Publikationer från Umeå universitet
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Sambandet mellan identitetsstatus och romantisk anknytning hos unga vuxna
Unga vuxnas psykiska ohälsa ökar samtidigt som deras känsla av sammanhang minskar i Sverige. Utöver förbättrade socioekonomiska förutsättningar, behövs fördjupade kunskaper om målgruppens psykologi och relationella fungerande för att samhället ska kunna erbjuda bättre stöd och behandling för denna målgrupp. Tidigare forskning och teoribildning inom anknytning respektive identitetsutveckling är omfattande, men relativt få studier har studerat sambandet mellan identitetsformation och anknytningsstil. Tidigare forskning och teori indikerar att trygg anknytning har en positiv korrelation med mogen identitetsstatus, samt att otrygg anknytning korrelerar med mindre mogen identitetsstatus, och att dessa samband stärks med åldern och utvecklingen. Således var syftet med studien att undersöka huruvida unga vuxnas identitetsformation korrelerar med anknytningsstil i kärleksrelationer, i en svensk kontext. Deltagarna bestod av unga vuxna i åldern 16–29 år (n = 124) och studien genomfördes med hjälp av en anonym webbenkät vilken baserades på de två etablerade självskattningsformulären: Ego Identity Process Questionaire – Short Form (EIPQ-SF) för att mäta identitetsformation, och: Experiences in Close Relationships – Short version (ECR-S) för att mäta anknytning i kärleksrelationer. Deltagarna skattade även upplevd nöjdhet med den egna personen, samt upplevd nöjdhet i kärleksrelationer. Bivariata korrelationsanalyser visade emellertid på ett icke-signifikant samband mellan identitetsstatus och anknytning i kärleksrelationer, vilket skiljer sig från tidigare forskning och teoribildning. Författaren diskuterar huruvida skillnaderna i resultateten kan förstås utifrån bristande reliabilitet och validitet avseende studiedesignen, självskattningsformulärens inre konsistens och sociokulturell kontext. Fördjupade kunskaper och mer omfattande studier av dessa samband samt närliggande koncept bör utforskas vidare i framtida forskning. Nyckelord: Identitetsstatus, EIPQ, anknytning, ECR, unga vuxna. Young adult’s mental health increases at the same time their sense of coherence is decreasing in Sweden. In addition to improved socio-economical conditions, society is in need for advanced knowledge of young adult’s psychology and relational functioning in order to provide informed care and treatment. Previous research and theory on attachment and identity formation is extensive, but relatively little research has studied the relation between identity formation and romantic attachment. Previous research and theory indicate that secure attachment correlates positively with mature identity status, and that unsecure attachment correlates with immature identity status, and that this relation strengthens with age and development. Thus, the aim of the study was to investigate whether young adults’ identity formation relates to romantic attachment in a Swedish context. The participants consisted of young adults in the ages of 16–29 (n = 124), and the study was conducted with an anonymous web survey which was based on two established self-assessment forms: Ego Identity Process Questionaire – Short Form (EIPQ-SF) to asses identity formation, and: Experiences in Close Relationships – Short version (ECR-S) to assess romantic attachment. The participants also reported perceived satisfaction with themselves, as well as perceived satisfaction in romantic relationships. Bivariate correlation analyses, however, showed no significant correlation between identity status and romantic attachment, which differs from previous research and theory. The author discusses whether the differences in the results can be understood based on a lack of reliability and validity regarding the study desgin, the internal consistency of the self-report forms, and sociocultural context. Further knowledge and more comprehensive studies of these connections and related concepts should be explored further in future research. Keywords: Identitty status, EIPQ, attachment, ECR, young adults.
Att studera inkomstbanor som funktionella utfall
In this thesis, we present methods for studying patterns of income accumulation over time using functional data analysis. This is made possible by the availability of large-scale longitudinal register data in Sweden. By modelling individuals’ cumulative earnings trajectories as continuous functions of time, we can explore temporal dynamics as well as divergences in these trajectories based on initial labour market conditions. A major contribution of this thesis consists of extending the potential outcome framework for causal inference to functional data analysis. In Paper I, we use functional-on-scalar linear regression and an interval-wise testing procedure to study the associations between initial labour market size and income trajectories for one Swedish birth cohort. In Paper II, we present methods to draw causal conclusions in this setting. We introduce the functional average treatment effect (FATE), as well as an outcome-regression based estimator for this parameter. In addition, we show the finite sample distribution of this estimator under certain regularity conditions and demonstrate how simultaneous confidence bands can be used for inferences about the FATE. An application study in this paper estimates the causal effect of initial labour market size on income accumulation trajectories. In Paper III, these methods are applied to study the effect of initial firm age on earnings accumulation. Paper IV presents an outcome regression based and a double robust estimator for the mean of functional outcomes when some of these outcome functions are missing at random. We derive the asymptotic distributions of these two estimators as well as their covariance structure under more general conditions.
Attenuering av satellitsignaler till följd av atmosfärisk påverkan i norra Sverige
Earth-space traversing electromagnetic waves become attenuated as they propagate through the atmosphere. The sources of attenuation are weather phenomena in the Troposphere, and scintillation and absorption in the Ionosphere. On behalf of Arctic Space Technologies AB, an empirical model based on data from the last decade was built in Python, in order to estimate the level of attenuation and provide a better picture of the frequency environment at the site in Piteå. By utilizing recommendations from the International Telecommunication Union Radiocommunication Sector, and constraining the project to only consider the case where the satellite is at an 5° apparent elevation in Piteå, and a range of weather phenomena a nuanced picture can be obtained. It was found that the attenuation from the Ionosphere in typical satellite frequency bands is not of significance, and therefore only the Tropospheric sources were considered. The results showed that the S-band is the most reliable band to utilize, since little to no changes were observed for a range of weather scenarios. For the X-band, larger changes in the level of attenuation were observed for higher levels of precipitation, yet not as severe as for the Ku- and Ka- bands. However, for the Ku- and Ka-bands, large fluctuations in the attenuation were observed for different cases. In conclusion, the attenuation at Arctic space's site in Piteå for the S- and X-bands are the lowest and least effected by changes in weather. On the other hand, the Ku- and Ka-bands should be used predominantly under good weather circumstances
Characterization of carfentanil and thiofentanil using surface-enhanced raman spectroscopy and density functional theory
Fentanyls are synthetic opioids up to 10,000 times more potent than morphine. Although initially developed for medical applications, fentanyl and its analogues have recently grown synonymous with the ongoing opioid epidemic. To combat the continued spread of these substances, there is a need for rapid and sensitive techniques for chemical detection. Surface-enhanced Raman spectroscopy (SERS) has the potential for trace detection of harmful chemical substances. However, vibrational spectra obtained by SERS often differ between SERS substrates, as well as compared with spectra from normal Raman (NR) spectroscopy. Herein, SERS and NR responses from two fentanyl analogues, carfentanil (CF) and thiofentanil (TF), were measured and analysed with support from density functional theory (DFT) modelling. Using commercially available silver nanopillar SERS substrates, the SERS signatures of samples diluted in acetonitrile between 0.01 and 1000 µg/mL were studied. Relative SERS peak intensities measured in the range of 220–1800 cm−1 vary with concentration, while SERS and NR spectra largely agree for CF at higher concentrations ((Formula presented.) 100 µg/mL). For TF, three distinct NR peaks at 262, 366 and 667 cm−1 are absent or strongly suppressed in the SERS spectrum, attributed to the lone-pair electrons of the thiophene's sulphur atom binding to the Ag surface. The concentration dependence of the Raman peak at (Formula presented.) 1000 cm−1, assigned to trigonal bending of the phenyl ring, approximately follows a Langmuir adsorption isotherm. This work elucidates similarities and differences between SERS and NR in fentanyl detection and discusses the chemical rationale behind these differences
Real-world management of patients with pulmonary arterial hypertension : insights from EXPOSURE
Introduction: Further insights into real-world management and outcomes of patients with pulmonary arterial hypertension (PAH) are needed. This interim analysis of the ongoing, multicentre, prospective EXPOSURE (EUPAS19085) observational study describes characteristics, treatment patterns and outcomes of patients with PAH initiating a new PAH-specific therapy in Europe/Canada. Methods and Results: All analyses were descriptive. In total, 1944 patients with follow-up information were included; the majority were female, with World Health Organization functional class II/III symptoms and with idiopathic PAH or connective tissue disease-associated PAH. Most incident patients (N = 1100; diagnosed for ≤ 6 months) initiated treatment as monotherapy (48%) or double therapy (43%). Of those initiating monotherapy, 38% (199/530) escalated to double therapy (median [Q1, Q3] time to escalation 3.4 [1.9, 6.6] months), and of those initiating double therapy, 17% (78/457) escalated to triple therapy (median [Q1, Q3] time to escalation 7.0 [3.4, 12.7] months) during the observation period (median [Q1, Q3]: 17.0 [7.5, 29.9] months). The majority of the 834 prevalent patients (diagnosed > 6 months) entered the study on initiation of combination therapy and most did not change treatment regimen during the observation period (median [Q1, Q3]: 19.6 [10.2, 32.2] months). One-year survival was 88% for incident patients and 90% for prevalent patients. Conclusions: Results from EXPOSURE suggest a shift towards combination therapy and the alignment of real-world treatment patterns with current guideline recommendations. While survival estimates are encouraging, the extent of monotherapy use at treatment initiation and follow-up highlight an opportunity for further improvements through optimisation of treatment strategies in line with current guidelines. A graphical abstract is also available with this article. Trial Registration Number: EUPAS19085
Human herpesvirus 6A and axonal injury before the clinical onset of multiple sclerosis
Recent research indicates that multiple sclerosis is preceded by a prodromal phase with elevated levels of serum neurofilament light chain (sNfL), a marker of axonal injury. The effect of environmental risk factors on the extent of axonal injury during this prodrome is unknown. Human herpesvirus 6A (HHV-6A) is associated with an increased risk of developing multiple sclerosis. The objective of this study was to determine if HHV-6A serostatus is associated with the level of sNfL in the multiple sclerosis prodrome, which would support a causative role of HHV-6A. A nested case-control study was performed by crosslinking multiple sclerosis registries with Swedish biobanks. Individuals with biobank samples collected before the clinical onset of multiple sclerosis were included as cases. Controls without multiple sclerosis were randomly selected, matched for biobank, sex, sampling date and age. Serostatus of HHV-6A and Epstein-Barr virus was analysed with a bead-based multiplex assay. The concentration of sNfL was analysed with single molecule array technology. The association between HHV-6A serology and sNfL was assessed by stratified t-tests and linear regressions, adjusted for Epstein-Barr virus serostatus and sampling age. Within-pair ratios of HHV-6A seroreactivity and sNfL were calculated for each case and its matched control. To assess the temporal relationship between HHV-6A antibodies and sNfL, these ratios were plotted against the time to the clinical onset of multiple sclerosis and compared using locally estimated scatterplot smoothing regressions with 95% confidence intervals (CI). Samples from 519 matched case-control pairs were included. In cases, seropositivity of HHV-6A was significantly associated with the level of sNfL (+11%, 95% CI 0.2-24%, P = 0.045) and most pronounced in the younger half of the cases (+24%, 95% CI 6-45%, P = 0.007). No such associations were observed among the controls. Increasing seroreactivity against HHV-6A was detectable before the rise of sNfL (significant within-pair ratios from 13.6 years versus 6.6 years before the clinical onset of multiple sclerosis). In this study, we describe the association between HHV-6A antibodies and the degree of axonal injury in the multiple sclerosis prodrome. The findings indicate that elevated HHV-6A antibodies both precede and are associated with a higher degree of axonal injury, supporting the hypothesis that HHV-6A infection may contribute to multiple sclerosis development in a proportion of cases
Classification and characterization of traumatic brain injuries in the northern region of sweden
Background: Traumatic brain injury (TBI) is a common cause of death and disability, the incidence of which in northern Sweden is not fully investigated. This study classifies and characterize epidemiological and demographic features of TBIs in a defined population in Umeå county, Sweden. Specifically, to evaluate frequencies of (1) intracranial lesions detected with computed tomography (CT), (2) need for emergency intervention, and (3) hospital admission, in minimal, mild, moderate, and severe TBI, respectively. Methods: The data were gathered from 4057 TBI patients visiting our emergency room (ER) during a two-year period (2015–2016), of whom 56% were men and approximately 95% had minimal TBIs (Glasgow Coma Scale (GCS), score 15). Results: Of all injuries, 97.8% were mild (GCS 14–15), 1.7% were moderate (GCS 9–13), and 0.5% were severe (GCS < 9). CT scans were performed on 46% of the patients, with 28% being hospitalized. A high annual TBI incidence of 1350 cases per 100,000 citizens was found. The mortality rate was 0.5% with the majority as expected in the elderly group (>80 years). Conclusions: Minimal TBIs were not as mild as previously reported, with a relatively high frequency of abnormal CT findings and a high mortality rate. No emergency intervention was required in patients in the GCS 13–15 group with normal CT scans. These findings have implications for clinical practice in the ER with the suggestion to include biomarkers to reduce unnecessary CT scans
Place and youth political action : how place shapes political action in rural Sweden
There are important gaps in the research on youth political action due to a lack of attention to the roles of place and the experiences of young people in rural places. To address these gaps, this article presents findings from intensive interviews with 15 young people (aged between 16 and 29 years) who identified as politically/socially engaged and lived or had recently lived in a rural place in Sweden. Analysis of their responses, based on constructivist-grounded theory, shows that place dimensions shaped three social processes of young people’s political action: engaging in politics in (rural) places, finding recognition as political actors in (rural) places and negotiating political belonging in relation to (urban) places. By linking these processes with Agnew’s three-dimensional understanding of place, the analysis provides novel insights into how various dimensions of place shape crucial social processes of youth political action
The interplay between obesity and blood neutrophils in adult-onset asthma
Highlights: Severe obesity strongly associates to blood neutrophils in adult-onset asthma. B-neutrophils may partly mediate associations between obesity and asthma control. Clinical evaluation of adult-onset asthma should include assessing B-neutrophils
Increased risk of long-term disabilities following childhood bacterial meningitis in Sweden
IMPORTANCE: Few studies have examined the incidence of long-term disabilities due to bacterial meningitis in childhood with extended follow-up time and a nationwide cohort. OBJECTIVE: To describe the long-term risks of disabilities following a childhood diagnosis of bacterial meningitis in Sweden. DESIGN, SETTING, AND PARTICIPANTS: This nationwide retrospective registry-based cohort study included individuals diagnosed with bacterial meningitis (younger than 18 years) and general population controls matched (1:9) by age, sex, and place of residence. Data were retrieved from the Swedish National Patient Register from January 1, 1987, to December 31, 2021. Data were analyzed from July 13, 2022, to November 30, 2023. EXPOSURE: A diagnosis of bacterial meningitis in childhood recorded in the National Patient Register between 1987 and 2021. MAIN OUTCOMES AND MEASURES: Cumulative incidence of 7 disabilities (cognitive disabilities, seizures, hearing loss, motor function disorders, visual disturbances, behavioral and emotional disorders, and intracranial structural injuries) after bacterial meningitis in childhood. RESULTS: The cohort included 3623 individuals diagnosed with bacterial meningitis during childhood and 32 607 controls from the general population (median age at diagnosis, 1.5 [IQR, 0.4-6.2] years; 44.2% female and 55.8% male, median follow-up time, 23.7 [IQR, 12.2-30.4] years). Individuals diagnosed with bacterial meningitis had higher cumulative incidence of all 7 disabilities, and 1052 (29.0%) had at least 1 disability. The highest absolute risk of disabilities was found for behavioral and emotional disorders, hearing loss, and visual disturbances. The estimated adjusted hazard ratios (HRs) showed a significant increased relative risk for cases compared with controls for all 7 disabilities, with the largest adjusted HRs for intracranial structural injuries (26.04 [95% CI, 15.50-43.74]), hearing loss (7.90 [95% CI, 6.68-9.33]), and motor function disorders (4.65 [95% CI, 3.72-5.80]). The adjusted HRs for cognitive disabilities, seizures, hearing loss, and motor function disorders were significantly higher for Streptococcus pneumoniae infection (eg, 7.89 [95% CI, 5.18-12.02] for seizure) compared with Haemophilus influenzae infection (2.46 [95% CI, 1.63-3.70]) or Neisseria meningitidis infection (1.38 [95% CI, 0.65-2.93]). The adjusted HRs for cognitive disabilities, seizures, behavioral and emotional disorders, and intracranial structural injuries were significantly higher for children diagnosed with bacterial meningitis at an age below the median. CONCLUSIONS AND RELEVANCE: The findings of this cohort study of individuals diagnosed with bacterial meningitis during childhood suggest that exposed individuals may have had an increased risk for long-term disabilities (particularly when diagnosed with pneumococcal meningitis or when diagnosed at a young age), highlighting the need to detect disabilities among surviving children