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  • Isaksson, Emma
    Umeå University, Faculty of Social Sciences, Department of Law.
    Rätten till utbildning för unionsmedborgare i Sverige.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Jelinek Boman, Jenny
    Umeå University, Faculty of Social Sciences, Department of Law.
    Sexuellt självskade beteende inom svensk straffrätt - En analys av betydelsen av målsägandens sexuella självskade beteende vid rättstillämpningen.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Höglund, William
    Umeå University, Faculty of Social Sciences, Department of Law.
    Exporting data protection law. The extraterritorial reach of the GDPR.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Hagman, Henrik
    et al.
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Bostrom, D.
    Lundberg, Mats
    Backman, Rainer
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Alloy degradation in a co-firing biomass CFB vortex finder application at 880 degrees C2019In: Corrosion Science, ISSN 0010-938X, E-ISSN 1879-0496, Vol. 150, p. 136-150Article in journal (Refereed)
    Abstract [en]

    Mechanisms of alloy degradation in a fireside N-S-O-C-H-Cl-Na-K atmosphere at 880 degrees C were elucidated using SEM-EDS, chemical equilibrium calculations, and XRD. Alloys 310S, 800H/HT, and 600 were studied after 0, 8000, and 16,000 h exposure in a boiler co-firing biomass waste. For 310S and 800H/HT it was shown that nitrogen formed internal Cr nitrides lowering the Cr activity and inhibiting internal alloy Cr permeation, and that NaCl and Na2SO4 reacted with Cr oxide to form chromate and to accelerate the S and the Cl pickup. Alloy 600 showed no nitride or major chromate formation.

  • Hetta, Max
    Umeå University, Faculty of Social Sciences, Department of Law.
    Upplysningspliktens ekonomi.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Harris, Sansha J.
    et al.
    Papathanassoglou, Elizabeth D. E.
    Gee, Melanie
    Hampshaw, Susan M.
    Lindgren, Lenita
    Umeå University, Faculty of Medicine, Department of Nursing.
    Haywood, Annette
    Interpersonal touch interventions for patients in intensive care: A design-oriented realist review2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 2, p. 216-235Article, review/survey (Refereed)
    Abstract [en]

    Aim: To develop a theoretical framework to inform the design of interpersonal touch interventions intended to reduce stress in adult intensive care unit patients.

    Design: Realist review with an intervention design-oriented approach.

    Methods: We searched CINAHL, MEDLINE, EMBASE, CENTRAL, Web of Science and grey literature sources without date restrictions. Subject experts suggested additional articles. Evidence synthesis drew on diverse sources of literature and was conducted iteratively with theory testing. We consulted stakeholders to focus the review. We performed systematic searches to corroborate our developing theoretical framework.

    Results: We present a theoretical framework based around six intervention construction principles. Theory testing provided some evidence in favour of treatment repetition, dynamic over static touch and lightening sedation. A lack of empirical evidence was identified for construction principles relating to intensity and positive/negative evaluation of emotional experience, moderate pressure touch for sedated patients and intervention delivery by relatives versus healthcare practitioners.

  • Holmgren, Tomas
    Umeå University, Faculty of Social Sciences, Department of Law.
    Sexualbrottslagstiftningen byggd på frivillighet. Ett studium över samtyckesdebatten och hur den korresponderar med den dömande verksamheten.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Lovvik, Tone S.
    et al.
    Carlsen, Sven M.
    Salvesen, Oyvind
    Steffensen, Berglind
    Bixo, Marie
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Gomez-Real, Francisco
    Lennebotn, Marianne
    Hestvold, Kristin, V
    Zabielska, Renata
    Hirschberg, Angelica L.
    Trouva, Anastasia
    Thorarinsdottir, Solveig
    Hjelle, Sissel
    Berg, Ann Hilde
    Andrae, Frida
    Poromaa, Inger S.
    Molin, Johanna
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Underdal, Maria
    Vanky, Eszter
    Use of metformin to treat pregnant women with polycystic ovary syndrome (PregMet2): a randomised, double-blind, placebo-controlled trial2019In: The Lancet Diabetes and Endocrinology, ISSN 2213-8587, E-ISSN 2213-8595, Vol. 7, no 4, p. 256-266Article in journal (Refereed)
    Abstract [en]

    Background: Women with polycystic ovary syndrome (PCOS) have an increased risk of pregnancy complications. Epi-analysis of two previous randomised controlled trials that compared metformin with placebo during pregnancy in women with PCOS showed a significant reduction in late miscarriages and preterm births in the metformin group. The aim of this third randomised trial (PregMet2) was to test the hypothesis that metformin prevents late miscarriage and preterm birth in women with PCOS.

    Methods: PregMet2 was a randomised, placebo-controlled, double-blind, multicentre trial done at 14 hospitals in Norway, Sweden, and Iceland. Singleton pregnant women with PCOS aged 18-45 years were eligible for inclusion. After receiving information about the study at their first antenatal visit or from the internet, women signed up individually to participate in the study. Participants were randomly assigned (1: 1) to receive metformin or placebo by computer-generated random numbers. Randomisation was in blocks of ten for each country and centre; the first block had a random size between one and ten to assure masking. Participants were assigned to receive oral metformin 500 mg twice daily or placebo during the first week of treatment, which increased to 1000 mg twice daily or placebo from week 2 until delivery. Placebo tablets and metformin tablets were identical and participants and study personnel were masked to treatment allocation. The primary outcome was the composite incidence of late miscarriage (between week 13 and week 22 and 6 days) and preterm birth (between week 23 and week 36 and 6 days), analysed in the intention-to-treat population. Secondary endpoints included the incidence of gestational diabetes, preeclampsia, pregnancy-induced hypertension, and admission of the neonate to the neonatal intensive care unit. We also did a post-hoc individual participant data analysis of pregnancy outcomes, pooling data from the two previous trials with the present study. The study was registered with ClinicalTrials. gov, number NCT01587378, and EudraCT, number 2011-002203-15.

    Findings: The study took place between Oct 19, 2012, and Sept 1, 2017. We randomly assigned 487 women to metformin (n=244) or placebo (n=243). In the intention-to-treat analysis, our composite primary outcome of late miscarriage and preterm birth occurred in 12 (5%) of 238 women in the metformin group and 23 (10%) of 240 women in the placebo group (odds ratio [OR] 0.50, 95% CI 0.22- 1.08; p = 0.08). We found no significant differences for our secondary endpoints, including incidence of gestational diabetes (60 [25%] of 238 women in the metformin group vs 57 [24%] of 240 women in the placebo group; OR 1.09, 95% CI 0.69-1.66; p=0.75). We noted no substantial between-group differences in serious adverse events in either mothers or offspring, and no serious adverse events were considered drug-related by principal investigators. In the post-hoc pooled analysis of individual participant data from the present trial and two previous trials, 18 (5%) of 397 women had late miscarriage or preterm delivery in the metformin group ]compared with 40 (10%) of 399 women in the placebo group (OR 0.43, 95% CI 0.23-0.79; p=0.004).

    Interpretation: In pregnant women with PCOS, metformin treatment from the late first trimester until delivery might reduce the risk of late miscarriage and preterm birth, but does not prevent gestational diabetes.

  • Gustafsson, Hanna
    Umeå University, Faculty of Social Sciences, Department of Law.
    Selektiva distributionssystem som begränsar internethandel - EU-domstolens senaste bedömningar att godkänna begränsningar av internethandel i ljuset av målet att utveckla en digital inre marknad.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Forsgren, Rebecka
    Umeå University, Faculty of Social Sciences, Department of Law.
    Free, prior and informed consent. En rättslig analys av förslaget till en ny ordning för konsultation med det samiska folket genom Ds 2017:43.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Sarneel, Judith M.
    et al.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences. Ecology & Biodiversity, Institute of Environmental Biology, Utrecht University, Utrecht, Netherlands; Plant Ecophysiology, Institute of Environmental Biology, Utrecht University, Utrecht, Netherlands.
    Hefting, Mariet M.
    Kowalchuk, George A.
    Nilsson, Christer
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Van der Velden, Merit
    Visser, Eric J. W.
    Voesenek, Laurentius A. C. J.
    Jansson, Roland
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Alternative transient states and slow plant community responses after changed flooding regimes2019In: Global Change Biology, ISSN 1354-1013, E-ISSN 1365-2486, Vol. 25, no 4, p. 1358-1367Article in journal (Refereed)
    Abstract [en]

    Climate change will have large consequences for flooding frequencies in freshwater systems. In interaction with anthropogenic activities (flow regulation, channel restoration and catchment land-use) this will both increase flooding and drought across the world. Like in many other ecosystems facing changed environmental conditions, it remains difficult to predict the rate and trajectory of vegetation responses to changed conditions. Given that critical ecosystem services (e.g. bank stabilization, carbon subsidies to aquatic communities or water purification) depend on riparian vegetation composition, it is important to understand how and how fast riparian vegetation responds to changing flooding regimes. We studied vegetation changes over 19 growing seasons in turfs that were transplanted in a full-factorial design between three riparian elevations with different flooding frequencies. We found that (a) some transplanted communities may have developed into an alternative stable state and were still different from the target community, and (b) pathways of vegetation change were highly directional but alternative trajectories did occur, (c) changes were rather linear but faster when flooding frequencies increased than when they decreased, and (d) we observed fastest changes in turfs when proxies for mortality and colonization were highest. These results provide rare examples of alternative transient trajectories and stable states under field conditions, which is an important step towards understanding their drivers and their frequency in a changing world.

  • Ferelius, Andreas
    Umeå University, Faculty of Social Sciences, Department of Law.
    Folket, riksdagen och Europeiska unionen - En analys av förarbetena inför Sveriges medlemskap i EU ur ett demokratiperspektiv.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Ekström, Terese
    Umeå University, Faculty of Social Sciences, Department of Law.
    Omedelbar verkställighet av förvaltningsbeslut - konsekvenser för enskilda ur ett rättssäkerhetsperspektiv.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Eriksson, Annelie
    Umeå University, Faculty of Social Sciences, Department of Law.
    Utökade möjligheter att säkra digital bevisning - Hur väl upprätthålls integritetsskyddet för enskilda i strävan efter en effektivare brottsbekämpning?2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Lundberg, Katarina
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    "Det känns som matte är roligt!": Hur elevers tankar och motivation påverkar matematiklärandet2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This study aims of examining how pupils in first year of school thinks of mathematics, what motivation they have for learning about it and how that affect their learning in mathematics. It also includes describing how special teachers can strengthen student’s mathematical development based on research as well as students’ thoughts and motivation. Qualitative methods were used in this study. Semi structured interviews were done with ten children in year one of school and the analysis of the pupil’s mathematics learning were made by using National Agency for Education's (2018) National Assessment Support in number perception. The study shows that most of the pupils likes mathematics in year one of school and that the pupils in this study overall have more positive thoughts then negative thoughts about mathematics. This study also shows that the pupil’s thoughts and motivations seem to affect the learning in mathematics. It turns out that the more positive thoughts and the higher inner motivation seems to lead to higher mathematic learning. The more negative thoughts and the higher external motivation seems to lead to lower mathematic learning.

  • Ellefors, Sara
    Umeå University, Faculty of Social Sciences, Department of Law.
    Samvetsfrihet - en rätt till samvetsvägran? En analyserande uppsats om samvetsfrihet, rätten att utöva den och möjligheten att begränsa den med hänvisning till aborträtten.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Englund, Nils
    Umeå University, Faculty of Social Sciences, Department of Law.
    Att vara en god förälder - En rättspolitisk utvärdering av föräldrars principalansvar för sina barns brottslighet.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Danielsson Nykänen, Emil
    Umeå University, Faculty of Social Sciences, Department of Law.
    Multipla teorier och skillnader. En uppsats om konstitutionell pluralism i EU - I stormens öga.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Bayisa, Fekadu
    et al.
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Yu, Jun
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Model-based computed tomography image estimation: partitioning approach2019In: Journal of Applied Statistics, ISSN 0266-4763, E-ISSN 1360-0532Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    There is a growing interest to get a fully MR based radiotherapy. The most important development needed is to obtain improved bone tissue estimation. The existing model-based methods perform poorly on bone tissues. This paper was aimed at obtaining improved bone tissue estimation. Skew-Gaussian mixture model and Gaussian mixture model were proposed to investigate CT image estimation from MR images by partitioning the data into two major tissue types. The performance of the proposed models was evaluated using the leaveone-out cross-validation method on real data. In comparison with the existing model-based approaches, the model-based partitioning approach outperformed in bone tissue estimation, especially in dense bone tissue estimation.

  • Danelid, Clara
    Umeå University, Faculty of Social Sciences, Department of Law.
    Ränta på koncerninterna lån. Den svenska korrigeringsregelns tillämpning på lånetransaktioner.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Huijben, Jilske A.
    et al.
    Wiegers, Eveline J. A.
    de Keizer, Nicolette F.
    Maas, Andrew I. R.
    Menon, David
    Ercole, Ari
    Citerio, Giuseppe
    Lecky, Fiona
    Wilson, Lindsay
    Cnossen, Maryse C.
    Polinder, Suzanne
    Steyerberg, Ewout W.
    van der Jagt, Mathieu
    Lingsma, Hester F.
    Aries, Marcel
    Badenes, Rafael
    Beishuizen, Albertus
    Bilotta, Federico
    Chieregato, Arturo
    Cingolani, Emiliano
    Cnossen, Maryse
    Coburn, Mark
    Coles, Jonathan P.
    Delargy, Mark
    Depreitere, Bart
    Flaatten, Hans
    Golyk, Volodymyr
    Grauwmeijer, Erik
    Haitsma, Iain
    Helbok, Raimund
    Hoedemaekers, Cornelia
    Jacobs, Bram
    Jellema, Korne
    Koskinen, Lars-Owe D.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Maegele, Marc
    Martin Delgado, Maria Cruz
    Moller, Kirsten
    Moreno, Rui
    Nelson, David
    Oldenbeuving, Annemarie W.
    Payen, Jean-Francois
    Pejakovic, Jasmina
    Ribbbers, Gerard M.
    Rossaint, Rolf
    Schoonman, Guus Geurt
    Steiner, Luzius A.
    Stocchetti, Nino
    Silvio, Fabio
    Takala, Riikka
    Tenovuo, Olli
    Valeinis, Eglis
    van den Bergh, Walter M.
    van Essen, Thomas
    van Leeuwen, Nikki
    Verhofstad, Michael H. J.
    Vos, Pieter E.
    Development of a quality indicator set to measure and improve quality of ICU care for patients with traumatic brain injury2019In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 23, article id 95Article in journal (Refereed)
    Abstract [en]

    Background: We aimed to develop a set of quality indicators for patients with traumatic brain injury (TBI) in intensive care units (ICUs) across Europe and to explore barriers and facilitators for implementation of these quality indicators.

    Methods: A preliminary list of 66 quality indicators was developed, based on current guidelines, existing practice variation, and clinical expertise in TBI management at the ICU. Eight TBI experts of the Advisory Committee preselected the quality indicators during a first Delphi round. A larger Europe-wide expert panel was recruited for the next two Delphi rounds. Quality indicator definitions were evaluated on four criteria: validity (better performance on the indicator reflects better processes of care and leads to better patient outcome), feasibility (data are available or easy to obtain), discriminability (variability in clinical practice), and actionability (professionals can act based on the indicator). Experts scored indicators on a 5-point Likert scale delivered by an electronic survey tool.

    Results. The expert panel consisted of 50 experts from 18 countries across Europe, mostly intensivists (N=24, 48%) and neurosurgeons (N=7, 14%). Experts agreed on a final set of 42 indicators to assess quality of ICU care: 17 structure indicators, 16 process indicators, and 9 outcome indicators. Experts are motivated to implement this finally proposed set (N=49, 98%) and indicated routine measurement in registries (N=41, 82%), benchmarking (N=42, 84%), and quality improvement programs (N=41, 82%) as future steps. Administrative burden was indicated as the most important barrier for implementation of the indicator set (N=48, 98%).

    Conclusions: This Delphi consensus study gives insight in which quality indicators have the potential to improve quality of TBI care at European ICUs. The proposed quality indicator set is recommended to be used across Europe for registry purposes to gain insight in current ICU practices and outcomes of patients with TBI. This indicator set may become an important tool to support benchmarking and quality improvement programs for patients with TBI in the future.

  • Möller, Carl-Johan
    Umeå University, Faculty of Science and Technology, Department of Physics.
    Development of Fingerprint Traceability in a Modern Sawmill2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Stålnacke, Oscar
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE).
    Individual investors’ information use, subjective expectations, and portfolio risk and return2019In: European Journal of Finance, ISSN 1351-847X, E-ISSN 1466-4364Article in journal (Refereed)
    Abstract [en]

    What information do individual investors use when making their financial decisions and how is it related to their stock market expectations, their confidence in these expectations, and the risk and return of their stock portfolios? I study these questions by combining survey data on the information usage among individual investors in Sweden with detailed registry data on their stock portfolios. I find that investors use filtered financial information (e.g. information packaged by a professional intermediary) more frequently than they use unfiltered financial information (e.g. information from annual reports and financial statements). Investors who frequently use filtered financial information are, however, more confident in their stock market expectations and take larger risks in their stock portfolios. Investors that instead use unfiltered financial information take lower portfolio risks and obtain higher portfolio returns. The findings in this paper thus suggest that investors can improve their financial decisions by using more unfiltered financial information rather than filtered financial information when they make their financial decisions.

  • Jahn, Olga
    et al.
    Leshchenko, Vyacheslav E.
    Tzallas, Paraskevas
    Kassel, Alexander
    Krueger, Mathias
    Muenzer, Andreas
    Trushin, Sergei A.
    Tsakiris, George D.
    Kahaly, Subhendu
    Kormin, Dmitrii
    Veisz, Laszlo
    Umeå University, Faculty of Science and Technology, Department of Physics. Max-Planck-Institut für Quantenoptik, Garching, Germany.
    Pervak, Vladimir
    Krausz, Ferenc
    Major, Zsuzsanna
    Karsch, Stefan
    Towards intense isolated attosecond pulses from relativistic surface high harmonics2019In: Optica, ISSN 2334-2536, Vol. 6, no 3, p. 280-287Article in journal (Refereed)
    Abstract [en]

    Relativistic surface high harmonics have been considered a unique source for the generation of intense isolated attosecond pulses in the extreme ultra-violet and x-ray spectral ranges. Their practical realization, however, is still a challenging task and requires identification of optimum experimental conditions and parameters. Here, we present measurements and particle-in-cell simulations to determine the optimum values for the most important parameters. In particular, we investigate the dependence of harmonics efficiency, divergence, and beam quality on the pre-plasma scale length as well as identify the optimum conditions for generation of isolated attosecond pulses by measuring the dependence of the harmonics spectrum on the carrier - envelope phase of the driving infrared field. (C) 2019 Optical Society of America under the terms of the OSA Open Access Publishing Agreement

  • Alaridah, Nader
    et al.
    Hallbäck, Erika Tång
    Tångrot, Jeanette
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine). National Bioinformatics Infrastructure Sweden (NBIS), SciLifeLab, Computational Life Science Cluster, Umeå University, Umeå, Sweden.
    Winqvistz, Niclas
    Sturegard, Erik
    Floren-Johanssons, Kerstin
    Jonsson, Bodil
    Tenland, Erik
    Welinder-Olssons, Christina
    Medstrand, Patrik
    Kaijser, Bertil
    Godaly, Gabriela
    Transmission dynamics study of tuberculosis isolates with whole genome sequencing in southern Sweden2019In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 4931Article in journal (Refereed)
    Abstract [en]

    Epidemiological contact tracing complemented with genotyping of clinical Mycobacterium tuberculosis isolates is important for understanding disease transmission. In Sweden, tuberculosis (TB) is mostly reported in migrant and homeless where epidemiologic contact tracing could pose a problem. This study compared epidemiologic linking with genotyping in a low burden country. Mycobacterium tuberculosis isolates (n = 93) collected at Scania University Hospital in Southern Sweden were analysed with the standard genotyping method mycobacterial interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) and the results were compared with whole genome sequencing (WGS). Using a maximum of twelve single nucleotide polymorphisms (SNPs) as the upper threshold of genomic relatedness noted among hosts, we identified 18 clusters with WGS comprising 52 patients with overall pairwise genetic maximum distances ranging from zero to nine SNPs. MIRU-VNTR and WGS clustered the same isolates, although the distribution differed depending on MIRU-VNTR limitations. Both genotyping techniques identified clusters where epidemiologic linking was insufficient, although WGS had higher correlation with epidemiologic data. To summarize, WGS provided better resolution of transmission than MIRU-VNTR in a setting with low TB incidence. WGS predicted epidemiologic links better which could consolidate and correct the epidemiologically linked cases, avoiding thus false clustering.

  • Zhou, Yueting
    et al.
    Liu, Jianxin
    Guo, Songjie
    Zhao, Gang
    Ma, Weiguang
    Cao, Zhensong
    Dong, Lei
    Zhang, Lei
    Yin, Wangbao
    Wu, Yongqian
    Xiao, Lianxuan
    Axner, Ove
    Umeå University, Faculty of Science and Technology, Department of Physics.
    Jia, Suotang
    Laser frequency stabilization based on a universal sub-Doppler NICE-OHMS instrumentation for the potential application in atmospheric lidar2019In: Atmospheric Measurement Techniques, ISSN 1867-1381, E-ISSN 1867-8548, Vol. 12, no 3, p. 1807-1814Article in journal (Refereed)
    Abstract [en]

    Lidar is an effective tool for high-altitude atmospheric measurement in which a weak absorption line for the target gas is selected to ensure a large optical depth. The laser frequency stabilization to the line center is required, and a sub-Doppler (sD) spectroscopy of the target line is preferred as a frequency reference. In this paper, a novel universal sD noise-immune cavity-enhanced optical heterodyne molecular spectroscopy (NICE-OHMS) instrumentation based on a fiber-coupled optical single-sideband electro-optic modulator (f-SSM) for the potential application in atmospheric lidar for different target gases with different types of lasers is reported. The f-SSM can replace all frequency actuators in the system, so as to eliminate the individual design of feedback servos that often are tailored for each laser. The universality of the instrumentation was demonstrated by the alternative use of either an Er-doped fiber laser or a whispering-gallery mode laser. Then the instruments based on both lasers were used to produce the sD signals of acetylene, which worked as a frequency reference to stabilize the laser. By performing the lockings, relative frequency stabilizations of 8.3 x 10(-13) and 7.5 x 10(-13) at an integration time of 240 s were demonstrated.

  • Harvey, E. Therese
    et al.
    Walve, Jakob
    Andersson, Agneta
    Umeå University, Faculty of Science and Technology, Umeå Marine Sciences Centre (UMF). Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Karlson, Bengt
    Kratzer, Susanne
    The Effect of Optical Properties on Secchi Depth and Implications for Eutrophication Management2019In: Frontiers in Marine Science, E-ISSN 2296-7745, Vol. 5, p. 1-19, article id 496Article in journal (Refereed)
    Abstract [en]

    Successful management of coastal environments requires reliable monitoring methods and indicators. Besides Chlorophyll-a concentration (Chl-a), water transparency measured as Secchi Depth (ZSD) is widely used in Baltic Sea management for water quality assessment as eutrophication indicator. However, in many coastal waters not only phytoplankton but also coloured dissolved organic matter (CDOM) and suspended particulate matter (SPM) influence the under-water light field, and therefore the ZSD. In this study all three main optical variables(CDOM, Chl-a and SPM [organic and inorganic]) as well as ZSD were measured in three Swedish regions: the Bothnian Sea, the Baltic Proper and the Skagerrak in 2010-2014. Regional multiple regressions with Chl-a, CDOM and inorganic SPM as predictors explained the variations in ZSD well (R2adj = 0.53-0.84). Commonality analyses of the regressions indicated considerable differences between regions regarding the contribution of each factor to the variance, R2adj, in ZSD. CDOM explained most of the variance in the Bothnian Sea and the Skagerrak; in general, Chl-a contributed only modestly to the ZSD. In the Baltic Proper the largest contribution was from the interaction of all three variables. As expected, the link between Chl-a and ZSD was much weaker in the Bothnian Sea with high CDOM absorption and SPM concentration. When applying the Swedish EU Water Framework Directive threshold for Good/Moderate Chl-a status in the models it was shown that ZSD is neither a sufficient indicator for eutrophication, nor for changes in Chl-a. Natural coastal gradients in CDOM and SPM influence the reference conditions for ZSD and other eutrophication indicators, such as the depth distribution of macro-algae. Hence, setting targets for these indicators based on reference Chl-a concentrations and simple Chl-a to ZSD relationships might in some cases be inappropriate and misleading due to overestimation of water transparency under natural conditions.

  • Clendenen, Tess V.
    et al.
    Ge, Wenzhen
    Koenig, Karen L.
    Afanasyeva, Yelena
    Agnoli, Claudia
    Brinton, Louise A.
    Darvishian, Farbod
    Dorgan, Joanne F.
    Eliassen, A. Heather
    Falk, Roni T.
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Hankinson, Susan E.
    Hoffman-Bolton, Judith
    Key, Timothy J.
    Krogh, Vittorio
    Nichols, Hazel B.
    Sandler, Dale P.
    Schoemaker, Minouk J.
    Sluss, Patrick M.
    Sund, Malin
    Swerdlow, Anthony J.
    Visvanathan, Kala
    Zeleniuch-Jacquotte, Anne
    Liu, Mengling
    Breast cancer risk prediction in women aged 35-50 years: impact of including sex hormone concentrations in the Gail model2019In: Breast Cancer Research, ISSN 1465-5411, E-ISSN 1465-542X, Vol. 21, article id 42Article in journal (Refereed)
    Abstract [en]

    Background: Models that accurately predict risk of breast cancer are needed to help younger women make decisions about when to begin screening. Premenopausal concentrations of circulating anti-Mullerian hormone (AMH), a biomarker of ovarian reserve, and testosterone have been positively associated with breast cancer risk in prospective studies. We assessed whether adding AMH and/or testosterone to the Gail model improves its prediction performance for women aged 35-50.

    Methods: In a nested case-control study including ten prospective cohorts (1762 invasive cases/1890 matched controls) with pre-diagnostic serum/plasma samples, we estimated relative risks (RR) for the biomarkers and Gail risk factors using conditional logistic regression and random-effects meta-analysis. Absolute risk models were developed using these RR estimates, attributable risk fractions calculated using the distributions of the risk factors in the cases from the consortium, and population-based incidence and mortality rates. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminatory accuracy of the models with and without biomarkers.

    Results: The AUC for invasive breast cancer including only the Gail risk factor variables was 55.3 (95% CI 53.4, 57.1). The AUC increased moderately with the addition of AMH (AUC 57.6, 95% CI 55.7, 59.5), testosterone (AUC 56.2, 95% CI 54.4, 58.1), or both (AUC 58.1, 95% CI 56.2, 59.9). The largest AUC improvement (4.0) was among women without a family history of breast cancer.

    Conclusions: AMH and testosterone moderately increase the discriminatory accuracy of the Gail model among women aged 35-50. We observed the largest AUC increase for women without a family history of breast cancer, the group that would benefit most from improved risk prediction because early screening is already recommended for women with a family history.

  • Wode, Kathrin
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Umeå University, Faculty of Medicine, Department of Nursing. Regional Cancer Center Stockholm Gotland, Stockholm, Sweden; Department for Upper Gastrointestinal Cancer, K42, Karolinska University Hospital, Stockholm, Sweden.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Regional Cancer Center Stockholm Gotland, Stockholm, Sweden.
    Sharp, Lena
    Stoltenberg, Anna
    Nordberg, Johanna Hök
    Cancer patients' use of complementary and alternative medicine in Sweden: a cross-sectional study2019In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 19, article id 62Article in journal (Refereed)
    Abstract [en]

    Background: Access to and advice on Complementary and Alternative Medicine (CAM) are uncommon within Swedish conventional cancer care and little is known about cancer patients' own use of CAM. The aim of this cross-sectional study was to explore Swedish cancer patients patterns of CAM use, their experiences and preferences.

    Methods. Questionnaires were distributed consecutively to 1297 cancer patients at a university hospital's out-patient oncology units. The response rate was 58% (n=755). Descriptive statistics were used to analyze the survey data. A logistic regression model was used to investigate the association between CAM use and gender, age and level of education. Open-ended responses were analyzed, using qualitative content analysis.

    Results: Lifetime CAM use was reported by 34% (n=256), and 26% (n=198) used CAM after cancer diagnosis. Being female, younger and having higher education predicted CAM use. Most commonly used methods were natural products including vitamins and mineralsand relaxation. Main reasons for CAM use were improvement of physical, general and emotional wellbeing and increasing the body's ability to fight cancer. Satisfaction with CAM usage was generally high. Reported adverse effects were few and mild; 54% of users spent <50 Euro a month on CAM. One third had discussed their CAM use with cancer care providers. More than half of all participants thought that cancer care providers should be able to discuss (58%) and to consider (54%) use of CAM modalities in cancer care.

    Conclusions: Despite limited access and advice within conventional cancer care, one fourth of Swedish cancer patients use CAM. The insufficient patient-provider dialogue diverges with most patients' wish for professional guidance in their decisions and integration of CAM modalities in conventional cancer care. Concurrent and multimodal CAM use implies challenges and possibilities for cancer care that need to be considered.

  • Norqvist, Mathias
    et al.
    Umeå University, Faculty of Science and Technology, Umeå Mathematics Education Research Centre (UMERC). Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Jonsson, Bert
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lithner, Johan
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education. Umeå University, Faculty of Science and Technology, Umeå Mathematics Education Research Centre (UMERC).
    Qwillbard, Tony
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Holm, Linus
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Investigating algorithmic and creative reasoning strategies by eye tracking2019In: Journal of Mathematical Behavior, ISSN 0732-3123, E-ISSN 1873-8028Article in journal (Refereed)
    Abstract [en]

    Imitative teaching and learning approaches have been dominating in mathematics education. Although more creative approaches (e.g. problem-based learning) have been proposed and implemented, a main challenge of mathematics education research is to document robust links between teaching, tasks, student activities and learning. This study investigates one aspect of such links, by contrasting tasks providing algorithmic solution templates with tasks requiring students’ constructions of solutions and relating this to students’ learning processes and outcomes. Information about students’ task solving strategies are gathered by corneal eye-tracking, which is related to subsequent post-test performances and individual variation in cognitive proficiency. Results show that students practicing by creative tasks outperform students practicing by imitative algorithmic tasks in the post-test, but also that students that perform less well on creative tasks tend to try ineffective imitative strategies.

  • Public defence: 2019-05-10 09:00 Sal 933, Umeå
    Wahlin, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Atherosclerotic cardiovascular disease in rheumatoid arthritis: aspects of pathogenesis and risk2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patients with rheumatoid arthritis (RA) have an increased prevalence and severity of atherosclerosis, and a corresponding increased risk of cardiovascular disease. The mechanisms causing this are not well elucidated, but both traditional cardiovascular risk factors and RA-associated factors have been associated with atherosclerosis and increased risk of cardiovascular events in patients with RA. Cardiovascular risk estimation based on traditional cardiovascular risk factors, often underestimates the risk in patients with RA. The aims of this thesis were to examine factors and biomarkers associated with atherosclerosis in patients with RA, and to evaluate an algorithm for cardiovascular risk estimation in patients with RA.

    Methods Patients with early RA in the four northernmost counties of Sweden have since 1995 been included in a prospective study of both the progress of RA and comorbidities. Besides clinical data, radiographs, genetic markers and autoantibodies are registered. Paper I includes 665 patients aged 40-80 years from that cohort, in whom the 10-year risk of a first cardiovascular event was estimated with both Expanded Cardiovascular Risk Prediction Score in Rheumatoid Arthritis (ERS-RA), and the general population based ACC/AHA algorithm. The estimations were then compared to the actual outcomes. Paper II examines factors associated with coronary artery calcification (CAC) in 22 patients with long-standing RA. Papers III and IV use data from a cohort of patients <60 years of age at diagnosis of RA (n=79), in whom development of atherosclerosis has been prospectively followed since diagnosis of RA. This is a subset of patients from the larger cohort in paper I. Controls matched for age and sex (n=44) are examined as well. In paper III, phenotypes of T-cells and IgG-antibodies against cytomegalovirus (CMV) are analysed in relation to carotid intima-media thickness (IMT). In paper IV, bone mineral density and markers and regulators of bone metabolism are analysed in relation to IMT.

    Results Cardiovascular risk estimation with the RA-specific algorithm ERS-RA is not superior to estimation with the ACC/AHA algorithm. Both algorithms underestimate the risk in patients with a high grade of inflammation and in patients with an estimated moderate risk. In patients with long-standing RA, presence of CAC is associated with inflammatory activity, both at time of examination and in earlier stages of RA. Presence of anti-CMV IgG antibodies and altered T-cells (both CD4+ and CD8+) lacking the co-stimulatory molecule CD28 (CD28null) are associated with a higher IMT, and patients IgG-positive for CMV have a rapid increase in IMT after onset of RA. Regulators of bone metabolism (sclerostin, osteoprotegerin and osteocalcin) are associated with a higher IMT in patients with RA.

    Conclusion Cardiovascular risk estimation in patients with RA still needs to be improved. The fact that CMV-positivity, altered populations of T-cells and IMT all are associated, and that also regulators of bone metabolism reflect IMT, suggests that the pathogenesis of atherosclerosis in patients with RA is multifactorial.  This thesis provides knowledge of the accelerated development of atherosclerosis in RA and could possibly be relevant also in other chronic inflammatory diseases, where markers of accelerated atherosclerosis and increased cardiovascular risk are lacking.

  • Nyirenda, Moffat J
    et al.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Pregnancy, programming, and predisposition2019In: The Lancet Global Health, E-ISSN 2214-109X, Vol. 7, no 4, p. e404-e405Article in journal (Other (popular science, discussion, etc.))
  • Odelberg, Nina
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Cengiz, Yucel
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Jänes, Arthur
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Hennings, Joakim
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    The Impact of a Surgical Unit's Structure and Operative Technique on Quality in Two Swedish Rural Hospitals2019In: Journal of investigative surgery, ISSN 0894-1939, E-ISSN 1521-0553Article in journal (Refereed)
    Abstract [en]

    Introduction: Laparoscopic cholecystectomy (LC) is a commonly performed surgical procedure with a low complication rate. It is performed either as an acute or as an elective procedure. Most elective LCs are performed on nonlethal diseases and this is why good quality is important. Our study compared the quality of LC in two surgical units in northern Sweden (Sundsvall and ostersund) which use different clinical structures (subspecialised vs. general surgery) and surgical techniques (ultrasound fundus first vs. conventional diathermy). The study aimed to investigate whether these differences affected the quality of outcomes after LC.

    Materials and methods: This is a registry-based study which included 607 elective LCs from January 2014 to May 2016. There were 286 from Sundsvall and 321 from ostersund. Primary outcomes were operative time and the percentage of day surgeries. The secondary outcome was the presence of postoperative complications within the first 30 days in terms of bile duct injury, bleeding that necessitated reoperation, bile leakage and abscesses treated with drainage and mortality.

    Results: The time length of surgery was shorter in Sundsvall (mean 48.3 min) compared to ostersund (mean 108.6 min, p < 0.001. The percentage of day care surgeries was 94% in Sundsvall and 23% in ostersund, p < 0.001. Six patients (2.1%) had a complication in Sundsvall compared to seven patients (2.2%) in ostersund, p = 1.00.

    Conclusion: There is a significant difference between the two hospitals regarding operative time and the percentage of day surgeries. Complication rates in both units were equal and low.

  • Macura, Biljana
    et al.
    Byström, Pär
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Airoldi, Laura
    Eriksson, Britas Klemens
    Rudstam, Lars
    Stottrup, Josianne G.
    Impact of structural habitat modifications in coastal temperate systems on fish recruitment: a systematic review2019In: Environmental Evidence, ISSN 2047-2382, E-ISSN 2047-2382, Vol. 8, no 1, article id 14Article in journal (Refereed)
    Abstract [en]

    Background: Shallow nearshore marine ecosystems are changing at an increasing rate due to a range of human activities such as urbanisation and commercial development. As a result, an increasing number of structural modifications occur in coastal nursery and spawning habitats of fish. Concomitant to this increase, there have been declines in many coastal fish populations and changes in the composition of fish communities. As requested by Swedish stakeholders, this review aimed to synthesise scientific evidence of the impact on fish recruitment of structural modifications in temperate coastal areas.

    Methods: We searched for peer-reviewed and grey literature on such impacts in English, Dutch, Danish, Finnish, German, Swedish and Spanish. Searches were performed in bibliographic databases, specialist websites, bibliographies of review articles. We also contacted stakeholder to find relevant literature. Eligible studies included small- and large-scale field studies in marine systems and large lakes (> 10,000 km(2)) in temperate regions of the Northern and Southern Hemispheres. Included replicated comparisons of fish recruitment between altered and unaltered control areas, comparisons before and after an alteration, or both. Relevant outcomes (response variables) included measures of recruitment defined as abundance of juvenile fish in coastal habitats. All fish species were considered. Articles were screened for eligibility by title, abstract and full text. Eligible studies were critically appraised based on their external and internal validity. From each eligible study of sufficient validity, we extracted information on study design, measured outcomes, exposure, type of comparator, effect modifiers and study findings. Study findings were synthesised narratively.

    Results: We searched for eligible studies in 15 databases, 24 specialist websites, Google Scholar, and bibliographies of 11 review articles. The review finally included 37 studies that were eligible and of sufficient validity to be considered for final synthesis. Most studies (23 of 37) were from the Northern Hemisphere. Studies varied in design, spatial resolution, target fish species, and type of structural habitat change. This high level of variation did not allow for a quantitative synthesis and prevented us from drawing general conclusions on the impact of structures or structural modifications on fish recruitment. In this review we provide a narrative synthesis of the evidence base and classify eligible studies into six categories (based on type of exposure and comparator). The categories are as follows: the impacts on fish recruitment of: (1) artificial structures in coastal areas, (2) structures designed as fish attractors, (3) large scale urban sprawl, (4) 'novel' habitats, (5) habitat loss, and (6) restoration.

    Conclusions: This review revealed a very limited evidence base for how structural modifications and marine urban sprawl can affect fish recruitment. Thus, there is a substantial mismatch between stakeholder needs and research evidence. Further, the impact and ecological performance of artificial structures depend both on context and species. Clearly, there is a need for more research on the subject, especially on long-term consequences at larger spatial scales.

  • Walker, Emily V.
    et al.
    Davis, Faith G.
    Shaw, Amanda
    Louchini, Rabia
    Shack, Lorrains
    Woods, Ryan
    Kruchko, Carol
    Spinelli, John
    Guiot, Marie-Christine
    Perry, James
    Melin, Beatrice S.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Barnholtz-Sloan, Jill
    Turner, Donna
    King, MaryJane
    Hannah, Heather
    Bryant, Heather
    Malignant primary brain and other central nervous system tumors diagnosed in Canada from 2009 to 20132019In: Neuro-Oncology, ISSN 1522-8517, E-ISSN 1523-5866, Vol. 21, no 3, p. 360-369Article in journal (Refereed)
    Abstract [en]

    Background: We present a national surveillance report on malignant primary brain and other central nervous system (CNS) tumors diagnosed in the Canadian population in 2009–2013.

    Methods: Patients were identified through the Canadian Cancer Registry, an administrative dataset that includes cancer incidence data from all provinces/territories in Canada. Tumor types were classified by site and histology using the definitions from the Central Brain Tumor Registry of the United States (CBTRUS). Incidence rates (IRs) and 95% confidence intervals (CIs) were calculated per 100000 person-years (py) and age-standardized to the 2011 Canadian population for comparisons within Canada and to the 2000 United States population for comparisons with the US.

    Results: Overall, 12515 malignant brain and other CNS tumors were diagnosed in the Canadian population in 2009–2013 (IR: 8.71/100000 py; 95% CI: 8.56, 8.86); 7085 were among males (IR: 10.06/100000 py; 95% CI: 9.82, 10.29) and 5430 among females (IR: 7.41/100000 py; 95% CI: 7.22, 7.61). Of these, 12115 were classifiable according to histological subgroups defined by CBTRUS. The most common histology was glioblastoma (IR: 4.06/100000 py; 95% CI: 3.95, 4.16). Among those aged 0–19 years, 1130 malignant brain and CNS tumors were diagnosed in 2009–2013 (IR: 3.36/100000 py; 95% CI: 3.16, 3.56). The most common histology among the pediatric population was embryonal tumor (IR: 0.74/100000 py; 95% CI: 0.65, 0.84).

    Conclusions: These data represent an initial detailed report on the frequency and distribution of primary malignant brain and other CNS tumors diagnosed in the Canadian population in 2009–2013. The reported distributions of tumor diagnoses by sex and age reflected expected patterns based on the literature from similar populations. A report incorporating data on nonmalignant primary brain tumors is forthcoming.

  • Hitimana, Regis
    et al.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Mogren, Ingrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Krantz, Gunilla
    Nzayirambaho, Manasse
    Semasaka Sengoma, Jean Paul
    Pulkki-Brännström, Anni-Maria
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Incremental cost and health gains of the 2016 WHO antenatal care recommendations for Rwanda: results from expert elicitation2019In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 17, no 1, article id 36Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: High-quality evidence of effectiveness and cost-effectiveness is rarely available and relevant for health policy decisions in low-resource settings. In such situations, innovative approaches are needed to generate locally relevant evidence. This study aims to inform decision-making on antenatal care (ANC) recommendations in Rwanda by estimating the incremental cost-effectiveness of the recent (2016) WHO antenatal care recommendations compared to current practice in Rwanda.

    METHODS: Two health outcome scenarios (optimistic, pessimistic) in terms of expected maternal and perinatal mortality reduction were constructed using expert elicitation with gynaecologists/obstetricians currently practicing in Rwanda. Three costing scenarios were constructed from the societal perspective over a 1-year period. The two main inputs to the cost analyses were a Monte Carlo simulation of the distribution of ANC attendance for a hypothetical cohort of 373,679 women and unit cost estimation of the new recommendations using data from a recent primary costing study of current ANC practice in Rwanda. Results were reported in 2015 USD and compared with the 2015 Rwandan per-capita gross domestic product (US$ 697).

    RESULTS: Incremental health gains were estimated as 162,509 life-years saved (LYS) in the optimistic scenario and 65,366 LYS in the pessimistic scenario. Incremental cost ranged between $5.8 and $11 million (an increase of 42% and 79%, respectively, compared to current practice) across the costing scenarios. In the optimistic outcome scenario, incremental cost per LYS ranged between $36 (for low ANC attendance) and $67 (high ANC attendance), while in the pessimistic outcome scenario, it ranged between $90 (low ANC attendance) and $168 (high ANC attendance) per LYS. Incremental cost effectiveness was below the GDP-based thresholds in all six scenarios.

    DISCUSSION: Implementing the new WHO ANC recommendations in Rwanda would likely be very cost-effective; however, the additional resource requirements are substantial. This study demonstrates how expert elicitation combined with other data can provide an affordable source of locally relevant evidence for health policy decisions in low-resource settings.

  • Sirili, Nathanael
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    Frumence, Gasto
    Kiwara, Angwara
    Mwangu, Mughwira
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    "Doctors ready to be posted are jobless on the street…" the deployment process and shortage of doctors in Tanzania.2019In: Human Resources for Health, ISSN 1478-4491, E-ISSN 1478-4491, Vol. 17, no 1, article id 11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The World Health Organization advocates that health workforce development is a continuum of three stages of entry, available workforce and exit. However, many studies have focused on addressing the shortage of numbers and the retention of doctors in rural and remote areas. The latter has left the contribution of the entry stage in particularly the deployment process on the shortage of health workforce less understood. This study therefore explored the experiences of medical doctors (MDs) on the deployment process after the internship period in Tanzania's health sector.

    METHODS: A qualitative case study that adopted chain referral sampling was used to conduct 20 key informant interviews with MDs who graduated between 2003 and 2009 from two Medical Universities in Tanzania between February and April 2016. These MDs were working in hospitals at different levels and Medical Universities in eight regions and five geo-political zones in the country. Information gathered was analysed using a qualitative content analysis approach.

    RESULTS: Experiences on the deployment process fall into three categories. First, "uncertainties around the first appointment" attributed to lack of effective strategies for identification of the pool of available MDs, indecision and limited vacancies for employment in the public sector and private sector and non-transparent and lengthy bureaucratic procedures in offering government employment. Second, "failure to respect individuals' preferences of work location" which were based on the influence of family ties, fear of the unknown rural environment among urbanized MDs and concern for career prospects. Third, "feelings of insecurity about being placed at a regional and district level" partly due to local government authorities being unprepared to receive and accommodate MDs and territorial protectionism among assistant medical officers.

    CONCLUSIONS: Experiences of MDs on the deployment process in Tanzania reveal many challenges that need to be addressed for the deployment to contribute better in availability of equitably distributed health workforce in the country. Short-term, mid-term and long-term strategies are needed to address these challenges. These strategies should focus on linking of the internship with the first appointment, work place preferences, defining and supporting career paths to health workers working under the local government authorities, improving the working relationships and team building at the work places and fostering rural attachment to medical students during medical training.

  • Gonsalves, Allison J.
    et al.
    Faculty of Education, McGill University, Canada.
    Silfver, Eva
    Umeå University, Faculty of Social Sciences, Department of Education.
    Danielsson, Anna
    Uppsala University, Uppsala, Sweden.
    Berge, Maria
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    “It’s not my dream, actually”: students’ identity work across figured worlds of construction engineering in Sweden2019In: International Journal for STEM education, E-ISSN 2196-7822, Vol. 6, no 13, p. 1-17Article in journal (Refereed)
    Abstract [en]

    Background: Research in engineering education has pointed to the need for new engineers to develop a broader skillsetwith an emphasis on “softer” social skills. However, there remains strong tensions in the identity work that engineersmust engage in to balance the technical demands of the discipline with the new emphasis on heterogeneous skills(Faulkner, Social Studies of Science 37:331–356, 2007). This study explores how three unconventional students experiencethese tensions in the final year of their construction engineering program, and as they move in and out of workplacefield experiences.Results: Using a figured worlds framework (Holland et al., Identity and agency in cultural worlds, 1998), we explore thedominant subject positions for students in construction engineering classroom and workplaces in a 3-year Swedishengineering program. Results demonstrate that dominant subject positions for construction engineers can troublestudents’ identity work as they move across classroom and workplace settings.Conclusions: This study expands our knowledge of the complexity of students’ identity work across classroom andworkplace settings. The emergence of classroom and workplace masculinities that shape the dominant subject positionsavailable to students are shown to trouble the identity work that students engage in as they move across these learningspaces. We examine students’ identity strategies that contribute to their persistence through the field. Finally, we discussimplications for teaching and research in light of students’ movements across these educational contexts.

  • Public defence: 2019-05-17 12:30 N420, Umeå
    Sidenvall, Johan
    Umeå University, Faculty of Science and Technology, Umeå Mathematics Education Research Centre (UMERC). Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Lösa problem: om elevers förutsättningar att lösa problem och hur lärare kan stödja processen2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In mathematics education, there is generally too much emphasis on rote learning and superficial reasoning. If learning is mostly done by rote and imitation, important mathematical competencies such as problem-solving, reasoning, and conceptual understanding are not developed. Previous research has shown that students who work with problems (i.e. constructs a new solution method to a task), to a greater extent increase their mathematical understanding than students who only solve routine tasks.

    The aim of the thesis was to further understand why teaching is dominated by rote learning and imitation of procedures and investigate how opportunities for students to solve tasks through problem-solving could be improved. This was done through the following studies. (1) Investigating the relation between types of solution strategy required, used, and the rate of correct task solutions in students’ textbook task-solving. (2) Studying the relationship between students’ beliefs and choice of solution strategy when working on problems. (3) Conducting a textbook analysis of mathematics textbooks from 12 countries, to determine the proportions of tasks that could be solved by mimicking available templates and of tasks where a solution had to be constructed without guidance from the textbook. (4) Conducting a literature review in order to characterize teaching designs intended to enhance students to develop mathematical understanding through problem solving and reasoning. (5) Conducting an intervention study were a teacher guide, structured in line with central tenets of formative assessment, was developed, tested, and evaluated in real classroom settings. The teacher guide was designed to support teachers in their support of students’ in their problem-solving process. Studies I, II and V were conducted in Swedish upper secondary school settings. 

    The students’ opportunities to solve tasks through problem-solving were limited: by the low proportion of problems among the easier tasks in the textbooks; by the students' choice of using imitative solution strategies; and by the guidance of solution methods that students received from other students and their teachers. The students’ opportunities were also limited by the students' beliefs of mathematics and the fact that a solution method of problem tasks was not always within reach for the students, based on the students' knowledge. In order to improve students’ opportunities, teachers should allow students to work with more problems in a learning environment that lets students engage in problem-solving and support students' work on problems by adapting their support to students' difficulties. The results also give implications for the construction and use of textbooks and how the use of the teacher guide could be part of teachers’ professional development and a tool that teacher students may meet within their education.

  • Critchley, Linda
    Umeå University, Faculty of Social Sciences, Department of Law.
    Trovärdighet - ett privilegium? Om bevisvärderingen av intellektuellt funktionsnedsatta kvinnors muntliga utsaga i våldtäktsmål.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Carlsson, Emelie
    Umeå University, Faculty of Social Sciences, Department of Law.
    Barnets bästa i vårdnadsmål - är juridiken tillräcklig? Utifrån ett barnperspektiv och med en diskussion om huruvida terapeutisk juridik borde tillämpas som ett komplement.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Byberg, Helena
    Umeå University, Faculty of Social Sciences, Department of Law.
    Egendomsskyddet vid fastighetsbildning - En analys av proportionalitetsprincipens genomslag vid bildandet av vedbrandsgårdar.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Berggren, Isabelle
    Umeå University, Faculty of Social Sciences, Department of Law.
    Disappearing island states and human rights. Preservation of statehood and human rights in times of climate change.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Larsson, Olle
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Kågström, Rasmus
    Umeå University, Faculty of Arts, Department of culture and media studies.
    CROSSCHECKING ELLER MISSHANDEL?: En kritisk diskursanalys av kvällstidningars framställande av brott på ishockeyplanen.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Ice hockey is seen as a rough sport. Sometimes situations tend to become too violent and

    players now and then get suspended for their acts on the ice. In very unusual cases the legal

    system has been forced to step in and prosecute players for situations on the ice. This is the

    case with Jakob Lilja. The purpose of this essay is therefore to seek answers on how two

    Swedish tabloids have framed Lilja and how the news coverage has changed during this time.

    The theory used in the study makes it possible to highlight how Lilja has been framed in the

    tabloids and it also gives the study the opportunity to further explain how Lilja has been

    portrayed. The scientific method used in this study has been a critical discourse analysis to be

    able to study the 43 articles included in the analysis in a qualitative manner. The study shows

    that the news coverage from the case has changed during the course of the time. The early

    coverage shows the framing of Lilja as an ice hockey player while the latter coverage more

    frame him as a criminal. But there are differences. The different tabloids have framed the case

    in different ways and the study shows that one of them has framed Lilja more than the other.

  • Kristofersson, Amanda
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Flink, Elina
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Att kommunicera en kommunikatör: Vad är en strategisk kommunikatör och vad förväntas av yrkesrollen?2019Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study aims to examine what competencies are expected from a strategiccommunicator 2019, as well as how education and the work field is cooperating.Expectations on competencies regarding the strategic communication profession and thecooperation between education and work field is analyzed based upon empirical data. Thedata is conducted from a combined quantitative and qualitative online-survey withstudents at the strategic communication at Umeå University (N = 45), and semi-structuredqualitative interview with associate professor at the program for strategic communicationat Umeå University and a selection of employees from six different companies within theprivate sector. Two different Likert-scales is used for measuring collaboration andcompetencies in the online-survey. Strategic communication theory and complexity theoryare used for discussion of the analyzed data. The results show that students find the levelof collaboration between education and work field to be low (mean score falls under 3 outof 7 for all the variables). However, the majority have been in touch with companieswithin strategic communication (68 percent). Education and work field show a low levelof cooperation, but both parts want to increase the collaboration. The only competencythat is mentioned by all three parties is to be creative. Generally, for all three parties, thereis a focus on subjective characteristics rather than technical and practical ability andcompetence. There is a natural development of a higher demand on communicativeorganizations and strategic communicators must therefore practice communication in itscomplexity and leave the transmission model in order to move toward aprofessionalization. The variety of competencies required can be explained fromcomplexity theory that the strategic communicator benefits from being complex andflexible to meet the demands from a complex society. Thus, the conclusion is that theresults show a need for an increased level of communication between education and workfield.

  • Edlund, Anette
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies. 9306174948.
    Blomqvist, Ellinor
    Umeå University, Faculty of Arts, Department of culture and media studies.
    PR, PÅVERKAN & PROMILLE: En kvalitativ och kritisk diskursiv jämförelseanalys av hur kommersiella och ideella organisationer konstruerar PR-kampanjer på sociala medier.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this essay was to examine the Public Relation strategies in four PR-campaigns. The objects of the study were two commercial organisations, Carlsberg and Smirnoff, and two non-governmental organisations, Addict Aide and IQ, with alcohol as the pervading subject. The study intended to compare similarities and differences, persuasion tactics and discourse themes. To accomplish the object of the study the theoretical framework of James E. Grunigs Four models of Public Relations was used. Alongside Grunig’s theory, Relationship management theory was applied to understand social media's role as a strategy in the four campaigns. The method used was a qualitative content analysis combined with a semiotic image analysis, and a critical discourse analysis. The results showed that communication that's is based in two-way communication has the biggest chance of success. The results also showed that social media plays an important part as a strategy in organizations strategic communication and Public Relations endeavors. Both in reaching the target audience, but also in maintaining beneficial relationships between the organization and its audience. The essay’s conclusions were that the audience participation has become an important strategic part in the Public Relation field with the emergence of two-way communication. As well as the fact that cultural and social practices plays an important part in the construct of organizations PR-strategies.

  • Berglund, Amanda
    Umeå University, Faculty of Social Sciences, Department of Law.
    Framtidsfullmakter - hjälpande eller stjälpande? Förhållandet till andra typer av ställföreträdarskap och möjlig problematik.2019Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • Kejerhag, Jenny
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Nordgren, Shanelle
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Lokalmedias rapportering - ett famlande i blindo efter publiken som tyst ger sig av?: En studie om publikens och redaktionernas syn på den lokala medierapporteringen i Västerbotten och relationen mellan publik och redaktion.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this thesis, “Local news - a fumbling in darkness after an audience that leavesquietly”, is to investigate how the local news media in Västerbotten decides what to reportabout, and what to leave out and why. It also investigates what the audience think about thenews they are being served. It looks at the relationship between the audience and the localnews media. Four different local media companies are being examined, two of them arepublic service media, the Swedish Television and the Swedish Radio. The other two arenewspapers and private owned media companies, Västerbottens-kuriren and VästerbottensFolkblad. The theories that are being used in this thesis is gatekeeping, agenda setting, localjournalism, click journalism, journalists ideal and audience studies such as uses andgratification. The methods that are used are a quantitative survey and semi-structuredinterviews. The survey is directed to audience to get a sense of what news they want and howthey look at their relationship with local news media companies. The purpose of theinterviews is to get a view of how the media companies are producing news, and how theyexperience their relationship with their audience. The study has shown that the audiencedoesn't always know what they want the news media to report about. One overall themethough was that the audience wished for more local news. The media companies have theambition to produce local news and cover the whole county but fails due to the lack ofresources. The media needs a more active audience to increase the support both in trust, butalso for their economy. Here both the media companies and the audience has a responsibilityin the question.

  • Gedankien Niemi, Hadassa
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Forsberg, Isabelle
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Att bygga jämställt: En studie om rekryteringskommunikation mot kvinnor i en mansdominerad bransch2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The demand for labour force in the European building industry has increased in recent years due to the constant migrations and the need to provide housing, schools and hospitals to accommodate this growing population. Due to this scenario and to governmental policies that were created to supply this need, Swedish building companies want to recruit more female employees in particular. The purpose of this case study is to investigate whether, and if so how, the building company NCC uses its external communication to strategically attract more women to the industry.

    Our research was of a qualitative nature. We analysed, with the help of a Multimodal Critical Discourse Analysis approach, recruitment materials and job advertisements published on the company’s homepage, in order to demonstrate how men and women are represented in NCC’s recruitment communication and in which way the company communicates specifically to women. We have also analysed which aspects of the company’s recruitment communication were appealing to women, through focus group interviews made with female engineering students. As theoretical ground for this case study we have chosen previous research and literature in the fields of organizational communication, employer branding, decoding in communication processes, gender studies, stereotyping and gender aware recruitment.

    The findings in this study show that both men and women are represented in NCC’s recruitment communication, but that a bigger focus is placed on the visual representation of women.  NCC strategically aims at attracting women both in the way female workers are visually portrayed on the homepage but even in the wording found in the company’s recruitment texts and job advertisements. This targeted communication does not reach its full potential in terms of attractiveness to women though, perhaps due to the rather cosmetic visual representation of the company’s work environment, as well as the lack of personal connection that is made between the portrayed employees and the potential job candidates.

  • Backlund, Benjamin
    Umeå University, Faculty of Arts, Department of culture and media studies.
    “The government is watching – don’t step on their toes”: An investigation of the press freedom and the working conditions for journalists in Tanzania2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    According to reports from Reporters sans frontiers and Freedom House, the freedom of the press has declined during the recent years in the sub-Saharan country Tanzania. Using the human rights reports as an entry point, this study set out to investigate the working conditions for journalists in the capital de facto of Tanzania, Dar es Salaam. An important aim was to dig deeper and show the local and culturally specific conditions. The study supports that the press freedom, as well as the working conditions have declined during the last years for the journalists in Dar es Salaam. However, the study also shows that the new laws and government measures, described by the human rights reports as reducing the press freedom, is not considered by every journalist to be negative. The challenges differ among the corps of journalists, as their values of journalism differs. The greatest denominator among the informants was the high-degree of journalistic interventionism, directed at helping the society. In some cases, this took form as a practice of development journalism. The strong connections to the local community, the country and the religious affiliations are thought to contribute to these values. For journalists in private media, the press freedom was found to be the most acute problem, while for journalists in state-owned media it was economic issues. The press freedom was connected to the perceived job autonomy, and senior journalists and journalists working for international media were found to be more autonomous. Self-censorship was used by many in the private media sector as a tool to avoid both bureaucratic harassment from government, as well as violent repercussions. The main challenges included new restricting laws, economic issues which lead to the practice of brown envelopes, the parliament being located in Dodoma, gender-issues, scared sources and the advancement of social media. Theories and earlier research evolving from the values of journalism and journalism in Africa were used as tools to understand and compare with. The results are based on fieldwork conducted during a period of two months in the beginning of 2019, with qualitative interviews held with journalists in the city of Dar es Salaam.