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  • Söderman, Annika
    et al.
    Örebro University, School of Health Sciences.
    Östlund, Ulrika
    Centre for Collaborative Palliative Care, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Werkander Harstäde, Carina
    Centre for Collaborative Palliative Care, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    The adaptation of the Dignity Care Intervention to a Swedish context2018In: Nordic Conference in Nursing Research - Methods and Networks for the future, 2018, 2018Conference paper (Other academic)
    Abstract [en]

    Background: The Dignity Care Intervention (DCI) was developed in Scotland by Johnston and co-workers for nurses in municipality care, to enhance dignity in persons with palliative care needs. DCI includes a questionnaire, examples of reflective questions and suggests care actions. DCI has been tested in Ireland, and is now adapted to Swedish.

    Objective: To translate and adapt the DCI to a Swedish palliative context.

    Method: The questionnaire was translated and adapted into Swedish and reviewed by an expert group, before validated in cognitive interviews (N=7) with older persons. To update evidence concerning care actions from a Swedish context, a review of Swedish research literature and interviews with older persons, relatives and health care professionals were carried out. This gathered knowledge has been integrated into the Swedish DCI (DCI-SWE) and a feasibility study now takes place in one municipality in home care, Sweden. Included nurses got repeated information and participated in a shorter DCI-education, and will use the DCI in their everyday work for three months. Follow-up interviews will be conducted and analysed with qualitative content analysis.

    Results: The Swedish version of the questionnaire was experienced relevant for older persons, and both the Swedish review and the interviews gave culturally relevant proposals about dignity care actions. Further, a feasibility study will contribute to the ongoing development of the Swedish DCI-version.

    Conclusion and implication for practice: Implementing DCI in Sweden can enhance dignity in persons with palliative care needs and facilitate for a person-centered care.

  • Söderman, Annika
    et al.
    Örebro University, School of Health Sciences.
    Östlund, Ulrika
    Centre for Collaborative Palliative Care, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; Centre for Research & Development, Uppsala University/Region Gävleborg, Gävle, Sweden.
    Werkander Harstäde, Carina
    Centre for Collaborative Palliative Care, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    Enhancing dignity in older persons in Sweden: adaptation of the Dignity Care Intervention2018In: 24th Nordic Congress of Gerontology, 2018Conference paper (Other academic)
    Abstract [en]

    Background : In end of life, the older persons´ experiences of dignity can be affected due to serious illness and life changes, derived from physical, psychological, social and existential dimension. Loss of dignity impact the persons´ will to live. The Dignity Care Intervention (DCI) was developed and tested in Scotland and Ireland, to enhance dignity of older persons with palliative care needs, by nurses in municipality care. DCI consists a patient dignity inventory, reflective questions and examples of evidence-based care actions.

    The aim was to develop and adapt the DCI to a Swedish context.

    Methods: The patient dignity inventory was overall accepted by older persons in home care, however some changes in the wording were performed. The Swedish care actions reflected mostly earlier care actions described in the original version. However some more care actions derived in some of the categories in the Swedish DCI (DCI-SWE) e.g. “social support”, and some less care actions derived for example in the category “aftermath concerns”.  In DCI-SWE general care actions like e.g. to show respect were concretized unlike the original DCI.

    Conclusions: The DCI-SWE has prospects to enhance older persons´ dignity, and is now tested in a feasibility study by twelve nurses in home care.

  • Söderman, Annika
    et al.
    Örebro University, School of Health Sciences.
    Östlund, Ulrika
    Uppsala University/Region Gävleborg, Gävle, Sweden.
    Werkander Harstäde, Carina
    Linnaeus University, Växjö, Sweden.
    Blomberg, Karin
    Örebro University, School of Health Sciences.
    En intervention för att bevara sköra äldre personers värdighet: utveckling och anpassning till en svensk kontext 2018In: Forskningen och utvecklingens dag, 2018, Örebro, 2018Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Utvärdering av palliativ vård i Sverige har visat att vården är ojämlik och att äldre personer får sämre palliativ vård. För att främja äldre personers livskvalitet den sista tiden i livet är bevarande av värdighet grundläggande. Förlust av värdighet kan innebära förtvivlan, en känsla av att vara en börda för andra och en önskan om att få dö, vanliga upplevelser hos sköra äldre personer. Konkreta arbetssätt behöver därför utvecklas för att bevara äldre personers värdighet, vilket idag saknas inom svensk palliativ vård. En värdighetsbevarande intervention (DCI) har utvecklats och prövats i Skottland och Irland. Interventionen består av ett formulär för kartläggning av värdighet, reflekterande frågor samt evidensbaserade vårdhandlingar.

    Syfte: Syftet var att utveckla och anpassa DCI till en svensk kontext.

    Metod: Utveckling och kulturanpassning skedde genom 1) översättning och anpassning av formuläret till svensk kontext via en expertpanel och via kognitiva intervjuer med äldre personer 2) identifiering av värdighetsbevarande vårdhandlingar relevanta för en svensk kontext, utifrån en litteraturgenomgång samt via intervjuer med äldre personer, deras närstående och vårdpersonal.

    Resultat: Mindre revideringar av formuläret genomfördes, men överlag accepterades det av de äldre personerna. Identifierade värdighetsbevarande vårdhandlingar speglade mestadels de redan angivna i originalversionen DCI. Dock framkom fler vårdhandlingar än i originalet vid några av kategorierna i den svenska DCI (DCI-SWE) som t.ex. ”socialt stöd”, medan det framkom färre vårdhandlingar än originalet vid t.ex. ”dödens följder för andra”. I DCI-SWE konkretiserades generella vårdhandlingar som t.ex. att lyssna och visa respekt, till skillnad från originalet.

    Konklusion: DCI-SWE har möjlighet att främja sköra äldre personers värdighet, och prövas nu av sjuksköterskor i en genomförbarhetsstudie inom hemsjukvården.

  • Björkvall, Anders
    Örebro University, School of Humanities, Education and Social Sciences.
    Det värdefulla skräpet: ”Upcycling” och värdeökningens semiotik2018In: Grammatik, kritik, didaktik: Nordiska studier i systemisk-funktionell lingvistik och socialsemiotik / [ed] Inga-Lill Grahn, Hans Landqvist, Benjamin Lyngfelt, Andreas Nord, Lena Rogström, Barbro Wallgren Hemlin, Göteborg: Göteborgs universitet, 2018, Vol. 34, p. 55-77Chapter in book (Refereed)
  • Holmberg, John
    et al.
    Larsson, Jörgen
    Nässén, Jonas
    Svenberg, Sebastian
    Örebro University, School of Humanities, Education and Social Sciences.
    Andersson, David
    Low-carbon transitions and the good life2012Report (Other academic)
    Abstract [en]

    A transition to a low-carbon economy requires farreaching reductions in emissions, which in addition will have to take place at the same time as the global population is growing. A growing population also makes ever greater demands on welfare, while the ecological, social and economic systems that have to sustain this development are already under severe strain. It is commonly argued that emission reductions in a growing world economy can and should be achieved by technical innovations so that the transition to a low-carbon economy does not imply a negative impact on human well-being.

    This report discusses whether there might perhaps be another way of understanding the situation. Is the presumed linkage between well-being and climate impact always negative? Could a greater focus on human well-being be a driver of, rather than an obstacle to, sustainable development? This report attempts to identify possible strategies to support both [the good life] and decreased emissions. By adopting this research approach, the authors aim to make a contribution to the discussion of low-carbon transitions in society.

  • Svenberg, Sebastian
    Örebro University, School of Humanities, Education and Social Sciences.
    Sent på jorden2017In: Röda rummet, ISSN 1403–3844, Vol. 173-174, no 1-2, p. 10-11Article, book review (Other (popular science, discussion, etc.))
  • Svenberg, Sebastian
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Elam, Mark
    Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.
    Swedish Nuclear Waste Management on the Move: From the Finnish Uptake of KBS-3 to the Rise of SKB International2014Report (Other academic)
  • Svenberg, Sebastian
    Örebro University, School of Humanities, Education and Social Sciences.
    Social ontologi2017In: Salongen - Nettidsskrift for filosofi og idehistorieArticle in journal (Other (popular science, discussion, etc.))
  • Svenberg, Sebastian
    Örebro University, School of Humanities, Education and Social Sciences.
    Expanding conjunctions and climate change2016In: AcclimatizeArticle in journal (Other (popular science, discussion, etc.))
  • Thunberg, Sara
    Örebro University, School of Law, Psychology and Social Work.
    Victimization, Positioning, and Support2018In: En forskningskonferens kring föräldraskap och föräldra-barnrelationen, 2018Conference paper (Other academic)
  • Tryggvason, Ásgeir
    Örebro University, School of Humanities, Education and Social Sciences.
    Democratic Education and Agonism: Exploring the Critique from Deliberative Theory2018In: Democracy & Education, ISSN 1085-3545, E-ISSN 2164-7992, Vol. 26, no 1, p. 1-9, article id 1Article in journal (Refereed)
    Abstract [en]

    Due to the current political challenges facing democratic societies, including an apparent presence of populist rhetoric, the question of how political discussions should take place in democratic education is as urgent as ever. In the last two decades, one of the most prominent approaches to this question has been the use of deliberative theory. However, the deliberative approach has been criticized from an agonistic perspective for neglecting the role of emotions in political discussions. Deliberative theorists have in turn responded to this critique and argued that the agonistic approach tends to put too much emphasis on students’ emotions and identities in political discussions. Recently, as a contribution to this debate, the idea of assimilating agonism with deliberation has been suggested as a way of overcoming the differences between agonism and deliberative theory.

    The purpose of this paper is to contribute to the educational debate between agonism and deliberative theory by exploring the deliberative critique from the vantage point of agonism. I claim that the deliberative critique of agonism is unfounded and based on a misreading of Mouffe’s agonistic theory. Furthermore, I argue that the attempt to assimilate agonism with deliberation is not compatible with Mouffe’s agonistic theory

  • Dahlberg, Karuna
    et al.
    Örebro University, School of Health Sciences.
    Jaensson, Maria
    Örebro University, School of Health Sciences.
    Nilsson, Ulrica
    Örebro University, School of Health Sciences.
    Eriksson, Mats
    Örebro University, School of Health Sciences.
    Odencrants, Sigrid
    Örebro University, School of Health Sciences.
    Holding It Together - Patients' Perspectives on Postoperative Recovery When Using an e-Assessed Follow-Up: Qualitative Study2018In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 20, no 5, article id e10387Article in journal (Refereed)
    Abstract [en]

    Background: There is an emerging trend to perform surgeries as day surgery. After a day surgery, most of the recovery period takes place at home, and patients are responsible for their own recovery. It has been suggested that electronic health (eHealth) technologies can support patients in this process. A mobile app has recently been developed to assess and follow up on postoperative recovery after a day surgery.

    Objective: The aim of this study was to explore experiences associated with postoperative recovery after a day surgery in patients using a mobile app to assess the quality of their recovery.

    Methods: This is a qualitative interview study with an explorative and descriptive design. Participants were recruited from 4 different day surgery units in different parts of Sweden. The study included 18 participants aged >17 years who had undergone day surgery and used the Recovery Assessment by Phone Points, a mobile app for follow-up on postoperative recovery after day surgery. Participants were purposively selected to ensure maximum variation. Semistructured individual interviews were conducted. Data were analyzed using thematic analysis.

    Results: A total of two themes and six subthemes emerged from the data: (1) the theme Give it all you’ve got with the subthemes Believing in own capacity, Being prepared, and Taking action, where participants described their possibilities of participating and themselves contributing to improving their postoperative recovery; and (2) the theme The importance of feeling safe and sound with the subthemes Feeling safe and reassured, Not being acknowledged, and Not being left alone, which describe the importance of support from health care professionals and next of kin.

    Conclusions: It is important that patients feel safe, reassured, and acknowledged during their postoperative recovery. They can achieve this themselves with sufficient support and information from the health care organization and their next of kin. Using a mobile app, both for assessment and to enable contact with the day surgery unit during the postoperative recovery period, can improve care and create a feeling of not being alone after surgery. We propose that postoperative recovery starts in the prerecovery phase when patients prepare for their recovery to get the best possible outcome from their surgery.

  • Holmberg, John
    et al.
    Chalmers University of Technology, Gothenburg, Sweden.
    Larsson, Jörgen
    Gothenburg University, Gothenburg, Sweden.
    Nässén, Jonas
    Chalmers University of Technology, Gothenburg, Sweden.
    Svenberg, Sebastian
    Gothenburg University, Gothenburg, Sweden.
    Andersson, David
    Chalmers University of Technology, Gothenburg, Sweden.
    Klimatomställningen och det goda livet2011Report (Other academic)
  • Gillå, Cristina
    et al.
    Landstiget Värmland.
    Lind, Maria
    Region Örebro län.
    Lindgren Fändriks, Anna
    Landstinget Värmland.
    Källström, Åsa
    Örebro University, School of Law, Psychology and Social Work.
    Anderzen-Carlsson, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Almqvist, Kjerstin
    Karlstad University, Karlstad, Sweden.
    Att inom Barnhälsovården i Landstinget Värmland och Region Örebro län fråga om våld i nära relationer2018Report (Other academic)
  • Kristoffersson, Eleonor
    Örebro University, School of Law, Psychology and Social Work.
    Observatory for the protection of taxpayers' rights: National report of Sweden2018In: Obesrvatory on the protection of taxpayers' rights / [ed] Pasquale Pistone, Philip Baker, International Bureau of Fiscal Documentation (IBFD), 2018Conference paper (Refereed)
  • Tano, Sofia
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Economics, Umeå, Sweden.
    Migration and Regional Sorting of Skills2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis consists of an introductory part and four papers.

    Paper [I] estimates jointly the choice of whether to enroll in education and the choice of location among young people. Being a particularly mobile group, the location choices of young individuals shape much of the regional distribution of human capital, growth, and local public sector budgets. Applying Swedish register data on nest leavers, we seek to determine factors deciding the education and location choice of young people. The results indicate a systematic selection higher education based on school grades and preferences for locations with higher per capita tax bases and with lower shares of elderly people. The importance of family networks for the choice of location is confirmed.             

    Paper [II] examines how individual ability, reflected by the grade point average (GPA) from comprehensive school affects the probability of migration among university graduates. The econometric analysis applies detailed micro-data of two entire cohorts of young individuals retrieved from the Swedish population registers. The results indicate that individual abilities are strongly influential both concerning completion of a university degree and for the migration decision. In addition, we find a positive relationship between the GPA and migrating from regions with lower per capita tax bases and/or a relatively small share of highly educated individuals. Analogously, individuals with a high GPA tend to stay in more densely populated regions, suggesting a clustering of human capital vis-à-vis school grades. 

    Paper [III] estimates the relationship between migration across labour market regions and the subsequent changes in earnings by using the GPA from the final year of comprehensive school as a proxy for ability. This measure aims to capture heterogeneity in the returns to migration for individuals conditional on education attainment. Using Swedish register data on young adults, a difference-in-difference propensity score matching estimator is applied to estimate income differences measured up to seven years after migration. The results show variation between different ability groups regarding the returns to regional migration. There are indications of larger gains for individuals holding top grades, while the bottom half seems to benefit less, or face slightly negative effects.

    Paper [IV] examines whether power couple formation and the location choice of such couples are driven by factors already inherent in young people during their formative school years. The paper also extends the analysis by modeling location choice among different sizes of labor market areas, given different power statuses of the couples. Based on analysis of Swedish register data, we produce evidence that power spouses evolve from the population of high achieving school age individuals; the latter is identified by high academic performance during their years of compulsory school. Regarding location choice, the results indicate that power couples display a relatively high tendency to migrate from their regions of origin to large cities.

    List of papers
    1. Regional sorting of human capital: the choice of location among young adults in Sweden
    Open this publication in new window or tab >>Regional sorting of human capital: the choice of location among young adults in Sweden
    2014 (English)Report (Other academic)
    Abstract [en]

    Migration rates are highest among young adults, especially students, and their location choices affect the regional distribution of human capital, growth and local public sector budgets. Using Swedish register data on young adults, the choice of whether to enroll in education and the choice of location are estimated jointly. The results indicate a systematic selection into investment in further education based on school grades and associated preferences for locations with higher per capita tax bases. For students, the estimates indicate lower preferences for locations with higher shares of older people.  The importance of family networks for the choice of location is confirmed. 

    Place, publisher, year, edition, pages
    Umeå: Umeå University, 2014. p. 25
    Series
    Umeå economic studies, ISSN 0348-1018 ; 878
    Keywords
    Agglomeration, human capital, local public sector, location choice
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66556 (URN)
    Funder
    Swedish Research CouncilSwedish Research Council Formas
    Available from: 2018-04-12 Created: 2018-04-12 Last updated: 2018-05-07Bibliographically approved
    2. Regional Clustering of Human Capital: School Grades and Migration of University Graduates
    Open this publication in new window or tab >>Regional Clustering of Human Capital: School Grades and Migration of University Graduates
    2014 (English)Report (Other academic)
    Abstract [en]

    The spatial distribution of human capital plays a fundamental role for regional differences in economic growth and welfare. This paper examines how individual ability indicated by the grade point average (GPA), from comprehensive school, affects the probability of migration among young university graduates in Sweden. Using detailed micro data available from the Swedish population registers, the study examines two cohorts of individuals who enrol in tertiary education. The results indicate that individual abilities reflected by the GPA are strongly influential when it comes to completing a university degree and for the migration decision after graduation. Moreover, there is a positive relationship between the GPA and the choice of migrating from regions with a relatively low tax base and a relatively small share of highly educated people in the population. Analogously, individuals with a high GPA tend to stay at a higher rate in more flourishing regions.

    Place, publisher, year, edition, pages
    Umeå: Umeå University, 2014. p. 25
    Series
    Umeå economic studies, ISSN 0348-1018 ; 879
    Keywords
    Bivariate probit, individual ability, migration, regional clustering, university graduates
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66554 (URN)
    Note

    This study is part of a project “Higher Education and Regional Economies” supported by the Academy of Finland.

    Available from: 2018-04-12 Created: 2018-04-12 Last updated: 2018-05-07Bibliographically approved
    3. Internal Migration of Young Adults: Heterogeneity in Effects on Labour Income by School Grades
    Open this publication in new window or tab >>Internal Migration of Young Adults: Heterogeneity in Effects on Labour Income by School Grades
    2014 (English)Report (Other academic)
    Abstract [en]

    The present paper estimates the relationship between migration across labour-market regions and the subsequent changes in earnings in Sweden by using the individual’s grade point average (GPA) from the final year of comprehensive school as a proxy for ability. This measure aims to capture heterogeneity in the effects of mobility on earnings for individuals conditional on educational attainment and other observed traits. Register data from Sweden, including two whole cohorts of individuals, is used. A difference-in-difference propensity score matching estimator is applied to estimate the relationship between income and migration up to seven years after migrating. The results show variation between different ability groups with respect to the return to regional migration. There are indications of larger gains for individuals holding top grades, while the bottom half seems to benefit less, or have slightly negative returns. The difference in return to migration across GPA quartiles is larger for women than for men.

    Place, publisher, year, edition, pages
    Umeå: Umeå University, 2014. p. 28
    Series
    Umeå Economic Studies, ISSN 0348-1018 ; 880
    Keywords
    Human capital, income, internal migration, propensity score matching
    National Category
    Economics
    Research subject
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66551 (URN)
    Available from: 2018-04-12 Created: 2018-04-12 Last updated: 2018-05-07Bibliographically approved
    4. Back to the Future: Migration, Matching and the Power Couple Phenomenon in Sweden
    Open this publication in new window or tab >>Back to the Future: Migration, Matching and the Power Couple Phenomenon in Sweden
    2014 (English)Report (Other academic)
    Abstract [en]

    This paper contributes to a recent and growing literature addressing the phenomenon of high-credentialed power couples. It seeks to determine the extent to which precursors of power couple formation and location choice of couples at midlife are evident in young people during their formative school years. Its second objective is to extend the analysis of location choice by modeling location choice among different sizes of labor market areas, given different power status of the couples.

    Based on analysis of Swedish register data, we produce evidence that power spouses evolve from the population of high achieving school age individuals, the latter identified by high academic performance during the years of compulsory schooling. Other factors such as parental education and family income also play a role. In addition, there appear to be regional disparities in the evolution of power couples. The evidence also points to the presence self-selection arising from unmeasured heterogeneity, both in spouse matching and to a lesser extent in location choice. Regarding location choice, the results indicate that power couples display a disproportionate tendency to migrate from their regions of origin to large cities.

    Place, publisher, year, edition, pages
    Umeå: Umeå universitet, 2014. p. 27
    Series
    Umeå Economic Studies, ISSN 0348-1018 ; 881
    Keywords
    Early markers, education, location choice, marital matching
    National Category
    Economics
    Identifiers
    urn:nbn:se:oru:diva-66547 (URN)
    Available from: 2018-04-11 Created: 2018-04-11 Last updated: 2018-05-07Bibliographically approved
  • Tsertsidis, Antonios
    et al.
    Örebro University, Örebro University School of Business.
    Kolkowska, Ella
    Örebro University, Örebro University School of Business.
    Hedström, Karin
    Örebro University, Örebro University School of Business.
    Technologies used by elderly to support aging in place and their functions: A systematic literature review2018In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 17, no Suppl., p. 145s-145sArticle, review/survey (Refereed)
  • Uggla, Ylva
    Örebro University, School of Humanities, Education and Social Sciences. Evironmental Sociology Section.
    Framing and visualising biodiversity in EU policy2018In: Journal of Integrative Environmental Sciences, ISSN 1943-815X, E-ISSN 1943-8168, Vol. 15, no 1, p. 103-122Article in journal (Refereed)
    Abstract [en]

    This study seeks insights into how biodiversity is framed and visualised in EU policy. The paper presents analysis of both the visual content and written text of two brochures summarising two central EU biodiversity policy documents. The study illustrates how the two modes of communication differ. First, the written text primarily presents an anthropocentric and economic framing of biodiversity values, whereas the visual material generally features the beauty and wonders of nature. Second, the written text strongly emphasises the threats to biodiversity and the detrimental side of human activity, whereas the visual material generally shows close relationships between humans and nature, with humans engaged in small-scale outdoor activities. The analysis illustrates how various representations of biodiversity intersect in the same context, and that the visual representation decontextualises the issue of biodiversity loss from the human exploitation of natural resources and the concrete actions and processes causing it.

  • 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
    Keywords
    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
    Show others...
    (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: 2018-06-18Bibliographically approved
    3. Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study
    Open this publication in new window or tab >>Internet delivered transdiagnostic treatment with telephone support for pain patients 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
    Keywords
    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: 2018-06-08Bibliographically approved
  • Andersson, Joacim
    et al.
    Örebro University, School of Health Sciences.
    Garrison, Jim
    Virginia Polytechnic Institute and State University, USA.
    Östman, Leif
    Uppsala University, Uppsala, Sweden.
    Empirical Philosophical Investigations in Education and Embodied Experience2018Book (Refereed)
    Abstract [en]

    Chapter 1

     This chapter explores some of the most interesting intersections between the philosophy of John Dewey and the later Ludwig Wittgenstein. Practical epistemological analysis (PEA), Situated Epistemic Relations (SER), and Situated Artistic Relations (SAR) examine learning primarily as a sociolinguistic practice. Since it is a sociolinguistic practice, much of both the product and the process of learning are plainly visible to sophisticated methodological observation. This chapter emphasizes the primacy of practice in comprehending linguistic meaning (i.e., forms of life, language-games, meaning as use, etc.), the rejection of a private language, antifoundationalism, and epistemological contextualism, action, and antirepresentationalism. It establishes the philosophical framework for our analytical method developed in Chap. 3  and assumed in Chap. 4 .

  • Pettersson, Nicklas
    Stockholm University, Stockholm, Sweden.
    Some results from simulations with kernel imputation2010In: Workshop on Survey Sampling Theory and Methodology: August 23-27, 2010, Vilnius, Vilnius, Lithuania: Statistics Lithuania , 2010Conference paper (Refereed)
    Abstract [en]

    This paper presents someresults from the use of kernel imputation with boundary adjustment. The simulationsshow promising results and the method usually behaves equal to or better thancompetitive methods.

  • Björklund, Johanna
    et al.
    Örebro University, School of Science and Technology.
    Eksvärd, Karin
    Inspire Action and Research AB, Knivsta, Sweden.
    Schaffer, Christina
    Department of Physical Geography, Stockholm University, Stockholm, Sweden.
    Exploring the potential of edible forest gardens: experiences from a participatory action research project in Sweden2018In: Agroforestry Systems, ISSN 0167-4366, E-ISSN 1572-9680Article in journal (Refereed)
    Abstract [en]

    To meet the environmental challenges that are presently confronting society, the narrow focus on agricultural production needs to be altered to one that places equal value on the generation of crucial ecosystem services. Current research shows that perennial intercropping systems such as agroforestry may be a feasible alternative. Based on studies during the establishment of edible forest gardens in 12 participating farms in Sweden, this paper explores the potential of utilizing multi-strata designs for food production in temperate, highincome countries. Design and species composition of such gardens, types of food they provide, and how they would best fit into the present landscape are discussed. Factors for success and major problems related to the establishment are shared. Potential benefits were found to be closely related to a thorough analysis of the social and ecological contexts before establishment. Characteristics of the site and goals of the garden need to guide species and design choices. If forest garden approaches to food production should contribute to more than local selfsufficiency, the gardens need to increase in scale. Marginal lands and transitions areas between different land uses may be appropriate. Large knowledge gaps concerning potential production, social and economic benefits, and agronomic issues were identified.

  • Andrén, Thomas
    The Swedish Confederation of Professional Associations (Saco), Stockholm, Sweden.
    Inkomstförsäkringars effekt på arbetslöshet och matchning2015In: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, Vol. 21, no 1, p. 54-71Article in journal (Refereed)
    Abstract [sv]

    Inkomsttaket i den allmänna arbetslöshetsförsäkringen är idag så lågt att få individer erhåller 80 procent av tidigare lön. Det har drivit fram alternativa lösningar för inkomstbortfall vid arbetslöshet där fackförbunden idag erbjuder sina medlemmar kompletterande kollektiva inkomstförsäkringar med högre inkomsttak. I den här artikeln undersöks dels om dessa försäkringar är associerade med längre arbetslöshetsperioder, dels om sannolikheten för återfall i nya ersättningsperioder påverkas.

  • Asiimwe, Edgar Napoleon
    et al.
    Örebro University, Örebro University School of Business.
    Grönlund, Åke
    Örebro University, Örebro University School of Business.
    Hatakka, Mathias
    Dalarna University, Sweden.
    Practices and challenges in an emerging m-learning environment2017In: ijEDict - International Journal of Education and Development using Information and Communication Technology, ISSN 1814-0556, E-ISSN 1814-0556, Vol. 13, no 1, p. 103-122Article in journal (Refereed)
    Abstract [en]

    This study reports an interpretative case study investigating practices and challenges in an emerging m-learning environment at Makerere University in Uganda. The research was part of the MobiClass pilot project. Data was collected by means of observations and interviews with teachers and various m-learning support staff, including teacher trainers, systems administrators and a software developer. The Framework for Rational Analysis of Mobile Education (FRAME) is used as an analytic framework. The research focuses on how learning content management systems (LCMS) are implemented and used for m-learning purposes. We observed teacher training and m-learning content development practices and found that teacher skills for developing educational content, institutional m-learning policies and training programs are crucial success factors. The main finding is the importance of the support staff; it takes a long time to implement new technology and change teaching practices, support staff is needed to manage, inspire and support student and teachers.

  • Berg, Monika
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Lidskog, Rolf
    Örebro University, School of Humanities, Education and Social Sciences.
    Pathways to deliberative capacity: the role of the IPCC2018In: Climatic Change, ISSN 0165-0009, E-ISSN 1573-1480, Vol. 148, no 1-2, p. 11-24Article in journal (Refereed)
    Abstract [en]

    This article explores the arguments for expanding deliberation in the Intergovernmental Panel on Climate Change (IPCC) and scrutinizes their implications for the deliberative capacity of global environmental governance (GEG). An analysis of the IPCC is presented that builds on a systematic literature review and thus a broad set of scientific debates concerning the IPCC. Based on this analysis, two different paths are outlined, one moderate and one radical; these paths ascribe different democratizing functions to the IPCC and rely on different epistemologies. The moderate path emphasizes decision capacity, whereas the radical path strives to create deliberative space and to identify the value inherent in different claims. It is argued that the IPCC cannot accommodate the aspirations of these different pathways in a single assessment. Parallel assessments must be developed in complementary subject areas with different science-policy relations.

  • Alexopoulou, Sofia
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Fart, Frida
    Örebro University, School of Medical Sciences.
    Jonsson, Ann-Sofie
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Karni, Liran
    Örebro University, Örebro University School of Business.
    Kenalemang, Lame Maatla
    Örebro University, School of Humanities, Education and Social Sciences.
    Krishna, Sai
    Örebro University, School of Science and Technology.
    Lindblad, Katarina
    Örebro University, School of Music, Theatre and Art.
    Loutfi, Amy
    Örebro University, School of Science and Technology.
    Lundin, Elin
    Örebro University, School of Health Sciences.
    Samzelius, Hanna
    Örebro University, School of Humanities, Education and Social Sciences.
    Schoultz, Magnus
    Örebro University, School of Humanities, Education and Social Sciences.
    Spang, Lisa
    Örebro University, School of Health Sciences.
    Söderman, Annika
    Örebro University, School of Health Sciences.
    Tarum, Janelle
    Örebro University, School of Health Sciences.
    Tsertsidis, Antonios
    Örebro University, Örebro University School of Business.
    Widell, Bettina
    Örebro University, School of Humanities, Education and Social Sciences.
    Nilsson, Kerstin (Editor)
    Örebro University, School of Medical Sciences.
    Successful ageing in an interdisciplinary context: popular science presentations2018Book (Other (popular science, discussion, etc.))
  • Bergh, Andreas
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Wahlström, Ninni
    Department of Education, Linnaeus University, Växjö, Sweden.
    Conflicting goals of educational action: a study of teacher agency from a transactional realism perspective2018In: Curriculum Journal, ISSN 0958-5176, E-ISSN 1469-3704, Vol. 29, no 1, p. 134-149Article in journal (Refereed)
    Abstract [en]

    This study focuses on the different ways in which teachers relate their situational agency and professional assignment to the national curriculum content and curriculum dilemmas. It builds theoretically on transactional realism and empirically on analyses of interviews with teachers, exploring the nature of teacher agency during the enactment of a new Swedish curriculum reform. To uphold a dual perspective of teachers’ relation to the curriculum as both collectively and individually experienced and as both an ideal and realistic–practical relation, we term the future as ‘projective experiences’, the presence as ‘practical-evaluative experiences’ and the past ‘iterational experiences’ in relation to agency. Especially, we are interested in the ‘what’ in the curriculum – what the teachers find intriguing, important or impossible and what affects how they relate to the curriculum as part of the multidimensional structures influencing their agency. This approach reveals that the crucial issue of teacher agency is related to the policy discourse on knowledge and equity as standards and the uniformity of assessment and its pedagogical consequences.

  • Bergh, Andreas
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Löfdahl Hultman, Annica
    Faculty of Art and Social Sciences, Karlstad University, Karlstad, Sweden.
    Englund, Tomas
    Örebro University, School of Humanities, Education and Social Sciences.
    Local enactment of the Swedish ‘advanced teacher reform’2018In: Journal of Curriculum Studies, ISSN 0022-0272, E-ISSN 1366-5839Article in journal (Refereed)
    Abstract [en]

    This article focuses on a new form of governing that targets a selected group of teachers. Specifically, it analyses how the Swedish so-called advanced teacher reform is enacted at the local level and discusses its implications for teachers’ professionalism. The methodological approach enables a local analysis in a broader international policy context. Using characteristic elements from curriculum theory to analyse the relationship between different levels and elaborating on the linguistic turn of curriculum theory, three concepts are central in the analysis: enactment, linguistic criteria and professionalism. Empirically, the study draws on material from a two-year application process in a medium-sized municipality. The result demonstrates that the local enactment process is clearly influenced by transnational policy trends and that less allowance is made for teachers’ own experience-based knowledge in the second studied year. The linguistic analysis shows how the applicants using the ‘right concepts’ were selected to become ‘advanced teachers’. As complex and qualitative aspects disappeared from the agenda, this type of governing, with its standardized use of language, may reduce schools’ educational potential. Changes like this raise new questions about how schools can maintain and develop democratic and professional values whilst being exposed to new policy trends.

  • 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.

  • Nicklas, Lindgren
    et al.
    Örebro University, School of Humanities, Education and Social Sciences.
    Öhman, Johan
    Örebro University, School of Humanities, Education and Social Sciences.
    A posthuman approach to human-animal relationships: advocating critical pluralism2018In: Environmental Education Research, ISSN 1350-4622, E-ISSN 1469-5871Article in journal (Refereed)
    Abstract [en]

    This paper contributes to the debate about the absence of nonhuman animals (The term ‘nonhuman animal’ is used to emphasise the interconnection with the human being, viewed as a human animal. Using this terminology does not avoid a homogenising, stereotyping and simplifying of a multiplicity of animal (and human) beings. Nonetheless, we think that such a ‘simplification’ of concepts is inescapable in academic discussions concerning humans and nonhuman animals.) in environmental and sustainable education (ESE) and the challenge of the anthropocentric characterisation of European education. Relating to the debate about a pluralistic approach in ESE as a ‘one-species only pluralism’, we draw on Val Plumwood’s ecofeministic dialogical interspecies ethics and Rosi Braidotti’s understanding of a posthuman/ nomadic subjectivity. By regarding ‘difference’ as a constituting force, we present a ‘critical pluralistic’ approach to human-animal relationships in ESE. Instead of drawing new lines of moral consideration for nonhuman beings, an ethical and political appreciation of what nonhuman others can do in ESE is suggested. Recommendations for educational practice are to recognise nonhuman agency to reveal political and ethical dimensions, recognise the agency of non-living animals and stay in conflicts and ‘study up’ and develop an immanent critique, which could lead to alternative pedagogical approaches to human-animal relationships in different cross-curricula settings.

  • 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.

  • 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
    Keywords
    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
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    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
    Keywords
    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
  • Vrettou, Maria
    et al.
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Nillson, Kent W.
    Västerås Centre for Clinical Research, Uppsala University, Västerås, Sweden.
    Tuvblad, Catherine
    Department of Psychology, University of Southern California, Los Angeles, United States.
    Rehn, Mattias
    Västerås Centre for Clinical Research, Uppsala University, Västerås, Sweden.
    Andershed, Anna-Karin
    Örebro University, School of Law, Psychology and Social Work.
    Wallén-Mackenzie, Åsa
    Department of Organismal Biology, Uppsala University, Uppsala, Sweden.
    Andershed, Henrik
    Örebro University, School of Law, Psychology and Social Work.
    Nylander, Ingrid
    Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden.
    Comasco, Erika
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    VGLUT2 genotype interacts with environmental experiences to predict alcohol misuse in young adults2016In: ISBRA ESBRA World Congress on Alcohol an Alcoholism, Berlin, Germany, 2016Conference paper (Other academic)
    Abstract [en]

    The heritability of alcohol use disorder (AUD) ranges between 40 to 60%, as demonstrated by twin studies. Environmental factors are hence of importance for the developmental trajectory of the disorder. Gene-by-environment interactions indeed influence neuroplasticity and determine the individual’s susceptibility or resilience to AUD. Lately, a role of Vesicular Glutamate Transporter 2 (VGLUT2)-mediated neurotransmission has been indicated in studies of addiction- and alcohol-related phenotypes. We previously demonstrated an association between the single nucleotide polymorphism (SNP) rs2290045 in the VGLUT2 gene and alcohol dependence as well as showed an interaction effect between voluntary ethanol drinking and early life stress on Vglut2 expression in the ventral tegmental area of outbred rats. In the present study, using a population-based, cross-sectional and retrospective design, we aimed to investigate the association between two candidate VGLUT2 SNPs, rs1900586 and rs2290045, and aversive as well as supportive environmental factors on alcohol misuse in young adults. A total of 2,500 (52.6% females) individuals (mean age: 22.15 years) were included in the study. Aversive life events (i.e., physical violence, verbal aggression, witnessing violence) and parent-child relationship (i.e., early: until 18 years of age; lifetime: until present) were self-reported. Alcohol misuse was assessed using the AUD Identification Test (AUDIT). Preliminary results showed no main genotype effects on drinking profile. Multivariable analyses revealed that SNP rs1900586 interacted with exposure to verbal aggression and early parent-child relationship in respect to AUDIT scores. Male carriers of the major (T) allele reported higher AUDIT scores when exposed to verbal aggression and poor early parent-child relationship than the C carriers exposed to the same environment, while the opposite pattern was noted in the presence of supportive parent-child relationship. In individuals with symptoms of dependence or harmful alcohol use, SNP rs1900586 interacted with exposure to physical violence and parent-child relationship (early and lifetime) in both sexes. The same interaction effect was detected for SNP rs2290045 in females. These preliminary findings provide the first evidence that VGLUT2 genotype moderates the environmental sensitivity to alcohol misuse among young adults and call for further investigation in independent cohorts, including clinical samples.

  • Jussila, Jari L.
    et al.
    Tampere University of Technology, Tampere, Finland.
    Kärkkäinen, Hannu
    Tampere University of Technology, Tampere, Finland.
    Aramo-Immonen, Heli
    Tampere University of Technology, Tampere, Finland.
    Huthamäki, Jukka
    Tampere University of Technology, Tampere, Finland.
    Tuottavuusloikka sosiaalisen median avulla2015In: TiedeAreena 2015 / [ed] Maria Väkiparta, Tampere, Finland: Tampere University of Technology, 2015, , p. 35p. 26-27Chapter in book (Other academic)
  • Tuomi, Pauliina
    Tampere University of Technology, Tampere, Finland.
    Häyrynen, Maunu
    University of Turku, Turku, Finland.
    Jussila, Jari
    Tampere University of Technology, Tampere, Finland.
    Kalliola, Satu
    Tampere University, Tampere, Finland.
    Kiili, Kristian
    Tampere University of Technology, Tampere, Finland.
    Lipping, Tarmo
    Tampere University of Technology, Tampere, Finland.
    Repka, Sari
    University of Turku, Turku, Finland.
    Saarikoski, Petri
    University of Turku, Turku, Finland.
    Seppänen, Marko
    Tampere University of Technology, Tampere, Finland.
    Sivula, Anna
    University of Turku, Turku, Finland.
    Siivonen, Salla
    University of Turku, Turku, Finland.
    Soini, Jari
    Tampere University of Technology, Tampere, Finland.
    TiedeAreena 20162016Collection (editor) (Other academic)
  • 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
    Keywords
    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
    Keywords
    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
  • Bergström, Gunnar
    et al.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Lohela-Karlsson, M.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Kwak, L.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bodin, Lennart
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Jensen, I.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Torgén, Margareta
    Department of Medical Science, Uppsala University, Uppsala, Sweden.
    Nybergh, L.
    Division of Intervention and Implementation Research in Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden..
    Preventing sickness absenteeism among employees with common mental disorders or stress-related symptoms at work: Design of a cluster randomized controlled trial of a problem-solving based intervention versus care-as-usual conducted at the Occupational Health Services2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, no 1, article id 436Article in journal (Refereed)
    Abstract [en]

    Background: Common mental disorders (CMDs) are among the leading causes of sick leave in Sweden and other OECD countries. They result in suffering for the individual and considerable financial costs for the employer and for society at large. The occupational health service (OHS) can offer interventions in which both the individual and the work situation are taken into account. The aim of this paper is to describe the design of a study evaluating the effectiveness of an intervention given at the OHS to employees with CMDs or stress-related symptoms at work. In addition, intervention fidelity and its relation to the outcome will be assessed in a process analysis.

    Methods: The study is designed as a cluster randomized trial in which the participating OHS consultants are randomized into either delivering the intervention or performing care as usual. Employees with CMDs or stress-related symptoms at work are recruited consecutively by the OHS consultants. The intervention aims to improve the match between the employee and the job situation. Interviews are held individually with the employee and the nearest supervisor, after which a joint meeting with both the employee and the supervisor takes place. A participatory approach is applied by which the supervisor and the employee are guided by the OHS consultant and encouraged to actively take part in problem solving concerning the work situation. Outcomes will be assessed at baseline and at six and 12 months. A long-term follow-up at 3 years will also be performed. The primary outcome is registered sickness absence during a 1-year period after study inclusion. Secondary outcomes are mental health and work ability. The intervention's cost effectiveness, compared to treatment as usual, both for society and for the employer will be evaluated. A process evaluation by both the OHS consultants and the employee will be carried out.

    Discussion: The study includes analyses of the effectiveness of the intervention (clinical and economic) as well as an analysis of its implementation at the participating OHSs. Possible methodological challenges such as selection bias and risk of contamination between OHS consultants delivering the experimental condition and consultants giving usual care are discussed.

  • Fredriksson, Ingela
    et al.
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden.
    Geidne, Susanna
    Örebro University, School of Health Sciences.
    Eriksson, Charli
    Örebro University, School of Health Sciences.
    Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no Suppl. 20, p. 72-79Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden.

    Methods: In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents (n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis.

    Results: As part of the youth centres’ strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills.

    Conclusions: There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people’s background and life situation plays a role for their participation in leisure time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

  • Seger, Karin
    Örebro University, Örebro University School of Business.
    Institutional Logics and Accounting Professionals: The case of K2 and K32018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Accounting firms have long been considered a ‘black box’ in the literature, but over the last two decades or so, a growing body of literature has emerged which points to how the accounting profession may be seen as a profession in transformation, one in which the underlying logic of their work has gone from emphasizing professional values to one in which commercial values constitute the main rules of the game.

    This thesis draws upon and add to this literature as it directs attention to how co-existing and potentially conflicting institutional logics enable and constrain accounting professionals, in practice and over time. To allow this, I have conducted a qualitative and processual study of the process of converting the existing financial accounting practices for small limited companies in Sweden through new standards - K2 and K3. The scientific purpose has been to generate a micro-oriented and processual modelling of how accounting professionals influence and shape accounting practices in small limited companies, and to identify and theorize on the type of institutional logics underlying their work. My empirical findings show that the professionals influence and shape accounting practices by proposing and proclaiming suitable solutions, and by pre-packaging and marketing these as definite solutions. They also show that the construction of such solutions involves long and complex processes, during which the professionals interpret and judge different alternatives before marketing them to their clients. And from the institutional logics perspective, they show that the process may be understood as one in which the professionals mainly try to live up to professional rather than commercial expectations.

    Based on these findings, a number of contributions to the literature are identified, relating to how accounting professionals are enabled and constrained by the professional logic, how the effects of logics are highly non-deterministic, and how a single logic may generate tensions within itself even though it is predominant and not in conflict with other logics.

  • Vimefall, Elin
    Örebro University, Örebro University School of Business.
    Child education, child labor and the agricultural economy2016Report (Other academic)
    Abstract [en]

    Over the last decades, we have seen impressive progress in development around the world, and the proportion of people living in poverty (on less than $1.25 a day) has decreased from 36 percent in 1990 to 18 percent in 2010. However, this progress has been unequal, and a large part of the change is due to the development of some Asian countries, while most countries in Africa have seen more modest development. In sub- Saharan Africa, approximately 48 percent of the population still lives on less than $1.25 a day (UN 2014). There is also considerable inequality within countries. For example, in Kenya, the richest 10 percent of the population receives an estimated 40 percent of total income (World Bank 2014). Most poor people live in rural parts of the country, and they are more likely to be women, children, or members of a minority ethnic group. The research presented in this brief focus on these individuals, the most vulnerable in society. The paper draws substantially from my Ph.D. dissertation “Essays on Child Education, Child Labor and the Agricultural Economy”. The dissertation consists of four separate papers, with somewhat different focus. The first two papers focus on children and human capital, while the other two focus on the agricultural economy. In the first paper we ask whether children from different ethnolinguistic backgrounds have different probabilities of being in school. In the second paper I examine the connection between income diversification and working children. In the third paper I look at income diversification among female-headed households. In the last paper we analyze how different groups of households are affected when the price of maize increases.

  • Kågebro, Elin
    et al.
    Örebro University, Örebro University School of Business.
    Vredin Johansson, Maria
    Nationalekonomiska institutionen, Uppsala universitet, Uppsala, Sweden.
    Ekonomiska verktyg som beslutsstöd i klimatanpassningsarbetet: en metodöversikt2008Report (Other academic)
    Abstract [sv]

    En hel del anpassning till framtidens förändrade klimat kommer att ske successivt och självmant i respons på upplevda klimatförändringar. I många fall kan det fungera utmärkt men för investeringar och åtgärder med relativt lång livstid (säg mer än 25 år) och för investeringar och åtgärder som är känsliga för väderextremer ökar klimatförändringarna behovet av planering och framförhållning. I sådana situationer kan ekonomiska beslutsmodeller, som syftar till att fungera som planerings- och prioriteringsverktyg, vara till nytta för beslutsfattarna. I den här rapporten beskriver vi de vanligaste ekonomiska beslutsmodellerna; kostnadsnyttoanalys (CBA), kostnadseffektanalys (CEA) och multikritera-analys (MCA). Genom att tillhandahålla genomarbetade beslutsunderlag tror vi att dessa modeller kan förenkla beslut som rör klimatanpassningsåtgärder. Beskrivningarna kommer att tjäna som underlag för det fortsatta arbetet med att ta fram verktyg som kan användas på lokal nivå för klimatanpassningsbeslut inom Climatools.

  • 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
    Keywords
    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
    Keywords
    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
    Show others...
    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
    Keywords
    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
    Show others...
    (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
  • Hernandez Bennetts, Victor
    et al.
    Örebro University, School of Science and Technology.
    Lilienthal, Achim
    Örebro University, School of Science and Technology.
    Khaliq, Ali Abdul
    Örebro University, School of Science and Technology.
    Pomareda Sese, Victor
    Institute for Bioengineering of Catalonia (IBEC), Barcelona, Spain.
    Trincavelli, Marco
    Örebro University, Örebro, Sweden..
    Gasbot: A Mobile Robotic Platform for Methane Leak Detection and Emission Monitoring2012In: Proceedings of the IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS), Workshop on Robotics for Environmental Monitoring (WREM), Vilamoura, Portugal, October 7-12, 2012, 2012Conference paper (Refereed)
    Abstract [en]

    Due to its environmental, economical and safety implications, methane leak detection is a crucial task to address in the biogas production industry. In this paper, we introduce Gasbot, a robotic platform that aims to automatize methane emission monitoring in landfills and biogas production sites. The distinctive characteristic of the Gasbot platform is the use of a Tunable Laser Absorption Spectroscopy (TDLAS) sensor, along with a novel gas distribution algorithm to generate methane concentration maps of indoor and outdoor exploration areas. The Gasbot platform has been tested in two different scenarios: an underground corridor, where a pipeline leak was simulated and in a decommissioned landfill site, where an artificial methane emission source was introduced.

  • Saarinen, Jari
    et al.
    Department of Automation and Systems Technology, Aalto University, Alto, Finland.
    Andreasson, Henrik
    Örebro University, School of Science and Technology.
    Lilienthal, Achim
    Örebro University, School of Science and Technology.
    Independent Markov Chain Occupancy Grid Maps for Representation of Dynamic Environments2012In: 2012 IEEE/RSJ International Conference on Intelligent Robots and Systems, New York, USA: IEEE, 2012, p. 3489-3495Conference paper (Refereed)
    Abstract [en]

    In this paper we propose a new grid based approach to model a dynamic environment. Each grid cell is assumed to be an independent Markov chain (iMac) with two states. The state transition parameters are learned online and modeled as two Poisson processes. As a result, our representation not only encodes the expected occupancy of the cell, but also models the expected dynamics within the cell. The paper also presents a strategy based on recency weighting to learn the model parameters from observations that is able to deal with non-stationary cell dynamics. Moreover, an interpretation of the model parameters with discussion about the convergence rates of the cells is presented. The proposed model is experimentally validated using offline data recorded with a Laser Guided Vehicle (LGV) system running in production use.

  • Björkvall, Anders
    Örebro University, School of Humanities, Education and Social Sciences.
    Critical genre analysis of management texts in the public sector: Towards a theoretical and methodological framework2018In: Kritiska text- och diskursstudier / [ed] Wojahn, Daniel, Seiler Brylla, Charlotta & Westberg, Gustav, Huddinge, Sweden: Södertörns högskola , 2018, 1, p. 57-79Chapter in book (Refereed)
    Abstract [en]

    An emerging genre at Swedish public authorities – ‘platform of values’ (Swedish ‘värdegrund’) or ‘value statement’/‘core values’ – functions as a backdrop to the theoretical and methodological discussions in this paper. The paper argues for the development of a critical genre analysis that goes beyond being primarily descriptive and that has its main expla- natory value at a level of generality above mode-specific features of, for instance, language or images. Based on a review of how the term ‘critical’ has been defined and applied in relation to genre in critical discourse analysis/studies (CDA/CDS), multimodality, and genre studies of profes- sional communication a number of prerequisites for a critical genre analysis are formulated. Based on these prerequisites, affordance and pro- venance are put forward as ‘true’ multimodal concepts that can form the foundation for a critical genre analysis of, in this case, multimodal ‘plat- form of values’ texts. The applicability of these concepts is illustrated through an analysis of a ‘platform of value’ text from an administrative court in Sweden. 

  • Memedi, Mevludin
    et al.
    Örebro University, Örebro University School of Business.
    Tshering, Gaki
    Informatics, Business School, Örebro University, Örebro, Sweden.
    Fogelberg, Martin
    Informatics, Business School, Örebro University, Örebro, Sweden.
    Jusufi, Ilir
    Department of Computer Science and Media Technology, Linnaeus University, Växjö, Sweden.
    Kolkowska, Ella
    Örebro University, Örebro University School of Business.
    Klein, Gunnar O.
    Örebro University, Örebro University School of Business.
    An interface for IoT: feeding back health-related data to Parkinson's disease patients2018In: Journal of Sensor and Actuator Networks, ISSN 1007-7294, E-ISSN 1089-747X, Vol. 7, no 1, article id 14Article in journal (Refereed)
    Abstract [en]

    This paper presents a user-centered design (UCD) process of an interface for Parkinson’s disease (PD) patients for helping them to better manage their symptoms. The interface is designed to visualize symptom and medication information, collected by an Internet of Things (IoT)-based system, which will consist of a smartphone, electronic dosing device, wrist sensor and a bed sensor. In our work, the focus is on measuring data related to some of the main health-related quality of life aspects such as motor function, sleep, medication compliance, meal intake timing in relation to medication intake, and physical exercise. A mock-up demonstrator for the interface was developed using UCD methodology in collaboration with PD patients. The research work was performed as an iterative design and evaluation process based on interviews and observations with 11 PD patients. Additional usability evaluations were conducted with three information visualization experts. Contributions include a list of requirements for the interface, results evaluating the performance of the patients when using the demonstrator during task-based evaluation sessions as well as opinions of the experts. The list of requirements included ability of the patients to track an ideal day, so they could repeat certain activities in the future as well as determine how the scores are related to each other. The patients found the visualizations as clear and easy to understand and could successfully perform the tasks. The evaluation with experts showed that the visualizations are in line with the current standards and guidelines for the intended group of users. In conclusion, the results from this work indicate that the proposed system can be considered as a tool for assisting patients in better management of the disease by giving them insights on their own aggregated symptom and medication information. However, the actual effects of providing such feedback to patients on their health-related quality of life should be investigated in a clinical trial.

  • Hasselbladh, Hans
    et al.
    Stockholms universitet, Företagsekonomiska institutionen, Stockholm, Sweden.
    Bejerot, Eva
    Stockholms universitet, Psykologiska institutionen, Stockholm, Sweden.
    Gustafsson, R. Å.
    Bortom New Public Management: Institutionell transformation i svensk sjukvård2008Book (Refereed)
    Abstract [sv]

    Den offentliga sektorn i Sverige har präglats av förändring och turbulens sedan slutet av 1980-talet. Rationaliseringar och omstruktureringar

    har skett i stort sett all slags offentlig verksamhet. Inom forskningen sammanfattas ofta dessa förändringar med beteckningen ”New Public Management” (NPM). Bokens titel ”Bortom NPM” anspelar på att många av de metoder och förhållningssätt som sammanfattas under etiketten NPM nu är befästa och oomtvistade. Det centrala temat i vår bok är att visa hur introduktionen av NPM under 1980-talet lade grunden för längre gående förändringar inom svensk sjukvård än de ofta uppmärksammade tillämpningarna av ekonomistyrning och marknadsorientering. Det pågår en institutionell transformation av svensk sjukvård. I boken skildras framväxten av en ny transorganisatorisk styrningsregim i svensk sjukvård – förändringar som går bortom NPM. Detta mönster framträder tydligast när blicken lyfts från enskilda verksamheter, kommuner eller landsting.

    Bokens analyser bygger på en Foucaultinspirerad forskningstradition och visar hur den analyserade förändringen har skapat en diskursiv stängning kring vissa bestämda ideal, kunskapsformer och praktiker, en maktförskjutning till ett regleringslandskap bortom offentlighetens blick och en ny innebörd i att vara anställd för olika yrkesgrupper.

  • Bejerot, Eva
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stockholm, Sweden.
    Hasselbladh, HansÖrebro University, Örebro University School of Business. Stockholms universitet, Företagsekonomiska institutionen.
    Kvalitet utan gränser: en kritisk belysning av kvalitetsstyrning2002Collection (editor) (Other academic)
    Abstract [sv]

    Kvalitetsstyrning har under det senaste decenniet etablerats som en statligt sanktionerad styrdoktrin i Sverige, i USA och EU. Doktrinens språk, metoder och mål har etablerats i universitetsutbildningar, nationella kvalitetsinstitut och i lagar och föreskrifter. Eftersom kvalitetsstyrning kan omdefiniera vad organisationer är och syftar till är det viktigt att belysa området. "Kvalitet utan gränser" är den första boken på svenska med kritiska betraktelser av detta nya sätt att styra arbete. Ett antal forskare från Sverige, Norge och Danmark försöker i boken besvara frågor som: "Varför kvalitetsstyrning?" och "Vad är kvalitetsstyrning?".

  • Andersson, Tommy
    Örebro University, School of Medical Sciences.
    Atrial fibrillation and cause of death, sex differences in mortality, and anticoagulation treatment in low-risk patients2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Atrial fibrillation (AF) is the most common arrhythmia but information on cause of death in patients with AF is sparse, and whether individuals at low risk of cerebral infarction (CVL) should receive antico-agulant medication is controversial. Studies of sex differences with respect to mortality risk have shown conflicting results.

    Methods: Data were obtained from Swedish National Registers. In Study I, there were 272 186 AF patients and matched controls and in Studies II and III, 9519 AF patients and no other diagnosis and matched controls. Study IV compared treatment with warfarin to no treatment in 48 433 patients with AF. Hazard ratio (HR) was calculated with 95% confidence intervals and outcome rates as number per 1000 person-years.

    Results: Ischemic heart disease (IHD) was the most common underlying cause of death and was present in 40.2% of AF patients at a HR of 1.7 (1.4-2.1). CVL/stroke was a cause of death in 13.1%, HR 2.7 (1.8-4.0). Among underlying and contributing causes of death, the most common diagnoses were IHD in 43.5%, HR 1.7 (1.4-2.0) and heart failure in 33.1%, HR 2.9 (2.2-3.7). The HRs for mortality in females with AF in age categories ≤65, 65-74, and 75-85 were 2.15, 1.72, and 1.44, and for males 1.76, 1.36, and 1.24. The rates of mortality in females with AF in age categories 55-64, 65-74, and 75-85 were 6.2, 20.7, and 57.3, and for males 8.5, 27.3, and 64.5. In patients 65-74 years, females with a CHA2DS2-VASc score of 2, and males with a score of 1 receiving warfarin treatment showed a significantly reduced risk of cerebral infarc-tion/stroke, HR 0.46 (0.25-0.83) for females and for males, HR 0.39 (0.21-0.73).

    Conclusions: Most common causes of death in AF patients were CVL/stroke, heart failure, and IHD. HR of mortality in patients with AF was higher in females than in males but absolute risk was higher in males with AF compared to females with AF. Anticoagulant therapy was benefi-cial in patients ≥65 years, regardless of the CHA2DS2-VASc score.

    List of papers
    1. All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995-2008: a Swedish nationwide long-term case-control study
    Open this publication in new window or tab >>All-cause mortality in 272 186 patients hospitalized with incident atrial fibrillation 1995-2008: a Swedish nationwide long-term case-control study
    Show others...
    2013 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 34, no 14, p. 1061-1067Article in journal (Refereed) Published
    Abstract [en]

    Aims To evaluate long-term all-cause risk of mortality in women and men hospitalized for the first time with atrial fibrillation (AF) compared with matched controls. Methods and results A total of 272 186 patients (44% women) <= 85 years at the time of hospitalization with incidental AF 1995-2008 and 544 344 matched controls free of in-hospital diagnosis of AF were identified. Patients were followed via record linkage of the Swedish National Patient Registry and the Cause of Death Registry. Using Cox regression models, the long-term relative all-cause mortality risk, adjusted for concomitant diseases, in women vs. controls was 2.15, 1.72, and 1.44 (P < 0.001) in the age categories <= 65, 65-74, and 75-85 years, respectively. The corresponding figures for men were 1.76, 1.36, and 1.24 (P < 0.001). Among concomitant diseases, neoplasm, chronic renal failure, and chronic obstructive pulmonary disease contributed most to the increased all-cause mortality vs. controls. In patients with AF as the primary diagnosis, the relative risk of mortality was 1.63, 1.46, and 1.28 (P < 0.001) in women and 1.45, 1.17, and 1.10 (P < 0.001) in men. Conclusion Atrial fibrillation was an independent risk factor of all-cause mortality in patients with incident AF. The concomitant diseases that contributed most were found outside the thromboembolic risk scores. The highest relative risk of mortality was seen in women and in the youngest patients compared with controls, and the differences between genders in each age category were statistically significant.

    Keywords
    Atrial fibrillation, Mortality, Gender, Age, Long term
    National Category
    Cardiac and Cardiovascular Systems
    Research subject
    Cardiology
    Identifiers
    urn:nbn:se:oru:diva-38709 (URN)10.1093/eurheartj/ehs469 (DOI)000317424300014 ()23321349 (PubMedID)2-s2.0-84876218799 (Scopus ID)
    Note

    Funding agencies ar:

    AstraZeneca R&D, Mölndal, Sweden

    Örebro Heart Foundation Research and

    Committee of Örebro University Hospital

    Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2018-05-22Bibliographically approved
    2. Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: A nationwide cohort study of 9519 patients
    Open this publication in new window or tab >>Gender-related differences in risk of cardiovascular morbidity and all-cause mortality in patients hospitalized with incident atrial fibrillation without concomitant diseases: A nationwide cohort study of 9519 patients
    Show others...
    2014 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 177, no 1, p. 91-99Article in journal (Refereed) Published
    Abstract [en]

    Background: Previous studies of patients with "lone" and "idiopathic" atrial fibrillation (AF) have provided conflicting evidence concerning the development, management and prognosis of this condition.

    Methods: In this nation-wide, retrospective, cohort study, we studied patients diagnosed with incidental AF recorded in national Swedish registries between 1995 and 2008. Controls were matched for age, sex and calendar year of the diagnosis of AF in patients. All subjects were free of any in-hospital diagnosis from 1987 and until patients were diagnosed with AF and also free of any diagnosis within one year from the time of inclusion. Follow-up continued until 2009. We identified 9519 patients (31% women) and 12,468 matched controls.

    Results: Relative risks (RR) versus controls for stroke or transient ischemic attack (TIA) in women were 19.6, 4.4, 3.4 and 2.5 in the age categories <55, 55-64, 65-74 and 75-85, years respectively. Corresponding figures for men were 3.4, 2.5, 1.7 and 1.9. RR for heart failure were 6.6, 6.6, 6.3 and 3.8 in women and 7.8, 4.6, 4.9 and 2.9 in men. All RR were statistically significant with p < 0.01. RR for myocardial infarction and all-cause mortality were statistically significantly increased only in the two oldest age categories in women and 65-74 years in men.

    Conclusions: Patients with AF and no co-morbidities at inclusion had at least a doubled risk of stroke or TIA and a tripled risk of heart failure, through all age categories, as compared to controls. Women were at higher RR of stroke or TIA than men. (C) 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-SA license (http://creativecommons.org/licenses/by-nc-sa/3.0/).

    Place, publisher, year, edition, pages
    Elsevier, 2014
    Keywords
    Atrial fibrillation, Cardiovascular morbidity, Mortality, Cohort, Nationwide
    National Category
    Cardiac and Cardiovascular Systems
    Identifiers
    urn:nbn:se:oru:diva-56310 (URN)10.1016/j.ijcard.2014.09.092 (DOI)000343895000046 ()25499348 (PubMedID)
    Note

    Funding Agencies:

    AstraZeneca RD Mölndal

    Örebro Heart Foundation

    Research Committee of Örebro University Hospital OLL 2012-265231

    Available from: 2017-03-14 Created: 2017-03-14 Last updated: 2018-06-19Bibliographically approved
    3. Patients without comorbidities at the time of diagnosis of atrial fibrillation: causes of death during long-term follow-up compared to matched controls
    Open this publication in new window or tab >>Patients without comorbidities at the time of diagnosis of atrial fibrillation: causes of death during long-term follow-up compared to matched controls
    Show others...
    2017 (English)In: Clinical Cardiology, ISSN 0160-9289, E-ISSN 1932-8737, Vol. 40, no 11, p. 1076-1082Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Little is known about the long-term, cause-specific mortality risk in patients without comorbidities at the time of diagnosis of atrial fibrillation (AF).

    METHODS: From a nation-wide registry of patients hospitalized with incident AF between 1995 and 2008 we identified 9 519 patients with a first diagnosed AF and no comorbidities at the time of AF diagnosis. They were matched with 12 468 controls. The follow-up continued until December 2008. Causes of death were classified according to the ICD-10 codes.

    RESULTS: During follow-up, 11.1% of patients with AF and 8.3% of controls died. Cardiovascular diseases were the most common causes of death and the only diagnoses which showed significantly higher relative risk in patients with AF than controls (HR 2.0, 95% CI 1.8-2.3), and the relative risk was significantly higher in women than in men. Stroke was a more common cause among patients with AF, 13.1% versus 9.7% (HR 2.7, 95% CI 1.8-4.0), while cerebral hemorrhage was more common among controls, 4.7% versus 10.2% (HR 0.9, 95% CI 0.6-1.5). The time from AF diagnosis to death was 6.0 ± 3.1 years.

    CONCLUSIONS: In patients with incident AF and no known comorbidities at the time of AF diagnosis, only cardiovascular diseases were more often causes of death as compared to controls. Women carried a significantly higher relative risk than men.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2017
    Keywords
    atrial fibrillation, cause of death, idiopathic, morbidity, mortality
    National Category
    Cardiac and Cardiovascular Systems
    Identifiers
    urn:nbn:se:oru:diva-61704 (URN)10.1002/clc.22776 (DOI)000417744800020 ()28841233 (PubMedID)2-s2.0-85028540727 (Scopus ID)
    Funder
    AstraZeneca
    Note

    Funding Agency:

    Örebro Heart Foundation 

    Research Committee of Örebro University Hospital, Sweden 

    Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-03-26Bibliographically approved
    4. Patients with atrial fibrillation and outcomes of cerebral infarction in those with treatment of warfarin versus no warfarin with references to CHA(2)DS(2)-VASc score, age and sex: A Swedish nationwide observational study with 48 433 patients
    Open this publication in new window or tab >>Patients with atrial fibrillation and outcomes of cerebral infarction in those with treatment of warfarin versus no warfarin with references to CHA(2)DS(2)-VASc score, age and sex: A Swedish nationwide observational study with 48 433 patients
    Show others...
    2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 5, article id e0176846Article in journal (Refereed) Published
    Abstract [en]

    Aims: There is controversy in the guidelines as to whether patients with atrial fibrillation and a low risk of stroke should be treated with anticoagulation, especially those with a CHA(2)DS(2)-VASc score of 1 point.

    Methods: In a retrospective, nationwide cohort study, we used the Swedish National Patient Registry, the National Prescribed Drugs Registry, the Swedish Registry of Education and the Population and Housing Census Registry. 48 433 patients were identified between 1 January 2006 and 31 December 2008 with incident atrial fibrillation who were divided in age categories, sex and a CHA(2)DS(2)-VASc score of 0, 1, 2 and >= 3 and they were included in a time-varying analysis of warfarin treatment versus no treatment. The primary end-point was cerebral infarction and stroke, and patients were followed until 31 December 2009.

    Results: Patients with 1 point from the CHA(2)DS(2)-VASc score showed the following adjusted hazard ratios (HR) with a 95% confidence interval: men 65-74 years 0.46 (0.25-0.83), men < 65 years 1.11 (0.56-2.23) and women < 65 years 2.13 (0.94-4.82), where HR < 1 indicates protection with warfarin. In patients < 65 years and 2 points, HR in men was 0.35 (0.18-0.69) and in women 1.84 (0.86-3.94) while, in women with at least 3 points, HR was 0.31 (0.16-0.59). In patients 65-74 years and 2 points, HR in men was 0.37 (0.23-0.59) and in women 0.39 ( 0.21-0.73). Categories including age >= 65 years or >= 3 points showed a statistically significant protection from warfarin.

    Conclusions: Our results support that treatment with anticoagulation may be considered in all patients with an incident atrial fibrillation diagnosis and an age of 65 years and older, i.e. also when the CHA(2)DS(2)-VASc score is 1.

    Place, publisher, year, edition, pages
    Public Library of Science, 2017
    National Category
    Cardiac and Cardiovascular Systems
    Research subject
    Cardiology
    Identifiers
    urn:nbn:se:oru:diva-57914 (URN)10.1371/journal.pone.0176846 (DOI)000400648500084 ()28472091 (PubMedID)2-s2.0-85019090489 (Scopus ID)
    Note

    Funding Agencies:

    Research Committee of Örebro University  0LL 2012-265231 

    AstraZeneca RD Mölndal  

    Örebro Heart Foundation 

    Available from: 2017-06-08 Created: 2017-06-08 Last updated: 2018-03-26Bibliographically approved
  • Zekavat, Amir Reza
    et al.
    Örebro University, School of Science and Technology.
    Jansson, Anton
    Örebro University, School of Science and Technology.
    Gundlach, Carsten
    Technical University of Denmark, Kongens Lyngby, Denmark.
    Pejryd, Lars
    Örebro University, School of Science and Technology.
    Effect of X-ray Computed Tomography Magnification on Surface Morphology Investigation of Additive Manufacturing Surfaces2018In: 8th Conference on Industrial Computed Tomography, 2018Conference paper (Refereed)
    Abstract [en]

    Additive manufacturing (AM) in the last decade has become a widespread manufacturing process. The possibilities that such technologies have provided for manufacturing of complex geometries compared to conventional manufacturing processes has made them popular in many branches of industry. Despite the advantages of these methods, there are limiting issues which needs to be thoroughly investigated. A limiting factor, especially for powder bed AM parts is their undesired surface finish. AM surfaces can be investigated using various methods such as optical or tactile methods, however for complex AM surfaces they are incapable of capturing all details such as deep valleys at surface level. X-ray computed tomography (CT), can provide 3D information of complex AM surfaces and does not have limitations that line of sight and tactile methods have. There are several parameters in CT investigation, which can potentially alter the obtained results. Depending on the CT magnification at which the data is acquired the result specifically surface level detail might be affected. The aim of this study is to investigate the effect of different CT magnifications on surface texture measurement of additively manufactured surfaces. Surface features, including highest peaks and deepest valleys contributing to maximum and minimum thickness of specimen from different magnifications were compared with each other. The result shows that, the lower magnification scans underestimate both peak and valley measurements in comparison to the highest magnification scan. Measurement of valleys and re-entrant features were underestimated at more considerable level. The results from this study provide some understanding regarding surface morphology assessment of AM parts and the level of detail which can be expected depending on the CT magnification.