Publikationer från Uppsala Universitet
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The diminishing spaces for collegial work
No full text In this conceptual paper, we discuss how collegiality as a governing form in contemporary universities is challenged in its possibilities to influence organizational control over (and responsibility for) universities’ teaching and research. In particular, we discuss how contemporary organizational conditions, beyond mere formal structures, might limit the space within which collegiality finds its relevance and where these conditions undermine the very academic practice collegiality is set to serve. We suggest two different processes of 'decollegialization ' of higher education and research that – as we see them – jointly redefine collegiality as a governing form: colonization and adulteration
Decompressive craniectomy following subarachnoid hemorrhage : A prospective Swedish multicenter study
No full textIntroduction: Decompressive craniectomy (DC) in patients with severe aneurysmal subarachnoid hemorrhage (aSAH) can be a life-saving procedure. The aim of this nationwide prospective study was to investigate the use of DC in aSAH patients in Sweden. Research question: To explore the risk factors and functional outcome associated with DC in patients with aSAH. Material and methods: Patients treated for aSAH at all neurosurgical centers in Sweden during a 3.5-year period (2014-2018) were prospectively registered. Clinical, radiological and treatment-related factors with regard to DC were analyzed using Chi-Square and logistic regression analysis. Functional outcome was assessed by the extended Glasgow outcome scale one year after the bleeding. Results: During the study period, 1037 patients were treated for aSAH. Thirty-five patients (3.4%) underwent DC. At one year follow-up, 25 of these (71%) had unfavorable functional outcome. Multivariate logistic regression analysis revealed that poor clinical grade before aneurysm treatment, middle cerebral artery (MCA) aneurysm, edema on the initial computed tomography (CT), and adverse events during aneurysm occlusion were independent and significant risk factors for performing DC. Discussion and conclusion: DC is relatively uncommon in aSAH patients and is related to increased risk of unfavorable outcome. However, favorable functional outcome was seen in 29% of patients with DC. Adverse events during aneurysm occlusion were significant risk factors for DC
1-year data on patient-reported outcome is enough after surgery for degenerative cervical myelopathy : a cohort study from the Swedish Spine register
No full textBackground and purpose: Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adults. Repeated follow-ups after surgery are resource consuming. The aim was to examine whether patient-reported outcome measures (PROMs) change after the first year. The purpose of this study was to investigate whether it is necessary to obtain follow-up data from patients more than 1 year after surgery for DCM. Methods: We included individuals treated surgically for DCM in the Swedish Spine registry (Swespine), with available preoperative, 1-, and 2-year PROMs, primarily the European Myelopathy Scale (EMS) and secondarily the Neck Disability Index (NDI), and the European Quality of life Visual Analogue Scale (EQ-VAS). A tertiary analysis included available 5-year data. Median, interquartile range (IQR), and Bland-Altman plots were used to compare PROM data at different follow-up time points. Results: 642 individuals had baseline, 1-, and 2-year follow-up data, of whom 347 also had 5-year data. EMS was 14 (12-16) preoperative, 15 (12-17) at the 1-year follow-up, and 15 (12-17) at the 2-year follow-up. Corresponding data for NDI was 38 (24-50), 25 (12-42), and 26 (12-42) and for EQ-VAS 50 (30-60), 60 (42-77), and 60 (40-75). Similar findings were seen in individuals who also had 5-year data. Bland-Altman plots indicated good agreement between 1and 2-year data, and between 1and 5-year data and were without proportional bias. Conclusion: In individuals treated for DCM no clinically meaningful change in PROMs occurred after the 1-year follow-up
Bronchodilator responsiveness and future chronic airflow obstruction : a multinational longitudinal study
No full textBackground: Bronchodilator responsiveness testing is mainly used for diagnosing asthma. We aimed to investigate whether it is associated with progression to chronic airflow obstruction over time. Methods: The multinational Burden of Obstructive Lung Disease cohort study surveyed adults, aged 40 years and above, at baseline and followed them up after a mean of 9.1 years. Recruitment took place between January 2, 2003 and December 26, 2016. Follow-up measurements were collected between January 29, 2019 and October 24, 2021. On both occasions, study participants provided information on respiratory symptoms, health status and several environmental and lifestyle exposures. They also underwent pre- and post-bronchodilator spirometry. We defined bronchodilator responsiveness at baseline using the American Thoracic Society and European Respiratory Society (ATS/ERS) 2022 definition, and the presence of chronic airflow obstruction at follow-up as a post-bronchodilator forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC) less than the lower limit of normal. We used multi-level regression models to estimate the association between baseline bronchodilator responsiveness and incident chronic airflow obstruction. We stratified analyses by gender and performed a sensitivity analysis in never smokers. Findings: We analysed data from 3701 adults with 56% being women. Compared to those without bronchodilator responsiveness at baseline, those with bronchodilator responsiveness had 36% increased risk of developing chronic airflow obstruction (RR: 1.36, 95%CI 1.04, 1.80). This effect was stronger in women (RR: 1.45, 95%CI 1.09, 1.91) than men (RR: 1.07, 95%CI 0.51, 2.24). Never smokers with bronchodilator responsiveness also were at greater risk of incident chronic airflow obstruction (RR: 1.48, 95%CI 1.01, 2.20). Interpretation: Bronchodilator responsiveness appears to be a risk factor for incident chronic airflow obstruction. It is important that future studies in other large population-based cohorts replicate these findings
Islamic Ecotheology
No full textThe intensifying debate over environmental destruction, global heating, and humanity’s roll in the emission of that greenhouse gases threating the Earth, humanity, and all animal and plant life, has been accompanied by a parallel debate over these same issues by Muslim thinkers. The reason is that these threats are not limited to coun-tries in the West but undermine the conditions for life on the entire planet.One element of the debate in the West has been the role played by religion, or, more precisely, Christianity in the environmental and climate crisis. The Christian creation story, which elevates human beings to lords of creation with sovereignty over the Earth, has been a prominent target of criticism. Its perspective has been accused of conferring legitimacy upon humanity’s plundering of nature. A similar viewpoint can be found in the Muslim creation narrative, which presents human beings as the supreme creation in whose service God has created everything under the heavens. For Muslims, the question is how to engage with this criticism. Do Muslim theologians agree that Islam’s creation narrative and view of humanity have contributed to the overexploitation of the resources of nature? How do Muslim theologians regard Islamic creation theology’s view of the relation between humanity and God’s non-human creations? This debate is connected to a larger question that relates to the role of religion in climate and environmental issues. Do Muslim theologians agree that Islam is a part of the problem, or do they present Islamic creation theology and its theological eth-ics as the solution to the problem? Does Islamic ecotheology see the solution as lying in religion/Islam or somewhere else? Do they think that the solution lies in the individual or should the issue be dealt with at the collective level as politics?
Riding Bubbles Out of The Swampland
No full textThe discovery of the accelerating expansion of the universe has sparked considerable efforts to incorporate a small, positive cosmological constant within the framework of string theory, a task fraught with challenges. The dark bubble model offers a promising alternative by proposing an expanding cosmology on a 1+3-dimensional braneworld embedded in an AdS background, thus sidestepping many of the difficulties associated with metastable de Sitter (dS) vacua. This thesis serves as a comprehensive review of the dark bubble model, synthesising results from key papers and presenting detailed derivations to enhance accessibility for newcomers. Starting with the 5-dimensional model, we derive the induced positive dark energy density as a function of the brane tension for a bubble of true AdS vacuum nucleating in an initial false vacuum. We then extend the analysis to the embedding of the dark bubble in AdS solution of Type IIB string theory, where we similarly obtain \rho_\Lambda > 0 expressed in terms of 10-dimensional parameters. Our review also examines the energy scale hierarchy, highlighting a novel inversion with —a departure from standard compactification scenarios with strict bounds on extra-dimensional volumes. Finally, we explore the implications of this model in quantum cosmology, particularly claims that it naturally selects the Vilenkin tunnelling boundary conditions. By compiling and clarifying these developments, this thesis aims to provide a valuable resource for understanding the dark bubble model and its potential as a UV-complete framework incorporating a positive cosmological constant.Upptäckten av universums accelererande expansion har lett till stora ansträngningar att införliva en liten och positiv kosmologisk konstant inom ramen för strängteorin, en uppgift som är full av utmaningar. Den mörka bubbelmodellen erbjuder ett lovande alternativ genom att föreslå en expanderande kosmologi på en 1+3-dimensionell bran-värld inbäddad i en högredimensionell AdS-bakgrund, och därmed kringgå många av de svårigheter som är förknippade med metastabila de Sitter (dS) vakum. Denna avhandling är en genomgång av den mörka bubbelmodellen, sammanfattar resultat från viktiga artiklar och presenterar detaljerade härledningar för att förbättra tillgänglighet för nykomlingar i ämnet. Vi börjar med den 5-dimensionella modellen och härleder den inducerade positiva mörka energitätheten som en funktion av bran-spänningen för en bubbla av äkta AdS-vakuum vilken bildas i ett initialt falskt vakuum. Vi utvidgar sedan analysen till inbäddningen av den mörka bubblan i AdS-lösningen av strängteori av typ IIB, där vi på liknande sätt får \rho_\Lambda > 0 uttryckt i termer av 10-dimensionella parametrar. Vi undersöker också energiskalehierarkin och poängterar den unika inversione - en avvikelse från det vanliga sättet att kompaktifiera extra dimensioner med dess strikta volymsgränser. Slutligen undersöker vi konsekvenserna av denna modell inom kvantkosmologi, särskilt påståenden att den naturligt väljer Vilenkins gränsvillkor istället för Hartles och Hawkings. Avhandlingen syftar till att tillhandahålla en värdefull resurs för att förstå den mörka bubbelmodellen och dess potential som ett UV-komplett ramverk med en positiv kosmologisk konstant
Combined use of the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework with other implementation frameworks : a systematic review
No full textBackground Appropriately and comprehensive applying implementation frameworks is one of the key challenges in implementation science resulting in increased use of multiple implementation frameworks within projects. This is particularly true for frameworks such as PARIHS/i-PARIHS. Therefore, this systematic review aimed to examine if and why the PARIHS/i-PARIHS framework has been applied in research with other implementation frameworks. Methods We searched six databases from 2016 (the year following i-PARIHS’ publication) to April 2024 and supplemented this with a citation search of the seminal i-PARIHS paper. We included studies that 1) were peer-reviewed with a protocol or empirical study design, 2) have applied the PARIHS or i-PARIHS framework for implementation planning, delivery, analysis, or evaluation and 3) also used at least one other implementation framework. Descriptive statistics were conducted to report on study characteristics and frequency for each implementation framework used with PARIHS/i-PARIHS. A qualitative, content analysis was used to analyse the answers to open-ended extraction questions. Results Thirty-six articles met criteria for inclusion and included 16 protocols and 20 empirical articles (twelve intervention and eight cross-sectional studies). Thirty-four of the studies used one additional implementation framework and two studies used two additional implementation frameworks. In total, nine implementation frameworks were applied with PARIHS/i-PARIHS, including: 1) RE-AIM, 2) CFIR, 3) NPT, 4) REP, 5) TDF, 6), DSF, 7) KTA, 8) Stetler’s Model, and 9) SIF. Thirty-four reported a rationale for using PARIHS/i-PARIHS and 34 reported a rationale for using the other implementation framework. Only eleven reported a rationale for using more than one implementation framework. Only three reported strengths of combining implementation frameworks. Conclusions Overall, this review identified that implementation researchers are using PARIHS/i-PARIHS in combination with other implementation frameworks and providing little to no rationale for why. Use of multiple implementation frameworks without detailed rationales compromises our ability to evaluate mechanisms of effectiveness. Implementation researchers and practitioners need to be more explicit about their framework selection, detailing the complementary strengths of the frameworks that are being used in combination, including why using one is not sufficient. Trial registration This systematic review was registered with PROSPERO: ID: 392147
Enabling polycentric governance in cybersecurity : A comparison of state support in low- and high-income countries
No full textIn line with a more digitalized world, cyber threats against nations, businesses, and individuals increase. Such threats appear to affect countries around the world, high- as well as low-income countries. This thesis investigates whether and how state support for local and private cybersecurity measures differs between these two economic contexts. A polycentric governance approach is used when analyzing national cybersecurity strategies of Uganda, Sierra Leone, Estonia, and Australia in order to examine the role of the state in ambition setting, coordination, financial support, and regulatory support. Through a qualitative content analysis, the findings of this thesis suggest that there exists differences between the approaches of high- and low-income countries, although all four countries engage in state-supported cybersecurity efforts. The low-income countries have a focus on raising public awareness, integrating cybersecurity into education, and encouraging cooperation through state-driven platforms. On the other hand, high-income countries apply with detailed regulatory frameworks, financial commitments, and structured support mechanisms.
Politik och Påverkan: Narkotikapolitikens Evolution : En jämförelse mellan Socialdemokraterna och Moderaternafrån 2000-talet till Idag.
No full textSwedish drug policy has had a major impact on Swedish society. Not necessarily the drugsthemselves, but rather what drugs as a phenomenon bring. This refers to the social harm thatpeople who abuse drugs do to themselves and to those around them who are close to theaddict. It also raises structural issues, as drugs do not seem to affect only the poorest insociety. Drugs are used by all types of people in all classes of society and almost always causethe same types of harm. Sweden has long had a repressive attitude to drugs, and this may beone of the explanations for the problems we have today. In this study, the political stance oftwo dominant parties in relation to drugs has been compared to put the state of society intoperspective, from the beginning of the 2000s to today. The study has shown that in recentyears, drugs have brought additional problems that do not only affect the user or those aroundthem. It has accompanied the criminal development that drugs are subject to illegal trade thataffects society in the form of brutal violence.