Fetal thoracic circumference in mid-pregnancy and infant lung function

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.Background and Aim: Impaired lung function in early infancy is associated with later wheeze and asthma, while fetal thoracic circumference (TC) predicts severity of neonatal lung hypoplasia. Exploring fetal origins of lung function in infancy, we aimed to determine if fetal TC in mid‐pregnancy was associated with infant lung function. Methods: From the prospective Scandinavian general population‐based PreventADALL mother–child birth cohort, all 851 3‐month‐old infants with tidal flow‐volume measurements in the awake state and ultrasound fetal size measures at 18 (min–max 16–22) weeks gestational age were included. Associations between fetal TC and time to peak tidal expiratory flow to expiratory time (tPTEF/tE) were analyzed in linear regression models. To account for gestational age variation, we adjusted TC for simultaneously measured general fetal size, by head circumference (TC/HC), abdominal circumference (TC/AC), and femur length (TC/FL). Multivariable models were adjusted for maternal age, maternal asthma, pre‐pregnancy body mass index, parity, nicotine exposure in utero, and infant sex. Results: The infants (47.8% girls) were born at mean (SD) gestational age of 40.2 (1.30) weeks. The mean (SD) tPTEF/tE was 0.39 (0.08). The mean (SD) TC/HC was 0.75 (0.04), TC/AC 0.87 (0.04), and TC/FL 4.17 (0.26), respectively. Neither TC/HC nor TC/AC were associated with infant tPTEF/tE while a week inverse association was observed between TC/FL and tPTEF/tE (β ^ = −0.03, 95% confidence interval [−0.05, −0.007], p = 0.01). Conclusion: Mid‐pregnancy fetal TC adjusted for fetal head or abdominal size was not associated with tPTEF/tE in healthy, awake 3‐month‐old infants, while a weak association was observed adjusting for fetal femur length.publishedVersio

Fetal thoracic circumference and lung volume and their rlation to fetal size and pulmonary artery blood flow

Objective: Research on early origins of lung disease suggests the need for studying the relationships of thoracic and lung size with fetal size and pulmonary circulation. The primary aim of this study is therefore to explore the associations between fetal thoracic circumference, lung volume, and fetal size. We also aim to assess if lung volume and thoracic circumference are associated with fetal pulmonary artery blood flow velocity measures. Methods: Cross-sectional assessment of singleton pregnancies from the general population (n = 447) at 30 gestational weeks (GW) was performed using ultrasound measurement of fetal thoracic circumference, lung volume, head and abdominal circumference, and femur length. We obtained Doppler blood flow velocity measures from the proximal branches of the fetal pulmonary artery. Associations between variables were studied using Pearson's correlation and multiple linear regression analyses. Results: Both thoracic circumference and lung volume correlated with fetal size measures, ranging from r = 0.64 between thoracic circumference and abdominal circumference, to r = 0.28 between lung volume and femur length. Adjustment for gestational age, maternal nicotine use, pre-pregnancy body mass index, and fetal sex marginally influenced the associations with abdominal circumference. The correlations of thoracic circumference and lung volume with pulmonary artery blood flow velocity measures were weak (r ≤ 0.17). Conclusion: We found moderate to low correlation between thoracic circumference, lung volume, and fetal size at 30 GW. The closest relationship was with the abdominal circumference. We found low correlations of thoracic circumference and lung volume with pulmonary artery blood flow velocity measures.publishedVersio

Maternal human papillomavirus infections at mid-pregnancy and delivery in a Scandinavian mother–child cohort study

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Maternal human papillomavirus infection during pregnancy and preterm delivery, a mother–child cohort study in Norway and Sweden

Introduction: Human papillomavirus (HPV) infection is common in women of reproductive age. Infection and inflammation are leading causes for preterm delivery (PTD), but the role of HPV infection in PTD and prelabor rupture of membranes (PROM) is unclear. We aimed to explore whether HPV infection during pregnancy in general, and high-risk-HPV (HR-HPV) infection specifically, increased the risk of PTD, preterm prelabor rupture of membranes (PPROM), PROM at term, and/or chorioamnionitis. Material and Methods: In pregnant women, who were participating in a prospective multicenter cohort study from a general population in Norway and Sweden (PreventADALL, ClinicalTrials.gov NCT02449850), HPV DNA was analyzed in available urine samples at mid-gestation (16–22 weeks) and at delivery, and in the placenta after delivery with Seegene Anyplex II HPV28 PCR assay. The risk of PTD, PPROM, PROM, and chorioamnionitis was analyzed using unadjusted and adjusted logistic regression analyses for any 28 HPV genotypes, including 12 HR-HPV genotypes, compared with HPV-negative women. Further, subgroups of HPV (low-risk/possibly HR-HPV, HR-HPV-non-16 and HR-HPV-16), persistence of HR-HPV from mid-gestation to delivery, HR-HPV-viral load, and presence of multiple HPV infections were analyzed for the obstetric outcomes. Samples for HPV analyses were available from 950 women with singleton pregnancies (mean age 32 years) at mid-gestation and in 753 also at delivery. Results: At mid-gestation, 40% of women were positive for any HPV and 24% for HR-HPV. Of the 950 included women, 23 had PTD (2.4%), nine had PPROM (0.9%), and six had chorioamnionitis (0.6%). Of the term pregnancies, 25% involved PROM. The frequency of PTD was higher in HR-HPV-positive women (8/231, 3.5%) than in HPV-negative women (13/573, 2.3%) at mid-gestation, but the association was not statistically significant (odds ratio 1.55; 95% confidence interval 0.63–3.78). Neither any HPV nor subgroups of HPV at mid-gestation or delivery, nor persistence of HR-HPV was significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis. No HPV DNA was detected in placentas of women with PTD, PPROM or chorioamnionitis. Conclusions: HPV infection during pregnancy was not significantly associated with increased risk for PTD, PPROM, PROM, or chorioamnionitis among women from a general population with a low incidence of adverse obstetric outcomes

Miljöbilens förutsättningar i glesa bygder : Tillgänglighet samt sociala och ekonomiska aspekterför individer och hushåll. Kunskapsöversikt för BISEK

This report presents a review of research into the prerequisites for adoption of alternative fuel vehicles(AFVs) in sparsely populated areas. Focus is on issues related to accessibility as well as social andeconomic aspects on the individual and household levels. Geographically, the review focuses mainlyon the Swedish context. Methodology‐wise, the report is based on a literature review encompassingseveral issues: varying views and definitions of rural or sparsely populated areas and the heterogeneitypresent within such broad categories; problems related to accessibility in sparsely populated areas;geographical variations within the Swedish car fleet; access to renewable fuels; theoretical perspectiveson the diffusion of innovations (DOI) and adoption of new technologies, including geographicalperspectives on these issues; and research into the adoption of AFVs more specifically.Moreover, other social and economic aspects of potential relevance for the adoption of AFVs arediscussed. In addition to the literature review, a pilot‐style interview with a resident of a sparselypopulated area in Sweden was conducted.Poor local accessibility is frequently a problematic issue in sparsely populated areas, and a maincause for an extensive car dependency. However, the geographical categories “sparsely populated”or “rural” areas contain substantial differences in prerequisites for accessibility depending not onlyon intra‐local supply, but also on e.g., location with respect to urban centres and major cities, andthe residents’ travel patterns. So far, the adoption and diffusion of AVFs in sparsely populated areashas been limited. Many largely sparsely populated municipalities are among those with the lowestshares of AVFs in the vehicle fleet, and consequently the conventional fossil fuel vehicles dominate.While access to e.g., refueling infrastructure is obviously a key prerequisite for AFV adoption, a lackin this respect does not appear to be a main reason why AFVs are scarce in sparsely populated areas.Theoretical perspectives on DOI suggest that different groups, e.g., regarding socioeconomic attributes,tend to adopt innovations at different stages of the process of diffusion. Also, innovations tendto spread from the higher levels to the lower levels of the urban hierarchy. To date, research intoconsumer adoption of AVFs, despite having generated a substantial body of literature, has largelyneglected geographical factors in general, and an explicit focus on sparsely populated areas is lackingin particular. An explorative interview with a resident in a rural area in Sweden indicated that carchoice was guided by economic factors, whereas environmental concerns were more or less absent.The respondent also expressed a lack of knowledge about AFVs and, importantly, a view that AFVsare a non‐issue, something that lies outside of the realm of awareness.There are various potential impediments as well as opportunities for the adoption of AVFs insparsely populated areas, with regard to contextual factors as well as socioeconomic factors. However,AVF adoption in these geographical settings is an issue which requires more research. This issue ispertinent not least in recognition of the fact that the residents these areas constitute a substantialshare of the population, and cannot be overlooked in the ongoing process of transition of thetransport system towards reduced carbon dependence

Tillgänglighetsparadoxen : Geografisk närhet, avstånd och mobilitet i vardagsperspektiv

This thesis aims to explore the importance of proximity and mobility, respectively, for individuals’ accessibility, as well as the relationship between these two key spatial dimensions of accessibility in the context of everyday life. The thesis is based upon three empirical research papers which focus on accessibility-related preferences, actual accessibility conditions, and travel patterns. Focus is directed towards the spatial relationships between individuals’ residential location vis-à-vis the location of a selection of different amenities including work, education, service and leisure functions as well as social relations. The analyses are based on a wide range of quantitative data, including questionnaire surveys as well as official register data for the Swedish population.      The first paper shows that residential proximity to amenities was most valued by individuals in the case of social relations and basic daily activities. The level of satisfaction with current accessibility conditions was generally high, with the exception of social relations where the findings suggest the existence of a ‘proximity deficit’. The second paper shows that observed average distances to most amenities have decreased over time (1995–2005). Concerning service amenities, the increases in proximity over the period were primarily due to a restructuring of the localization patterns within the service sector. A comparison of potential accessibility conditions and actual travel patterns revealed that people tend to travel farther than to the nearest amenity options, presumably to a large extent because of selective individual preferences, which may downplay the importance of distance in destination choice. The third paper shows that although the numerical supply of amenities within different spatial ranges has a significant influence on how far individuals travel for service errands, supply size alone is not sufficient for explaining travel length. The findings also suggest that although people tend to utilize the supply of amenities available locally, they are also willing to extend their travel distance in order to reach the amenity supply available within the region. Thus, even when there is a local supply, a rich regional supply may induce longer trips.      A juxtaposition of the findings of the three empirical studies suggests the existence of an ‘accessibility paradox’ with several facets. First, although people express an affinity for residential proximity to many amenities, this is not necessarily reflected in actual destination choices, since minimization of travel distance is apparently not always a key criterion. This is also suggested by the conclusion that the spatial structure of the amenity supply alone accounts for only a relatively small part of the explanation of travel length, which is influenced by many other factors. In addition, actual travel distances show an increasing trend over time despite the concurrent reductions in potential distances. Second, the development over time indicates that the proximity deficit regarding social relations may be increasing in the sense that average distances have increased to many of the amenities considered important to have nearby, for instance adult children, but have decreased to those where proximity is not considered particularly important. Third, there is a discrepancy between the observed trend towards increased proximity to many amenities and much of the general discourse on accessibility, which tends to emphasize deteriorating conditions.

The advantage of 'near' : Which accessibilities matter to whom?

This paper explores people’s preferences for living close to destinations such as work, service, leisure and social activities, satisfaction with the proximities offered by their residential location, as well as more general residential satisfaction. The paper draws on the literature on accessibility, residential choice and residential preferences, and is empirically based on a survey targeted at individuals aged 20-64 in the Swedish population. The results suggest that ‘proximity preferences’ are structured by both practical and social rationales. Preferences also differ to varying degrees between groups with respect to gender, age and type of residential environment. Self-reported distances are short for virtually all destina-tions except those relating to social relations. People’s satisfaction with their residential location relative to their everyday life accessibility needs is also explored in regression analyses. The findings imply that residential location satisfaction is related to type of resi-dential environment, dwelling type/tenure, whether the respondents had considered mov-ing to increase the proximity to certain destinations, and their level of satisfaction with the distances from home to various destinations

Contested Lands? : Dissonance and Common Ground in Stakeholder Views on Forest Values

Forest lands are used in increasingly plural ways and serve society with numerous benefits. This paper analyses the views of private forest owners and the general public in Sweden on the values of the forest. Two main dimensions were identified: ‘preservation and recreation’ values, reflecting ecological and social aspects; and ‘production’ values, reflecting economic aspects. While the general public emphasised the importance of forest uses which cater to ecological and social forest values more strongly compared to the forest owners, no significant difference was found concerning economic forest values. This suggests that while there is scope for contestation over forest land use, there is also some potential for common ground across stakeholder groups. These findings add to the body of knowledge of the views on the use of forest lands, and can inform forest related planning, management and policy development.Planering för en dynamisk stads-landsbygdsrelation: att leva och verka på flera platse