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  • Fröbert, Ole
    et al.
    Götberg, Matthias
    Angerås, Oskar
    Jonasson, Lena
    Erlinge, David
    Engstrøm, Thomas
    Persson, Jonas
    Jensen, Svend E.
    Omerovic, Elmir
    James, Stefan K.
    Lagerqvist, Bo
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Kåregren, Amra
    Moer, Rasmus
    Yang, Cao
    Agus, David B.
    Erglis, Andrejs
    Jensen, Lisette O.
    Jakobsen, Lars
    Christiansen, Evald H.
    Pernow, John
    Design and rationale for the Influenza vaccination After Myocardial Infarction (IAMI) trial: a registry-based randomized clinical trial2017In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 189, 94-102 p.Article in journal (Refereed)
    Abstract [en]

    Background Registry studies and case-control studies have demonstrated that the risk of acute myocardial infarction (AMI) is increased following influenza infection. Small randomized trials, underpowered for clinical end points, indicate that future cardiovascular events can be reduced following influenza vaccination in patients with established cardiovascular disease. Influenza vaccination is recommended by international guidelines for patients with cardiovascular disease, but uptake is varying and vaccination is rarely prioritized during hospitalization for AMI. Methods/design The Influenza vaccination After Myocardial Infarction (IAMI) trial is a double-blind, multicenter, prospective, registry-based, randomized, placebo-controlled, clinical trial. A total of 4,400 patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI undergoing coronary angiography will randomly be assigned either to in-hospital influenza vaccination or to placebo. Baseline information is collected from national heart disease registries, and follow-up will be performed using both registries and a structured telephone interview. The primary end point is a composite of time to all cause death, a new AMI, or stent thrombosis at 1 year. Implications The IAMI trial is the largest randomized trial to date to evaluate the effect of in-hospital influenza vaccination on death and cardiovascular outcomes in patients with STEMI or non-STEMI. The trial is expected to provide highly relevant clinical data on the efficacy of influenza vaccine as secondary prevention after AMI.

  • Juto, Hans
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Gärtner Nilsson, Mattis
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Möller, Michael
    Wennergren, David
    Morberg, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Evaluating non-responders of a survey in the Swedish fracture register: no indication of different functional result2017In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, 278Article in journal (Refereed)
    Abstract [en]

    Background: The Swedish Fracture Register (SFR) currently contains information on more than 190,000 fractures. Patient Reported Outcome Measures (PROMs) are used for monitoring functional results after fracture treatment. One weakness, as in many surveys, is a low response rate. The aim of the current study was to examine if non-responders of a survey in the SFR differ in PROMs scores, how age and gender influence the response rate and reasons for not responding. Methods: Patients with fractures of radius, ulna or humerus between June and August 2013 and registered in the SFR were included in the study. The non-responders to both the pre-injury and the 1-year survey were contacted by phone and reminded to reply. A comparison of the results of both EQ-5D and Short Musculoskeletal Function Assessment (SMFA) could be made between the responders after a phone reminder and the initial responders. The response rate for the register as a whole was extracted in order to identify how age and gender affect the response rate. Results: Three hundred seventeen of the patients included in the study responded initially. After phone reminder another 94 patients answered the pre-injury survey. Two hundred sixty eight responded initially to the 1-year follow-up survey and 42 after phone reminder. No significant difference was identified in the score of the pre-injury survey between initial responders and responders after phone reminder neither in the EQ-5D nor in the Short Musculoskeletal Function Assessment (SMFA). Regarding the 1-year survey, responders after a phone reminder reported a significantly better outcome in crude data of SMFA score. This difference disappeared after controlling for confounding factors through case control matching. The highest response rate to PROMs in the SFR was among females in the age range 60-69 years. Conclusion: This study indicates that both in the preinjury survey as well as in the 1-year survey the non-responders in the SFR report similar function compared to the initial responders. Age and gender of patients affect the response rate of the survey which needs to be taken into consideration in analysis of data from the SFR.

  • Prigge, Justin R.
    et al.
    Coppo, Lucia
    Martin, Sebastin S.
    Ogata, Fernando
    Miller, Colin G.
    Bruschwein, Michael D.
    Orlicky, David J.
    Shearn, Colin T.
    Kundert, Jean A.
    Lytchier, Julia
    Herr, Alix E.
    Mattsson, Åse
    Taylor, Matthew P.
    Gustafsson, Tomas N.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Clinical Bacteriology. Division of Biochemistry, Medical Biochemistry & Biophysics, Karolinska Institutet, Stockholm, Sweden.
    Arnér, Elias S. J.
    Holmgren, Arne
    Schmidt, Edward E.
    Hepatocyte Hyperproliferation upon Liver-Specific Co-disruption of Thioredoxin-1, Thioredoxin Reductase-1, and Glutathione Reductase2017In: Cell reports, ISSN 2211-1247, E-ISSN 2211-1247, Vol. 19, no 13, 2771-2781 p.Article in journal (Refereed)
    Abstract [en]

    Energetic nutrients are oxidized to sustain high intracellular NADPH/NADP(+) ratios. NADPH-dependent reduction of thioredoxin-1 (Trx1) disulfide and glutathione disulfide by thioredoxin reductase-1 (TrxR1) and glutathione reductase (Gsr), respectively, fuels antioxidant systems and deoxyribonucleotide synthesis. Mouse livers lacking both TrxR1 and Gsr sustain these essential activities using an NADPH-independent methionine-consuming pathway; however, it remains unclear how this reducing power is distributed. Here, we show that liver-specific co-disruption of the genes encoding Trx1, TrxR1, and Gsr (triplenull) causes dramatic hepatocyte hyperproliferation. Thus, even in the absence of Trx1, methionine-fueled glutathione production supports hepatocyte S phase deoxyribonucleotide production. Also, Trx1 in the absence of TrxR1 provides a survival advantage to cells under hyperglycemic stress, suggesting that glutathione, likely via glutaredoxins, can reduce Trx1 disulfide in vivo. In triple-null livers like in many cancers, deoxyribonucleotide synthesis places a critical yet relatively low-volume demand on these reductase systems, thereby favoring high hepatocyte turnover over sustained hepatocyte integrity.

  • Taj, Tahir
    et al.
    Malmqvist, Ebba
    Stroh, Emilie
    Oudin Åström, Daniel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Center for Primary Health Care Research, Department of Clinical Science, Malmö, Lund University, Malmö, Sweden.
    Jakobsson, Kristina
    Oudin, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
    Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study2017In: International Journal of Environment and Bioenergy, ISSN 1832-2077, E-ISSN 1660-4601, Vol. 14, no 6, 587Article in journal (Refereed)
    Abstract [en]

    Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 mu g/m(3) increase in nitrogen dioxide (NO2) levels in Malmo, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 mu g/m(3) increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.

  • Scholz, Saskia
    et al.
    Baharom, Faezzah
    Rankin, Gregory
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Maleki, Kimia T.
    Gupta, Shawon
    Vangeti, Sindhu
    Pourazar, Jamshid
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Discacciati, Andrea
    Höijer, Jonas
    Bottai, Matteo
    Björkström, Niklas K.
    Rasmuson, Johan
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Evander, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ljunggren, Hans-Gustaf
    Klingström, Jonas
    Ahlm, Clas
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Smed-Sörensen, Anna
    Human hantavirus infection elicits pronounced redistribution of mononuclear phagocytes in peripheral blood and airways2017In: PLoS Pathogens, ISSN 1553-7366, E-ISSN 1553-7374, Vol. 13, no 6, e1006462Article in journal (Refereed)
    Abstract [en]

    Hantaviruses infect humans via inhalation of virus-contaminated rodent excreta. Infection can cause severe disease with up to 40% mortality depending on the viral strain. The virus primarily targets the vascular endothelium without direct cytopathic effects. Instead, exaggerated immune responses may inadvertently contribute to disease development. Mononuclear phagocytes (MNPs), including monocytes and dendritic cells (DCs), orchestrate the adaptive immune responses. Since hantaviruses are transmitted via inhalation, studying immunological events in the airways is of importance to understand the processes leading to immunopathogenesis. Here, we studied 17 patients infected with Puumala virus that causes a mild form of hemorrhagic fever with renal syndrome (HFRS). Bronchial biopsies as well as longitudinal blood draws were obtained from the patients. During the acute stage of disease, a significant influx of MNPs expressing HLA-DR, CD11c or CD123 was detected in the patients' bronchial tissue. In parallel, absolute numbers of MNPs were dramatically reduced in peripheral blood, coinciding with viremia. Expression of CCR7 on the remaining MNPs in blood suggested migration to peripheral and/or lymphoid tissues. Numbers of MNPs in blood subsequently normalized during the convalescent phase of the disease when viral RNA was no longer detectable in plasma. Finally, we exposed blood MNPs in vitro to Puumala virus, and demonstrated an induction of CCR7 expression on MNPs. In conclusion, the present study shows a marked redistribution of blood MNPs to the airways during acute hantavirus disease, a process that may underlie the local immune activation and contribute to immunopathogenesis in hantavirus-infected patients.

  • Webster, Steve J.
    et al.
    Brode, Sven
    Ellis, Lou
    Fitzmaurice, Timothy J.
    Elder, Matthew J.
    Gekara, Nelson O.
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Tourlomousis, Panagiotis
    Bryant, Clare
    Clare, Simon
    Chee, Ronnie
    Gaston, Hill J. S.
    Goodall, Jane C.
    Detection of a microbial metabolite by STING regulates inflammasome activation in response to Chlamydia trachomatis infection2017In: PLoS Pathogens, ISSN 1553-7366, E-ISSN 1553-7374, Vol. 13, no 6, e1006383Article in journal (Refereed)
    Abstract [en]

    The innate immune system is a critical component of host defence against microbial pathogens, but effective responses require an ability to distinguish between infectious and noninfectious insult to prevent inappropriate inflammation. Using the important obligate intracellular human pathogen Chlamydia trachomatis; an organism that causes significant immunopathology, we sought to determine critical host and pathogen factors that contribute to the induction of inflammasome activation. We assayed inflammasome activation by immunoblotting and ELISA to detect IL-1 beta processing and LDH release to determine pyroptosis. Using primary murine bone marrow derived macrophages or human monocyte derived dendritic cells, infected with live or attenuated Chlamydia trachomatis we report that the live organism activates both canonical and non-canonical inflammasomes, but only canonical inflammasomes controlled IL-1 beta processing which preceded pyroptosis. NADPH oxidase deficient macrophages were permissive to Chlamydia trachomatis replication and displayed elevated type-1 interferon and inflammasome activation. Conversely, attenuated, non-replicating Chlamydia trachomatis, primed but did not activate inflammasomes and stimulated reduced type-1 interferon responses. This suggested bacterial replication or metabolism as important factors that determine interferon responses and inflammasome activation. We identified STING but not cGAS as a central mediator of interferon regulated inflammasome activation. Interestingly, exogenous delivery of a Chlamydia trachomatis metabolite and STING ligand D cyclic di-AMP, recovered inflammasome activation to attenuated bacteria in a STING dependent manner thus indicating that a bacterial metabolite is a key factor initiating inflammasome activation through STING, independent of cGAS. These data suggest a potential mechanism of how the innate immune system can distinguish between infectious and non-infectious insult and instigate appropriate immune responses that could be therapeutically targeted.

  • Ljungberg, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Engström, Karl Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Albertsson, Elin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Holmer, Paul
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Biobank Research.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Traditional Cardiovascular Risk Factors and Their Relation to Future Surgery for Valvular Heart Disease or Ascending Aortic Disease: A Case-Referent Study2017In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 6, no 5, e005133Article in journal (Refereed)
    Abstract [en]

    Background: Risk factors for developing heart valve and ascending aortic disease are based mainly on retrospective data. To elucidate these factors in a prospective manner, we have performed a nested case-referent study using data from large, population-based surveys. Methods and Results: A total of 777 patients operated for heart valve disease or disease of the ascending aorta had previously participated in population-based health surveys in Northern Sweden. Median time (interquartile range) from survey to surgery was 10.5 (9.0) years. Primary indications for surgery were aortic stenosis (41%), aortic regurgitation (12%), mitral regurgitation (23%), and dilatation/dissection of the ascending aorta (17%). For each case, referents were allocated, matched for age, sex, and geographical area. In multivariable models, surgery for aortic stenosis was predicted by hypertension, high cholesterol levels, diabetes mellitus, and active smoking. Surgery for aortic regurgitation was associated with a low cholesterol level, whereas a high cholesterol level predicted surgery for mitral regurgitation. Hypertension, blood pressure, and previous smoking predicted surgery for disease of the ascending aorta whereas diabetes mellitus was associated with reduced risk. After exclusion of cases with coronary atherosclerosis, only the inverse associations between cholesterol and aortic regurgitation and between diabetes mellitus and disease of the ascending aorta remained. Conclusions: This is the first truly prospective study of traditional cardiovascular risk factors and their association with valvular heart disease and disease of the ascending aorta. We confirm the strong association between traditional risk factors and aortic stenosis, but only in patients with concomitant coronary artery disease. In isolated valvular heart disease, the impact of traditional risk factors is varying.

  • Claesson, Rolf
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Höglund-Åberg, Carola
    Umeå University, Faculty of Medicine, Department of Odontology.
    Haubek, Dorte
    Johansson, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Age-related prevalence and characteristics of Aggregatibacter actinomycetemcomitans in periodontitis patients living in Sweden2017In: Journal of Oral Microbiology, ISSN 2000-2297, E-ISSN 2000-2297, Vol. 9, 1334504Article in journal (Refereed)
    Abstract [en]

    Background: The presence of Aggregatibacter actinomycetemcomitans in patients with periodontitis has been extensively studied for decades. Objective: To study the prevalence of A. actinomycetemcomitans in younger and older periodontitis patients and to genetically characterize isolates of this bacterium. Design: Data from microbiological analyses of 3459 subgingival plaque samples collected from 1445 patients, 337 'younger' patients (<= 35 yrs) and 1108 'older' patients (>35 yrs) during 15 years (2000-2014), has been summerized. Isolates of A. actinomycetemcomitans were serotyped, leukotoxin promoter typed (JP2 and non JP2) and arbitrarily primed PCR (APPCR) genotyped. The origin of the JP2 genotype detected in the study population was determined. Results: The prevalence of A. actinomycetemcomitans was higher among younger than older patients and samples from the younger patients contained higher proportions of the bacterium. Serotype b was more prevalent among younger patients and the majorty of these isolates was from the same AP-PCR genotype. The JP2 genotype was detected in 1.2% of the patients, and the majority of these carriers were of non-African origin. Conslusions: For presence and charcteristics of A. actinomycetemcomitans in clinical samples the age of the carriers were a discriminating factor. Additional, apparently non- African carriers of the JP2 genotype of A. actinomycetemcomitans were identified.

  • Magnusson, Rebecca
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Effects of litter quality and latitude on decomposition.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Decomposition of organic material (litter) is an important part of the global carbon cycle. Environmental conditions, litter quality and the microbial community are the main factors affecting decomposition. The decomposition is divided into two phases, one fast initial phase and one slow second phase. The tea bag index (TBI) was used as a standardized method to measure decomposition rate along a latitudinal gradient. A common garden set up and extractions were made to determine the composition of the litter to investigate if climate or litter quality affected the decomposition rate. The result showed that the decomposition rate increased with higher latitude. The litter from higher latitude has more material that is easy to decompose. Natural litter abroad had higher decomposition rate than at home. On the contrary, standard litter at home had higher decomposition rate than abroad. This indicates that litter quality is more important than latitude. Further studies are needed with more sites along the gradient to conclude how climate and litter quality are affecting decomposition.   

  • Tao, Liang
    et al.
    Peng, Lisheng
    Berntsson, Ronnie P. -A.
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics. Department of Biochemistry and Biophysics, Stockholm University, Stockholm, Sweden.
    Liu, Sai Man
    Park, SunHyun
    Yu, Feifan
    Boone, Christopher
    Palan, Shilpa
    Beard, Matthew
    Chabrier, Pierre-Etienne
    Stenmark, Pål
    Krupp, Johannes
    Dong, Min
    Engineered botulinum neurotoxin B with improved efficacy for targeting human receptors2017In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 8, 53Article in journal (Refereed)
    Abstract [en]

    Botulinum neurotoxin B is a Food and Drug Administration-approved therapeutic toxin. However, it has lower binding affinity toward the human version of its major receptor, synaptotagmin II (h-Syt II), compared to mouse Syt II, because of a residue difference. Increasing the binding affinity to h-Syt II may improve botulinum neurotoxin B's therapeutic efficacy and reduce adverse effects. Here we utilized the bacterial adenylate cyclase two-hybrid method and carried out a saturation mutagenesis screen in the Syt II-binding pocket of botulinum neurotoxin B. The screen identifies E1191 as a key residue: replacing it with M/C/V/Q enhances botulinum neurotoxin B binding to human synaptotagmin II. Adding S1199Y/W or W1178Q as a secondary mutation further increases binding affinity. Mutant botulinum neurotoxin B containing E1191M/S1199Y exhibits similar to 11-fold higher efficacy in blocking neurotransmission than wild-type botulinum neurotoxin B in neurons expressing human synaptotagmin II, demonstrating that enhancing receptor binding increases the overall efficacy at functional levels. The engineered botulinum neurotoxin B provides a platform to develop therapeutic toxins with improved efficacy.

  • Witt, S. H.
    et al.
    Streit, F.
    Jungkunz, M.
    Frank, J.
    Awasthi, S.
    Reinbold, C. S.
    Treutlein, J.
    Degenhardt, F.
    Forstner, A. J.
    Heilmann-Heimbach, S.
    Dietl, L.
    Schwarze, C. E.
    Schendel, D.
    Strohmaier, J.
    Abdellaoui, A.
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Air, T. M.
    Akil, H.
    Alda, M.
    Alliey-Rodriguez, N.
    Andreassen, O. A.
    Babadjanova, G.
    Bass, N. J.
    Bauer, M.
    Baune, B. T.
    Bellivier, F.
    Bergen, S.
    Bethell, A.
    Biernacka, J. M.
    Blackwood, D. H. R.
    Boks, M. P.
    Boomsma, D. I.
    Borglum, A. D.
    Borrmann-Hassenbach, M.
    Brennan, P.
    Budde, M.
    Buttenschon, H. N.
    Byrne, E. M.
    Cervantes, P.
    Clarke, T-K
    Craddock, N.
    Cruceanu, C.
    Curtis, D.
    Czerski, P. M.
    Dannlowski, U.
    Davis, T.
    de Geus, E. J. C.
    Di Florio, A.
    Djurovic, S.
    Domenici, E.
    Edenberg, H. J.
    Etain, B.
    Fischer, S. B.
    Forty, L.
    Fraser, C.
    Frye, M. A.
    Fullerton, J. M.
    Gade, K.
    Gershon, E. S.
    Giegling, I.
    Gordon, S. D.
    Gordon-Smith, K.
    Grabe, H. J.
    Green, E. K.
    Greenwood, T. A.
    Grigoroiu-Serbanescu, M.
    Guzman-Parra, J.
    Hall, L. S.
    Hamshere, M.
    Hauser, J.
    Hautzinger, M.
    Heilbronner, U.
    Herms, S.
    Hitturlingappa, S.
    Hoffmann, P.
    Holmans, P.
    Hottenga, J-J
    Jamain, S.
    Jones, I.
    Jones, L. A.
    Jureus, A.
    Kahn, R. S.
    Kammerer-Ciernioch, J.
    Kirov, G.
    Kittel-Schneider, S.
    Kloiber, S.
    Knott, S. V.
    Kogevinas, M.
    Landen, M.
    Leber, M.
    Leboyer, M.
    Li, Q. S.
    Lissowska, J.
    Lucae, S.
    Martin, N. G.
    Mayoral-Cleries, F.
    McElroy, S. L.
    McIntosh, A. M.
    McKay, J. D.
    McQuillin, A.
    Medland, S. E.
    Middeldorp, C. M.
    Milaneschi, Y.
    Mitchell, P. B.
    Montgomery, G. W.
    Morken, G.
    Mors, O.
    Muehleisen, T. W.
    Mueller-Myhsok, B.
    Myers, R. M.
    Nievergelt, C. M.
    Nurnberger, J. I.
    O'Donovan, M. C.
    Loohuis, L. M. O.
    Ophoff, R.
    Oruc, L.
    Owen, M. J.
    Paciga, S. A.
    Penninx, B. W. J. H.
    Perry, A.
    Pfennig, A.
    Potash, J. B.
    Preisig, M.
    Reif, A.
    Rivas, F.
    Rouleau, G. A.
    Schofield, P. R.
    Schulze, T. G.
    Schwarz, M.
    Scott, L.
    Sinnamon, G. C. B.
    Stahl, E. A.
    Strauss, J.
    Turecki, G.
    Van der Auwera, S.
    Vedder, H.
    Vincent, J. B.
    Willemsen, G.
    Witt, C. C.
    Wray, N. R.
    Xi, H. S.
    Tadic, A.
    Dahmen, N.
    Schott, B. H.
    Cichon, S.
    Noethen, M. M.
    Ripke, S.
    Mobascher, A.
    Rujescu, D.
    Lieb, K.
    Roepke, S.
    Schmahl, C.
    Bohus, M.
    Rietschel, M.
    Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia2017In: Translational Psychiatry, ISSN 2158-3188, E-ISSN 2158-3188, Vol. 7, e1155Article in journal (Refereed)
    Abstract [en]

    Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report describes the first case–control genome-wide association study (GWAS) of BOR, performed in one of the largest BOR patient samples worldwide. The focus of our analysis was (i) to detect genes and gene sets involved in BOR and (ii) to investigate the genetic overlap with BIP. As there is considerable genetic overlap between BIP, major depression (MDD) and schizophrenia (SCZ) and a high comorbidity of BOR and MDD, we also analyzed the genetic overlap of BOR with SCZ and MDD. GWAS, gene-based tests and gene-set analyses were performed in 998 BOR patients and 1545 controls. Linkage disequilibrium score regression was used to detect the genetic overlap between BOR and these disorders. Single marker analysis revealed no significant association after correction for multiple testing. Gene-based analysis yielded two significant genes: DPYD (P=4.42 × 10−7) and PKP4 (P=8.67 × 10−7); and gene-set analysis yielded a significant finding for exocytosis (GO:0006887, PFDR=0.019; FDR, false discovery rate). Prior studies have implicated DPYD, PKP4 and exocytosis in BIP and SCZ. The most notable finding of the present study was the genetic overlap of BOR with BIP (rg=0.28 [P=2.99 × 10−3]), SCZ (rg=0.34 [P=4.37 × 10−5]) and MDD (rg=0.57 [P=1.04 × 10−3]). We believe our study is the first to demonstrate that BOR overlaps with BIP, MDD and SCZ on the genetic level. Whether this is confined to transdiagnostic clinical symptoms should be examined in future studies.

  • Nordström, Carl-Henrik
    et al.
    Koskinen, Lars-Owe
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Olivecrona, Magnus
    Aspects on the Physiological and Biochemical Foundations of Neurocritical Care2017In: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 8, 274Article, review/survey (Refereed)
    Abstract [en]

    Neurocritical care (NCC) is a branch of intensive care medicine characterized by specific physiological and biochemical monitoring techniques necessary for identifying cerebral adverse events and for evaluating specific therapies. Information is primarily obtained from physiological variables related to intracranial pressure (ICP) and cerebral blood flow (CBF) and from physiological and biochemical variables related to cerebral energy metabolism. Non-surgical therapies developed for treating increased ICP are based on knowledge regarding transport of water across the intact and injured blood-brain barrier (BBB) and the regulation of CBF. Brain volume is strictly controlled as the BBB permeability to crystalloids is very low restricting net transport of water across the capillary wall. Cerebral pressure autoregulation prevents changes in intracranial blood volume and intracapillary hydrostatic pressure at variations in arterial blood pressure. Information regarding cerebral oxidative metabolism is obtained from measurements of brain tissue oxygen tension (PbtO2) and biochemical data obtained from intracerebral microdialysis. As interstitial lactate/pyruvate (LP) ratio instantaneously reflects shifts in intracellular cytoplasmatic redox state, it is an important indicator of compromised cerebral oxidative metabolism. The combined information obtained from PbtO2, LP ratio, and the pattern of biochemical variables reveals whether impaired oxidative metabolism is due to insufficient perfusion (ischemia) or mitochondrial dysfunction. Intracerebral microdialysis and PbtO2 give information from a very small volume of tissue. Accordingly, clinical interpretation of the data must be based on information of the probe location in relation to focal brain damage. Attempts to evaluate global cerebral energy state from microdialysis of intraventricular fluid and from the LP ratio of the draining venous blood have recently been presented. To be of clinical relevance, the information from all monitoring techniques should be presented bedside online. Accordingly, in the future, the chemical variables obtained from microdialysis will probably be analyzed by biochemical sensors.

  • Lange, Dale J.
    et al.
    Shahbazi, Mona
    Silani, Vincenzo
    Ludolph, Albert C.
    Weishaupt, Jochen H.
    Ajroud-Driss, Senda
    Fields, Kara G.
    Remanan, Rahul
    Appel, Stanley H.
    Morelli, Claudia
    Doretti, Alberto
    Maderna, Luca
    Messina, Stefano
    Weiland, Ulrike
    Marklund, Stefan L.
    Andersen, Peter M.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience. Department of Neurology, Ulm University, Ulm, Germany.
    Pyrimethamine Significantly Lowers Cerebrospinal Fluid Cu/Zn Superoxide Dismutase in Amyotrophic Lateral Sclerosis Patients with SOD1 Mutations2017In: Annals of Neurology, ISSN 0364-5134, E-ISSN 1531-8249, Vol. 81, no 6, 837-848 p.Article in journal (Refereed)
    Abstract [en]

    Objective: Cu/Zn superoxide dismutase (SOD1) reduction prolongs survival in SOD1-transgenic animal models. Pyrimethamine produces dose-dependent SOD1 reduction in cell culture systems. A previous phase 1 trial showed pyrimethamine lowers SOD1 levels in leukocytes in patients with SOD1 mutations. This study investigated whether pyrimethamine lowered SOD1 levels in the cerebrospinal fluid (CSF) in patients carrying SOD1 mutations linked to familial amyotrophic lateral sclerosis (fALS/SOD1). Methods: A multicenter (5 sites), open-label, 9-month-duration, dose-ranging study was undertaken to determine the safety and efficacy of pyrimethamine to lower SOD1 levels in the CSF in fALS/SOD1. All participants underwent 3 lumbar punctures, blood draw, clinical assessment of strength, motor function, quality of life, and adverse effect assessments. SOD1 levels were measured in erythrocytes and CSF. Pyrimethamine was measured in plasma and CSF. Appel ALS score, ALS Functional Rating Scale-Revised, and McGill Quality of Life Single-Item Scale were measured at screening, visit 6, and visit 9. Results: We enrolled 32 patients; 24 completed 6 visits (18 weeks), and 21 completed all study visits. A linear mixed effects model showed a significant reduction in CSF SOD1 at visit 6 (p<0.001) with a mean reduction of 13.5% (95% confidence interval [CI] 58.4-18.5) and at visit 9 (p<0.001) with a mean reduction of 10.5% (95% CI55.2-15.8). Interpretation: Pyrimethamine is safe and well tolerated in ALS. Pyrimethamine is capable of producing a significant reduction in total CSF SOD1 protein content in patients with ALS caused by different SOD1 mutations. Further long-term studies are warranted to assess clinical efficacy.

  • Jörgren, F.
    et al.
    Johansson, Robert
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Arnadottir, H.
    Lindmark, G.
    The importance of rectal washout for the oncological outcome after Hartmann's procedure for rectal cancer: analysis of population-based data from the Swedish Colorectal Cancer Registry2017In: Techniques in Coloproctology, ISSN 1123-6337, E-ISSN 1128-045X, Vol. 21, no 5, 373-381 p.Article in journal (Refereed)
    Abstract [en]

    During rectal cancer surgery the bowel may contain viable, exfoliated cancer cells, a potential source for local recurrence (LR). The amount and viability of these cells can be reduced using intraoperative rectal washout, a procedure that reduces the LR risk after anterior resection. The aim of this study was to analyse the impact of washout on oncological outcome when performed in Hartmann's procedure (HP) for rectal cancer. A national cohort study on data for patients registered from 1995 to 2007 in the Swedish Colorectal Cancer Registry was carried out. The final analysis included patients belonging to TNM stages I-III who had undergone R0 HP with a registered 5-year follow-up. Multivariate analysis was performed. A total of 1188 patients were analysed (686 washout and 502 no washout). No differences were detected between the washout group and the no washout group concerning rates of LR [7% (49/686) vs. 10% (49/502); p = 0.13], distant metastasis (DM) [17% (119/686) vs. 18% (93/502); p = 0.65], and overall recurrence (OAR) [21% (145/686) vs. 24% (120/502); p = 0.29]. For both groups, the 5-year cancer-specific survival was below 50%. In multivariate analysis, washout neither decreased the risk of LR, DM, or OAR nor increased overall or the cancer-specific 5-year survival. The oncological outcome did not improve when washout was performed in HP for rectal cancer.

  • Holmlund, Petter
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Johansson, Elias
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Qvarlander, Sara
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Wåhlin, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Ambarki, Khalid
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Koskinen, Lars-Owe D.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Eklund, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Human jugular vein collapse in the upright posture: implications for postural intracranial pressure regulation2017In: Fluids and Barriers of the CNS, ISSN 2045-8118, E-ISSN 2045-8118, Vol. 14, 17Article in journal (Refereed)
    Abstract [en]

    Background: Intracranial pressure (ICP) is directly related to cranial dural venous pressure (P-dural). In the upright posture, P-dural is affected by the collapse of the internal jugular veins (IJVs) but this regulation of the venous pressure has not been fully understood. A potential biomechanical description of this regulation involves a transmission of surrounding atmospheric pressure to the internal venous pressure of the collapsed IJVs. This can be accomplished if hydrostatic effects are cancelled by the viscous losses in these collapsed veins, resulting in specific IJV cross-sectional areas that can be predicted from flow velocity and vessel inclination. Methods: We evaluated this potential mechanism in vivo by comparing predicted area to measured IJV area in healthy subjects. Seventeen healthy volunteers (age 45 +/- 9 years) were examined using ultrasound to assess IJV area and flow velocity. Ultrasound measurements were performed in supine and sitting positions. Results: IJV area was 94.5 mm(2) in supine and decreased to 6.5 +/- 5.1 mm(2) in sitting position, which agreed with the predicted IJV area of 8.7 +/- 5.2 mm(2) (equivalence limit +/- 5 mm(2), one-sided t tests, p = 0.03, 33 IJVs). Conclusions: The agreement between predicted and measured IJV area in sitting supports the occurrence of a hydrostatic-viscous pressure balance in the IJVs, which would result in a constant pressure segment in these collapsed veins, corresponding to a zero transmural pressure. This balance could thus serve as the mechanism by which collapse of the IJVs regulates P-dural and consequently ICP in the upright posture.

  • Backman, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Hedman, Linnea
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Health Sciences, Luleå University, Luleå, Sweden.
    Stridsman, Caroline
    Jansson, Sven-Arne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindberg, Anne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lundbäck, Bo
    Rönmark, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    A population-based cohort of adults with asthma: mortality and participation in a long-term follow-up2017In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 4, 1334508Article in journal (Refereed)
    Abstract [en]

    Background and objective: Asthma is a major public health concern. The aim of this study was to characterize a large population-based cohort of adults with asthma, and to study factors associated with all-cause mortality and non-participation in a long-term follow-up. Design: Random and stratified samples from five population-based cohorts were clinically examined during 1986-2001, and all subjects with asthma were included in the study (n = 2055, age 19-72 years, 55% women). Independent associations between different risk factors and (i) mortality and (ii) non-participation in a clinical follow-up in 2012-2014 were estimated. Results: In 1986-2001, 95% reported any wheeze and/or attacks of shortness of breath in the past 12 months, and/or asthma medication use. Over the up to 28 years of follow-up time, the cumulative mortality was 22.7%. Male gender, current smoking, and lower forced expiratory volume in 1 sec of predicted (FEV1% of predicted) were independent risk factors for mortality, while obesity was associated with non-participation in the follow-up. Older ages, ischemic heart disease, and low socioeconomic status were associated with both mortality and non-participation. Conclusions: The risk factors associated with mortality in this adult population-based asthma cohort were similar to those commonly identified in general population samples, i.e. male gender, current smoking, and lower FEV1% of predicted, while obesity was associated with non-participation in a long-term follow-up. Ischemic heart disease, low socioeconomic status, and older ages were associated with both mortality and non-participation.

  • Slupsky, Carolyn M.
    et al.
    He, Xuan
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Andersson, Yvonne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Rudolph, Colin
    Lönnerdal, Bo
    West, Christina E.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Postprandial metabolic response of breast-fed infants and infants fed lactose-free vs regular infant formula: a randomized controlled trial2017In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, 3640Article in journal (Refereed)
    Abstract [en]

    Lactose intolerance is a major concern driving the growth of lactose-free foods including lactose-free infant formula. It is unknown what the metabolic consequence is of consumption of a formula where lactose has been replaced with corn syrup solids (CSS). Here, a randomized double-blinded intervention study was conducted where exclusively formula-fed infants were fed formula containing either lactose or CSS-based infant formula and compared with an equal number of exclusively breast-fed infants. Plasma metabolites and insulin were measured at baseline, 15, 30, 60, 90 and 120 min after feeding. Differences in plasma metabolite profiles for formula-fed infants included a rapid increase in circulating amino acids, creatinine and urea compared with breast-fed infants. At 120 min post-feeding, insulin was significantly elevated in formula-fed compared with breast-fed infants. Infants fed lactose-based formula had the highest levels of glucose at 120 min, and leucine, isoleucine, valine and proline at 90 and 120 min, whereas infants fed CSS-based formula had the lowest levels of non-esterified fatty acids at all time points, and glucose at 120 min. Overall, these differences highlight that changes in infant formula composition impact infant metabolism, and show that metabolomics is a powerful tool to help with development of improved infant formulas.

  • Do Yi, Su
    et al.
    Noh, Jae Dong
    Minnhagen, Petter
    Umeå University, Faculty of Science and Technology, Department of Physics.
    Song, Mi-Young
    Chon, Tae-Soo
    Kim, Beom Jun
    Human bipedalism and body-mass index2017In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, 3688Article in journal (Refereed)
    Abstract [en]

    Body-mass index, abbreviated as BMI and given by M/H2 with the mass M and the height H, has been widely used as a useful proxy to measure a general health status of a human individual. We generalise BMI in the form of M/Hp and pursue to answer the question of the value of p for populations of animal species including human. We compare values of p for several different datasets for human populations with the ones obtained for other animal populations of fish, whales, and land mammals. All animal populations but humans analyzed in our work are shown to have p ≈ 3 unanimously. In contrast, human populations are different: As young infants grow to become toddlers and keep growing, the sudden change of p is observed at about one year after birth. Infants younger than one year old exhibit significantly larger value of p than two, while children between one and five years old show p ≈ 2, sharply different from other animal species. The observation implies the importance of the upright posture of human individuals. We also propose a simple mechanical model for a human body and suggest that standing and walking upright should put a clear division between bipedal human (p ≈ 2) and other animals (p ≈ 3).

  • Andersson, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Incidence of acute pulmonary embolism, related comorbidities and survival: analysis of a Swedish national cohort2017In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 17, 155Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the study was to determine the incidence of acute pulmonary embolism (PE) in Sweden and any regional differences. To assess short-and long-term survival analysis after an episode of PE, before and after excluding patients with known malignancies, and to determine the most common comorbidities prior to the PE event. Methods: All in-hospital patients, including children, diagnosed with acute PE in 2005 were retrieved from the Swedish National Patient Registry (NPR) and incidence rates were calculated. All registered comorbidities from 1998 until the index events were collected and survival up to 4 years after the event were calculated and compared to matched controls. Results: There were 5793 patients of all ages diagnosed with acute PE in 2005 resulting in a national incidence of 0.6/1000/year. The mean age was 70 years and 52% were women. The most frequent comorbidities were cardiac-, vascular-, infectious-and gastrointestinal diseases, injuries and malignancies. The mortality rates were more than doubled in patients with recent PE compared to that in a matched control group (49.1% vs 21.9%), and the excess mortality remained after exclusion of deaths occurring within one year and after exclusion of patients with any malignancy prior to the event. Conclusions: PE is associated with high age as well as with multiple comorbidities, and with an increased shortand long-term mortality. This study highlights the importance of a proper follow-up after an acute PE.

  • Alfredsson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jeghannathan, Bhoomikumar
    Attitudes towards mental health and the integration of mental health services into primary health care: a cross-sectional survey among health-care workers in Lvea Em District, Cambodia2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, 1331579Article in journal (Refereed)
    Abstract [en]

    Background: Cambodia is a country where the resources for treating mental health disorders are far from sufficient. One strategy to narrow the treatment gap is to integrate mental health into primary health care (PHC). Understanding the knowledge and attitudes towards mental health integration that health-care workers have is important for assessing the challenges and opportunities when planning a potential integration project. Objective: The aim of this study was to assess these basic conditions in Lvea Em District, Cambodia. Design: A structured self-reporting questionnaire regarding attitudes and knowledge about mental health and its integration into PHC was collected from 75 health-care workers in Lvea Em District, Cambodia in October 2015. Firstly, descriptive analyses were carried out, and secondly, linear regression analyses to assess the relationship between attitudes and socio-demographic variables were conducted. Results: There was clear support towards integrating mental health services into PHC among these participants as 81.3% were interested in personally delivering mental health care at their units. Respondents who reported having received some kind of mental health-care training tended to have a more positive attitude towards mentally ill people (p = 0.005) and those who thought there was a high need for mental health care had a more favourable attitude towards the integration of mental health services (p = 0.007). Conclusions: The most important finding from this survey was the willingness and the acceptance of the need for integration of mental health care. This enhances the feasibility of integrating mental health services at the PHC level. Improving the competence of mental health care in these settings will likely help to reduce the treatment gap for mental, neurological and substance use disorders in Cambodia.

  • Vives-Cases, Carmen
    et al.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hernández, Alison
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sanz-Barbero, Belen
    Davó-Blanes, MCarmen
    La Parra-Casado, Daniel
    Priorities and strategies for improving Roma women's access to primary health care services in cases on intimate partner violence: a concept mapping study2017In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 16, 96Article in journal (Refereed)
    Abstract [en]

    Background: With an explicit focus on Roma women in Spain (Kale/Spanish Gypsies), this study aims to integrate key informants' opinions about the main actions needed to improve primary health care services' and professionals' responses to Roma women in an Intimate Partner Violence (IPV) situation. Methods: Concept mapping study. A total of 50 (brainstorming phase), 36 (sorting and rating phase) and 16 (interpretation phase) participants from Roma civil society groups, primary health care professionals and other related stakeholders (social services, academic experts and other IPV NGOs representatives) from different cities in Spain were involved in the different study phases. Results: Among the 55 action proposals generated, ten priority actions were identified through consensus as most important for improving primary health care's response to Romani women in an IPV situation, and these included primary, secondary and tertiary prevention activities. Conclusion: Results indicated that efforts to address this challenge should take an integrated approach that reinforces the primary health care response to IPV in general, while also promoting more specific actions to address barriers to access that affect all Roma women and those who experience IPV in particular.

  • Nordström, Mikael
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Undersökning av samarbetsverktyget Copy/Monitor och koordinater i Autodesk Revit2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Building information modeling (BIM) is widely used in the construction industry today, and is fast becoming the standard for developers planning building projects. Industry leaders in the engineering and architecture business usually have well thought out and efficient ways of working within this field, but with ever increasing competition these companies are forced to continually find ways of streamlining their practices to stay ahead of the competition. There are often several different companies involved across multiple disciplines when it comes to the modeling of a building, and the different BIM tools available offer many ways for them to coordinate.

     

    The purpose of this study is to examine whether one of the collaboration tools available in Autodesk Revit called Copy/Monitor could help to streamline the modeling process. The tests done of the collaboration tool were applied to a three-dimensional model of a building. Through practical use of the different functions, and compiled theoretical knowledge, the study shows that there are advantages of using this tool when planning multi-disciplined projects in Revit. The possibility of monitoring changes of elements when linking models is a powerful function and could prevent time consuming reworking later on in the project. It is of great importance however to note how the models are constructed, what type of project it is, as well as personal preferences when it comes to how the workflow should operate and what elements should be monitored.

     

    Another purpose of the study was to give an explanation of coordinates in the software. Through theoretical compilation and practical tests the study shows that handling of coordinates when linking models works as the theory suggests. It is worth noting however that problems may arise in later stages of the project if the users that originally created the models are unaware of what the software’s different settings mean. There must be strict guidelines for how the coordinates should be handled from the start of the project, to avoid errors down the line that may be hard to identify and correct.

  • Lundgren, Markus
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Fallolyckor i byggbranschen: Sociala faktorers inverkan på risken av arbetsplatsolyckor2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Since 1994, the number of employed in the construction industry has increased from 106 000 to almost a doubling of 175 000 in 2015. Of 175 000, more than one percent experienced a workplace accident, 23 percent of which were falling accidents. This thesis project is a study of how stress, education, safety culture, gender, and age can be contributing factors to an increased risk of accidents at work. The study compares the previously mentioned factors to what the employees of the construction company Rekab experience in the workplace. Rekab is today one of Norrland's largest privately-owned construction companies with just over 200 employees, distributed in the areas of Umeå, Örnsköldsvik and Sundsvall. In the study, a survey was submitted to 55 of Rekabs employees in Umeå. Of these, 27 replies came in, of which 24 could be used. Of the 24 respondents two were women, the rest were men. From the survey, it was found that all of the respondents perceived Rekabs safety culture as good, that everyone in addition to one of the respondents had relevant education and that almost half of the respondents experienced stress to such an extent that they affected their work, many of which were found in the younger age groups. In summary, there seems to be a good safety culture at the company, thanks to a well-implemented work environment and safety work. Unfortunately, the progress has not come as far when stress is concerned. Stress is a big contributor to increased risk of accidents and something that has to be actively worked with to make it disappear

  • Andersson, Tomas
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Optimering av balkonglösning2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This dissertation describes the theory behind a specific solution for balcony attachment for concrete constructions designed by Prefabmästarna. The purpose is to get a deeper understanding of design according to Eurocode and EKS (Swedish application of eurocode) and to optimize the current solution for balcony attachment in view of reduced material usage. The design is based on a prefabricated balcony slab is fasten to a T-section whose flanges are molded in a prefabricated DFS-slab. Two tie-rods is threaded into the balcony slab and fasten to the T-section with a washer. After mounting of the balcony slab the DFS slab is molded on which stabilizes the T-section from instabilites. The results show that the structure is largely optimized but that there are room for improvements in specific places. For balconies with a length of 2.0 meters the T-section can be reduced with 10 kg of steel, which corresponds to more than 50 % of the T-section weight compared with the reference solution. Also at the 2.5 meter balconies the T-section can be reduced with 7 kg of steel, which corresponds to a 38 % reduction in material use compared with the reference solution. A common standard for the T-section is possible for balconies with a length of 2.0 and 2.5 meters.

  • Herberg, Erik R.
    et al.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences. Kiel School of Sustainability, Christian-Albrechts-Universitat zu Kiel, Kiel, Germany.
    Sarneel, Judith M.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences. Ecology & Biodiversity Group and Plant Ecophysiology Group, Utrecht University, CH Utrecht, The Netherlands.
    Recruitment of riparian plants after restoration of geomorphic complexity in northern Sweden2017In: Applied Vegetation Science, ISSN 1402-2001, E-ISSN 1654-109X, Vol. 20, no 3, 435-445 p.Article in journal (Refereed)
    Abstract [en]

    Question: Restoration of channelized streams increases geomorphic complexity but it remains unclear how this interacts with processes that drive future vegetation changes (dispersal, germination and establishment). This study asks if increased geomorphic complexity increases recruitment conditions of sown seeds or affects post-dispersal natural seedling densities. Location: Vindel River catchment, northern Sweden. Methods: We selected seven study streams with paired reaches that differed in the degree to which geomorphic complexity was restored. Basic reaches used simple restoration methods while enhanced reaches additionally added large boulders and woody debris. We sowed seeds of six species at ten locations in each reach in 2014 and counted the number of seedlings after 8wk and the number of naturally occurring seedlings in a plot adjacent to the sowing locations in 2013 and 2014. Using factor analysis based on 34 complexity measurements, overall geomorphic complexity was quantified for eight of the 14 reaches. Results: Total numbers of sown (2014) and natural seedlings (2013 and 2014) summed per reach did not differ between restoration types when tested pair-wise. Enhanced restoration did not always significantly increase geomorphic complexity, which differed considerably between the streams. More complex reaches were steeper, had larger size sediment and more nutrient-poor soils. Total recruitment of sown species significantly decreased with increasing complexity. Numbers of natural seedlings differed considerably from 2013 to 2014, but were not related to complexity. In 2014, a potential parent plant of the same species occurred within the same plot for 71.8% of the natural seedlings that could be identified. Conclusions: The recruitment of sown seeds was affected by overall geomorphic complexity rather than by the enhanced restoration. The absence of a correlation between geomorphic complexity and natural seedlings could indicate that natural seedling dynamics are not solely determined by recruitment conditions, but also by dispersal.

  • Burström, Åsa
    et al.
    Bratt, Ewa-Lena
    Frenckner, Björn
    Nisell, Margret
    Hanséus, Katarina
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Öjmyr-Joelsson, Maria
    Adolescents with congenital heart disease: their opinions about the preparation for transfer to adult care2017In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 176, no 7, 881-889 p.Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to explore what adolescents with congenital heart disease (CHD) view as important in the preparation for the transfer to adult care. We performed interviews in four focus groups with adolescents (14-18 years old) at four university hospitals in Sweden. Data was analysed using qualitative content analysis. The analysis revealed one main category; Becoming a manager of the condition and four subcategories; Sufficient knowledge about the health, Be a participant in the care, Parental support, and Communicate with others about the health. The adolescents' ages differentiated the discussion in the groups. The older adolescents seemed to have more interest in transition planning, information and transfer. The younger described more frustrations about communication and handling the disease. Conclusion: To become a manager of the CHD in daily life, the adolescents want disease specific knowledge, which should be communicated in a developmentally appropriate way. Adolescents want to participate and be involved in the transition process. They need support and guidance in how to communicate their CHD. Parental support is fundamental but it change over time. Moreover, peer-support is becoming more significant during the transition process.

  • Zetterström, Kalle
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Låt aldrig historien upprepas: En kvalitativ studie om hur lärare motverkar antisemitism i skolan2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Wigren, Jesper
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Kvinnan och läroboken: En feministisk analys av läromedel ireligionskunskap2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Lundell Samuelsson, Anna
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Den osynliga kvinnan: En litteraturstudie av kvinnans position och roll i fornnordisk religion och tidig kristendom2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Holmberg, Cecilia
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Religion, en praktisk skyddsmantel?: En kvantitativ studie om elevers upplevelse avtrygghet, lycka och tillit.2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna studie syftar till att undersöka elevers upplevelse av trygghet, lycka och tillit.Undersökningen baseras på en webbenkät som sätts i förhållande till World Value Surveysvärderingsstudier. I studien ställer jag security-blanket teorin1, som handlar om att religionen kanskänka människan trygghet och lycka, mot mitt och World Value Surveys resultat. Detta för attundersöka dess giltighet och ifall teorin har någon verklig, praktisk funktion. Resultatet frånwebbenkäten visar att de elever utan en uppväxt i en religiös miljö upplevde sig tryggare, lyckligareoch visade på en högre grad av tillit till andra människor än de elever med en uppväxt i en religiösmiljö. Detta resultat ligger i linje med World Value Surveys data. Slutsatsen är att security-blanketteorin verkar vara ogiltig och att den inte har någon verklig, praktisk funktion i varje fall här och nu.Däremot finns data som tyder på att religion eller religiositet kanske kan göra redan lyckligamänniskor lite lyckligare. Religionens roll och funktion för människan i olika delar av världen är ettinvecklat och komplicerat ämne som fortfarande är relevant för religionsvetenskapen att studera ochdebattera.

  • Henningsson, William
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Djävulens trumslagare: En studie av trolldomsrannsakningarna ilappmarken 1649–17392017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Hannu, Evelina
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Vem är tornedalingen?: En jämförande studie av två generationers syn på dentornedalska kulturen utifrån ett religionsvetenskapligtperspektiv2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den här uppsatsen syftar till att undersöka hur två generationer av tornedalingar uppfattar kulturen, språket samt identiteten i Tornedalen och även hur laestadianismen påverkat dessa. Det som framgår utifrån de intervjustudier jag har gjort är att det inte finns en samstämmig syn på vad som är den tornedalska kulturen eller identiteten, även om många likheter går att finna, så som ärligheten, gästfriheten och det stora jakt – och fiskeintresset. Laestadianismens påverkan på Tornedalen går att hitta, även om alla informanter inte var lika medvetna om det som andra. Språket i Tornedalen hade enligt informanterna en stor betydelse för både den tornedalska kulturen så väl som identiteten, dock fanns det inga direkta samband mellan meänkielin (tornedalsfinskan) och laestadianismen, mer än att det språket var talat under predikningar och har på så sätt varit avgörande för att den laestadianska tron fått fäste i Tornedalen.

  • Gidlund, Julia
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Besök som en del av lärandet: En undersökning om studiebesök och gästföreläsare i religionsundervisningen2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Falkensköld Rehnman, Kim
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    ”Gud såg att det var gott”: En queerteologisk analys av skapandet avmänniskan i 1 Mosebok 1-22017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • Andersson Vidén, Anton
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    IS i religionskunskap: Religionslärares attityder kring IS i religionskunskapsundervisning2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Hägglund, Johan
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Hur presenteras heliga skrifter?: En analys av behandlingen av de abrahamitiska religionernas heliga skrifter i läroböcker2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • Ronestjärna, Benjamin
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Att bevara traditionen i skrift: En jämförande studie mellan ”den västliga” kodex Bezae Cantabrigiensis och den Alexandrinska kodex Vaticanus2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The field of New Testament textual criticism is a vast area with a multitude of manuscripts to examine. Codex Bezae Cantabrigiensis (hereafter referred to as D) is one of the most diverse manuscripts and has fascinated scholars for centuries with its many peculiar and notable read-ings. Where, in textual criticism, the Alexandrian text-type is the normative, D is a landmark within the “Western” text-type. This thesis examines D by collating it and one of the Alexan-drian text-type’s most attested manuscripts, codex Vaticanus (hereafter B). The collation is done using Nestle-Aland’s critical edition Novum Testamentum Graece 28 ed., because of its critical apparatus. However, due to the size of the critical apparatus the collation involves only the Gospel of John. The aim of this thesis is to search for readings in D that could indicate what context it was written in and, further, finding what tradition lies behind D. For this purpose, a database has been constructed, containing all differences between the manuscripts, classified according to types of differences and the parts of speech they involve.This thesis argues that D clarifies many of the readings of the Gospel of John with stylistic and narrative techniques, such as narrative explanations and the addition of prepositions, accu-satives, genitives and reflexive pronouns. Thus, implicit structures are avoided. Because of said clarifications this thesis argues that D was written in an environment where it was necessary to clarify uncertain aspects of the storyline. It is proposed that while Greek was the main language in the context where D was written it was not the first language of the scribe, and dialects may have affected the language in D.This thesis also argues that D reinforces the perception of the story. The Gospel of John uses the perfect tense more often than any of the other gospels, which results in the story often being perceived as ongoing rather than finished, as would be the perception of the reader. D has reinforced this tendency and also avoids theological utterances applicable to anybody, conse-quently keeping the perception in the gospel that of the story. Some passages in D also show that D has incorporated thinking from the synoptic gospels and created its own tradition.In summary, this thesis argues that some of D’s differences in comparison to B are related to provisions made for needs present in the context it was written in.

  • Gullbrand, Lina
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Lidandets existens: En studie om synen på lidande och dess konsekvenser2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This essay explores the understanding of suffering from an ethical stand point. The issue of defining suffering is not an easy task albeit an important one, depending on the definition different consequences ensues. This essay examines how suffering is defined in the field of bioethics, and how these definitions become apparent through the argument of certain biomedical ethicists. To pinpoint the moral arguments and dilemmas a preexisting case, the case of Baby (or Infant) Doe is examined from each biomedical ethicist’s perspective. From the conclusions gathered from the studies, this essay will then attempt to answer the question of defining and understanding suffering.

  • Eriksson, Martin
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Forum for Studies on Law and Society.
    Gunnarsson, Åsa
    Umeå University, Faculty of Social Sciences, Umeå Forum for Studies on Law and Society.
    The Decline of the Swedish Inheritance and Gift Tax, 1991–20042017Report (Refereed)
    Abstract [en]

    During the period 1991–2004, political support for the inheritance and gift taxation in Sweden diminished, which contributed to two major policy shifts. In 1991, a new tax schedule which reduced top rates was introduced. The tax was thereafter completely repealed in 2004. In this paper, we examine how background factors such as competitiveness and political legitimacy influenced these decisions. By studying the preceding decision-making processes, we find that the influence of these factors shifted over time and appeared in different combinations. While the 1991 reform was strongly influenced by competitiveness arguments, the repeal of the inheritance and gift tax was primarily a result of the declining legitimacy of the tax.

  • Hagenvald, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Frilund, Ella
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Djup hjärnstimulering i kaudala zona incerta: Hur talförståeligheten påverkas hos patienter med Essentiell tremor2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Kabudula, Chodziwadziwa W.
    et al.
    Houle, Brian
    Collinson, Mark A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Gomez-Olive, Francesc Xavier
    Clark, Samuel J.
    Tollman, Stephen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Progression of the epidemiological transition in a rural South African setting: findings from population surveillance in Agincourt, 1993-20132017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, 424Article in journal (Refereed)
    Abstract [en]

    Background: Virtually all low-and middle-income countries are undergoing an epidemiological transition whose progression is more varied than experienced in high-income countries. Observed changes in mortality and disease patterns reveal that the transition in most low-and middle-income countries is characterized by reversals, partial changes and the simultaneous occurrence of different types of diseases of varying magnitude. Localized characterization of this shifting burden, frequently lacking, is essential to guide decentralised health and social systems on the effective targeting of limited resources. Based on a rigorous compilation of mortality data over two decades, this paper provides a comprehensive assessment of the epidemiological transition in a rural South African population. Methods: We estimate overall and cause-specific hazards of death as functions of sex, age and time period from mortality data from the Agincourt Health and socio-Demographic Surveillance System and conduct statistical tests of changes and differentials to assess the progression of the epidemiological transition over the period 1993-2013. Results: From the early 1990s until 2007 the population experienced a reversal in its epidemiological transition, driven mostly by increased HIV/AIDS and TB related mortality. In recent years, the transition is following a positive trajectory as a result of declining HIV/AIDS and TB related mortality. However, in most age groups the cause of death distribution is yet to reach the levels it occupied in the early 1990s. The transition is also characterized by persistent gender differences with more rapid positive progression in females than males. Conclusions: This typical rural South African population is experiencing a protracted epidemiological transition. The intersection and interaction of HIV/AIDS and antiretroviral treatment, non-communicable disease risk factors and complex social and behavioral changes will impact on continued progress in reducing preventable mortality and improving health across the life course. Integrated healthcare planning and program delivery is required to improve access and adherence for HIV and non-communicable disease treatment. These findings from a local, rural setting over an extended period contribute to the evidence needed to inform further refinement and advancement of epidemiological transition theory.

  • Wang, Yuhang
    et al.
    Ding, Fangrong
    Wang, Tao
    Liu, Wenjie
    Lindquist, Susanne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hernell, Olle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Wang, Jianwu
    Li, Jing
    Li, Ling
    Zhao, Yaofeng
    Dai, Yunping
    Li, Ning
    Purification and characterization of recombinant human bile salt-stimulated lipase expressed in milk of transgenic cloned cows2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 5, e0176864Article in journal (Refereed)
    Abstract [en]

    Bile salt-stimulated lipase (BSSL) is a lipolytic digestive enzyme with broad substrate specificity secreted from exocrine pancreas into the intestinal lumen in all species and from the lactating mammary gland into the milk of some species, notably humans but not cows. BSSL in breast milk facilitates digestion and absorption of milk fat and promotes growth of small for gestational age preterm infants. Thus, purified recombinant human BSSL (rhBSSL) can be used for treatment of patients with fat malabsorption and expressing rhBSSL in the milk of transgenic cloned cows would therefore be a mean to meet a medical need. In the present study, a vector pBAC-hLF-hBSSL was constructed, which efficiently expressed active rhBSSL in milk of transgenic cloned cows to a concentration of 9.8 mg/ml. The rhBSSL purified from cow milk had the same enzymatic activity, N-terminal amino acid sequence, amino acid composition and isoelectric point and similar physicochemical characteristics as human native BSSL. Our study supports the use of transgenic cattle for the cost-competitive, large-scale production of therapeutic rhBSSL.

  • Vdovikova, Svitlana
    et al.
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine). Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR).
    Luhr, Morten
    Szalai, Paula
    Skalman, Lars Nygård
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Francis, Monika K.
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Lundmark, Richard
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics. Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Engedal, Nikolai
    Johansson, Jörgen
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine). Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR).
    Wai, Sun N.
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine). Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR).
    A Novel Role of Listeria monocytogenes Membrane Vesicles in Inhibition of Autophagy and Cell Death2017In: Frontiers in Cellular and Infection Microbiology, E-ISSN 2235-2988, Vol. 7, 154Article in journal (Refereed)
    Abstract [en]

    Bacterial membrane vesicle (MV) production has been mainly studied in Gram-negative species. In this study, we show that Listeria monocytogenes, a Gram-positive pathogen that causes the food-borne illness listeriosis, produces MVs both in vitro and in vivo. We found that a major virulence factor, the pore-forming hemolysin listeriolysin O (LLO), is tightly associated with the MVs, where it resides in an oxidized, inactive state. Previous studies have shown that LLO may induce cell death and autophagy. To monitor possible effects of LLO and MVs on autophagy, we performed assays for LC3 lipidation and LDH sequestration as well as analysis by confocal microscopy of HEK293 cells expressing GFP-LC3. The results revealed that MVs alone did not affect autophagy whereas they effectively abrogated autophagy induced by pure LLO or by another pore-forming toxin from Vibrio cholerae, VCC. Moreover, Listeria monocytogenes MVs significantly decreased Torin1-stimulated macroautophagy. In addition, MVs protected against necrosis of HEK293 cells caused by the lytic action of LLO. We explored the mechanisms of LLO-induced autophagy and cell death and demonstrated that the protective effect of MVs involves an inhibition of LLO-induced pore formation resulting in inhibition of autophagy and the lytic action on eukaryotic cells. Further, we determined that these MVs help bacteria to survive inside eukaryotic cells (mouse embryonic fibroblasts). Taken together, these findings suggest that intracellular release of MVs from L. monocytogenes may represent a bacterial strategy to survive inside host cells, by its control of LLO activity and by avoidance of destruction from the autophagy system during infection.

  • Schwartzbaum, Judith
    et al.
    Edlinger, Michael
    Zigmont, Victoria
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Rempala, Grzegorz A.
    Nagel, Gabriele
    Hammar, Niklas
    Ulmer, Hanno
    Foeger, Bernhard
    Walldius, Goran
    Manjer, Jonas
    Malmstrom, Hakan
    Feychting, Maria
    Associations between prediagnostic blood glucose levels, diabetes, and glioma2017In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, 1436Article in journal (Refereed)
    Abstract [en]

    Previous literature indicates that pre-diagnostic diabetes and blood glucose levels are inversely related to glioma risk. To replicate these findings and determine whether they could be attributed to excess glucose consumption by the preclinical tumour, we used data from the Apolipoprotein MOrtality RISk (AMORIS) (n = 528,580) and the Metabolic syndrome and Cancer project (Me-Can) cohorts (n = 269,365). We identified individuals who were followed for a maximum of 15 years after their first blood glucose test until glioma diagnosis, death, emigration or the end of follow-up. Hazard ratios (HRs), 95% confidence intervals (CIs) and their interactions with time were estimated using Cox time-dependent regression. As expected, pre-diagnostic blood glucose levels were inversely related to glioma risk (AMORIS, P-trend = 0.002; Me-Can, P-trend = 0.04) and pre-diagnostic diabetes (AMORIS, HR = 0.30, 95% CI 0.17 to 0.53). During the year before diagnosis, blood glucose was inversely associated with glioma in the AMORIS (HR = 0.78, 95% CI 0.66 to 0.93) but not the Me-Can cohort (HR = 0.99, 95% CI 0.63 to 1.56). This AMORIS result is consistent with our hypothesis that excess glucose consumption by the preclinical tumour accounts for the inverse association between blood glucose and glioma. We discuss additional hypothetical mechanisms that may explain our paradoxical findings.

  • Fahlsten, Maja
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    "Kompetensutveckling är A och O2: En kvalitativ studie om studie- och yrkesvägledares möjligheter till kompetensutveckling inom den kommunala vuxenutbildningen2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Med denna kvalitativa studie har det vart som avsikt att undersöka studie- och yrkesvägledares möjligheter till kompetensutveckling inom den kommunala vuxenutbildningen. Tre respondenter från varsin kommun med minst fem års arbetslivserfarenhet är kärnan i denna studie med en koppling till Humankapitalteorin. Deras egna erfarenheter har lyfts fram varpå det likaså har undersökts om respondenterna anser att prestationsförmågan påverkas utifrån den möjlighet till kompetensutveckling som finns och hur möjligheten till kompetensutveckling har förändrats under en fem års period.

    Resultatet visar på att de tre respondenterna hade varierande möjligheter och erfarenheter av kompetensutveckling och att det var för åtminstone en av respondenterna en möjlighet som har minskat under en period på fem år. Det gemensamma för respondenterna var att ingen känner sig påverkad i sin prestationsförmåga utifrån möjligheten till kompetensutveckling och en gemensam syn på kompetensutvecklingens värde. Den gemensamma synen var att p.g.a. ett föränderligt samhälle och utbildningssystem är det viktigt med kompetensutveckling för att känna sig säker i sin arbetsroll, men också för att kunna utföra det på bästa möjliga sätt. Vardagslärandet i form av problemlösning och samtal med elever var en stor bidragande faktor till respondenternas kompetensutveckling. Studien visar således på att respondenternas strävan efter att vara trygg och kunnig i sin arbetsroll är motivationen till att ständigt kompetensutveckla sig själv på olika vis i den mån man kan. 

  • Elvin, Caroline
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Offside på studie- och yrkesvägledningen: En studie om påverkan inom studie- och yrkesvägledning för elitsatsande fotbollsspelare2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Studien belyster två elitsatsande fotbollsspelares väg genom eller förbi studie- och yrkesvägledningen, samt två studie- och yrkesvägledares erfarenheter från arbete med elitsatsande individer. En av studie- och yrkesvägledarna är själv f.d. elitidrottare och delger därmed även sina erfarenheter som sökande. Studiens syfte är att klargöra respondenternas erfarenheter för att kunna lyfta olika påverkansfaktorer som kan finnas hos dessa sökande, samt att belysa vad inom vägledningen som kan gagna dessa individer inför, under och efter sin karriär. Studiens frågeställningar berör därmed respondenternas erfarenheter av tidigare vägledning samt deras tankar om framtidens vägledning. Studien kan även väcka tankar om vägledning inom andra elitsatsande områden utöver fotbollen.

    Studien utgår från ett fenomenologiskt perspektiv då den avser att visa respondenternas egna upplevelser av vägledningen, den är även kvalitativ för att kunna få djupgående information. Då studien handlar om olika påverkansfaktorer används Social Cognitive Career Theory och Learning Theory of Career Counseling samt begreppet ”Cooling down” för att delvis kunna beskriva hur viss påverkan i individers omgivning senare kan påverka deras karriärval.

    Resultatet visar påverkan från många olika faktorer i fotbollsseplarnas omgivning. För studie- och yrksesvägledningen får det betydelse genom att vi ständigt jobbar utifrån individens bästa medan andra enligt denna studies respondenter ser fotbollsspelaren mer generellt som en idrottare. Då en elitsatsning innebär stor målmedvetenhet så saknas det utrymme för en reservplan som hade kunnat lindra den oro som spelarna har med sig under karriären. Studiens resultat kan inte generaliseras på grund av dess storlek men väcker tankar om vilken påvkeran som kan förekomma i en fotbollsspelares karriär. 

  • Löfgren, Camilla
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Öjebrant, Helen
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Dyslexi och vägledning: Jag vill höra att jag kan göra allt2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to give an increased knowledge of how students with dyslexia experience the counselling they received in regard to further studies and future work in connection to the transition from compulsory education to upper secondary school. As well as what is perceived as the most optimum process of counselling given from the needs of the student. Furthermore, there was an interest for a greater understanding of how student counselling work with dyslexic students and what knowledge the student counsellors have about this hidden disability. Qualitative interviews were done, both with students with dyslexia as well as student counsellors working for the years of compulsorily education. The interviews showed that students had not received what to them was an adequate and optimum guidance in regard to their needs. Much like the research found in connection to dyslexia the students note that their own self-esteem and self-worth in regard to the schoolwork lessens along the way. Something that is found to be reassuring is that the student counsellors interviewed say that there are no limitations for dyslexic students when it comes to choose of studies as long as they get proper support and adaptation after their needs. 

  • Christopher, Landoff
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Vestin, Caroline
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Korrekt kompetensförsörjning: En studie om studie- och yrkesvägledares samverkansroll i starka industrikommuner2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this thesis was to investigate the attitudes and working methods that study- and career counselors apply when it comes to competence provision. The main focus of the thesis was to investigate whether the study and career counselors consider that competence development work is an essential part of their work in a primary school in a municipality with a dominant market of industries. Therefor our main question was about how the study and career counsellors are working with this today, if there is any influence from external stakeholders and what the desired role of collaboration they would like to have in the future. We have contacted forty study and career counsellors who work in primary school in member municipalities in the network of Industristarka Kommuner and they were interviewed by mail and in some cases by phone. There were totally nine study and career counsellors that were represented in the survey. The study results in a model for the collaborative role, which could be divided into four stages, directly active, indirectly active, indirectly passive and direct passive, depending on the position and behavior of study and career counselors in the question of collaboration. The roles could also be linked to different career theories and were largely dependent on how the top of the board looked and most of our informants had a desire to take a step back and allow someone else to manage the skills to solve time for other guidance work. 

  • Weinesson, Emma
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Hellsing, Jenny
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Studie- och yrkesvägledares arbete i en föränderlig omvärld: Skolans samverkan med arbetsmarknaden och utbildningsmarknaden2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Idag förändras vår omvärld i rask takt och utbudet på arbets- och utbildningsmarknaden samt dess innehåll likaså. Vi ville därför med denna studie ta reda på hur studie- och yrkesvägledare på gymnasienivå arbetar med yrken och utbildningar. Detta är en kvalitativ studie där vi valt intervjuer som metod, där åtta stycken studie- och yrkesvägledare som arbetar på gymnasieskolor i tre olika kommuner i Sverige är våra respondenter. Resultaten från våra intervjuer har analyserats med hjälp av teorier samt diskuterats och jämförts med tidigare forskning på området. Studiens resultat visar att samtliga studie- och yrkesvägledare vi intervjuat, ser sig själva som aktiva i att hålla sig uppdaterade om vad som händer på arbets- och utbildningsmarknaden. Hur detta förmedlas till eleverna är främst genom vägledningssamtal eftersom tiden ute i klasserna är väldigt begränsad på skolorna. Genom samverkan med andra aktörer såsom arbetsgivare, yrkesverksamma människor, högskolor med flera får eleverna inblick i livet utanför den egna skolan. Inom vissa branscher råder stor efterfrågan på arbetskraft medan det på andra områden är svårt att få arbete, detta tycker respondenterna att det är viktigt att informera eleverna om samtidigt som de inte lägger någon värdering i det. 

  • Magnusson Byberg, Petra
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Vägledningssamtal, vad är det?: En kvalitativ studie med elever från årskurs nio om hur de ser på sin studie- och yrkesvägledning2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med den här studien är att undersöka och analysera elevers studie- och yrkesvägledning i årskurs nio för att kunna se om den studie- och yrkesvägledning de fått stämmer överens med styrdokumenten. Jag är också nyfiken på vad elevernas samtal hos studie- och yrkesvägledaren handlar om, och om de har fått tillräckligt med studie- och yrkesvägledning i grundskolan, enligt styrdokumenten. Jag använde mig av kvalitativa intervjuer. Resultatet analyserades gentemot tidigare forskning, samt mot Gottfredsons och Krumboltz vägledningsmetoder som jag anser är relevanta för området. Mitt resultat visade att eleverna inte har fått med sig den studievägledning som styrdokumenten anser eleverna har rätt till i grundskolan eftersom de enligt intervjuerna kopplar sina vägledningssamtal mestadels till strikt gymnasieinformation. Eleverna har ingen kunskap utifrån styrdokumenten om vad samtalen ska innehålla och då heller inte har möjlighet att ställa krav på sina samtal. I studien framkom det dock att eleverna mestadels var nöjda med sin studie- och yrkesvägledning.