complications such as delirium, hypoxemia, urinary tract infections, pain, malnutrition and an active rehabilitation. It is obvious that improved quality of care reduces patient suffering and seemingly the costs for society.
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| 12. |
- Sarstrand, Anna-Maria, 1976-
(författare)
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De första invandrarbyråerna : Om invandrares inkorporering på kommunal nivå åren 1965-1984
- 2007
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)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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| 13. |
- Tran, Phong, et al.
(författare)
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De novo dNTP production is essential for normal postnatal murine heart development
- 2019
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Ingår i: Journal of Biological Chemistry. - : American Society for Biochemistry and Molecular Biology. - 0021-9258 .- 1083-351X. ; 394:44, s. 15889-15897
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Tidskriftsartikel (refereegranskat)abstract
- The building blocks of DNA, dNTPs, can be produced de novo or can be salvaged from deoxyribonucleosides. However, to what extent the absence of de novo dNTP production can be compensated for by the salvage pathway is unknown. Here, we eliminated de novo dNTP synthesis in the mouse heart and skeletal muscle by inactivating ribonucleotide reductase (RNR), a key enzyme for the de novo production of dNTPs, at embryonic day 13. All other tissues had normal de novo dNTP synthesis and theoretically could supply heart and skeletal muscle with deoxyribonucleosides needed for dNTP production by salvage. We observed that the dNTP and NTP pools in wild-type postnatal hearts are unexpectedly asymmetric, with unusually high dGTP and GTP levels compared with those in whole mouse embryos or murine cell cultures. We found that RNR inactivation in heart led to strongly decreased dGTP and increased dCTP, dTTP, and dATP pools; aberrant DNA replication; defective expression of muscle-specific proteins; progressive heart abnormalities; disturbance of the cardiac conduction system; and lethality between the second and fourth weeks after birth. We conclude that dNTP salvage cannot substitute for de novo dNTP synthesis in the heart and that cardiomyocytes and myocytes initiate DNA replication despite an inadequate dNTP supply. We discuss the possible reasons for the observed asymmetry in dNTP and NTP pools in wildtype hearts.
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| 14. |
- Unneby, Anna, 1985-
(författare)
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Pain and pain management with femoral nerve block following hip fracture : effects and experiences: the perspective of older patients and staff
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Older people with hip fractures are often frail with several comorbidities and roughly half of them have dementia disorders. Pain is common among patients with hip fracture and pain management in these patients is a challenge. Opioids are known to relieve pain while at rest but are not as effective in movement. One alternative to opioids is a femoral nerve block (FNB). Previous studies have shown that FNBs can decrease pain and the need for opioids, but these studies excluded patients with dementia. Few studies have investigated whether FNBs decrease the incidence of complications in general, and delirium in particular. These studies were also based on different types of nerve blocks and methods. Few studies have described patients’ experiences of pain and pain management, and there are no studies on patients’ experiences of receiving or being treated with FNBs. In addition, there are no studies on staff´s experience of nursing care among patients with hip fractures who received an FNB. Objectives: The overall aim of this thesis is to investigate the effect of a preoperative FNB in patients with hip fracture in terms of pain and complications, and, further, to describe experiences of pain and pain management among patients with hip fracture who received FNBs as well as staff´s experiences of treating them. The first two papers (I and II) investigate the effect of an FNB compared to opioids, with a focus on pain and complications. To gain a deeper understanding, the final two papers (III and IV) describe experiences of pain and pain management in patients with hip fractures who received an FNB, and the staff's experiences of nursing care with patients with hip fractures who received an FNB. Methods: Papers I and II are based on a randomized controlled study which included patients aged 70 years or older with hip fractures, including those with cognitive impairment or dementia. Patients were randomized on arrival at the orthopaedic ward in terms of pain treatment to be administered; the options were FNB (with opioids if needed) or opioids alone. In paper I, 266 patients were included; the mean age was 84 years, 64% were women, and 45% had a dementia diagnosis. Paper II included 236 patients; the mean age was the same, 66% were women, and 46% had a dementia diagnosis. Pain assessment scales (self-rated VAS and VAS by proxy) was used preoperative to assess patients’ pain in rest. Nurses assessed the incidence of delirium using Nu-DESC, both pre- and postoperatively. In addition, a structural interview was performed with validated assessments 3 to 5 days after surgery by the author (AU). The assessments, nursing and medical records were subsequently evaluated by a specialist in geriatric medicine together with a trained research nurse in terms of complications, dementia, depression and delirium. Data collected in papers I and II were analysed using comparative and descriptive statistical analysis. In papers III and IV, semi-structured interviews were performed with patients (paper III) and with staff (nurses and assistant nurses, paper IV) based on interview guides with open-ended questions that offered opportunities for clarification and follow-up questions. In paper III, 23 patients with hip fractures aged 70 years or older who were treated with FNBs were interviewed, and in paper IV, staff working in the orthopaedic ward and emergency department with experience of caring for patients with hip fractures treated with FNBs were interviewed. The interviews were audio-recorded, transcribed and analysed using qualitative content analysis. Results: The results in paper I showed that patients who received an FNB assessed lower pain scores over a period of 12 hours. Patients required smaller amounts of opioids and the number of patients requiring opioids was reduced compared with the group that received opioids alone. Overall, in paper II was it a high incidence of complications, common complications in both groups were pre and postoperative delirium (44% and 73%), nutritional problems (71%), anaemia (66%), constipation (64%) and urinary tract infection (45%), but no statistical difference was found between groups of those complications. The results in paper II showed that 39% of the patients who received an FNB and 49% of those who received opioids developed delirium before surgery, with no statistical difference. In paper III, patients described how the pain before surgery was experienced from no pain, to the worst possible pain and everything in between. They described how they dealt with pain in their own way, but also how they felt dependent on the staff's willingness to relieve the pain. They described that the pain treatment could be lifesaving, but that it could also create the feeling of a near-death experience. Further, some patients experienced memory loss regarding the time before surgery, which made it difficult to remember the pain and pain treatment they received. Finally, in paper IV, the staff described that the FNB setting the agenda when caring for older patients with hip fracture in the preoperative phase. Nursing care required timing, with a need of staff orienting to time and customizing their communication. The outcome of the FNB affected nursing care, depending on if the FNB was successful or not successful. Further, staff faced ethical challenges regarding doing good and not harm and relieving pain and avoiding side-effects. Conclusion: This thesis shows that FNB is a feasible preoperative pain management for patients with a hip fracture, even among those with dementia. Evidence-based guidelines are necessary as a basis for assessing pain and providing pain management, but staff should add an individualized pain management approach. Staff should evaluate every patient and see each patient as a unique individual with different experiences of pain and pain management to successfully relieve pain among patients with a hip fracture.
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| 15. |
- Wall, Erika, 1978-
(författare)
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Riskförståelse : Teoretiska och empiriska perspektiv
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis introduces the concept of ‘sense-making of risk’ (riskförståelse) for the purpose of the theoretical and empirical study of the individual’s sense-making of risk. Particular weight is attached to an examination of the term’s various components, its compass, and the relationship between sense-making of risk and behaviour. The premise is that risk is created and defined by the common conceptions that exist within the framework of a specific social context; the effect is to focus attention on the significance of social and cultural contexts. To provide a full picture of sense-making of risk, and risk behaviour, and to study these phenomena using a variety of methodological perspectives, the data was gathered from both polls and focus-group interviews. It is in the first article, based on a focus-group interview study, that the concept of sense-making of risk is introduced: the empirical results demonstrate that it can be used to chart how young people with similar risk perceptions differ in their understanding of a variety of risks. A theoretical model is proposed that establishes that there are two dimensions to the individual’s sense-making of risk. The second article considers young people’s risk behaviour in traffic milieus. The principal conclusion drawn in this study is that the individual’s sense-making of risk is insufficient to explain behaviour in relation to risk: the spatial context must also be taken into account. The third article focuses on the relationship between place attachment and sense-making of risk, and demonstrates that various aspects of place attachment have implications for the individual’s sense-making of risk. The fourth and final article offers a cluster analysis. The article’s most important result is its refinement of the theoretical concepts. Structure of meaning is singled out as the basis for the individual’s sense-making of risk. In its empirical application the concept was shown to be useful in studying the behavioural differences between various social groups, since grouping by structure of meaning furnishes an explanation for variations in risk and risk-reducing behaviour. The introductory and concluding chapters assemble the studies’ findings and offer a full account of the concept of sense-making of risk. The thesis’ most important conceptual contribution is to the question of how the individual arrives at a personal sense-making of risk. However, it will fall to future studies to establish the concept’s general applicability by considering its theoretical ramifications and empirical implementation. In this way, sense-making of risk can take its place in a specifically sociological conceptual apparatus that focuses on how the individual relates to risk.
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| 16. |
- Danielsson, Erna, Professor, 1954-, et al.
(författare)
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Risk Communication : A Comparative Study of Eight EU Countries
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- How do EU member states communicate risks to their citizens? In this study, we define risk communication as the information provided by different levels of government to citizens regarding possible future crises. The questions serving as departure points for this study are as follows: How is the administrative system for risk communication set up in the countries studied? How the different risk communication campaigns are (provided that they exist) embedded in the larger administrative context? How is risk communication strategy formulated in each country and what kind of threats are emphasized? In order to tackle these questions, we examine the risk communication strategy of eight countries: Sweden, Finland, Germany, England, France, Estonia, Greece and Cyprus. Our data consist of governmental web sites, publications, campaigns, as well as other modes of communication, such as videos posted on YouTube, with questions centering on institutional actors, methods of delivery, content, and effectiveness. We acknowledge that risk communication aims at supporting vulnerable populations and evening out imbalances, but at the same time we flesh out the power dimension of risk. In our analysis, we search for reproduction of norms and social inequality in risk communication practices. The results show that some patterns emerge regarding the way different EU countries convey information to the public, but they do not hold strictly to geography or administrative system. Digital media are the foremost vehicle of risk communication and the message generally conveyed is geared towards traditional, middle class households with the main language of the country as their first language. Volunteer organizations are present in all the countries in question, though not at the same degree. The conveyance of “self-protection” guidelines implicitly places the responsibility of protection to the individual. The results also show that in some countries, materiality has become more prevalent than the social dimension of risk in the message the public sector conveys, and that there is a move from focusing on risk to focusing on security.
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| 17. |
- Ekholm, Sara
(författare)
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Föräldraskap och klimatoro – betydelsen av omsorg
- 2023
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis is to study the relationships between parenthood, care and worry about the consequences of climate change and how these relate to climate behaviour. The thesis is based on the argument that care affect the degree of worry for the person to whom the care is directed and that the social context surrounding the individual has an influence on their experiences and worries about risks, in this case climate risks. In relation to climate change worry, it addresses differences in care practice between parents and people who are not parents, and between mothers and fathers. Time and practice with caring responsibilities may differ between these groups and may therefore also relate to levels of worry. Care practice can thus be one of several aspects that can be significant for climate change worry. Four studies have jointly addressed the overall purpose of the thesis and a ‘mixed methods’ approach has been used where quantitative and qualitative methods have been combined. The studies have thus complemented each other through four different sets of empirical material: three sets of quantitative survey data with random samples and one set of qualitative interview data. The empirical context of the survey studies includes a regional and a national survey in Sweden and a European survey. The qualitative material is based on interviews with respondents from several regions in Sweden that are vulnerable to climate change. The results of the thesis as a whole show a recurring pattern, in a Swedish context, regarding the relationship between parenthood and worry about the consequences of climate change. They show that parents in general are more worried about climate change than people who are not parents (Articles 1, 2 and 3). So, this pattern is reflected in the three independent surveys mentioned above, conducted at different times over a six-year period. The results also show that women are generally more worried than men are about the consequences of climate change. Fathers, on the other hand, are significantly more likely to experience climate change worry than men who are not fathers, a difference that is not evident between mothers and women who are not mothers (Articles 2 and 3). One of the studies (Article 3) examine whether the role of parenthood, as well as the role of mothers and fathers, differs between three care regimes (Orloff, 2002), in relation to climate change worry. Regimes here refer to normative and regulatory systems that are not reduced to individual institutions in society (Hood, Rothstein & Baldwin, 2001). It is only in the care regime prevailing in Sweden that parenthood reveals a significantly greater degree of climate change worry, both between parents and people who are not parents and between fathers and men who are not fathers. One possible explanation for this may be the nature of care regimes and how they relate to the individual, including the regulation of care time structures for both men and women through parental insurance. The fact that climate change worry increases for men who become fathers may be about the development of “caring masculinities” (Elliot, 2016) that relate to men’s emotional experiences such as worry, here through their spending time with their children. This seems to be particularly evident for men who become fathers in contexts where men are given more time for care practice, as shown in the Swedish context. Parents’ worry about the impact of climate change thus appears to be linked to care practice. A term for this kind of worry is referred to in the thesis as care-worry (Article 4) and includes a worry rooted in caring for and having a responsible attitude towards other people, both towards the specific child being cared for, and a concern for people in general and for future generations. This is supported by van Manen’s (2002) argument that worry is part of caring. People’s care-worry is also shaped by the specific context of discourses about caring, worry and risk (see Lupton, 2013; see also Giritli Nygren, Olofsson & Öhman, 2020). Based on parents’ experiences of climate change, the concept of care-worry has been empirically explored (Article 4) and reveals four ideal types that can illustrate parental care-worry in different ways. These are the worrying type, the trusting type, the calculating type and the security-seeking type. Differences between the ideal types are evident in the degree of worry, sense of uncertainty about the future and desire for control or security, with the common link of taking responsibility for the climate situation. Parents’ different types of climate behaviour can also be related to their type of care-worry. The worrying type talks about the climate situation with others, while the trusting type cares about sustainable consumption and is confident that global climate action will solve the climate situation. The calculating type focuses primarily on a climate-mitigating approach, such as reduced energy consumption, and the security-seeking type on a lifestyle adapted to the climate by means of such things as sustainable housing. Parents’ care-worry thus seems to relate to practical action with climate behaviour that takes personal responsibility for limiting the impact of climate change on future generations. The overall conclusions and contributions of the thesis are thus essentially that parenthood is significant for worry about climate change in the Swedish care regime, i.e. that parents have greater climate change worry than those who are not parents. It is also the case that in Sweden fathers’ climate change worry is greater than that of men who are not fathers, a difference that does not appear in women who become mothers. Caring for children can thus increase worry about the consequences of climate change, i.e. parents experience care-worry in relation to future climate risks that their children and other people may face. A further conclusion is that care-worry can also be a motivating aspect to act on climate change by limiting one’s climate impact for the sake of future generations.
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| 18. |
- Ghorbani, Morteza, et al.
(författare)
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Unravelling the Acoustic and Thermal Responses of Perfluorocarbon Liquid Droplets Stabilized with Cellulose Nanofibers
- 2019
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Ingår i: Langmuir. - : American Chemical Society. - 0743-7463 .- 1520-5827. ; 35:40, s. 13090-13099
-
Tidskriftsartikel (refereegranskat)abstract
- The attractive colloidal and physicochemical properties of cellulose nanofibers (CNFs) at interfaces have recently been exploited in the facile production of a number of environmentally benign materials, e.g. foams, emulsions, and capsules. Herein, these unique properties are exploited in a new type of CNF-stabilized perfluoropentane droplets produced via a straightforward and simple mixing protocol. Droplets with a comparatively narrow size distribution (ca. 1-5 μm in diameter) were fabricated, and their potential in the acoustic droplet vaporization process was evaluated. For this, the particle-stabilized droplets were assessed in three independent experimental examinations, namely temperature, acoustic, and ultrasonic standing wave tests. During the acoustic droplet vaporization (ADV) process, droplets were converted to gas-filled microbubbles, offering enhanced visualization by ultrasound. The acoustic pressure threshold of about 0.62 MPa was identified for the cellulose-stabilized droplets. A phase transition temperature of about 22 °C was observed, at which a significant fraction of larger droplets (above ca. 3 μm in diameter) were converted into bubbles, whereas a large part of the population of smaller droplets were stable up to higher temperatures (temperatures up to 45 °C tested). Moreover, under ultrasound standing wave conditions, droplets were relocated to antinodes demonstrating the behavior associated with the negative contrast particles. The combined results make the CNF-stabilized droplets interesting in cell-droplet interaction experiments and ultrasound imaging.
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| 19. |
- Humbert, Marion, et al.
(författare)
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Functional SARS-CoV-2 cross-reactive CD4+ T cells established in early childhood decline with age
- 2023
-
Ingår i: Proceedings of the National Academy of Sciences of the United States of America. - : National Academy of Sciences. - 0027-8424 .- 1091-6490. ; 120:12
-
Tidskriftsartikel (refereegranskat)abstract
- Pre-existing SARS-CoV-2-reactive T cells have been identified in SARS-CoV-2-unexposed individuals, potentially modulating COVID-19 and vaccination outcomes. Here, we provide evidence that functional cross-reactive memory CD4+ T cell immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is established in early childhood, mirroring early seroconversion with seasonal human coronavirus OC43. Humoral and cellular immune responses against OC43 and SARS-CoV-2 were assessed in SARS-CoV-2-unexposed children (paired samples at age two and six) and adults (age 26 to 83). Pre-existing SARS-CoV-2-reactive CD4+ T cell responses targeting spike, nucleocapsid, and membrane were closely linked to the frequency of OC43-specific memory CD4+ T cells in childhood. The functional quality of the cross-reactive memory CD4+ T cell responses targeting SARS-CoV-2 spike, but not nucleocapsid, paralleled OC43-specific T cell responses. OC43-specific antibodies were prevalent already at age two. However, they did not increase further with age, contrasting with the antibody magnitudes against HKU1 (β-coronavirus), 229E and NL63 (α-coronaviruses), rhinovirus, Epstein–Barr virus (EBV), and influenza virus, which increased after age two. The quality of the memory CD4+ T cell responses peaked at age six and subsequently declined with age, with diminished expression of interferon (IFN)-γ, interleukin (IL)-2, tumor necrosis factor (TNF), and CD38 in late adulthood. Age-dependent qualitative differences in the pre-existing SARS-CoV-2-reactive T cell responses may reflect the ability of the host to control coronavirus infections and respond to vaccination. Copyright © 2023 the Author(s).
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| 20. |
- Kadefors, Anna, Professor, 1962-, et al.
(författare)
-
Innovation processes and dissemination of research-based knowledge in Swedish rock engineering : Experiences in the trust geoinfra project
- 2019
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Innovation in the project-based construction industry is generally perceived to be complex and poorly understood on a system level. This report describes and discusses the innovation system in Swedish underground construction based on a study of knowledge dissemination and implementation in relation to the large collaborative R&D program TRUST, Transparent Underground Structures.The study is primarily based on interviews performed with representatives of clients, contractors, consultants, researchers and funding bodies within the TRUST program. There are two main focus areas: the innovation system level and the TRUST project. The innovation system level describes drivers, organization and processes for engaging in R&D and implementing results within the Swedish Transport Administration (STA), contractor companies and consultancy firms, but also interviewee opinions about the innovation culture in Swedish rock engineering and construction more generally. The section covering the TRUST project describes the background, performance and experiences from the TRUST collaboration as well as innovation processes within some of the sub-projects.Underground construction is a part of the construction sector where comparatively much research is carried out and university-industry collaboration is lively. Still, our results confirm many of the observations made by previous researchers on innovation in construction in general: the small resources within companies devoted to research and innovation, the importance of champions at the project level and the difficulties to disseminate knowledge and implement company level initiatives. The contractor interviews illustrate how sensitive their innovation processes are to chance factors such as timing of new relevant business projects and the experiences and knowledge of the individuals that happen to be assigned to a specific project. In this respect, the client is more in control. However, the interviewed client representatives from STA express the same kind of difficulties in driving innovation more strategically on the organizational level and convince their project managers to open up for R&D tests and new knowledge in their business projects.Previous research has also shown that there are many drivers for firms to engage in R&D collaborations with public funding. R&D collaboration provides access to knowledge networks by enabling participation in reference groups and communities. Important such networks in Swedish underground construction were BeFo and SBUF. Another driver for R&D collaboration was to support M Sc and PhD education for future recruitment. Thus, the individuals themselves were often the most important research output. Implementation of results was not a primary motivation although a more strategic approach was emerging among both public organizations and private companies, who put more emphasis than they used to on application in practice of research results. One consultancy company was especially active in developing their R&D strategy to support a business model based on premium services. In general, however, knowledge development for underground construction was still mainly driven by individual specialists based on their contacts in business projects. Organizations had developed centrally defined R&D strategies, but these did not deal explicitly with technical disciplines but tended to focus on general goals such as sustainability, or on participation in high profile research collaborations.Most specialists within academia as well as industry were involved in several networks and perceived these to provide useful interaction platforms. Research funding was governed by BeFo and SBUF, and these peer networks thus strongly influenced research strategy on a national level. The number of PhDs in industry had increased over the last years, and important informal networks developed over time between these individuals and their former university departments. Such relationships formed the basis for gaining research funding, which is often dependent on industry co-funding.When establishing TRUST, the assumption was that a large coordinated R&D project would be better for communicating with industry and implementing results than several smaller projects. However, it turned out to be more or less the other way around. The existing system could handle innovation in construction projects, but not innovation on the organizational level. This became apparent when trying to find a joint test site. In smaller research projects, access to business projects is provided by individuals on the client or supplier side, often with an R&D background, who use their personal contacts to provide access to researcher to perform measurements in ongoing construction projects. This often requires that site work is going well and that measurements are found not to cause too much disturbance. Large programs for site measurements involving numerous actors, such as TRUST, call for planning and upfront commitment. The failure to arrange fieldwork in TRUST illustrate the difficulties to take the step from a bottom up, ad-hoc, individual based regime to an organizational strategy with national level anchoring and implications. Thus, the TRUST program appeared to be an ideal partner for the Swedish Transport Administration, but in practice the size of the project turned out to be a major disadvantage.In general, the internal innovation capabilities of companies and client authorities need to be developed in order for organizations to benefit from the collaborative research programs and act upon the knowledge developed. One aspect is that measures should be taken to more explicitly involve business project managers in both R&D and implementation. Innovation capability development is needed especially on the client side, since long term strategies in supplier organizations will not develop if the strategies of the dominant clients is not clear. However, assuming that the geo area in general is largely an open innovation environment, it also seems useful to explore if different actors could perform complementary activities in an industry innovation system. For example, specialist networks both within organizations and on the industry level may be more formally mobilized in external monitoring, strategy development and evaluation. In the future, top management, technically oriented specialists and researchers need to develop a joint understanding of how the innovation system works, including the regulatory and contractual environment.There is also a need to invest also in research that is relatively far from application. Thus, evaluation processes and output measurement systems should be adapted to how close to implementation the research project is and also assess the need to build capabilities on the receiver side.
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| 21. |
- Kadefors, Anna, Professor, 1962-, et al.
(författare)
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University-industry collaboration and innovation in a project-based engineering context
- 2017
-
Konferensbidrag (refereegranskat)abstract
- The construction industry plays a key role in society but innovation in this project-based context is perceived as slow and poorly understood. Interorganizational collaboration is important in both business projects and R&D. Based on a study of a large collaborative R&D programme to develop knowledge and new engineering methods for Swedish underground construction, we discuss and analyse the innovation system in this area with a focus on implementation of research-based knowledge. To sketch the institutional context, we summarize key findings in research on innovation in construction. Innovation in this sector is project-based and dependent on individual champions, and the large underground research program exposed system weaknesses originating in a lack of organizational absorptive capacity especially within the dominant client organization. An important finding is that absorptive capacities within organizations shape system level innovation capabilities and potential roles of industry network. It is therefore essential to understand the actor level in suggesting measures to increase implementation. The paper develops knowledge to support collaborative strategy formulation in this complex area.
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| 22. |
- Lane, Anna-Lena
(författare)
-
Building-related renewable electricity production with storage and energy-efficient buildings : Exploring barriers, drivers and quality assurance
- 2020
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a need to reduce unsustainable use of fossil fuels. Increased usage of renewable energy by combined use of photovoltaic solar panels (PV) with battery storage is one way. Another way is to increase awareness of energy usage and reduce the energy performance gap by building energy-efficient buildings. Buildings have a long lifetime and high energy usage will have an impact for a long time.Barriers, drivers and non-energy benefits (NEBs) for investments in battery storage in photovoltaic systems (PV) in the context of farmers in Sweden with PV systems was investigated by a questionnaire study. The questionnaire was sent to farmers in Sweden who already have photovoltaics installed and about 100 persons answered, a response rate of 59%.Among the drivers for investments in battery storage in PV systems in agriculture it was found that the highest-ranked driver, i.e., to use a larger part of the electricity produced oneself, turns out to be the highest priority for grid owners seeking to reduce the need for extensive investments in the grid. The primary NEBs found were the possibility to become more independent of grid electricity.A method for the building process, called ByggaE, which aims to reduce the energy performance gap, has been developed and described. The method is based on two main processes with activities. Documents that support the activities can be found and stored in the energy documentation, a digital map structure. The two main processes are:The client’s activity to formulate requirements and ways to verify these requirements.The main process for other actors is to identify, handle and follow up risks or critical parts.An overall relation between the energy efficiency gap and the energy performance gap has been identified. Realistic assumptions and follow-up related to the assumptions are found to be important to reduce both the energy efficiency gap and the energy performance gap.
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| 23. |
- Larsson, Emelie
(författare)
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Risky distances : Peripheralisation and normalisation in the case of a maternity ward closure in Sweden
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explores risk, peripheralisation and normalisation in the case of the maternity ward closure at Sollefteå Hospital, located inland in the Swedish region of Västernorrland. When the ward closed in 2017, it drew significant media attention and political discussions on the continuous cuts to Swedish maternity care and the growing economic gap between urban and rural areas – discussions that actualised questions of power and risk. This thesis, building on newspaper articles and interviews with expectant parents and midwives in Sollefteå, uses feminist risk theory to 1) investigate the experiences of those directly affected by the closure, i.e. expectant parents and midwives at the ward and 2) explore how the theoretical approach of ‘doing risk’ can be used to deepen our understanding of the processes of peripheralisation and normalisation. The two aims are addressed in four empirical studies and in the Discussion and Concluding remarks. I conclude that three peripheralisation processes were at work in the closure of BB Sollefteå: peripheralisation of women’s risks, periheralisation of people in rural municipalities from the welfare state and peripheralisation of small-ward work practices in the healthcare discourse. I also found that the closure made Swedish norms on childbirth and discourses on family visible, predominantly manifested through the ‘gender-equal nuclear family’ norm, which repeated in the material. Further, addressing the thesis’ second aim, I conclude that normalisation and peripheralisation can be seen as regulatory practices, which in different ways are structured around risk and power. In this context, ‘doing risk’ helps to theorize how these concepts intersect, and relate to ideology, and thus contributes to a better understanding of ideological processes in contemporary societies.
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| 24. |
- Loskutova, Ksenia, et al.
(författare)
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Assessment of the Mechanical Propertiesof Cellulose Nanofiber-Stabilized Droplets Using Acoustophoresis
- 2021
-
Konferensbidrag (refereegranskat)abstract
- In this work, the compressibility of Pickering-stabilized perfluoropentane droplets was determined by using acoustophoresis. Polyamide beads with known density, size and compressibility were used to calculate the pressure amplitude inside the microchannel. The results show that the compressibility of CNF-stabilized droplets is significantly higher than for water, but lower than for pure PFC5. This shows promising potential for these droplets to be used in ultrasound-mediated clinical applications. It has also been shown that acoustophoresis can successfully measure the compressibility of pressure-sensitive particles for small USW pressure amplitudes. As the droplets relocate to pressure anti-nodes just as gas-filled microbubbles, it would be possible to study cell-droplet and cell-gasbubble in the same setup.
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| 25. |
- Loskutova, Ksenia, et al.
(författare)
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Measuring the Compressibility of Cellulose Nanofiber-Stabilized Microdroplets Using Acoustophoresis
- 2021
-
Ingår i: Micromachines. - : MDPI. - 2072-666X. ; 12:12, s. 1465-
-
Tidskriftsartikel (refereegranskat)abstract
- Droplets with a liquid perfluoropentane core and a cellulose nanofiber shell have the potential to be used as drug carriers in ultrasound-mediated drug delivery. However, it is necessary to understand their mechanical properties to develop ultrasound imaging sequences that enable in vivo imaging of the vaporization process to ensure optimized drug delivery. In this work, the compressibility of droplets stabilized with cellulose nanofibers was estimated using acoustophoresis at three different acoustic pressures. Polyamide particles of known size and material properties were used for calibration. The droplet compressibility was then used to estimate the cellulose nanofiber bulk modulus and compare it to experimentally determined values. The results showed that the acoustic contrast factor for these droplets was negative, as the droplets relocated to pressure antinodes during ultrasonic actuation. The droplet compressibility was 6.6-6.8 x10(-10) Pa-1, which is higher than for water (4.4x10(-10) Pa-1) but lower than for pure perfluoropentane (2.7x10(-9) Pa-1). The compressibility was constant across different droplet diameters, which was consistent with the idea that the shell thickness depends on the droplet size, rather than being constant.
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