Family-based prevention of childhood obesity : long-term outcomes, challenges and implications for future research

Background: Childhood obesity is considered to be one of the most serious health challenges of the 21st century. There have been indications that the prevalence has reached a plateau in high-income countries, yet the prevalence is increasing in poorer parts of the world. The same tendencies are seen within richer countries, with higher prevalence in more disadvantaged groups. Despite many ambitious attempts, an effective solution has not yet been found. Family-based early prevention interventions targeting the whole population has been called for, as well as more studies aiming at understanding factors that predispose for childhood obesity or moderate the outcomes of interventions. The cluster-randomized PRIMROSE trial had the aim of primary prevention of childhood obesity. It was based on Motivational Interviewing (MI) and cognitive behavioral principles, and delivered to parents within Swedish child health care services. Aims: The overall aim of this thesis was to investigate the long-term results of the PRIMROSE trial in terms of intervention nurses’ MI proficiency and children’s weight status at follow-up, and to gain further understanding of the results by exploring the experiences of nurses and study coordinators who had worked in the trial, as well as investigating parental risk factors for children’s weight status. Methods: In Study I the MI proficiency level among nurses who had participated in the PRIMROSE trial was explored after the nurses had received the full training package of workshop and supervision. Proficiency at follow-up and potential predictors were also analyzed. In Study II the effect of the PRIMROSE intervention in terms of children’s weight status was investigated, as well as potential moderators of the effect. Study III had a qualitative approach and intervention nurses and study coordinators who had worked in the trial were interviewed. In Study IV we explored parental self-efficacy, health behaviors and weight status as potential risk factors for children’s weight status. Results: The nurses’ proficiency levels after completing the training was generally low, and the results did not change at follow-up. There were no long-term effects of the PRIMROSE intervention on children’s weight status, and no significant moderators. The analyses of potential predictors of children’s weight status yielded no significant results except for strong associations between parents and children’s anthropometry. The interviews with the nurses and study coordinators revealed two overarching themes: “The nurses felt it was rewarding to participate in the trial, but challenging to combine working with the intervention with regular work at the child health care center”; and “The study coordinators felt they were in a difficult position handling the conflicting needs of the research group and the nurses’ commitment to usual child health care services”. The importance of support, encouragement and clear communication was emphasized, as was adaptation of the training in MI to the setting and target group. Stress and lack of time seem to have been major barriers to delivering the intervention as it was intended. Conclusions: The results of the PRIMROSE trial are in line with previous prevention trials targeting individuals’ diet and PA, indicating that we need to shift our focus. Tackling obesity demands a system approach including upstream interventions also targeting the policy level. In addition, the multifactorial etiology of childhood obesity points to the importance of multifactorial solutions, and there’s a need for more high-quality research aiming to increase our knowledge about modifiable predisposing factors and moderators. In addition, the oftenreported challenges in regards to practitioners’ stress levels and difficulties combining regular work duties with working in clinical trials indicates the importance of organizational suppor

Attitude and behaviour – a study of consumers’ explanations for the gap in between

The purpose with this study is to explore how consumers explain the attitude-behaviour gap in the field of environmental consumerism. For this qualitative research, constructionism as an ontological approach was chosen to reach the purpose. Further, phenomenological philosophy has been the interpretative approach and in order to reach rich and nuanced empirical material focus groups were chosen as the procedure for this research. From the study it can be concluded that four themes were prominent as explanations for the attitude-behaviour gap: price, lack of information, values and beliefs and marketing communication. The first two can to some extent be overcome through marketing communication, however they all indicate that lack of motivation is an explanation for the attitude-behaviour gap

Preferential voting, accountability and promotions into political power: Evidence from Sweden

Preferential voting has been introduced in a number of proportional election systems over the last 20 years, mainly as a means to increase the accountability of individual politicians. But most of these reforms have been criticized as blatant failures. In this paper, we discover a genuinely new fact, which calls into question this negative evaluation. We show that preferential voting in a general election can operate as a stand-in internal primary election for top party positions. To do this, we rely on a unique data set from four waves of Swedish local elections, which includes every nominated politician in each of 290 municipal assemblies. We use a natural-experiment (regression-discontinuity) approach to estimate the causal effect of winning the most preferential votes on becoming the local party leader, and find that narrow 'list winners' are over 50 percent more likely to become party leaders than their runner-ups. Comparing across politicians, the effect of list winning is the strongest for competent politicians, who are also more likely to draw preferential votes than mediocre politicians. Comparing across municipalities, the response to narrow list winning is the strongest within unthreatened governing majorities, where voters also use the preferential vote the most frequently

How University management can work to reduce the CO2emissions of business travel : a case study of the Swedish University of Agriculture, Uppsala

En utav de största hållbarhetsutmaningar som samhället står inför idag kretsar kring klimatfrågan. Klimatförändringarnas största orsak världen över är koldioxidutsläppen vilket påverkas av såväl stora som små aktörer. Av Sveriges statliga myndigheter står universiteten för de största CO2-utsläppen då det kommer till flygresor. Sveriges lantbruksuniversitet är ett universitet med en tydlig hållbarhetsprofil och tanken bakom denna studie har grundats sig i att med SLU som fallstudie undersöka hur ledning inom universitetet kan arbeta för att skapa engagemang kring miljöarbetet angående minskade koldioxidutsläpp vid tjänsteresor. Utvalt fokusområde för studien är institutionen för ekonomi och har valts för att få en djupgående förståelse kring hur arbetet på en mer operativ nivå kan fungera. Studien är av kvalitativ karaktär där empiriinsamlingen skett genom sju semistrukturerade intervjuer med anställda vid olika yrkesnivåer på universitetet. Individernas olika positioner på universitetet gör att både ledningens och medarbetarnas perspektiv skildras, vilket gör studiens resultat mer trovärdigt. Slutsatsen indikerar på att för att ett framgångsrikt engagemang kring mindre utsläppsintensivt resande hos medarbetarna ska fungera, bör fokus läggas på tre grundläggande aspekter. Den första är individanpassad motivation, den andra tydlig kommunikation och den tredje är skapandet av förutsättningar för nya mönster. Dessa tre bör ske i kombination med varandra för störst positiv effekt.One of the biggest and most urgent sustainability challenges for society today is the climate issue. The biggest cause of climate change is the carbon dioxide emissions, which are affected by both large and small actors. Of all the Swedish authorities, the Universities stands for being the organisations with the largest amount of carbon dioxide emissions when it comes to air travel. The Swedish University of Agricultural Sciences is a university with a clear sustainability profile. The idea behind this study is to investigate how they manage to within the University create commitment towards more environmental work when it comes to reducing carbon dioxide emissions during missions. The chosen focus area for the study is the Department of Economics and has been chosen to gain an in-depth understanding of how the work at a more operational level can function. The study is of a qualitative nature, where the empirical collection has been done through seven semi-structured interviews with employees at different professional levels at the university. Individually different positions at the university portrays both the management and employees perspective, which makes the study result more credible. The conclusion of this study says that in order for a successful commitment-work contributing climate-friendly travel among employees, the focus should be placed on three basic aspects. The first is individualized motivation, the other clear communication and the third is the creation of conditions for new patterns. These three should be combined with each other for the greatest positive effect

Inspirera i nuet

Syftet med studien är att undersöka hur tre olika cellopedagoger arbetar med inspiration. Undersökningen bygger på litteratur och tidigare forskning som syftar till ämnet inspiration, med eller utan koppling till musik, samt närliggande ämne som kreativitet, motivation, mentorskap och pedagogik. Utifrån denna litteratur, observationer av celloundervisning och intervjuer enligt kvalitativ forskningsmetod har studiens resultat sammanfattat olika metoder för hur ett inspirationsarbete kan utformas. Resultatet har delats upp i inspirationsarbete vid lektionstillfället och utanför lektionstillfället. Diskussionen innehåller mina egna tankar om hur mycket man ska styra sina elever mot inspiration samt hur man fördelar sin energi i jakten på inspirerade elever. I slutändan är inspiration individuellt men det finns generella kunskaper att hämta. Med hjälp av ökad medvetenhet kan man utveckla sin förmåga att bemästra denna balansgång och därmed utveckla sin förmåga att inspirera.The purpose of the study is to examine how three different cello teachers work with inspiration. The survey is linked to literature and previous research with the topic of inspiration, with or without a connection to music, and related subjects such as creativity, motivation, mentoring and education. Based on the literature, observations from cello lessons and interviews according to the methods of qualitative research, the result shows various methods and ways on how the work with inspiration can be designed. I have seperated the results into two areas; inspiration related to the lesson and the work with inspiration that takes part outside the lesson. The discussion contains my own thoughts on how much to guide the students toward inspiration and how a teacher should distribute the energy among his or her students. In the end, inspiration is individual but there is general knowledge to be gained. If you increase your awareness you may develop you ability to inspire

Verkligt bruk - Begreppets varumärkesrättsliga innebörd med särskilt fokus på små och medelstora brukare inom EU

Den europeiska varumärkesrätten är under förändring och nyligen antog Europaparlamentet ett nytt varumärkesdirektiv och en ny varumärkesförordning. En av de frågor som har varit mest omdiskuterad inför förändringarna är huruvida det räcker med användning av ett varumärke i en medlemsstat för att det territoriella kriteriet som är kopplat till bedömningen av verkligt bruk ska anses uppfyllt i artikel 15.1 i VMF. Tidigare har rådets och kommissionens gemensamma förklaring ansetts gälla, i vilken det anges att det räcker med användning i en medlemsstat. Med anledning av det snabbt växande antalet medlemsstater inom EU har dock den gemensamma förklaringen ifrågasatts. År 2012 avgjordes det uppmärksammade målet ONEL där EU-domstolen för första gången tog ställning till innebörden av det territoriella kriteriet i artikel 15.1 i VMF. EU-domstolen påpekade att verkligt bruk ska bedömas utifrån alla relevanta omständigheter i varje enskilt mål och att bedömningen ska göras utan hänsyn till medlemsländernas nationella gränser. Istället ska hänsyn tas till den aktuella marknaden för de varor eller tjänster som varumärket är registrerat för. Vid bedömningen av verkligt bruk hänvisade domstolen till Minimax-avgörandet där de grundläggande kriterierna vid bedömningen av verkligt bruk tidigare har fastslagits. Därutöver påpekade domstolen att det territoriella kriteriet är en del av bedömningen av verkligt bruk. Gällande svensk nationell rätt lyser praxis på området med sin frånvaro. Sannolikt har det territoriella kriteriet en mindre betydelse för svensk rätt, eftersom kriteriet inte har belysts i svensk praxis. Det territoriella kriteriet i 3 kap. 2 § 1 st. VML är troligen uppfyllt efter användning i en del av det svenska territoriet. Efter ONEL-avgörandet har det uppkommit kritik gällande hur EU-domstolens tolkning påverkar små och medelstora företag inom EU. Kritiken har uppkommit i ljuset av att kommissionen år 2008 gav ett löfte i småföretagsakten om att göra gemenskapsvarumärken mer tillgängliga för små och medelstora företag. Immaterialrättsspecialister och intresseorganisationer har uttryckt oro över att små och medelstora företag nu måste lägga om sin varumärkesstrategi och att bedömningen av verkligt bruk inte är rättssäker. I ljuset av den tidigare debatten om det territoriella kriteriet och med anledning av ONEL-avgörandet fanns det förhoppningar om att kriteriet skulle klargöras i den nya europeiska varumärkeslagstiftningen. I Max Planck-Institutets studie, som genomfördes inför de kommande lagändringarna, föreslogs dock ingen ändring. Däremot föreslog institutet att äldre gemenskapsvarumärken och senare registrerade nationella varumärken skulle kunna samexistera i vissa fall. Förslaget grundade sig på att det är svårt att rättfärdiga gemenskapsvarumärkens existens i situationer då ett nationellt varumärke används i ett avlägset område jämfört med det område där ett visst gemenskapsvarumärke används. Dock återfinns inte regeln i den senaste versionen av förslaget till nytt direktiv. Sammanfattningsvis kan sägas att det territoriella kriteriet fortfarande skapar ovisshet och att det hittills är för tidigt att säga vilken effekt ONEL-avgörandet har på små och medelstora företag inom EU.The European trademark law is under revision and recently the European Parliament adopted a new Community Trademark Regulation and a new Trademark Directive. One of the most discussed issues concerning the new legislation is weather it is sufficient to use a trademark in one member state to fulfill the requirement of genuine use in Article 15.1 in the Community Trademark Regulation. Previously the European Council and the European Commission made a Joint Statement, stating that use which is genuine within the meaning of Article 15 in one country constitutes genuine use in the Community. The Joint Statement was however questioned in connection with the growing number of Member States within the EU. In the year of 2012 the European Court of Justice took a position regarding the territorial criterion in Article 15.1 in the Community Trademark Regulation. The Court stated that genuine use should be assessed on all the relevant circumstances of each case and without regard to the national borders of the Member States. Instead, the assessment should be made with consideration of the current market for the goods or services for which the trademark is registered. The Court of Justice referred to the Minimax-decision in which the basic criteria for assessing genuine use has previously been stated. In addition, the Court noted that the territorial criterion is part of the assessment of genuine use. Practice from Swedish courts regarding the territorial criterion has been absent and the criterion seems to be of less importance within Swedish national law. The territorial criterion in Swedish law is probably fulfilled when use has been made in a smaller part of the Swedish territory. After the ONEL decision criticism has arisen regarding how the Court’s interpretation will affect small and medium-sized enterprises in the EU. The criticism comes in the light of the Small Business Act for Europe, in which the European Commission promised to make Community trademarks more available to small and medium-sized enterprises. Intellectual Property specialists and lobby organizations have expressed concern regarding that small and medium-sized enterprises must change their brand strategy and that the assessment of genuine use creates uncertainty. Due to the ONEL decision and the debate concering the territorial criterion, there were hopes that the territorial criterion would be clarified in the new Community Trademark Regulation and in the new Trademark Directive. However, no changes were suggested in the study made by the Max Planck-Institute. Instead, the institute proposed a rule of coexistance between Community trademarks and later registered national trademarks. Max Planck’s proposal was based on the fact that it’s hard to justify the existence of Community trademarks in situations where a national trademark is used in a remote location compared to the area where the Community trademark is being used. However, the rule is absent in the latest proposal for a new Directive. To conclude, the territorial criterion still creates uncertanity and it’s to early to say what exact effects the ONEL decision has on small and medium-sized enterprises in the EU

Evaluation of a new type of temporary immersion system (TIS) bioreactors for plant micropropagation

Micropropagation has been revealed to be an efficient propagation method for production of large quantities of true to type and disease free plants, while traditional methods of micropropagation on solid medium are limited in commercial production due to high labor costs. Bioreactor production in liquid medium has therefore been studied and tested in recent years, but there are still no appropriate types of bioreactors until now. A new type of bioreactors based on the temporary immersion system (TIS) principle has been developed by Professor Margareta Welander at the Department of Plant Breeding and Biotechnology, the Swedish University of Agricultural Sciences (SLU), Alnarp, Sweden, and by Dr. AJ Sayegh, TC propagation Ltd, Bree, Enniscorthy, Co Wexford, Ireland. The aim of this study is to evaluate this new bioreactor for micropropagation using the three widely cultivated and important, horticultural species Digitalis lutea x purpurea, Echinacea purpurea ‘Magnus’ and Rubus idaeus ‘Mormorshallon’ in comparison with micropropagation on solid medium. Fresh and dry weights, the shoot production rate as well as survival and general plant appearance were evaluated. Further on, pH, conductivity, and composition of mineral nutrients and carbohydrates were measured regularly during the culture period. The acclimatization capability of the plantlets in greenhouse was also evaluated. The results show that this newly developed bioreactor is suitable for mass production of target plant species with a similar survival rate and plant quality to those from solid medium. The multiplication rate was either similar or better than that from solid medium. Plant analyses revealed a significant difference (p≤0.05) in fresh weight between TIS and the solid medium. However, the optimal cultivation medium differed between the species, where D. lutea x purpurea and E. purpurea ‘Magnus’ gained more weight with TIS while R. idaeus ‘Mormorshallon’ gained more weight with solid medium. No significant differences were found when comparing dry weights and the multiplication rate except for E. purpurea ‘Magnus’ where TIS resulted in a significantly p≤0.05) higher number of shoots of an adequate size for ex vitro acclimatization. Except for almost full depletion of iron and a 50% decrease in NH4+ concentration in the media of D. lutea x purpurea and E. purpurea ‘Magnus’, only minor changes in pH, conductivity, carbohydrate and mineral nutrient concentrations were observed over time for all species. Overall, the results of the medium analyses show that the bioreactor system is stable and reliable

Det funktionella undantaget - En studie av gränsdragningen mellan mönsterskydd och teknisk funktion

Den 1 juli 2002 implementerades Europaparlamentets och rådets direktiv 98/71/EG om mönsterskydd i den svenska mönsterskyddslagen (1970:485). Harmoniseringen av mönsterrätten inom EU förde med sig en undantagsbestämmelse som återfinns i 4 a § 1 st. 1p. mönsterskyddslagen (1970:485), vilken stadgar att mönsterskydd undantas för detaljer i en produkts utseende som uteslutande är bestämda av produktens tekniska funktion. Bestämmelsen har sedan tillkomsten vållat diskussion om hur den ska tolkas då det saknas ett klargörande avgörande från EU-domstolen på området. Uppsatsen syftar till att utreda hur gränsen dras mellan mönsterskydd och teknisk funktion enligt dagens mönsterrättsliga system samt undersöka om det finns några alternativ till hur dagens gränsdragning sker. I uppsatsen presenteras relevant argumentation som återfinns på området i förarbeten, doktrin, artiklar och praxis. De två frågorna som besvaras är följande: • Hur dras gränsen mellan mönsterskydd och teknisk funktion enligt dagens mönsterrättsliga system? • Skulle gränsdragningen kunna ske på något annat sätt än hur den görs idag? Uppsatsen avslutas med en analys skriven främst ur ett konsumentperspektiv. I analysen sammanställs de tolkningar och argument som har framkommit för att kunna besvara hur gränsdragningen görs enligt dagens mönsterrättsliga system. I avsnittet kritiseras hur den huvudsakliga tolkningen av bestämmelsen görs. Slutligen redogörs min egen ståndpunkt samt förslag på hur bestämmelsen kan ges en ny ordalydelse.On the 1 of July 2002 the Directive 98/71/EC of the European Parliament and of the Council on the legal protection of designs was implemented in the Swedish Design Protection Act (1970:485). The harmonization of the design rights within the EU brought an exemption provision contained in section 4 a § 1 pc. 1p. in the Design Protection Act (1970: 485), which statutes that a design right must not subsist in such features of the appearance of a product which are solely dictated by the technical function of that product. The provision has since its appearance caused a discussion about how it should be interpreted in the absence of a clarification ruling from the European Court of Justice. This essay examines how the line is drawn between design and technical function according to the current legal design system and whether there are any alternatives to the main interpretation that is used today. The examination is based on arguments found in relevant legal preparatory works, doctrine, articles and legal practice. The two questions that are being answered are the following: • How is the line drawn between design and technical function according to the current legal design system? • Are there any alternatives to today’s main interpretation? The essay ends with an analysis, written primarily from a consumer perspective. In the analysis the found interpretations and arguments are compiled, and criticism of the interpretation of the provision is presented. Finally, I describe my own point of view and propose a new wording to the provision