Miljökrav i offentlig upphandling - En analys av rättsliga och praktiska hinder

Today, green public procurement is considered an important part of a positive environmental and social development. This is partly because of the large economic importance of public procurement and partly because environmental considerations constitute an aspect of public procurement with increased significance. By imposing environmental requirements, contracting authorities can affect the supply of sustainable goods and services, thus push the environmental technical development forward. The possibilities to take environmental aspects and requirements into consideration have undergone an extensive development. At the time of the adoption of Directive 2014/24/EU and the new Swedish Public Procurement Act, these possibilities were further expanded and clarified. In the light of this development, the purpose of this thesis is to examine the possibilities and obligations of contracting authorities to take environmental considerations into account in accordance with the law, by imposing environmental requirements. Part of this thesis has examined how contracting authorities handle environmental requirements in practice. It has been questioned whether current legislation enables efficient environmental requirements or if a change in legislation is needed in order to make environmental work more efficient. The thesis has shown that current legislation provides several possibilities to take environmental considerations into account and to impose environmental requirements in public procurement. However, the thesis has also shown that there are factors that limit and risk to limit environmental requirements. From a practical perspective, three key obstacles have been identified: lack of financial resources, lack of knowledge and lack of guidance. From a legal point of view, it has been found that the fundamental principles of procurement, and the construction of the general provision on environmental considerations of the Swedish Public Procurement Act, the “should-rule” (sv. bör-regeln), limit the nature and scope of environmental requirements. However, a renewed interpretation of the law on public procurement, could imply an increased scope for environmental requirements. Furthermore, the construction of the should-rule has been found unsatisfactory from the objectives intended to be achieved through green public procurement. In conclusion, a strict regulation of contracting authorities' obligations to take environmental considerations into account, may therefore be considered. A must-rule will better match today’s expectations on contracting authorities to apply environmental considerations.Miljöanpassad offentlig upphandling betraktas idag som en viktig del i främjandet av en positiv miljö- och samhällsutveckling. Detta beror dels på den offentliga upphandlingens stora ekonomiska betydelse, dels på att miljöhänsyn är en aspekt av offentlig upphandling som tillmäts allt större betydelse. Genom att ställa miljökrav i offentlig upphandling kan upphandlande myndigheter påverka utbudet av hållbara varor och tjänster och på så sätt driva den miljötekniska utvecklingen framåt. Möjligheterna att beakta miljöhänsyn och ställa miljökrav har under senare tid genomgått en genomgripande utveckling. I samband med införandet av EU-direktivet 2014/24/EU och nya lagen (2016:1145) om offentlig upphandling utökades och förtydligades dessa möjligheter ytterligare. Mot bakgrund av denna utveckling är syftet med uppsatsen att granska upphandlande myndigheters möjligheter och skyldigheter, att genom uppställande av miljökrav, beakta miljöhänsyn vid offentlig upphandling enligt gällande rätt. En del av granskningen har tagit utgångspunkt i hur upphandlande myndigheter hanterar miljökrav i praktiken. Det ifrågasätts huruvida nuvarande lagstiftning möjliggör att miljökrav ställs på ett ändamålsenligt sätt eller om en lagförändring skulle behövas för att effektivisera miljöarbetet. Framställningen har visat att gällande rätt uppställer flertalet möjligheter att beakta miljöhänsyn och ställa miljökrav vid offentlig upphandling. Framställningen har emellertid också visat att det finns faktorer som på olika sätt begränsar och riskerar att begränsa att miljökrav ställs på ett ändamålsenligt sätt. Ur ett praktiskt perspektiv har tre konkreta hinder identifierats: bristande ekonomiska resurser, bristande kunskap och bristande vägledning. Ur ett rättsligt perspektiv har konstaterats att de grundläggande principerna för upphandling samt utformningen av den i LOU centrala miljöhänsynsbestämmelsen, bör-regeln, till viss del begränsar miljökravens art och omfattning. En förnyad tolkning av upphandlingsrätten skulle dock kunna innebära ett ökat utrymme att ställa miljökrav. Det har vidare konstaterats att bör-regelns utformning är otillfredsställande utifrån målen som avses att uppnås genom miljöanpassad offentlig upphandling. En skärpt reglering av upphandlande myndigheters skyldigheter att beakta miljöhänsyn kan därmed anses vara lämplig. Ett skall-krav torde i större utsträckning överensstämma med dagens förväntningar på upphandlande myndigheter att arbeta med ett ökat miljöhänsynstagande

Humak avoimen tiellä

Humak avoimen tiellä on katsaus Humanistisen ammattikorkeakoulun avoimen ammattikorkeakoulun syntyyn, ensimmäisiin vuosikymmeniin, keskeisiin tuotteisiin ja lopulta tulevaisuuden näkymiin. Julkaisun nimi ”Humak avoimen tiellä” kuvaa hyvin avoimen ammattikorkeakoulun aseman muutosta välttämättömästä toiminnosta kohti yhdeksi keskeisintä ammattikorkeakoulun toimintoa. Julkaisu jakautuu kolmeen osaan: ensimmäisessä osassa ”Historian havinaa” keskitytään kuvaamaan avoimen ammattikorkeakoulun kehittymisen vuosia erityisesti Humakin vahvuusalojen näkökulmista. Tarjontaa kaikille -osiossa kuvataan Humakin laajaa ja monipuolista tuotetarjontaa, jota on näinä vuosikymmeninä kehitetty. Viimeinen osio ”Kohti jatkuvaa oppimista” kuvaa jatkuvan oppimisen tulevaisuuden näkymiä. Julkaisun kirjoittajina on Humakin pitkän linjan avoimen ammattikorkeakoulun kehittäjiä, lehtoreita, opintosihteerejä ja viestinnän ammattilaisia. Ääneen pääsevät myös muutamat väyläopiskelijat. Julkaisu soveltuu kaikille jatkuvan oppimisen kehittämisestä kiinnostuneille ja jatkuvan oppimisen parissa työskenteleville

Foreword: Empirical Research and the Issue of Jury Competence

Estimates from an extended Kalman filter (EKF) is used in an Iterative Learning Control (ILC) algorithm applied to a realistic two-link robot model with flexible joints. The angles seen from the arm side of the joints (arm angles) are estimated by an EKF in two ways: 1) using  measurements of angles seen from the motor side of the joints (motor angles), which normally  are the only measurements available in commercial industrial robot systems, 2) using both motor- angle and tool-acceleration measurements. The estimates are then used in an ILC algorithm. The results show that the actual arm angles are clearly improved compared to when only motor angles are used in the ILC update, even though model errors are introduced

Long-term cognitive functioning is impaired in ICU-treated COVID-19 patients : a comprehensive controlled neuropsychological study

Publisher Copyright: © 2022, The Author(s).Background: Cognitive impairment has emerged as a common post-acute sequela of coronavirus disease 2019 (COVID-19). We hypothesised that cognitive impairment exists in patients after COVID-19 and that it is most severe in patients admitted to the intensive care unit (ICU). Methods: This prospective controlled cohort study of 213 participants performed at the Helsinki University Hospital and the University of Helsinki, Finland, comprised three groups of patients—ICU-treated (n = 72), ward-treated (n = 49), and home-isolated (n = 44)—with confirmed COVID-19 between March 13 and December 31, 2020, participating in a comprehensive neuropsychological evaluation six months after the acute phase. Our study included a control group with no history of COVID-19 (n = 48). Medical and demographic data were collected from electronic patient records and interviews carried out four months after the acute phase. Questionnaires filled six months after the acute phase provided information about change in cognitive functioning observed by a close informant, as well as the presence of self-reported depressive and post-traumatic symptoms. Results: The groups differed (effect size η2p = 0.065, p = 0.004) in the total cognitive score, calculated from neuropsychological measures in three domains (attention, executive functions, and memory). Both ICU-treated (p = 0.011) and ward-treated patients (p = 0.005) performed worse than home-isolated patients. Among those with more than 12 years of education, ICU-treated patients performed worse in the attention domain than ward-treated patients (p = 0.021) or non-COVID controls (p = 0.045); ICU-treated male patients, in particular, were impaired in executive functions (p = 0.037). Conclusions: ICU-treated COVID-19 patients, compared to patients with less severe acute COVID-19 or non-COVID controls, showed more severe long-term cognitive impairment. Among those with more than 12 years of education, impairment existed particularly in the domains of attention and for men, of executive functions. Trial registration number: ClinicalTrials.gov NCT04864938, retrospectively registered February 9, 2021.Peer reviewe

A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial

Background: Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective: The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods: HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results: Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions: This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy

Japanese Encephalitis in Small-Scale Pig Farming in Rural Cambodia: Pig Seroprevalence and Farmer Awareness

Japanese encephalitis (JE) is endemic in Cambodia, but circulation of JE virus (JEV) among domestic pigs has previously only been studied in the southern part of the country. The main purpose of this study was to determine the seroprevalence of JEV antibodies in smallholder pigs held in rural areas of Kampong Thom, Preah Vihear, Ratanakiri, and Stung Treng provinces, northeastern Cambodia. Another purpose was to identify possible associations between serologic status and other factors, such as reproductive disorders, and to investigate the farmers' knowledge of mosquito-borne diseases and use of preventive measures. In October 2019, 139 households were visited throughout the study area, and 242 pigs were sampled for blood. The sera were analysed with ELISA for JEV antibodies. Household representatives were interviewed, and data were recorded for each sampled pig. The apparent seroprevalence was 89.1% in pigs between 3 and 6 months of age, and 100% in pigs over 6 months of age. In total, 93.0% of the pigs tested positive. Province appeared to be the only factor significantly associated with serologic status (p < 0.001). Almost all (97.8%) respondents knew that mosquitos could transmit diseases, and 70.5% had heard of JE. However, only one respondent knew that JEV is transmitted to people through mosquito bites. Very few respondents knew that pigs can become infected with JEV, and no one knew that mosquitos transmit the virus. All families used some sort of mosquito protection for themselves, but only 15.1% protected their pigs from mosquito bites. The children were vaccinated against JE in 93 households, while adults only were vaccinated in eight households. The results suggest that JEV transmission is intense in northeastern Cambodia, and that people's knowledge about the transmission route of JEV and the role of pigs in the transmission cycle is low. Fortunately, people are well aware of mosquito-borne diseases in general and use mosquito protection, and many children are vaccinated against JE. Nonetheless, it is important that national vaccination is continued, and that people-especially in rural areas where pigs are commonly kept-are educated on the ecology and transmission of JEV

Associations of subjective and objective cognitive functioning after COVID-19 : A six-month follow-up of ICU, ward, and home-isolated patients

Publisher Copyright: © 2023 The AuthorsBackground: Subjective and objective cognitive dysfunction are reported after COVID-19 but with limited data on their congruence and associations with the severity of the acute disease. The aim of this cohort study is to describe the prevalence of subjective and objective cognitive dysfunction at three and six months after COVID-19 and the associations of subjective cognitive symptoms and psychological and disease-related factors. Methods: We assessed a cohort of 184 patients at three and six months after COVID-19: 82 patients admitted to the Intensive Care Unit (ICU), 53 admitted to regular hospital wards, and 49 isolated at home. A non-COVID control group of 53 individuals was included. Demographic and clinical data were collected. Subjective cognitive symptoms, objective cognitive impairment, and depressive and post-traumatic stress disorder (PTSD) symptoms were assessed. Results: At six months, subjective cognitive impairment was reported by 32.3% of ICU-treated, 37.3% of ward-treated, and 33.3% of home-isolated patients and objective cognitive impairment was observed in 36.1% of ICU-treated, 34.7% of ward-treated, and 8.9% of home-isolated patients. Subjective cognitive symptoms were associated with depressive and PTSD symptoms and female sex, but not with objective cognitive assessment or hospital metrics. Conclusions: One-third of COVID-19 patients, regardless of the acute disease severity, reported high levels of subjective cognitive dysfunction which was not associated with results from objective cognitive screening but with psychological and demographic factors. Our study stresses the importance of thorough assessment of patients reporting long-term subjective symptoms, screening for underlying mental health related factors such as PTSD or depression.Peer reviewe

Psyykkinen oireilu puoli vuotta COVID-19-taudin jälkeen suomalaisessa Recovid-20-aineistossa

TAUSTA : COVID-19-tautiin liittyy mielenterveyden ongelmia, erityisesti ahdistuneisuutta ja masennusta, joita voi ilmetä vielä akuuttivaiheen väistyttyä. Selvitimme suomalaisten COVID-19-potilaiden psyykkistä vointia kuuden kuukauden kuluttua sairauden akuuttivaiheesta. AINEISTO JA MENETELMÄT : Tutkimuksen kliininen aineisto koostui teho- ja muussa osastohoidossa hoidetuista ja kotona sairastaneista COVID-19-potilaista sekä verrokeista, jotka täyttivät kyselyitä kolmen ja kuuden kuukauden kuluttua sairauden akuuttivaiheesta. TULOKSET : Potilailla havaittiin puolen vuoden seurannassa verrokkeja enemmän ahdistuneisuutta, masennusta, traumaperäistä stressioireilua ja väsymystä. Oireet olivat pääosin lieviä, ja niitä selitti kolmen kuukauden kuluttua akuuttivaiheesta koettu psyykkinen oireilu. Akuuttivaiheessa koettu suurempi psyykkisen tuen tarve oli yhteydessä ahdistuneisuuteen ja traumaperäiseen stressioireiluun puolen vuoden seurannassa. PÄÄTELMÄT : Psyykkinen oireilu tulee ottaa huomioon COVID-19-potilaiden hoidossa. Akuuttivaiheen psyykkisen tuen riittämättömyys voi olla yhteydessä myöhempään ahdistuneisuusoireiluun ja traumaperäisen stressioireilun kokemiseen.Peer reviewe

Yhteistyöllä tulosta työkykyjohtamisessa: Moniaineisto- ja monimenetelmätutkimus

Yritysten toimintatavat ja työkyvyttömyyden ehkäisyyn käytetty rahallinen ja inhimillinen panostus vaihtelevat paljon. Osassa tutkimuksia on osoitettu työkyvyttömyyskustannusten laskevan, mutta mitkä toimet tuottavat parhaimman tuloksen? Tässä tutkimuksessa selvitettiin yritysten työkykyjohtamisen eroja ja niiden vaikutuksia työkyvyttömyyden ehkäisyyn tehtyjen investointien ja työkyvyttömyyskustannusten väliseen suhteeseen. Tutkimukseen osallistui kymmenen suomalaista suuryritystä, joista tarkasteltiin yhteensä 20 taloudellista yksikköä. Tutkimuksessa kerättiin tietoa takautuvasti aikaväliltä 2008 – 2013. Tutkimus osoitti, että työkyvyttömyyskustannuksiin voidaan vaikuttaa, mutta ei yksittäisillä toimilla. Yritysten strateginen työkykyjohtaminen, toimijoiden hyvä yhteistyö ja tavoitteiden vieminen käytäntöön havaittiin keinoiksi, joiden yhteisvaikutuksella työkyvyttömyyskustannuksia onnistuttiin alentamaan. Menestyvissä yrityksissä työkykyä tukevat ja palauttavat toimenpiteet oli kohdennettu oikein, tietoa oli käytettävissä ja yhteistoiminta oli koordinoitua

IL-13 Stimulates Proliferation and Expression of Mucin and Immunomodulatory Genes in Cultured Conjunctival Goblet Cells

Citation: Tukler Henriksson J, Coursey TG, Corry DB, De Paiva CS, Pflugfelder SC. IL-13 stimulates proliferation and expression of mucin and immunomodulatory genes in cultured conjunctival goblet cells. Invest Ophthalmol Vis Sci. 2015;56:4186-4197. DOI:10.1167/iovs.14-15496 PURPOSE. To investigate the effects of IL-13 on goblet cell proliferation, differentiation, and expression of mucin and immunomodulatory genes. METHODS. Explants were excised from the conjunctiva of young C57BL/6 mice. Cultures received 200 lL per week of either Keratinocyte media (KSFM) or KSFM supplemented with 10 ng/mL IL-13 and were incubated for 3 (D3), 7 (D7), or 14 (D14) days. Subsequently, cell proliferation was assessed or cultures were immunostained, collected for dot blot, or for reverse transcription (RT) and quantitative real-time PCR (qPCR) or for RT-PCR gene array. RESULTS. The cultured conjunctival epithelium expressed goblet cell associated keratin 7 and mucins MUC5AC and MUC2 and when stimulated with IL-13 showed increased proliferation at D3 and D7 (P &lt; 0.05) compared with control. MUC5AC expression was increased in the IL-13-treated group at D3 and D14 (P &lt; 0.05). IL-13-treated cultures showed increased chemokine ligand 26 (CCL26), chloride channel calcium activated channel 3 (CLCA3), fas ligand (FasL), and Relm-b at D7. All conjunctival cultures expressed MUC2, and its expression was decreased at D3 (P &lt; 0.05) and increased at D14 (P &lt; 0.05) with IL-13 treatment. CONCLUSIONS. This study demonstrated that conjunctival goblet cells are IL-13 responsive cells that produce factors known to maintain epithelial barrier, stimulate mucin production, and modulate immune response in nonocular mucosa when treated with IL-13. The functional significance of IL-13-stimulated factors remains to be determined. Keywords: conjunctiva, goblet cells, interleukin-13, cell culture T he conjunctiva covers two-thirds of the ocular surface and functions as a support tissue for cornea. 2,3 Conjunctival goblet cells are surrounded by lymphocytes and dendritic cells and their density has been found to change in certain ocular surface immune/inflammatory conditions. 4 Goblet cell density has been reported to decrease in aqueous tear deficiency, a condition where T helper 1 (Th1) and Th17 cells infiltrate the conjunctiva, and increase in atopic keratoconjunctivitis and vernal keratoconjunctivitis, predominantly Th2-mediated diseases. 5-8 The mucus stimulating activity of the Th2 cytokine IL-13 has been reported to have a defensive role in the intestines by eliminating helminthic parasites and in the airways by protecting from particles or allergens. 9,10 However, excessive IL-13 expression is associated with goblet cell hyperplasia and mucous hypersecretion, both in the gut and in the airways where it can result in airway obstruction. The purpose of the present study was to investigate whether the Th2 cytokine IL-13 can modulate proliferation, differentiation, and expression of mucin and immunomodulatory gene