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  • Hulo, Fatma
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Jämförelse av effektivitet och säkerhet vid oral eller intravenös järnsubstitution för behandling av järnbristanemi under graviditet2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • Karlström, Malin
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Ankyloserande Spondylit och tumörnekrosfaktor-α-hämmare: En jämförelse av effekt och säkerhet vid behandling hos patienter med ankyloserande spondylit2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • Tanghöj, Gustaf
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Unit of Research Education and Development, Östersund Hospital, Östersund, Sweden.
    Odermarsky, Michal
    Naumburg, Estelle
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics. Unit of Research Education and Development, Östersund Hospital, Östersund, Sweden.
    Liuba, Petru
    Early Complications After Percutaneous Closure of Atrial Septal Defect in Infants with Procedural Weight Less than 15 kg2017In: Pediatric Cardiology, ISSN 0172-0643, E-ISSN 1432-1971, Vol. 38, no 2, 255-263 p.Article in journal (Refereed)
    Abstract [en]

    Atrial septal defect (ASD) is the most common congenital cardiac lesion accounting for 10-15% of all cardiac malformations. In the majority of cases, the secundum type of the ASD is closed percutaneously in the catheterization laboratory. Although transcatheter closure of ASD is considered safe and effective in pediatric patients, there are limited data regarding the efficacy and safety of device ASD closure in smaller infants. The aim of this study was to determine risk of complications within 72 h following device closure of ASD in children of body weight < 15 kg compared to larger children. Overall 252 children who underwent transcatheter closure of ASD at Children's Heart Centre in Lund, Sweden, between 1998 and 2015 were included. Data regarding demographics, comorbidity and complications occurring during and after device procedure until discharge were retrieved from the hospital's databases. Echocardiographic data were obtained from the digital and videotape recordings. Nearly half of the study cohort (n = 112; 44%) had a procedural weight < 15 (median 11.3) kg with a median procedural age of 2.02 years. Among this study group, 22 (9%) children had post-procedural in-hospital complications, of which 16 (7%) were considered as major and six (2%) considered as minor. No deaths occurred. There was no significant difference in of the occurrence of major or minor complications between the two groups (p = 0.32). Larger ASD was more often associated with minor complications, OR 1.37 (95% CI 0.99-1.89), which most often consisted of transient arrhythmias during or after the procedure. Percutaneous ASD device closure can be performed safely in low-weight infants with a risk of post-procedural in-hospital complications comparable to larger/older children. Nevertheless, careful considerations of the indications to device closure is needed, particularly in children with larger ASD, as recommended by the current international guidelines for ASD closure.

  • Seekell, David
    et al.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Carr, Joel
    Dell'Angelo, Jampel
    D'Odorico, Paolo
    Fader, Marianela
    Gephart, Jessica
    Kummu, Matti
    Magliocca, Nicholas
    Porkka, Miina
    Puma, Michael
    Ratajczak, Zak
    Rulli, Maria Cristina
    Suweis, Samir
    Tavoni, Alessandro
    Resilience in the global food system2017In: Environmental Research Letters, ISSN 1748-9326, E-ISSN 1748-9326, Vol. 12, no 2, 025010Article in journal (Refereed)
    Abstract [en]

    Ensuring food security requires food production and distribution systems function throughout disruptions. Understanding the factors that contribute to the global food system's ability to respond and adapt to such disruptions (i.e. resilience) is critical for understanding the long-term sustainability of human populations. Variable impacts of production shocks on food supply between countries indicate a need for national-scale resilience indicators that can provide global comparisons. However, methods for tracking changes in resilience have had limited application to food systems. We developed an indicator-based analysis of food systems resilience for the years 1992-2011. Our approach is based on three dimensions of resilience: socio-economic access to food in terms of income of the poorest quintile relative to food prices, biophysical capacity to intensify or extensify food production, and the magnitude and diversity of current domestic food production. The socio-economic indicator has a large variability, but with low values concentrated in Africa and Asia. The biophysical capacity indicator is highest in Africa and Eastern Europe, in part because of a high potential for extensification of cropland and for yield gap closure in cultivated areas. However, the biophysical capacity indicator has declined globally in recent years. The production diversity indicator has increased slightly, with a relatively even geographic distribution. Few countries had exclusively high or low values for all indicators. Collectively, these results are the basis for global comparisons of resilience between countries, and provide necessary context for developing generalizations about resilience in the global food system.

  • Forssell, Linnéa
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Sjöström, Elin
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Inte en vanlig eljätte men lite mer inlindat i bomull: En receptionsanalys av Skellefteå Krafts externa kommunikation av CSR och hållbar utveckling samt hur studenter avkodar budskapet.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    A reception analysis on Skellefteå Krafts external communication on CSR and sustainable development and in what ways students decode the message.

    As an effect of today's climate changes and global issues, one of the most important subjects for companies to communicate to consumers and stakeholders is corporate social responsibility (CSR). The purpose of this paper is to investigate in what ways the concept of responsibility in relation to corporate social responsibility and sustainable development infuse meaning in the external communication by the company Skellefteå Kraft. The paper also examines the way three respondent groups of students relate to this message.

    The theoretical frame stretches from different views on CSR- communication to green brand strategy and sustainable development. The critic on CSR-communication includes the concept of greenwashing. The study also relies on theories within semiotic analysis, reception analysis and Stuart Halls encoding decoding model. Using the method visual semiotic analysis made it possible to reveal what Stuart Hall calls the preferred reading of the company's external communication. To be able to analyze the way students relate to the message qualitative interviews was used. Tools within reception analyze was applied on the material from the interviews.

    Both the visual semiotic analysis and the analyze of the interviews showed that the external communication did not include the economic side of CSR as much as the social- and environmental aspect. This was to be expected since the campaigns are focused on customers and other stakeholders. The main result was that the respondents in large made a hegemonic read of both the advertising films and the campaign site. They lay focus primarily on the caption and less on the image itself. The respondents could mainly distinguish the communication of social responsibility. This may be because both campaigns focus primarily on the human being and different life styles. When it comes to environmental responsibility the analysis show that Skellefteå Kraft uses ecological arguments in their external communication about energy and electrician, but they do not demonstrate the extraction which does in fact have some negative effects on nature. If Skellefteå Kraft had been more willing to demonstrate the extraction process they probably would have been described as honest and their ecological arguments would have been more comprehensible. This would also be proof that the company has little to hide when it comes to environmental

    responsibility. The advertising film as well as the campaign site communicates joyfulness and naturally produced electricity.

  • Sonevik, Linnéa
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Wahlgren, Agnes
    Umeå University, Faculty of Arts, Department of culture and media studies.
    ”I’ve never been politically correct – truthfully it takes far too much time and can often make it more difficult to achieve total victory”: En kritisk diskursanalys av Donald Trumps tal under valåret 20162017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study, ​“‘I’ve never been politically correct – truthfully it takes far too much time and can often make it more difficult to achieve total victory’ - a Critical Discourse Analysis of Donald Trump's speeches during United States presidential election of 2016”​, examines the political communication through linguistic strategies throughout 10 of Donald Trump’s speeches from the Trump rallies during the election year 2016. In order to serve that purpose, this thesis investigates which ones of the discourses that dominates the republican agenda in this context. ​Accordingly to the Critical Discourse Analysis the aim is also to see whether the worldview in Trumps speeches is constructed or deconstructed.

    The study is based on a theoretical framework with theories about social constructionism, nationalism and populism. A quantitative content analysis was made through the online text tool “Textometrica” in order to see Trumps main discourses. The qualitative content analysis was made through Norman Faircloughs three-dimensional model for a Critical Discourse Analysis.

    According to the analysis of this study, the five main discourses are ​Establishment, Trump, USA, Immigration ​and​ Work​. Around these discourses, Donald Trump’s main strategy is constructing an opposition between “us” and “them”, where “us” consist with Trump himself and the american people, and “them” includes the establishment, other countries and immigrants. Based on these opponents, and through disparaging “them” in a strategy, here called “the thief-strategy”, Trump constructs a reality where “us” is the better half and he appears as the hero in this duo.

    In conclusion, Trumps strategy in order to win the presidential election 2016 included running a political agenda characterized by populism which later on can lead to a polarized community, and a dissatisfied american people who will be open for change and a new leader.

  • Pettersson, Felix
    Umeå University, Faculty of Arts, Department of culture and media studies.
    ”Det handlar om mentala faktorer”: En studie i hur vinnarmentalitet gestaltas i svensk sportpress2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: ”It’s about mental factors” – Examining how a “winner’s mentality” is portrayed in Swedish sports mediaThis essay aims to explore what the Swedish sports media means when it discusses the term of a “winner’s mentality”, through a discourse analysis. More specifically this essay studies how the language in nine different sports papers in Sweden construes the meaning of the word by combining it with different signs and through the use of metaphors, a commonly used linguistic trick in Sportugese. The articles selected for analysis were all published in a one month span between the 8th of December 2016 and the 8th of January 2017. This particular period of time was selected because it included the 2017 World Juniors in ice hockey, a tournament in which the Swedes have placed fourth three years in a row, and which sparked a debate in the Swedish sports press about the team’s “winner’s mentality”.The study found five major themes within the sports journalistic discourse. A major aspect was focusing on the athlete´s psychology, their self-confidence and their will to win. This closely resembles the discourse in popular psychology, more specifically self-help texts where the readers are encouraged to change through active will. Another major theme was that of a winning record. According to the sports press, if an athlete or a team wins more often than not than that proves they possess a “winner’s mentality” and helps them win in the future as well. The essay also found differences in “winner´s mentality” based on a cultural aspect. Swede’s ability to win was downplayed while Americans were praised for their unusually strong mental abilities. This is also found in Swedish self-help texts and might indicate a much larger discourse in national identity at work. The two last themes identified were the importance of experience, and also that a “winner´s mentality” could be affected by a large amount of external factors.Overall the study found that the discourse was in disagreement within itself. A “winner´s mentality” could mean plenty of different things, and in some cases actively opposes itself. Another finding was that the sports press rarely reflects on the meaning of the term and instead mostly uses it as a rhetoric weapon or to make a point across. This raises the question whether or not the term has an actual use within sports terminology and debate if it can be interpreted in many different ways.

  • Söderqvist, Marlene
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Lyckodiskurser i en senmodern verklighet: En kvantitativ innehållsanalys och kritisk diskursanalys av porträtteringen av lyckliga människor i kvällspress under 20152016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    We are today living in a society with endless possibilities. A society where you can dream about something more. What makes you happy is important to study, though it’s a big part of people’s life quality. It’s important to consider how media chooses to portray it, because it affects how the society judges and adapts to the message media is sending out. The purpose of this essay is to consider how happiness is constructed in evening papers and how it differs between different gender portrayals.

    The methods that were used were a quantitative content analysis and a critical discourse analysis founded by Norman Fairclough. The material was mainly taken from Swedish evening papers Aftonbladet and Expressen. A total of 203 articles were analyzed, and a total of 19 articles were more closely analyzed with a critical discourse analysis.

    Theories that were used in the analysis were theories about happiness, gender, framing and stereotypes, as well as earlier research on the subject concerning portraits and gender.The result shows that there are different subjects that are being connected to happiness, but being in a happy relationship and having a well receiving job are the most popular ones. Most the portrayed people are famous in some way. There are several differences between male and female portrayals and the most vital ones are a central focus on men’s work life, and for women there are more focus on children, looks and praise for managing to fight her way through life.

  • Lif, Stina
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Bland hyckleri och hemohes: En textanalytisk studie av den svenska rapporteringen om finska och ryska dopningsfall2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study has been to, through a quantitative content analysis and a qualitative

    text analysis, determine which meaning nationality is given in news reports in Swedish daily

    press, and how it creates the event as a scandal. Focusing on two major scandals in cross

    country skiing, articles from the Finnish scandal in Lahtis 2001 and the revealing of doped

    Russian skiers in 2016 has been analysed. The theoretical framework for the study has been

    Stuart Halls representation theory, the framing theory, and theories regarding media scandals

    and nationality. The results from the quantitative and qualitative analyses has been divided

    into four themes: Imagined communities, Us and them, Individual and corporate and Fallen

    star. The results show that nationality is given meaning through the creation of imagined

    communities. It creates a gap between us and them, a sense of the nations parting from each

    other in form of cultural and moral aspects. There is also a difference between the

    representation of the countries. In the Russian doping scandal, Russia is considered as a doped

    nation, with a systematic doping where little guilt is to be put on the skiers themselves. In

    Finland, the nation stands for the people and is not in any ways to be associated with the

    doping scandal. Instead, the skiers get all the blame and little notion is made about the doping

    as being organised. This has also made the scandals to be divided into individual or corporate

    doping. As for the framing of the event as a scandal, attributes as “cheating” and a portrayal

    of the skiers as fallen stars is represented. By revealing the names of the suspected dopers it

    increases the news worth. An unexpected outcome was that the Russian dopers was not

    mentioned by name as often as the Finnish, which could enhance the event as a scandal even

    more. Furthermore, doping scandals could be studied in many different ways and is an

    interesting subject to immerse oneself in.

  • Källman, Marie
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Fellman, Elin
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Kvinnor i olympiaden. En jämförande studie av kvinnors representation och framställning i media under OS-åren 1996 och 20162017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Women in the olympics - A quantitative and qualitative analysis of the representation and portayal of female athletes in the olympics

    The purpose of the study was to examine how often female athletes occur in swedish sports media and how they are portrayed, in comparison to male athletes. The years studied was 1996 and 2016. Since the female participants increased over those twenty years it was interesting to see if the media followed that development. The study is based on earlier research such as Natalie Koivula and her concepts of the trivialization, infantilization and ambivalens of female athletes. Some theories used in the study is agenda setting, discourse analysis and different gender theories by, among others, Hirdman, Butler and Conell & Pearse.

    A quantitative and a qualitative analysis has been used in order to determine the representation and portrayal of female athletes. Over 400 articles about the olympics from the newspapers Aftonbladet and Expressen was coded using a content analysis to identify how often female athletes occur in comparison to men. For the discourse analysis 12 articles, three from every newspaper and year was coded using both theories and earlier research.

    The result shows that there was a difference in both representation and portrayal between men and women in 1996, with men overrepresented in both team sports and individual sports. In 2016 there the results show a complete reversal with women overrepresented in all sports. There was a clear difference in the portrayal of female and male athletes in 1996, where womens looks were described more often than their sporting efforts. In 2016 however the portrayal of women were more similar to men, with a few exceptions.

    The results of the study from 1996 can be explained by the patriarchal structures that our society is built on. Although the patriarchy still is present it is clear to see that feminism and gender issues have affected the society over the last twenty years, giving female athletes a better chance to be represented and portrayed equally to male athletes.

  • Jernstig, Embla
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Wikström, Mikaela
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Hur viktig är vikten?: En kvantitativ och kvalitativ studie av Expressen och Aftonbladets framställning av vikt, utseende och hälsa.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In media we often see articles about how to lose weight, what we shouldn’t like about our bodies and how to get rid of these so called problems. In this essay we examine how weight is portrayed in Sweden’s two largest evening papers, Expressen and Aftonbladet. The purpose of the essay is to see how Swedish evening papers portray weight in relation to health, appearance, and diet. We have used a quantitative content analysis combined with a qualitative critical discourse analysis to examine this. The two methods combined strengthen the validity and reliability in our results. We examine articles from the newspapers from the years of 1996, 2006 and 2016 to be able to see the differences between these years. Through the quantitative content analysis, we found many interesting patterns. Some of the most important findings are that weight often is portrayed in a way of change and not as something static. A loss of weight is in a majority of the articles described as something positive, whereas to gain weight is described as a problem and something negative. We have also found interesting results about gender. Women take the roll of a private person in a majority of the cases. The role of the expert in the articles have changed from a majority of men to a majority of women. Dieting is portrayed as something typically feminine. In the discourse of weight there seems to be at strong connection between the skinny body, happiness and health whereas the fat body is submissively connected to sickness and ill-health. Our bodies seem to be looked at like a project to be taken care of, in order to fit in to the bodily-norms. If someone fits in to the norm they get values in life in return. Our conclusion is that stereotypical norms of the skinny body and the good in loss of weight is reproduced in Expressen and Aftonbladet, and that this haven’t changed over time. We argue that this can lead to consequences in peoples lifes and a discrimination to certain groups in the society.

  • Hansson Vikström, Greta
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Hedlund, Julia
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Det flexibla livet som journalister älskar: En jämförelse mellan journalister på en tidning och radioredaktion i norra Sverige2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract Title: “Journalists who loves the flexible life” - A case between journalists occupational

    perception and work-future who works at a newspaper compared to a radio station in northern Sweden.

    This study is a qualitative comparison between journalists without permanent employment on a commercial newspaper and a public service owned radio station in a medium sized town in northern Sweden. The main purpose was to analyse the occupational perception and work-future among young journalists without permanent employment in the public service and the commercial sector. Another intention was to figure out if there was any similarities or differences between working for a public service owned radio station compare to a commercial newspaper. We wanted to investigate how these journalists experience and manage their work and in which way they look at their own future and journalism in general. The research applies theories such as the precariat and studies about convergence. The chosen method for the study were qualitative semi-structured interviews based on the answers from six journalists and was processed through a thematic analysis.

    The main conclusion of this study was that multi journalism has become a part of the journalistic agenda, both on the radio station and the newspaper. It showed that journalists has to be flexible when it comes to working schedules. Even though they had to adapt to a lot of the journalistic requirement they still accepted the funny, but yet stressful life as a journalist. One conclusion that can be drawn is that todays journalism can demand almost anything, and job seeking journalists will adapt quite well regardless of change. A final conclusion was that it's difficult to predict the future of these journalists. But a common stand point for the journalists was that almost everyone could imagine a future in another profession.

  • Bergström, Tim
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Eriksson, Jon
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Nationalism och Norrientalism: En diskursanalys av den norrländska självständighetsdebatten sensommaren 2016 och framåt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The student thesis Nationalism and Norrientalism: A Discourse Analysis of the Norrlandic Independence Debate of Late Summer 2016 and Beyond aims to examine the style and content of the recent secession debate in the Swedish and Norrlandic printed press.

    From the late summer of 2016 to the beginning of 2017 the question of Norrlandic sovereignty was a prioritized topic in the legacy media debate, as well as in social media. It commenced after the Swedish government enterprise Vattenfall planned to relocate forty employment opportunities from Jokkmokk, raising the question of Norrlandic independence based on a post-colonialist view of the region. This thesis examines how the framing of Northern Sweden as a colony has been established, re-established or refuted in the different discourses of the printed debate, through a faceted lens composed of various theories of Orientalism and nationalism.

    Rooted in the discourse theory of Ernesto Laclau and Chantal Mouffe, merged with the critical discourse analysis of Norman Fairclough, and leaning against media theories of inoculation and framing, the study takes aim at the myths, metaphors, articulations and antagonisms which constituted the polemics in the printed press of the period.

    The results conclude that the debate revolved around independence, resources, and the myth regarding Norrland—often described as a barren landscape, marked by vast distances and a lack of social services. The term colony was used to describe Norrland as marginalised and robbed of its natural resources, whereas the term was met by opposition from the objecting side, who emphasised the historic and present representation of Norrlanders in high politics. The colonial identity was constituted in the press through internal Orientalism by Stockholm writers and self-Orientalisation by Norrlandic ones. The most distinct patterns of difference between the objecting side and the advocating side of independence was the determination of the real economic loser of a Norrlandic secession from Sweden.

  • Angvarson, Elin
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Nilsson, Jesper
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Jag är inte porrmoralist, men...: En diskursanalys av pornografidebatten i svensk press år 20162017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this essay is to investigate the opinions of pornography in the Swedish press 2016. To perform this, a quantitative method and discourse analysis on 139 published texts have been used. This study shows that the year of 2016 primarily is focused on a strong sence of concern about the effects of pornography rather than the industry itself, and the concerns are primarily rooted in anxiety of the effects on pornography-consumers, that is primarily young boys and men. The debate that is mainly represented by women with a great variety of work titles like scholars, criminologist, politicians, mothers, columnists, and film directors. The articles used for this study were found in newspapers and magazines from all over Sweden. When opinions about pornography is expressed it's usually a negative or critical opinions. If the opinion is positive or defending towards pornography it's usually a response to an already written negative or critical article. The critic is from different feminist theories, pro and counter arguments from both radical- and liberal feminism. Arguments that has its roots in the three counter waves during the 70's-, 80's- and 21's centrury is portrayed by the liberal feminist Petra Östergren in the publication Porr, Horor och Feminister. Some of the feminist arguments occur in contexts that describes the effects of pornography like something that inspire men and young boys to commit violent crimes. But there are also some arguments from the liberal feminist side that is more positive and that is arguing against the fact that women's pleasure is excluded from the male influenced debate. In the beginning of 2016 was the debate mostly focused on violence in pornography, that after a criminologist by the name Nina Rung published an article about sexuell crimes. During the summer the debate was mostly focused on sexual assaults due to the high numbers of assaults and harassments during the summer festivals. It will not be until october that the debate reached its heights, due to an article about the negative effects of pornography written by a group of politicians, tv-personalities and celebrities. Opinions that are possible to recognise during the rest of the year are adults and their concerns for kids and youths. A will to protect children and teenagers from pornography are strongly defined, but also a major discussion about sex norms and ideal in pornography are to be seen during 2016. The effect of pornography are also included in contexts like pornography- or emotional-impotence. An interesting part of the discourse analysis is the concept disclaimer. A linguistic discourse concept introduced by the researcher Teun A. van Dijk. The term have been used frequently by the counter porn critics. “I'm no moralist, but…” is an usual term used by the porn critics, something that could be used due to today's desire and habbit of building once’s own identity in our social media-opinion bubbles. 

  • Shah, Mansi
    et al.
    Cardenas, Ryan
    Wang, Belinda
    Persson, Jenny
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Mongan, Nigel P.
    Grabowska, Anna
    Allegrucci, Cinzia
    HOXC8 regulates self-renewal, differentiation and transformation of breast cancer stem cells2017In: Molecular Cancer, ISSN 1476-4598, E-ISSN 1476-4598, Vol. 16, 38Article in journal (Refereed)
    Abstract [en]

    Background: Homeobox genes are master regulators of cell fate during embryonic development and their expression is altered in cancer. By regulating the balance between cell proliferation and differentiation, they maintain homeostasis of normal tissues. Here, we screened the expression of homeobox genes in mammary stem cells to establish their role in stem cells transformation in breast cancer. Methods: Using a Homeobox Genes PCR array, we screened 83 homeobox genes in normal cancer breast stem/progenitor cells isolated by flow cytometry. The candidate gene HOXC8 epigenetic regulation was studied by DNA methylation and miRNA expression analyses. Self-renewal and differentiation of HOXC8-overexpressing or knockdown cells were assessed by flow cytometry and mammosphere, 3D matrigel and soft agar assays. Clinical relevance of in vitro findings were validated by bioinformatics analysis of patient datasets from TCGA and METABRIC studies. Results: In this study we demonstrate altered expression of homeobox genes in breast cancer stem/progenitor cells. HOXC8 was consistently downregulated in stem/progenitor cells of all breast molecular subtypes, thus representing an interesting tumour suppressor candidate. We show that downregulated expression of HOXC8 is associated with DNA methylation at the gene promoter and expression of miR196 family members. Functional studies demonstrated that HOXC8 gain of function induces a decrease in the CD44(+)/CD24(-/low) cancer stem cell population and proportion of chemoresistant cells, with a concomitant increase in CD24(+) differentiated cells. Increased HOXC8 levels also decrease the ability of cancer cells to form mammospheres and to grow in anchorage-independent conditions. Furthermore, loss of HOXC8 in non-tumorigenic mammary epithelial cells expands the cancer stem/progenitor cells pool, increases stem cell self-renewal, prevents differentiation induced by retinoic acid and induces a transformed phenotype. Conclusions: Taken together, our study points to an important role of homeobox genes in breast cancer stem/progenitor cell function and establishes HOXC8 as a suppressor of stemness and transformation in the mammary gland lineage.

  • Coe, Anna-Britt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    The importance of taking into account different perspectives of a health problem: the case of fibromyalgia2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, 1275189Article in journal (Refereed)
  • Hagglund, Anna-Carin
    et al.
    Umeå University, Faculty of Medicine, Umeå Centre for Molecular Medicine (UCMM).
    Jones, Iwan
    Umeå University, Faculty of Medicine, Umeå Centre for Molecular Medicine (UCMM).
    Carlsson, Leif
    Umeå University, Faculty of Medicine, Umeå Centre for Molecular Medicine (UCMM).
    A novel mouse model of anterior segment dysgenesis (ASD): conditional deletion of Tsc1 disrupts ciliary body and iris development2017In: Disease Models and Mechanisms, ISSN 1754-8403, E-ISSN 1754-8411, Vol. 10, no 3, 245-257 p.Article in journal (Refereed)
    Abstract [en]

    Development of the cornea, lens, ciliary body and iris within the anterior segment of the eye involves coordinated interaction between cells originating from the ciliary margin of the optic cup, the overlying periocular mesenchyme and the lens epithelium. Anterior segment dysgenesis (ASD) encompasses a spectrum of developmental syndromes that affect these anterior segment tissues. ASD conditions arise as a result of dominantly inherited genetic mutations and result in both ocular-specific and systemic forms of dysgenesis that are best exemplified by aniridia and Axenfeld-Rieger syndrome, respectively. Extensive clinical overlap in disease presentation amongst ASD syndromes creates challenges for correct diagnosis and classification. The use of animal models has therefore proved to be a robust approach for unravelling this complex genotypic and phenotypic heterogeneity. However, despite these successes, it is clear that additional genes that underlie several ASD syndromes remain unidentified. Here, we report the characterisation of a novel mouse model of ASD. Conditional deletion of Tsc1 during eye development leads to a premature upregulation of mTORC1 activity within the ciliary margin, periocular mesenchyme and lens epithelium. This aberrant mTORC1 signalling within the ciliary margin in particular leads to a reduction in the number of cells that express Pax6, Bmp4 and Msx1. Sustained mTORC1 signalling also induces a decrease in ciliary margin progenitor cell proliferation and a consequent failure of ciliary body and iris development in postnatal animals. Our study therefore identifies Tsc1 as a novel candidate ASD gene. Furthermore, the Tsc1-ablated mouse model also provides a valuable resource for future studies concerning the molecular mechanisms underlying ASD and acts as a platform for evaluating therapeutic approaches for the treatment of visual disorders.

  • Athanasiu, Lavinia
    et al.
    Giddaluru, Sudheer
    Fernandes, Carla
    Christoforou, Andrea
    Reinvang, Ivar
    Lundervold, Astri J.
    Nilsson, Lars-Göran
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Aging Research Center, Karolinska Institutet, Stockholm, Sweden.
    Kauppi, Karolina
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Eriksson, Elias
    Sundet, Kjetil
    Djurovic, Srdjan
    Espeseth, Thomas
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Steen, Vidar M.
    Andreassen, Ole A.
    Le Hellard, Stephanie
    A genetic association study of CSMD1 and CSMD2 with cognitive function2017In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 61, 209-216 p.Article in journal (Refereed)
    Abstract [en]

    The complement cascade plays a role in synaptic pruning and synaptic plasticity, which seem to be involved in cognitive functions and psychiatric disorders. Genetic variants in the closely related CSMD1 and CSMD2 genes, which are implicated in complement regulation, are associated with schizophrenia. Since patients with schizophrenia often show cognitive impairments, we tested whether variants in CSMD1 and CSMD2 are also associated with cognitive functions per se. We took a discovery-replication approach, using well-characterized Scandinavian cohorts. A total of 1637 SNPs in CSMD1 and 206 SNPs in CSMD2 were tested for association with cognitive functions in the NCNG sample (Norwegian Cognitive NeuroGenetics; n = 670). Replication testing of SNPs with p-value < 0.001 (7 in CSMD1 and 3 in CSMD2) was carried out in the TOP sample (Thematically Organized Psychosis; n =1025) and the BETULA sample (Betula Longitudinal Study on aging, memory and dementia; n = 1742). Finally, we conducted a meta-analysis of these SNPs using all three samples. The previously identified schizophrenia marker in CSMD1 (SNP rs10503253) was also included. The strongest association was observed between the CSMDI SNP rs2740931 and performance in immediate episodic memory (p-value = 5 Chi 10(-6), minor allele A, MAF 0.48-0.49, negative direction of effect). This association reached the study-wide significance level (p <= 1.2 Chi 10(-5)). SNP rs10503253 was not significantly associated with cognitive functions in our samples. In conclusion, we studied n = 3437 individuals and found evidence that a variant in CSMD1 is associated with cognitive function. Additional studies of larger samples with cognitive phenotypes will be needed to further clarify the role of CSMD1 in cognitive phenotypes in health and disease.

  • Ameh, Soter
    et al.
    Klipstein-Grobusch, Kerstin
    D'ambruoso, Lucia
    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 (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; The International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH) Accra, Ghana.
    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 (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; The International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries (INDEPTH) Accra, Ghana.
    Gomez-Olive, Francesc Xavier
    Quality of integrated chronic disease care in rural South Africa: user and provider perspectives2017In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 32, no 2, 257-266 p.Article in journal (Refereed)
    Abstract [en]

    The integrated chronic disease management (ICDM) model was introduced as a response to the dual burden of HIV/AIDS and non-communicable diseases (NCDs) in South Africa, one of the first of such efforts by an African Ministry of Health. The aim of the ICDM model is to leverage HIV programme innovations to improve the quality of chronic disease care. There is a dearth of literature on the perspectives of healthcare providers and users on the quality of care in the novel ICDM model. This paper describes the viewpoints of operational managers and patients regarding quality of care in the ICDM model. In 2013, we conducted a case study of the seven PHC facilities in the rural Agincourt sub-district in northeast South Africa. Focus group discussions (n = 8) were used to obtain data from 56 purposively selected patients >= 18 years. In-depth interviews were conducted with operational managers of each facility and the sub-district health manager. Donabedian's structure, process and outcome theory for service quality evaluation underpinned the conceptual framework in this study. Qualitative data were analysed, with MAXQDA 2 software, to identify 17 a priori dimensions of care and unanticipated themes that emerged during the analysis. The manager and patient narratives showed the inadequacies in structure (malfunctioning blood pressure machines and staff shortage); process (irregular prepacking of drugs); and outcome (long waiting times). There was discordance between managers and patients regarding reasons for long patient waiting time which managers attributed to staff shortage and missed appointments, while patients ascribed it to late arrival of managers to the clinics. Patients reported anti-hypertension drug stock-outs (structure); sub-optimal defaulter-tracing (process); rigid clinic appointment system (process). Emerging themes showed that patients reported HIV stigmatisation in the community due to defaulter-tracing activities of home-based carers, while managers reported treatment of chronic diseases by traditional healers and reduced facility-related HIV stigma because HIV and NCD patients attended the same clinic. Leveraging elements of HIV programmes for NCDs, specifically hypertension management, is yet to be achieved in the study setting in part because of malfunctioning blood pressure machines and anti-hypertension drug stock-outs. This has implications for the nationwide scale up of the ICDM model in South Africa and planning of an integrated chronic disease care in other low-and middle-income countries.

  • Markström, Sanna
    Umeå University, Faculty of Arts, Department of culture and media studies.
    När reklamen kliver in i samhällsdebatten: En kvalitativ analys av Åhléns kampanj Bryt klädmaktsordningen2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to examine how Åhléns challenge existing gender norms and stereotypes in their campaign Bryt klädmaktsordningen. The study also wish to highlight the reactions that the campaign has received on Åhléns Facebook-page. The theoretical starting point is based on theories concerning representation and stereotypes and specifically how these theories can be seen in the context of advertising campaigns. The concepts of norms and norms criticism has been established and the concept of sex and gender has been discussed within the theoretical framework. Theories of semiotics has also been presented to provide a basis to the two qualitative methods in the study. First, a semiotic picture analysis is used to analyze the visual elements of the material. Then, a thematic text analysis is used to analyze the textual material consisted of comments from the Facebook-page. The result of the semiotic analysis shows that Åhléns challenge gender norms and stereotypes by presenting women and men in contrary to what is expected of them. A part of the result that was found a bit surprising is that the analysis also shows that the presentation is not entirely equitable between the men and women. The result of the thematic text analysis is first categorised into five different themes: “shouts of encouragement”, “keep politics away!”, “threats of boycott”, “great, but…” and “campaign defender”. The result shows that the reactions largely stands for or against Åhléns, this campaign or norm critical advertising. A surprising result was those who both praised and condemned Åhléns or campaign in the same comment. Based on the result, the conclusion is that Åhléns can participate and highlight social problems through their marketing communication and that they have done so by challenging the previling norms in the camaign. The fact that Åhléns has chosen to take a stand on gender norms through this campaign also shows that a norm critical advertising campaign can lead to a community discussion regarding prevailing gender norms. 

  • Eklund, Julia
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Jaako, Amanda
    Umeå University, Faculty of Arts, Department of culture and media studies.
    "De har ju ett syfte med allt de gör": En kvalitativ studie av IKEAs reklamserie Där livet händer2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Is commercialism a threat to authenticity? This is a qualitative research method and study of IKEAs advertising series Där livet händer. To appear genuine and authentic has become highly important for companies and brands. Critical consumption discourses makes it harder for companies to be perceived as genuine.

    Där livet händer was launched autumn of 2016 by IKEA Sweden. An advertising series with a concept that aims to represent swedes in their everyday life. The creators of the production worked to avoid traditional language within advertising, instead they wanted to achieve an authentic expression.

    This study aims to get a better and deeper understanding of advertising where the producer strives for authentic expression. To fulfill the purpose of the study we have used a semiotic analysis of the series Där livet händer, and done qualitative group interviews with different types of consumer groups with different kinds of perspectives on consumption. The theoretical framework for this study is based on Jenkins theory about convergence, Bauman’s theory about consumption culture and Fairclough’s critical discourse analysis.

    This study shows that the consumer’s individual identity projects through consumption controls how they perceive commercial messages. Brands can through authentic expression, as in authentic recognition, reach different types of consumer groups. To be perceived as authentic, however, seems to be more difficult. Especially if you want to reach consumer groups with more critical perspectives on mass consumption. The home is central in the IKEA commercials, it is also strongly related to the origin, presence and human identity. By recognition linked to the nuclear family and the home, IKEA has more or less managed to affect the different consumer groups in this study. 

  • Norqvist, Lars
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Leffler, Eva
    Umeå University, Faculty of Social Sciences, Department of Education.
    Learning in non-formal education: is it ‘‘youthful’’for youth in action?2017In: International Review of Education, ISSN 0020-8566, E-ISSN 1573-0638, Vol. 63, no 2, 235-256 p.Article in journal (Refereed)
    Abstract [en]

    This article offers insights into the practices of a non-formal education programme for youth provided by the European Union (EU). It takes a qualitative approach and is based on a case study of the European Voluntary Service (EVS). Data were collected during individual and focus group interviews with learners (the EVS volunteers), decision takers and trainers, with the aim of deriving an understanding of learning in non-formal education. The research questions concerned learning, the recognition of learning and perspectives of usefulness. The study also examined the Youthpass documentation tool as a key to understanding the recognition of learning and to determine whether the learning was useful for learners (the volunteers). The findings and analysis offer several interpretations of learning, and the recognition of learning, which take place in non-formal education. The findings also revealed that it is complicated to divide learning into formal and non-formal categories; instead, non-formal education is useful for individual learners when both formal and non-formal educational contexts are integrated. As a consequence, the division of formal and non-formal (and possibly even informal) learning creates a gap which works against the development of flexible and interconnected education with ubiquitous learning and mobility within and across formal and non-formal education. This development is not in the best interests of learners, especially when seeking useful learning and education for youth (what the authors term “youthful” for youth in action).

  • Dahlin, Lars B.
    et al.
    Andersson, Gert
    Backman, Clas
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Hand Surgery. Department of Hand Surgery, University Hospital of Northern Sweden, Umeå University, Umeå, Sweden.
    Svensson, Hampus
    Bjorkman, Anders
    Rehabilitation, Using Guided Cerebral plasticity, of a Brachial plexus Injury treated with Intercostal and phrenic Nerve transfers2017In: Frontiers in Neurology, ISSN 1664-2295, E-ISSN 1664-2295, Vol. 8, 72Article in journal (Refereed)
    Abstract [en]

    Recovery after surgical reconstruction of a brachial plexus injury using nerve grafting and nerve transfer procedures is a function of peripheral nerve regeneration and cerebral reorganization. A 15-year-old boy, with traumatic avulsion of nerve roots C5-C7 and a non-rupture of C8-T1, was operated 3 weeks after the injury with nerve transfers: ( a) terminal part of the accessory nerve to the suprascapular nerve, (b) the second and third intercostal nerves to the axillary nerve, and (c) the fourth to sixth intercostal nerves to the musculocutaneous nerve. A second operation-free contralateral gracilis muscle transfer directly innervated by the phrenic nerve-was done after 2 years due to insufficient recovery of the biceps muscle function. One year later, electromyography showed activation of the biceps muscle essentially with coughing through the intercostal nerves, and of the transferred gracilis muscle by deep breathing through the phrenic nerve. Voluntary flexion of the elbow elicited clear activity in the biceps/gracilis muscles with decreasing activity in intercostal muscles distal to the transferred intercostal nerves (i.e., corresponding to eighth intercostal), indicating cerebral plasticity, where neural control of elbow flexion is gradually separated from control of breathing. To restore voluntary elbow function after nerve transfers, the rehabilitation of patients operated with intercostal nerve transfers should concentrate on transferring coughing function, while patients with phrenic nerve transfers should focus on transferring deep breathing function.

  • Juliusson, G.
    et al.
    Abrahamsson, J.
    Lazarevic, V.
    Antunovic, P.
    Derolf, A.
    Garelius, H.
    Lehmann, S.
    Myhr-Eriksson, K.
    Mollgard, L.
    Uggla, B.
    Wåhlin, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Wennstrom, L.
    Hoglund, M.
    Prevalence and characteristics of survivors from acute myeloid leukemia in Sweden2017In: Leukemia, ISSN 0887-6924, E-ISSN 1476-5551, Vol. 31, no 3, 728-731 p.Article in journal (Refereed)
  • Krajewski, Stefanie Sandra
    et al.
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Isoz, Isabelle
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Johansson, Jörgen
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Antibacterial and antivirulence effect of 6-N-hydroxylaminopurine in Listeria monocytogenes2017In: Nucleic Acids Research, ISSN 0305-1048, E-ISSN 1362-4962, Vol. 45, no 4, 1914-1924 p.Article in journal (Refereed)
    Abstract [en]

    The emerging development of antibiotic resistant bacteria calls for novel types of antibacterial agents. In this work we examined the putative antibacterial effect of purine analogs in Listeria monocytogenes. We show that, among several tested purine analogs, only 6-N-hydroxylaminopurine (6-N-HAP) reduces the viability of the Gram-positive pathogenListeria monocy-togenes. As in Bacillus subtilis, 6-N-HAP terminates expression at guanine riboswitches in L. monocyto-genes hence preventing expression of their downstream genes. However, we show that the bacteriocidal effect of the compound was unlinked to the terminated expression at the guanine riboswitches. When further examining the antimicrobial effect, we observed that 6-N-HAP acts as a potent mutagen in L. monocytogenes, by increasing the mutation rate and inducing the SOS-response. Also, addition of 6N-HAP decreased virulence gene expression by reducing both the levels and activity of the virulence regulator PrfA.

  • Vogelzang, Nicholas J.
    et al.
    Coleman, Robert E.
    Michalski, Jeff M.
    Nilsson, Sten
    O'Sullivan, Joe M.
    Parker, Christopher
    Widmark, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Thuresson, Marcus
    Xu, Lei
    Germino, Joseph
    Sartori, Oliver
    Hematologic Safety of Radium-223 Dichloride: Baseline Prognostic Factors Associated With Myelosuppression in the ALSYMPCA Trial2017In: Clinical Genitourinary Cancer, ISSN 1558-7673, E-ISSN 1938-0682, Vol. 15, no 1, 42-52 p.Article in journal (Refereed)
    Abstract [en]

    Radium-223 was minimally myelosuppressive. Multivariate analyses of data from ALSYMPCA patients identified baseline factors that may increase hematologic toxicity risk with radium-223. Extent of disease and degree of prostate-specific antigen elevation were predictive of grade 2-4 anemia; prior docetaxel, and decreased hemoglobin and platelets were predictive of grade 2-4 thrombocytopenia. Patients with these factors should be closely monitored during radium-223 therapy. Background: Myelosuppression is common in patients with progressive castration-resistant prostate cancer and bone metastases. Radium-223 prolongs overall survival in these patients but may cause myelosuppression; understanding risk factors will improve clinical decision making. We describe hematologic safety of radium-223 in ALSYMPCA and post hoc analyses identifying patients at increased risk for hematologic toxicity. Patients and Methods: Hematologic parameters and adverse events were analyzed. Multivariate analyses assessing baseline risk factors for hematologic toxicities were performed separately for radium-223 and placebo patients. Results: Nine hundred one patients received radium-223 (n = 600) or placebo (n = 301); 65% of radium-223 and 48% of placebo patients had the full 6 cycles. Grade 3/4 thrombocytopenia was more common in radium-223 versus placebo patients (6% vs. 2%). Logistic regression analyses identified significant baseline predictors for grade 2-4 hematologic toxicities related to radium-223 treatment: extent of disease (6-20 vs. < 6 bone metastases; odds ratio [OR] = 2.76; P = .022) and elevated prostate-specific antigen (OR = 1.65; P = .006) for anemia; prior docetaxel (OR = 2.16; P = .035), decreased hemoglobin (OR = 1.35; P = .008), and decreased platelets (OR = 1.44; P = .030) for thrombocytopenia. Neutropenia events were too few in placebo patients for a comparative analysis. There were no significant associations between hematologic toxicities and number of radium-223 injections received (4-6 vs. 1-3). Conclusion: Radium-223 has a favorable safety profile with a low myelosuppression incidence. Understanding baseline factors associated with myelosuppression may assist clinicians in avoiding severe myelosuppression events with radium-223.

  • Zhang, Xiangwei
    et al.
    Wang, Yang
    Li, Cheng
    Helmersson, Jing
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jiang, Yuanzhu
    Ma, Guoyuan
    Wang, Guanghui
    Dong, Wei
    Sang, Shaowei
    Du, Jiajun
    The prognostic value of tumor length to resectable esophageal squamous cell carcinoma: a retrospective study2017In: PeerJ, ISSN 2167-8359, E-ISSN 2167-8359, Vol. 5, e2943Article in journal (Refereed)
    Abstract [en]

    Background: The current TNM classification system does not consider tumor length for patients with esophageal carcinoma (EC). This study explored the effect of tumor length, in addition to tumor depth and lymph node involvement, on survival in patients with esophageal squamous cell carcinoma (ESCC).

    Methods: A total of 498 ESCC patients who underwent surgical resection as the primary treatment were selected in the retrospective study. Pathological details were collected, which included tumor type, TNM stage, differentiation. Other collected information were: the types of esophageal resection, ABO blood group, family history and demographic and lifestyle factors. A time-dependent receiver operating characteristic (ROC) curve and a regression tree for survival were used to identify the cut-off point of tumor length, which was 3 cm. Univariate and multivariate Cox proportional hazard regression models were used to identify the prognostic factors to ESCC.

    Results & Discussion: The 1-, 3-, 5-year overall survival rates were found to be 82.5%, 55.6%, and 35.1%, respectively. Patients who had larger tumor length (>3 cm) had a higher risk for death than the rest patients. From the univariate Cox proportional hazards regression model, the overall survival rate was significantly influenced by the depth of the tumor and lymph node involvement (either as dummy or continuous variables), Sex, and tumor length. Using these four variables in the multivariate Cox proportional hazard regression model, we found that the overall survival was significantly influenced by all variables except Sex. Therefore, in addition to the depth of the tumor and lymph node involvement (as either dummy or continuous variables), the tumor length is also an independent prognostic factor for ESCC. The overall survival rate was higher in a group with smaller tumor length (≤3 cm) than those patients with larger tumor length (>3 cm), no matter what the tumor stage was.

    Conclusion: The tumor length was found to be an important prognostic factor for ESCC patients without receiving neoadjuvant therapy. The modification of EC staging system may consider tumor length to better predict ESCC survival and identify higher risk patients for postoperative therapy.

  • Sundh, Josefin
    et al.
    Janson, Christer
    Johansson, Gunnar
    Linden, Anders
    Lofdahl, Claes-Goran
    Sandström, Thomas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Larsson, Kjell
    Characterization of secondary care for COPD in Sweden2017In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 4, 1270079Article in journal (Refereed)
    Abstract [en]

    Introduction: Only a selected proportion of chronic obstructive pulmonary disease (COPD) patients are managed in secondary care. The aim of this study was to characterize disease severity, treatment and structure of secondary care for COPD in Sweden.

    Methods: Information was collected from 29 of 33 existing secondary care units of respiratory medicine in Sweden, using both individual data from 373 consecutively enrolled COPD patients with Global initiative on Obstructive Lung Disease (GOLD) stage III–IV and a structural questionnaire about available resources at the units. Patient data included exacerbations, health status assessed by COPD Assessment Test (CAT), lung function, comorbid conditions, pharmacological treatment and vaccinations. Structural data included available smoking cessation support, multidisciplinary rehabilitation, physical training, patient education and routine follow-up after exacerbations at the respective unit. All patients were reclassified according to the GOLD 2014 group A–D classification. Multiple linear regression investigated associations of available resources with number of exacerbations and CAT score.

    Results: According to GOLD 2014, 87% of the population were GOLD D and 13% were GOLD C. Triple inhaled therapy were prescribed in 88% of the patients. Over 75% of the units had resources for smoking cessation, multidisciplinary rehabilitation, physical training and patient education. Routine follow-up after exacerbations was available in 35% of the units. Being managed at units with access to structured patient education was associated with statistically significantly fewer exacerbations (adjusted regression coefficient (95% confidence interval) −0.79 (−1.39 to −0.19), p = 0.010).

    Conclusion: Most stage III–IV COPD patients managed at secondary care respiratory units in Sweden have maximized inhaled therapy and high risk disease even when reclassified according to GOLD 2014. Most units have access to smoking cessation, rehabilitation and patient education. Patients managed at units with structured patient education have a lower exacerbation risk.

  • Public defence: 2017-05-04 09:30 KBE301, Lilla Hörsalen (KBC), Umeå
    Vasconcelos, Francisco Rivera
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Effects of warming and browning on benthic and pelagic ecosystem components in shallow lakes2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The majority of lakes on Earth are shallow, unproductive and located at high latitudes. These lakes are experiencing big changes due to climate change, where two environmental drivers operate simultaneously, browning and warming. How they affect lake ecosystems is not well understood. Here, I addressed this issue by using a theoretical and an experimental approach. In particular, I generated model predictions and compared them with the results of a realistic large-scale experiment, where browning and warming were manipulated in a factorial design. In addition, model outcomes were compared with data from 12 unproductive lakes sampled along a gradient of browning. Another novelty of my thesis is that it integrates benthic and pelagic food web components in the model and experimental approaches. I found that browning affected the resources availability for benthic and pelagic producers in the model and in the experiment. With browning, benthic primary producers became increasingly light limited and declined, while pelagic producers became less nutrient limited and increased. Pelagic nutrient limitation was alleviated by two non-exclusive mechanisms. Browning directly enriched the water with nutrients, and browning indirectly increased the nutrient flowing from the sediment to the pelagic habitat via suppression of benthic producers. To tease apart these two mechanisms I applied structural equation modeling (SEM). The indirect evidence by SEM suggests that both mechanisms contributed equally to the pelagic nutrient concentration in the experiment. Interestingly, a model food web with only primary producers shows similar qualitative behavior as a food web with grazers and carnivores included. This happens because carnivorous fish exert strong top-down control in the more productive habitat, which relaxes grazing pressure on primary producers and increases resource limitation in the adjacent habitat. Biomass of benthic and pelagic consumers followed the same pattern as their resources. The lake data were largely congruent with model expectations and supported the findings of the experiment. Furthermore, the model also predicted a negative relationship between total phosphorus and both primary and fish production, which was observed across the 12 lakes. Warming effects were more complex. The model predicts that warming effects should depend on browning and are expected to be strongest in the more productive of the two (benthic and pelagic) habitats. For example, at low levels of browning the biomasses of benthic algae and fish are expected to decline with warming, which was observed in the experiment. In contrast, observed warming effects at high levels of browning deviated from model expectations. The mechanisms by which browning and warming interactively affect lake food webs are still poorly understood. This thesis offers a conceptual foundation for their further study through the integration of within- and between-habitat interactions.

  • Hartvik, Anna
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Förutsättningar att skapa en god psykosocial arbetsmiljö: Hinder och hjälpmedel som prefekter upplever i det systematiska arbetsmiljöarbetet2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to investigate the conditions that Heads of Department are facing when conducting Systematic Work Environment Management (SWEM) within psychosocial work environment at Umeå University. The study has focused on the obstacles and tools that Heads of Department are experiencing in their efforts to investigate, assess, and measures to reduce risks and follow up actions in the psychosocial work environment. To investigate this, I conducted semi-structured interviews with four Heads of Department and a Head of Unit at Umeå University. The interviews were recorded, transcribed and analysed. The result of the study is that dialogue and cooperation on different levels of the workplace seems to be the foundation of their SWEM within psychosocial work environment. A relationship-oriented leadership, good communication climate at the workplace, and various support functions are also important tools. Some of the obstacles that they experience are heavy workload, performance cultures, and sometimes lack of central support. SWEM also seems to be more time-consuming within psychosocial work environment than within the physical environment. It is not possible to draw any general conclusions from this study, but it has indicated several tracks that might be interesting to investigate further to improve conditions for the Heads of Department. For example, to further map their psychosocial environment, if the central support is perceived as sufficient and how to safeguard the local support from, for example, human resources specialists and work safety representatives.

  • Enthoven, Paul
    et al.
    Molander, Peter
    Oberg, Birgitta
    Stålnacke, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Department of Clinical Sciences, Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden.
    Stenberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gerdle, Bjorn
    DO PAIN CHARACTERISTICS GUIDE SELECTION FOR MULTIMODAL PAIN REHABILITATION?2017In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 2, 161-169 p.Article in journal (Refereed)
    Abstract [en]

    Objective: To determine whether self-reported pain measures are associated with selection for multimodal or multidisciplinary rehabilitation (MMR) and whether this selection is influenced by sex. Design: Cross-sectional cohort study. Subjects: A total of 1,226 women and 464 men with chronic pain conditions from 2 university hospitals. Methods: Drawing from the Swedish Quality Registry for Pain Rehabilitation (SQRP), data on pain, psychological symptoms, function, health, and activity/participation were collected. Multiple logistic regression was used to investigate association of pain measures with selection for MMR (no/yes) after multidisciplinary assessment. Covariates were: age, educational level, anxiety, depression, working status, and several pain measures. Results: High pain intensity in the previous week (odds ratio (OR) 0.92; 95% confidence interval (CI) 0.86-0.99) and high pain severity (Multidimensional Pain Inventory) (OR 0.83; 95% CI 0.74-0.95) were negatively associated with selection for MMR, whereas higher number of pain quadrants was positively associated with selection for MMR. Similar results were obtained for women, but none of the measures was predictive for men. Conclusion: This practice-based study showed that higher scores on self-reported pain were not associated with selection for MMR, and in women there was a negative association for higher pain intensity and pain severity. Thus, other factors than pain determine whether patients are selected for MMR.

  • Boldrup, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Gu, Xiaolian
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Coates, Philip J.
    Norberg-Spaak, Lena
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Fåhraeus, Robin
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology. RECAMO, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic; Institut de Génétique Moléculaire, Université Paris 7, Hôpital St. Louis, 75010 Paris, France.
    Laurell, Göran
    Umeå University, Faculty of Medicine, Department of Clinical Sciences. Department of Surgical Sciences/ENT, Uppsala University, 752 36 Uppsala, Sweden.
    Wilms, Torben
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Nylander, Karin
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Gene expression changes in tumor free tongue tissue adjacent to tongue squamous cell carcinoma2017In: OncoTarget, ISSN 1949-2553, E-ISSN 1949-2553, Vol. 8, no 12, 19389-19402 p.Article in journal (Refereed)
    Abstract [en]

    Due to the high frequency of loco-regional recurrences, which could be explained by changes in the field surrounding the tumor, patients with squamous cell carcinoma of head and neck show poor survival. Here we identified a total of 554 genes as dysregulated in clinically tumor free tongue tissue in patients with tongue tumors when compared to healthy control tongue tissue. Among the top dysregulated genes when comparing control and tumor free tissue were those involved in apoptosis (CIDEC, MUC1, ZBTB16, PRNP, ECT2), immune response (IFI27) and differentiation (KRT36). Data suggest that these are important findings which can aid in earlier diagnosis of tumor development, a relapse or a novel squamous cell carcinoma of the tongue, in the absence of histological signs of a tumor.

  • Romar, Jan-Erik
    et al.
    Umeå University, Faculty of Social Sciences, Department of Education.
    Frisk, Alexandra
    The Influence of Occupational Socialization on Novice Teachers' Practical Knowledge, Confidence and Teaching in Physical Education2017In: Qualitative Research in Education, ISSN 2014-6418, Vol. 6, no 1, 86-116 p.Article in journal (Refereed)
    Abstract [en]

    The purpose of this qualitative multiple-case study was to examine the influence of occupational socialization on three novice physical education teachers' practical knowledge, confidence in teaching content and enacted pedagogical practices. This study involved three novice teachers who taught in Finnish primary schools. Data sources included nonparticipant lesson observations and semi-structured in-depth teacher interviews. The analysis occurred in two phases. Initially, we created a case narrative for each teacher with respect to the research questions through an inductive process that integrated the occupational socialization theory. For the second phase, a cross-case analysis was completed to provide a comprehensive and in-depth understanding of the data set. Each teacher's occupational socialization experiences influenced their teaching confidence, planning practices and enacted pedagogical actions. In addition, the teacher education program experience extended their practical knowledge and was evident in their PE teaching. Therefore, in designing the pedagogical structure in teacher education, it is essential to consider pre-service teachers' experiences about teaching, schooling, sport and physical education and thereby strengthen their knowledge and skills of how to teach physical education and provide students with quality learning experiences.

  • Odlander, Lennart
    Umeå University, Faculty of Arts, Department of language studies.
    Prosodisk läsning: En studie om elever med lässvårigheter i årskurs 3.2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aim of the study is to expand the understanding what prosody looks like for primary school children with reading difficulties. In doing so, the study investigates the relationships in prosody between  children with high skilled reading and low skilled reading. The study uses spectograms to measure the prosodic characteristics in 7- to  9-year old children. Reading comprehension and word decoding were assessed. The investigation reveales that children with reading difficulties produce more intrasentential pauses, and their reading is characterized by flat intonation patterns. The prosodic patterns suggests that the pupils do not percieve the grammatical information encoded in the test sentences. The study provides evidence that reading prosody seems to be related to reading comprehension. This finding is also supported in previous research.

  • Önnebro, BrittMarie
    Umeå University, Faculty of Arts, Department of language studies.
    Intensiv avkodningsträning för en vuxen andraspråkselev: En interventionsstudie på sfi2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This study analyses the effects of an intervention using Wendickmodellens Intensivläsning to practice word decoding. The focus was to study if this intervention could help adult L2 learners in their decoding progress. The study also investigated whether the students´ phonological knowledge increased during the intervention. Two adult students with word decoding difficulties in Swedish were identified and selected to participate in this study. One student took part in the intervention as the intervention group, and the other one participated in ordinary classroom activities, as a control group. The intervention group received decoding practice, five days a week, 20-30 minutes each time, for a total of 20 sessions during a five week period. Both students were tested before and after the intervention. The results showed that the student participating in the intervention made progress in decoding ability in each test compared to the control student. Both students increased their phonological awareness. The conclusion of this study is that decoding practice with Wendickmodellens Intensivläsning increases decoding ability.

  • Kang, Jung Koo
    et al.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences. The Center for Quantitative Sciences in Biomedicine, North Carolina State University, Raleigh, NC, USA.
    Thibert-Plante, Xavier
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Eco-evolution in size-structured ecosystems: simulation case study of rapid morphological changes in alewife2017In: BMC Evolutionary Biology, ISSN 1471-2148, E-ISSN 1471-2148, Vol. 17, 58Article in journal (Refereed)
    Abstract [en]

    Background: Over the last 300 years, interactions between alewives and zooplankton communities in several lakes in the U.S. have caused the alewives' morphology to transition rapidly from anadromous to landlocked. Lakes with landlocked alewives contain smaller-bodied zooplankton than those without alewives. Landlocked adult alewives display smaller body sizes, narrower gapes, smaller inter-gill-raker spacings, reach maturity at an earlier age, and are less fecund than anadromous alewives. Additionally, landlocked alewives consume pelagic prey exclusively throughout their lives whereas anadromous alewives make an ontogenetic transition from pelagic to littoral prey. These rapid, well-documented changes in the alewives' morphology provide important insights into the morphological evolution of fish. Predicting the morphological evolution of fish is crucial for fisheries and ecosystem management, but the involvement of multiple trophic interactions make predictions difficult. To obtain an improved understanding of rapid morphological change in fish, we developed an individual-based model that simulated rapid changes in the body size and gill-raker count of a fish species in a hypothetical, size-structured prey community. Model parameter values were based mainly on data from empirical studies on alewives. We adopted a functional trait approach; consequently, the model explicitly describes the relationships between prey body size, alewife body size, and alewife gill-raker count. We sought to answer two questions: ( 1) How does the impact of alewife populations on prey feed back to impact alewife size and gill raker number under several alternative scenarios? ( 2) Will the trajectory of the landlocked alewives' morphological evolution change after 150-300 years in freshwater? 

    Results: Over the first 250 years, the alewives' numbers of gill-rakers only increased when reductions in their body size substantially improved their ability to forage for small prey. Additionally, alewives' gill- raker counts increased more rapidly as the adverse effects of narrow gill- raker spacings on foraging for large prey weremade less severe. For the first150- 250 years, alewives' growth decreased monotonically, and their gill- raker number increased monotonically. After the first 150-250 years, however, the alewives exhibited multiple evolutionary morphological trajectories in different trophic settings. In several of these settings, their evolutionary trajectories even reversed after the first 150-250 years. 

    Conclusions: Alewives affected the abundance and morphology of their prey, which in turn changed the abundance and morphology of the alewives. Complex low-trophic-level interactions can alter the abundance and characteristics of alewives. This study suggests that the current morphology of recently (similar to 300 years)-landlocked alewives may not represent an evolutionarily stable state.

  • Almgren, Monika
    Umeå University, Faculty of Arts, Department of language studies.
    Högläsning i skolan ur ett specialpedagogiskt perspektiv2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aim of the study was to investigate how reading aloud is organized in the class-room and if the teachers made any adaptations for students with reading comprehension difficulties. Three teachers and two special education teachers were interviewed about their views on reading aloud and adaptations. Two students were interviewed about their experiences of listening to read-alouds. The results of the study showed that the students appreciated to listen to their teachers reading aloud and to take part in conversations about the text. The teachers who had been educated by Skolverket, Läslyftet, used comprehension strategies during the reading aloud lessons and found the strategies to be a good adaptation for the students with comprehension problems. The special education teachers mostly worked with students with word- reading difficulties. They did not use read-alouds and comprehensions strategies in their teaching. The study also indicate the importance of implementing research in education. 

  • Svenson, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Roos, Göran
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Wikström, Pernilla
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Long leukocyte telomere length in prostate cancer patients at diagnosis is associated with poor metastasis-free and cancer-specific survival2017In: Tumor Biology, ISSN 1010-4283, E-ISSN 1423-0380, Vol. 39, no 2Article in journal (Refereed)
    Abstract [en]

    Previous studies have suggested that leukocyte telomere length is associated with risk of developing prostate cancer. Investigations of leukocyte telomere length as a prognostic factor in prostate cancer are, however, lacking. In this study, leukocyte telomere length was investigated both as a risk marker, comparing control subjects and patient risk groups (based on serum levels of prostate-specific antigen, tumor differentiation, and tumor stage), and as a prognostic marker for metastasis-free and cancer-specific survival. Relative telomere length was measured by a well-established quantitative polymerase chain reaction method in 415 consecutively sampled individuals. Statistical evaluation included 162 control subjects without cancer development during follow-up and 110 untreated patients with newly diagnosed localized prostate cancer at the time of blood draw. Leukocyte telomere length did not differ significantly between control subjects and patients, or between patient risk groups. Interestingly, however, and in line with our previous results in breast and kidney cancer patients, relative telomere length at diagnosis was an independent prognostic factor. Patients with long leukocyte telomeres (>= median) had a significantly worse prostate cancer-specific and metastasisfree survival compared to patients with short telomere length. In contrast, for patients who died of other causes than prostate cancer, long relative telomere length was not coupled to shorter survival time. To our knowledge, these results are novel and give further strength to our hypothesis that leukocyte telomere length might be used as a prognostic marker in malignancy.

  • Lippman, Sheri A.
    et al.
    Pettifor, Audrey
    Rebombo, Dumisani
    Julien, Aimee
    Wagner, Ryan G.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand Johannesburg, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa.
    Dufour, Mi-Suk Kang
    Kabudula, Chodziwadziwa Whiteson
    Neilands, Torsten B.
    Twine, Rhian
    Gottert, Ann
    Gomez-Olive, F. Xavier
    Tollman, Stephen M.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand Johannesburg, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa.
    Sanne, Ian
    Peacock, Dean
    Kahn, Kathleen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), Faculty of Health Sciences, School of Public Health, University of the Witwatersrand Johannesburg, 27 St Andrews Road, Parktown 2193, Johannesburg, South Africa.
    Evaluation of the Tsima community mobilization intervention to improve engagement in HIV testing and care in South Africa: study protocol for a cluster randomized trial2017In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 12, no 9Article in journal (Refereed)
    Abstract [en]

    Background: HIV transmission can be decreased substantially by reducing the burden of undiagnosed HIV infection and expanding early and consistent use of antiretroviral therapy (ART). Treatment as prevention (TasP) has been proposed as key to ending the HIV epidemic. To activate TasP in high prevalence countries, like South Africa, communities must be motivated to know their status, engage in care, and remain in care. Community mobilization (CM) has the potential to significantly increase uptake testing, linkage to and retention in care by addressing the primary social barriers to engagement with HIV care-including poor understanding of HIV care; fear and stigma associated with infection, clinic attendance and disclosure; lack of social support; and gender norms that deter men from accessing care. Methods/design: Using a cluster randomized trial design, we are implementing a 3-year-theory-based CM intervention and comparing gains in HIV testing, linkage, and retention in care among individuals residing in 8 intervention communities to that of individuals residing in 7 control communities. Eligible communities include 15 villages within a health and demographic surveillance site (HDSS) in rural Mpumalanga, South Africa, that were not exposed to previous CM efforts. CM activities conducted in the 8 intervention villages map onto six mobilization domains that comprise the key components for community mobilization around HIV prevention. To evaluate the intervention, we will link a clinic-based electronic clinical tracking system in all area clinics to the HDSS longitudinal census data, thus creating an open, population-based cohort with over 30,000 18-49-year-old residents. We will estimate the marginal effect of the intervention on individual outcomes using generalized estimating equations. In addition, we will evaluate CM processes by conducting baseline and endline surveys among a random sample of 1200 community residents at each time point to monitor intervention exposure and community level change using validated measures of CM. Discussion: Given the known importance of community social factors with regard to uptake of testing and HIV care, and the lack of rigorously evaluated community-level interventions effective in improving testing uptake, linkage and retention, the proposed study will yield much needed data to understand the potential of CM to improve the prevention and care cascade. Further, our work in developing a CM framework and domain measures will permit validation of a CM conceptual framework and process, which should prove valuable for community programming in Africa.

  • Toren, K.
    et al.
    Bake, B.
    Olin, A-C
    Engstrom, G.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Vikgren, J.
    Hedner, J.
    Brandberg, J.
    Persson, H. L.
    Skold, C. M.
    Rosengren, A.
    Bergstrom, G.
    Janson, C.
    Measures of bronchodilator response of FEV1, FVC and SVC in a Swedish general population sample aged 50-64 years, the SCAPIS Pilot Study2017In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 12, 973-980 p.Article in journal (Refereed)
    Abstract [en]

    Background: Data are lacking from general population studies on how to define changes in lung function after bronchodilation. This study aimed to analyze different measures of bronchodilator response of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and slow vital capacity (SVC). Materials and methods: Data were derived from the Swedish Cardiopulmonary Bioimage Study (SCAPIS) Pilot study. This analysis comprised 1,050 participants aged 50-64 years from the general population. Participants were investigated using a questionnaire, and FEV1, FVC and SVC were recorded before and 15 minutes after inhalation of 400 mu g of salbutamol. A bronchodilator response was defined as the relative change from baseline value expressed as the difference in units of percent predicted normal. Predictors of bronchodilator responses were assessed using multiple linear regression models. Airway obstruction was defined as FEV1/FVC ratio below lower limit of normal (LLN) before bronchodilation, and COPD was defined as an FEV1/FVC ratio below LLN after bronchodilation. Physician-diagnosed asthma was defined as an affirmative answer to " Have you ever had asthma diagnosed by a physician?". Asymptomatic never-smokers were defined as those not reporting physician-diagnosed asthma, physician-diagnosed COPD or emphysema, current wheeze or chronic bronchitis and being a lifelong never-smoker. Results: Among all subjects, the greatest bronchodilator responses (FEV1, FVC and SVC) were found in subjects with asthma or COPD. The upper 95th percentile of bronchodilator responses in asymptomatic never-smokers was 8.7% for FEV1, 4.2% for FVC and 5.0% for SVC. The bronchodilator responses were similar between men and women. In a multiple linear regression model comprising all asymptomatic never-smokers, the bronchodilator response of FEV1 was significantly associated with airway obstruction and height. Conclusion: When the bronchodilator response in asymptomatic never-smokers is reported as the difference in units of predicted normal, significant reversibility of FEV1, FVC and SVC to bronchodilators is 9%, 4% and 5%, respectively.

  • Mohamed, Ayaan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Parkinson’s Disease medications: In correlation to the Unified Parkinson’s disease rating scale2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • Public defence: 2017-05-05 09:00 Hörsal E04, byggnad 6E, Norrlands universitetssjukhus, Umeå
    Lundberg, Ida
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Molecular understanding of KRAS- and BRAF-mutated colorectal cancers2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Colorectal cancer (CRC) is the third most commonly diagnosed malignancy in both men and women, and one of the leading causes of cancer-related deaths worldwide. One frequently mutated pathway involved in oncogenesis in CRC is the RAS/RAF/MAP kinase pathway. Oncogenic activation of KRAS and BRAF occur in 30‒40% and 5‒15% of all CRCs, respectively, and the mutations are mutually exclusive. Even though KRAS and BRAF are known to act in the same pathway, KRAS- and BRAF-mutated CRCs have different clinical and histopathological features. For example, BRAF mutation in CRC is tightly linked to microsatellite instability (MSI) and a CpG island methylator phenotype (CIMP), which is not seen in KRAS-mutated tumours. BRAF-mutated CRCs are also more often found in right-sided tumours. However, the underlying molecular reasons for these differences have not yet been defined.

    The overall aim of this thesis was to investigate molecular differences between KRAS- and BRAF-mutated CRCs to understand how KRAS and BRAF mutations differentially affect tumour progression. We used an in vitro cell culture system to explore molecular differences between KRAS- and BRAF-mutated CRCs and verified our findings using CRC tissue specimens from the Colorectal Cancer in Umeå Study (CRUMS).

    We found that BRAF mutation, but not KRAS mutation, was associated with expression of the stem cell factor SOX2. Furthermore, SOX2 was found to be correlated to a poor patient prognosis, especially in BRAF-mutated cancers. We further investigated the role of BRAF in regulation of SOX2 expression and found that SOX2 is at least partly regulated by BRAF in vitro. We continued by investigating the functional role of SOX2 in CRC and found that SOX2-expressing cells shared several characteristics with cancer stem cells, and also had down-regulated expression of the intestinal epithelial marker CDX2. There was a strong correlation between loss of CDX2 expression and poor patient prognosis, and patients with SOX2 expression were found to have a particularly poor prognosis when CDX2 levels were down-regulated. In conclusion, in these studies we identified a subgroup of BRAF-mutated CRCs with a particularly poor prognosis, and having a cancer stem cell-like appearance with increased expression of SOX2 and decreased expression of CDX2.

    Tumour progression is regulated by interactions with cells of the immune system. We found that BRAF-mutated CRCs were more highly infiltrated by Th1 lymphocytes than BRAF wild-type tumours, while the opposite was true for KRAS-mutated CRCs. Interestingly, we found that part of this difference is probably caused by differences in secreted chemokines and cytokines between KRAS- and BRAF-mutated CRCs, stimulating different arms of the immune response.

    Altered levels of expression of miRNAs have been seen in several malignancies, including CRC. We found that BRAF- and KRAS-mutated CRCs showed miRNA signatures different from those of wild-type CRCs, but the expression of miRNAs did not distinguish KRAS-mutated tumours from BRAF-mutated tumours.

    In summary, our findings have revealed possible molecular differences between KRAS- and BRAF-mutated CRCs that may explain some of the differences in their clinical and histopathological behaviour.

  • Georgsson, Marcus
    Umeå University, Faculty of Social Sciences, Department of Education.
    Fungerar yrkesutbildning på gymnasieskolan?: Lärares och elevers önskemål om yrkesutbildningarnas innehåll.2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    På gymnasiet har trätekniska utbildningen sett ungefär likadan ut under en lång tid. Vad ansåg lärarna och eleverna om utbildningen? Syftet med denna studie var att beskriva och analysera hur elever och lärare på ett yrkesförberedande program uppfattade yrkesutbildningen och vilka föreställningar de hade om de krav som arbetsmarknaden ställer. De lärare som upplevde sig uppnå läroplanens mål ansåg sig sannolikt också uppnå de krav som arbetsgivarna ställer. Som källor till detta examensarbete har gymnasieskolorna i träteknik i två norrlandslän varit engagerade. Begränsningen i arbetet har varit svårigheten att få ställda kompetenskrav från arbetsgivarna vilket medförde att sådana frågor inte fanns med i enkät-undersökningarna. En slutsats jag drog av min undersökning var att elever och lärare var positiva till yrkesutbildningen. Den största faktorn som framkom var att det fanns stor möjlighet att individanpassa undervisningen och just möjligheten att själv välja inriktningar och bestämma hur utbildningen ska vara upplevdes mycket positiv.

  • Lindberg, Linda
    Umeå University, Faculty of Social Sciences, Department of Education.
    Utvecklingssamtal i grundskolan: - Ett möte mellan hem och skola2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Arbetat handlar om utvecklingssamtal. Jag har undersökt hur elever och lärare i grundskolans tidigare år upplever utvecklingssamtalet, samt tagit reda på vad tidigare forskning säger om vikten av förberedelser inför och utvärdering av ett utvecklingssamtal. För att få redan på elever upplevelser har jag intervjuat några elever. Genom att observera några utvecklingssamtal i en klass två kunde jag dra slutsatsen om att läraren är den som pratar mest men att även eleven och elevens vårdnadshavare pratar en hel del. Den välkända 2/3-dels regeln gäller även vid utvecklingssamtal, även om jag inte tog tid för hur mycket de olika parterna pratade kan jag ändå dra slutsatsen att den stämmer ganska bra. Arbetet behandlar också vad som kännetecknar ett bra samtal. Det som framkommit som det mest viktiga är att det skapas en bra stämning mellan alla de inblandade parterna. Genom att alla lyssnar på varandra och visar att det som någon annan säger är viktigt kan viktiga band knytas för ett gott framtida samarbete.

  • Sandberg, Olivia
    Umeå University, Faculty of Social Sciences, Department of Education.
    Fysisk aktivitet eller inaktivitet?: - En studie om elevers intresse för idrott och hälsa i skolan2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka elevers uppfattningar och intresse för fysisk aktivitet i skolan.I dagens samhälle kan vi i media läsa larmraporter om att barn och ungas vikt ökar samtidigt som den fysiska aktiviteten minskar. Aldrig förr sägs barn tillbringat så mycket tid framför datorn som nu. Skolan har en viktig roll i att förmedla en värdegrund som eleverna sedan kan ta med sig i sin ryggsäck inför livets alla prövningar. I Sverige är dock antalet idrottstimmar få och kring detta har en del kritiska röster höjts. För studien användes en kvantitativ metod i form av en enkät. Enkäten bestod av 11 frågor som totalt 64 elever svarade på. Två olika skolor deltog i undersökningen. Eleverna gick i årskurs 3 och årskurs 6. Resultatet visade på att de tillfrågade eleverna hade en positiv inställning till ämnet idrott och hälsa i skolan, de ansåg sig själva förstå syftet med idrott och hälsa i skolan och majoriteten svarade att de ville ha fler idrottstimmar i skolan. Elevernas fritid visade i resultatet på att de oftare och under längre tid satt framför datorn under helgen än under vardagarna. Dock angav alla svarande i undersökningen att de mer eller mindre var fysiskt aktiva under fritiden.

  • Blackburn, M.
    et al.
    Ledesma, Jose L. J.
    Näsholm, Torgny
    Laudon, Hjalmar
    Sponseller, Ryan A.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Evaluating hillslope and riparian contributions to dissolved nitrogen (N) export from a boreal forest catchment2017In: Journal of Geophysical Research - Biogeosciences, ISSN 2169-8953, E-ISSN 2169-8961, Vol. 122, no 2, 324-339 p.Article in journal (Refereed)
    Abstract [en]

    Catchment science has long held that the chemistry of small streams reflects the landscapes they drain. However, understanding the contribution of different landscape units to stream chemistry remains a challenge which frequently limits our understanding of export dynamics. For limiting nutrients such as nitrogen (N), an implicit assumption is that the most spatially extensive landscape units (e.g., uplands) act as the primary sources to surface waters, while near-stream zones function more often as sinks. These assumptions, based largely on studies in high-gradient systems or in regions with elevated inputs of anthropogenic N, may not apply to low-gradient, nutrient-poor, and peat-rich catchments characteristic of many northern ecosystems. We quantified patterns of N mobilization along a hillslope transect in a northern boreal catchment to assess the extent to which organic matter-rich riparian soils regulate the flux of N to streams. Contrary to the prevailing view of riparian functioning, we found that near-stream, organic soils supported concentrations and fluxes of ammonium (NH4+) and dissolved organic nitrogen that were much higher than the contributing upslope forest soils. These results suggest that stream N chemistry is connected to N mobilization and mineralization within the riparian zone rather than the wider landscape. Results further suggest that water table fluctuation in near-surface riparian soils may promote elevated rates of net N mineralization in these landscapes.

  • Wikberg, Olivia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Hur påverkas prestationsförmågan och muskelvävnad hos uthållighetsidrottare av proteintillskott?2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • Viklund, Ida
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Läkemedelsbiverkningar hos barn: En litteraturstudie om incidens, riskfaktorer och läkemedel2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • Lidman, Johan
    et al.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Jonsson, Micael
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Burrows, Ryan M.
    Bundschuh, Mirco
    Sponseller, Ryan A.
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Composition of riparian litter input regulates organic matter decomposition: Implications for headwater stream functioning in a managed forest landscape2017In: Ecology and Evolution, ISSN 2045-7758, E-ISSN 2045-7758, Vol. 7, no 4, 1068-1077 p.Article in journal (Refereed)
    Abstract [en]

    Although the importance of stream condition for leaf litter decomposition has been extensively studied, little is known about how processing rates change in response to altered riparian vegetation community composition. We investigated patterns of plant litter input and decomposition across 20 boreal headwater streams that varied in proportions of riparian deciduous and coniferous trees. We measured a suite of in-stream physical and chemical characteristics, as well as the amount and type of litter inputs from riparian vegetation, and related these to decomposition rates of native (alder, birch, and spruce) and introduced (lodgepole pine) litter species incubated in coarse- and fine-mesh bags. Total litter inputs ranged more than fivefold among sites and increased with the proportion of deciduous vegetation in the riparian zone. In line with differences in initial litter quality, mean decomposition rate was highest for alder, followed by birch, spruce, and lodgepole pine (12, 55, and 68% lower rates, respectively). Further, these rates were greater in coarse-mesh bags that allow colonization by macroinvertebrates. Variance in decomposition rate among sites for different species was best explained by different sets of environmental conditions, but litter-input composition (i.e., quality) was overall highly important. On average, native litter decomposed faster in sites with higher-quality litter input and (with the exception of spruce) higher concentrations of dissolved nutrients and open canopies. By contrast, lodgepole pine decomposed more rapidly in sites receiving lower-quality litter inputs. Birch litter decomposition rate in coarse-mesh bags was best predicted by the same environmental variables as in fine-mesh bags, with additional positive influences of macroinvertebrate species richness. Hence, to facilitate energy turnover in boreal headwaters, forest management with focus on conifer production should aim at increasing the presence of native deciduous trees along streams, as they promote conditions that favor higher decomposition rates of terrestrial plant litter.

  • Anderson, N. John
    et al.
    Saros, Jasmine E.
    Bullard, Joanna E.
    Cahoon, Sean M. P.
    Mcgowan, Suzanne
    Bagshaw, Elizabeth A.
    Barry, Christopher D.
    Bindler, Richard
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Burpee, Benjamin T.
    Carrivick, Jonathan L.
    Fowler, Rachel A.
    Fox, Anthony D.
    Fritz, Sherilyn C.
    Giles, Madeleine E.
    Hamerlik, Ladislav
    Ingeman-Nielsen, Thomas
    Law, Antonia C.
    Mernild, Sebastian H.
    Northington, Robert M.
    Osburn, Christopher L.
    Pla-Rabes, Sergi
    Post, Eric
    Telling, Jon
    Stroud, David A.
    Whiteford, Erika J.
    Yallop, Marian L.
    Yde, Jacob C.
    The Arctic in the Twenty-First Century: Changing Biogeochemical Linkages across a Paraglacial Landscape of Greenland2017In: BioScience, ISSN 0006-3568, E-ISSN 1525-3244, Vol. 67, no 2, 118-133 p.Article in journal (Refereed)
    Abstract [en]

    The Kangerlussuaq area of southwest Greenland encompasses diverse ecological, geomorphic, and climate gradients that function over a range of spatial and temporal scales. Ecosystems range from the microbial communities on the ice sheet and moisture-stressed terrestrial vegetation (and their associated herbivores) to freshwater and oligosaline lakes. These ecosystems are linked by a dynamic glacio-fluvial-aeolian geomorphic system that transports water, geological material, organic carbon and nutrients from the glacier surface to adjacent terrestrial and aquatic systems. This paraglacial system is now subject to substantial change because of rapid regional warming since 2000. Here, we describe changes in the eco-and geomorphic systems at a range of timescales and explore rapid future change in the links that integrate these systems. We highlight the importance of cross-system subsidies at the landscape scale and, importantly, how these might change in the near future as the Arctic is expected to continue to warm.