Northern Sweden Research Articles

Temporal trends and educational inequalities in obesity, overweight and underweight in pre-pregnant women and their male partners: a decade (2010-2019) with no progress in Sweden.

Trends in overweight and obesity among expectant parents can provide useful information about the family environment in which children will grow up and about possible social inequalities that may be passed on to them. Therefore, we aimed to assess whether the prevalence of underweight, overweight and obesity changed over time in pre-pregnant women and their male partners in northern Sweden, and if there were any educational inequalities. This study is based on cross-sectional data from a repeated survey of the population in Västerbotten, Sweden. The study population included 18,568 pregnant women and 18,110 male partners during the period 2010-2019. Multinomial logistic regression models were fitted separately for pregnant women and male partners to assess whether the prevalence of age-adjusted underweight, normal weight, overweight and obesity had evolved between 2010 and 2019, and whether trends differed by educational level. Among women, obesity prevalence increased from 9.4% in 2010 to 11.7% in 2019. Among men, it went from 8.9 to 12.8%. Educational inequalities were sustained across the study period. In 2019, the prevalence of obesity was 7.8 percentage points (pp) (CI = 4.4-11.3) higher among women with low compared to high education. The corresponding figure for men was 6.4 pp (CI = 3.3-9.6). It is not obvious that the prevalence of obesity among parents-to-be will decrease under current dispositions. Public health policies and practice should therefore be strengthened.

The Life After Stroke In Northern Sweden Study (LASINS): Methodology, cohort demographics and initial results.

To advance rehabilitation we need a comprehensive understanding of functioning and disability of people after stroke. To present an overview of the methodology of the Life After Stroke In Northern Sweden Study, compare participants and non-participants regarding gender and age, and describe baseline sociodemographics, stroke characteristics and the participants' self-rated degree of recovery. Data were collected through a study specific questionnaire, from the participants' medical records and with internationally established self-assessment tools focusing on sleep disturbances, depressive symptoms, fatigue, physical activity, and remaining physical and cognitive impairments, activity limitations, participation restrictions and life satisfaction. Of 301 potential participants, 160 comprise the final sample (response rate 53%; 86 men and 74 women, mean age 73 years±11, mean time since stroke onset 35 months±11; 18- 61). Most participants had an ischemic stroke (87%), were retired (84%), cohabitant (63%) and walked independently (71%). The mean self-rated degree of recovery was 75 (SD±24; 0- 100). These baseline data together with forthcoming studies will describe stroke-related impairments, activity limitations, participation restrictions and life satisfaction more than one year after stroke, and deepen our understanding of factors of importance for a healthy and successful life after stroke.

Investigating Labor Market Transformations in Northern Sweden

Investigating Labor Market Transformations in Northern Sweden

The 1919–21 influenza pandemic in Greenland

ABSTRACT In Alaska, the 1918–20 influenza pandemic was devastating, with mortality rates up to 90% of the population, while in other arctic regions in northern Sweden and Norway mortality was considerably lower. We investigated the timing and age-patterns in excess mortality in Greenland during the period 1918–21 and compare these to other epidemics and the 1889–92 pandemic. We accessed the Greenlandic National Archives and transcribed all deaths from 1880 to 1921 by age, geography, and cause of death. We estimated monthly excess mortality and studied the spatial-temporal patterns of the pandemics and compared them to other mortality crises in the 40-year period. The 1918–21 influenza pandemic arrived in Greenland in the summer of 1919, one year delayed due to ship traffic interruptions during the winter months. We found that 5.2% of the Greenland population died of the pandemic with substantial variability between counties (range, 0.1% to 11%). We did not see the typical pandemic age-pattern of high young-adult mortality, possibly due to high baseline mortality in this age-group or remoteness. However, despite substantial mortality, the mortality impact was not standing out relative to other mortality crises, or of similar devastation reported in Alaskan populations.

Towards objective measurements of habitual dietary intake patterns: comparing NMR metabolomics and food frequency questionnaire data in a population-based cohort

BackgroundLow-quality, non-diverse diet is a main risk factor for premature death. Accurate measurement of habitual diet is challenging and there is a need for validated objective methods. Blood metabolite patterns reflect direct or enzymatically diet-induced metabolites. Here, we aimed to evaluate associations between blood metabolite patterns and a priori and data-driven food intake patterns.Methods1, 895 participants in the Northern Sweden Health and Disease Study, a population-based prospective cohort study, were included. Fasting plasma samples were analyzed with 1H Nuclear Magnetic Resonance. Food intake data from a 64-item validated food frequency questionnaire were summarized into a priori Healthy Diet Score (HDS), relative Mediterranean Diet Score (rMDS) and a set of plant-based diet indices (PDI) as well as data driven clusters from latent class analyses (LCA). Orthogonal projections to latent structures (OPLS) were used to explore clustering patterns of metabolites and their relation to reported dietary intake patterns.ResultsAge, sex, body mass index, education and year of study participation had significant influence on OPLS metabolite models. OPLS models for healthful PDI and LCA-clusters were not significant, whereas for HDS, rMDS, PDI and unhealthful PDI significant models were obtained (CV-ANOVA p < 0.001). Still, model statistics were weak and the ability of the models to correctly classify participants into highest and lowest quartiles of rMDS, PDI and unhealthful PDI was poor (50%/78%, 42%/75% and 59%/70%, respectively).ConclusionAssociations between blood metabolite patterns and a priori as well as data-driven food intake patterns were poor. NMR metabolomics may not be sufficiently sensitive to small metabolites that distinguish between complex dietary intake patterns, like lipids.

Testing the P/S Amplitude Seismic Source Discriminant at Local Distances Using Seismic Events Within and Surrounding the Kloof Gold Mine, South Africa, and the Kiruna Iron Ore Mine, Northern Sweden

ABSTRACT We investigate the utility of the P/S amplitude discriminant for small seismic events recorded at local distances on surface seismic networks using (1) mining-related events from within the Kloof gold mine in South Africa; and (2) mining-related events and earthquakes within and adjacent to the Kiruna iron ore mine in northern Sweden. For the Kloof mine, seventy-five source mechanisms characterized by moment tensor solutions obtained using high-frequency in-mine seismic data are used to evaluate three mine-related source types, isotropic (crush), compensated linear vector dipole (crush-slip), and double-couple (DC; pure slip). For the Kiruna mine region, 270 events are used to evaluate earthquake sources, chemical explosions, and mine-related seismic events (primarily isotropic). For the Kloof mine events, we find that average P/S amplitude ratios measured in the 2–6 Hz frequency band discriminate between isotropic and DC events, and if only pure-slip events with a DC component of &amp;gt;60% are considered, the effective frequency band can be extended from 2 to 8 Hz. For the Kiruna region events, P/S amplitude ratios effectively discriminate earthquakes from chemical explosions in the 4–6 Hz and 10–28 Hz frequency bands. Our findings further show that average P/S amplitude ratios for mine-related events and earthquakes separate at frequencies of 10 Hz and higher. A comparison of amplitude ratios for crush and pure-slip events located within a depth range of 1 km in the Kloof mine, and a comparison of amplitude ratios of shallow (&amp;lt;10 km depth) and deep-focus (&amp;gt;20 km depth) earthquakes in the Kiruna region, indicate that the P/S amplitude discriminant is not influenced significantly by source depth. These findings thus suggest that the P/S amplitude discriminant, originally developed for larger events recorded at regional and teleseismic distances, can be extended to smaller events recorded at local distances.

Staff perspectives on poor mental health in secondary school students: an increasing problem handled with insufficient resources.

An increasing number of schools are recognizing the importance of addressing students' mental health based on the association with educational outcomes and long-term health. The school organization and the members of the school staff play important but, in several ways, challenging roles in this work. The purpose of this study was to explore views of staff from schools and school health services on mental ill health among students and their own role in detecting and managing it. A qualitative study was conducted in a sparsely populated municipality in northern Sweden. In total, 40 participants from three secondary schools and the school health services participated either in focus groups or individual interviews. Participants were teachers, assistants, school nurses, school counselors and psychologists. Data were analyzed using thematic analysis. The analysis revealed the main theme Student mental ill health: an increasing problem handled with insufficient resources and two subthemes, i.e., Uncertainty in interpreting students' signs of mental ill health and the need to clarify roles and establish a supportive organization. It was concluded that school staff were uncertain regarding how to interpret signs of mental ill health among students and required better knowledge and more resources to help students with mental ill health. A clearer organization and consensus regarding support for students with mental ill health were also necessary in light of the division of responsibilities between school staff and the school health services.

A drained nutrient-poor peatland forest in boreal Sweden constitutes a net carbon sink after integrating terrestrial and aquatic fluxes.

Northern peatlands provide a globally important carbon (C) store. Since the beginning of the 20th century, however, large areas of natural peatlands have been drained for biomass production across Fennoscandia. Today, drained peatland forests constitute a common feature of the managed boreal landscape, yet their ecosystem C balance and associated climate impact are not well understood, particularly within the nutrient-poor boreal region. In this study, we estimated the net ecosystem carbon balance (NECB) from a nutrient-poor drained peatland forest and an adjacent natural mire in northern Sweden by integrating terrestrial carbon dioxide (CO2 ) and methane (CH4 ) fluxes with aquatic losses of dissolved organic C (DOC) and inorganic C based on eddy covariance and stream discharge measurements, respectively, over two hydrological years. Since the forest included a dense spruce-birch area and a sparse pine area, we were able to further evaluate the effect of contrasting forest structure on the NECB and component fluxes. We found that the drained peatland forest was a net C sink with a 2-year mean NECB of -115 ± 5 g C m-2 year-1 while the adjacent mire was close to C neutral with 14.6 ± 1.7 g C m-2 year-1 . The NECB of the drained peatland forest was dominated by the net CO2 exchange (net ecosystem exchange [NEE]), whereas NEE and DOC export fluxes contributed equally to the mire NECB. We further found that the C sink strength in the sparse pine forest area (-153 ± 8 g C m-2 year-1 ) was about 1.5 times as high as in the dense spruce-birch forest area (-95 ± 8 g C m-2 year-1 ) due to enhanced C uptake by ground vegetation and lower DOC export. Our study suggests that historically drained peatland forests in nutrient-poor boreal regions may provide a significant net ecosystem C sink and associated climate benefits.

Meaning-making in the practice of collaboration: how implicit normative structures guide collaborative processes around contested natural resource issues

Although communication is considered crucial for collaboration in natural resource management (NRM), its role has so far been superficially studied. In this paper, we present a way to investigate this communication by focusing on its implicit aspects. We observed and examined communication in three processes that aimed to find solutions to predator-reindeer problems through collaboration between reindeer herders and wildlife authorities in northern Sweden. Despite the three processes sharing the same external and internal conditions, they developed in completely different directions. We explain this by considering each process as a social practice and identifying the character of the normative structures guiding its members’ sense-making and action. We show how the structures emerged, were reproduced and affected the course of events and outcomes of each process. We conclude that recognising the significance of the implicit aspects of communication offers novel opportunities to better understand collaboration in NRM.

Sweden as a last resort for European skiing? An outbound market perspective

ABSTRACT Previous work identified Northern Swedish skiing as a beneficiary from worsening climate change, with its relative improvement in snow reliability increasing its attractiveness over areas of the European Alps. This study advances the supply-side discussion of Northern Sweden as a ‘last resort’ with demand-side insights. It examines whether Europe’s major outbound ski market would adapt its destination choice due to climate change impacts on European skiing. A survey of 296 skiers was administered through the Ski Club of Great Britain. British ski tourists held negative perceptions of the price, accessibility, and quality/variety of ski terrain in Sweden. These concerns improved amongst those who had visited Sweden to ski, demonstrating familiarity with Swedish skiing may overcome barriers to substituting away from the European Alps. British ski tourists ranked snow conditions as the most important factor in their destination choice, thus snow reliability should form the basis of Swedish destination image moving forward. The majority of respondents (76%) opted for spatial substitution under poor snow conditions, ranking Sweden as the fifth most popular substitution destination, after four major Alpine ski nations, indicating that until climate reliable locations in the European Alps are exhausted, Sweden may not benefit substantially from climate change adaptation.

Single-level reduction of the hydropower area Equivalent bilevel problem for fast computation

For inclusion in large-scale power system models, various aggregations and simplifications in the modeling of relevant actors are needed. This paper focuses on reduced models of hydropower, so called area Equivalent models. They use a simplified topology but are not a direct aggregation of the real hydropower system. Instead, the area Equivalent is constructed to mimic the simulated power production of a more detailed hydropower reference model. Here, this goal is fulfilled by formulating a bilevel problem minimizing the difference in simulated power production between the area Equivalent and its reference. Solving this can be computationally heavy. Thus, for a fast solution of this bilevel problem, a single-level reduction is done, which is then solved using two methods. The first method includes McCormick envelopes to form a linear single-level problem. Second is a modified Benders with a relaxed sub-problem to handle the non-convex single-level. These are then also compared to Particle Swarm Optimization. Moreover, six new upper-level objective functions are investigated for a case study of hydropower in northern Sweden. The method using McCormick envelopes is fast (2–5 min), but the area Equivalent shows lower average performance. The modified Benders finds a solution in 5–31 min with good performance.

Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes From an 11-year Retrospective Observational Cohort in Northern Sweden.

Tularemia is an important reemerging disease with a multimodal transmission pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden. Data from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011 and 2021 were collected through review of electronic medical records and participant questionnaires; 415 of 784 accepted participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or polymerase chain reaction). A multivariable logistic regression model was used to investigate variables associated with retreatment. Median age of participants was 54 years (interquartile range [IQR], 41.5-65) and 49.2% were female. Although ulceroglandular tularemia was the predominant form (n = 215, 65.7%), there were several cases of pulmonary tularemia (n = 40; 12.2%). Inflammatory markers were largely nonspecific, with monocytosis frequently observed (n = 36/75; 48%). Tularemia was often misdiagnosed on presentation (n = 158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics and 102 (31.2%) retreated. Persistent lymphadenopathy was infrequent (n = 22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with retreatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR, 3.25-20.75] vs 7 [IQR, 4-11.25] days; adjusted P = .076), and doxycycline-based treatment regimen (vs ciprofloxacin; adjusted P = .084), although this was not significant after correction for multiple comparisons. We comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis, and timely commencement of treatment for an appropriate duration.

Improving glacio-hydrological model calibration and model performance in cold regions using satellite snow cover data

Hydrological modeling realism is a central research question in hydrological studies. However, it is still a common practice to calibrate hydrological models using streamflow as a single hydrological variable, which can lead to large parameter uncertainty in hydrological simulations. To address this issue, this study employed a multi-variable calibration framework to reduce parameter uncertainty in a glacierized catchment. The current study employed multi-variable calibration using three different calibration schemes to calibrate a glacio-hydrological model (namely the FLEXG) in northern Sweden. The schemes included using only gauged streamflow data (scheme 1), using satellite snow cover area (SCA) derived from MODIS data (scheme 2), and using both gauged streamflow data and satellite SCA data as references for calibration (scheme 3) of the FLEXG model. This study integrated the objective functions of satellite-derived SCA and gauged streamflow into one criterion for the FLEXG model calibration using a weight-based approach. Our results showed that calibrating the FLEXG model based on solely satellite SCA data (from MODIS) produced an accurate simulation of SCA but poor simulation of streamflow. In contrast, calibrating the FLEXG model based on the measured streamflow data resulted in minimum error for streamflow simulation but high error for SCA simulation. The promising results were achieved for glacio-hydrological simulation with acceptable accuracy for simulation of both streamflow and SCA, when both streamflow and SCA data were used for calibration of FLEXG. Therefore, multi-variable calibration in a glacierized basin could provide more realistic hydrological modeling in terms of multiple glacio-hydrological variables.

Abandoning conversion from even-aged to uneven-aged forest stands – the effects on production and economic returns

ABSTRACT There is growing interest in continuous cover forestry in Sweden. The historical domination of even-aged forest management means there is a need to focus on methods for transforming even-aged to uneven-aged stands. Practical conversion management today is highly adaptive, and the possibility of failures, such as persistent lack of tree recruitment, must be allowed for. We used simulations to evaluate various scenarios in which conversion management is introduced at different development stages in even-aged stands and then abandoned in favour of clear-felling. A shift towards an inverse J-shaped diameter distribution at the end of the simulations was most evident in northern Sweden and with an early introduction of conversion forestry. The largest losses were incurred in a scenario where the conversion management started with removing larger trees at pre-commercial thinning: it reduced the volume of production by up to 25% and, if clear-felled, resulted in a lower land expectation value than conventional management. Earlier decision to abandon conversion management reduced the losses, but the effect of timing was minor. In summary, the results indicate that conversion management could be started and abandoned without any major economic loss during the timeframe of a normal rotation.

Drought response of the boreal forest carbon sink is driven by understorey–tree composition

The boreal forest is an important global carbon sink, but its response to drought remains uncertain. Here, we compiled biometric- and chamber-based flux data from 50 boreal forest stands to assess the impact of the 2018 European summer drought on net ecosystem production (NEP) across a 68 km2 managed landscape in northern Sweden. Our results reveal a non-uniform reduction in NEP (on average by 80 ± 16 g C m−2 yr−1 or 57 ± 13%) across the landscape, which was greatest in young stands of 20–50 years (95 ± 39 g C m−2 yr−1), but gradually decreased towards older stands (54 ± 57 g C m−2 yr−1). This pattern was attributed to the higher sensitivity of forest-floor understorey to drought and its decreasing contribution to production relative to trees during stand development. This suggests that an age-dependent shift in understorey–tree composition with increasing stand age drives the drought response of the boreal forest NEP. Thus, our study advocates the need for partitioning ecosystem responses to improve empirical and modelling assessments of carbon cycle–climate feedbacks in boreal forests. It further implies that the forest age structure may strongly determine the carbon sink response to the projected increase in drought events across the managed boreal landscape.

Diagnostic Accuracy and Safety of Teledermoscopy for Cutaneous Melanoma Triage in Northern Sweden.

Abstract is missing (Short communication)

Shifts in microbial community composition and metabolism correspond with rapid soil carbon accumulation in response to 20 years of simulated nitrogen deposition

Anthropogenic nitrogen (N) deposition and fertilization in boreal forests frequently reduces decomposition and soil respiration and enhances C storage in the topsoil. This enhancement of the C sink can be as strong as the aboveground biomass response to N additions and has implications for the global C cycle, but the mechanisms remain elusive. We hypothesized that this effect would be associated with a shift in the microbial community and its activity, and particularly by fungal taxa reported to be capable of lignin degradation and organic N acquisition. We sampled the organic layer below the intact litter of a Norway spruce (Picea abies (L.) Karst) forest in northern Sweden after 20 years of annual N additions at low (12.5 kg N ha−1 yr−1) and high (50 kg N ha−1 yr−1) rates. We measured microbial biomass using phospholipid fatty-acid analysis (PLFA) and ergosterol measurements and used ITS metagenomics to profile the fungal community of soil and fine-roots. We probed the metabolic activity of the soil community by measuring the activity of extracellular enzymes and evaluated its relationships with the most N responsive soil fungal species. Nitrogen addition decreased the abundance of fungal PLFA markers and changed the fungal community in humus and fine-roots. Specifically, the humus community changed in part due to a shift from Oidiodendron pilicola, Cenococcum geophilum, and Cortinarius caperatus to Tylospora fibrillosa and Russula griseascens. These microbial community changes were associated with decreased activity of Mn-peroxidase and peptidase, and an increase in the activity of C acquiring enzymes. Our results show that the rapid accumulation of C in the humus layer frequently observed in areas with high N deposition is consistent with a shift in microbial metabolism, where decomposition associated with organic N acquisition is downregulated when inorganic N forms are readily available.

Om språkbruk, generaliseringar och ett besvärligt material

This article deals with narratives from northern Sweden about the Spanish flu pandemic (1918–1920). There are about 50 narratives collected between ca. 1950 and 1980. All of them were elicited in interviews: some were told in interaction with two or more informants, some are told by one informant in interaction with the interviewer, and some are monologues. There are different interviewers. The interviews have not been planned or conducted in a systematic and consistent way, or with a purpose to investigate the informants’ experiences of the Spanish flu. Rather, the main purpose seems to have been to elicit stories about “the old days”. Drawing on linguistic choices from the material as a whole, this article discusses the informants’ notion of the pandemic and their conceptions of etiology. The article concludes that the most conspicuous feature is what is not mentioned by any informant, namely the word influenza. Further, the Spanish flu clearly belongs to a past era that has no resemblance to modern society. It was an era characterized by suffering, poor sanitary conditions and starvation. As well, the article briefly discusses the critique of medical humanities and the study of illness narratives for the lack of systematic analyses and syntheses of how these are constructed in general.

Batrachochytrium dendrobatidis strain affects transcriptomic response in liver but not skin in latitudinal populations of the common toad (Bufo bufo)

Batrachochytrium dendrobatidis (Bd) is a fungal pathogen that has decimated amphibian populations worldwide for several decades. We examined the changes in gene expression in response to Bd infection in two populations of the common toad, Bufo bufo, in a laboratory experiment. We collected B. bufo eggs in southern and northern Sweden, and infected the laboratory-raised metamorphs with two strains of the global panzoonotic lineage Bd-GPL. Differential expression analysis showed significant differences between infected and control individuals in both liver and skin. The skin samples showed no discernible differences in gene expression between the two strains used, while liver samples were differentiated by strain, with one of the strains eliciting no immune response from infected toads. Immune system genes were overexpressed in skin samples from surviving infected individuals, while in liver samples the pattern was more diffuse. Splitting samples by population revealed a stronger immune response in northern individuals. Differences in transcriptional regulation between populations are particularly relevant to study in Swedish amphibians, which may have experienced varying exposure to Bd. Earlier exposure to this pathogen and subsequent adaptation or selection pressure may contribute to the survival of some populations over others, while standing genetic diversity in different populations may also affect the infection outcome.

Toxic metals and essential trace elements in placenta and their relation to placental function

IntroductionPlacental function is essential for fetal development, but it may be susceptible to malnutrition and environmental stressors. ObjectiveTo assess the impact of toxic and essential trace elements in placenta on placental function. MethodsToxic metals (cadmium, lead, mercury, cobalt) and essential elements (copper, manganese, zinc, selenium) were measured in placenta of 406 pregnant women in northern Sweden using ICP-MS. Placental weight and birth weight were obtained from hospital records and fetoplacental weight ratio was used to estimate placental efficiency. Placental relative telomere length (TL) and mitochondrial DNA copy number (mtDNAcn) were determined by quantitative PCR (n = 285). Single exposure-outcome associations were evaluated using linear or spline regression, and joint associations and interactions with Bayesian kernel machine regression (BKMR), all adjusted for sex, maternal smoking, and age or BMI. ResultsMedian cadmium, mercury, lead, cobalt, copper, manganese, zinc, and selenium concentrations in placenta were 3.2, 1.8, 4.3, 2.3, 1058, 66, 10626, and 166 μg/kg, respectively. In the adjusted regression, selenium (>147 μg/kg) was inversely associated with placental weight (B: −158; 95 % CI: −246, −71, per doubling), as was lead at low selenium (B: −23.6; 95 % CI: −43.2, −4.0, per doubling). Manganese was positively associated with placental weight (B: 41; 95 % CI: 5.9, 77, per doubling) and inversely associated with placental efficiency (B: −0.01; 95 % CI: −0.019, −0.004, per doubling). Cobalt was inversely associated with mtDNAcn (B: −11; 95 % CI: −20, −0.018, per doubling), whereas all essential elements were positively associated with mtDNAcn, individually and joint. ConclusionAmong the toxic metals, lead appeared to negatively impact placental weight and cobalt decreased placental mtDNAcn. Joint essential element concentrations increased placental mtDNAcn. Manganese also appeared to increase placental weight, but not birth weight. The inverse association of selenium with placental weight may reflect increased transport of selenium to the fetus in late gestation.