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After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

Resilient performance is a crucial characteristic of complex socio-technical systems, enabling them to sustain essential functionality during changing or stressful conditions. Resilience Engineering (RE), a sub-field of safety research, focuses on this perspective of resilience. RE emphasises its “cornerstone model”, presenting the REsystem goals of “anticipating, monitoring, responding and learning”. The cornerstone of learning remains fragmented and undertheorized in the existing literature. This paper aims to enrich RE research and its practical implications by developing a nuanced and comprehensive understanding of the role of learning from resilient performance. To achieve this aim, a scoping literature review was conducted to assess how learning is conceptualised in the RE literature and the theoretical foundations on which previous work rests. The main findings show that RE researchers view learning as the process of understanding the system, sharing knowledge, and re-designing system properties. The application of established learning theories is limited. This paper contributes to research by proposing an organisational process for the RE cornerstone of learning, paving the way for deeper discussions in future studies about learning from resilient performance within complex sociotechnical systems.

After colectomy there are four options available. The least complicated and most common is to leave the end ileostomy and not go for any reconstructive surgery. Then there is the ileal pouch anal anastomosis (IPAA) in which the rectum is removed, but the anal canal and a small rectal “cuff” is preserved. The pouch is created from the distal ileum and anastomosed to the rectal cuff. In the ileorectal anastomosis (IRA) the rectum is spared, and the distal ileum is anastomosed to the top of the rectum. In the continent ileostomy (CI), also referred to as the Kock pouch, the fecal flow is let out through the abdominal wall, but a pouch and a nipple valve mechanism is created making the stoma continent which needs to be manually emptied. This thesis aims to investigate function, quality of life, satisfaction, complications, and aspects associated with the chance of having reconstructive surgery after colectomy for inflammatory bowel disease (IBD), i.e. ulcerative colitis (UC) or Crohn’s disease (CD). The first two papers focus on the continent ileostomy, the most uncommon of the options after colectomy. In Paper 1 all patients who have received a CI at our center were identified and medical charts were reviewed for complications and CI patency. Function and quality of life were evaluated with the 36-item short form survey (SF-36), short health scale (SHS) and a local CI specific questionnaire for function and satisfaction. In Paper II, the Swedish national patient register (NPR) was used to identify all patients with an IBD diagnosis who had received a CI and data on diagnosis, demographics, reoperations, and excisions were obtained from the register. Paper III describes an ongoing prospective non-randomized, multi-center, open-label, controlled trial between IRA and IPAA in UC patients subjected to colectomy. The primary endpoint is satisfaction but Quality of Life (QoL), sexual function, bowel function and complications are also evaluated. In Paper IV, we invest

The Swedish Commission on Health Inequality defined health inequality as systematic differences in health between groups in society with different social positions. All avoidable socioeconomic health inequalities are unfair, and as stated by WHO's Commission on the Social Determinants of Health, we have a moral obligation to try to reduce them. "Putting these inequities right is a matter of social justice. Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative." This ethical imperative is especially apparent regarding the health of children and adolescents. Children’s right to the highest attainable standard of health is also enshrined in Article 24 of the Convention on the Rights of the Child. To reach the goal of a reduction of health inequalities, research is necessary to describe the social gradients of health. Research is also needed to better understand why these gradients occur. A better understanding and knowledge about health inequalities can lead to policies that reduce these inequalities and ensure children’s right to health. This thesis investigates social inequality in child health using data from a Swedish population-based prospective birth cohort, the All Babies in Southeast Sweden (ABIS) cohort. Social inequality in obesity in the ABIS cohort is also compared with other birth cohorts participating in the Elucidating Pathways to Child Health Inequality (EPOCH) collaboration which includes cohorts from six high-income countries; Sweden, the Netherlands, Canada (one national and one cohort from Quebec), UK, Australia, and USA. In Paper 1 we show that health inequalities in overweight and obesity are detectable already at two years of age and that these inequalities increase during childhood. In adolescents, low socioeconomic status increases the risk of becoming overweight and the risk of components of the metabolic syndrome, including high blood pressure and dyslipidemia (low high-density cholesterol)., Hälsoojämlikhet definierades av den Svenska kommissionen för jämlik hälsa som "systematiska skillnader i hälsa mellan samhällsgrupper med olika social position." Debatten om de bakomliggande orsakerna till hälsoojämlikhet tog fart efter att rapporten "the Black Report" kom ut i Storbritannien på 1980-talet. I denna rapport konstaterades att ojämlikheten i hälsa hade ökat mellan socioekonomiska grupper trots införandet av fri sjukvård och andra samhällsförbättringar. Orsakerna till den ökande ojämlikheten har sedan dess debatterats och ett antal teorier har lagts fram för att förklara fenomenet. Fortfarande råder det dock oenighet kring hur de olika bakomliggande faktorerna leder fram till skillnaderna i hälsa. Internationella organisationer har samtidigt arbetat för att minska skillnaderna, bland annat WHO som 2008 bildades "the Commission on Social Determinants of Health". Denna kommission slog fast i sin rapport att vi alla har en moralisk plikt att minska skillnaderna i hälsa; "Att ställa dessa skillnader till rätta handlar om social rättvisa. Att minska hälsoojämlikhet är för kommissionen ett etiskt imperativ". Rätten till bästa möjliga hälsa slås också fast i Barnkonventionen, artikel 24. För att kunna minska hälsoojämlikheter behöver man studera inom vilka områden/sjukdomar skillnader uppstår och varför, med målet att utforma åtgärder för att minska skillnaderna. Denna avhandling syftar till att studera socioekonomiska skillnader i barns hälsa. Avhandlingen baseras på data från den svenska prospektiva födelsekohortstudien Alla Barn i Sydöstra Sverige (ABIS). Social ojämlikhet i övervikt och obesitas jämförs även med den sociala ojämlikheten i motsvarande data från födelsekohorter i fem andra höginkomstländer; Nederländerna, Kanada, Storbritannien, Australien och USA. Resultaten från Studie 1 visade att socioekonomiska skillnader i risken att utveckla obesitas kan upptäckas redan vid 2 års ålder och att denna skillnad i risk ökade under uppväxten. I tonåren fra

The Swedish Commission on Health Inequality defined health inequality as systematic differences in health between groups in society with different social positions. All avoidable socioeconomic health inequalities are unfair, and as stated by WHO's Commission on the Social Determinants of Health, we have a moral obligation to try to reduce them. "Putting these inequities right is a matter of social justice. Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative." This ethical imperative is especially apparent regarding the health of children and adolescents. Children’s right to the highest attainable standard of health is also enshrined in Article 24 of the Convention on the Rights of the Child. To reach the goal of a reduction of health inequalities, research is necessary to describe the social gradients of health. Research is also needed to better understand why these gradients occur. A better understanding and knowledge about health inequalities can lead to policies that reduce these inequalities and ensure children’s right to health. This thesis investigates social inequality in child health using data from a Swedish population-based prospective birth cohort, the All Babies in Southeast Sweden (ABIS) cohort. Social inequality in obesity in the ABIS cohort is also compared with other birth cohorts participating in the Elucidating Pathways to Child Health Inequality (EPOCH) collaboration which includes cohorts from six high-income countries; Sweden, the Netherlands, Canada (one national and one cohort from Quebec), UK, Australia, and USA. In Paper 1 we show that health inequalities in overweight and obesity are detectable already at two years of age and that these inequalities increase during childhood. In adolescents, low socioeconomic status increases the risk of becoming overweight and the risk of components of the metabolic syndrome, including high blood pressure and dyslipidemia (low high-density cholesterol)., Hälsoojämlikhet definierades av den Svenska kommissionen för jämlik hälsa som "systematiska skillnader i hälsa mellan samhällsgrupper med olika social position." Debatten om de bakomliggande orsakerna till hälsoojämlikhet tog fart efter att rapporten "the Black Report" kom ut i Storbritannien på 1980-talet. I denna rapport konstaterades att ojämlikheten i hälsa hade ökat mellan socioekonomiska grupper trots införandet av fri sjukvård och andra samhällsförbättringar. Orsakerna till den ökande ojämlikheten har sedan dess debatterats och ett antal teorier har lagts fram för att förklara fenomenet. Fortfarande råder det dock oenighet kring hur de olika bakomliggande faktorerna leder fram till skillnaderna i hälsa. Internationella organisationer har samtidigt arbetat för att minska skillnaderna, bland annat WHO som 2008 bildades "the Commission on Social Determinants of Health". Denna kommission slog fast i sin rapport att vi alla har en moralisk plikt att minska skillnaderna i hälsa; "Att ställa dessa skillnader till rätta handlar om social rättvisa. Att minska hälsoojämlikhet är för kommissionen ett etiskt imperativ". Rätten till bästa möjliga hälsa slås också fast i Barnkonventionen, artikel 24. För att kunna minska hälsoojämlikheter behöver man studera inom vilka områden/sjukdomar skillnader uppstår och varför, med målet att utforma åtgärder för att minska skillnaderna. Denna avhandling syftar till att studera socioekonomiska skillnader i barns hälsa. Avhandlingen baseras på data från den svenska prospektiva födelsekohortstudien Alla Barn i Sydöstra Sverige (ABIS). Social ojämlikhet i övervikt och obesitas jämförs även med den sociala ojämlikheten i motsvarande data från födelsekohorter i fem andra höginkomstländer; Nederländerna, Kanada, Storbritannien, Australien och USA. Resultaten från Studie 1 visade att socioekonomiska skillnader i risken att utveckla obesitas kan upptäckas redan vid 2 års ålder och att denna skillnad i risk ökade under uppväxten. I tonåren fra

The Swedish Commission on Health Inequality defined health inequality as systematic differences in health between groups in society with different social positions. All avoidable socioeconomic health inequalities are unfair, and as stated by WHO's Commission on the Social Determinants of Health, we have a moral obligation to try to reduce them. "Putting these inequities right is a matter of social justice. Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative." This ethical imperative is especially apparent regarding the health of children and adolescents. Children’s right to the highest attainable standard of health is also enshrined in Article 24 of the Convention on the Rights of the Child. To reach the goal of a reduction of health inequalities, research is necessary to describe the social gradients of health. Research is also needed to better understand why these gradients occur. A better understanding and knowledge about health inequalities can lead to policies that reduce these inequalities and ensure children’s right to health. This thesis investigates social inequality in child health using data from a Swedish population-based prospective birth cohort, the All Babies in Southeast Sweden (ABIS) cohort. Social inequality in obesity in the ABIS cohort is also compared with other birth cohorts participating in the Elucidating Pathways to Child Health Inequality (EPOCH) collaboration which includes cohorts from six high-income countries; Sweden, the Netherlands, Canada (one national and one cohort from Quebec), UK, Australia, and USA. In Paper 1 we show that health inequalities in overweight and obesity are detectable already at two years of age and that these inequalities increase during childhood. In adolescents, low socioeconomic status increases the risk of becoming overweight and the risk of components of the metabolic syndrome, including high blood pressure and dyslipidemia (low high-density cholesterol)., Hälsoojämlikhet definierades av den Svenska kommissionen för jämlik hälsa som "systematiska skillnader i hälsa mellan samhällsgrupper med olika social position." Debatten om de bakomliggande orsakerna till hälsoojämlikhet tog fart efter att rapporten "the Black Report" kom ut i Storbritannien på 1980-talet. I denna rapport konstaterades att ojämlikheten i hälsa hade ökat mellan socioekonomiska grupper trots införandet av fri sjukvård och andra samhällsförbättringar. Orsakerna till den ökande ojämlikheten har sedan dess debatterats och ett antal teorier har lagts fram för att förklara fenomenet. Fortfarande råder det dock oenighet kring hur de olika bakomliggande faktorerna leder fram till skillnaderna i hälsa. Internationella organisationer har samtidigt arbetat för att minska skillnaderna, bland annat WHO som 2008 bildades "the Commission on Social Determinants of Health". Denna kommission slog fast i sin rapport att vi alla har en moralisk plikt att minska skillnaderna i hälsa; "Att ställa dessa skillnader till rätta handlar om social rättvisa. Att minska hälsoojämlikhet är för kommissionen ett etiskt imperativ". Rätten till bästa möjliga hälsa slås också fast i Barnkonventionen, artikel 24. För att kunna minska hälsoojämlikheter behöver man studera inom vilka områden/sjukdomar skillnader uppstår och varför, med målet att utforma åtgärder för att minska skillnaderna. Denna avhandling syftar till att studera socioekonomiska skillnader i barns hälsa. Avhandlingen baseras på data från den svenska prospektiva födelsekohortstudien Alla Barn i Sydöstra Sverige (ABIS). Social ojämlikhet i övervikt och obesitas jämförs även med den sociala ojämlikheten i motsvarande data från födelsekohorter i fem andra höginkomstländer; Nederländerna, Kanada, Storbritannien, Australien och USA. Resultaten från Studie 1 visade att socioekonomiska skillnader i risken att utveckla obesitas kan upptäckas redan vid 2 års ålder och att denna skillnad i risk ökade under uppväxten. I tonåren fra

At least three probabilistic definitions of hidden Markov models (HMMs) have been used frequently in the literature. Unfortunately, one of these definitions shows fatal flaws, however nowadays a lot of literature still uses this definition. The aim of this paper is on one hand to specifically point out one such fatal flaw (in terms of deriving the well-known forward-backward algorithm), and on the other hand to list key properties of HMMs under the other two plausible (and equivalent) probabilistic definitions for further developments. As applications, we rigorously layout forward-backward algorithms for inhomogeneous HMMs and hidden reciprocal models, and fully present connections between HMMs and undirected graphical models which are not mentioned anywhere in the literature, to the best of our knowledge., Funding Agencies|Swedish International Development Cooperation Agency (SIDA)

The Swedish Commission on Health Inequality defined health inequality as systematic differences in health between groups in society with different social positions. All avoidable socioeconomic health inequalities are unfair, and as stated by WHO's Commission on the Social Determinants of Health, we have a moral obligation to try to reduce them. "Putting these inequities right is a matter of social justice. Reducing health inequities is, for the Commission on Social Determinants of Health, an ethical imperative." This ethical imperative is especially apparent regarding the health of children and adolescents. Children’s right to the highest attainable standard of health is also enshrined in Article 24 of the Convention on the Rights of the Child. To reach the goal of a reduction of health inequalities, research is necessary to describe the social gradients of health. Research is also needed to better understand why these gradients occur. A better understanding and knowledge about health inequalities can lead to policies that reduce these inequalities and ensure children’s right to health. This thesis investigates social inequality in child health using data from a Swedish population-based prospective birth cohort, the All Babies in Southeast Sweden (ABIS) cohort. Social inequality in obesity in the ABIS cohort is also compared with other birth cohorts participating in the Elucidating Pathways to Child Health Inequality (EPOCH) collaboration which includes cohorts from six high-income countries; Sweden, the Netherlands, Canada (one national and one cohort from Quebec), UK, Australia, and USA. In Paper 1 we show that health inequalities in overweight and obesity are detectable already at two years of age and that these inequalities increase during childhood. In adolescents, low socioeconomic status increases the risk of becoming overweight and the risk of components of the metabolic syndrome, including high blood pressure and dyslipidemia (low high-density cholesterol)., Hälsoojämlikhet definierades av den Svenska kommissionen för jämlik hälsa som "systematiska skillnader i hälsa mellan samhällsgrupper med olika social position." Debatten om de bakomliggande orsakerna till hälsoojämlikhet tog fart efter att rapporten "the Black Report" kom ut i Storbritannien på 1980-talet. I denna rapport konstaterades att ojämlikheten i hälsa hade ökat mellan socioekonomiska grupper trots införandet av fri sjukvård och andra samhällsförbättringar. Orsakerna till den ökande ojämlikheten har sedan dess debatterats och ett antal teorier har lagts fram för att förklara fenomenet. Fortfarande råder det dock oenighet kring hur de olika bakomliggande faktorerna leder fram till skillnaderna i hälsa. Internationella organisationer har samtidigt arbetat för att minska skillnaderna, bland annat WHO som 2008 bildades "the Commission on Social Determinants of Health". Denna kommission slog fast i sin rapport att vi alla har en moralisk plikt att minska skillnaderna i hälsa; "Att ställa dessa skillnader till rätta handlar om social rättvisa. Att minska hälsoojämlikhet är för kommissionen ett etiskt imperativ". Rätten till bästa möjliga hälsa slås också fast i Barnkonventionen, artikel 24. För att kunna minska hälsoojämlikheter behöver man studera inom vilka områden/sjukdomar skillnader uppstår och varför, med målet att utforma åtgärder för att minska skillnaderna. Denna avhandling syftar till att studera socioekonomiska skillnader i barns hälsa. Avhandlingen baseras på data från den svenska prospektiva födelsekohortstudien Alla Barn i Sydöstra Sverige (ABIS). Social ojämlikhet i övervikt och obesitas jämförs även med den sociala ojämlikheten i motsvarande data från födelsekohorter i fem andra höginkomstländer; Nederländerna, Kanada, Storbritannien, Australien och USA. Resultaten från Studie 1 visade att socioekonomiska skillnader i risken att utveckla obesitas kan upptäckas redan vid 2 års ålder och att denna skillnad i risk ökade under uppväxten. I tonåren fra