Publikationer från Uppsala Universitet
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Characteristics of Falls among Community-Dwelling Older Adults : The SCOPE Study
No full textIntroduction: Falls among older adults are frequent and will remain a health concern. We describe fall characteristics among older adults living independently in the community based on location, severity, and sex. Methods: As part of the SCOPE study, fall occurrence, location, causes, circumstances, and consequences were reported by 1,754 community-dwelling older adults across Europe at baseline (F0), 12-month follow-up (FU12), and 24-month follow-up (FU24). A geriatric assessment that included demographics, clinical and medication assessment, depression, Cumulative Illness Rating Scale, blood and urine examination, hand grip strength, and fear of falling was performed. Falls characteristics were described, and a multivariate logistic regression analysis was performed to examine the probability of being severely injured because of a fall, inside or outdoors. Results: Data on falls revealed 938 falls at baseline, 773 falls at FU12, and 797 falls at FU24. Approximately 70% of these falls resulted in no injury or untreated injuries, while 8.5% led to bone fractures. Most falls (54.8%) occurred outdoors, primarily during ambulation (64.6%). About 50% of the falls were due to trips, slips, or bumping into objects, while 20.3% were due to balance and gait impairments. Women experienced falls about 30% more frequently than men. Conclusions: Our findings offer new insights into the patterns of falls by location, sex, and injury type. This may help suggest ways of preventing falls. It is reasonable to recommend that older adults train their balance and specifically balance reactive responses to a situation whenever balance is lost accidently and unexpectedly
Characterisation of unicoronal synostosis for improved surgical outcomes
No full textThe severity of unicoronal synostosis is highly variable, but explanatory patient- or treatment-related factors have yet to be defined. There is a lack of standardised and precise measurements to quantify severity, and severity does not traditionally influence the choice of surgical treatment approach. The aim of this thesis was to provide an objective 3D morphological characterisation of unicoronal synostosis, to investigate the relationship between morphology and function, and to assess its relevance to surgical treatment. An automatic and objective statistical shape modelling workflow was developed to quantify the severity of orbital morphology. These 3D measures were used to evaluate the effects of surgery and subsequent growth, revealing persistent asymmetry after reconstruction by fronto-orbital advancement and remodelling. The preoperative heterogenicity of the forehead, skull base and orbits was objectively characterised, and its relationship to explanatory patient-specific factors was investigated in a retrospective two-centre cohort study conducted at Necker Hospital, France, and Uppsala University Hospital, Sweden. Peri-pterionic suture fusion seemed to limit asymmetry. Severe skull base asymmetry was associated with multiple additional issues, suggesting advantages of surgical strategies that address skull base asymmetry. Associations between ophthalmological manifestations and morphological orbital severity, or globe/orbit volume relations, were investigated preoperatively and at age three to five. Postoperative improvement in symmetry was associated with reduced anisometropia but also with new-onset strabismus, implying a complex relationship between morphology and function that is not yet fully understood. The relationship between preoperative morphological severity and long-term ophthalmological outcomes was also investigated in a retrospective two-centre cohort study conducted at Necker Hospital, France, and Uppsala University Hospital, Sweden. Global shape deviation of the ipsilateral orbit preoperatively was identified as a potential predictive factor for worse functional outcome. Neither age at surgery nor contralateral morphology were found to influence long-term functional outcomes. The results suggested benefits to surgical treatment methods that address only the ipsilateral side. In conclusion, these findings indicated a need to refine and individualise surgical treatment in unicoronal synostosis, based on factors influencing severity and long-term function, to enable successful morphological and functional outcomes. Best surgical practice in unicoronal synostosis has yet to be defined
Fishy choices: Investigating the dietary composition of European shag (Gulosus aristotelis) and great cormorant (Phalacrocorax carbo) in the Skagerrak
No full textThe European shag appears to be rapidly increasing in Sweden, and this increase has sparked an interest in their feeding habits and how their diet compares to the well-established great cormorant. For this reason, the diets of the European shag (Gulosus aristotelis) and great cormorant (Phalacrocorax carbo) were investigated through the analysis of regurgitated pellets collected in two areas in the Skagerrak, Väderöarna and Soteskär, off the Swedish west coast. While this method has inherent limitations, the findings suggest that shags primarily depend on small gadoids (Gadidae), wrasses (Labridae), and sandeels (Ammodytidae). In contrast, cormorants predominantly consume wrasses (Labridae) and gadoids (Gadidae). The diet of the shag was similar at both Soteskär and Väderöarna, these findings also applied to cormorants. However, differences between their diets at both locations were significant. Despite notable differences in their diets, dietary overlap was observed. Cormorants tended to consume larger and more benthic fish species compared to shags. To better understand the ecological role of these predators and their impact on fish populations, further understanding of their ecology in terms of diet, distribution, and number of individuals, among others, is needed
Extended thermal admittance spectroscopy for the investigation of composition-dependent meta-stability behaviours in wide-gap (Ag,Cu)(In,Ga)Se2 solar cells
No full textIn this contribution, voltage- and temperature-dependent admittance spectroscopy is used in concert with other electrical characterisation techniques to gain insight into composition-dependent variations in the meta-stable behaviour of the (Ag,Cu)(In,Ga)Se2 system. The extended thermal admittance spectroscopy techniques are powerful tools for the evaluation of meta-stabilities, providing multiple approaches for the determination of the likely origins of observed capacitance features. These capabilities, which enable cross-referencing and verification of capacitance feature labelling, enhance the confidence in conclusions deduced from the often ambiguous and complex admittance spectroscopy methods. Our results indicate that high levels of Ag alloying lead to charge transport barriers active at low temperatures (below ∼ 220 K) and, for the off-stoichiometric case, a shallow acceptor state ∼ 150meV above the valence band edge. Lightsoaking (LS)-induced increases in the activation energy and, consequently, decreases in the occupation of this acceptor state closely reflect the decrease in net doping concentration induced by LS in the off-stoichiometric high-Ag device. The presence of the acceptor state also correlates with the large difference in net doping concentration between the close- and off-stoichiometric high-Ag devices. For moderate Ag-alloying and Ag-free devices, it is shown that off-stoichiometry introduces secondary capacitance features, alongside a common feature observed in both close- and off-stoichiometric devices. These features are determined to originate from a combination of deep defects and charge transport barriers
'All I Do Is Sit in a Chair Until the Pain Fades' : Experiences of Living With Gout
No full textBackground Living with gout impacts most dimensions of life. However, there is a lack of studies exploring the trajectory of patients' experiences of living with and being treated for gout, beyond the experiences during a flare. This study aimed to explore how individuals with gout experience the disease, its effects on daily life and their encounters with healthcare. Methods A constructivist grounded theory was used, involving simultaneous data collection and analysis. Semi-structured individual interviews were conducted with 12 individuals living with gout and aged between 40 and 87 in Central Sweden. Results Navigating the uncertainty of living with gout was represented through two categories: 'a mismatch between individuals' needs and the provision of care' and 'a process of adaptation'. The mismatch involved unmet needs for pain relief, feeling dismissed as having a minor condition and a lack of personalised care. The adaptation process included seeking explanations, developing self-management strategies and adjusting to pain and functional limitations. Conclusions Living with gout entails a significant degree of uncertainty. The process of adaptation is affected by a mismatch between individuals' needs and the care provided, in addition to the disease's 'roller coaster' nature and its slow progression. Patient and Public Contribution This study is part of a research project aimed at gathering knowledge essential for developing an intervention in primary care. A patient, appointed by the Swedish Rheumatism Association, is actively participating in the project's research group. The results of this study have been discussed and analysed within the research group, including input from the patient participant
Predictive factors for limited health literacy among persons with cirrhosis : A Swedish explorative cross-sectional study
No full textIntroduction Fatigue and altered cognitive capacity are common symptoms following cirrhosis. Patients consider information about cirrhosis difficult to understand. Health literacy levels vary among persons with chronic illnesses, which can hamper participation in and adaptation to treatment, potential restrictions and recommendations. Limited health literacy might also lead to decreased autonomy. Purpose The aim was to explore predictors of limited health literacy among adults with cirrhosis. Materials and methods This cross-sectional study explored health literacy among 167 Swedish adults with cirrhosis, 94 men and 73 women with a median age of 65 years using the 'Newest Vital Sign' instrument. Predictors of limited health literacy were examined in relation to patient characteristics and cirrhosis disease events. The study is reported following the STROBE guidelines. Results The prevalence of limited health literacy was 58%. Low education and covert hepatic encephalopathy were associated with limited health literacy (p < 0.05). Conclusion Limited health literacy is common among Swedish adults with cirrhosis. Both covert hepatic encephalopathy and low education might be predictors of limited health literacy. Healthcare providers should tailor their patient education based on the patient's literacy level to facilitate understanding, learning and self-management
Sveriges Geografi : Gamified geography tool: Development and Evaluation of an Interactive Learning Application
No full textAs the world becomes increasingly digital, mobile phones and computers have become a major part of our everyday life. As a result, there has been a push to integrate learning with digital platforms. This project aims to develop an interactive geography application that combines learning with an enjoyable gaming experience, targeted at students and tourists. The goal is to create a game that makes learning Swedish geography fun and accessible. By using pedagogical theories such as constructivism and behaviorism along with principles from user interface design, a game was developed with different game modes that test geography knowledge regarding Sweden’s provinces and cities. The game was developed using React and Github. and tests the users knowledge through clickable maps, trivia questions and pictures. Three rounds of user testing were conducted. The first round identified issues with feedback and color design, resulting in player frustration and a low score in the learning aspect. Round two, after modifications such as clearer feedback, improved color schemes and more consistent UI, showed improvements in both learning and user satisfaction. Feedback from the final testing round laid the groundwork for future development. The results show that gamification, combined with a theoretical foundation and user centered development can improve motivation for learning and understanding geography. By implementing principles from user interface theory such as consistency in button placement, color schemes, the ability to choose between different interaction models, and clear navigational cues, we observed an improvement in ease of use during user testing. Additionally, the inclusion of features such as multiplayer and responsive visual feedback, grounded in learning theory, enhanced the learning experience for users. For future work, this project could be expanded by adding multiplayer to all game modes, more trivia questions, a more advanced result view and classroom tools for teachers to enhance the learning experience. Accessibility and language support could also be enhanced, by adding more language options a wider range of users would be able to play the game.
The relationship between emotional impulsivity (Urgency), aggression, and symptom dimensions in patients with borderline personality disorder
No full textBackground A hallmark of borderline personality disorder (BPD) is a disposition to anger, irritability and aggression. High impulsivity, particularly high emotional impulsivity (urgency), has been associated with aggression in BPD patients. Aims This study aimed to explore, in a sample of patients with BPD, the subtleties of the relationship between borderline symptomatology, different facets of impulsivity, and an aggressive disposition. Methods Two hundred and twenty patients with a DSM-5 (Sect. 2) diagnosis of BPD were assessed on measures of impulsivity (UPPS model), aggression (Brief Aggression Questionnaire, BAQ-12) and borderline symptoms (Borderline Personality Questionnaire, BPQ). Results Results showed: (i) there was a close relationship between BPD symptomatology and an aggressive predisposition measured by BAQ-12; (ii) emptiness and intense anger were the BPD symptom dimensions most significantly associated with aggression (iii) both negative and positive urgency, and to a lesser extent lack of premeditation and sensation seeking, mediated the relationship between borderline symptom dimensions and aggression. Discussion & conclusion Results suggest a close relationship between almost all dimensions of BPD, but especially anger, and impulsive aggression. They further suggest that urgency, particularly negative urgency, mediates this relationship. Future studies will need to parse aggression into motivationally distinct types.In the publication, Sylvia Martin's first and last names are listed in the wrong order in comparison to the co-authorsCorrection in: BORDERLINE PERSONALITY DISORDER AND EMOTION DYSREGULATION, Volume 12, Issue 1, Article Number 21DOI: 10.1186/s40479-025-00298-z</p
Voluntary termination of pregnancy in the context of decriminalized safe abortion : a longitudinal study on the availability, coverage, and utilization of services during 2016-2021 in Nampula province, northern Mozambique
No full textBackground Reducing maternal deaths is a critical public health concern. The Sustainable Development Goals (SDGs) aim to reduce maternal mortality globally to less than 70/100,000 live births by 2030. Mozambique has one of the highest maternal mortality rates in the world, at 233/100,000 live births. Of all maternal deaths, 11% are attributed to abortion. Mozambique decriminalized abortion in 2014 under certain conditions and approved clinical guidelines for service provision in 2016, aiming to reduce maternal deaths from unsafe abortion. This study assesses the availability, coverage, and utilization of facility-based voluntary termination of pregnancy (VTP) during the period 2016-2021 in Nampula province, northern Mozambique. Methods A descriptive quantitative study was performed, using secondary data analysis extracted from the national health monitoring information system (SIS-MA). Trends in the availability and utilization of VTP services were calculated from 2016 to 2021. The results were analysed while considering the geospatial distribution, coverage, and level of care of health facilities providing such services. Results Utilization of VTP services significantly increased by 77% (p < 0.001) and complications related to unsafe abortion decreased by 23.5% (p = 0.018) during 2016-2021. Conclusions Despite the significant improvement in service availability and utilization, the geographic distribution and population coverage of public health facilities providing services remains uneven and limited to semi-urban and urban areas, leaving unsafe abortion as the only option for women in rural areas. Despite these challenges, the results of this study reinforce scientific evidence that decriminalization of VTP and expansion of services may significantly improve access to and utilization of facility-based VTP, holding great potential for decreasing unsafe abortion-related complications and deaths
Battery Storage Control Strategies in Microgrids: : SimulationBased Evaluation of Peak Shaving, Degradation, and CostEfficiency
No full textSmall-scale electricity grids, also known as microgrids, integrate consumption with localproduction, and storage of electrical energy. Microgrids can enhance self-consumption of locallygenerated electricity and reduce peak power demand, an increasingly vital aspect given thecapacity challenges in the Swedish power grid. The choice of control strategy for managing thebattery impacts the performance of the microgrid by altering the ability of the system to reducepower peaks, manage battery health and achieve economic viability. This thesis explores thepotential of microgrids to mitigate peak power demand through the simulation of a microgridcomprising two industrial-scale buildings, each equipped with a photovoltaic (PV) installation.Additionally, a secondary test case using load data from municipal buildings is included in theappendix to assess the generalizability of the results. Three different control strategies, each designed with a separate objective, were used to carryout the simulations. The first strategy is forecast-based, using predictions of load and PVproduction to proactively respond to expected power peaks. The second strategy prioritizesbattery health by avoiding harmful microcycling and using the battery mainly for more significantload-demand cycles. Lastly, the third strategy follows a simpler logic that maximizes the selfconsumption of solar energy on an hourly basis, without regard for forecast data or batterydegradation. The results from the simulations emphasize how each control strategy leads todifferent trade-offs between peak shaving, self-consumption, battery degradation, and economicperformance. Thus, this thesis discusses and analyzes the reasons behind the obtained resultsas well as potential strengths and weaknesses of the three different control strategies. Whencombined with an intelligent control system, microgrids have the potential to reduce powerpeaks. Thus, this study demonstrates that microgrids can play an important role in addressingcapacity challenges in the Swedish power system and that the investment can even beeconomically profitable under favorable conditions. Ultimately, the study emphasizes theimportance of aligning the control strategy with the overall goals and characteristics of themicrogrid which is crucial regardless of whether the objective with the microgrid is reducingpeak loads, maximizing solar self-consumption, or preserving battery health over time