45 research outputs found
Att vara fysiskt aktiv under adjuvant cytostatikabehandling : interventionsstudier för personer med bröst - och kolorektalcancer
Bakgrund: Regelbunden fysisk aktivitet har sedan lÀnge visat sig vara viktigt för att upprÀtthÄlla en god hÀlsa hos mÀnniskor och det Àr kÀnt att fysisk inaktivitet Àr en betydande riskfaktor för en rad olika hÀlsoproblem och att det medför en ökad risk för ohÀlsa. Adjuvant cytostatikabehandling Àr en vanligt förekommande behandling vid cancer som orsakar fysiska sÄvÀl som psykiska symtom som negativt pÄverkar en persons hÀlsa och livskvalitet.
Syfte: Det övergripande syftet med avhandlingsarbetet Àr att undersöka hur fysisk aktivitet inverkar pÄ hÀlsa och livskvalitet hos personer med bröst- eller kolorektalcancer under adjuvant cytostatikabehandling.
Metod: Avhandlingen baseras pĂ„ tvĂ„ randomiserade kontrollerade interventionsstudier. Studie 1 (n=77, personer med bröst â eller kolorektalcancer) Ă€r en pilotstudie med fokus pĂ„ genomförbarhet och följsamhet till en intervention med fysisk aktivitet i form av dagliga promenader under pĂ„gĂ„ende cytostatikabehandling (delarbete I). Studie 2 (n=240, kvinnor med bröstcancer) fokuserar pĂ„ att jĂ€mföra effekter av olika former av fysisk aktivitet pĂ„ mĂ„ttlig till hög intensitetsnivĂ„ under pĂ„gĂ„ende cytostatikabehandling (delarbete IIIâIV). För att undersöka deltagarnas upplevelser av att vara fysiskt aktiva under cytostatikabehandlingen genomfördes intervjuer (n=13), bĂ„de individuella och i fokusgrupp med deltagare frĂ„n studie 2 (delarbete II).
Resultat: Fysisk aktivitet i form av dagliga promenader var genomförbart, och följsamheten mot stegmĂ„let 10 000 steg/dag var stabil under interventionsperioden; med ett genomsnitt pĂ„ ca 8300 steg/dag (delarbete I). Kvinnor som deltagit i fysisk aktivitet under cytostatikabehandlingen upplevde minskad emotionell stress, en fysiskt starkare kropp samt socialt stöd frĂ„n bĂ„de studiepersonal och andra kvinnor i studien (delarbete II). Fysisk aktivitet pĂ„ mĂ„ttlig till hög intensitetsnivĂ„, och sĂ€rskilt kombinerad styrke- och konditionstrĂ€ning under pĂ„gĂ„ende cytostatikabehandling minskade signifikant symtom, och förbĂ€ttrade â eller bevarade â fysisk kapacitet och hĂ€lsorelaterad livskvalitet jĂ€mfört med en kontrollgrupp (delarbete IIIâIV).
Konklusion: Denna avhandling pÄvisar att kombinerad styrke- och konditionstrÀning Àr mer effektivt för att minska cancer relaterad fatigue och öka muskelstyrka i bÄde över- och underkropp jÀmfört med enbart konditionstrÀning. Högintensiv konditionstrÀning med kort duration Àr lika effektivt som konditionstrÀning med lÀngre duration pÄ mÄttlig intensitetsnivÄ för att behÄlla konditionsnivÄn under cytostatikabehandling för den hÀr populationen. Fysisk aktivitet beskrevs av kvinnorna som ett verktyg för att frÀmja fysisk, psykisk och social hÀlsa, och trots symtombörda kunde de allra flesta vara fysiskt aktiva under pÄgÄende behandling med cytostatika. Kunskapen frÄn studierna i denna avhandling kan anvÀndas av vÄrdpersonal inom onkologisk vÄrd för att rekommendera den typ av fysisk aktivitet som sannolikt skulle vara mest effektiv för att förbÀttra hÀlsa och livskvalitet hos kvinnor med bröstcancer som genomgÄr cytostatikabehandling
Combined manganese oxides as oxygen carriers for biomass combustion â Ash interactions
Carbon capture and storage (CCS) has been acknowledged as an important strategy for mitigation of climate change. Although highly applicable for fossil fuels, CCS with biomass could have the added advantage of resulting in negative emissions of carbon dioxide. One promising carbon capture technology is chemical-looping combustion (CLC). In CLC the reactors are filled with metal oxide bed material called oxygen carriers. Before CLC can be implemented for biomass combustion at a large scale, biomass ash components interaction with oxygen carriers needs to be further understood. Four combined manganese oxides Mn3O4-SiO2, Mn3O4-SiO2-TiO2, Mn3O4-Fe2O3 and Mn3O4-Fe2O3-Al2O3 were exposed to common biomass ash components K, Ca and P. The ash components can exist in many forms, but here the compounds CaCO3, K2CO3 and CaHPO4 were used. Exposures were performed at 900 \ub0C for six hours in oxidising, reducing and inert conditions. Crystalline phases were analysed by XRD and morphology examined with SEM-EDX. Results show that oxygen carrier particles containing silicon were more likely to form agglomerates, especially in combination with potassium, whereas the particles including iron were more stable. MnFeAl was the oxygen carrier that showed least agglomerating behaviour while simultaneously showing a propensity to absorb some ash components. Some inconsistencies between thermodynamic predictions and experimental results is observed. This may be explained by lack of relevant data in the used databases, were only a few of the oxygen carrier-ash systems and subsystems have been optimised. Further optimisation related to manganese rich systems should be performed to obtain reliable results
Grön offentlig upphandling i transportsektorn
MĂ„nga kommuner i Sverige stĂ€ller krav pĂ„ miljöbilar i upphandlingen av kommunala tjĂ€nstebilar, och en del stĂ€ller Ă€ven specifika krav pĂ„ elbilar. Detta projekt har utvĂ€rderat offentlig upphandling för att svara pĂ„ frĂ„gor om vilken potential upphandling har för att frĂ€mja förnybara drivmedel, vilka de praktiska erfarenheterna Ă€r, huruvida offentlig upphandling anvĂ€nds strategiskt och hur styrmedlet kan vidareutvecklas.Metoden som anvĂ€nts Ă€r komparativa fallstudier av kommunerna Malmö och Ăstersund, samt regionerna SkĂ„ne och JĂ€mtland. Det empiriska underlaget för studierna bestĂ„r av en kombination av dokumentstudier och semistrukturerade kvalitativa intervjuer som genomförts med upphandlare, miljöstrateger, kollektivtrafikstrateger, politiker och representanter frĂ„n privata transÂportoperatörer.Det övergripande syftet Ă€r att öka förstĂ„elsen för utmaningarna med grön offentlig upphandling och hur dessa bemötts i nĂ„gra utvalda fall. Ăven om det rĂ„der skillnader i de olika orternas och regionernas politiska, geografiska och infrastrukturella förutsĂ€ttningar samt i sĂ€ttet pĂ„ vilket kraven i upphandling utformats som följd av detta, sĂ„ har studien kunnat peka pĂ„ nĂ„gra generella policyimplikationer som rör lagstiftning och reglering, kostnader, politiska mĂ„l och samverkan mellan aktörer. Resultaten frĂ„n projektet bidrar dĂ€rmed till kunskapen om hur anvĂ€ndningen av offentlig upphandling kan förbĂ€ttras och utvecklas
Arts-Based Methods for Transformative Engagement. A Toolkit
This open access toolkit offers a collection of almost 30 methods, practical examples, workshop outlines and tips for creative facilitation, as well as resources and relevant academic references. The ideas and methods collected in this toolkit are intended to support new ways of thinking and doing in our work as change agents towards regenerative societies. Compiled by a research team collaborating through the SUSPLACE Innovative Training Network, it is the result of our collective research and experimentation with creative and arts-based methods of engagement. To break free of habituated ways of thinking and perceiving, a field of research addressing the âinner-dimensions of sustainabilityâ argues that deep transformation requires âchange from the inside out.â This entails engaging with emotions, changing cultural narratives and worldviews, and stimulating specific mindset shifts conducive to socio-ecological innovation. This toolkit invites participants to disrupt default anthropocentric worldviews and draw more deeply from their own values, intentions, and an expanded sense of ecological self. Theoretically, it draws from a variety of approaches, including Metaphorical Thinking, Aesthetic Practices, Arts Based Environmental Education, Care for Place, and Appreciative Inquiry. Theory U is used as an organizing framework. These methods are just a starting point and can inform the design of workshops, events, co-production strategies, and the development of sustainability initiatives. Used alone or in concert, they invite improvisation and can be used by facilitators of all experience levels, across various fields
Differences in diagnostic patterns of obstructive airway disease between areas and sex in Sweden and Finland-the Nordic EpiLung study
Objective:To investigate the current prevalence of physician-diagnosed obstructive airway diseases by respiratory symptoms and by sex in Sweden and Finland. Method:In 2016, a postal questionnaire was answered by 34,072 randomly selected adults in four study areas: Vastra Gotaland and Norrbotten in Sweden, and Seinajoki-Vaasa and Helsinki in Finland. Results:The prevalence of asthma symptoms was higher in Norrbotten (13.2%), Seinajoki-Vaasa (14.8%) and Helsinki (14.4%) than in Vastra Gotaland (10.7%), and physician-diagnosed asthma was highest in Norrbotten (13.0%) and least in Vastra Gotaland (10.1%). Chronic productive cough was most common in the Finnish areas (7.7-8.2% versus 6.3-6.7%) while the prevalence of physician-diagnosed chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) varied between 1.7 and 2.7% in the four areas. Among individuals with respiratory symptoms, the prevalence of asthma was most common in Norrbotten, while a diagnosis of COPD or CB was most common in Vastra Gotaland and Seinajoki-Vaasa. More women than men with respiratory symptoms reported a diagnosis of asthma in Sweden and Seinajoki-Vaasa but there were no sex differences in Helsinki. In Sweden, more women than men with symptoms of cough or phlegm reported a diagnosis of CB or COPD, while in Finland the opposite was found. Conclusion:The prevalence of respiratory symptoms and corresponding diagnoses varied between and within the countries. The proportion reporting a diagnosis of obstructive airway disease among individuals with respiratory symptoms varied, indicating differences in diagnostic patterns both between areas and by sex.Peer reviewe
The prognostic impact of the tumour stroma fraction: A machine learning-based analysis in 16 human solid tumour types
Background: The development of a reactive tumour stroma is a hallmark of tumour progression and pronounced tumour stroma is generally considered to be associated with clinical aggressiveness. The variability between tumour types regarding stroma fraction, and its prognosis associations, have not been systematically analysed.Methods: Using an objective machine-learning method we quantified the tumour stroma in 16 solid cancer types from 2732 patients, representing retrospective tissue collections of surgically resected primary tumours. Image analysis performed tissue segmentation into stromal and epithelial compartment based on pan-cytokeratin staining and autofluorescence patterns.Findings: The stroma fraction was highly variable within and across the tumour types, with kidney cancer showing the lowest and pancreato-biliary type periampullary cancer showing the highest stroma proportion (median 19% and 73% respectively). Adjusted Cox regression models revealed both positive (pancreato-biliary type periampullary cancer and oestrogen negative breast cancer, HR(95%CI)=0.56(0.34-0.92) and HR (95%CI)=0.41(0.17-0.98) respectively) and negative (intestinal type periampullary cancer, HR(95%CI)=3.59 (1.49-8.62)) associations of the tumour stroma fraction with survival.Interpretation: Our study provides an objective quantification of the tumour stroma fraction across major types of solid cancer. Findings strongly argue against the commonly promoted view of a general associations between high stroma abundance and poor prognosis. The results also suggest that full exploitation of the prognostic potential of tumour stroma requires analyses that go beyond determination of stroma abundance.</p