Publikationer från Uppsala Universitet
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The Swedish model of health dialogues, a combined individual- and community-based primary preventive program for cardiovascular disease, is associated with reduced mortality : a systematic review
No full textBackground Behavioural risk factors are key determinants of premature death. The Swedish model of health dialogues, which has been developed since 1985, aims to promote healthy behaviours, for prevention of cardiovascular disease, by inviting everyone in specific age groups to primary care for health dialogues combined with community-oriented activities. The health dialogue was performed by trained nurses, based on individual results from questionnaires on health behaviors and results of physiological measures, using visual pedagogic tools and motivational interviewing techniques. The community intervention part of the program aimed to encourage and enhance healthy behaviors, e.g. by collaboration with civil society, e.g. local sports organizations and/or grocery stores. Methods In this first systematic review of the model, seven studies were identified fulfilling the inclusion criteria, having control/reference groups, defined outcome health measures (mortality, risk factors, lifestyle behaviours) and follow-ups of at least one year. GRADE (Grading of Recommendations, Assessment, Development and Evaluation) was used to assess the quality of evidence. The effect on mortality, on risk factors and lifestyle behaviours was evaluated. Results The model showed effects with reduced premature all-cause mortality and cardiovascular mortality with a moderate level of evidence. Specifically, intention to treat analyses showed a 9.4% and 29% reduction in all-cause mortality in two studies, and 5% reduction of cardiovascular mortality in one large study. Furthermore, levels of blood pressure, cholesterol, fasting blood glucose, waist and BMI were reduced (moderate/low level of evidence) and dietary habits were improved (moderate level of evidence). Health benefits of the model were greater when health dialogues were combined with community-oriented activities. Conclusions The results of this first systematic review of the Swedish model of health dialogues showed significant effects of the Swedish model of health dialogue, on cardiovascular and all-cause mortality. The method is a multifactorial intervention that includes both individual and community/societal intervention, where the respective contributions of both parts of the intervention cannot be delineated
Gatekeepers of the Undesired? : A systematic review on local housing policy and the settlement of vulnerable groups
No full textA neglected dimension of housing policy is how municipalities use it as a gatekeeping mechanism to exclude vulnerable groups and thereby control their territory. To examine this topic, we apply a systematic review that draws on the international academic literature and utilizes three bibliometric analyses. First, statistical analysis reveals the field's growth and how it is characterized by publications often combining an impressive set of data and methods. Second, the material is explored through network analysis, emphasizing how a few important journals lead the distribution of knowledge. Finally, a thematic analysis highlights consistency in the detrimental effects of exclusionary policies across different contexts. A distinction between planned excluding practices and policies with such unintended effects are also evident. The analysis underscores the conflict between individual responsibilities and societal obligations, where current policies tend to place substantial burdens on the individual
Modern surgical treatments for lymphedema
No full textLymphedema occurs when the lymphatic system is malformed, leaking or is damaged by infection or cancer treatment. Enlarged extremities due to extensive fluid retention and adipose tissue deposition, recurrent cellulitis, and the requirement for hard-to-wear compression garments lead to impaired limb function and decreased quality of life. This narrative review aims to elucidate classification, diagnostic tools, and conservative management strategies leading the path to patient selection for microsurgical reconstructive procedures or volume reduction procedures. The surgical approaches include reconstructive procedures such as lymphaticovenous anastomosis (LVA) and lymph node transfer and reductive procedures, mainly liposuction and occasionally excisional surgery. Comparing the efficacy of lymphedema surgeries is fully dependent on standardized and reproducible outcome measures. A growing body of knowledge has evolved pointing to the benefits of reconstructive microsurgery of the lymphatic system with or without surgical volume reduction. Tissue engineering and stem cell research leads the way for new approaches. However, several questions remain emphasizing the research needs. Ongoing multicentre trials aiming to elucidate the efficacy and accessibility of surgical treatments for this condition are on their way
The TP53 tumor suppressor gene : From molecular biology to clinical investigations
No full textExtensively studied over the past four decades, the TP53 gene has emerged as a pivotal watchman in cellular defense and a key factor in cancer biology. TP53 is the most frequently mutated gene in human malignancies, 50% of which carry alterations to it. Initially, the functions of p53 were thought to be restricted to cell-cycle arrest and apoptosis. With time, however, a growing number of functions have been discovered, illustrating p53's role as a master switch between any cellular stress and cellular or multicellular responses that contribute to its anti-tumor activity. Indeed, the peculiar landscape of TP53 mutations and its high heterogeneity are linked both to the structure of the protein and its ubiquitous function in regulating cellular homeostasis. Mutations in p53 are associated with poor response to therapy and shorter survival in most cancer types, and the diagnosis of p53 mutations is currently used to improve case management in some types of leukemia and lymphoma. Although TP53 has been defined as a tumor suppressor gene, overexpressed mutated p53 variants found in human tumors are defined as dominant oncogenes with a potential gain of function, which makes the gene a very attractive target for developing new cancer treatments. Beyond its role in cancer, our review also highlights TP53's significance in non-neoplastic conditions, such as bone marrow failure syndromes and certain developmental disorders, where chronic p53 activation plays a crucial role in cellular stress responses, demonstrating its broader biological importance
Quality assurance through GAP analysis
No full textIn a time when demands for quality, standardisation and traceability are becoming increasingly central, particularly within the automotive industry, it is essential for suppliers to demonstrate compliance with industry-specific standards such as IATF16949. This study was conducted with the purpose of examining to what extent anexisting quality management system meets the additional requirements of IATF 16949:2016, as well as identifying potential gaps and areas for improvement in relation to the requirements. Through a combination of documents, literature reviews, observations and recurring discussions the work was carried out with a focus limited to chapters 4-7 and 10 of IATF 16949. A GAP-analysis was used to map the differences between the current practices and the requirements set by the target standard. The result show that many of the additional requirements set by IATF 16949 are already fulfilled, particularly in the areas of organizational context, leadership and improvements. At the same time, areas for improvement were identified where complementary measures such as clearer documentation, systemized risk management and formalized procedures for certain processes are required to achieve full compliance. Based on these results, it is concluded that there are favourable conditions within the specific chapters covered by the study to achieve certification according to IATF 16949. The identified gaps can largely be addressed through complementary efforts within the existing system rather than through extensive structural changes
Water knowledge in the French colony of Saint Domingue
No full text This paper explores the formation of water knowledge in the French colony of Saint Domingue in the eighteenth century. Throughout the French colonies, water management was an especially volatile topic, as droughts, epidemics, and panics surrounding poisonings led to frequent deaths and violence. This made the safety and potential healing abilities of waters in Saint Domingue a central concern to the inhabitants and administrators of the colony. Chemical and medical work on the subject of waters became a prized activity, encouraged by the scientific society of the island, the Cercle des Philadelphes. Analysts used and adapted metropolitan analytical methods, but the realities of slavery and imperialism deeply affected their methods and conclusions, especially as physicians attempted to better understand the local springs by utilizing the knowledge and bodies of enslaved workers. Intersecting studies of colonial spas and colonial science, this study of water knowledge in Saint Domingue thus illustrates the interplay between chemistry, medicine, and colonial power. I show that while the material practice of chemistry came to resemble that of metropolitan France, the medical use of Saint Domingue’s waters was shaped by the knowledge and bodies of enslaved workers and healers
The Electroweak Phase Transition in the Standard Model Effective Field Theory
No full textIn this work, we investigate the effects of including SMEFT operators on the nature of the electroweak phase transition. In particular, we include the three SMEFT dimension-6 operators that contain only Higgs fields and their derivatives in the Lagrangian, and we use that to compute the effective potential and field-dependent masses. We then implement a SMEFT model in TransitionListener to obtain the phase transition and gravitational wave parameters for a set of 5000 parameter points consistent with current experimental constraints. This allows us to map out the SMEFT parameter space and to determine where a first-order electroweak phase transition can occur. Most of the parameter points considered resulted in first-order phase transitions. We find that the strength of a first-order phase transition is correlated with the quartic coupling and the Wilson coefficient: as and become more negative, the transition becomes stronger. For the strongest transitions, the resulting gravitational wave signal is observable by LISA. Most of the points that did not result in a first-order phase transition were concentrated in a particular region of parameter space. For points with −0.29 ≲ ≲ −0.17 and ≲ −2.2 × 10−6 GeV−2, the transition becomes too supercooled to allow for the nucleation of one bubble per Hubble volume today. Beyond that, for ≲ −0.29, the low-temperature minimum never becomes the global minimum, so symmetry breaking is energetically unfavourable
The Aesthetics of Stones
No full text In this paper, I shall examine the aesthetic experience afforded by stones – in particular the kind of smoothly rounded enchanting pebbles that invite us to handle and collect them – and argue that it is not simply an experience of natural objects, but that their appeal is related to their being comparable to artefacts, although the workmanship was enacted not by a human but by superhuman forces. Such stones have, as it were, an ontological position between natural aesthetic phenomena and artefacts and summons us to connect with our earthly origins. Finding a stone that is not only pleasing to the eye but more importantly to the hand can bring one into contact with the planet’s deep past. I explore the affinities between stones and Korsmeyer’s (2019) “Real Things” – rare, old or singular artefacts, characterised by genuineness and a distinct aura, that invite us to come closer to and touch them
Modelling Driver Interaction in Semi-Autonomous Vehicles Using Markov Chains : Effects of Information Level, Sex, and Environment
No full textThis thesis investigates how drivers who are driving an autonomous vehicle behaviour shifts during interactions with autonomous vehicles, with particular attention to transitions between three states: Normal (N), Alert (A), and Takeover (T). Using a Markov Chain framework, I reanalysed existing data originally collected in large-scale studies of human–AV interaction [29, 30]. The analysis examined the impact of three key factors: information level (high vs. low), sex (male vs. female), and driving environment (highway vs. suburban) on driver state transitions. The dataset consisted of responses from 206 participants who engaged with structured driving scenarios across both highway and suburban contexts. Each participant experienced three sequential scenes per environment, with systematic variation in the information presented by the AV. My re-analysis revealed clear differences in behavioural patterns between the environments: highway scenarios showed a more distributed set of transitions across all states, whereas suburban scenarios were dominated by the Normal state. Statistical testing indicated that sex was a crucial factor, with female drivers more likely to shift into the Alert state in highway contexts. The influence of information level was also stronger in highway environments than in suburban ones. These findings show how important it is to think about both contextual and individual factors in the design of human–machine interfaces for autonomous vehicles. Rather than applying uniform information strategies, AV systems may benefit from adaptive approaches that take into account the driving environment and user characteristics. By applying probabilistic modelling to this dataset, this thesis adds value to the insight of human–automation interaction and establishes a basis for predicting driver behaviour and designing adaptive AV interfaces that promote both safety and comfort
Internal conflicts and the measurement of evolutionary individuality
No full textIn biology, individuals can be identified at various levels of organization, ranging from the molecular and cellular-e.g., viruses and protists-to the organismal and societal-e.g., termites and termite colonies. This nested biological hierarchy results from evolutionary transitions in individuality, in which lower-lying entities (particles) come together to form higher-level entities (collectives). These collectives are then taken to be individuals in their own right, capable of being the units on which selection acts and where adaptations may reside. Challenges arise, however, when we recognize the possibility for internal conflict, for example from selfish genetic elements within organisms. Here we develop a quantitative approach to biological individuality, in which collectives qualify as individuals to the extent that their particles possess a unity of purpose-i.e., that they possess aligned fitness interests. We propose a mathematical framework that measures the degree of individuality exhibited by organisms and other biological collectives in the presence of internal conflicts. This framework not only helps pinpoint where in the hierarchy biological individuality sits, but also identifies the level at which adaptation may reside. We develop two metrics: fitness unity, which measures the threat posed by internal conflicts to a collective individual's status as an optimizing agent; and trait unity, which measures differences in optimal strategies among its particles. Finally, we consider cases where internal conflicts become so disruptive to individualized biological collectives so that it no longer makes sense to think of them as individuals, but instead as compromises of multiple competing particles