umu.sePublikationer
1 - 10 av 10
rss atomLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
  • Disputation: 2017-10-26 13:00 Betula, byggnad 6M NUS (målpunkt L), Umeå
    Strömvall, Kerstin
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Extratumoral effects of highly aggressive prostate cancer2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Populärvetenskaplig sammanfattning

    Prostatacancer är den i särklass vanligaste cancerformen hos män i Sverige. De flesta patienter har en mycket långsamt växande tumör som inte orsakar dem några större besvär under deras livstid, men enbart i Sverige dör ca 2500 patienter/år av sjukdomen. Det är först vid uppkomst av metastaser som sjukdomen blir dödlig. Befintliga diagnos- och prognosmetoder är otillräckliga när det gäller att uppskatta och förutse tumörens aggressivitet och risk för att bilda metastaser. Detta gör att vissa patienter inte får tillräcklig behandling eller behandlas försent medan andra behandlas i onödan. Behovet av förbättrad diagnostik är därför stort. Om vi kan hitta markörer för potentiellt metastaserande sjukdom, och i bästa fall också behandla innan metastaser uppstår, skulle det förbättra chansen för överlevnad markant.

    För att kunna växa och spridas behöver en tumör inte bara förbereda närliggande vävnader utan förmodligen hela kroppen. Vår hypotes är att potentiell dödliga tumörer sannolikt är bättre på detta än mer ofarliga. Man vet från studier av andra cancerformer att farliga tumörer orsakar förändringar i det organ dit cancern senare sprids. Dessa förändringar sker för att de tumörceller som senare anländer ska kunna överleva, och processen har fått namnet pre-metastatisk nisch. Bl.a. har man sett att immunsystemet hämmas och nybildning av kärl ökar. Det är vanligt att metastaser uppstår i närliggande lymfkörtlar innan uppkomst av metastaser i andra organ. Dock är väldigt lite känt om pre-metastatiska förändringar i lymfkörtlar eftersom den forskning som hittills är gjord främst har tittat på andra organ. Inom prostatacancer finns det förvånande få studier av premetastatiska nischer överhuvudtaget, och man vet därför inte om de alls förekommer eller vilka förändringar som i så fall sker.

    Vår grupp har tidigare myntat uttrycket TINT som står för Tumor Instructed (Indicating) Normal Tissue (TINT är ett engelskt verb som betyder färga) och syftar på förändringar i normal vävnad som inducerats av tumören, dvs. att tumörer färgar av sig på omgivningen. Det kan vara förändringar i normal vävnad nära tumören, som i det här fallet resten av prostatan, eller i vävnad långt ifrån tumören som till exempel regionala lymfkörtlar, lungor och benmärg.

    Syftet med det här avhandlingsarbetet var att undersöka TINT-förändringar inducerade av aggressiv cancer och se om dessa skiljer sig från TINT-förändringar inducerade av mindre farliga tumörer, samt att utvärdera om någon TINT-förändring skulle kunna användas för att prognostisera vilka patienter som har hög risk att få metastaser.

    Vi har använt oss av en prostatacancer-modell i råtta där vi analyserat genoch proteinuttryck i pre-metastatiska regionala lymfkörtlar, tumörer och prostata-TINT (dvs. prostatavävnad utanför tumören). TINT-förändringar inducerade av MatLyLu (MLL), en tumör med hög metastaserande förmåga, jämfördes mot TINT-förändringar inducerade av AT1, en snabbväxande tumör men med låg förmåga att bilda metastaser.

    Vi kunde vi se flera skillnader mellan modellerna. Genuttrycket i MLL-prostata-TINT indikerade en aktivering av cellulära funktioner som visat sig stimulera tumörväxt och spridning såsom celldelning, viabilitet, migration, invasion, och angiogenes (nybildning av kärl). I AT1-prostata-TINT var genuttrycket kopplat till samma funktioner men verkade istället inhibera dessa. Genom att titta på vävnaderna i mikroskop kunde vi se att MLL-tumörer rekryterade färre T-celler (som har en viktig funktion i immunsvaret mot tumören), men istället fler makrofager och granulocyter till både tumören och prostata-TINT (dessa typer av immunceller har visats kunna hjälpa tumörer att växa och sprida sig). MLL-tumörer hade också fler blodkärl och lymfkärl strax utanför tumören.

    I de regionala lymfkörtlarna från djur med MLL-tumörer visade genuttrycket tecken på försämrad antigenpresentation, samt immunhämning och/eller induktion av immuntolerans. Immuntolerans innebär att immuncellen inte längre reagerar mot det specifika antigen den blivit tolerant emot. Detta är vanligt förekommande hos individer med cancer och är ett sätt för tumören att undkomma immunförsvaret. I vävnadsprover av lymfkörtlarna kunde vi se färre antigenpresenterande celler, och liksom i tumörerna fanns det färre T-celler i MLL-modellen, något vi kunde se redan när tumörerna var väldigt små.

    CD169 är ett protein som bl.a. uttrycks av sinus-makrofager i lymfkörtlar. Dessa makrofager har en central funktion i att aktivera ett tumör-specifikt immunsvar. I råttmodellen kunde vi se att regionala lymfkörtlar från djur med MLL-tumörer hade lägre nivåer av CD169 än regionala lymfkörtlar från djur med AT1-tumörer, och då antalet sinus-makrofager visat sig ha prognostiskt värde i t.ex. tjocktarmscancer, ville vi se om det kunde vara så även i prostatacancer. Därför kvantifierade vi uttrycket av CD169 i metastasfria regionala lymfkörtlar från prostatacancerpatienter och såg att låga nivåer av CD169 medförde en ökad risk för att dö i prostatacancer.

    Sammantaget tyder resultaten på att MLL-tumören jämfört med AT1- tumören bättre lyckas förbereda omgivande vävnad för att gynna tumörväxt och spridning, både lokalt i prostatan men också längre bort från tumören i de regionala lymfkörtlarna. Våra fynd stämmer väl överens med aktuell tumörbiologisk forskning om hur tumörer påverkar sin omgivning. Något som inte visats tidigare är att miljön utanför tumören verkar skilja sig drastiskt beroende på tumörens metastaserande förmåga, samt att dessa skillnader går att se relativt tidigt under sjukdomsförloppet och förmodligen även långt bort från tumören. Vi har också visat att särskilt aggressiv prostatacancer verkar inducera en pre-metastatisk nisch i tumördränerande lymfkörtlar likt det som beskrivits i andra modellsystem och i andra cancertyper, men hittills inte i prostatacancer. Fler studier behövs för att bättre karaktärisera de förändringar som en potentiellt dödlig prostatacancer orsakar i andra vävnader, och för att ta reda på hur denna kunskap kan användas för att förbättra diagnostik och behandling.

  • Disputation: 2017-10-27 09:00 Aulan, Vårdvetarhuset, Umeå
    Sundqvist, Johanna
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Forced repatriation of unaccompanied asylum-seeking refugee children: towards an interagency model2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction Not all children seeking asylum without parents or other relatives are entitled to residence permits. In the last few years, more than one in four unaccompanied asylum-seeking refugee children have been forced to repatriate, either to their home country or to a transit country. Mostly the children refuse to leave the country voluntarily, and it becomes a forced repatriation. Five actors collaborate in the Swedish child forced repatriation process: social workers, staff at care homes, police officers, Swedish Migration Board officers and legal guardians. When a child is forced to repatriate, the Swedish workers involved must consider two different demands. The first demand requires dignified repatriation, which is incorporated from the European Union’s (EU’s) Return Directive into Swedish Aliens Act. The second demand requires that the repatriation process be conducted efficiently, which means that a higher number of repatriation cases must be processed. The fact that the same professionals have different and seemingly contradictory requirements places high demands on the involved collaborators. Two professionals have a legal responsibility for the children until the last minute before they leave Sweden: social workers and police officers. That makes them key actors in forced repatriation, as they carry most of the responsibility in the process. Further, they often work with children who are afraid what will happen when they return to their home country and often express their fear through powerful emotions. Being responsible and obliged to carry out the government’s decision, despite forcing children to leave a safe country, may evoke negative emotional and mental stress for the professionals involved in forced repatriation.

    Aim The overall aim of this study is to explore and analyse forced repatriation workers’ collaboration and perceived mental health, with special focus on social workers and police officers in the Swedish context.

    Materials and methods The study combines a qualitative and quantitative research design in order to shed light at both a deep and general level on forced repatriation. In qualitative substudy I, a qualitative case study methodology was used in one municipality in a middle-sized city in Sweden. The municipality had a contract regarding the reception of unaccompanied asylum-seeking refugee children iv with the Swedish Migration Board. The municipality in focus has a population of more than 100,000 inhabitants. The city in which the data were collected has developed a refugee reception system where unaccompanied asylumseeking refugee children are resettled and await a final decision regarding their permit applications. This situation made it possible to recruit participants who had worked with unaccompanied refugee children without a permit. Semi-structured interviews were conducted with a total of 20 social workers, staff at care homes, police officers, Swedish Migration Board officers and legal guardians. A thematic approach was used to analyse the data. In quantitative substudies II, III and IV, a national survey of social workers (n = 380) and police officers (n = 714), with and without experience of forced repatriation, was conducted. The questionnaires included sociodemographic characteristics, the Swedish Demand-Control Questionnaire, Interview Schedule for Social Interaction, Ways of Coping Questionnaire and the 12- item General Mental Health Questionnaire. Factor analysis, correlational analysis, and univariate and multivariable regression models were used to analyse the data.

    Results The qualitative results in substudy I showed low levels of collaboration among the actors (social workers, staff at care homes, police officers, Swedish Migration Board officers and legal guardians) and the use of different strategies to manage their work tasks. Some of them used a teamwork pattern, showing an understanding of the different roles in forced repatriation, and were willing to compromise for the sake of collaboration. Others tended to isolate themselves from interaction and acted on the basis of personal preference, and some tended to behave sensitively, withdraw and become passive observers rather than active partners in the forced repatriation. The quantitative results in substudy II showed that poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for mental health among social workers, while psychological job demand, decision latitude and marital status were predictors among police officers. Substudy III showed that both social workers and police officers reported relatively high access to social support. Furthermore, police officers working in forced repatriation with low levels of satisfaction with social interaction and close emotional support increased the odds of psychological disturbances. In substudy IV, social workers used more escape avoidance, distancing and positive-reappraisal coping, whereas police officers used more planful problem solving and self-controlling coping. Additionally, social workers with experience in forced repatriation used more planful problem solving than those without experience.

    Conclusions In order to create the most dignified forced repatriation, based on human dignity, for unaccompanied asylum-seeking refugee children and with healthy actors, a forced repatriation system needs: overall statutory national guidance, interagency collaboration, actors working within a teamworking pattern, forced repatriation workers with reasonable job demands and decision latitude, with a high level of social support and adaptive coping strategies. The point of departure for an interagency model is that it is impossible to change the circumstances of the asylum process, but it is possible to make the system more functional and better adapted to both the children’s needs and those of the professionals who are set to handle the children. A centre for unaccompanied asylum-seeking refugee children, consisting of all actors involved in the children’s asylum process sitting under the same roof, at the governmental level (Swedish Migration Board, the police authority) and municipality level (social services, board of legal guardians), can meet all requirements.

  • Disputation: 2017-10-27 09:00 Hörsal D Unod T9, Umeå
    Lindqvist, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk mikrobiologi, Virologi.
    The role of the type I interferons and viperin during neurotropic flavivirus infection2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Flaviviruses are globally distributed pathogens that cause millions of human infections annually. One of the most detrimental outcomes of flavivirus infection is encephalitis, which is caused by neurotropic flaviviruses such as West Nile virus (WNV), Japanese encephalitis virus (JEV), and Tick-borne encephalitis virus (TBEV). The type I interferons (IFNs) are powerful cytokines, and they are known as the first line of defense against viral infection. IFNs are expressed at low or undetectable levels at the basal state, but recognition of invading pathogens triggers a robust IFN response. After synthesis, IFN is secreted and acts in an autocrine or paracrine manner by binding to the interferon-α/β receptor (IFNAR) receptor, which is expressed on the surface of all nucleated cells. Binding to IFNAR mediates a downstream cascade that triggers expression of hundreds of interferon-stimulated genes (ISGs). Some ISGs express signaling molecules to amplify the response while others are potent antiviral proteins that can efficiently limit viral infection. The impact of the type I IFN response in tick-borne flavivirus infection was not previously known. We found that the type I IFN response was crucial for protection of mice against neurotropic infection with tick-borne flaviviruses such as TBEV and Langat virus (LGTV). The response was needed both in the periphery as well as in the central nervous system (CNS), as transgenic mice lacking either peripherally or CNS-located IFNAR both succumbed to LGTV infection. Although we found that the local IFN response within the CNS is essential for protection against lethal LGTV infection, the cells responsible for the local IFN production were not known.

    Astrocytes are one of the most abundant cell types within the CNS, but their role in neurotropic flavivirus infection was not fully characterized. In other viral infections, astrocytes are potent IFN producers, thus we were interested in characterizing the role of the type I IFN response in astrocytes during neurotropic flavivirus infection and its contribution to flavivirus pathogenesis. We found that upon flavivirus infection, astrocytes mount a strong type I IFN response that protects neighboring astrocytes from TBEV, JEV, WNV, and ZIKV infection. Furthermore, IFN signaling was found to protect astrocytes from TBEV-induced cytopathic effects. However, the ISGs that mediated these effects were not known.

    In vitro studies of viperin, which was discovered in 2001 as an ISG with broad antiviral activity, has shown strong antiviral activity against TBEV, but its role in vivo and mode of action in flavivirus infection was not known. Using mice deficient in viperin, we wanted to determine the role of viperin in flavivirus infection. We found that viperin plays a region-specific role in the brain by controlling LGTV replication in the olfactory bulb and cerebrum. Remarkably, viperin was able to inhibit TBEV replication in primary cortical neurons isolated from the cerebrum but not in granule cell neurons isolated from the cerebellum. Furthermore, IFN treatment failed to compensate for loss of viperin in cortical neurons, indicating that viperin might be the most important ISG against TBEV in cortical neurons. Interestingly, we also found that viperin is needed for the IFN-mediated antiviral response against WNV and ZIKV in cortical neurons. Thus, viperin showed broad but region-specific antiviral mechanisms against different flaviviruses.

    Although viperin has been shown to inhibit many viruses, the molecular antiviral mechanism is not clear and appears to differ between viruses. We performed a co-immunoprecipitation (CoIP) screen to identify TBEV proteins that could interact with viperin, and prM, E, NS2A, NS2B, and NS3 were identified. Interaction of viperin with NS3 resulted in degradation of the viral protein. We screened NS3 of JEV, yellow fever virus (YFV), ZIKV, and TBEV. Interestingly, although all NS3 proteins tested interacted with viperin, only those of ZIKV, and TBEV were significantly degraded by viperin. The degradation of NS3 correlated well with the antiviral activity of viperin, as only TBEV and ZIKV were inhibited.

    In summary, this work revealed the importance of the local type I IFN response in the brain during neurotropic infections by flaviviruses. We identified astrocytes to be an important IFN producer within the CNS during neurotropic flavivirus infection. Astrocytes release type I IFN quickly after viral infection, and this interferon protects neighboring neurons and astrocytes from infection. Furthermore, viperin, a very potent antiviral ISG, is highly expressed in astrocytes and it is essential for controlling viral replication and mediating viral clearance in both neurons and astrocytes of the cerebrum. We also found that viperin specifically targeted the NS3 proteins of TBEV and ZIKV for degradation.

    Publikationen är tillgänglig i fulltext från 2018-10-27 10:31
  • Disputation: 2017-10-27 10:00 KB.E3.03 (Stora hörsalen, Carl Kempe-salen), KBC-huset, Umeå
    Näsström, Elin
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Diagnosis of acute and chronic enteric fever using metabolomics2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Enteric (or typhoid) fever is a systemic infection mainly caused by Salmonella Typhi and Salmonella Paratyphi A. The disease is common in areas with poor water quality and insufficient sanitation. Humans are the only reservoir for transmission of the disease. The presence of asymptomatic chronic carriers is a complicating factor for the transmission. There are major limitations regarding the current diagnostic methods both for acute infection and chronic carriage. Metabolomics is a methodology studying metabolites in biological systems under influence of environmental or physiological perturbations. It has been applied to study several infectious diseases, with the goal of detecting diagnostic biomarkers. In this thesis, a mass spectrometry-based metabolomics approach, including chemometric bioinformatics techniques for data analysis, has been used to evaluate the potential of metabolite biomarker patterns for diagnosis of enteric fever at different stages of the disease.

    In Paper I, metabolite patterns related to acute enteric fever were investigated. Human plasma samples from patients in Nepal with culture-confirmed S. Typhi or S. Paratyphi A infection were compared to afebrile controls. A metabolite pattern discriminating between acute enteric fever and afebrile controls, as well as between the two causative agents of enteric fever was detected. The strength of using a panel of metabolites instead of single metabolites as biomarkers was also highlighted. In Paper II, metabolite patterns for acute enteric fever, this time focusing only on S. Typhi infections, were investigated. Human plasma from patients in Bangladesh with culture-positive or -negative but clinically suspected S. Typhi infection were compared to febrile controls. Differences were found in metabolite patterns between the culture-positive S. Typhi group and the febrile controls with a heterogeneity among the suspected S. Typhi samples. Consistencies in metabolite patterns were found to the results from Paper I. In addition, a validation cohort with culture-positive S. Typhi samples and a control group including patients with malaria and infections caused by other pathogens was analysed. Differences in metabolite patterns were detected between S. Typhi samples and all controls as well as between S. Typhi and malaria. Consistencies in metabolite patterns were found to the primary Bangladeshi cohort and the Nepali cohort from Paper I. Paper III focused on chronic Salmonella carriers. Human plasma samples from patients in Nepal undergoing cholecystectomy with confirmed S. Typhi or S. Paratyphi A gallbladder carriage were compared to non-carriage controls. The Salmonella carriage samples were distinguished from the non-carriage controls and differential signatures were also found between the S. Typhi and S. Paratyphi A carriage samples. Comparing metabolites found during chronic carriage and acute enteric fever (in Paper I) resulted in a panel of metabolites significant only during chronic carriage. This work has contributed to highlight the potential of using metabolomics as a tool to find diagnostic biomarker patterns associated with different stages of enteric fever.

  • Disputation: 2017-10-27 10:00 Hörsal B, Samhällsvetarhuset, Umeå
    Österlind, Malin
    Umeå universitet, Samhällsvetenskapliga fakulteten, Pedagogiska institutionen.
    Strävan efter samhällsförbättring: idrottspolitiska problematiseringar och lösningsstrategier för formandet av den nyttiga idrotten och den idrottande individen2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Sport and sport participation is generally believed to positively contribute to society and individuals and have become important to welfare policy in the westernised world. Simultaneously, there has been an increased political and academic interest in turning sport policy, sport and sport participation into a relevant object of study and evaluation. The overall aim of this dissertation is to develop knowledge on contemporary sport policy and evaluation in relation to ideas about the social significance of sport and sport participation. The purpose is to critically examine how sport policy evaluations, their problematisations and solution proposals help to shape particular images of the good society, good sports and the ideal sport participant. Three research questions are posed: (1) Through what ways of thinking, speaking and knowing are societal and sport policy problems, goals and ideals defined? (2) Through what techniques, methods and strategies are solutions proposed to solve the problems and achieve desired goals and ideals? (3) How are different types of individual and collective (non-)soughtafter subjectivities anticipated and shaped? Drawing on the concept of governmentality, the study focuses on the governing of sport's and the sport participant's conduct, the political problematisations and rationalities regarding this conduct, and the strategies proposed to enhance this conduct. The governmental role of evaluation, knowledge production and scientific expertise is given specific attention. The gradual shifts in governmental rationalities and technologies, from a social form of governing to an advanced liberal form of governing, in the Swedish welfare state provide an overall framework of the study. Two kinds of empirical materials are analysed. First, final reports of sport political government Commissions of inquiries, published in the Swedish Government Official Reports (SOU) from 1922-2008, are analysed. Second, reports of sport political evaluations, published by the Swedish Research Council for Sport Science (CIF) from 2011-2015, are analysed. The analysis reported on in article 1 shows that citizens' 'good' and 'healthy' behaviour and bodies are a focus of problematisation throughout the studied period. In relation to this, sport is seen as an important tool and solution. Parallel to the increased critique of sport in contemporary times, a neo-liberal governmentality is embraced which in turn affects how 'problems' and 'solutions' are thought of in individualistic and rational ways. The analysis reported on in article 2 shows that the 2008 government Commission adopted two main 'problematics'. The democratic problematic concerned a commitment to issues of democracy and equality of opportunities and specified a particular problem of sport; sport excludes rather than includes. The health problematic concerned a commitment to issues of public health and physical activity and focused on a particular problem of the population: people are physically inactive and unhealthy. The argument being proposed in article 2 is that these two problematics construct the ‘problem’ of sport and the sport (non)participant in specific ways, drawing on particular forms of knowledge and discourse, with certain implications for the judgements made and the solutions proposed by the Commission. The analysis reported on in article 3 demonstrates three strategies of evaluation and governing: strategies of representation; deliberation; and reflexivity. The argument being proposed in article 3 is that these three strategies draw on different yet overlapping forms and methods of knowledge about sport participation and thereby also produce different (non-)sport participant subject positions. The analysis reported on in article 4 offers an alternative theoretical conceptualisation, based on governmentality, of the Swedish sports model and shows how sport policy, governing and power can be seen in the light of shifting forms of governmental rationality (i.e. governing from a social point of view to an advanced liberal way of governing). In conclusion, the analyses provided in the thesis as a whole suggest that processes of societal and political improvement in contemporary political governing of sport and sport participation, involves particular images of the good society, good sports and the ideal sport participant.

  • Disputation: 2017-10-27 13:00 Hörsal B, 9 tr, Umeå
    Doohan, Isabelle
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Surviving a major bus crash: experiences from the crash and five years after2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Bakgrund Stora trafikskadehändelser kan ha en betydande inverkan på de överlevande och deras närståendes liv, likaså på sjukvårdspersonal, vittnen, och andra som är involverade. Trots detta så är de överlevandes perspektiv sällsynta eller saknas i forskning om stora trafikskadehändelser i Sverige. Det saknas även en helhetsförståelse av överlevande och deras erfarenheter. Genom att studera hur det är att överleva en busskrasch kan omhändertagande och stöd anpassas och förbättras.

    Det övergripande syftet är att öka förståelsen av kort- och långsiktiga konsekvenser och erfarenheter av att överleva en stor busskrasch.

    Metod Kontexten är två busskrascher som inträffade i februari 2007 och december 2014 i Sverige. Antal deltagare är 110 av 112 överlevande och data samlades in en månad, tre månader och fem år efter krascherna, via telefonintervjuer, officiella rapporter och medicinska journaler. Analysmetoder inkluderar kvalitativ innehållsanalys, deskriptiv statistik, tematisk analys och mixad metod.

    Resultat En månad efter kraschen upplevde överlevande fysiskt obehag och/eller psykisk stress i varierande grad i sin vardag (Studie I). Gällande upplevelser av det initiala omhändertagandet (Studie II) identifierades fyra huvudresultat; obehag på skadeplats, brister i omhändertagande och bemötande, missnöje med krisstöd, och tillfredsställande initialt omhändertagande och stöd. Betydelsen av empati och medkänsla från personal och frivilliga samt samhörighet med medpassagerare lyftes fram av de överlevande. Fem år efter busskraschen i Rasbo (Studie III) fanns det överlevande som fortfarande kämpade med fysiska skador och psykiska problem. Andra tydliga långsiktiga konsekvenser var en bestående gemenskap mellan medpassagerare, en tacksamhet över livet, samt oro och rädsla i trafiken, speciellt vid bussåkande. Uppföljningen efter busskraschen i Tranemo (Studie IV) indikerade att sociala aspekter var betydelsefulla för återhämtningsprocessen hos överlevande och att skadornas svårighetsgrad inte var betydande för det psykiska välbefinnandet. En stark samhörighet upplevdes bland de närstående som reste tillsammans och de verkade följa varandras återhämtning.

    Slutsatser Ett starkt behov av kort- och långsiktigt socialt och psykologiskt stöd i form av gemenskap och empati är tydligt i samtliga studier. De överlevande bör uppmärksammas som aktörer med kapacitet och resurser till att bidra till sin egen och medpassagerares återhämtning och hälsa. Det behövs en ökad förståelse för hur olika de överlevande är, med varierande fysiska, psykologiska, sociala, och existentiella behov. 

  • Disputation: 2017-10-27 13:00 N420, Umeå
    Fodor, Szabolcs
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för tillämpad fysik och elektronik.
    Towards semi-automation of forestry cranes: automated trajectory planning and active vibration damping2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Forests represent one of the biggest terrestrial ecosystems of Earth, that can produce important raw renewable materials such as wood with the help of sun, air and water. To efficiently extract these raw materials, the tree harvesting process is highly mechanized in developed countries, meaning that advanced forestry machines are continuously used to fell, to process and to transport the logs and biomass obtained from the forests. However, working with these machines is demanding both mentally and physically, which are known factors to negatively affect operator productivity. Mental fatigue is mostly due to the manual operation of the on-board knuckleboom crane, which requires advanced cognitive work with two joystick levers, while the most serious physical strains arise from cabin vibrations. These vibrations are generated from knuckleboom crane vibrations as a result of aggressive manual operation.

    To enhance operator workload, well-being, and to increase productivity of the logging process, semi-automation functions are suggested, which are supervised automatic executions of specific work elements. Some of the related issues are addressed in the current thesis. Therefore, the content is divided into: (1) the design and development of a semi-automation function focused only on the base joint actuator (slewing actuator) of a knuckleboom crane, and (2) active vibration damping solutions to treat crane structure vibrations induced by the main lift cylinder (inner boom actuator). The considered reference machine is a downsized knuckleboom crane of a forwarder machine, which is used to pick up log assortments from a harvesting site.

    The proposed semi-automation function presented in the first part could be beneficial for operators to use during log loading/unloading scenarios. It consists from a closed-loop position control architecture, to which smooth reference slewing trajectories are provided by a trajectory planner that is automated via operator commands. The used trajectory generation algorithms are taken from conventional robotics and adapted to semi-automation context with proposed modifications that can be customizable by operators.

    Further, the proposed active vibration damping solutions are aimed to reduce vibrations of the knuckleboom crane excited by the inner boom actuator due to aggressive manual commands. First, a popular input shaping control technique combined with a practical switching logic was investigated to deal with the excited payload oscillations. This technique proved to be useful with a fixed crane pose, however it did not provide much robustness in terms of different link configurations. To tackle this problem an H2-optimal controller is developed, which is active in the pressure feedback-loop and its solely purpose is to damp the same payload oscillations. During the design process, operator commands are treated and explained from input disturbance viewpoint.

    All of the hypothesis throughout this thesis were verified with extensive experimental studies using the reference machine.

  • Disputation: 2017-11-03 10:00 KB.E3.01 (Lilla Hörsalen), Umeå
    Ochtrop, Philipp
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Selective protein functionalisation via enzymatic phosphocholination2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [sv]

    Proteiner utgör huvudbeståndsdelen av alla biomolekyler i en cell. Dessa är involverade i alla cellulära processer som bestämmer cellens egenskaper. För att förstå de cellulära processerna är det nödvändigt att förstå proteinernas funktion på molekylär nivå. Att studera proteiner i deras naturliga omgivning, det vill säga inuti en cell eller i ett cellextrakt, är en stor utmaning i dagens livsvetenskaper. Eftersom proteiner är kemiskt lika varandra så är det svårt att skilja ett från tusentals andra. Att specifikt märka proteiner för att skilja ut dem från bakgrunden har blivit ett viktigt arbetssätt i modern biokemi och cellbiologi. Avhandlingen beskriver utvecklandet av en ny metod för reversibel och kovalent enzymatisk märkning baserat på fosfokolinering/defosfokolinering av en kort aminosyrasekvens i intakta proteiner. En syntesmetod för att framställa onaturliga CDP-kolinderivat har etablerats vilket tillåter oss att framställa CDP-kolin som bär en funktionalitet, vilket kan vara ett färgämne eller en affinitetstagg. Dessa onaturliga CDP-kolinderivat accepteras som co-substrat av enzymet AnkX från Legionella pneumophila vilket transfererar den funktionaliserade delen av CDP-kolinderivatet till en kort aminosyrasekvens baserad på AnkX’s naturliga substrat vid infektion, det lilla GTPaset Rab1. Under avhandlingsarbetets gång identifierades den kortaste aminosyrasekvensen som känns igen av AnkX, endast de åtta aminosyrorna TITSSYYR är nödvändiga för igenkänning av AnkX. Dessa åtta aminosyror kan genetiskt infogas i början, slutet eller mitt i ett protein för igenkänning och funktionalisering via AnkX och våra syntetiska CDP-kolinderivat. Vid Legionellainfektion i eukaryota celler klyvs fosfokolineringen efter en viss tid, eftersom Legionella pneumophila producerar ett fosfodiesteras, Lem3, som tar bort de fosfokolineringar som AnkX har installerat när de inte längre behövs. Vi har använt Lem3 för att ta bort märkning i sekvensen TITSS(PC)YYR, vilket gör vår strategi helt reversibel. Vi har kunnat demonstrera att AnkX-Lem3 systemet accepterar ett brett spektrum av CDP-kolinderivat, vilket gör metoden till den första av sitt slag, eftersom den är fullt reversibel. Vi har vidare undersökt vilka proteiner AnkX reagerar med inuti celler, vi använde oss av ett CDP-kolinderivat funktionaliserat med biotin, vilket har tillåtit oss att fiska ut alla de proteiner som fosfokolineras av AnkX. Förutom de små GTPaserna i Rab-familjen så identifierade vi även IMPDH2, ett enzym som reglerar det hastighetsbestämmande steget i syntesen av guanosin-nukleotider. Detta är mycket intressant, eftersom det leder till frågan ifall Legionella pneumophila manipulerar sin värdcell genom att förändra mängden GTP i förhållande till ATP.

  • Disputation: 2017-11-03 10:15 S Hörsal A, Samhällsvetarhuset, Umeå
    Åberg, Kajsa G.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för geografi och ekonomisk historia, Kulturgeografi.
    "Anyone could do that": Nordic perspectives on competence in tourism2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    In academic reasoning, as well as policy rhethoric, much attention has been drawn to the low thresholds to employment and entrepreneurship in tourism. The purpose of this thesis is to go beyond the simplified images and examine the educational characteristics of the tourism workforce in a way that includes both a geographical and work task related aspect. By employing a sequential mix of methods, two perspectives on competence in tourism are presented. First, the actual presence of formal education within the workforce is mapped and discussed based on descriptive analyses of register data. Thereafter, thematic analyses of interviews are used to allow for a discussion on underlying reasoning of recruitment. The theoretical point of departure is that the workforce is a crucial input factor of the production process in labour intense service sectors such as tourism. However, the access to a suitable workforce differs between destinations. It is therefore imperative to scrutinize its characteristics in order to set relevant strategies for development, as well as education.

    The thesis contains four individual papers and an introductory section. The first two papers are based on register data on the Swedish national workforce in the years 2000, 2005 and 2010. The results show that the general level of formal education is not exceptionally low in tourism and that it is rather linked to geography than occupational sector. There was also confirmed to be a mismatch between tourism-specific education and work in tourism. In the second part of the thesis, focus is turned to the managerial segment within destination development. The geographical scope includes the northern region of Sweden and one case study area each in Norway and Finland. The empirical material shows that tourism-specific education was not prioritized when recruiting for destination management.

    The empirical findings are brought together in the concluding discussion of the thesis. It is there suggested that reasoning on the educational characteristics of the tourism workforce needs to  include the diversity of local preconditions and needs relating to geography and work tasks.            

  • Disputation: 2017-11-10 09:00 Sal A, byggnad 23, Umeå
    Löfgren, Hans O.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Barn- och ungdomspsykiatri.
    Preventive psychosocial parental and school programmes in a general population2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction Numerous preventive programmes have emerged, and need to be investigated to determine their effects on the normal population. Earlier studies have shown a decrease in depressive symptoms, positive effects on children’s disruptive behaviour problems, and an improvement in parental competence. About a fifth of the parents in previous studies had problem-oriented (targeted) reasons for enrolment, whereas the rest of the parents had general (universal) reasons. The results of those studies suggest that the programmes are cost effective in terms of Quality-Adjusted Life Years.

    Aim Four sub-studies were performed, and their aims were to investigate the effect of parental training programmes (PTPs) in a naturalistic setting on parents’ mental health in the general population, to investigate how PTPs affect parents’ sense of parental competence, to investigate how PTPs affect parental stress and analyse the parents open questions about the PTPs, and to investigate the feasibility and to measure the effect on depression, anxiety, and social problems of two preventive school programmes for pupils in grade 7.

    Method In a longitudinal quantitative study in a real-world setting, 279 parents from the general population in northern Sweden participated in five PTPs. A comparison group of 702 parents without intervention was included. Simultaneously, a community sample of 59 pupils in grade 7 participated in two preventive school programmes. Both studies were conducted from 2010 to 2013. Parents were assigned to professionally supported interventions that included 5-10 two-hour sessions. Respondents filled in a web-based questionnaire with the General Health Questionnaire (GHQ), the Parents Sense of Competence (PSOC) for parents who had children aged 0-17 years, and the Swedish Parenthood Stress Questionnaire (SPSQ) for parents who had children aged 0-10 years. The intervention groups’ results were compared to comparison group of 702 parents from northern Sweden that had not participated in any parental training programme. In the school study, one of the preventive programmes was an ongoing programme called “Life-Skills”, and the other was an implemented Canadian programme called “Choosing Healthy Actions and Thoughts” (CHAT). The pupils completed a test battery including the Sense of Coherence (SOC), the Children’s Depression Inventory (CDI), and the Youth Self-Report (YSR) instruments. Follow up of the parental programme study was done six months after the post-intervention measure, and follow up of the school study was at one year.

    Results The improvements in GHQ were statistically significant for the mean of the 279 parents in the intervention group compared to the mean of a comparison group of the 702 parents who did not receive any intervention. This suggests that evidence-based PTPs enhance parental well-being even for parents without problems. The intervention group showed a statistically significant improvement in parental competence compared to the comparison group over time. The intervention itself had a significant effect on parental satisfaction, but the efficacy effect was not sustained when taking into account potential confounders. In the SPSQ, the intervention group was smaller due to the fact that the instrument was not validated for children over the age of 10 and one of the parental training groups was only for parents of teenagers. A reduction of stress in the sub-scale of health problems was detected, but no other subscale showed the intervention to have a significant effect when controlling for confounding variables. In the school study, both programmes had good feasibility according to the stake- holders and had several positive mental health outcomes over time. Compared to Life-Skills, CHAT had more significant positive effects on reducing anxious/depressive symptoms and girls experienced significant positive effects on reduced anxious/depressive behaviour, while boys reduced their aggressive behaviours.

    Conclusions Earlier studies indicate that PTPs enhance perceived parental competence among referred parents. The present study shows that PTPs applied in the general population might also enhance perceived parental benefits such as improved health and satisfaction, suggesting that PTPs can be an important preventive strategy to enhance parenthood. The results suggest that parents who feel a need to increase their parenting competence might participate in PTPs based on lower scores than the comparison control group both before and after the intervention. The school-based programme shows that schools may be a suitable arena for preventive programmes because there was a significant short-term improvement in depression symptoms. Further studies need to explore how parents’ participation in PTPs affects children’s mental health in the general population in quantitative longitudinal studies in real-word settings. There is also a need for bigger studies and RCTs on school preventions and on how children’s health develops naturally in the population.