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  • Nordström, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. School of Sports Science, UiT The Arctic University of Norway, Tromsø, Norway..
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Traumatic brain injury and the risk of dementia diagnosis: A nationwide cohort study2018In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 15, no 1, article id e1002496Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Traumatic brain injury (TBI) has been associated with dementia. The questions of whether the risk of dementia decreases over time after TBI, whether it is similar for different TBI types, and whether it is influenced by familial aggregation are not well studied.

    METHODS AND FINDINGS: The cohort considered for inclusion comprised all individuals in Sweden aged ≥50 years on December 31, 2005 (n = 3,329,360). Diagnoses of dementia and TBI were tracked through nationwide databases from 1964 until December 31, 2012. In a first cohort, individuals diagnosed with TBI (n = 164,334) were matched with up to two controls. A second cohort consisted of subjects diagnosed with dementia during follow-up (n = 136,233) matched with up to two controls. A third cohort consisted of 46,970 full sibling pairs with discordant TBI status. During a mean follow-up period of 15.3 (range, 0-49) years, 21,963 individuals in the first cohort (6.3% with TBI, 3.6% without TBI) were diagnosed with dementia (adjusted odds ratio [OR], 1.81; 95% confidence interval [CI], 1.75-1.86). The association was strongest in the first year after TBI (OR, 3.52; 95% CI, 3.23-3.84), but the risk remained significant >30 years (OR, 1.25; 95% CI, 1.11-1.41). Single mild TBI showed a weaker association with dementia (OR, 1.63; 95% CI, 1.57-1.70) than did more severe TBI (OR, 2.06; 95% CI, 1.95-2.19) and multiple TBIs (OR, 2.81; 95% CI, 2.51-3.15). These results were in general confirmed in the nested case-control cohort. TBI was also associated with an increased risk of dementia diagnosis in sibling pairs with discordant TBI status (OR, 1.89; 95% CI, 1.62-2.21). A main limitation of the present study is the observational design. Thus, no causal inferences can be made based on the associations found.

    CONCLUSIONS: The risk of dementia diagnosis decreased over time after TBI, but it was still evident >30 years after the trauma. The association was stronger for more severe TBI and multiple TBIs, and it persisted after adjustment for familial factors.

  • Rietdijk, Saskia
    et al.
    Janssen, Tanja
    van Weijen, Daphne
    van den Bergh, Huub
    Rijlaarsdam, Gert
    Umeå University, Faculty of Arts, Department of language studies. University of Amsterdam, The Netherlands; University of Antwerp, Belgium.
    Improving writing in primary schools through a comprehensive writing program2017In: The Journal of Writing Research, ISSN 2030-1006, E-ISSN 2294-3307, Vol. 9, no 2, p. 173-225Article in journal (Refereed)
    Abstract [en]

    This study examined the effects of an innovative comprehensive writing program in upper primary education on students' writing performance and on teachers' classroom practices, beliefs and skills. The program focused on the communicative nature of writing, on writing as a process, and on explicit teaching of five genre-specific writing strategies. It was implemented by 43 teachers in their regular classrooms (Grades 4 to 6, N = 1052), with three conditions: (1) a writing program condition, (2) the same program complemented by professional development sessions and coaching, and (3) a control condition in which teachers taught their usual writing lessons. Students' writing performance was measured three times with multiple writing tasks. Data on teachers' practices, beliefs and skills were collected through lesson observations, interviews, questionnaires, teacher logs, and a text assessment task. The comprehensive writing program had a beneficial effect on students' writing performance and the extent to which teachers taught writing strategies. The complementary professional development and coaching had a direct effect on the number of lessons implemented, and an indirect effect on students' performance. Overall, the innovation proved to be effective for improving students' writing performance in the upper grades of primary schools.

  • Netzén Örn, Marcel
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Economics.
    Governance and Economic Growth: - A Vector Autoregressive approach on the Frontiermarket2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Economic growth is a hot topic among economists around the world. The last century many parts of the world have faced an acceleration in the economic growth. However, that is not the case for all countries and today there is a large economic gap between the rich and poor countries. But why have some parts of the world succeeded to create economic growth while others do not?

    The purpose of this study is to create a deeper understanding of the mechanism between economic growth and governance in the frontier market. To do this, a Vector autoregressive time series model will be used. The frontier market is an ad-hoc market index containing 22 countries that have not been classified as developing countries yet. In the poor parts of the world high level corruption and lack of political stability such as rule of law is a fact. Hence, the study will use control of corruption, rule of law as governance variables to investigate the association between governance and economic growth among the countries in the frontier market. Further it will investigate if there is a Granger causality between governance and economic growth and whether it is running from economic growth to governance or conversely. The results implies that there is association between governance and economic growth for Bahrain, Bangladesh, Croatia, Kazakhstan, Lebanon, Lithuania, Mauritius, Morocco, Pakistan, Romania, Slovenia, Serbia, Sri Lanka and Vietnam. But, the question remains if it is good governance that creates economic growth or if it is economic growth that creates good governance in the frontier market

  • Karlsson, Jesper
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Symplectic Automorphisms of C2n2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This essay is a detailed survey of an article from 1996 published by Franc Forstneric, where he studies symplectic automorphisms of C2n. The vision is to introduce the density property for holomorphic symplectic manifolds. Our idea is that of Dror Varolin when he in 2001 introduced the concept of density property for Stein manifolds. The main result here is the introduction of symplectic shears on C2n equipped with a holomorphic symplectic form and to show that the group generated by finite compositions of symplectic shears is dense in the group of symplectic automorphisms of C2n in the compact-open topology. We give a complete background of the tools from the theory of ordinary differential equations, smooth manifolds, and complex and symplectic geometry that is needed in order to prove this result.

  • Ajdinovic, Dzejla
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Resonemang och problemlösning i Matematik 1b: En uppgiftsanalys av två läroböcker2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Studien undersökte möjligheten att utveckla problemlösnings- och resonemangsförmåga i svenska läroböcker. Under studiens gång genomfördes en läromedelsanalys av två läroböcker för gymnasiekursen Matematik 1b, Matematik 5000 och Matematik Origo. Analysen tog hänsyn till olika aspekter av förmågorna, olika svårighetsgrader på uppgifterna samt olika centralt innehåll i ämnesplanen. Av 2223 uppgifter i Matematik 5000 kunde problemlösningsförmågan utvecklas i 5% och resonemangsförmågan i 6%. Motsvarande andelar i 1747 uppgifter i Matematik Origo var 7% respektive 10%. Analysen visade också att större andel av uppgifterna på de två högre svårighetsnivåerna gav möjlighet att utveckla förmågorna än de på den lägsta nivån i båda böckerna. Det framkom även att inte alla aspekter av förmågorna fick lika stort utrymme att utvecklas. I båda böckerna var det geometri-kapitlet som fokuserade på dessa förmågor i störst andel av uppgifterna.

  • Weidung, Bodil
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Department of Public Health and Caring Sciences, Geriatric Medicine, Uppsala University, Uppsala.
    Toots, Annika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Carlberg, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umea85+/GERDA2017In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 51, article id e9161Article in journal (Refereed)
    Abstract [en]

    Declining systolic blood pressure (SBP) is common in very old age and is associated with adverse events, such as dementia. Knowledge of factors associated with SBP changes could explain the etiology of this decline in SBP. This study investigated longitudinal changes in socioeconomic factors, medical conditions, drug prescriptions, and assessments and their associations with SBP changes among very old followed individuals.The study was based on data from the Umea85+/Gerontological Regional Database (GERDA) cohort study, which provided cross-sectional and longitudinal data on participants aged 85, 90, and 95 years from 2000 to 2015. Follow-up assessments were conducted after 5 years. The main outcome was a change in SBP. Factors associated with SBP changes were assessed using multivariate linear regression models.In the Umea85+/GERDA study, 454 surviving individuals underwent follow-up assessment after 5 years. Of these, 297 had SBP measured at baseline and follow-up. The mean changestandard deviation in SBP was -12 +/- 25mm Hg. SBP decline was associated independently with later investigation year (P=.009), higher baseline SBP (P<.001), baseline antidepressant prescription (P=.011), incident acute myocardial infarction during follow-up (P=.003), new diuretic prescription during follow-up (P=.044), and a decline in the Barthel Activities of Daily Living index at follow-up (P<.001).In conclusion, SBP declines among very old individuals. This decline seems to be associated with initial SBP level, investigation year, and health-related factors.

  • Sahlin, Hanna
    et al.
    Bjureberg, Johan
    Gratz, Kim L.
    Tull, Matthew T.
    Hedman, Erik
    Bjarehed, Jonas
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lundh, Lars-Gunnar
    Ljotsson, Brjann
    Hellner, Clara
    Emotion regulation group therapy for deliberate self-harm: a multi-site evaluation in routine care using an uncontrolled open trial design2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 10, article id e016220Article in journal (Refereed)
    Abstract [en]

    Objective Emotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of empirically supported treatments for individuals with borderline personality disorder and deliberate self-harm, an evaluation of ERGT in routine clinical care was conducted with therapists of different professional backgrounds who had received brief intensive training in ERGT prior to trial onset. Design Multi-site evaluation, using an uncontrolled open trial design with assessments at pretreatment, post-treatment and 6-month follow-up. &&Setting 14 adult outpatient psychiatric clinics across Sweden. Participants Ninety-five women (mean age=25.1 years) with borderline personality disorder (both threshold and subthreshold) and repeated self-harm were enrolled in the study. Ninety-three per cent of participants completed the post-treatment assessment and 88% completed the follow-up assessment. Primary and secondary outcome measures Primary outcome was self-harm frequency as measured with the Deliberate Self-Harm Inventory. Secondary outcomes included self-harm versatility, emotion dysregulation, other self-destructive behaviours, depression, anxiety, stress symptoms and interpersonal and vocational difficulties. Intervention ERGT is an adjunctive, 14-week, acceptance-based behavioural group treatment that directly targets both self-harm and its proposed underlying mechanism of emotion dysregulation. Results At post-treatment, intent-to-treat analyses revealed a significant improvement associated with a moderate effect size on the primary outcome of self-harm frequency (51%, reduction; Cohen's d=0.52, p<0.001) as well as significant improvements in the secondary outcomes of self-harm versatility, emotion dysregulation, other self-destructive behaviours and general psychiatric symptomatology. These results were either maintained or further improved on at 6-month follow-up. Conclusions ERGT appears to be a feasible, transportable and useful treatment for deliberate self-harm and other self-destructive behaviours, emotion dysregulation and psychiatric symptoms when delivered by clinicians in the community.

  • Lundgren, Victor
    et al.
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Karlsson, Johan
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Laborativ matematikundervisning: En studie om lärares perspektiv på undervisning med laborativa material i årskurs 1–6.2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie är att öka förståelsen gällande lärares användning av laborativt material i matematikundervisningen, samt att fördjupa kunskapen om vilka yrkeskompetenser som anses vara viktiga för en laborativ undervisningsmetod. För att svara på frågeställningarna har en studie med semistrukturerade kvalitativa intervjuer genomförts med 12 lärare från två olika skolor. Intervjuerna har analyserats utifrån den kulturhistoriska verksamhetsteorin, ramfaktorteorin samt genom en kategorisering av lärares kompetenser. Resultatet visar att samtliga lärare i undersökningen har en positiv syn på den laborativa undervisningen, men att faktorer som tillgänglighet av material, specifika behov hos elever och tid till planering tycks påverka lärares metodval. Slutligen visar studien på vikten av att läraren har ett flertal kompetenser för att undervisa med laborativt material, som exempelvis den praktiska- samt den matematikdidaktiska kompetensen.

  • Vesterlund, Anna
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    På gungfly i det geometriska träsket: -om elever i matematiksvårigheter och deras förståelse av geometriska begrepp2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien är att utifrån ett fokus på begreppsförståelse undersöka hur en varierad undervisning i geometri utvecklar SUM-elevers lärande. Det sker genom att en lektionsserie på fem lektioner genomförs med sju elever i årskurs 7. Lektionerna inspireras och utformas utifrån Skolverkets geometrimodul där varierad undervisning utgör en viktig del. En verksamhetsteoretisk modell ligger till grund som teoretisk utgångspunkt och som analysverktyg. Med verksamhetsteorins sociokulturella perspektiv och dess holistiska synsätt tas därmed hänsyn till flera medierande faktorer. I studien genomfördes reflektionsanteckningar, deltagande lektionsobservationer och elevintervjuer. Studiens resultat visar på att eleverna ökade sin förmåga att kommunicera geometrin, till viss del ökar deras förmåga att tolka och lösa problem. Ett positivt gruppklimat och konkret material kan ses som bidragande till det. Resultatet visar dock inte att elevernas förmåga att abstrahera geometriska begrepp ökat.

  • Sköld, Jenny
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Motivationsanalys av elever inomintensivundervisning i matematik2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    En av vinsterna med intensivundervisning i matematik är ökad motivation till lärande, vilket tidigareforskningsprojekt både internationellt och nationellt påvisar. Syftet är att öka kunskapen om och i så fall påvilka sätt intensivundervisning i matematik (IUM) påverkar elevers motivation. Fyra kvalitativa intervjuermed fenomenologisk ansats genomfördes med elever i behov av särskilda utbildningsinsatser i matematiksom haft intensivundervisning i matematik. Deras upplevda livsvärldar analyseras därefter utifrånmedbestämmandeteorins motivationsnivåer amotivation, yttre motivation och inre motivation. Studienuppvisar att IUM stärker motivationen främst hos elever med introjicerade skäl, eller högre, till att lära sigmatematik. Analysen visade att IUM stimulerar både inre och yttre motivation hos eleverna. Studien visaräven på att lärares och föräldrars insatser under IUM har stor inverkan på elevens motivationsnivå.Nyckelord: medbestämmande.

  • Näsman, Sara
    et al.
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Sandqvist Bölenius, Britt-Marie
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Samverkan för matematikutveckling: En aktionsstudie om hur speciallärare och matematiklärarekan samverka för att stärka möjligheterna till lärande2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    I den här studien deltar två blivande speciallärare i en aktionsstudie i syfte att genomsamverkan med matematiklärare stärka elevers möjligheter till lärande i matematik hoselever i behov av anpassningar. Två aktioner på olika grundskolor presenteras, på den enaskolan i årskurs 3 och på den andra i årskurs 5. Professionella strukturerade samtal och nogavalda samverkansformer har visat sig resultera i en ökning av såväl generella anpassningarsom anpassningar på individnivå för både SUM-elever och elever i behov av utmaningar. Istudien presenteras en mängd anpassningar som genomförts och slutligen förs en intressantdiskussion om hur detta sätt att arbeta kan bli verklighet i vår kommande yrkesroll.

  • Dahlin, Lars B.
    et al.
    Wiberg, Mikael
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). 2 Department of Surgical and Perioperative Science, University Hospital, Umeå.
    Nerve injuries of the upper extremity and hand2017In: EFORT OPEN REVIEWS, ISSN 2058-5241, Vol. 2, no 5, p. 158-170Article in journal (Refereed)
    Abstract [en]

    A nerve injury has a profound impact on the patient's daily life due to the impaired sensory and motor function, impaired dexterity, sensitivity to cold as well as eventual pain problems. To perform an appropriate treatment of nerve injuries, a correct diagnosis must be made, where the injury is properly classified, leading to an optimal surgical approach and technique, where timing of surgery is also important for the outcome. Knowledge about the nerve regeneration process, where delicate processes occur in neurons, non-neuronal cells (i. e. Schwann cells) and other cells in the peripheral as well as the central nervous systems, is crucial for the treating surgeon. The surgical decision to perform nerve repair and/or reconstruction depends on the type of injury, the condition of the wound as well as the vascularity of the wound. To reconnect injured nerve ends, various techniques can be used, which include both epineurial and fascicular nerve repair, and if a nerve defect is caused by the injury, a nerve reconstruction procedure has to be performed, including bridging the defect using nerve-grafts or nerve transfer techniques. The patients must be evaluated properly and regularly after the surgical procedure and appropriate rehabilitation programmes are useful to improve the final outcome.

  • Lindberg, Marianne
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Fenomenet mentorskap i gymnasieskolan: Mentors betydelse för elever i matematiksvårigheter2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Mentorskap har blivit vanligt i svenska gymnasieskolor sedan 1990-talet. Syftet med denhär studien har varit att undersöka och beskriva vad som är mentors uppdrag, med särskiltfokus på frågan om vilken betydelse mentor har för elever i matematiksvårigheter.Forskningsansatsen är fenomenologisk och det empiriska materialet kommer frånindividuella djupintervjuer med en rektor samt fem lärare som har mentorsuppdrag.Resultatet har analyserats ur ett ramfaktorteoretiskt perspektiv, och visar attmentorsuppdraget är otydligt. Det råder delade meningar om vad som är viktigt imentorsrollen. En funktion är dock entydig, att mentor utgör ett personligt stöd för sinaelever. Studien visar därmed att eftersom framgångar och misslyckanden imatematikstudier är starkt kopplat till självförtroende kan mentor vara av stor betydelseför elever i matematiksvårigheter. Ett hinder för detta upptäcktes dock då flera avmentorerna uttryckte en osäkerhet inför att stötta eleverna när det gäller studier imatematik till skillnad från alla andra ämnen.

  • Blom, Elin
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Matematiska stödinsatser: I glesbygdsskolor2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Denna fallstudie undersöker hur glesbygdsskolan utformar och organiserar stödinsatser för elever ibehov av särskilda utbildningsinsatser i matematik (SUM-elever). Det som studien fokuserar på är hurSUM-elever identifieras och kartläggs, vilka extra anpassningar och vilket särskilt stöd som utformasoch organiseras i matematik, arbetet med inkludering samt vilka arbetsuppgifter specialpedagogenhar i arbetet med matematiska stödinsatser. Studien bygger på intervjuer med lärare, specialpedagogoch rektor från två olika glesbygdsskolor i samma kommun samt deras kvalitetsredovisningar. Denteoretiska utgångspunkt som denna studie har är den fenomenologiska. Resultatet visar att skolornaupptäcker eleven i det dagliga arbetet. Lärarna anpassar den ordinarie undervisningen till SUMelevernavilket gör att särskilt stöd är ovanligt och stor andel av eleverna klarar nationella proven imatematik. Det råder en inkluderande miljö i glesbygdsskolan och specialpedagogensarbetsuppgifter är i till stor del att handleda och stötta lärarna.

  • Ljunggren, Joel
    Umeå University, Faculty of Science and Technology, Department of Science and Mathematics Education.
    Hur beskrivs genens funktion i läroböcker?: En studie av en gymnasie- och en universitetslärobok2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    I denna studie undersöks läroböckers beskrivning av begreppet gen. En gymnasielärobok och en universitetslärobok undersöktes med hjälp av en analysmetod utformad av Gericke och Hagberg för att identifiera olika modeller för att beskriva genens funktion. Genens funktion beskrivs med olika förklaringsmodeller men ingen tydlig distinktion görs mellan modellerna. Detta i koppling med att modellerna beblandas med varandra till hybridmodeller skapar inlärningssvårigheter. Detta eftersom att de olika modellerna beskriver genen på olika sätt och de kan därför rent logiskt inte blandas. Det är viktigt att lärare förstår att begreppsvariation och hybridiseringsmodeller förekommer i läroböcker för att kunna komplettera sin undervisning och lära elever om genen på bästa möjliga sätt.

  • Sironen, Tarja
    et al.
    Sane, Jussi
    Lokki, Marja-Liisa
    Meri, Seppo
    Andersson, Leif C.
    Hautala, Timo
    Kauma, Heikki
    Vuorinen, Sakari
    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.
    Ahlm, Clas
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Vaheri, Antti
    Fatal Puumala Hantavirus Disease: Involvement of Complement Activation and Vascular Leakage in the Pathobiology2017In: Open Forum Infectious Diseases, ISSN 2328-8957, Vol. 4, no 4, article id ofx229Article in journal (Refereed)
    Abstract [en]

    The case-fatality rate of hantavirus disease depends strongly on the causative hantavirus, ranging from 0.1% to 40%. However, the pathogenesis is not fully understood, and at present no licensed therapies exist. We describe fatal cases caused by Puumala hantavirus indicating involvement of complement activation and vascular leakage.

  • Public defence: 2018-02-23 09:00 Sal D, unodT9, by 1D, plan 9, NUS, Umeå
    Starnberg, Josefine
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Neurodevelopment and cardiovascular risk in 7-year old children born with marginally low birth weight2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Being born preterm (<37+0 gestational weeks) or with low birth weight (LBW, <2500 g) has been associated with a number of adverse health outcomes later in life. Most studied are cardiovascular and neurodevelopmental consequences in those born preterm and with very LBW (<1500 g). However, a majority of LBW children are born with a birth weight between 2000 and 2500 g, herein referred to as marginally LBW. The long-term risk profile for this substantially large group of children, is not known.

    Aim: The aim of this study was to explore cardiovascular risk and neurocognitive development in marginally LBW children born in Sweden.

    Method: This was originally a randomized controlled double-blinded trial aiming to explore the effects of iron supplementation in 285 children born with marginally LBW. The children were randomized to receive 0 mg/kg/day (placebo), 1 mg/kg/day or 2 mg/kg/day of iron supplements between 6 weeks and 6 months of age. As part of this observational follow-up study, 95 matched control children born with normal birth weight (NBW, 2501-4500 g) were recruited former to the first follow-up at 3.5-years. This thesis presents data from a follow-up at 7 years, including anthropometric data, blood pressure (BP), body composition (from a dual-energy X-ray absorptiometry) and laboratory markers of cardiovascular risk such as fasting glucose, insulin and lipid profile. Also, the children were tested using the validated neurocognitive tests WISC-IV (Wechsler Intelligence Scale for Children), Beery VMI (Beery-Buktenica developmental test of visual-motor integration) and TEA-Ch (Test of Everyday Attention for Children).

    Results: The marginally LBW children were thinner (15.1 vs 15.5 kg/m2, p=0.046), shorter (122.4 vs 124.9 cm, p=0.001) and had a higher prevalence of underweight (10.7 % vs 2.9 %, p=0.050) compared to their NBW peers. In addition, the LBW children had a significantly larger prevalence of high fasting insulin levels (>90th percentile of the control group). The subgroup of children born small for gestational age (SGA) also had a higher mean fasting glucose level, compared to NBW controls. There were no differences in prevalence of overweight or having an adverse lipid profile between the groups. The marginally LBW children who had received iron supplements, as part of the original intervention trial, had approximately 2 mmHg lower systolic BP, compared to the placebo group (p=0.026). The odds of having a high BP was lowered by 68 % (OR 0.32; CI 0.11-0.96) in the supplemented groups.

    The marginally LBW children had 3.1 points lower verbal comprehension IQ (p=0.004), 3.5 points lower Beery VMI (p=0.028) and poorer selective attention compared to those born with NBW.

    Conclusions: The marginally LBW children were thinner and shorter and they had an imbalanced glucose and insulin homeostasis, particularly those born SGA. Early iron supplements lowered systolic BP to a level similar to controls, suggesting a novel hypothesis regarding a long term protective effect against adverse programming. Finally, the children born with marginally LBW had poorer neurocognitive outcomes, prompting particular attention at school age.

  • Johansson, Kevin
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics. Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Utvärdering av en radarbaserad andningssensor2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In today's health care it is important to study and monitor vital parameters to diagnose respiratory diseases and have the ability to intervene in possible respiratory arrest. The XeThru X2M200 is new on the market and uses Ultra Wideband (UWB) radar technology to detect inhalation and exhalation. With this radar technology the product does not need to be in contact with the patient. An evaluation of the respiratory sensor has been desired and is being made to investigate the characteristics of the product. The main goals under consideration are the maximum distance between the respiratory sensor and person of interest, if the maximum distance is affected by the sensitivity, the precision of the respiratory sensor depend on the person's direction and whether different blankets prevent the measurement of inhalation and exhalation.


    To evaluate the characteristics of the respiratory sensor based on the main goals that have been set, measurements have been made on both test subjects and measurement objects. The results from the measurements have been shown graphically in XeThru Explorer (a software designed for the product). From the results obtained, the respiratory radar sensor appears to be useful to monitor breathing during sleep in a home environment. However, signal loss during certain periods is associated with the patient’s movement, which means that the respiratory sensor should not be used as intensive care monitoring or in similar departments, where the staff needs to quickly intervene in case of respiratory arrest. The breathing sensor can also lose signal without any movement. This is mainly caused by its positioning. To minimize the loss, the respiratory sensor should be placed without any object between the subject and respiratory sensor, and with the chest placed closes to the respiratory sensor. Placing the respiratory sensor in the ceiling has proven to be the most suitable position at sleep measurements. 

  • Weber, Christian
    et al.
    Fijalkowska, Barbara
    Ciecwierska, Katarzyna
    Lindblad, Anna
    Badura-Lotter, Gisela
    Andersen, Peter M.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
    Kuzma-Kozakiewicz, Magdalena
    Ludolph, Albert C.
    Lule, Dorothee
    Pasierski, Tomasz
    Lynoee, Niels
    Existential decision-making in a fatal progressive disease: how much do legal and medical frameworks matter?2017In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 16, article id 80Article in journal (Refereed)
    Abstract [en]

    Background: Healthcare legislation in European countries is similar in many respects. Most importantly, the framework of informed consent determines that physicians have the duty to provide detailed information about available therapeutic options and that patients have the right to refuse measures that contradict their personal values. However, when it comes to end-of-life decision-making a number of differences exist in the more specific regulations of individual countries. These differences and how they might nevertheless impact patient’s choices will be addressed in the current debate.

    Main text: In this article we show how the legal and medical frameworks of Germany, Poland and Sweden differ with regard to end-of-life decisions for patients with a fatal progressive disease. Taking Amyotrophic Lateral Sclerosis (ALS) as an example, we systematically compare clinical guidelines and healthcare law, pointing out the country-specific differences most relevant for existential decision-making. A fictional case report discusses the implications of these differences for a patient with ALS living in either of the three countries. Patients with ALS in Germany, Poland and Sweden are confronted with a similar spectrum of treatment options. However, the analysis of the normative frameworks shows that the conditions for making existential decisions differ considerably in Germany, Poland and Sweden. Specifically, these differences concern (1) the legal status of advance directives, (2) the conditions under which life-sustaining therapies are started or withheld, and (3) the legal regulations on assisted dying.

    Conclusion: According to the presented data, regulations of terminating life-sustaining treatments and the framework of “informed consent” are quite differently understood and implemented in the legal setting of the three countries. It is possible, and even likely, that these differences in the legal and medical frameworks have a considerable influence on existential decisions of patients with ALS.

  • Payne, Collin F.
    et al.
    Wade, Alisha
    Kabudula, Chodziwadziwa W.
    Davies, Justine I.
    Chang, Angela Y.
    Gomez-Olive, F. Xavier
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Berkman, Lisa F.
    Tollman, Stephen M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; INDEPTH Network, Accra, Ghana.
    Salomon, Joshua A.
    Witham, Miles D.
    Prevalence and correlates of frailty in an older rural African population: findings from the HAALSI cohort study2017In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 293Article in journal (Refereed)
    Abstract [en]

    Background: Frailty is a key predictor of death and dependency, yet little is known about frailty in sub-Saharan Africa despite rapid population ageing. We describe the prevalence and correlates of phenotypic frailty using data from the Health and Aging in Africa: Longitudinal Studies of an INDEPTH Community cohort.

    Methods: We analysed data from rural South Africans aged 40 and over. We used low grip strength, slow gait speed, low body mass index, and combinations of self-reported exhaustion, decline in health, low physical activity and high self-reported sedentariness to derive nine variants of a phenotypic frailty score. Each frailty category was compared with self-reported health, subjective wellbeing, impairment in activities of daily living and the presence of multimorbidity. Cox regression analyses were used to compare subsequent all-cause mortality for non-frail (score 0), pre-frail (score 1–2) and frail participants (score 3+).

    Results: Five thousand fifty nine individuals (mean age 61.7 years, 2714 female) were included in the analyses. The nine frailty score variants yielded a range of frailty prevalences (5.4% to 13.2%). For all variants, rates were higher in women than in men, and rose steeply with age. Frailty was associated with worse subjective wellbeing, and worse self-reported health. Both prefrailty and frailty were associated with a higher risk of death during a mean 17 month follow up for all score variants (hazard ratios 1.29 to 2.41 for pre-frail vs non-frail; hazard ratios 2.65 to 8.91 for frail vs non-frail).

    Conclusions: Phenotypic frailty could be measured in this older South African population, and was associated with worse health, wellbeing and earlier death.

  • Public defence: 2018-02-23 09:00 KBE301 (Lilla hörsalen), Umeå
    Blum, Kristin
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Targeted and untargeted analysis of organic contaminants from on-site sewage treatment facilities: Removal, fate and environmental impact2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    On-site sewage treatment facilities (OSSFs) are widely used all over the world to treat wastewater when large-scale sewage treatment plants (STPs) are not economically feasible. Although there is great awareness that the release of untreated wastewater into the environment can lead to water-related diseases and eutrophication, little is known about organic contaminants and their removal by OSSFs, environmental load and fate. Thus, this PhD thesis aims to improve the knowledge about treatment efficiencies in current OSSFs, the environmental impact and fate of contaminants released from OSSFs, as well as how biochar fortification in sand filter (soil beds) OSSFs might increase removal of these contaminants. State-of-the-art analytical techniques for untargeted and targeted analyses were used and the results evaluated with univariate and multivariate statistics.

    Environmentally-relevant contaminants discharged from OSSFs were identified using untargeted analysis with two-dimensional gas chromatography mass spectrometry (GC×GC-MS) and a MS (NIST) library search in combination with a prioritization strategy based on environmental relevance. A method was successfully developed for the prioritized contaminants using solid phase extraction and GC×GC-MS, and the method was also applicable to untargeted analysis. This method was applied to several studies. The first study compared treatment efficiencies between STP and soil beds and showed that treatment efficiencies are similar or better in soil beds, but the removal among the same type of treatment facilities and contaminants varied considerably. Hydrophilic contaminants were generally inadequately removed in both types of treatment facilities and resulted in effluent levels in the nanogram per liter range.

    Additionally, several prioritized and sometimes badly removed compounds were found to be persistent, mobile, and bioavailable and two additional, untargeted contaminants identified by the NIST library search were potentially mobile. These contaminants were also found far from the main source, a large-scale STP, at Lake Ekoln, which is part of the drinking water reservoir Lake Mälaren, Sweden. The study also showed that two persistent, mobile and bioavailable contaminants were additionally bioaccumulating in perch. Sampling for this study was carried out over several seasons in the catchment of the River Fyris. Parts of this catchment were affected by OSSFs, other parts by STPs. Potential ecotoxicological risks at these sites were similar or higher at those affected by STPs compared to those affected by OSSFs. Mass fluxes per capita were calculated from these levels, which were higher at STP-affected than at OSSF-affected sites in summer and autumn, but not in winter. Possibly, the diffuse OSSF emissions occur at greater average distances from the sampling sites than the STP point emissions, and OSSF-affected sites may consequently be more influenced by fate processes.

    The studies carried out suggested that there is a need to improve current treatment technologies for the removal of hydrophilic contaminants. Thus, the final study of this thesis investigated char-fortified sand filters (soil beds) as potential upgrades for OSSFs using a combination of advanced chemical analysis and quantitative structure-property relationship modeling. Removal efficiencies were calculated from a large variety of contaminants that were identified by untargeted analysis using GC×GC-MS and liquid chromatography ion mobility mass spectrometry as well as library searches (NIST and Agilent libraries). On average, char-fortified sand filters removed contaminants better than sand, partly due to an enhanced removal of several hydrophilic contaminants with heteroatoms. After a two-year runtime, sorption and particularly biodegradation must have contributed to the removal of these compounds.

    Generally, the combination of targeted and untargeted analysis has proven valuable in detecting a large variety of organic contaminants, as well as unexpected ones. The results imply that OSSFs have similar or better removal efficiencies, similar or lower environmental risks and similar or lower mass fluxes per capita, compared to STPs. Biochar fortification can improve the removal of organic contaminants in soil beds, but further research is needed to find technologies that reduce the discharge of all types of organic contaminants.

  • Public defence: 2018-02-23 13:00 Sal B, NUS 1D-Tandläkarhögskolan, Umeå
    Ljungberg, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Cardiovascular risk factors in aortic stenosis2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Aortic stenosis (AS) is the most common hemodynamic significant valvular heart disease and affects about 2% of the population. The incidence increases with age. When symptoms of the stenotic aortic valve disease eventually occur the 2-year mortality exceeds 50%. Aortic valve replacement (AVR) by surgery or by catheter intervention is the only known treatment. The causes of AS are only partly known, despite that the disease has been known since the beginning of 17th century. In younger individuals, a bicuspid valve is present in about 80% of the cases. The traditional cardiovascular risk-factors for ischemic heart disease have been linked to AS, and the histology of the stenotic aortic valve and the atherosclerotic plaques shares several features such as inflammation, lipid deposition and calcification. High levels of the lipoprotein Lp(a) has been linked to both atherosclerosis and AS, and a causal relation with AS is supported by Mandelian randomisation. End-stage renal disease is associated with increased risk of AS but if early impairment increases the risk is not known.

    Material and methods: We identified 799 patients with surgery for valvular heart disease and/or disease of the ascending aorta with a prior participation in one of three large population based health surveys in northern Sweden (Västerbotten Intervention Program [VIP], MONItoring Of trends and Determinants in CArdivascular Disease survey [MONICA], and the Mammary Screening Project [MSP]). For each case, four referents matched by age, gender, type and date of survey, and geographical area were randomly selected. From the health surveys, data on cardiovascular risk-factors and health history as well as measurements of anthropometry, blood pressure, glucose and cholesterol levels were retrieved. Each case was carefully validated and data from pre- and perioperative assessments were collected. The presence of coronary artery disease (CAD) was determined from the preoperative coronary angiogram. Apolipoproteins B and A1, Lp(a), creatinine and cystatin C were analysed in samples obtained at the initial survey. As this is a matched case-referent study where cases and referents had the same follow-up duration within strata, logistic regression using the conditional maximum likelihood routine designed for matched analysis was used to estimate odds ratios (ORs) with 95% confidence intervals. Studied variables were tested in uni- and multivariable models.

    Results: Paper 1: Of the identified 799 cases with questionnaires, 322 were primarily operated for AS, 91 for aortic regurgitation, 181 for mitral regurgitation, 131 for disease of ascending aorta, 52 for CAD (and for concomitant valvular or aortic disease). The remaining 22 had various indications for valvular heart surgery and were excluded. Altogether 38% of patients were women. Aortic stenosis: Hypertension (OR 1.87 [1.37–2.54]), diabetes (OR 1.78 [1.01–3.11]) and total cholesterol (OR 1.64 [1.07–2.49]) were associated with future AVR. After exclusion of concomitant CAD, none of the these risk-factors remained significant. Aortic regurgitation: None of the cardiovascular risk-factors was associated with increased risk for aortic regurgitation demanding surgery, whereas high levels of cholesterol were associated with reduced risk for surgery (OR 0.29 [0.12–0.71]). Mitral regurgitation: High levels of cholesterol associated with surgery for mitral regurgitation (OR 1.74 [1.01–3.00]), but not in those without CAD. Disease of the ascending aorta: Hypertension (OR 2.42 [1.44–4.06]) and previous smoking (OR 1.97 (1.12–3.49]) related to increased risk for surgery of the ascending aorta, whereas diabetes was inversely associated with surgery (OR 0.09 [0.01–0.73]). Excluding CAD, only diabetes remained protective (OR 0.24 [0.07–0.81]). Paper 2: 322 patients underwent AVR, and 70 had surgery before the age of 60 years and 252 had surgery after 60 years of age. After exclusion of patients with CAD, 49 and 82 patients remained in these age groups. Arterial hypertension associated with future AVR in those operated before the age of 60 years regardless of concomitant CAD or not (OR 3.40 [1.45–7.93] and OR 5.88 [1.46–23.72]). In those older than 60 years at surgery and with concomitant CAD, all traditional cardiovascular risk factors associated with surgery, but in those without concomitant CAD, only impaired fasting glucose (IFG) was associated with surgery (OR 3.22 [1.19–8.76]). Paper 3: 336 patients having surgery for AS. Lipoprotein(a) [Lp(a)] was independently associated with surgery in those with concomitant CAD (OR 1.29 [1.07–1.55]), but not in those without CAD. A high Apo B/A1 ratio was associated with surgery in patients with CAD (OR 1.43 [1.16–1.76]), but not in those without. Paper 4: The same cohort as in paper 3 was examined. Renal function was estimated by the ratio between glomerular filtration rates (eGFR) obtained from cystatin C and creatinine, and a low ratio indicates early impairment of renal function (“shrunken pore syndrome”). A high ratio independently associated with lower risk for future AVR (OR 0.84 [0.73–0.97]). Protective effect was seen in women but not in men (0.74 [0.60–0.92] and 0.93 [0.76 [0.76–1.13], respectively). After stratification for CAD, the association remained significant in women with CAD but not in men with CAD (0.60 [0.44–0.83] and 0.96 [0.76 [0.75–1.23], respectively).

    Conclusion: The traditional cardiovascular risk-factors associated with future surgery for valvular heart disease and for surgery of the ascending aorta, however with a clear difference if there was concomitant CAD or not. Arterial hypertension was a major risk factor for surgery for AS in younger patients without CAD, whereas impaired fasting glucose (IFG) associated with surgery in elderly patients without CAD. High levels of Lp(a) and a high Apo B/A1 ratio were associated with future AVR only in patients with concomitant CAD. Similarly, early renal impairment expressed as low ratio of eGFR by cystatin C and by creatinine (“shrunken pore”) associated with future AVR.

  • Public defence: 2018-02-23 10:00 Hörsal E, Humanisthuset, Umeå
    Fredriksson, Daniel
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Musiklandskap: musik och kulturpolitik i Dalarna2018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In this thesis, I study how conditions for music-making can be developed, maintained and challenged through government support processes in the Swedish region Dalarna. The research questions focus on the ways music, policy and governance relate to each other, what kinds of musicians and ways of making music are favored in these relations, and the agency and meaning of place. The study is made through participant observation of musical events, cultural policy meetings, and the everyday practice of cultural policy officials; interviews with musicians, organizers and cultural policy officials; cultural policy documents as well as musicians’ and organizers’ public documents such as concert posters and websites.

    The musical landscape of Dalarna is summarized as a complex web with pathways that reach far beyond the geographical borders of the region. The cultural cooperation model works as a hierarchy from center to periphery, from the national government, through agencies, regional government, musical institutions and organizers, musicians and audiences. We can analyze all these practices as being part of music, as musicking. But we could also describe them another way, where the practice of cultural policy is dependent on and conditioned by the musical practices it is set to govern. In this way, musicians are always in some way also creating policy.

    I discuss genre hierarchies and further argue that music can, or should, not always be motivated by its effects on regional development or its social impact, it also needs to be allowed to be unhealthy and unprofitable. When we support music, we should be aware that it can be a hobby as well as a business, a serious artistic endeavor as well as play. And more often than not, music is all of these things at the same time.

  • Olofsson, Stina
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Designing interfaces for the visually impaired: Contextual information and analysis of user needs2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This thesis explores how to design for the visually impaired. During the course of work, a literature study and interviews with blind and visually impaired people were conducted. The objective was to investigate what contextual information is wanted in new and unfamiliar spaces outside their home. The interviews also explored how they experience digital tools they are using today and what they think of the possibilities of voice and other user interfaces. The main finding from the study is that there are indications that multimodal interfaces are preferred. The interface should combine voice, haptic and graphics since the participants wanted to interact in different ways depending on functionality and context. Three main problem areas were identified, navigation, public transportation and shopping. Another result was that when developing for the visually impaired it should always be tested on people with a wide variation of vision loss to find the correct contextual information. 

  • Forsberg, Jacqueline
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Kreativitet - en attraktiv förmåga på framtida arbetsmarknaden: svenska grundskolelärares föreställningar om skolelevers kreativitet och kreativa beteende jämförda med amerikanska lärares2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Majoriteten av Sveriges arbetskraft befinner sig i yrken med hög risk att automatiseras inom kommande ett eller två decennier. Det är därför av största vikt att skolan förbereder den framtida arbetskraften för den omställning som sannolikt väntar arbetsmarknaden och förser eleverna med den kunskap och förmågor som de behöver. Kreativitet spås bli en av de stora tillgångarna på arbetsmarknaden. Därför är lärarnas egna implicita teorier om kreativitet intressant att studera eftersom de teorierna kommer att influera elevernas kreativa utveckling i klassrummet. Den här studien undersöks 65 svenska lärares attityder och underliggande föreställningar om kreativitet och kreativt beteende. Resultaten av enkätundersökningen jämförs sedan med en liknande amerikansk studie och fann både signifikanta skillnader mellan hur de svarat och att svenska lärare visade på en bred förståelse för kreativitet men att de missat den kanske viktigaste komponenten i kreativitet, nämligen originalitet.

  • Johansson, Lisa
    Umeå University, Faculty of Arts, Department of culture and media studies.
    "Vi finns några rader bort": En kvantitativ och netnografisk studie av Viasat Sport och C More Sports twitterkonversationer2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this essay was to examine conversations between two Swedish organizations and their customers to explore how online meetings and dialogs can affect organisations image and relationships between customers and organisations. Viasat and C More are both live sport broadcasters with online play services. The study was motivated by three research questions: (1) How high response rates do the company's Twitter accounts have on positive or negative feedback and questions? (2) What strategies do the companies twitter accounts apply to customers who experience problems with with their live broadcasts? (3) What appeal and tonality does the company's twitter accounts have?

    Previous research offers a descriptive account of interaction and interpersonal communication, communication strategies, relationship building between organizations and their customers on social media and effects of relationship management and relationship building in social media. The theoretical framework consists of theories about relationship building and management, interpersonal communication and crisis communication. A quantitative content analysis was implemented to analyse in what extent the chosen companies respond to their customers during September 16 2017 and November 21 2017. Data collected was 734 tweets, which resulted in 406 twitter conversations. A qualitative analysis was conducted with methodological tools form nethnography and social network analysis. The findings showed that both companies answered the majority of received tweets. Patterns and themes were found in the qualitative study that showed both differences and similarities in C More and Viasat’ way of interacting. Viasat often has the last word, and end conversations more often than C More did. Both companies act accordingly to Benoits theories about image restoration.

    Findings also suggest that both companies risk their reputations and images by engaging in dialog. Interaction and commitment is also the key to build and nurture customer and organisation relationship in order to gain positive outcomes.

  • Wedérus, Thomas
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Changing language, changing personality: Swedish bilinguals on the effects of speaking English2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Language influences not only the world-view but also the self-perceived personality of its users. One explanation for this is that the language used functions as a cue activating different sets of cultural frames within its users – a phenomenon known as Cultural Frame Shifting (CFS). Limited previous research on language and personality warrants exploring this topic further. The current study employed a qualitative design and semi-structured interviews to explore the views and experiences of 12 Swedish-English bilinguals. Results showed self-perceived changes in personality and extraversion, but also the sentiment of emotions being easier to express in English than in Swedish. Possible practical applications could include therapeutic work and treatment of social anxiety and public speaking anxiety.

  • Jansson, Johan
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Economical optimization of steam data for recovery boilers2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Pulp and paper mills are high power consuming industries. Pulp and integrated mills produce power via steam turbines in recovery boilers. Due to high power prices and the fact that biomass combusted in the recovery boiler is considered as green energy, there is today a desire to always increase the power generation when investing in new recovery boilers. In order to increase power output from the steam turbine the steam data (i.e temperature and pressure) needs to be increased. With higher steam temperature follows a higher risk of corrosion due to the non process element potassium in the boiler fuel. The uncertainties of high temperature corrosion and the unpredictable environment in the furnace makes it difficult to design recovery boilers. This results in higher investment cost and could lead to less profit for the mill buying the boiler. The question then stands whether the revenue obtained from the higher power generation, is higher than the investment made for the upgrade in order to produce the higher steam data over a certain time. And more specifically what steam data will be the most economical, when comparing revenue from power generation with investment cost?

    In this study, together with ÅF Industry AB, four boilers with different steam data (Boiler A: 38.5 bar, 450°C; Boiler B: 92 bar, 480°C; Boiler C: 106 bar, 500°C; Boiler D: 115 bar, 515°C) were compared. The boilers were compared for four potassium levels: 1.0wt%, 1.5wt%, 2.5wt%, 3.5wt%. And two values of power were used, 300 SEK/MWh and 700 SEK/MWh. The marginal differences between the boilers were: the amount of material used in the superheaters in order to produce different steam data; the type of material used in the superheaters and the furnace; whether an ash-treatment system was needed (in order to purge potassium from the process); the turbines and generators; whether a feed water demineralization equipment was needed; the yearly cost for make-up chemicals (due to usage of an ash-treatment system) and the amount of power generated. The boilers investment cost and net yearly revenue were compared in order to determine the marginal pay-off in years.

    The most economical choice of boiler for the different potassium levels for 300 SEK/MWh: 1.0wt%, Boiler D; 1.5wt%, Boiler C; 2.5wt%, Boiler B; 3.5wt%, Boiler D (A). And for 700 SEK/MWh: 1.0wt%, Boiler D; 1.5wt%, Boiler C; 2.5wt%, Boiler D (B); 3.5wt%, Boiler D. The conclusion in this thesis was that the deciding factor is whether the boiler is in need of an ash-treatment system. Higher steam data is preferable as long as ash-treatment can be avoided. However, when comparing two boilers with ash-treatment the one with higher steam data is more feasible. Low steam data, such as boiler A, will never be feasible, regardless of potassium level and value of power.

  • Gaioshko, Dariia
    et al.
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Business Administration.
    Armasheva, Irina
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Business Administration.
    Impact of individual virtual competence on work outcomes in virtual IT projects2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    As the world becomes more globalized and information technology develops more rapidly, companies are increasingly exploring the benefits of using virtual teams to work on projects that allow them to achieve their objectives. This phenomenon though keeps raising questions regarding the best practices in selection and management of employees whose work would be mostly conducted in virtual settings instead of traditional co-located teams. We have investigated the conditions of virtuality, identifying its benefits and challenges and came up to a conclusion that in order to be an effective virtual team member, a special set of skills and abilities may be needed. The central question of this study is: What individual knowledge, skills, and abilities (KSAs) that comprise virtual competence (IVC) should the virtual project team members possess, which could contribute to overcoming challenges of the virtual environment? To answer this question a variety of theories on a virtual team, professional competencies, team management and project management were examined. Quantitative research has been utilized to measure the relationship between the conceptualised construct of individual virtual competence and individual work outcomes in a project that is conducted by distributed global teams. Data on the skills of the individuals conducting their work in virtual IT project settings were collected with an online survey which was distributed among the chosen sample. The results of the survey indicated that the most important characteristics that contribute to overcoming challenges of virtuality are self-efficacy, social, and media skills, which also have a positive reflection on the individual work performance and job satisfaction. There are also interesting results regarding the effect of demographic characteristics on variables when compared with the results from the similar study conducted with a different group of respondents. In the end, a revised model of individual virtual competence is proposed that can shed some light on its impact on job performance and job satisfaction of an individual working in virtual project teams.

  • Smeds, Daniel
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Lilla huset på Jæren: Makrofossilanalyser av prover från en möjlig silversmejda2017Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This bachelor thesis explores the agricultural landscape in southwestern Norway during the Viking Age. Based on macrofossil samples from the site Sømme in Rogaland fylke the prehistoric use of cultivated and non-cultivated plants are analysed and compared to previous studies and the state of knowledge. The thesis also investigates the potential social status of the site Sømme, the silversmithy and the smith. The results suggest Hulled barley (Hordeum vulgare) was cultivated nearby based on charred seeds found in postholes of the house. Nitrogen demanding plants, such as Fat-hen (Chenopodium album), were also found, which suggests an agricultural practise that involved manuring. The social status of Sømme and the silversmith is likely to have been quite high. People in graves with smithy tools in Norway are considered to have held a high social status. In Joa, close to Sømme, is one such grave. The smith has most likely been in direct contact with the ruling class when crafting jewellery.

  • Persson, Sofie
    et al.
    Dahlquist, Gisela
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Gerdtham, Ulf-G.
    Carlsson, Katarina Steen
    Why childhood-onset type 1 diabetes impacts labour market outcomes: a mediation analysis2018In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 61, no 2, p. 342-353Article in journal (Refereed)
    Abstract [en]

    Aims/hypothesis: Previous studies show a negative effect of type 1 diabetes on labour market outcomes such as employment and earnings later in life. However, little is known about the mechanisms underlying these effects. This study aims to analyse the mediating role of adult health, education, occupation and family formation.

    Methods: A total of 4179 individuals from the Swedish Childhood Diabetes Register and 16,983 individuals forming a population control group born between 1962 and 1979 were followed between 30 and 50 years of age. The total effect of having type 1 diabetes was broken down into a direct effect and an indirect (mediating) effect using statistical mediation analysis. We also analysed whether type 1 diabetes has different effects on labour market outcome between the sexes and across socioeconomic status.

    Results: Childhood-onset type 1 diabetes had a negative impact on employment (OR 0.68 [95% CI 0.62, 0.76] and OR 0.76 [95% CI 0.67, 0.86]) and earnings (−6%, p < 0.001 and −8%, p < 0.001) for women and men, respectively. Each of the mediators studied contributed to the total effect with adult health and occupational field accounting for the largest part. However, some of the effect could not be attributed to any of the mediators studied and was therefore likely related to other characteristics of the disease that hamper career opportunities. The effect of type 1 diabetes on employment and earnings did not vary significantly according to socioeconomic status of the family (parental education and earnings).

    Conclusions/interpretation: A large part of the effect of type 1 diabetes on the labour market is attributed to adult health but there are other important mediating factors that need to be considered to reduce this negative effect.

  • Blom, Maria
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Förekomst och urlakning av PAH längs med väg 805, Jokkmokks kommun2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to determine if any amount of PAH (Polycyclic aromatic hydrocarbons) was leaching from the paved road surface of road 805 in Jokkmokk municipality. The study was also meant to determine which factors affected the leaching of PAH in the studied area.The surveyed road was divided into eight sections. Groundwater pipes were inserted into drilled holes, three in each section. Samples from soil, water and asphalt were collected from each section and analyzed for its content of PAH. The groundwater level was measured before each sampling. Some soil samples were analyzed for TOC (total organic carbon) and all the water samples for DOC (dissolved organic carbon). The results showed that PAH was leaching in very different amounts. There was a similarity in the amount of coal tar in the road surface and the amount of PAH in most sections. Although in one section the asphalt sample showed low amount of coal tar but high amount of PAH in the soil- and water samples. This anomaly could not be explained - the assumption was that the sampling had been incorrectly handled. The pollution in the surveyed area is assumed to be caused by the road surface and tire wear. Further studies are necessary to determine with certainty how PAH is leaching in different conditions and with different road pavements.

  • Nyman, Hildur
    Umeå University, Faculty of Arts, Department of language studies.
    Engelskan i Sverige: Attitydundersökning av engelskan i svenskan och i det svenska samhället2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study is to examine attitudes towards the use of English in the Swedish language, in Swedish society in general, and in Swedish academia. Mainly a quantitative method was used to examine these attitudes. An online questionnaire was constructed, consisting of different statements regarding the current linguistic situation in Sweden. It also contained a section where the participants had to choose between using an English word or a corresponding Swedish word. The study indicates that people tend to choose the English word instead of the corresponding Swedish word. In addition, people answering this questionnaire seem to be more worried about the use of English in the Swedish language than they are about the use of English in Swedish society in general and in academia. This study also shows that the younger you are, the more positive you tend to be towards the usage of English.

  • Edberg, Christina
    Umeå University, Faculty of Social Sciences, Department of Education.
    Rektors perspektiv på det specialpedagogiska uppdraget: Hur rektorer förhåller sig till skolans specialpedagogiska uppdrag2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]


    Denna rapport handlar om åtta rektorers tankar kring skolans specialpedagogiska uppdrag. De intervjuade rektorerna ansvarar alla för grundskolans tidigare år, vilket innebär antingen ansvar för årskurs F-3 alternativt för årskurs F-6. Informanterna kommer från tre olika kommuner samt har olika lång erfarenhet från rektorsyrket. Studien är en kvalitativ undersökning och resultat och analys bygger på semistrukturerade intervjuer. I resultatet kan bland annat utläsas att rektorer tar stort ansvar för skolans specialpedagogiska uppdrag samtidigt som en formell kompetens för uppdraget saknas hos många rektorer. Vidare har rektorerna en god vilja att samarbeta med specialpedagog samt har tillit till -och stort förtroende för specialpedagogens kompetens. Rektorer upplever sig också bli avlastade av specialpedagog inom det specialpedagogiska området och känner såväl förtroende för- liksom ett stöd i den kompetens specialpedagogen besitter. Det framkommer också att rektorer ser en tydlig skillnad på specialpedagog och speciallärare samt anser att tillgång till båda professionerna såväl som ett samarbete dem emellan, bidrar till goda förutsättningar för skolans specialpedagogiska arbete och utveckling. I analysen att försöka tolka och förstå förhållandet mellan rektorsrollen och det specialpedagogiska uppdraget, utgår studien analys ifrån ett systemteoretiskt perspektiv.

  • Farshidi, Azadeh
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    A Secondary Task Test for Evaluating Cognitive Load of MRP Pilots2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Remotely-controlled technologies are no longer limited to military applications, such as unmanned military airborne weapons or explosive diffuser robots. Nowadays we can see more and more of remotely controlled devices used as medical equipment, toys, and so forth. One of the most recent areas of interest is robotic telepresence, also known as Mobile Robot Presence (MRP), which provides the ability to interact socially and professionally with other people and even objects in remote locations. One of the known issues with using remotely-controlled devices is the cognitive overload which their operators (pilots) experience and MRP pilots are no exception. However, despite vast research on different ways to address this in military or medical scenarios, little has been done regarding MRPs. This thesis study aims to make a contribution in closing that gap by suggesting a method, developing a prototype implementing it; then conducting an empirical assessment of the method and the prototype as a part of a broader study on MRP, supported by Swedish Research Council. I have suggested a method comprised of a Secondary-task (ST) method and Subjective Rating Scales (SRS), in which the latter act as an evaluation method for the former. Both of them were used in an overarching study in search for the best control device amongst four chosen devices. I collected and analyzed secondary task performance data (e.g. response time, error rates), subjective user ratings, explicit rankings, and observations recordings. My analysis of the collected data shows that using a monitoring and response face recognition secondary task is a plausible method for the assessment of MRP pilot’s cognitive load.

  • Rodríguez, Gabriel Jesús
    et al.
    Córdoba-Doña, Juan Antonio
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Consejería de Salud de la Junta de Andalucía. Delegación Territorial de Cádiz, Espana.
    Escolar-Pujolar, Antonio
    Aguilar-Diosdado, Manuel
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Familia, economía y servicios sanitarios: claves de los cuidados en pacientes con diabetes y amputación de miembros inferiores. Estudio cualitativo en Andalucía: [Family, socioeconomic status and health services: Clues to health care in diabetic patients with lower limb amputations in Andalusia. A qualitative study]2017In: Atención Primaria, ISSN 0212-6567, E-ISSN 1578-1275Article in journal (Refereed)
    Abstract [en]

    Aim: To examine the experience of diabetic care in patients undergoing lower limb amputation.

    Design: A qualitative study using the phenomenological approach.

    Setting: Cadiz Health District.

    Participants: A total of 16 patients (11 men and 5 women) diagnosed with diabetes mellitus type 2 and with non-traumatic lower limb amputation.

    Methods: Semi-structured interviews were performed, followed by a content analysis according Graneheim and Lundman.

    Results: Four categories were identified: 1. The family is the cornerstone for diabetic care. 2. The socio-economic and working conditions determine the quality of self-care. 3. The patient-health professional interaction facilitates patient care. 4. Limitations in the provision of health services.

    Conclusion: Family, economic and working conditions, along with health system-related factors are the most important elements in the care of patients with diabetes and amputations. Social, economic and working conditions determine diabetic complications. In order to enhance health care impact on the prevention of diabetes mellitus complications, health system policy makers must take these facts seriously into consideration and in a more personalised manner.

  • Bensch, Suna
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science. Department of Computing Science.
    Hellström, ThomasUmeå University, Faculty of Science and Technology, Department of Computing Science. Department of Computing Science.
    Proceedings of Umeå’s 22nd Student Conference in Computing Science (USCCS 2018)2018Conference proceedings (editor) (Other academic)
  • Jonsson, Henrik
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Optimization of Sub Frames Design: Designing of new sub frame designs with CAD and analysing their strengths with FEA.2017Independent thesis Basic level (professional degree), 180 HE creditsStudent thesis
    Abstract [en]

    Ålö is a supplier in the agricultural Machinery Industry. They develop and manufacture mainly front-end loaders and they got other products groups too. One of the other product groups consists of the sub frames. The sub frames are the mechanical components that are required for the front loaders to fit to different tractors. The product integrations section, that develops the sub frames, wants to investigate the strengths of other concepts of designs than their traditional ones.

    New models of sub frames were created by using Solid Edge which is a CAD-system. The models’ strengths were simulated by using Femap which is its built-in FEM-tool for engineering analysis. The FE-analysis were compared to the FE-analysis of the original sub frames.


    A total of three design changes were investigated. One set of sub frame was investigated with a new concept of design. Another set of sub frame was investigated with the new concept of design and it was also investigated with thinner plates.


    What was concluded is that the design change with thinner plates resulted in a weight reduction of 5 kg but at the cost of higher levels of stress. To verify that the sub frame will last its desired life span prototypes should be physically tested by fatigue test. The new design concept resulted in too big increases of stress levels on one set of sub frame and on another set of sub frame it resulted in small differences of stress but with a weight increase.

  • Bäckström, Tove
    Umeå University, Faculty of Science and Technology, Department of Applied Physics and Electronics.
    Large digital screen as a corporate communication channel: Enhancing the dissemination of information, administration and interaction2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Public areas are more and more equipped with digital screens that are used to inform or promote a particular product. This is a way to communicate with the people on that area. The idea is to get people's attention, make them read and take in information and possibly buy the product that is marketed. This type of digital display is called digital signage and can also be used as an information channel of a company where information directed to employees and visitors is displayed. CGI Östersund has a screen placed in their office that works as such an information channel.

    This thesis is about investigating and analyzing the current presentation and creating a new solution with a custom interface that will be more effective and engage more people.

    The new solution is interactive and clickable with the help of a mouse. A user study has been done using a Kinect sensor to see how many people are watching the screen, how long they look at the screen and from what distance. This data was also supplemented by a survey sent to the employees at CGI Östersund. The result of the user study shows that there was no significant difference between the previous solution and the new one. This may be due to two main reasons: the lack of time in which the experiment was performed and the location of the digital screen that is not currently optimal.

  • Rayat, Pooya
    Umeå University, Faculty of Social Sciences, Department of Education.
    E-sport in i idrottsrörelsen?: Idrottsföreningar och deras uppfattningar om och förhållningssätt till framtida e-sport i den egna verksamheten2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    With the rapid expansion of e-sports, the e-sports federation in Sweden seeks legitimacy and support in their efforts to gain recognition as a real sport. With this background, a bill has been proposed to the National Sports Association of Sweden to include the movement as a member of the organization. Thus, granting the official legitimacy and support that the e-sports movement seeks as a sport. The purpose if this study was to examine how sports clubs perceive e-sports to see if they think it has a place within the context of a traditional sports club. The method used to retrieve this data was semi-structured interviews with key decision makers within the sports clubs randomly chosen within a specific county. The purpose was examined by breaking it down into three key questions, which were then used as headlines in the result. The results of the study are that there is a willingness among most of the sports clubs to begin the work of integrating e-sports within the club, but there were requirements. One of them was drift from the starters so that the board of direction can keep doing what they do, thus they want the e-sports section to operate on its own. Another requirement was that those who wish to start the e-sports sections know the economic parameters, preferably. The less enthusiastic leaders who did not wish to integrate e-sports still wished to learn more about e-sports as they saw that it will keep expanding, these leaders were however somewhat doubtful of how an e-sports club could be integrated into a sports club and what benefits there might be for both parties in this cooperation.

  • Bladh, Ylva
    Umeå University, Faculty of Arts, Department of language studies.
    I Mean, You Look Sexy.: Differences in perception of a male and female character amongst students in Seychelles2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study examines the difference in perception of a character in a male and a female guise amongst university students in Seychelles, and elaborates on how such difference reflects gender hierarchies in general. The students were given a questionnaire consisting of five scenarios, in which two or more characters communicated, and then answered questions about their perception of the characters. The character’s gender mattered to how he/she was perceived for at least one of the characters in the dialogue, in four of the scenarios, and in one scenario there was no difference in perception of the male guise and the female guise. The biggest difference in perception of a male guise and female guise was in a scenario in which one character commented on his/her colleague’s appearance. The male guise was perceived more negatively both when commenting and when rejecting such comment. However, the space in which the interaction took place, and the relationship between the characters influenced how they were perceived. So, when a group of people commented on an unknown person’s appearance, on the beach, the respondents perceived both the male guise and the female guise of the character similarly both as commenters and as receivers of the comment. 

  • Oudin, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Occupational and Environmental Medicine, Lund University, Medicon Village, Lund, Sweden.
    Åström, Daniel Oudin
    Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Asplund, Peter
    Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden..
    Steingrimsson, Steinn
    Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden; CELAM - Centre for Ethics, Law and Mental Health, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Szabo, Zoltan
    Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Carlsen, Hanne Krage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Psykiatri Affektiva, Sahlgrenska University Hospital, Gothenburg, Sweden; Environment and Natural Resources, University of Iceland, Reykjavík, Iceland; Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden.
    The association between daily concentrations of air pollution and visits to a psychiatric emergency unit: a case-crossover study2018In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 17, article id 4Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Air pollution is one of the leading causes of mortality and morbidity worldwide. Experimental studies, and a few epidemiological studies, suggest that air pollution may cause acute exacerbation of psychiatric disorders, and even increase the rate of suicide attempts, but epidemiological studies on air pollution in association with psychiatric disorders are still few. Our aim was to investigate associations between daily fluctuations in air pollution concentrations and the daily number of visits to a psychiatric emergency unit.

    METHODS: Data from Sahlgrenska University Hospital, Gothenburg, Sweden, on the daily number of visits to the Psychiatric emergency unit were combined with daily data on monitored concentrations of respirable particulate matter(PM10), ozone(O3), nitrogen dioxides(NO2) and temperature between 1st July 2012 and 31st December 2016. We used a case-crossover design to analyze data with conditional Poisson regression models allowing for over-dispersion. We stratified data on season.

    RESULTS: Visits increased with increasing PM10 levels during the warmer season (April to September) in both single-pollutant and two-pollutant models. For example, an increase of 3.6% (95% Confidence Interval, CI, 0.4-7.0%) was observed with a 10 μg/m3 increase in PM10 adjusted for NO2. In the three-pollutant models (adjusting for NO2 and O3 simultaneously) the increase was 3.3% (95% CI, -0.2-6.9). There were no clear associations between the outcome and NO2, O3, or PM10 during the colder season (October to March).

    CONCLUSIONS: Ambient air particle concentrations were associated with the number of visits to the Psychiatric emergency unit in the warm season. The results were only borderline statistically significant in the fully adjusted (three-pollutant) models in this small study. The observation could be interpreted as indicative of air pollution as either exacerbating an underlying psychiatric disorder, or increasing mental distress, even in areas with comparatively low levels of air pollution. In combination with the severe impact of psychiatric disorders and mental distress on society and individuals, our results are a strong warrant for future research in this area.

  • Bohlin, Katja Stenstrom
    et al.
    Ankardal, Maud
    Nüssler, Emil
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Lindkvist, Håkan
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Milsom, Ian
    Factors influencing the outcome of surgery for pelvic organ prolapse2018In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 29, no 1, p. 81-89Article in journal (Refereed)
    Abstract [en]

    Pelvic organ prolapse (POP) surgery is a common gynecological procedure. Our aim was to assess the influence of obesity and other risk factors on the outcome of anterior and posterior colporrhaphy with and without mesh. Data were retrieved from the Swedish National Register for Gynecological Surgery on 18,554 women undergoing primary and repeat POP surgery without concomitant urinary incontinence (UI) surgery between 2006 and 2015. Multivariate logistic regression analyses were used to identify independent risk factors for a sensation of a vaginal bulge, de novo UI, and residual UI 1 year after surgery. The overall subjective cure rate 1 year after surgery was 80% (with mesh 86.4% vs 77.3% without mesh, p < 0.001). The complication rate was low, but was more frequent in repeat surgery that were mainly mesh related. The use of mesh was also associated with more frequent de novo UI, but patient satisfaction and cure rates were higher compared with surgery without mesh. Preoperative sensation of a vaginal bulge, severe postoperative complications, anterior colporrhaphy, prior hysterectomy, postoperative infections, local anesthesia, and body mass index (BMI) 30 were risk factors for sensation of a vaginal bulge 1 year postsurgery. Obesity had no effect on complication rates but was associated increased urinary incontinence (UI) after primary surgery. Obesity had no influence on cure or voiding status in women undergoing repeat surgery. Obesity had an impact on the sensation of a vaginal bulge and the presence of UI after primary surgery but not on complications.

  • Guinea Diaz, Manuel
    et al.
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Hernandez-Verdeja, Tamara
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Kremnev, Dmitry
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Crawford, Tim
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Dubreuil, Carole
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Strand, Åsa
    Umeå University, Faculty of Science and Technology, Umeå Plant Science Centre (UPSC).
    Redox regulation of PEP activity during seedling establishment in Arabidopsis thaliana2018In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 9, article id 50Article in journal (Refereed)
    Abstract [en]

    Activation of the plastid-encoded RNA polymerase is tightly controlled and involves a network of phosphorylation and, as yet unidentified, thiol-mediated events. Here, we characterize PLASTID REDOX INSENSITIVE2, a redox-regulated protein required for full PEP-driven transcription. PRIN2 dimers can be reduced into the active monomeric form by thioredoxins through reduction of a disulfide bond. Exposure to light increases the ratio between the monomeric and dimeric forms of PRIN2. Complementation of prin2-2 with different PRIN2 protein variants demonstrates that the monomer is required for light-activated PEP-dependent transcription and that expression of the nuclear-encoded photosynthesis genes is linked to the activity of PEP. Activation of PEP during chloroplast development likely is the source of a retrograde signal that promotes nuclear LHCB expression. Thus, regulation of PRIN2 is the thiol-mediated mechanism required for full PEP activity, with PRIN2 monomerization via reduction by TRXs providing a mechanistic link between photosynthetic electron transport and activation of photosynthetic gene expression.

  • Krenek, Alexander
    et al.
    Austrian Institute of Economic Research (WIFO).
    Sommer, Mark
    Austrian Institute of Economic Research (WIFO).
    Schratzenstaller, Margit
    Austrian Institute of Economic Research (WIFO).
    Sustainability-oriented Future EU Funding: A European border carbon adjustment2018Report (Refereed)
    Abstract [en]

    The need to reform EU funding and recent political developments such as Brexit and the withdrawal from the United States from the 2015 Paris climate agreement could revitalize the debate about the introduction of border carbon adjustments (BCA) for the European emission trading system (ETS). The introduction of a BCA would allow the EU to phase out current carbon leakage provisions of the ETS and to auction off all emission allowances, thus rendering the ETS a more effective unilateral tool to price and reduce carbon emissions. By using a dynamic new Keynesian (DYNK) model, we estimate that a BCA for the ETS would generate substantial and stable revenues. Given different assumptions about the development of the carbon intensity of non-EU production and different BCA designs we find that estimated revenues would suffice to finance between a third and all of current EU expenditures by the year 2027, thus allowing Member States to reduce their current contributions to the EU budget accordingly. Administered at the EU borders a BCA would represent a sustainability-oriented instrument to finance the EU allowing EU Member States to cut more distortionary taxes such as those on labour, thereby increasing growth- and employment-friendliness of taxation. The proposed measure could thus contribute to tackle both environmental and fiscal challenges currently facing the EU.

  • Wilhelmsson, Sara
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    The relationship between coach and peer leadership and team cohesion within elite Swedish floorball players2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The present study aimed to (1) examine the direct relationship between coach transformational leadership and peer transformational leadership on team cohesion within elite Swedish floorball players, (2) examine potential differences between coach leadership behaviours and peer leadership behaviours on team cohesion, and (3) examine gender differences in perceived coach leadership behaviours, peer leadership behaviours and team cohesion.  A cross-sectional design was used and data was collected through self-assessment questionnaires of transformational leadership and team cohesion from 87 elite floorball players (59 females, 28 males). Age varied from 16 to 33 years (Mage = 22.4, SD = 3.87). Regression analyses revealed that both coach and peer transformational leadership predicted task cohesion, but coach transformational leadership had a stronger influence. There was no correlation between coach or peer transformational leadership and social cohesion. Independent t-tests indicate that female athletes tend to rate higher on peer transformational leadership and task cohesion. There were no gender differences regarding coach transformational leadership and social cohesion. The results from this study are discussed and a co-operation between coach and peer transformational leadership are purposed to increase task cohesion. Further research could refine which specific coach and peer transformational leadership behaviours that correlate to team cohesion, and further clarify the role gender might play.

  • Boles, Usama
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Cardiology Department, Letterkenny University Hospital, Letterkenny, Co. Donegal, Ireland.
    Johansson, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Odontology.
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Sharif, Zain
    David, Santhosh
    McGrory, Siobhan
    Henein, Michael Y.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Molecular & Clinical Sciences Research Institute, St. George University, London, UK.
    Cytokine Disturbances in Coronary Artery Ectasia Do Not Support Atherosclerosis Pathogenesis2018In: International Journal of Molecular Sciences, ISSN 1422-0067, E-ISSN 1422-0067, Vol. 19, no 1, article id 260Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Coronary artery ectasia (CAE) is a rare disorder commonly associated with additional features of atherosclerosis. In the present study, we aimed to examine the systemic immune-inflammatory response that might associate CAE.

    METHODS: Plasma samples were obtained from 16 patients with coronary artery ectasia (mean age 64.9 ± 7.3 years, 6 female), 69 patients with coronary artery disease (CAD) and angiographic evidence for atherosclerosis (age 64.5 ± 8.7 years, 41 female), and 140 controls (mean age 58.6 ± 4.1 years, 40 female) with normal coronary arteries. Samples were analyzed at Umeå University Biochemistry Laboratory, Sweden, using the V-PLEX Pro-Inflammatory Panel 1 (human) Kit. Statistically significant differences (p < 0.05) between patient groups and controls were determined using Mann-Whitney U-tests.

    RESULTS: The CAE patients had significantly higher plasma levels of INF-γ, TNF-α, IL-1β, and IL-8 (p = 0.007, 0.01, 0.001, and 0.002, respectively), and lower levels of IL-2 and IL-4 (p < 0.001 for both) compared to CAD patients and controls. The plasma levels of IL-10, IL-12p, and IL-13 were not different between the three groups. None of these markers could differentiate between patients with pure (n = 6) and mixed with minimal atherosclerosis (n = 10) CAE.

    CONCLUSIONS: These results indicate an enhanced systemic pro-inflammatory response in CAE. The profile of this response indicates activation of macrophages through a pathway and trigger different from those of atherosclerosis immune inflammatory response.

  • Rapp, Mimmi
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Economics.
    Det obrytbara mönstret?: - En studie av lönegapet inom den primärkommunala sektorn 2011–20152018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sverige rankades i Global Gender Gap Index 2016, av World Economic Forum, till det fjärde mest jämställda landet i världen. Trots denna topprankning förekommer både en oförklarad och förklarad löneskillnad mellan kvinnor och män på den svenska arbetsmarknaden. Syftet med denna studie är att granska lönegapet inom den primärkommunala sektorn samt hur utvalda kommunala faktorer påverkar denna existerande löneskillnad. Studien baseras på paneldata från svenska kommuner med ett invånarantal på minst 15 000 personer, under tidsperioden 2011–2015. De inkluderade kommunala faktorerna är utbildningsnivå, andel kvinnor inom primärkommunal sektor, andel rödgröna mandat i kommunfullmäktige, kvoten av antal uttagna nettodagar av föräldraförsäkring samt arbetslösheten inom kommunen. Studiens resultat bekräftar i enlighet med tidigare forskning att det finns ett lönegap mellan kvinnor och män samt att det har skett en minskning av detta lönegap.

  • Bjureberg, Johan
    et al.
    Sahlin, Hanna
    Hellner, Clara
    Hedman-Lagerlof, Erik
    Gratz, Kim L.
    Bjarehed, Jonas
    Jokinen, Jussi
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69, SE-11364 Stockholm, Sweden.
    Tull, Matthew T.
    Ljotsson, Brjann
    Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: a feasibility study2017In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, article id 411Article in journal (Refereed)
    Abstract [en]

    Background: Nonsuicidal self-injury (NSSI) is a serious health risk behavior that forms the basis of a tentative diagnosis in DSM-5, NSSI Disorder (NSSID). To date, established treatments specific to NSSI or NSSID are scarce. As a first step in evaluating the feasibility, acceptability, and utility of a novel treatment for adolescents with NSSID, we conducted an open trial of emotion regulation individual therapy for adolescents (ERITA): a 12-week, behavioral treatment aimed at directly targeting both NSSI and its proposed underlying mechanism of emotion regulation difficulties.

    Methods: Seventeen girls (aged 13–17; mean = 15.31) with NSSID were enrolled in a study adopting an uncontrolled open trial design with self-report and clinician-rated assessments of NSSI and other self-destructive behaviors, emotion regulation difficulties, borderline personality features, and global functioning administered at pre-treatment, post-treatment, and 6-month follow-up. Measures of NSSI and emotion regulation difficulties were also administered weekly during treatment.

    Results: Ratings of treatment credibility and expectancy and the treatment completion rate (88%) were satisfactory, and both therapeutic alliance and treatment attendance were strong. Intent-to-treat analyses revealed significant improvements associated with large effect sizes in past-month NSSI frequency, emotion regulation difficulties, self-destructive behaviors, and global functioning, as well as a medium effect size in past-month NSSI versatility, from pre- to post-treatment. Further, all of these improvements were either maintained or further improved upon at 6-month follow-up. Finally, change in emotion regulation difficulties mediated improvements in NSSI over the course of treatment.

    Conclusions: Results suggest the acceptability, feasibility, and utility of this treatment for adolescents with NSSID.

  • Watts, Eleanor L.
    et al.
    Appleby, Paul N.
    Albanese, Demetrius
    Black, Amanda
    Chan, June M.
    Chen, Chu
    Cirillo, Piera M.
    Cohn, Barbara A.
    Cook, Michael B.
    Donovan, Jenny L.
    Ferrucci, Luigi
    Garland, Cedric F.
    Giles, Graham G.
    Goodman, Phyllis J.
    Habel, Laurel A.
    Haiman, Christopher A.
    Holly, Jeff M. P.
    Hoover, Robert N.
    Kaaks, Rudolf
    Knekt, Paul
    Kolonel, Laurence N.
    Kubo, Tatsuhiko
    Le Marchand, Loic
    Luostarinen, Tapio
    Maclnnis, Robert J.
    Maenpaa, Hanna O.
    Mannisto, Satu
    Metter, E. Jeffrey
    Milne, Roger L.
    Nomura, Abraham M. Y.
    Oliver, Steven E.
    Parsons, J. Kellogg
    Peeters, Petra H.
    Platz, Elizabeth A.
    Riboli, Elio
    Ricceri, Fulvio
    Rinaldi, Sabina
    Rissanen, Harri
    Sawada, Norie
    Schaefer, Catherine A.
    Schenk, Jeannette M.
    Stanczyk, Frank Z.
    Stampfer, Meir
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Stenman, Ulf-Hakan
    Tjonneland, Anne
    Trichopoulou, Antonia
    Thompson, Ian M.
    Tsugane, Shoichiro
    Vatten, Lars
    Whittemore, Alice S.
    Ziegler, Regina G.
    Allen, Naomi E.
    Key, Timothy J.
    Travis, Ruth C.
    Circulating sex hormones in relation to anthropometric, sociodemographic and behavioural factors in an international dataset of 12,300 men2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 12, article id e0187741Article in journal (Refereed)
    Abstract [en]

    Introduction: Sex hormones have been implicated in the etiology of a number of diseases. To better understand disease etiology and the mechanisms of disease-risk factor associations, this analysis aimed to investigate the associations of anthropometric, sociodemographic and behavioural factors with a range of circulating sex hormones and sex hormone-binding globulin.

    Methods: Statistical analyses of individual participant data from 12,330 male controls aged 25–85 years from 25 studies involved in the Endogenous Hormones Nutritional Biomarkers and Prostate Cancer Collaborative Group. Analysis of variance was used to estimate geometric means adjusted for study and relevant covariates.

    Results: Older age was associated with higher concentrations of sex hormone-binding globulin and dihydrotestosterone and lower concentrations of dehydroepiandrosterone sulfate, free testosterone, androstenedione, androstanediol glucuronide and free estradiol. Higher body mass index was associated with higher concentrations of free estradiol, androstanediol glucuronide, estradiol and estrone and lower concentrations of dihydrotestosterone, testosterone, sex hormone-binding globulin, free testosterone, androstenedione and dehydroepiandrosterone sulfate. Taller height was associated with lower concentrations of androstenedione, testosterone, free testosterone and sex hormone-binding globulin and higher concentrations of androstanediol glucuronide. Current smoking was associated with higher concentrations of androstenedione, sex hormone-binding globulin and testosterone. Alcohol consumption was associated with higher concentrations of dehydroepiandrosterone sulfate, androstenedione and androstanediol glucuronide. East Asians had lower concentrations of androstanediol glucuronide and African Americans had higher concentrations of estrogens. Education and marital status were modestly associated with a small number of hormones.

    Conclusion: Circulating sex hormones in men are strongly associated with age and body mass index, and to a lesser extent with smoking status and alcohol consumption.