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  • 601.
    Tervo, Taru
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Neovius, Martin
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Constant adaptation of bone to current physical activity level in men: a 12-year longitudinal study2008In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 93, no 12, p. 4873-4879Article in journal (Refereed)
    Abstract [en]

    CONTEXT: A high peak bone mineral density (BMD; grams per square centimeter) could reduce the risk of osteoporosis related fractures later in life. OBJECTIVE: This 12-yr longitudinal study investigated whether a high BMD from previous high physical activity is maintained with reduced activity later in life. DESIGN: This was a longitudinal study. PARTICIPANTS: Three groups were investigated with a mean age of 17 yr at baseline; 51 athletes who stopped their active careers during follow-up (former athletes), 16 who were active throughout follow-up (active athletes), and 25 controls. Main Outcome Measures: BMD of the femoral neck, total body, and lumbar spine were examined five times during the 12-yr follow-up period. RESULTS: After adjustment for age, weight, and height, the former athletes were found to have higher BMD at all sites at every follow-up visit except the last one, when compared with controls (P < 0.05). The active athletes were found to have significantly higher BMD at all measured locations when compared with controls throughout the entire study (P < 0.05). From the first to the final follow-up visit, the former athletes were found to have lost more femoral neck BMD than both the active athletes (mean difference, 0.12 g/cm(2); P = 0.003) and controls (mean difference 0.08 g/cm(2); P = 0.02). CONCLUSION: This study suggests that BMD constantly adapts to the present physical activity levels in young men. Thus, increased BMD due to previous high physical activity may not prevent osteoporosis in later years.

  • 602. Thid, Micael
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Retsmedicinske systemer i de nordiske lande2004In: Retsmedicin: nordisk laerebog / [ed] Jørgen L. Thomsen, Köpenhavn: Foreningen af danske Laegestuderendes forlag aktieselskab , 2004, 1, p. 425-436Chapter in book (Other (popular science, discussion, etc.))
  • 603. Thid, Micael
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Rättsmedicinska system i de nordiska länderna2006In: Rättsmedicin / [ed] Thomsen J, Liber , 2006, p. 403-414Chapter in book (Other academic)
  • 604.
    Thun Westerberg, Helena
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Olika terapiers påverkan på riskfaktorena för hjärt-och kärlsjukdomar hos diabetespatienter2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 605.
    Thysell, Elin
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Multivariate profiling of metabolites in human disease: Method evaluation and application to prostate cancer2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    There is an ever increasing need of new technologies for identification of molecular markers for early diagnosis of fatal diseases to allow efficient treatment. In addition, there is great value in finding patterns of metabolites, proteins or genes altered in relation to specific disease conditions to gain a deeper understanding of the underlying mechanisms of disease development. If successful, scientific achievements in this field could apart from early diagnosis lead to development of new drugs, treatments or preventions for many serious diseases.  Metabolites are low molecular weight compounds involved in the chemical reactions taking place in the cells of living organisms to uphold life, i.e. metabolism. The research field of metabolomics investigates the relationship between metabolite alterations and biochemical mechanisms, e.g. disease processes. To understand these associations hundreds of metabolites present in a sample are quantified using sensitive bioanalytical techniques. In this way a unique chemical fingerprint is obtained for each sample, providing an instant picture of the current state of the studied system. This fingerprint or picture can then be utilized for the discovery of biomarkers or biomarker patterns of biological and clinical relevance.

    In this thesis the focus is set on evaluation and application of strategies for studying metabolic alterations in human tissues associated with disease. A chemometric methodology for processing and modeling of gas chromatography-mass spectrometry (GC-MS) based metabolomics data, is designed for developing predictive systems for generation of representative data, validation and result verification, diagnosis and screening of large sample sets.

    The developed strategies were specifically applied for identification of metabolite markers and metabolic pathways associated with prostate cancer disease progression. The long-term goal was to detect new sensitive diagnostic/prognostic markers, which ultimately could be used to differentiate between indolent and aggressive tumors at diagnosis and thus aid in the development of personalized treatments. Our main finding so far is the detection of high levels of cholesterol in prostate cancer bone metastases. This in combination with previously presented results suggests cholesterol as a potentially interesting therapeutic target for advanced prostate cancer. Furthermore we detected metabolic alterations in plasma associated with metastasis development. These results were further explored in prospective samples attempting to verify some of the identified metabolites as potential prognostic markers.

  • 606.
    Thysell, Elin
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Chorell, Elin
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Svensson, Michael B.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Moritz, Thomas
    Jonsson, Pär
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Processing of mass spectrometry based metabolomics data for large scale screening studies and diagnosticsManuscript (preprint) (Other academic)
    Abstract [en]

    In mass spectrometry based metabolomics predictive data processing and sample classification based on representative sample subsets makes it possible to screen large sample banks or data sets in an efficient fashion regarding both data quality and processing time. This is a requirement for making use of high sensitivity and complexity metabolite data and to turn the metabolomics field into a competitive omics platform for biological interpretation and diagnostics. Predictive metabolomics by means of hierarchical multivariate curve resolution (H-MCR) followed by orthogonal partial least squares discriminant analysis (OPLS-DA) was used for the processing and classification of gas chromatography/time of flight mass spectrometry (GC/TOFMS) data characterizing human blood serum samples collected in a study of strenuous physical exercise. The efficiency of the predictive processing as a high throughput tool for generating high quality data is clearly proven and stated as a main benefit of the method. Extensive model validation schemes by means of cross validation and external predictions verified the robustness of the extracted systematic patterns in the data. Comparisons regarding the extracted metabolite patterns between models emphasized the reliability of the methodology in a biological information context. Furthermore, the high predictive power concerning longitudinal predictions provided proof for the diagnostic potential of the methodology. Finally, the predictive metabolite pattern was interpreted physiologically as well as verified in the literature, highlighting the biological relevance of the diagnostic pattern. The suggested approach makes it feasible to screen large data or sample sets with retained data quality and interpretation and to do this in a high throughput fashion. The method could be of value for sample bank mining, metabolome-wide association studies, verification of marker patterns and development of diagnostic systems.

  • 607.
    Thysell, Elin
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Pohjanen, Elin
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Lindberg, Johan
    Schuppe-Koistinen, Ina
    Moritz, Thomas
    Jonsson, Pär
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Reliable Profile Detection in Comparative Metabolomics2007In: Omics, ISSN 1536-2310, E-ISSN 1557-8100, Vol. 11, no 2, p. 209-224Article in journal (Refereed)
    Abstract [en]

    A strategy for processing of metabolomic GC/MS data is presented. By considering the relationship between quantity and quality of detected profiles, representative data suitable for multiple sample comparisons and metabolite identification was generated. Design of experiments (DOE) and multivariate analysis was used to relate the changes in settings of the hierarchical multivariate curve resolution (H-MCR) method to quantitative and qualitative characteristics of the output data. These characteristics included number of resolved profiles, chromatographic quality in terms of reproducibility between analytical replicates, and spectral quality defined by purity and number of spectra containing structural information. The strategy was exemplified in two datasets: one containing 119 common metabolites, 18 of which were varied according to a DOE protocol; and one consisting of rat urine samples from control rats and rats exposed to a liver toxin. It was shown that the performance of the data processing could be optimized to produce metabolite data of high quality that allowed reliable sample comparisons and metabolite identification. This is a general approach applicable to any type of data processing where the important processing parameters are known and relevant output data characteristics can be defined. The results imply that this type of data quality optimization should be carried out as an integral step of data processing to ensure high quality data for further modeling and biological evaluation. Within metabolomics, this degree of optimization will be of high importance to generate models and extract biomarkers or biomarker patterns of biological or clinical relevance.

  • 608.
    Thysell, Elin
    et al.
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Stattin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology.
    Moritz, Thomas
    Wikström, Pernilla
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    Antti, Henrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Evaluation of metabolic alterations in patient plasma associated with disease aggressiveness in prostate cancerManuscript (preprint) (Other academic)
    Abstract [en]

    GC-MS was used for the study of plasma metabolite profiles in prostate cancer patients. Multivariate analysis of the acquired data revealed metabolites and metabolite patterns associated with prostate cancer disease progression from benign disease to distant metastases. Moreover, by evaluation of plasma metabolite patterns before and after radical prostatectomy differences associated with biochemical relapse was detected. Specifically we found two unidentified plasma metabolites which showed decreased plasma levels with increased disease progression and, furthermore, increased plasma levels post compared to pre surgery in patients who later experienced biochemical relapse. We hypothesize that those metabolites are consumed by aggressive tumors more than by indolent tumors. Identification of those metabolites are hence crucial, and under-way, in order to enable biological interpretation of the results. We further hypothesized that any tumor-derived metabolite secreted into plasma would show increased concentrations with increased PCa risk. Notably we did not detect any such metabolite, but only a few metabolites which showed increased plasma concentrations in patients with metastases compared to patients with benign disease and low risk PCa. In addition, verification of metabolite markers for metastatic disease detected previously by us and others was made, and included decreased plasma levels of stearic acid and increased levels of pseudouridine with metastatic disease.

  • 609.
    Tofiq, Shokhan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Study of COX-independentchemopreventive activity ofNSAIDs: NSAIDs chemopreventive action2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 610.
    Trolin, Heléne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    En kvalitativ studie om barns upplevelser av att växla mellan två hem: med utgångspunkt i det psykoterapeutiska förhållningssättet2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Idag bor ca 35 procent av barn till separerade/skilda föräldrar växelvis varannan vecka hos

    respektive förälder. Med en kvalitativ intervju och fenomenologisk ansats riktar sig studien till

    barn som bor växelvis, en vecka vardera hos sina separerade/skilda föräldrar och hur de

    upplever övergången mellan hemmen. I studien deltog åtta barn i åldern 6-18 år. Intervjun

    baseras på halvstrukturerade frågor med intervjuguide och den berör föräldrars stöd till barnen

    och hur förberedelsen ser ut i samband med bytet. Resultatet visar att barnen får praktiskt stöd

    av sina föräldrar medan det känslomässiga ansvaret tycks vila på dem själva. Bytet mellan

    hemmen tycks för de flesta som deltog i studien ha blivit som en rutin bland andra rutiner men

    när det väl är dags för en övergång så upplever de flesta informanterna ledsenhet och

    motstridiga känslor. Det psykoterapeutiska förhållningssättet har lyfts upp som en viktig faktor

    för utfallet av barnens berättelser och vikten av att inkludera barnen och följa upp deras behov.

  • 611.
    Tysse Sperrevik, Marianne
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Immunterapi av lungekreft: En spørreundersøkelse blant leger i Norge & Sverige2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 612.
    Uka, Festina
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    FARMACEUTENS ROLL OCH FRAMTID: En studie om hur professionen speglas i media2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 613.
    Unger, Johanna
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Användning av mikronålar för administrering av vaccin: Tekniken bakom och dess för- respektive nackdelar.2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 614. Ungerstedt, J.
    et al.
    Eriksson, A.
    Ölander, E.
    Umeå University.
    Bergfelt, E.
    Liljeholm, M.
    Umeå University.
    Kristjanssdottir, H. Lind
    Erger, T.
    Erixon, D.
    Umeå University.
    Isaksson, C.
    Umeå University.
    Birgegard, G.
    DEVELOPMENT OF A PROGRESS TEST BASED ON THE EHA CURRICULUM AND EHA CV PASSPORT, USED FOR YEARLY EVALUATION OF HEMATOLOGY RESIDENCY IN SWEDEN2015In: Haematologica, ISSN 0390-6078, E-ISSN 1592-8721, Vol. 100, p. 776-776Article in journal (Other academic)
  • 615.
    Vallström, Stina
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Kassation av läkemedel på äldreboenden - En studie gjord i Skellefteå kommun2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 616.
    van Doorn, Janis
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Karlsson, Fredrik
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Influence of speech task and utterance length on measurement of pitch variability in the speech of Parkinson's disease patients after deep brain stimulation2013In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 28, no Supplement 1, p. S448-Article in journal (Refereed)
  • 617.
    Vandeberger, Olivia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Rättspsykiatrisk vård och allvarlig psykisk störning: Med fokus på personlighetsstörningar2009Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Det gemensamma samlingsbegreppet psykisk störning innefattar flera olika slag av diagnoser. Det är när störningen bedömts som allvarlig inom rättspsykiatrin som tvångsvård och straffrättslig särbehandling kan ske. Allvarlig psykisk störning (APS), är ett juridiskt samlingsbegrepp för olika medicinska och psykosociala störningar; framför allt psykotiska tillstånd som utmärks av en störd verklighetsuppfattning. Vanligt är något av symtomen: förvirring, hallucinationer, tankestörning och/eller vanföreställningar. En avgränsning av begreppet beskrivs i förarbetena till 1991 års reform (prop. 1990/1991) samt ytterligare precisering i allmänna råd från Socialstyrelsen (1991:10). Svårare personlighetsstörningar med t.ex. impulsgenombrott av psykotisk karaktär eller ett starkt tvångsmässigt beteende hör till denna kategori. Personlighetsstörningar relaterat till brott, är ett ämne som förekommit i hög grad under senare tid i massmedia. I flera fall har rättspsykiatriskt undersökta individer fått diagnosen personlighetsstörning som en allvarlig psykisk störning, och blivit dömda till rättspsykiatrisk vård med fängelseförbud – men domstolen har senare ändrat påföljden till fängelse. Det har delvis kunna ske genom en stark oenighet om den ”rätta” diagnosen mellan de läkare som inkallats som sakkunnigexperter till rätten. Det har förekommit att de öppet deklarerat sin oenighet i rätten huruvida den dömde lider av en personlighetsstörning, autism, schizofreni och/eller har hjärnskador. Det har i vissa fall inneburit att trovärdigheten i de psykiatriska diagnoserna ifrågasatts och domen har överklagats till hovrätten, där tingsrättens påföljd ändrats. Det är endast en liten del av den totala brottsligheten i vårt land leder till någon form av rättspsykiatrisk bedömning; av de ca 1,2 miljoner brott som årligen begås klaras ca 300 000 fall upp. Omkring 120 000 personer lagföres årligen för dessa brott, varav ca 2000 personer genomgår någon form av rättspsykiatrisk bedömning. Ca 400 personer av dessa överförs efter dom till rättspsykiatrisk vård och ca 12 500 personer döms årligen till fängelse (RMV, 2002).

  • 618.
    Vanoli, Davide
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Quantification of atherosclerotic plaque area by vascular ultrasound: reproducibility and comparison between conventional B-mode imaging and contrast-enhanced ultrasoundManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Quantification of plaque burden represents a significant challenge to clinical practices, however, innovations in technologies, techniques and methodologies play a significant role in plaque assessment and burden quantification. Plaque area determination represents a useful method for quantifying atherosclerosis but poor visualization of plaques remains an issue that may significantly restrict its use. Contrast enhanced ultrasound (CEUS) has been proposed as a technique to improve the visualization of atherosclerotic plaques, however, blooming artefacts inherent to the CEUS technique, and which are known to vary depending on the intensity of the enhancement, may lead to an underestimation of the true plaque area.

    We hypothesised that plaque area measurements using CEUS will improve reproducibility of plaque area quantification, and that this will be independent of the time at which the image is acquired post-contrast administration when compared with conventional B-mode imaging. In this study, the areas of 42 carotid plaques from 33 subjects (18 men, mean age 61.3 ± 3.02 years) were measured offline. A series of four image loops were acquired for each study: first a conventional B-mode image, then 3 separate CEUS image loops at 5, 10 and 15 seconds post-contrast administration. Also, two expert operators (A and B) performed measurements to assess for inter-observer variability.

    Results: We found a strong correlation between B-mode plaque area measurements and CEUS plaque area measurements performed at 5 (T5, ICC=0.998), 10 (T10, ICC=0.999) and 15 (T15, ICC=0.998) seconds post contrast administration. The ICC for intra-observer variability was 0.99 for operator A, and 0.98 for operator B. The ICC for inter-observer variability was 0.96 for B-mode measurements, and 0.98, 0.98 and 0.99, respectively, for CEUS measurements at T5, T10 and T15.

    Conclusion: This study showed a strong consensus between B-mode and CEUS images. Blooming artefacts, inherent to the CEUS imaging technique, do not seem to significantly affect the measurement of plaque area in comparison to conventional B-mode imaging.

  • 619.
    Varis, Linn
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Antibiotikas miljöpåverkan: Risken för resistens hos bakterier samt rening av vatten2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 620.
    Varmin-Kask, Marcux
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Rättspsykiatrisk vård: En jämförelse mellan domar och medicinska bedömningar gällande kön2013Student paper other, 5 credits / 7,5 HE creditsStudent thesis
  • 621.
    Vesterlund, Liselotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    DNA-tekniken och dess betydelse inom rättsmedicinen: Dåtid, Nutid och FRAMTID2009Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    DNA-baserade metoder infördes inom rättsgenetiken i mitten av 1980-talet och har snabbt ersatt äldre metoder såsom blodgruppsbestämning och HLA[1]-vävnadstypning.

    År 2001 publicerades den första versionen av det humana genomet efter flera års arbete och till en kostnad av 300 miljoner dollar (Lander et al. 2001; Venter et al. 2001). Kunskapen om den specifika genetiska koden för en individ är dock inte samma sak som att veta den genetiska sekvensen för hela mänskligheten, då vi som olika individer skiljer oss åt på DNA sekvens nivå. Denna variation mellan individer beror på dels variation i antalet kopior av våra gener, så kallade “copy number variation” (CNVs) dels på polymorfism vid enstaka nukleotider i DNA sekvensen, så kallad “single nucleotide polymorphism” (SNPs). CNVs är något besvärligare att analysera i jämförelse med SNPs, vilket har lett till att SNPs har blivit ett värdefullt redskap för att skilja olika individer från varandra och även för att identifiera genförändringar inom olika syndrom och sjukdomstillstånd. Men även om vår nyfunna kunskap om det mänskliga genomet redan har gett oss inblick i flertalet olika genetiska sjukdomar och evolutionen av Homo sapiens så är informationen kanske inte bara av godo. De nya etiska betänkanden som uppstått i och med ny kunskap och teknik inom det genetiska området behandlas i slutet av denna uppsats för att belysa behovet av kunskap för att på bästa sätt kunna använda denna kunskap för mänsklighetens bästa.

     

    [1] HLA står för “human leukocyte antigen"-antigen. HLA är en typ av antigen-presenterande molekyler som existerar på cellytan hos alla celler med cellkärna.

  • 622.
    Vesterlund Pettersson, Mikael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Åklagares användning av rättsmedicinsk bevisning: en analys av hur åklagare värderar rättsmedicinska slutsatser inför beslut om åtal2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

     

    Den 21 oktober 2011 meddelade Solna tingsrätt dom i det uppmärksammade målet med läkaren vid Astrid Lindgrens barnsjukhus, som i media kom att kalla för ”barnläkarfallet”. Mot bakgrund av det uppmärksammade rättsfallet kom det att ifrågasättas huruvida åklagarna gör någon egentlig bevisrättslig prövning av rättsmedicinska slutsatser inför åtalsbeslut. Det är i det sammanhanget som intresset för den här uppsatsens frågeställningar för min del växte fram.

     

    Det här är en rättsvetenskaplig uppsatts på det medikolegala området med tvärvetenskapliga inslag. Jag har undersökt hur åklagare inför åtalsbeslut går till väga för att kritiskt värdera rättsmedicinsk bevisning, varför uppsatsen är av deskriptiv och inte normativ karaktär. Jag har använt en rättsdogmatisk metod som kompletterats med en interaktiv rättsvetenskaplig metod genom att intervjua tre åklagare vid åklagarkammaren i Skövde. Jag har använt mig av semistrukturerade intervjuer då åklagarna haft möjlighet att svara på frågorna utifrån sin referensram.

     

    Den övergripande frågeställningen i uppsatsen är om åklagare i allmänhet har förmågan att värdera medicinsk sakkunnigbevisning på det sätt som Högsta domstolen förväntar sig att domstolar och åklagare ska göra. Av intervjuerna framgår det att åklagarna i ärenden med grövre brottslighet eller allvarligare skador gör en ingående prövning av de rättsmedicinska slutsatsernas bevisrättsliga värde, men att prövningen inte är lika ingående vid mindre allvarlig brottslighet. Åklagarna har dock uttryckt stor tilltro till de statliga myndigheter som har i uppdrag att bistå rättsväsendet med medicinsk eller annan vetenskaplig sakkunskap. Det är därför sällan som åklagare själva tar initiativ till ett second opinion i de fall som den medicinska bevisningen stärker åklagarens gärningspåstående. Det förekommer dock att åklagare begär yttrade från socialstyrelsens rättsliga råd, men då handlar det inte sällan om att en misstänkt bedömts ha begått den åtalade gärningen under påverkan av allvarlig psykisk störning vilket åklagaren ifrågasätter. Om inte förvaret agerar och begär kompletterande bevisning kommer därför domstolarna i de allra flesta fallen bara ha åklagarens bevisning i form av rättsintyg eller obduktionsprotokoll att tillgå i sin prövning. 

  • 623.
    Vestin, Antonia
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Vilken evidens finns för standardbehandling av hjärtsvikt till äldre?: - En litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 624.
    Vikberg, Sanna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sörlén, Niklas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Brandén, Lisa
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. School of Sports Science, UiT The Arctic University of Norway, Tromsö, Norway..
    Hult, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Effects of Resistance Training on Functional Strength and Muscle Mass in 70-Year-Old Individuals With Pre-sarcopenia: A Randomized Controlled Trial2019In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 1, p. 28-34Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Sarcopenia has been defined as age-related loss of muscle mass and function. The aim of this randomized controlled trial was to examine the effects of a 10-week instructor-led resistance training program on functional strength and body composition in men and women aged 70 years with pre-sarcopenia.

    DESIGN, SETTING, AND PARTICIPANTS: Participants were randomized to either 10 weeks of a physical training regimen including optional nutritional supplementation (n = 36) or to a control group (n = 34) (ClinicalTrials.gov, no. NCT03297632). The main outcome was changes in the Short Physical Performance Battery (SPPB) score. Secondary outcomes included the Timed Up and Go test, chair sit-stand time, lean body mass, and fat mass.

    RESULTS: The intervention had no significant effect on SPPB in the total cohort (P = .18), when comparing changes in the intervention group with the control group. However, those given the intervention in the male subcohort increased 0.5 ± 0.4 (mean ± standard error for the difference) points in SPPB during follow-up (P = .02) compared to male controls. With respect to secondary outcomes, the intervention group decreased 0.9 ± 0.6 seconds in chair sit-stand time compared to controls (P = .01). Furthermore, the intervention resulted in significantly greater improvements for the training group than control group in all measures of body composition (P ≤ .01 for all). For example, lean body mass increased by a mean of 1147 ± 282 g (P < .001), and total fat mass decreased by a mean of 553 ± 225 g (P = .003), favoring the intervention group.

    CONCLUSION/IMPLICATIONS: The main finding of this intervention study is that an easy-to-use, functional resistance training program was effective in maintaining functional strength and increasing muscle mass in older adults with pre-sarcopenia.

  • 625. Vikström, Sofia
    et al.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Karolinska Inst, Dept Neurobiol Caring Sci & Soc, Div Nursing, S-14183 Huddinge, Sweden.
    Stenwall, Ewa
    Boström, Anne-Marie
    Saarnio, Lotta
    Kindblom, Kristina
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. La Trobe Univ, Sch Nursing & Midwifery, Bundoora, Vic 3086, Australia.
    Borell, Lena
    A model for implementing guidelines for person-centered care in a nursing home setting2015In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 27, no 1, p. 49-59Article in journal (Refereed)
    Abstract [en]

    Background: Systematic evaluations of knowledge translation interventions in nursing homes to improve practice are scarce. There is also a lack of studies focusing on creating sustainable evidence-based practice in the setting of residential dementia care. Methods: The aim of this paper is to describe a model for implementing national evidence-based guidelines for care of persons with dementia in nursing homes. The secondary aim is to outline the nursing home staff experiences during the first year of the implementation process. The intervention had a participatory action research approach. This included educational activities such as: (i) thematic seminars introducing national guidelines for dementia care, (ii) regular unit-based seminars; and (iii) later dissemination of information in reflective seminars and several days of poster-exhibitions. Areas of practice development were selected on each of the 24 units, based on unit-specific needs, and a quality improvement strategy was applied and evaluated. Each unit met ten times during a period of eight months. Data for this study were extracted from the reflective seminars and poster presentations, analyzed using a qualitative content analysis. Results: Findings showed that implementation of guidelines were perceived by staff as beneficial for both staff and the residents. However, barriers to identification of relevant sources of evidence and barriers to sustainable implementation were experienced. Conclusions: One of our assumptions was that dementia nursing homes can benefit from becoming knowledge driven, with care practices founded in evidence-based sources. Our findings show that to be partly true, even though most staff units found their efforts to pursue and utilize knowledge adversely impacted by time-logistics and practical workload challenges.

  • 626.
    Viktor, Nilsson
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Estimates of physical activity patterns in older adults considering cardiovascular risk factors: A Comparison between the International Physical Activity Questionnaire and Actigraph GT3X+ Measurements2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Physical activity has emerged as a determining factor in reducing the risk of chronic diseases. Previous studies have shown that self-reported physical activity tending to be overestimated in comparison with physical activity measured objectively. In this study we investigate the consistency between those methods and the association to cardiovascular risk factors in older adults. Methods: The study population consisted of 1403 men and women aged 70, living in Umeå, Sweden. Physical activity was objectively assessed for seven days by the Actigraph GT3X+ accelerometer in intensity levels of light, moderate and vigorous. For self-reported assessment the International physical activity questionnaire was used. Data from the survey were calculated in metabolic equivalents minutes/week for walking, moderate and vigorous activity level. Results: Self-reported activity levels of moderate and vigorous correlated significantly with light activity measured by accelerometers for both men (r=0.21, p< 0.01) and women (r=0.19 p<0.01). Self-reported walking correlated with moderate activity level from the accelerometer, for men (r=0.40 p< 0.01) and for women (r= 0.40, p< 0.01). Waist, Body Mass Index and triglycerides were significant (p<0.01) for all activity levels measured by accelerometers in women. Individuals with BMI ≥ 25 showed stronger correlations between walking METs and light activity compared to individuals with BMI <25. Conclusion: Overall individuals at the aged of 70 tend to overestimate physical activity at higher intensities in IPAQ compared to accelerometers.

    Keywords: Physical activity - Accelerometry - International Physical Activity Questionnaire - Measurement - Elderly

  • 627.
    Vinterflod, Charlotta
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Physicians’ perceptions on clinical pharmacy services: A qualitative study2015Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 628. von Malorte, Sofia
    et al.
    Cronqvist, Ellinor
    Ringbäck Weitoft, Gunilla
    Flyckt, Lena
    Bodlund, Karin
    Msghina, Mussie
    Rosenberg, David
    Umeå University.
    Davidson, Thomas
    Nya nationella riktlinjer för vård och stöd vid schizofreni: Lyfter fram »återhämtningsperspektivet«: Rehabilitering i kombination med läkemedel kan ge bättre livskvalitet2019In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116Article in journal (Refereed)
  • 629.
    Wagner, Ryan G
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    The Burden of Epilepsy: using population-based data to define the burden and model a cost-effective intervention for the treatment of epilepsy in rural South Africa2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Rationale Epilepsy is a common, chronic, neurological condition that disproportionately affects individuals living in low- and middle- income countries, including much of sub-Saharan Africa. Epilepsy is treatable, with the majority of individuals who take anti-epileptic drugs experiencing a reduction, or elimination, of seizures. Yet the number of individuals taking and adhering to medication in Africa is low and interventions aimed at improving treatment are lacking.

    Aims To define the epidemiology of convulsive epilepsy in rural South Africa in terms of incidence, mortality and disability-adjusted life years; to determine outpatient, out-of-pocket costs resulting from epilepsy treatment; to establish the level of adherence to anti-epileptic drugs amongst people with epilepsy; and, to determine whether the introduction of routine visits to people with epilepsy by community health workers is a cost-effective intervention for improving adherence to anti-epileptic drugs.

    Methods Nested within the Agincourt Health and Demographic Surveillance System, this work utilized a cohort of individuals diagnosed with convulsive epilepsy in 2008 to determine health care utilization and out-of-pocket costs due to care sought for epilepsy. Additionally, using blood samples from the cohort, anti-epileptic drug adherence was measured and, following the cohort, mortality rates were determined. Using these collected epidemiological parameters, disability-adjusted life years due to convulsive epilepsy were determined. Finally, combining the epidemiological and cost parameters, a community health worker intervention was modeled to determine its incremental cost-effectiveness ratio.

    Key Findings The burden of convulsive epilepsy is lower in rural South Africa than other parts of Africa, likely due to lower levels of known risk factors. Yet the burden, especially in terms of mortality, remains high, as does the treatment gap and health care utilization. Findings from the economic evaluation found the introduction of a community health worker to be highly cost-effective and would likely lower the burden of epilepsy in rural South Africa.

    Implications Epilepsy contributes to the burden of disease in rural South Africa, with high levels of mortality and a substantial treatment gap. The introduction of a community-health worker is likely to be one cost-effective, community based intervention that would lower the burden of epilepsy by improving adherence to anti-epileptic drugs. Implementing this intervention, based on these findings, is a justified and important next step.

  • 630.
    Wahab, Gulala
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Sammanställning och utvärdering av läkemedelsgenomgångar inom Västerbottens läns landsting under 20122013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 631.
    Waller, Elisabet
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Sudden infant death syndrome (SIDS)2009Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    When the cause of sudden unexpected death in infancy (SUDI) remains unknown despite a meticulous post-mortem examination including a review of the circumstances of death and hospital journals the death may be classified such as sudden infant death syndrome (SIDS). Through the years, many mechanisms behind SIDS have been postulated even though the most accepted theories today involve thermal stress, rebreathing of expired gases and infection or inflammation.

    The aim of this report is to provide the reader with overall information regarding different hypotheses presented in the last decades trying to explain the etiology of sudden infant death. The results are mainly based on epidemiological studies and post-mortem examinations. This article will also compare old and new hypotheses behind the cause of SIDS and emphasize the importance of post-mortem examinations in determining the cause of sudden unexpected death in infancy. 

  • 632.
    Wamil, Natacha
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    An Evaluation of the Prevalence of Potentially Inappropriate Medications in a Hospital in Northern Sweden: A cross-sectional study using the EU (7)- PIM list and the Swedish indicators for evaluating the quality of older peoples’ drug therapies2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 633.
    Wang, Chao
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Role of pro-inflammatory S100A9 protein in amyloid-neuroinflammatory cascade in Alzheimer’s disease and traumatic brain injury2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background Traumatic brain injury (TBI) is a complex disease with a spectrum of symptoms and disabilities. Over the past decade TBI has become the focus of research due to growing epidemiological and clinical evidences that TBI incidences are strong risk factors for Alzheimer’s disease (AD). Major pathological hallmarks of AD are massive accumulations of amyloid-β peptide (Aβ) toxic oligomers and plaques. Neuroinflammation is also considered as a common denominator in AD and aging. The epidemiological and experimental studies have supported that non-steroidal anti-inflammatory drugs markedly reduce the age-related prevalence of AD and can slow amyloid deposition by mechanisms that still remain elusive. S100A9 is a multifunctional cytokine with diverse roles in the cell signaling pathways associated with inflammation and cancers. A widespread expression of S100A9 was also reported in many other ailments involving inflammatory processes, such as AD, malaria, cerebral ischemia and TBI, implying that S100A9 may be a universal biomarker of inflammation. The distinctive feature of S100A9 compared to other pro-inflammatory cytokines is its ability to self-assemble into amyloids, which may lead to the loss of its signaling functions and acquired amyloid cytotoxicity, exceeding that of Aβ.

    Methods S100A9 properties was studied under various ex vivo and in vitro conditions. First, human and mouse tissues with TBI and AD were subjected to microscopic, immunohistochemical and immunofluorescent techniques. Then, aged mouse treated with native, oligomeric and fibrillary S100A9 was also studied by using behavioral and neurochemical analysis. Moreover, S100A9 was established as a biomarker of dementia progression and compared with others such as Aβ42 and tau proteins, by studying cerebrospinal fluid (CSF) samples from different stages of dementia. Finally, in vitro experiments on S100A9 amyloidogenesis, co-aggregation with Aβ40 and Aβ42, digestion and cytotoxicity were also performed by using spectroscopic, atomic force microscopy and cell biology methods.

    Results S100A9-driven amyloid-neuroinflammatory cascade serves as a link between TBI and AD. We have found that S100A9 contributes to the plaque formation and intraneuronal responses in AD, being a part of the amyloid-neuroinflammatory cascade. In TBI we have found that extensive S100A9 neuronal production and amyloid self-assembly is triggered immediately after injury, leading to apoptotic pathways and neuronal loss. S100A9 is an integral component of both TBI precursor-plaques, formed prior to Aβ deposition, and AD plaques, characterized by different degree of amyloid maturation, indicating that all plaques are associated with inflammation. Both intra- and extracellular amyloid-neuroinflammatory cascades are intertwined and showed similar tendencies in human and mouse tissues in TBI and AD. Ex vivo findings are further supported by in vitro experiments on S100A9 amyloidogenesis, digestion and cytotoxicity. Importantly, being highly amyloidogenic itself, S100A9 can trigger and aggravate Aβ amyloid self-assembly and significantly contribute to amyloid cytotoxicity. Moreover, the CSF dynamics of S100A9 levels matches very closely the content of Aβ42 in AD, vascular dementia and mild cognitive impairment due to AD, emphasizing the involvement of S100A9 together with Aβ in the amyloid-neuroinflammatory cascade in these ailments.

    Conclusions The conclusions of this thesis is that the inflammatory pathways and S100A9 specifically represent a potential target for the therapeutic interventions during various post-TBI stages and far prior AD development to halt and reverse these damaging processes.

  • 634.
    Wang, Chao
    et al.
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Iashchishyn, Igor
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Nyström, Sofie
    Klementieva, Oxana
    Kara, John
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Bengtsson, Sara
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Foderà, Vito
    Vetri, Valeria
    Sancataldo, Giuseppe
    Horvath, Istvan
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Moskalenko, Roman
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics. Department of Pathology, Sumy State University, Sumy, Ukraine.
    Rofougaran, Reza
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Bäckström, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Wang, Mingde
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Gouras, Gunnar
    Marklund, Niklas
    Shankar, S.K.
    Morozova-Roche, Ludmilla
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    S100A9-driven amyloid-neuroinflammatory cascade in traumatic brain injury as a risk factor for Alzheimer’s diseaseManuscript (preprint) (Other academic)
  • 635.
    Wang, Zihao
    Umeå University, Faculty of Science and Technology, Umeå Institute of Design.
    Conceptualization and design of a future chest drainage canister2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Changsha city in Hunan province, China.

    Place: Changsha Center Hospital, Hunan province.

    City Area: 11,819 square kilometers

    City population: 714.66 million

     

    I watched the whole process of chest drainage surgery, introduced by Yang Jicheng, who is a thoracic surgeon attending doctor at this capital.

    During the field research in China, I also had research opportunity of chest drainage management, mostly performed by nurses, where I found out lots of design opportunities about the Chong canister, which was the most popular chest drainage canister used all over the  China

    Then I went back to Umea, Sweden, met Fredrik Homner who is a thoracic surgery doctor working in Norrlands University Hospital for almost 30 years. I told him what I saw in China and we exchanged lots of opinion about chest drainage. I realized that Chinese chest drainage patients were suffering unnecessary pain from outmoded equipment, which in Sweden they had already updated since 20 years ago.

    Whit help of Fredrik Holmner, I had opportunity to watch the whole process of pulmonary resection and endoscope technical, the focus of this process was the insertion of chest drainage tube at the end of this 5 hours surgery.

    After I had seen so many materials related to chest drainage, I found out my design focus, which was the Maquet Oasis Drain,  that had been recognized as the most advanced chest drainage equipment in the world and had been widely used in Europe and United States.

  • 636.
    Ward, Ulla
    et al.
    Örebro University hospital, Örebro, Sweden.
    Nilsson, Ulrica G.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Örebro University hospital, Örebro, Sweden.
    Acupuncture for postoperative pain in day surgery patients undergoing arthroscopic shoulder surgery2013In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 22, no 1, p. 130-136Article in journal (Refereed)
    Abstract [en]

    The purpose of this quasi-experimental study was to examine the effect of acupuncture on postoperative pain in day surgery patients undergoing arthroscopic shoulder surgery. Twenty-two participants scheduled to undergo arthroscopic shoulder surgery were included. The results showed that on postoperative day one pain decreased (-1.1) in patients receiving acupuncture compared to the control group in which pain increased (2.0), p = .014. Sleep quality was also significantly higher in the acupuncture group compared to the control group, p = .042. In conclusions, acupuncture seems to have a reducing effect on postoperative pain as well as increase sleep quality in day surgery patients undergoing arthroscopic shoulder surgery. In regards to application, nurses should be encouraged to use additional nonpharmacologic approaches like acupuncture in postoperative pain management, as this can be a part of the multimodal analgesic regimes to improve patients care.

  • 637.
    Warren, Simon
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    VEGF-hämmare vid behandling av våt makuladegeneration2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 638.
    Wejerborn, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Suicide by cop: En jämförelse mellan nordamerikanska och svenska förhållanden2011Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Suicid i allmänhet

    Suicid är en människas medvetna handling att avsluta sitt liv. Orsaken till att människor begår suicid är många. Ofta finns det en känsla av hopplöshet och kanske också låg värdering av det egna livet. De flesta som lyckas ta sitt liv är män och det är en av de vanligaste sätt att dö bland yngre människor i Sverige i dag. Ytterligare riskfaktorer är att vara ogift, arbetslöshet, missbruk och dessutom lida av en personlighetsstörning. Gemensamt för människor med suicidtankar är att de ofta lider av en mycket stark ångest. Detta tillstånd kan leda till att döden uppfattas som en utväg.

    Varje person kan intuitivt förklara vad ordet självmord innebär. Men begreppet att ta sitt eget liv är dock betydligt mer komplicerat. Man kan ta livet av sig på många sätt. Durkheims klassiska bok Självmordet (1897) identifierar tre typer av självmord. Egoistiskt, altruistiskt och anomiskt. Dessa tre typer illustrerar en persons otillräckliga funktion eller överdrivna integration i samhället. Durkheim ansåg att suicidnivåerna i ett samhälle kan kopplas till den sociala kontext som finns i samhället. ”Egna erfarenheter och upplevelser, som ofta ansetts vara den omedelbara orsaken till att en individ begår självmord, har så att säga endast lånat detta inflytande från individens psykiska dispositioner, vilket i sin tur bara är en spegling av samhällstillståndet”(1897, sid. 8).

    Helena Rådbo (okänt årtal) som forskat kring suicidprevention skriver att man klassificerar ibland sättet att ta sitt liv i våldsam/hård metod och mjuk metod (violent and soft method). Till de våldsamma metoderna hör hängning, skjutvapen, att arrangera ”elolyckor”, att kasta sig från höga höjder och kollision med tåg eller annan tung trafik. Till de mjukare hör förgiftning med tabletter och dylikt. Ofta väljer män en mer våldsam metod. Och metoder med omfattande förstörelse föredras av framförallt yngre män. Detta styrks av en undersökning baserad på depression och suicid på Gotland gjord av Rihmer, Rutz och Pihlgren (1995). I denna kommer de fram till att av de män som ingick i undersökningen så hade två av tre använt våldsamma suicidmetoder.

    Suicide by Cop

    I Sverige har vi forskat kring suicid i preventivt syfte sedan 1970-talet och suicid har minskat sedan dess. Men det finns ett suicidfenomen som i princip är fullständigt outforskat i Sverige idag. Det är forskning på de människor som kommer i kontakt med polis och som beter sig så aggressiv och irrationellt åt att polismännen anser sig nödsakade att skjuta dem i självförsvar. I Nordamerika finns det sedan ett tiotal år tillbaka en etablerad forskning kring denna företeelse som kallas bland annat för Suicide by Cop eller Officer-Related Homicide.

    Inom svensk polis är detta fenomen inte allmänt känt och fram till slutet på 2000-talet så fick poliselever inte någon utbildning på detta. Ändå stöter alla polismän i yttre tjänst på personer som beter sig irrationellt, aggressivt och hotfullt åt trots polismannens, i normala fall, övertag genom beväpning och träning. När en svensk polis har skjutit verkanseld kommer det mer eller mindre per automatik kritik mot detta bland annat från massmedia. Och de poliser som tvingas skjuta står då i skottgluggen för denna kritik. Samtidigt som den skjutna personen ofta ses som offer för polisens övervåld. Detta i kombination med det samhälleliga behovet av att motverka suicid gör att det är önskvärt med mer forskning i ämnet Suicide by Cop ur ett svenskt perspektiv för att öka kunskapen och kanske på sikt kunna förhindra dessa skjuthändelser före de inträffar.

  • 639.
    Westerberg, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Rättsintyg2011Student paper other, 5 credits / 7,5 HE creditsStudent thesis
  • 640.
    Westesson, Beatrice
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Överförskrivnings-anmälningar från svenska apotek till Inspektionen för vård och omsorg 2000–20172018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 641.
    Westling, Linnea
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Jämförelse av den viktminskande effekten och biverkningar av Orlistat och Liraglutid vid behandling av fetma2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 642.
    Wetterberg, Marit
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Förekomst av läkemedelsavvikelser vid ortopedavdelningen på Mora lasarett2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 643.
    Wiklander, Ann-Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Barnahus - Bemötandet av barn som utsatts för våld och övergrepp i ett rättsmedicinskt perspektiv2010Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    På uppdrag av regeringen inleddes år 2005 en nationell försöksverksamhet med Barnahus i Sverige. Socialtjänst, barn- och ungdomspsykiatri, barnsjukvård, rättsläkare, polis och åklagare skulle samverka under samma tak i en miljö anpassad för barn. Försöksverksamheten inleddes på sex orter i Sverige: Malmö, Göteborg, Stockholm, Linköping, Sundsvall och Umeå. Försöksverksamheten med Barnahus kom att få två övergripande målsättningar, dels att rättsvårdande myndigheter skulle bedriva ett effektivt utredningsarbete som i förlängningen skulle leda till att fler gärningsmän lagfördes samt att verksamheten skulle innebära ett skydd och stöd för barnet. Ett annat mål med projektet var också att barnen inte skulle utsättas för onödiga påfrestningar i samband med brottsutredningar. 1) Rättsmedicinska undersökningar utgör en del av utredningsarbetet när rättsmedicinsk personal utreder barn som utsatts för våld och sexuella övergrepp.Undersökningarna kan upplevas av barnen som negativa och känslor av rädsla kan förekomma. Ibland får barnet sövas för att kunna genomgå en rättsmedicinsk undersökning. Då rättsintyget, i egenskap av bevismaterial i en brottmålsprocess, har stor betydelse eftersom det kan åberopas som bevisning till stöd för förekomsten av skador och skadors uppkomstsätt, så är det viktigt att rättsmedicinska undersökningar utförs i frekvent omfattning och på sådant sätt att det inte psykologiskt påverkar barnet negativt, till exempel att det känner en rädsla för framtida sjukhusbesök. 2)

     

  • 644.
    Willberg, Solveig
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Oidipus, Freud och det utsatta barnet2011Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna uppsats är att belysa och jämföra det utsatta barnets öde såsom det speglas i myten och dramat om Oidipus och i Freuds teori om oidipuskomplexet. Myten och senare Sofokles drama handlar om ett barn som av sina föräldrar sätts ut i skogen för att dö med genomborrade hälar, men blir funnet och räddat till livet. Som vuxen kommer Oidipus långt senare att ovetandes döda sin far och gifta sig med sin mor. Freud såg häri ett mönster som han menar går igen i varje pojkes psykosexuella utveckling – ett sexuellt begär i förhållande till modern och hatiska känslor i förhållande till fadern/rivalen. Freuds uppfattning har under senare år mött mycket kritik vilken refereras i uppsatsen. Oidipuskomplexet ersatte Freuds tidigare uppfattning att neuroserna orsakades av sexuella övergrepp – den s.k. förförelseteorin – och i uppsatsen diskuteras olika skäl till varför Freud övergav förförelseteorin. Bland annat diskuteras om Freuds familjebakgrund kan ha spelat in. Vidare redovisas den ursprungliga oidipusmyten, liksom Sofokles drama och det antika grekiska sammanhanget. Ett återkommande tema är omgivningens syn på det lilla barnet under antiken, på Freuds tid och i vår nutid. Författarens slutsatser är att Freud av flera olika skäl inte kunde behålla sin tidigare förståelse av det utsatte barnet och att oidipuskomplexets universalitet måste ifrågasättas.  Freud tycks förbise den utsatthet och totala hjälplöshet som varje barn föds till, och som inte minst är så påtaglig i berättelsen om Oidipus.

     

  • 645.
    Winroth, Ann Cristin
    Umeå University, Faculty of Arts, Culture and Media.
    Vardagligt och livsviktigt berättande om hälsa och bot2004In: Perspektiv på komplementärmedicin: medicinsk pluralism i mångvetenskaplig belysning / [ed] Motzi Eklöf, Lund: Studentlitteratur, 2004, p. 133-146Chapter in book (Other academic)
  • 646.
    Winroth, AnnCristin
    Umeå University, Faculty of Arts, Culture and Media.
    Hur tänker den alternativa patienten2004In: Människan och den medicinska mångfalden: 2003 års skandinaviska forskningskonferens om alternativ och komplementär medicin, Örebro: Örebro universitet , 2004Conference paper (Other academic)
  • 647.
    Wohrne, Therese
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Vorapaxar, en ny trombocyt-aggregationshämmare: Evaluering av kliniska användningsområden2013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 648.
    Yngve, Henny
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Edlund, Johannes
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samstämmighet i bedömning av utfallssteg visuellt och med hjälp av videoanalysprogram2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning:Avvikande rörelsemönster kan medföra muskuloskeletala besvär. Därför är det viktigt att kunna göra noggranna bedömningar utav rörelser hos olika individer. Två-dimensionella videoanalysprogram är lättillgänglig teknik som kan underlätta för fysioterapeuten. Få studier till dags dato har undersökt reliabilitet och validitet hos dessa program. Syfte Syftet med undersökningen var att utvärdera överrensstämmelsen emellan och inom två bedömare som använder det två-dimensionella videoanalysprogrammet Kinovea i jämförelse med visuell bedömning på plats för att utvärdera om det kan användas som hjälpmedel vid rörelseanalys. Metod Deltagarna i studien var 15 kvinnor och 17 män (medelålder 23,5 år) Samtliga fick utföra två utfallsseg. Utfallsstegen observerades och filmades av videokamera framifrån och från sidan. Två bedömare gjorde varsin bedömning visuellt och en senare bedömning med Kinovea, samt två vinkelmätningar av knäled i Kinovea. Den procentuella överenstämmelsen och korrelationen emellan och inom bedömarna analyserades. Resultat Resultaten enligt bedömningsverktyget visade att överrensstämmelsen emellan bedömare var moderat till bra i visuellbedömning och moderat till utmärkt i Kinovea. Inom bedömare 1 var överenstämmelsen mellan visuell och Kinovea bedömning bra till utmärkt och för bedömare 2 moderat till bra. Vinkelmätning visade en medelavvikelse på 2 -6 grader och Pearson’s korrelation emellan och inom bedömare var hög (r=0,86-0,98). Konklusion Kinovea tycks kunna användas som hjälpmedel för att observera en dynamisk rörelse såsom ett utfallssteg även om felmarginalen kan vara uppemot 6 grader vid upprepade bedömningar.

  • 649.
    Yousef, Dylan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    COX-hämmare och risk förakut njursvikt: - En jämförelse mellan coxiber, icke-selektivaNSAID och paracetamol2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 650.
    Yousef, Dylan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Periodens vara och utmaningar för apotekeni samband medlagerhållning: En enkätstudie2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
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