Publikationer från Umeå universitet
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"I have many burdens": experiences and perceptions of vulnerabilities, healthcare, and support among PLHIV in Sweden : a qualitative interview study
No full textPeople living with human immunodeficiency virus (PLHIV) often navigate complex and vulnerable circumstances shaped by intersecting social identities that influence their experiences with human immunodeficiency virus (HIV) infection, healthcare, and support services. This qualitative study explored how PLHIV in Sweden perceive and experience healthcare and social support. It draws on 32 in-depth interviews conducted in 2019, 2021, and 2024 with participants aged 20–65 years. Three central themes were identified through thematic analysis. The first theme, "Carrying Many Burdens: Multiple Vulnerabilities, Overlapping Conditions, and Socioeconomic Hardship", how overlapping identities, health issues, and financial hardship compound vulnerability. Second, "Varying Attitudes and Practices in Healthcare Settings", reflect inconsistent and sometimes problematic encounters with healthcare systems. The third theme, "Nongovernmental Organizations Support is Valuable but Limited", emphasizes the importance of support while revealing its inadequacy in reaching everyone and meeting all needs. These findings highlight the multifaceted vulnerabilities faced by PLHIV in Sweden and point to significant gaps in both healthcare and social support systems. Addressing these challenges calls for coordinated efforts across the structural, institutional, and individual levels
Semi-domesticated reindeer inhibit the recruitment and expansion of mountain birch at the fennoscandian treeline
No full textHerbivory may offset climate change-driven treeline expansion into the tundra, but the strength of this effect is rarely quantified. This study leverages a unique semi-natural experiment involving Malla Strict Nature Reserve in northernmost Finland, where the reindeer herding regime shifted from being nearly ungrazed for several decades to being heavily grazed for the past two decades. This is contrasted by low grazing pressure in the adjacent herding district in Norway, which is separated by the border fence preventing free reindeer movement between the two countries. We aimed to quantify the effects of reindeer browsing and grazing on mountain birch treeline position and structure on both sides. We measured seedling numbers and the allometry of trees, vegetation composition, nutrient concentrations in soils and birch leaves, and radial tree growth. We found higher numbers of seedlings and saplings in the area with lower reindeer density, indicating that the treeline may be responding to climatic forcing by expanding into the tundra. Contrastingly, we observed almost no recruitment and treeline expansion in the area with high reindeer density. Furthermore, while birch leaves showed signs of nitrogen enrichment under high reindeer density, we found no differences in soil chemical composition or birch tree growth rates. Our results suggest that the high density of reindeer in Malla Strict Nature Reserve keeps the treeline in a browsing trap, thereby preventing climate change-driven forest expansion. These results are highly relevant for land management decisions that aim to preserve mountain tundra
Exposure to ambient air pollution during pregnancy and risk of early-onset breast cancer
No full textBackground: Air pollution has been linked to breast cancer risk, but previous studies have seldom considered specific exposure windows, like pregnancy. During pregnancy the breast undergoes substantial changes and exposures may have a stronger impact than if they occurred during other time periods. This study aims to identify associations between ambient air pollution exposure during pregnancy and risk of early-onset breast cancer. Methods: Using nationwide data from Swedish registers, we constructed a cohort consisting of all cancer-free women in Sweden giving birth to their first child between 1991 and 2015. Residential exposure to nitrogen dioxide (NO2), particulate matter < 10 μm (PM10) and < 2.5 μm (PM2.5) were modelled based on air pollution concentrations from 2019. Particulate matter between 2.5 and 10 μm (PMcoarse) was calculated separately. Detailed data on residential addresses (including exact moving dates) were available for the entire study period, allowing for spatial variation in the exposure dataset. Mean air pollution levels were assessed at first pregnancy, last pregnancy, 35 years of age, and 2 years after the last delivery. Associations were evaluated using Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among 1,019,076 women, 12,085 (1.2%) were diagnosed with breast cancer and 65.2% moved at least once between their first pregnancy and two years after their last delivery. All exposures during pregnancy periods were positively associated with breast cancer, with the highest HR observed for exposure to PMcoarse during the last pregnancy (HRPMcoarse = 1.12 (95% CI = 1.04, 1.20) per 5 μg/m3 increase). The lowest HR were for NO2 levels estimated at 35 years of age, regardless of pregnancy status (HRNO2 = 1.03 (95% CI = 0.99, 1.06) per 10 μg/m3 increase). In analyses differentiating between invasive breast cancer and ductal carcinoma in situ, only invasive breast cancer was associated with air pollution exposure. Conclusions: In this cohort study, air pollution exposure was consistently associated with increased risk of early-onset breast cancer
Mapping values in sport clubs : towards a conceptual typology for understanding the bettering of grassroots sport governance
No full textResearch Question: The study aims to offer a typology illustrating sport clubs’ common values, and how they influence clubs’ potential responses to policy reforms and modernization efforts. Based on a conceptual framework focusing on the roots of modernization and tradition, as well as intrinsic and extrinsic motivation in grassroots sport, we construct a typology of values inherent and embedded in sport clubs.Research Research methods: We generated some 600 pages of empirical material from published club handbooks, guidelines, and strategy documents from 21 Norwegian sport clubs. The intertextual analysis was influenced by organizational discourse analysis. Results and Findings: The discursive analysis of sport clubs’ official communication reveals four overarching themes underpinning their governance: (a) lifelong activity and community creation; (b) democracy, schooling, and inclusion; (c) voluntarism, local anchoring, and collective understanding; and (d) innovation, professionalism, and communication. Our findings show the variance of values articulated by sport clubs and how they relate to wider traditional, modern, intrinsic, and extrinsic values. Implications: With this study, we can not only conceptualize how sport clubs view modernization efforts embedded in policy initiatives but also better theoretically understand how they would respond to potential reforms. Methodologically, this study provides an alternative approach to the often-quantitative methods on sport club typologies and often-binary golden standards used to measure and implement governance frameworks. For policymakers wanting sport clubs to better their governance, this study offers an understanding of the complexity in which sport clubs operate
From spatial to abstract and back again : the challenging case of hidden metonymies for metaphor identification scholars
No full textCognitive linguists have long argued that our comprehension of abstract concepts is primarily based on metaphorical or metonymic mappings from more concrete or familiar experiences (Lakoff & Johnson 1980/2008, 1999). Accordingly, metaphor identification commonly involves contrasting concrete senses of words with their contextual meanings. However, examples like a huge log spinning down into nothingness and Max opened a door into nothingness are reminders that, through metonymy, even highly familiar source concepts such as spatial areas can be targets grounded in abstract concepts. Both these instances evoke scenes in which the abstract notion of ‘nothingness’ is a space that physical entities move into. This study highlights the complexity of figurative language and underscores the need for further exploration into how abstract concepts can ground our understanding of more concrete experiences. It also serves to bridge the gap between current metaphor identification practices and the directionality of metonymy. Focusing mainly on mappings in one direction can pose challenges for metaphor researchers, as they might mistakenly categorize such cases as metaphorical rather than as expressions of spatial relations. This is particularly relevant in contemporary metaphor research, which often relies on establishing the basic meanings of individual words to identify metaphorical relationships.
Small Particles, Big Problems : Polystyrene nanoparticles induce DNA damage, oxidative stress, migration, and mitogenic pathways predominantly in non-malignant lung cells
No full textPolystyrene micro- and nanoplastics (PS-MNPs) are emerging environmental pollutants with potential implications for human health. This study investigated the cytotoxic effects of PS particles by using two different sizes of PS-MNPs (0.25 µm and 1 µm) on non-small cell lung cancer (A549, H460), small cell lung cancer (DMS53, H372), and normal lung epithelial (BEAS-2B) cells as well as on human-derived lung organoids. Neither PS-MPs nor PS-NPs interfered with cell viability or proliferation at lower concentrations (< 30 µg/cm2, equivalent to 50 µg/ml). Intracellular kinetic assays revealed that non-malignant (BEAS-2B) lung cells had the strongest turnover of PS-NPs compared to malignant cells. Since PS-NPs exhibited more pronounced cellular effects, additional analyses focused on their impact. Furthermore, we observed significantly increased migration, prolonged S-phase arrest with induced DNA damage, and oxidative stress in non-malignant (BEAS-2B) lung cells. Thus, our data suggest that BEAS-2B cells exhibit the highest sensitivity to PS-NPs. These cells displayed decreased base excision repair capacity and increased activation of survival pathways including AKT and ERK phosphorylation after PS-NP treatment. PS-NP internalization and increase of signal pathways were validated in a physiological lung organoid setting. Our findings suggest that while PS-NPs do not significantly affect the malignant behavior of cancer cells, they could promote malignant features in normal lung cells through the induction of survival pathways, migration, and altered stress response mechanisms
Wildfire, salvage logging and warming : their interactive effects on boreal conifer reforestation
No full textIn Boreal forests, wildfires are common disturbance agents, important for sustaining forest regeneration and ecosystem processes. However, climate warming has intensified fire activity and severity in recent years, and warmer conditions following fire can alter environmental factors affecting tree seedling survival and growth. Management interventions can potentially counterbalance the effects of fire severity and warming. Using a field experiment, we investigated the main and interactive effects of fire severity, experimental warming, understory shrub presence and salvage logging on the growth of different conifer (Picea abies and Pinus sylvestris) provenances, to provide insight about how tree seedlings of various species respond to multiple environmental drivers following fire. Our study shows that low fire severity without salvage logging resulted in poorer seedling above-ground growth, whereas experimental warming and ericaceous shrubs removal increased seedling biomass regardless of fire severity or logging treatment. Our results suggest that enhanced light availability and reduced resource competition from the understory supports the growth of conifer seedlings following fire. Post-fire warming further stimulated the growth of conifer seedlings (particularly in high-severity burn areas) potentially due to increased early colonization by fast-growing deciduous trees. Moreover, in warmer conditions, northern provenances of P. sylvestris planted in southern locations also showed greater height growth compared to local populations, highlighting the potential for assisted migration under climate change. Synthesis and applications. This study demonstrates that artificial regeneration through planting can support forest recovery following wildfire, especially under high fire severity in sites where natural regeneration is poor. Salvage logging can enhance the growth of P. sylvestris seedlings and indirectly benefit P. abies on low-severity sites by facilitation by deciduous species that create favourable microhabitats. However, the broader ecological impacts of salvage logging (such as on biodiversity loss and soil and habitat structure) must be considered in management planning. Post-fire vegetation management, including control of competitive ericaceous shrubs, may further improve seedling establishment. Selecting climate-adapted seedling provenances can boost reforestation success under future warming. These findings support an adaptive management framework that integrates fire severity, logging intensity, understory control and assisted migration to foster resilient forest landscapes in a changing climate
Diagnostic accuracy of otitis media with and without a fictitious AI support among physicians in primary care and medical students
No full textBackground: Otitis media (OM) in children is a common infection in primary care, contributing to a significant global health and economic burden. In high-income countries, diagnostic inaccuracy leads to over-diagnosis of acute OM (AOM) and over-prescribing of antibiotics, which may contribute to antibiotic resistance. Aim: To investigate the diagnostic accuracy and the influence of artificial intelligence (AI) in diagnosing OM among primary care physicians and medical students. Method: A diagnostic accuracy study in which primary care physicians and medical students diagnosed AOM, OM with effusion (OME), and normal eardrums using 21 high-quality digital images, both without and with a fictitious AI support. We estimated the technological impact of the fictitious AI support. Results: Overall diagnostic accuracy was 64% without, and 75% with AI support. The most experienced physicians reached 69% without, and 80% with AI; the least experienced 61% without, and 73% with AI; medical students reached 64% without, and 74% with AI. Accuracy for AOM was 77% without and 86% with AI, and for OME 46% without and 66% with AI. Mean diagnostic confidence increased significantly with AI support. The technological impact was 1.4. Automation bias was 1.2 overall, 0.9 for the most experienced and 1.2 for the least experienced physicians. Conclusion: We report modest diagnostic accuracy for OM among primary care physicians and medical students. The fictitious AI support system improved both accuracy and diagnostic confidence and reduced over-diagnosis. The most experienced physicians achieved the highest accuracy, the less experienced were more often misled by the fictitious AI
Eating alone, social life, and self-rated health : insights from a cross-sectional study of 70- to 75-year-olds in Sweden
No full textCommensality is central to social life - supporting social relations and even happiness - while eating alone is linked to poorer mental and physical health. This study examines whether eating alone and engagement in social activities are associated with loneliness and self-rated health among community-living older adults in Sweden. Data from a national cross-sectional survey of 695 adults aged 70-75-years were used to assess both the frequency and subjective experience of eating alone and engagement in social activities. Using logistic regression and interaction analysis, the associations with loneliness and self-rated health were examined. The frequency and subjective experience of eating alone were both associated with loneliness. The association between eating alone and loneliness was not dependent on whether eating alone was perceived as bothersome. Lower engagement in social activities was associated with loneliness and lower self-rated health. No associations between the frequency and subjective experience of eating alone and self-rated health were observed. In this sample, the proportion of loneliness was high in groups bothered by eating alone, indicating specific subgroups for whom eating alone can be problematic. More research is needed to understand the issue of eating alone - and who it affects. This could help guide the development and implementation of policies targeting groups vulnerable to loneliness and poor health
Sugar-sweetened beverages consumption among the Sámi in Sweden : prevalence and socioeconomic risk factors
No full textIntroduction: The consumption of sugar-sweetened beverages (SSB) is a significant public health issue linked to various diseases like diabetes, obesity, and hypertension. SSB include flavored beverages with added sugars, and their high consumption is prevalent worldwide. Notably, there is limited research on SSB consumption within Indigenous communities, including the Sámi, the only Indigenous group in the European Union. The aim of this study was to estimate the prevalence of SSB consumption and identify associated risk factors among the Sámi population in Sweden. Methods: The research utilized data from the SámiHET survey. A total of 3,658 Sámi aged 18 to 84 responded to the survey, which included questions on health outcomes, lifestyle behaviours, and socioeconomic data. SSB consumption was assessed by frequency of intake, and sociodemographic, socioeconomic, and sociocultural factors were analyzed to identify associated risk factors. Prevalence ratios and their 95% confidence intervals were estimated, using sampling weights to enhance generalizability. Results: The study found that 29.5% of participants reported consuming SSB at least twice a week. Men and younger individuals displayed higher consumption patterns. Statistically significant associations were also observed with lower educational levels and belonging to mountain reindeer herding communities. However, economic stress and income levels were not found to have a statistical association with SSB consumption. Conclusions: The research highlights a substantial consumption of SSB among the Sámi, similar to national levels but lower than other Indigenous groups globally. Factors like gender, age, education, and specific sociocultural contexts (e.g., belonging to a reindeer herding community) were significantly associated with SSB consumption. Culturally adapted public health interventions targeting youth and men and increasing health literacy among the entire Sámi population are recommended to promote better health but also to prevent future chronic diseases