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  • Public defence: 2018-05-25 13:00 Örebro universitet, Hörsalen, Musikhögskolan, Örebro
    Tang, Aili
    Örebro University, Örebro University School of Business.
    Firm dynamics and competition in the electricity market2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis consists of four independent essays that deal with the firm dynamics and competition in the electricity market. Specifically, it addresses two important facets of firm dynamics, namely, firm performance (growth and profitability) and the change in competition intensity that Swedish electricity firms face, brought by the process of deregulation in Swedish electricity market.

    Essay 1 investigates whether Gibrat’s law holds for individual firms. The results support the claim that Gibrat’s law is more likely to be rejected ex ante when an entire firm population is considered, but more likely to be confirmed ex post after market selection has “cleaned” the original population of firms or when the analysis treats more disaggregated data.

    Essay 2 examines the determinants of firm growth in the Swedish electricity sector. The results indicate that large firms do not grow faster than do other firms in the sector, and that electricity firms’ internal resources are indeed the key determinants of firm growth in the Swedish electricity industry.

    Essay 3 shows that although multi-plant firms are more prevalent than single-plants firms in industries characterized by scale economies and imperfect competition, multi-plant electricity firms on average have a one percentage-point lower return on total asset than their single-plant counterparts as they reach a ‘steady state’ firm size when an optimal size is identified. The potential reasons could be loss of control across hierarchical levels within multi-plant firms or the adaption to technological changes lag behind in comparison to single–plant firms.

    Essay 4 compare competition intensity before and after the launch of Internet electricity price comparison sites (IEPCS). The heterogeneous effects on competition intensity are found, with the largest effect on competition found in parts of the market that were already characterized by high levels of competition before the launch of IEPCS.

    List of papers
    1. Does Gibrat’s Law hold for Swedish energy firms?
    Open this publication in new window or tab >>Does Gibrat’s Law hold for Swedish energy firms?
    2015 (English)In: Empirical Economics, ISSN 0377-7332, E-ISSN 1435-8921, Vol. 49, no 2, p. 659-674Article in journal (Refereed) Published
    Abstract [en]

    Gibrat's law predicts that firm growth is purely random and should be independent of firm size. We use a random effects-random coefficient model to test whether Gibrat's law holds on average in the studied sample as well as at the individual firm level in the Swedish energy market. No study has yet investigated whether Gibrat's law holds for individual firms, previous studies having instead estimated whether the law holds on average in the samples studied. The present results support the claim that Gibrat's law is more likely to be rejected ex ante when an entire firm population is considered, but more likely to be confirmed ex post after market selection has "cleaned" the original population of firms or when the analysis treats more disaggregated data. From a theoretical perspective, the results are consistent with models based on passive and active learning, indicating a steady state in the firm expansion process and that Gibrat's law is violated in the short term but holds in the long term once firms have reached a steady state. These results indicate that approximately 70 % of firms in the Swedish energy sector are in steady state, with only random fluctuations in size around that level over the 15 studied years.

    Place, publisher, year, edition, pages
    Springer Berlin/Heidelberg, 2015
    Keyword
    Firm size; Firm growth; Random coefficient; Energy sector
    National Category
    Economics
    Research subject
    Complex Systems – Microdata Analysis
    Identifiers
    urn:nbn:se:oru:diva-62323 (URN)10.1007/s00181-014-0883-x (DOI)000358935300012 ()2-s2.0-84938553585 (Scopus ID)
    Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-04-25Bibliographically approved
    2. Firm growth in the Swedish energy sector: Will large firms become even more dominant?
    Open this publication in new window or tab >>Firm growth in the Swedish energy sector: Will large firms become even more dominant?
    2014 (English)In: International Journal of Energy and Statistics, ISSN 2335-6804, Vol. 2, no 4, p. 247-267Article in journal (Refereed) Published
    Abstract [en]

    This paper examines the determinants of firm growth in the Swedish energy sector using a sample of 200 energy firms active from 2000 to 2010. The article has two aims. First, we seek to investigate whether there is reason to believe that the Swedish energy market will become more concentrated in the future, dominated by a few firms. That would be the result if, for example, large firms systematically and over time grew faster than the smaller firms in the Swedish market. Second, we investigate whether firm growth can mainly be explained by firm-specific variables, supporting Penrose's [1] suggestion that internal resources are the key determinants of firm growth rates. To this end, quantile regression is used in addition to ordinary least squares regression, to provide a more complete estimation of the growth distribution of firms conditional on different attributes. The results indicate that large firms do not grow faster than other firms in the sector, and that energy firms' internal resources are indeed the key determinants of firm growth in the Swedish energy industry.

    Place, publisher, year, edition, pages
    World Scientific, 2014
    Keyword
    Market power, energy market regulation, energy market competetion, quantile regresssion, competetion policy
    National Category
    Economics
    Identifiers
    urn:nbn:se:oru:diva-62322 (URN)10.1142/S2335680414500173 (DOI)
    Available from: 2015-12-18 Created: 2017-11-13 Last updated: 2018-04-25Bibliographically approved
    3. Are multi-plant firms more or less profitable?: Evidence from Swedish electricity firms
    Open this publication in new window or tab >>Are multi-plant firms more or less profitable?: Evidence from Swedish electricity firms
    (English)Manuscript (preprint) (Other academic)
    National Category
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66773 (URN)
    Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-25Bibliographically approved
    4. Do Internet price comparison sites make markets more competitive?: An analysis using Swedish electricity firms
    Open this publication in new window or tab >>Do Internet price comparison sites make markets more competitive?: An analysis using Swedish electricity firms
    (English)Manuscript (preprint) (Other academic)
    National Category
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66774 (URN)
    Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-25Bibliographically approved
  • Public defence: 2018-06-01 09:00 Örebro universitet, Campus USÖ, hörsal C3, Örebro
    Arvidsson Lindvall, Mialinn
    Örebro University, School of Health Sciences.
    Physiotherapeutic perspectives on balance control after stroke: exercises, experiences and measures2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate physiotherapeutic perspectives on balance after stroke, in terms of exercises, experiences and measurements. Study I was a pilot randomized controlled trial with 46 persons who had had a stroke, 24 of whom were included in the intervention group and 22 who were included in the control group. The intervention consisted of 8 weeks of body awareness therapy (BAT). There were no significant differences over time between the groups in the outcome measures of balance, walking, self-reported balance confidence and quality of life. Study II had a qualitative design using content analysis. Participants in the intervention group from Study I and the four physiotherapists who had been in charge of the BAT were interviewed. One overall theme emerged: "Simple yet challenging", which was based on six categories. Study III investigated the validity and test-retest reliability of the Six-Spot Step test (SSST), an instrument used to assess the ability to take load on each leg. A cross-sectional design with 81 persons who had had stroke was performed. The convergent validity was strong to moderate, and the test-retest reliability was good. In Study IV a mixed method design including both qualitative and quantitative data collection was used. The participants’ experiences of balance and its influence in everyday life were presented in two themes: "Feeling dizzy and unstable is a continuous challenge" and "Feeling trust and confidence despite dizziness and unsteadiness". Taken together, the different data sets provided complementary and confirmatory information about balance. All participants experienced the balance limitations as a continuous challenge in everyday life, yet they also felt trust and confidence.

    In summary, BAT can be a complement in physiotherapeutic stroke rehabilitation and the SSST can be used as a measuring instrument of walking balance in persons with stroke. Living with balance limitations was experienced as a challenge but the participants were still able to manage their everyday life and activities.

    List of papers
    1. Body awareness therapy in persons with stroke: a pilot randomised controlled trial
    Open this publication in new window or tab >>Body awareness therapy in persons with stroke: a pilot randomised controlled trial
    2014 (English)In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 28, no 12, p. 1180-1188Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate the effects of body awareness therapy on balance, mobility, balance confidence, and subjective health status in persons with stroke.

    Design: A pilot randomized controlled study with follow-up at one and 4–6 weeks after the intervention period.

    Setting: Four primary healthcare centres in Örebro County Council.

    Subjects: Persons more than six months post stroke, with walking ability of 100 metres.

    Intervention: The experimental intervention was body awareness therapy in groups once a week for eight weeks. The controls were instructed to continue their usual daily activities.

    Main measures: Berg Balance Scale, Timed Up and Go Test, Timed Up and Go Test with a cognitive component, 6-minute walk test, and Timed-Stands Test. Self-rated balance confidence was assessed using the Activities-specific Balance Confidence Scale, and subjective health status using the Short Form 36 (SF-36) questionnaire.

    Results: A total of 46 participants were included (mean age 64 years); 24 in the experimental intervention group and 22 in the control group. No significant differences in changed scores over time were found between the groups. Within the experimental intervention group, significant improvements over time was found for the tests Berg Balance Scale, Timed Up and Go cognitive, and 6-minute walk test. Within the control group, significant improvements over time were found for the Timed Up and Go Cognitive, and the Timed-Stands Test.

    Conclusion: In comparison to no intervention, no effects were seen on balance, mobility, balance confidence, and subjective health status after eight weeks of body awareness therapy.

    Place, publisher, year, edition, pages
    Sage Publications, 2014
    Keyword
    Body awareness therapy, postural control, physiotherapy, stroke
    National Category
    Health Sciences Nursing
    Research subject
    Health and Medical Care Research; Rehabilitation Medicine
    Identifiers
    urn:nbn:se:oru:diva-35843 (URN)10.1177/0269215514527994 (DOI)000347118700004 ()24668360 (PubMedID)2-s2.0-84921668455 (Scopus ID)
    Note

    Funding Agencies:

    Swedish Stroke Association

    Norrbacka Eugenia Foundation 803-11

    Research Committee Orebro County Council OLL-227701

    Available from: 2014-08-04 Created: 2014-08-04 Last updated: 2018-05-09Bibliographically approved
    2. Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists
    Open this publication in new window or tab >>Basic Body Awareness Therapy for patients with stroke: Experiences among participating patients and physiotherapists
    2016 (English)In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 20, no 1, p. 83-89Article in journal (Refereed) Published
    Abstract [en]

    Background: After a stroke many patients have muscle weakness, spasticity and compromised sensation leading to decreased postural stability. Basic Body Awareness Therapy includes slow movements that challenge postural control.

    Aim: The aim was to describe experiences of 8 weeks of Basic Body Awareness Therapy from the perspective of both patients with stroke and physiotherapists.

    Method: This study had a qualitative design. Twenty-one patients and four physiotherapists were interviewed. The interviews were analysed using manifest and latent content analysis.

    Results: One overall theme emerged "Simple yet challenging" which was based on six categories: "Facing one's limitations", "Individualized movements", "A feeling of harmony", "Improved balance", "Integrated knowledge" and "Frustration and doubt". The patients described improvement in balance and stability, as well as increased wellbeing.

    Conclusion: The patients and physiotherapists related that Basic Body Awareness Therapy challenges balance but also provides an opportunity to reflect on the body. (C) 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

    Place, publisher, year, edition, pages
    Elsevier, 2016
    Keyword
    Basic Body Awareness Therapy, Physiotherapy, Qualitative study, Stroke
    National Category
    Nursing
    Research subject
    Rehabilitation Medicine
    Identifiers
    urn:nbn:se:oru:diva-52163 (URN)10.1016/j.jbmt.2015.06.004 (DOI)000381689000012 ()26891641 (PubMedID)2-s2.0-84958039596 (Scopus ID)
    Available from: 2016-09-14 Created: 2016-09-14 Last updated: 2018-05-09Bibliographically approved
    3. Validity and test-retest reliability of the Six-Spot Step Test in persons after stroke
    Open this publication in new window or tab >>Validity and test-retest reliability of the Six-Spot Step Test in persons after stroke
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66907 (URN)
    Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09Bibliographically approved
    4. "I can still manage": a mixed-method study of balance after stroke
    Open this publication in new window or tab >>"I can still manage": a mixed-method study of balance after stroke
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-66909 (URN)
    Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09Bibliographically approved
  • Public defence: 2018-06-07 09:15 Örebro universitet, Campus USÖ, hörsal C3, Örebro
    Arinell, Karin
    Örebro University, School of Medical Sciences.
    Immobilization as a risk factor for arterial and venous thrombosis2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: Immobilization and a sedentary lifestyle are correlated with an elevated risk of both arterial and venous thrombosis. The goal of this research was to investigate whether markers associated with cardiovascular disease risk are altered during long term immobilization in a human model and in the brown bear, which survives annual cycles of long-term immobilization.

    Methods: In study populations assigned to 20-60 days of strict head-down-tilt bed rest 24h a day, we analysed blood levels of the emerging cardiovascular disease marker cystatin C, soluble markers of in vivo platelet activation P-selectin and PDGF-BB, and platelet aggregation. Blood samples were taken from free-ranging brown bears in summer and again during hibernation for analysis of lipid profile and platelet aggregation. Histological examination was performed on the left anterior descending coronary artery and aortic arches of bears harvested during the hunting season.

    Results: During prolonged bed rest in humans, levels of cystatin C and platelet aggregation remained unchanged, but we observed a significant decrease in platelet activation markers. Brown bear plasma lipids were elevated during hibernation compared with the active state and cholesterol levels were generally considerably higher than normal human values. The arterial specimens showed no signs of atherosclerosis. Platelet aggregation was halved during hibernation compared to the active state.

    Conclusions: Long-term immobilization has effects on several cardiovascular risk factors in both humans and bears. Increased knowledge and understanding of the protective mechanisms that allows the brown bear to survive repeated periods of immobilization could contribute to new strategies for prevention and treatment of cardiovascular disease in humans.

    List of papers
    1. Effect of prolonged standardized bed rest on cystatin C and other markers of cardiovascular risk
    Open this publication in new window or tab >>Effect of prolonged standardized bed rest on cystatin C and other markers of cardiovascular risk
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    2011 (English)In: BMC Physiology, ISSN 1472-6793, E-ISSN 1472-6793, Vol. 11, article id 17Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Sedentary lifestyle is associated with coronary artery disease but even shorter periods of physical inactivity may increase cardiovascular risk. Cystatin C is independently associated with cardiovascular disease and our objective was to investigate the relation between this novel biomarker and standardized bed rest. Research of immobilization physiology in humans is challenging because good biological models are in short supply. From the Women International Space simulation for Exploration study (WISE) we studied markers of atherosclerosis and kidney function, including cystatin C, in a standardized bed rest study on healthy volunteers. Fifteen healthy female volunteers participated in a 20-day ambulatory control period followed by 60 days of bed rest in head-down tilt position (-6°) 24 h a day, finalized by 20 days of recovery. The subjects were randomized into two groups during bed rest: a control group (n = 8) that remained physically inactive and an exercise group (n = 7) that participated in both supine resistance and aerobic exercise training.

    RESULTS: Compared to baseline values there was a statistically significant increase in cystatin C in both groups after bed rest (P < 0.001). Glomerular filtration rate (GFR), calculated by both cystatin C and Cockcroft-Gault equation, decreased after bed rest while there were no differences in creatinine or creatine kinase levels. CRP did not change during bed rest in the exercise group, but there was an increase of CRP in the control group during recovery compared to both the baseline and the bed rest periods. The apo-B/apo-Ai ratio increased during bed rest and decreased again in the recovery period. Subjects experienced a small but statistically significant reduction in weight during bed rest and compared to baseline weights remained lower at day 8 of recovery.

    CONCLUSION: During and following prolonged standardized bed rest the concentrations of several clinically relevant cardiovascular risk markers change.

    Place, publisher, year, edition, pages
    BioMed Central, 2011
    National Category
    Cardiac and Cardiovascular Systems
    Identifiers
    urn:nbn:se:oru:diva-66787 (URN)10.1186/1472-6793-11-17 (DOI)22152087 (PubMedID)2-s2.0-83055192077 (Scopus ID)
    Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2018-04-26Bibliographically approved
    2. Brown Bears (Ursus arctos) Seem Resistant to Atherosclerosis Despite Highly Elevated Plasma Lipids during Hibernation and Active State
    Open this publication in new window or tab >>Brown Bears (Ursus arctos) Seem Resistant to Atherosclerosis Despite Highly Elevated Plasma Lipids during Hibernation and Active State
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    2012 (English)In: Clinical and Translational Science, ISSN 1752-8054, E-ISSN 1752-8062, Vol. 5, no 3, p. 269-272Article in journal (Refereed) Published
    Abstract [en]

    Hibernation is an extreme physiological challenge for the brown bear (Ursus arctos) in which metabolism is based mainly on lipids. The study objective was to compare plasma lipids in hibernating and active free-ranging brown bears and relate them to arterial histopathology. Blood was drawn from seven immobilized free-ranging brown bears (three females, 23 years old) during hibernation in February and from the same bears while active in June and analyzed by enzymatic and automated hematology methods within 48 hours of sampling. Left anterior descending coronary arteries and aortic arches from 12 bears (six females, 1.512 years old) killed in hunting were examined by histopathology. Total plasma cholesterol decreased from hibernation to the active period (11.08 +/- 1.04 mmol/L vs. 7.89 +/- 1.96 mmol/L, P= 0.0028) as did triglyceride (3.16 +/- 0.62 mmol/L vs. 1.44 +/- 0.27 mmol/L, P= 0.00012) and LDL cholesterol (4.30 +/- 0.71 mmol/L vs. 2.02 +/- 1.03 mmol/L, P= 0.0075), whereas HDL cholesterol was unchanged. No atherosclerosis, fatty streaks, foam cell infiltration, or inflammation were seen in any arterial samples. Brown bears tolerate elevated cholesterol levels, obesity, physical inactivity, and circulatory slow flow during hibernation without signs of -atherosclerosis. This species might serve as a reverse translational model for atherosclerosis resistance.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2012
    Keyword
    apolipoproteins, cholesterol, hibernation physiology, triglycerides
    National Category
    Other Biological Topics
    Identifiers
    urn:nbn:se:oru:diva-58327 (URN)10.1111/j.1752-8062.2011.00370.x (DOI)000305077100014 ()22686205 (PubMedID)2-s2.0-84862224614 (Scopus ID)
    Note

    Funding Agencies:

    NordForsk (an organization under the Nordic Council of Ministers)  44042

    Available from: 2017-06-27 Created: 2017-06-27 Last updated: 2018-05-15Bibliographically approved
    3. Downregulation of platelet activation markers during long-term immobilization
    Open this publication in new window or tab >>Downregulation of platelet activation markers during long-term immobilization
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    2013 (English)In: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 24, no 5, p. 369-374Article in journal (Refereed) Published
    Abstract [en]

    Immobilization and sedentary lifestyle are risk factors for venous thromboembolism and cardiovascular disease, yet little is known about platelet function during long-term physical inactivity. Our aim was to investigate platelet activation markers and their coupling to standardized immobilization: platelet-derived growth factor (PDGF-BB) and P-selectin. We studied 15 healthy females participating in the Women International Space simulation for Exploration study. Following a 20-day ambulatory control period, the subjects underwent 60 days of bed rest in head-down tilt position (-6 degrees) 24 hours a day, finalized by 20 days of recovery. The subjects were randomized into two groups during bed rest: a control group (n = 8) that remained physically inactive and an exercise group (n = 7) that participated in both supine resistance and aerobic exercise training. Blood samples for the analysis of platelet activation markers were collected at baseline (5 days before bed rest), after 44 days of bed rest and 8 days into the recovery period. Compared to baseline, the levels of P-selectin and PDGF-BB decreased after bed rest (by 55%, p = 0.01 and 73%, p < 0.03, respectively) and remained decreased in the recovery period (by 76%, p < 0.001 and 78%, p < 0.02, respectively, compared to baseline). Platelet count (baseline value for the exercise group 260 000/mu l +/- 34 000 and baseline value for the control group 210 000/mu l +/- 30 000) did not change during the bed rest study (two-way repeated measurements ANOVA, p = ns). There were no statistical differences between the physically inactive and the exercise group. During long-term immobilization, a known risk factor for thrombosis, the levels of P-selectin and PDGF-BB decreased. Our findings indicate downregulation of platelet activation during immobilization.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2013
    Keyword
    Platelets, P-selectin, PDGF, immobilization, thrombosis
    National Category
    Hematology Cardiac and Cardiovascular Systems
    Identifiers
    urn:nbn:se:oru:diva-56417 (URN)10.3109/09537104.2012.715215 (DOI)000321065000005 ()22931233 (PubMedID)2-s2.0-84879764932 (Scopus ID)
    Available from: 2017-03-16 Created: 2017-03-16 Last updated: 2018-05-15Bibliographically approved
    4. Biochemical Foundations of Health and Energy Conservation in Hibernating Free-Ranging Subadult Brown Bear Ursus arctos
    Open this publication in new window or tab >>Biochemical Foundations of Health and Energy Conservation in Hibernating Free-Ranging Subadult Brown Bear Ursus arctos
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    2016 (English)In: Journal of Biological Chemistry, ISSN 0021-9258, E-ISSN 1083-351X, Vol. 291, no 43, p. 22509-22523Article in journal (Refereed) Published
    Abstract [en]

    Brown bears (Ursus arctos) hibernate for 5-7 months without eating, drinking, urinating and defecating at a metabolic rate of only 25% of the summer activity rate. Nonetheless, they emerge healthy and alert in spring. We quantified the biochemical adaptations for hibernation by comparing the proteome, metabolome, and hematologic features of blood from hibernating and active free-ranging subadult brown bears with a focus on conservation of health and energy. We found that total plasma protein concentration increased during hibernation, even though the concentrations of most individual plasma proteins decreased, as did the white blood cell types. Strikingly, antimicrobial defense proteins increased in concentration. Central functions in hibernation involving the coagulation response and protease inhibition, as well as lipid transport and metabolism, were upheld by increased levels of very few key or broad-specificity proteins. The changes in coagulation factor levels matched the changes in activity measurements. A dramatic 45-fold increase in sex-hormone-binding-globulin SHBG levels during hibernation draws, for the first time, attention to its significant but unknown role in maintaining hibernation physiology. We propose that energy for the costly protein synthesis is reduced by three mechanisms, (i) dehydration, which increases protein concentration without de novo synthesis; (ii) reduced protein degradation rates due to a 6 °C reduction in body temperature, and decreased protease activity; and (iii) a marked redistribution of energy resources only increasing de novo synthesis of few key proteins. This comprehensive global data identified novel biochemical strategies for bear adaptations to the extreme condition of hibernation, and have implications for our understanding of physiology in general.

    Place, publisher, year, edition, pages
    Rockville, USA: American Society for Biochemistry and Molecular Biology, 2016
    Keyword
    Antimicrobial proteins, blood constituents, coagulation factor, complement system, hibernation physiology, metabolomics, protein turnover, proteomics, sex hormone-binding globulin (SHBG)
    National Category
    Biochemistry and Molecular Biology
    Research subject
    Biochemistry
    Identifiers
    urn:nbn:se:oru:diva-52176 (URN)10.1074/jbc.M116.742916 (DOI)000386760600013 ()27609515 (PubMedID)2-s2.0-84992343533 (Scopus ID)
    Note

    Funding Agency:

    Lundbech Foundation R126-2012-12408

    Aalborg University

    Available from: 2016-09-21 Created: 2016-09-14 Last updated: 2018-04-26Bibliographically approved
    5. Physical inactivity and platelet function in humans and brown bears: A comparative study
    Open this publication in new window or tab >>Physical inactivity and platelet function in humans and brown bears: A comparative study
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    2018 (English)In: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 29, no 1, p. 87-90Article in journal (Refereed) Published
    Abstract [en]

    Physical inactivity increases the risk of thromboembolism. However, good standardized human models on inactivity are in short supply and experimental models are few.

    Our objective was to investigate how standardized bed rest affects platelet aggregation in humans and to investigate if aggregation is altered in a translational model system - the hibernating brown bear (Ursus arctos). We collected blood from (1) healthy male volunteers participating in a 21-day bed rest study in head-down tilt position (-6°) 24 h a day; (2) free-ranging brown bears captured during winter hibernation and again during active state in summer. We analyzed platelet function using multiple electrode platelet aggregometry. In total, 9 healthy male volunteers (age 31.0 ± 6.4 years) and 13 brown bears (7 females and 6 males, age 2.8 ± 0.6 years) were included. In hibernating bears adenosine diphosphate, arachidonic acid, thrombin receptor activating peptide, and collagen impedance aggregometry tests were all halved compared to summer active state. In human volunteers no statistically significant changes were found between baseline and the end of bed rest. In human male volunteers 3 weeks of bed rest did not affect platelet function. In hibernating brown bears platelet aggregation was halved compared to summer and we hypothesize that this is a protective measure to avoid formation of thrombi under periods of low blood flow.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2018
    Keyword
    Thrombosis; Platelets; Platelet aggregation; Immobilization
    National Category
    Physiology Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy) Hematology
    Identifiers
    urn:nbn:se:oru:diva-61740 (URN)10.1080/09537104.2017.1336530 (DOI)000423584700015 ()28758823 (PubMedID)2-s2.0-85026519068 (Scopus ID)
    Available from: 2017-11-01 Created: 2017-11-01 Last updated: 2018-04-26Bibliographically approved
  • Public defence: 2018-06-08 09:00 Örebro universitet, Campus USÖ, hörsal C1, Örebro
    Wickberg, Åsa
    Örebro University, School of Medical Sciences.
    Adjuvant treatments to prevent local reurrence after breast-conserving surgery for early breast cancer: radiation, endocrine- or brachytherapy2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Radiotherapy after breast-conserving surgery due to breast cancer is an established treatment, known to reduce the incidence of recurrence and even death from the disease. However some women are over-treated with sometimes serious adverse effects. De-escalating the treatment and find alternative adjuvant methods are becoming an important issue. In study I, we present the outcomes from a long-term follow-up trial randomising 381 women with breast cancer to surgery alone or to surgery with the addition of radiotherapy. The incidence of any first breast cancer event was significantly higher without radiotherapy but the protecting effect lasted for only the first five years. In study II, we collected the tissue samples from the tumours in study I to construct tissue micro-arrays. Immuno-histochemical analyses were performed and the tumours were classified into the intrinsic subtypes. The luminal B/HER2 negative subtype was found to be prognostic for ipsilateral breast cancer recurrence (IBTR). The intrinsic subtypes did not interact with radiotherapy. Study III was a multicentre prospective cohort study where the 601 study participants with early breast cancer were treated with surgery and endocrine therapy alone without postoperative radiotherapy. The cumulative incidence of IBTR after five years was low -1.2% and only one woman died of breast cancer. In study IV we evaluated the feasibility and treatment complications when introducing a new method for intraoperative brachytherapy (IOBT) using HDR equipment. We designed a pilot study including fifty women where half of them were treated during primary surgery and the others during a second procedure. The treatment was well tolerated and no logistic problems were reported. No acute adverse effects from IOBT were seen.

    List of papers
    1. Sector Resection With or Without Postoperative Radiotherapy for Stage I Breast Cancer: 20-Year Results of a Randomized Trial
    Open this publication in new window or tab >>Sector Resection With or Without Postoperative Radiotherapy for Stage I Breast Cancer: 20-Year Results of a Randomized Trial
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    2014 (English)In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 32, no 8, p. 791-797Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To investigate how radiotherapy (XRT) adds to tumor control using a standardized surgical technique with meticulous control of surgical margins in a randomized trial with 20 years of follow-up.

    Patients and Methods: Three hundred eighty-one women with pT1N0 breast cancer were randomly assigned to sector resection with (XRT group) or without (non-XRT group) postoperative radiotherapy to the breast. With follow-up through 2010, we estimated cumulative proportion of recurrence, breast cancer death, and all-cause mortality.

    Results: The cumulative probability of a first breast cancer event of any type after 20 years was 30.9% in the XRT group and 45.1% in the non-XRT group (hazard ratio [HR], 0.58; 95% CI, 0.41 to 0.82). The benefit of radiotherapy was achieved within the first 5 years. After 20 years, 50.4% of the women in the XRT group died compared with 54.0% in the non-XRT group (HR, 0.92; 95% CI, 0.71 to 1.19). The cumulative probability of contralateral cancer or death as a result of cancer other than breast cancer was 27.1% in the XRT group and 24.9% in the non-XRT group (HR, 1.17; 95% CI, 0.77 to 1.77). In an anticipated low-risk group, the cumulative incidence of first breast cancer of any type was 24.8% in the XRT group and 36.1% in the non-XRT group (HR, 0.61; 95% CI, 0.35 to 1.07).

    Conclusion: Radiotherapy protects against recurrences during the first 5 years of follow-up, indicating that XRT mainly eradicates undetected cancer foci present at primary treatment. The similar rate of recurrences beyond 5 years in the two groups indicates that late recurrences are new tumors. There are subgroups with clinically relevant differences in risk.

    Place, publisher, year, edition, pages
    American Society of Clinical Oncology, 2014
    National Category
    Cancer and Oncology
    Identifiers
    urn:nbn:se:oru:diva-56811 (URN)10.1200/JCO.2013.50.6600 (DOI)000332483400016 ()24493730 (PubMedID)2-s2.0-84899626690 (Scopus ID)
    Available from: 2017-03-24 Created: 2017-03-24 Last updated: 2018-05-15Bibliographically approved
    2. Influence of the subtype on local recurrence risk with or without radiotherapy in a randomized trial
    Open this publication in new window or tab >>Influence of the subtype on local recurrence risk with or without radiotherapy in a randomized trial
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Surgery
    Identifiers
    urn:nbn:se:oru:diva-66947 (URN)
    Available from: 2018-05-15 Created: 2018-05-15 Last updated: 2018-05-18Bibliographically approved
    3. Omitting radiotherapy in women ≥ 65 years with low-risk early breast cancer after breast-conserving surgery and adjuvant endocrine therapy is safe
    Open this publication in new window or tab >>Omitting radiotherapy in women ≥ 65 years with low-risk early breast cancer after breast-conserving surgery and adjuvant endocrine therapy is safe
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Surgery
    Identifiers
    urn:nbn:se:oru:diva-66948 (URN)
    Available from: 2018-05-15 Created: 2018-05-15 Last updated: 2018-05-18Bibliographically approved
    4. Intraoperative high dose rate brachytherapy during breast-conserving surgery: a prospective pilot study
    Open this publication in new window or tab >>Intraoperative high dose rate brachytherapy during breast-conserving surgery: a prospective pilot study
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Surgery
    Identifiers
    urn:nbn:se:oru:diva-66949 (URN)
    Available from: 2018-05-15 Created: 2018-05-15 Last updated: 2018-05-18Bibliographically approved
  • Public defence: 2018-06-08 09:15 Örebro universitet, Långhuset, Hörsal L2, Örebro
    Wurm, Matilda
    Örebro University, School of Law, Psychology and Social Work.
    Understanding Comorbid Pain and Emotions: A transdiagnostic approach2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Experiencing pain, including an emotional reaction, is part of being hu­man. Emotional comorbidity is common in pain patients, and corre­lated to higher symptomatology and worse treatment outcome. The shared vulnerability model suggests that many vulnerability and main­taining factors may be involved in both pain and emotional problems. Hence, they may be transdiagnostic. Since our knowledge about these shared factors is lacking, potential targets for risk assessment, preven­tion, and treatment are likely underutilized. The overarching aim of this dissertation was to further our understanding of comorbid musculo­skeletal pain and emotional problems by investigating the role of trans­diagnostic factors. Specifically, it was studied if levels of shared vulner­abilities (negative affect and anxiety sensitivity) and symptomatology covary in pain patients depending on the occurrence of comorbid social anxiety symptoms (Study I); if peer-related stress predicts musculoskel­etal pain problems over time in adolescents, and if this is mediated by worry and moderated by gender (Study II); and if symptomatology can be decreased in pain patients with comorbid emotional problems by using an internet delivered unified protocol for emotional disorders (Study III). Results show that vulnerabilities covaried with comorbid pain and social anxiety. Also, peer-related stress predicted musculoskel­etal pain problems in adolescents and was mediated by worry for girls. However, the internet-delivered unified protocol did not unequivocally decrease symptomatology. In sum, the studies in this dissertation pro­vide partial support for the role of transdiagnostic factors in comorbid musculoskeletal pain and emotional problems. A transdiagnostic ap­proach may offer a parsimonious understanding of the  development and maintenance of this comorbid symptomatology.

    List of papers
    1. Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment
    Open this publication in new window or tab >>Characteristics and consequences of the co-occurence between social anxiety and pain-related fear in chronic pain patients receiving multimodal pain rehabilitation treatment
    2016 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 12, p. 45-52Article in journal (Refereed) Published
    Abstract [en]

    Background and aims: Chronic pain problems are related to specific pain related fears and maladaptive pain-coping but also commonly co-occur with other anxiety problems. Shared emotional vulnerabil-ity factors may explain this comorbidity and may influence treatment outcome. Indeed, pain patients going through multimodal pain treatment are a heterogeneous group and treatment results vary. One understudied anxiety disorder co-occurring with pain is social anxiety. This may be relevant as many pain-related challenges are situated in social contexts. The aim of this study is to investigate the occur-rence of subgroups with differential patterns of social anxiety and pain related fear in a sample of chronic pain patients who receive multimodal pain treatment. The aim is also to study the characteristics of these potential subgroups and the consequences of different patterns of social anxiety and pain related fear.

    Methods: 180 patients with chronic musculoskeletal pain answered questionnaires before and after a multimodal pain treatment in a hospital rehabilitation setting in middle Sweden. A cluster analysis using pre-treatment scores on the Social Phobia Screening Questionnaire and the Tampa Scale of Kinesiophobia was performed. Subgroups were thereafter validated and compared on impairment due to social anxi-ety, pain catastrophizing, anxiety, and depression. Moreover, subgroups were described and compared on vulnerability factors (anxiety sensitivity, negative affect) and outcome factors (pain intensity, pain interference, and return to work self-efficacy).

    Results: Four distinct clusters emerged: (1) low scores, (2) pain-related fear only, (3) social concern only, and (4) high social anxiety and pain-related fear. Patients high on social anxiety and pain-related fear had significantly higher levels of anxiety sensitivity, negative affect, and higher general emotional symptomatology. They also had remaining problems posttreatment.

    Conclusions: A subgroup of patients with clinical levels of social anxiety has suboptimal rehabilitation results, with residual emotional problems and high levels of emotional vulnerability.

    Implications: These patients may be in need of additional treatment efforts that are not being met today. To prevent insufficient treatment results and prolonged work disability, these patients need to be detected during screening and may benefit from pain treatment that takes their emotional problems into account.

    Place, publisher, year, edition, pages
    Amsterdam: Elsevier, 2016
    Keyword
    Social anxiety, pain related fear, chronic pain, comorbidity, treatment outcome, vulnerability factors
    National Category
    Psychology Neurology
    Research subject
    Psychology; Neurology
    Identifiers
    urn:nbn:se:oru:diva-51689 (URN)10.1016/j.sjpain.2016.03.006 (DOI)000383375000009 ()2-s2.0-84962840819 (Scopus ID)
    Note

    Funding Agency:

    Regional Research Council (Regionala Forskningsrådet, RFR)

    Available from: 2016-08-17 Created: 2016-08-17 Last updated: 2018-05-16Bibliographically approved
    2. Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over time
    Open this publication in new window or tab >>Musculoskeletal pain in adolescents: Prevalence, and the role of peer-related stress, worry, and gender in the development of pain problems over time
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:oru:diva-66950 (URN)
    Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-05-16Bibliographically approved
    3. Internet delivered transdiagnostic treatment with telephone support for painpatients with emotional comorbidity: a replicated single case study
    Open this publication in new window or tab >>Internet delivered transdiagnostic treatment with telephone support for painpatients with emotional comorbidity: a replicated single case study
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    2017 (English)In: Internet Interventions, ISSN 2214-7829, Vol. 10, p. 54-64Article in journal (Refereed) Published
    Abstract [en]

    In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimaltreatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarchingaim of this study was to test an internet delivered therapist guided transdiagnostic treatment withtelephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of EmotionalDisorders was used as an intervention for pain patients with residual pain problems and comorbid emotionalproblems after having received a multimodal pain rehabilitation. The study used a replicated AB single caseexperimental design (N =5; 3 females). Outcome measures were depressive and general anxiety symptoms, painintensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance) andpatient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP) indicate a decrease of anxiety forthree participants and a decrease of depression for four participants. Decreases were small and did not alwaysreach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two outof four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnosticcriteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patientsatisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support maybe a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, theeffects are unclear. The gap between high patient satisfaction and small changes in symptomatology should beexplored further.

    Place, publisher, year, edition, pages
    Elsevier, 2017
    Keyword
    Internet delivered treatment; pain; transdiagnostic; emotional comorbidity; single case
    National Category
    Other Medical Sciences not elsewhere specified
    Research subject
    Psychology
    Identifiers
    urn:nbn:se:oru:diva-62356 (URN)10.1016/j.invent.2017.10.004 (DOI)2-s2.0-85032807121 (Scopus ID)
    Projects
    SÅS
    Available from: 2017-11-14 Created: 2017-11-14 Last updated: 2018-05-16Bibliographically approved
  • Public defence: 2018-06-08 10:00 Örebro universitet, Hörsalen, Musikhögskolan, Örebro
    Savsin, Selen
    Örebro University, Örebro University School of Business.
    Essays on Offshoring, Labor Demand and Hypothetical Bias in Choice Experiments2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This dissertation consists of four papers on offshoring, labor demand and hypothetical bias in travel-time stated choice experiments. They are summarized as follows. Essay 1: Firm-level Effects of Offshoring of Materials and Services on Relative Labor Demand analyzes the effect of relocation of production process abroad (offshoring), on relative labor demand for the Swedish manufacturing sector over the period 1997-2002. This essay gives no support to the expected negative effect of out-location of high-skilled activity in Swedish firms and even shows an increase in relative demand of high-skilled labor due to service offshoring. Essay 2: Labour Demand, Offshoring and Inshoring: Evidence from Swedish Firm-level Data adds to the existing literature of offshoring by simultaneously analyzing the effect of offshoring and inshoring measured as firm-level imports and exports, respectively, of intermediate goods (materials) or services on firm-level relative labor demand for high-skilled labor. The causality that we find between relative labor demand and service offshoring, cannot be established neither from goods nor services inshoring. Essay 3: Is ‘Referencing’ a Remedy to Hypothetical Bias in Value of Time Elicitation? Evidence from Economic Experiments demonstrates negative hypothetical bias, i.e. higher value of time is revealed by real choice when it is compared with the value estimated from a hypothetical choice survey. Referencing, that involves interviewing the respondents about the attributes of a reference trip that has been made and then constructing the stated choice experiment presenting variations of that trip, is tested as a suggested remedy. The results indicate that any negative hypothetical bias that would exist without referencing treatment would have been further magnified by the referencing design. Essay 4: Joint Usage of Referencing and Certainty in Travel Time Stated Choice Experiments explores the heterogeneous association of referencing with respect to self-reported choice-certainty with responses in stated choice experiments. The findings in the essay show that while uncertain respondents are more likely to accept the offer of a travel-time prolongation for monetary compensation with referencing, certain respondents tend to be less likely to accept the offer under referencing conditions.

    List of papers
    1. Firm-level effects of offshoring of materials and services on relative labor demand
    Open this publication in new window or tab >>Firm-level effects of offshoring of materials and services on relative labor demand
    2016 (English)In: Review of World Economics, ISSN 1610-2878, E-ISSN 1610-2886, Vol. 152, no 2, p. 321-350Article in journal (Refereed) Published
    Abstract [en]

    Based on firm-level data over the period 1997-2002 for the Swedish manufacturing sector the objective of this paper is to analyze relative labor demand effects due to offshoring, separating between materials and services offshoring and also geographical location of trade partner. Overall, our results give no support to the fears that offshoring of materials or services lead to out-location of high-skilled activity in Swedish firms. Rather, this paper finds evidence that the aggregate effects from offshoring lead to increasing relative demand of high-skilled labor, mainly due to services offshoring to middle income countries.

    Place, publisher, year, edition, pages
    Springer, 2016
    Keyword
    offshoring, firm-level data, relative employment, translog cost function
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-47589 (URN)10.1007/s10290-015-0243-8 (DOI)000378901200004 ()2-s2.0-84954329126 (Scopus ID)
    Funder
    The Jan Wallander and Tom Hedelius Foundation, P2007-0228:1
    Note

    An earlier version of this article is published in

    Savsin, S. (2014). The skill composition in the light of sourcing:offshoring and inshoring.  (Licentiate dissertation). Örebro: Örebro University

    Available from: 2016-01-19 Created: 2016-01-19 Last updated: 2018-05-16Bibliographically approved
    2. Labour Demand, Offshoring and Inshoring: Evidence from Swedish Firm-level Data
    Open this publication in new window or tab >>Labour Demand, Offshoring and Inshoring: Evidence from Swedish Firm-level Data
    2017 (English)In: The World Economy, ISSN 0378-5920, E-ISSN 1467-9701, Vol. 40, no 2, p. 240-274Article in journal (Refereed) Published
    Abstract [en]

    The objective of this paper was to analyse effects on firm–level relative demand for skilled labour due to imports of intermediates (offshoring) and exports of intermediates (inshoring). The study is based on a data set of Swedish manufacturing firms, 1997–2002, using trade flows in intermediate goods and services, respectively. Descriptive data show that goods inshoring is much larger than goods offshoring, while the reverse is true for services. There is, however, a strong increase in services inshoring over the study period. Controlling for potential endogeneity in offshoring and inshoring, our results indicate that there is a positive effect of services offshoring on the skill composition of workers in Swedish firms, while no such causality can be established from inshoring.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2017
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-35856 (URN)10.1111/twec.12396 (DOI)000396889400001 ()2-s2.0-84964389348 (Scopus ID)
    Available from: 2014-08-05 Created: 2014-08-05 Last updated: 2018-05-16Bibliographically approved
    3. Is 'referencing' a remedy to hypothetical bias in value of time elicitation?: Evidence from economic experiments
    Open this publication in new window or tab >>Is 'referencing' a remedy to hypothetical bias in value of time elicitation?: Evidence from economic experiments
    2017 (English)In: Transportation, ISSN 0049-4488, E-ISSN 1572-9435Article in journal (Refereed) Epub ahead of print
    Abstract [en]

    This paper demonstrates that commonly used methods for eliciting value of time can give downward bias and investigates whether this can be reversed by ‘referencing’ as has been suggested (e.g., by Hensher in Transp Res B 44:735–752,2010), i.e. with attributes of choice alternatives pivoted around a recently made journey. Value-of-time choice experiments were conducted in two rounds. In the first round, real and hypothetical purchases of performance of a simple time-consuming task were done to assess hypothetical bias; in the second round, participants were asked to do hypothetical travel choices with and without ‘referencing’ to a specific occasion, to be able to test ‘referencing’ as a remedy to the bias confirmed in the first round. A negative hypothetical bias was found for allocation of time at another occasion than the present (but not for a decision concern allocation of time ‘here and now’). A striking result was held from the second round experiments: ‘referencing’ indeed affects responses, but by reducing the elicited implicit value of time, so any negative hypothetical bias that would exist without ‘referencing’ would have been further magnified by the ‘referencing’ design.

    Place, publisher, year, edition, pages
    Springer, 2017
    Keyword
    Value of time, Stated choice, Certainty calibration, Referencing
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-59113 (URN)10.1007/s11116-017-9803-1 (DOI)
    Available from: 2017-08-17 Created: 2017-08-17 Last updated: 2018-05-16Bibliographically approved
    4. Joint Usage of Referencing and Certainty in Travel Time Stated Choice Experiments
    Open this publication in new window or tab >>Joint Usage of Referencing and Certainty in Travel Time Stated Choice Experiments
    (English)Manuscript (preprint) (Other academic)
    National Category
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66951 (URN)
    Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2018-05-16Bibliographically approved
  • Public defence: 2018-06-08 13:00 Örebro universitet, Campus USÖ, hörsal C3, Örebro
    Ganda Mall, John-Peter
    Örebro University, School of Medical Sciences.
    Non-digestible Polysaccharides and Intestinal Barrier Function: specific focus on its efficacy in elderly and patients with Crohn’s disease2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A large number of elderly suffer from gastrointestinal (GI) symptoms such as constipation and diarrhoea. The underlying mechanisms of age-acquired GI symptoms are not well studied but are necessary to clarify in order to recommend the right treatment. Non-digestible polysaccharides (NPS) are dietary fibres that could have beneficial effects on the intestinal immune system and barrier function, although their efficacy needs to be evaluated. Paper I showed that elderly with GI symptoms have significantly higher small intestinal permeability than a general elderly population, along with a stronger association to psychological distress. In Paper II we performed a randomised controlled trial with a general population of elderly that consumed either placebo, the NPS’s arabinoxylan or oat β-glucan for a period of 6 weeks. No protective effects were observed related to indomethacin-induced intestinal hyperpermeability, inflammatory markers, or self-reported health if compared to placebo. Paper III showed that stimulation with a yeast-derived β-glucan significantly attenuated Compound (C) 48/80-induced hyperpermeability in colonic biopsies from elderly with GI symptoms mounted in Ussing chambers, but not in young healthy adults. Arabinoxylan attenuated only C48/80-induced transcellular permeability in elderly but both paracellular and transcellular permeability in young healthy adults. Paper IV showed that the same yeast-derived β-glucan from paper III could cross the epithelium of ileal tissues from patients with Crohn’s disease (CD) and non-CD controls, mounted in Ussing chambers, and attenuate C48/80-induced hyperpermeability. In conclusion, we found that elderly with GI symptoms display a deteriorated barrier function and that administration of selective NPS can have beneficial effect on intestinal permeability in selective populations.

    List of papers
    1. Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress?
    Open this publication in new window or tab >>Are self-reported gastrointestinal symptoms among older adults associated with increased intestinal permeability and psychological distress?
    Show others...
    2018 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, no 1, article id 75Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Despite the substantial number of older adults suffering from gastrointestinal (GI) symptoms little is known regarding the character of these complaints and whether they are associated with an altered intestinal barrier function and psychological distress. Our aim was to explore the relationship between self-reported gut health, intestinal permeability and psychological distress among older adults.

    METHODS: Three study populations were included: 1) older adults with GI symptoms (n = 24), 2) a group of older adults representing the general elderly population in Sweden (n = 22) and 3) senior orienteering athletes as a potential model of healthy ageing (n = 27). Questionnaire data on gut-health, psychological distress and level of physical activity were collected. Intestinal permeability was measured by quantifying zonulin in plasma. The level of systemic and local inflammation was monitored by measuring C-reactive protein (CRP), hydrogen peroxide in plasma and calprotectin in stool samples. The relationship between biomarkers and questionnaire data in the different study populations was illustrated using a Principal Component Analysis (PCA).

    RESULTS: Older adults with GI symptoms displayed significantly higher levels of both zonulin and psychological distress than both general older adults and senior orienteering athletes. The PCA analysis revealed a separation between senior orienteering athletes and older adults with GI symptoms and showed an association between GI symptoms, psychological distress and zonulin.

    CONCLUSIONS: Older adults with GI symptoms express increased plasma levels of zonulin, which might reflect an augmented intestinal permeability. In addition, this group suffer from higher psychological distress compared to general older adults and senior orienteering athletes. This relationship was further confirmed by a PCA plot, which illustrated an association between GI symptoms, psychological distress and intestinal permeability.

    Place, publisher, year, edition, pages
    BioMed Central, 2018
    Keyword
    Older adults; Gastrointestinal symptoms; Intestinal barrier function; Psychological distress
    National Category
    Geriatrics
    Identifiers
    urn:nbn:se:oru:diva-66053 (URN)10.1186/s12877-018-0767-6 (DOI)000428260300001 ()29554871 (PubMedID)2-s2.0-85044174344 (Scopus ID)
    Funder
    Knowledge Foundation, 20110225
    Note

    Funding Agencies:

    Bo Rydins stiftelse  F0514 

    Faculty of Medicine and Health at Örebro University  

    Diarrheal Disease Research Centre, Linköping University  

    Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-05-04Bibliographically approved
    2. Effects of dietary fibres on indomethacin-induced intestinal permeability in elderly: A randomised placebo controlled parallel clinical trial
    Open this publication in new window or tab >>Effects of dietary fibres on indomethacin-induced intestinal permeability in elderly: A randomised placebo controlled parallel clinical trial
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Basic Medicine
    Identifiers
    urn:nbn:se:oru:diva-66863 (URN)
    Available from: 2018-05-04 Created: 2018-05-04 Last updated: 2018-05-04Bibliographically approved
    3. Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptoms
    Open this publication in new window or tab >>Differential effects of dietary fibres on colonic barrier function in elderly individuals with gastrointestinal symptoms
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Basic Medicine
    Identifiers
    urn:nbn:se:oru:diva-66866 (URN)
    Available from: 2018-05-04 Created: 2018-05-04 Last updated: 2018-05-04Bibliographically approved
    4. A β-Glucan-Based Dietary Fiber Reduces Mast Cell-Induced Hyperpermeability in Ileum From Patients With Crohn's Disease and Control Subjects
    Open this publication in new window or tab >>A β-Glucan-Based Dietary Fiber Reduces Mast Cell-Induced Hyperpermeability in Ileum From Patients With Crohn's Disease and Control Subjects
    Show others...
    2017 (English)In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 24, no 1, p. 166-178Article in journal (Refereed) Published
    Abstract [en]

    Background: Administration of β-glucan has shown immune-enhancing effects. Our aim was to investigate whether β-glucan could attenuate mast cell (MC)-induced hyperpermeability in follicle-associated epithelium (FAE) and villus epithelium (VE) of patients with Crohn's disease (CD) and in noninflammatory bowel disease (IBD)-controls. Further, we studied mechanisms of β-glucan uptake and effects on MCs in vitro.

    Methods: Segments of FAE and VE from 8 CD patients and 9 controls were mounted in Ussing chambers. Effects of the MC-degranulator compound 48/80 (C48/80) and yeast-derived β-1,3/1,6 glucan on hyperpermeability were investigated. Translocation of β-glucan and colocalization with immune cells were studied by immunofluorescence. Caco-2-cl1- and FAE-cultures were used to investigate β-glucan-uptake using endocytosis inhibitors and HMC-1.1 to study effects on MCs.

    Results: β-glucan significantly attenuated MC-induced paracellular hyperpermeability in CD and controls. Transcellular hyperpermeability was only significantly attenuated in VE. Baseline paracellular permeability was higher in FAE than VE in both groups, P<0.05, and exhibited a more pronounced effect by C48/80 and β-glucan P<0.05. No difference was observed between CD and controls. In vitro studies showed increased passage, P<0.05, of β-glucan through FAE-culture compared to Caco-2-cl1. Passage was mildly attenuated by the inhibitor methyl-β-cyclodextrin. HMC-1.1 experiments showed a trend to decreasing MC-degranulation and levels of TNF-α but not IL-6 by β-glucan. Immunofluorescence revealed more β-glucan-uptake and higher percentage of macrophages and dendritic cells close to β-glucan in VE of CD compared to controls.

    Conclusions: We demonstrated beneficial effects of β-glucan on intestinal barrier function and increased β-glucan-passage through FAE model. Our results provide important and novel knowledge on possible applications of β-glucan in health disorders and diseases characterized by intestinal barrier dysfunction.

    Place, publisher, year, edition, pages
    Lippincott-Raven Publishers, 2017
    Keyword
    Crohn’s disease, intestinal permeability, β-glucan
    National Category
    Gastroenterology and Hepatology
    Identifiers
    urn:nbn:se:oru:diva-63994 (URN)10.1093/ibd/izx002 (DOI)000427524400018 ()29272475 (PubMedID)
    Funder
    Swedish Foundation for Strategic Research , RB13-016Swedish Research Council, 2014-02537
    Note

    Funding Agency:

    LIONS research foundation

    Available from: 2018-01-09 Created: 2018-01-09 Last updated: 2018-05-04Bibliographically approved
  • Public defence: 2018-06-14 13:15 Örebro universitet, Långhuset, Hörsal L2, Örebro
    Anniko, Malin
    Örebro University, School of Law, Psychology and Social Work.
    Stuck on repeat: Adolescent stress and the role of repetitive negative thinking and cognitive avoidance2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Stress and stress-related mental health problems such as anxiety and depressive symptoms are common in adolescents and seem to be increasing, especially in mid- to late-adolescent girls. Although adolescence, as a period of rapid growth and profound change, is often marked by an increase in normal stressors (e.g. conflicts with parents, fitting in with peers, increased academic demands), most adolescents do not develop more persis-tent problems with stress. To be able to develop effective preventive interventions there is a need to understand both what adolescents are ascribing their stress to, how different stressor domains relate to outcomes, and why some adolescents go on to develop stress-related mental health problems while others do not.          

    This dissertation aimed to answer some of these questions by investigating the role of cognitive avoidance and repetitive negative thinking (RNT) in the development of stress-related mental health problems (Study I & III). It also aimed to develop and validate a shortened version of a questionnaire designed to measure stressor load within different life domains in adolescence (Study II). Findings show that the shortened version of the Adolescents Stress Questionnaire seems to be a valid measure of stressor load within different domains in adolescence. School-related stressors were the most prevalent sources of stress, but social stressors seem to have a stronger link to increases in mental health symptoms. Also, adolescents who report higher levels of distress and stressor load tend to increase their engagement in cognitive avoidance and RNT over time which in turn predicts further increases in mental health symptoms. This suggests that cognitive avoidance and RNT may be important mechanisms in the development of stress-related mental health problems in adoles-cence.

    List of papers
    1. Investigating the mediating role of cognitive emotion regulation in the development of adolescent emotional problems
    Open this publication in new window or tab >>Investigating the mediating role of cognitive emotion regulation in the development of adolescent emotional problems
    2018 (English)In: Nordic Psychology, ISSN 1901-2276, E-ISSN 1904-0016, Vol. 70, no 1, p. 3-16Article in journal (Refereed) Published
    Abstract [en]

    Previous research has indicated that cognitive emotion regulation strategies contribute to the development and maintenance of emotional problems in adults and adolescents. However, there is a lack of longitudinal research with adolescent samples, hence knowledge of exactly how these strategies influence the development of emotional problems in adolescence is sparse. This study investigated maladaptive cognitive emotion regulation (cognitive avoidance and repetitive negative thinking) as a potential mediator in the development of anxiety and depressed mood over time in adolescence. Self-reported depressed mood, anxiety, and cognitive emotion regulation strategies were assessed during school hours in a sample of Swedish 10th graders (N=149; 53% girls), with follow-up assessments one and two years later. Repetitive negative thinking and cognitive avoidance formed a unidimensional factor of cognitive emotion regulation. Cognitive emotion regulation was found to mediate the development of both anxiety and depressed mood over time, lending support to the previous findings that cognitive emotion regulation strategies such as cognitive avoidance and repetitive negative thinking might act as transdiagnostic mechanisms in the development of emotional symptoms in adolescence. This suggests that maladaptive forms of cognitive emotion regulation could be important targets in prevention and treatment of emotional problems in adolescence.

    Place, publisher, year, edition, pages
    Routledge, 2018
    Keyword
    Emotion regulation, anxiety, depressed mood, adolescence, longitudinal design
    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:oru:diva-65648 (URN)10.1080/19012276.2017.1323665 (DOI)000425787700002 ()2-s2.0-85019197348 (Scopus ID)
    Available from: 2018-03-12 Created: 2018-03-12 Last updated: 2018-05-22Bibliographically approved
    2. Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S): construct validity and sex invariance in a large sample of Swedish adolescents
    Open this publication in new window or tab >>Development of a Shortened Version of the Adolescent Stress Questionnaire (ASQ-S): construct validity and sex invariance in a large sample of Swedish adolescents
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    2018 (English)In: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology, E-ISSN 2245-8875Article in journal (Other academic) Epub ahead of print
    Abstract [en]

    Background: Stressor experience is an important topic of research concerning adolescent health and ill-health. For this, valid and reliable measures of adolescent stress are needed. The Adolescent Stress Questionnaire 2 was developed to tap into stressor domains specific for adolescence. Psychometric evaluations in Australian and European samples have indicated adequate psychometric properties. However, the ASQ-2 is quite extensive, which may render its use in large cohort studies, where several aspects of adolescent health are investigated, inconvenient and problematic.

    Objective: To evaluate the psychometric properties of a short version of the ASQ-2 (ASQ-S) in terms of construct validity and factorial invariance across gender.

    Method: The ASQ-2 was translated into Swedish and items were retained from nine of the ten scales based on factor loadings. One scale (stress of emerging adult responsibilities) was removed entirely due to low internal consistency and variance explained. The remaining 27 items were piloted and then included in an ongoing 5-year longitudinal study involving the participation of all students in the 7th and 8th grade in public schools from three Swedish municipalities (N = 2768, 47.5 % girls, mean age 13.64 years). For this study data from the first and second wave was used.

    Results: A nine factor Confirmatory Factor Analysis (CFA) showed a good fit to the data and invariance across sexes was supported. The nine scales correlated positively with depressive symptoms, anxiety and worry and negatively with self-esteem. Girls reported higher stress levels than boys in eight of the nine scales. Stressors related to peer pressure predicted reported levels of anxiety and worry one year later, whereas stressors related to romantic relationships predicted depressive symptoms.

    Conclusions: Overall this study suggests that the ASQ-S could be a valid measure of adolescent stressor experience and psychometrically equivalent to the full ASQ-2.

    Place, publisher, year, edition, pages
    New York, NY, USA: Exeley Inc., 2018
    Keyword
    Adolescents, stress measurement, psychometrics, sex invariance, emotional distress
    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:oru:diva-67064 (URN)10.21307/sjcapp-2018-001 (DOI)
    Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2018-05-22Bibliographically approved
    3. Stress-related Mental Health Problems in Adolescence: What are Adolescents Stressed About and Could Worry be a Potential Target in Prevention? A Longitudinal Investigation
    Open this publication in new window or tab >>Stress-related Mental Health Problems in Adolescence: What are Adolescents Stressed About and Could Worry be a Potential Target in Prevention? A Longitudinal Investigation
    (English)Manuscript (preprint) (Other academic)
    National Category
    Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:oru:diva-67066 (URN)
    Available from: 2018-05-22 Created: 2018-05-22 Last updated: 2018-05-22Bibliographically approved
  • Public defence: 2018-06-15 09:00 Örebro universitet, Forumhuset, Hörsal F, Örebro
    Dahlberg, Karuna
    Örebro University, School of Health Sciences.
    e-Assessed follow-up of postoperative recovery: developement, evaluation and patient experiences2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The majority of all surgeries are performed as day surgery. After discharge, patients are expected to take responsibility for their postoperative recovery themselves. Recovery Assessment by Phone Points (RAPP) is an e-assessment developed for assessing and providing follow-up on postoperative recovery, which includes the Swedish web-version of the Quality of Recovery questionnaire (SwQoR). It also enables the patient to get in contact with the day surgery unit. The overall aim of this thesis was to further develop and evaluate a systematic follow-up of postoperative recovery using a mobile app in adult persons undergoing day surgery, as well as to describe their experiences of postoperative recovery when using the mobile app. Study I: This study included three steps. Equivalence testing between the paper and app versions of the SwQoR showed agreement (n=69). The feasibility and acceptability evaluation showed that participants (n=63) were positive towards using a mobile phone application during postoperative recovery. Content validity of the SwQoR reduced the original 31 items to 24. Studies II and III: A multicentre, two-group, parallel, single-blind randomized controlled trial including 997 participants was conducted to investigate the effect of e-assessment on postoperative recovery (II) and cost-effectiveness (III) in a RAPP group compared with a control group. The RAPP group reported significantly better quality of postoperative recovery on postoperative days 7 and 14 compared with the control group. Moreover, RAPP may be cost-effective as it provides low-cost care. Study IV: Explored experience of postoperative recovery in participants using a mobile phone app during their postoperative recovery. Qualitative inductive semi-structured interviews (n=18) were performed. Findings showed that feeling safe is important during postoperative recovery. This feeling can be created by patients themselves, but sufficient support and information from health care and next of kin is needed. Overall, this thesis showed positive results for RAPP, suggesting that RAPP is a solution that may benefit patients after day surgery.

    List of papers
    1. Evaluation of the Swedish Web-Version of Quality of Recovery (SwQoR): Secondary Step in the Development of a Mobile Phone App to Measure Postoperative Recovery
    Open this publication in new window or tab >>Evaluation of the Swedish Web-Version of Quality of Recovery (SwQoR): Secondary Step in the Development of a Mobile Phone App to Measure Postoperative Recovery
    2016 (English)In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 5, no 3, article id e192Article in journal (Refereed) Published
    Abstract [en]

    Background: The majority of all surgeries are performed on an outpatient basis (day surgery). The Recovery Assessment by Phone Points (RAPP) app is an app for the Swedish Web-version of Quality of Recovery (SwQoR), developed to assess and follow-up on postoperative recovery after day surgery.

    Objectives: The objectives of this study are (1) to estimate the extent to which the paper and app versions of the SwQoR provide equivalent values; (2) to contribute evidence as to the feasibility and acceptability of a mobile phone Web-based app for measuring postoperative recovery after day surgery and enabling contact with a nurse; and (3) to contribute evidence as to the content validity of the SwQoR.

    Methods: Equivalence between the paper and app versions of the SwQoR was measured using a randomized crossover design, in which participants used both the paper and app version. Feasibility and acceptability was evaluated by a questionnaire containing 16 questions regarding the value of the app for follow-up care after day surgery. Content validity evaluation was based on responses by day surgery patients and the staff of the day surgery department.

    Results: A total of 69 participants completed the evaluation of equivalence between the paper and app versions of the SwQoR. The intraclass correlation coefficient (ICC) for the SwQoR was .89 (95% CI 0.83-0.93) and .13 to .90 for the items. Of the participants, 63 continued testing the app after discharge and completed the follow-up questionnaire. The median score was 69 (inter-quartile range, IQR 66-73), indicating a positive attitude toward using an app for follow-up after day surgery. A total of 18 patients and 12 staff members participated in the content validity evaluation. The item-level content validity index (I-CVI) for the staff group was in the 0.64 to 1.0 range, with a scale-level content validity index (S-CVI) of 0.88. For the patient group, I-CVI was in the range 0.30 to 0.92 and S-CVI was 0.67. The content validity evaluation of the SwQoR, together with three new items, led to a reduction from 34 to 24 items.

    Conclusions: Day surgery patients had positive attitudes toward using the app for follow-up after surgery, and stated a preference for using the app again if they were admitted for a future day surgery procedure. Equivalence between the app and paper version of the SwQoR was found, but at the item level, the ICC was less than .7 for 9 items. In the content validity evaluation of the SwQoR, staff found more items relevant than the patients, and no items found relevant by either staff or patients were excluded when revising the SwQoR.

    Place, publisher, year, edition, pages
    Toronto, Canada: JMIR Publications, Inc, 2016
    Keyword
    mHealth, ambulatory surgical procedures, postoperative period, mobile phones
    National Category
    Nursing
    Identifiers
    urn:nbn:se:oru:diva-52584 (URN)10.2196/resprot.5881 (DOI)27679867 (PubMedID)
    Available from: 2016-09-27 Created: 2016-09-27 Last updated: 2018-05-22Bibliographically approved
    2. Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial
    Open this publication in new window or tab >>Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial
    2017 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 119, no 5, p. 1030-1038Article in journal (Refereed) Published
    Abstract [en]

    Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores.

    Methods: The study was a single-blind, multicentre randomized controlled trial. A total of 997 patients were randomly allocated to either RAPP or standard care. The Swedish web version of a quality of recovery (SwQoR) questionnaire was used to evaluate the patients' postoperative recovery, either on paper or using an application (RAPP) on postoperative days seven and 14.

    Results: On postoperative day seven the RAPP group reported significantly better values in seven out of 24 items of the SwQoR: sleeping difficulties; not having a general feeling of wellbeing; having difficulty feeling relaxed/comfortable; and dizziness; headache; pain in the surgical wound; and a swollen surgical wound compared with the control group, implying a good postoperative recovery. Both men and women in the RAPP group reported significantly better values (and, hence good postoperative recovery) compared with the control group in the items sleeping difficulties; not having a general feeling of wellbeing and pain in the surgical wound.

    Conclusions: Measurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients' quality of recovery and identify key areas for improvement in perioperative care.

    Place, publisher, year, edition, pages
    Oxford University Press, 2017
    Keyword
    Mobile application, patient outcome assessment, postoperative complications, postoperative period
    National Category
    Anesthesiology and Intensive Care
    Identifiers
    urn:nbn:se:oru:diva-61084 (URN)10.1093/bja/aex331 (DOI)000413642900026 ()29077818 (PubMedID)2-s2.0-85034763250 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
    Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2018-05-22Bibliographically approved
    3. Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial
    Open this publication in new window or tab >>Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial
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    2017 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 119, no 5, p. 1039-1046Article in journal (Refereed) Published
    Abstract [en]

    Background: Most surgeries are done on a day-stay basis. Recovery assessment by phone points (RAPP) is a smartphonebased application (app) to evaluate patients after day surgery. The aim of this study was to estimate the cost-effectiveness of using RAPP for follow-up on postoperative recovery compared with standard care.

    Methods: This study was a prospective parallel single-blind multicentre randomized controlled trial. Participants were randomly allocated to the intervention group using RAPP or the control group receiving standard care. A cost-effectiveness analysis was performed based on individual data and included costs for the intervention, health effect [quality-adjusted life-years (QALYs)], and costs or savings in health-care use.

    Results: The mean cost for health-care consumption during 2 weeks after surgery was estimated at e37.29 for the intervention group and e60.96 for the control group. The mean difference was e23.66 (99% confidence interval 46.57 to0.76; P¼0.008). When including the costs of the intervention, the cost-effectiveness analysis showed net savings of e4.77 per patient in favour of the intervention. No difference in QALYs gained was seen between the groups (P¼0.75). The probability of the intervention being cost-effective was 71%.

    Conclusions: This study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective toolin providing low-cost health-care contacts and in systematically assessing the quality of postoperative recovery.

    Clinical trial registration:NCT02492191

    Place, publisher, year, edition, pages
    Oxford University Press, 2017
    Keyword
    Ambulatory surgery, cost effectiveness, mobile applications, postoperative period
    National Category
    Anesthesiology and Intensive Care
    Identifiers
    urn:nbn:se:oru:diva-61954 (URN)10.1093/bja/aex332 (DOI)000413642900027 ()29077819 (PubMedID)2-s2.0-85034731856 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2013-4765Swedish Research Council, 2015-02273
    Available from: 2017-10-25 Created: 2017-10-25 Last updated: 2018-05-22Bibliographically approved
    4. Holding it together: patients’ perspectives on postoperative recovery when using an e-assessed follow-up
    Open this publication in new window or tab >>Holding it together: patients’ perspectives on postoperative recovery when using an e-assessed follow-up
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:oru:diva-67060 (URN)
    Available from: 2018-05-21 Created: 2018-05-21 Last updated: 2018-05-22Bibliographically approved
  • Public defence: 2018-06-15 13:15 Örebro universitet, Teknikhuset, Hörsal T, Örebro
    Seger, Karin
    Örebro University, Örebro University School of Business.
    Institutional Logics and Accounting Professionals: The case of K2 and K32018Doctoral thesis, monograph (Other academic)
  • Public defence: 2018-06-15 13:15 Örebro universitet, Långhuset, Hörsal L2, Örebro
    Khaliq, Ali Abdul
    Örebro University, School of Science and Technology.
    From Ants to Service Robots: an Exploration in Stigmergy-Based Navigation Algorithms2018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Navigation is a core functionality of mobile robots. To navigate autonomously, a mobile robot typically relies on internal maps, self-localization, and path planning. Reliable navigation usually comes at the cost of expensive sensors and often requires significant computational overhead.

    Many insects in nature perform robust, close-to-optimal goal directed navigation without having the luxury of sophisticated sensors, powerful computational resources, or even an internally stored map. They do so by exploiting a simple but powerful principle called stigmergy: they use their environment as an external memory to store, read and share information. In this thesis, we explore the use of stigmergy as an alternative route to realize autonomous navigation in practical robotic systems.

    In our approach, we realize a stigmergic medium using RFID (Radio Frequency Identification) technology by embedding a grid of read-write RFID tags in the floor. A set of mobile robots, then, build and store maps used for navigation in the stigmergic medium itself. These maps are of three types: (1) goal maps which guide robots to known locations; (2) clearance maps which help robots avoid obstacles; (3) feature maps which can be used to store observable properties, such as light intensity or gas concentration. We show how these maps can be built both in static and in dynamic environments and used for navigation of heterogeneous robots. We also show that goal maps can be used for navigation to previously unknown and/or dynamic locations, and that feature maps can be used to navigate towards specific features, e.g., places with high gas concentration that are beyond the sensor’s range. We address the issue of perceptual errors (e.g., broken tags) during navigation. We further study the use of the built navigation maps to enable different types of human-aware robot navigation on the RFID floor.

    We define several stigmergic algorithms for building maps and navigating on these maps. We formally analyse the properties of the main algorithms, and empirically evaluate all the algorithms both in simulation and with multiple physical robots. Results collected from tens of hours of real experiments and thousands of simulated runs demonstrate the effectiveness of our approach.

  • Public defence: 2018-06-15 13:15 Örebro universitet, Prismahuset, Hörsal P1, Örebro
    Spjut, Lina
    Örebro University, School of Humanities, Education and Social Sciences.
    Att (ut)bilda ett folk: Nationell och etnisk gemenskap i Sveriges och Finlands svenskspråkiga läroböcker för folk- och grundskola åren 1866-20162018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In this comparative study, elementary school textbooks in history, geography and social science/civics from Sweden and Finland 1866 – 2016 are analysed and compared. The focus is textbooks’ expressions of imagined communities, identification and common history. The study has an asymmetric design, because the textbooks are all written in Swedish for pupils in a Swedish majority population in Sweden and a Finland-Swede minority population in Finland.

    The aim is to contribute a deeper understanding of textbooks’ role in creating and teaching imagined communities. Research questions focus on how imagined communities are mediated in textbooks and results are compared between Sweden and Finland and over time, and on similarities and differences in offered communities expressed through concepts and use of history. The thesis also raises questions about how present needs affect textbooks’ interpretations of the past and what that signifies. Theory and method are inspired by Fairclough’s Critical Discourse Analysis. The theoretical framework is typologies of use of history, and the textbooks have been contextualised through the contexts of school, curricula, politics, minorities, language policies and history culture. The textbooks’ development over time, between contexts and between school subjects are compared at all levels throughout the study.

    Results show that textbooks have had, and still have a role in creating and educating pupils into national and ethnical identities; this is seen over the entire period of time studied, though with different approaches according to the school subject and country. Even though ethnical and nationalistic narratives are more implicit today, they are still visible in current textbooks.

    The full text will be freely available from 2018-05-23 13:00
  • Public defence: 2018-06-15 13:15 Örebro universitet, Långhuset, Hörsal L3, Örebro
    Badinlou, Farzaneh
    Örebro University, School of Law, Psychology and Social Work.
    The power of action and knowledge in episodic memory for school-aged children2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Developmental and cognitive research suggests that there are age-related differ-ences in children’s episodic memory across school ages due to the development of knowledge, which in turn affects memory strategy use and information pro-cessing over time. However, there are controversial findings related to devel-opmental patterns and factors involved in children’s episodic memory function.

    This dissertation studies action memory, a form of episodic memory, across school ages to explore developmental differences and children’s memory per-formance as related to different encoding conditions, retrieval modes, materi-als, and events. In study I, the effects of different encoding conditions (i.e., verbal tasks, VTs; experimenter-performed tasks, EPTs; and subject-performed tasks, SPTs) and memory tests (i.e., recall and recognition) were examined across school ages. This study found that the developmental pattern of action memory was more pronounced for enacted encoding than verbal encoding, the most pronounced in recall test than in recognition test. In study II, the recall period of enactment effects and the effects of task difficulty were investigated as functions of age and encoding conditions in school-aged children. The re-sults revealed that enacted encoding not only outperformed verbal encoding but also that the response speed increased over the recall period, the effect be-ing more noticeable in older than younger children. Moreover, the level of task difficulty can be regarded as an important factor affecting the pattern of memory output among school-aged children. Study III explored the effect of children’s declarative knowledge on memory performance by presenting knowledge-based cues such as objects and semantic integration items. Provid-ing cues related to children’s prior knowledge in the encoding and test phases improved memory performance, especially in older children. The overall results indicated clear-cut developmental differences in episodic memory across school ages. Episodic memory functions differed as functions of age, encoding, testing instructions, and type of event. SPTs and EPTs can improve memory function, this improvement was more pronounced in SPTs than in EPTs. The positive impact of action memory on memory performance is discussed in terms of the cognitive mechanism, memory strategies, and information processing involved.