Tobacco and multiple sclerosis susceptibility

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system (CNS) that arises from a combination of a complex genetic predisposition and environmental factors. For northern Europeans, the lifetime risk of MS is 1:400, making it the most common non-traumatic cause of disability in young adults. The strongest genetic associations with MS are located within the human leukocyte antigen (HLA) complex and in recent years, a large number of non-HLA risk loci that influence disease susceptibility have been identified. The contribution of lifestyle and environmental factors is more difficult to study. However, it is important to identify these factors since they are potentially preventable and may also lead to hypotheses on critical pathogenic events. This thesis focuses on the impact of tobacco on MS risk. We replicated the finding of an association between smoking and MS risk and demonstrated that the risk of developing the disease increases with cumulative dose of smoking. However, snuff use, which leads to exposure to high doses of nicotine, was associated with decreased MS risk (paper I). In paper II, we showed an inverse dose-response correlation between cumulative dose of snuff use and disease risk. Nicotine has been shown to be protective in several models of inflammatory diseases, and may thus exert anti-inflammatory and immune-modulating effects in a way that reduces the risk of developing MS. In paper IV, we investigated the association between smoking and MS in more detail. Both duration and intensity of smoking contribute independently to the risk of developing the disease. Smoking affects MS risk regardless of age at exposure, in contrast to many other environmental risk factors which seem to act mainly during adolescence. The detrimental effect of smoking slowly abates after smoking cessation regardless of the timing of smoking and regardless of the cumulative dose of smoking. In paper III, we demonstrated that exposure to passive smoking among never smokers is associated with increased risk of MS. Tobacco smoke, but not tobacco consumption in the form of moist snuff, increases MS risk, suggesting that the critical effects of smoking may be caused by irritation in the lungs. Smoking increases pro-inflammatory cell activation and induces post-translational modifications of proteins in the lungs. In paper V, an interaction was demonstrated between carriage of HLA-DRB1*15, absence of HLA A*02, and smoking in the development of MS. We hypothesize that smoke-induced lung irritation, in the context of MS risk HLA genes, may generate post-translationally modified peptides which are cross-reactive with CNS antigens, promoting a CNS-directed autoaggressive immunity that results in MS. Further studies would be valuable in order to investigate whether other forms of lung irritation contribute to the triggering of MS. Apart from generating data of importance for preventive measures, our finding of an interaction between smoking and HLA genotype emphasizes the need to include data on environmental exposures in genetic analyses of complex diseases and vice versa

Evaluating End User Development as a Requirements Engineering Technique for Communicating Across Social Worlds During Systems Development

Requirements engineering is a key activity in systems development. This paper examines six systems development projects that have used end user development (EUD) as a requirements engineering technique for communicating across social worlds. For this purpose, we employed the theoretical lens of design boundary object in order to focus on functional and political ecologies during the development process. Four features were investigated: (1) the capability for common representation, (2) the capability to transform design knowledge, (3) the capability to mobilise for design action, and (4) the capability to legitimise design knowledge across social worlds. We concluded that EUD means a high degree of end user involvement and takes advantage of end users’ know-how. It has the ability to capture requirements and transfer them into the final information system without the need to make an explicit design rationale available to the systems developers. However, systems developers have little or no influence on business requirements. Their role is mainly as technical experts rather than business developers. The systems developers took control and power of technical requirements, while requirements that relate to business logic remained with the end users. Consequently, the systems developers did not act as catalysts in the systems development process

e-Government for all – Norm-critical Perspectives and Public Values in Digitalization

There are hopes that e-government will bring many benefits, including efficiency, democratization, participation, and emancipation of citizens. However, despite some evidence that supports these claims there are also cases that digitalization can exclude citizens and build new barriers. This is a special challenge for already disadvantaged groups falling outside the norms. In this study we approach the notion of a norm-critical perspective in relation to e-government through a review of literature in combination with action research oriented workshops. From this we conclude that there is a need for more norm-critical perspectives in research on e-government, as most research today focuses on socio-economic digital-divide issues. We also show that it is difficult for involved actors to see beyond the norms and be norm-critical since the norms are embedded into the practices, which in this case, e-government has developed and used

Uncovering Situations of Cargo Cult Behavior in Agile Software Development Method Use

Misinterpretations and faulty use of Software Development Method (SDM) practices and principles are identified pitfalls in Software Development (SD). Previous research indicates cases with method adoption and use failures; one reason could be the SDM Cargo Cult (CC) behavior, where SD organizations claim to be agile but not doing agile. Previous research has suggested the SDM CC framework as an analytical tool. The aim of this paper is to refine the SDM CC framework and empirically test this version of the framework. We use data from an ethnographical study on three SD teams’ Daily Scrum Meetings (DSM). The empirical material was collected through observations, interviews, and the organization’s business documents. We uncovered twelve CC situations in the SD teams’ use of the DSM practice, structured into seven categories of SDM deviations: bringing irrelevant information, canceling meetings, disturbing the team, receiving unclear information, bringing new requirements, problem-solving, and task distribution

Citizen Diversity in e-Government Research: Moving the Field Forward

Whereas broad launch of public e-services ensures equal and homogenous treatment of citizens, citizen diversity is often set aside. By means of a literature study we describe how research has addressed diversity in the field of eGovernment. we analyzed the papers according to the following codes: group; application domain; unit of analysis; and technology in use or design. Results showed that the most common application domain was e-services with access and use as the most common units of analysis. The most frequently researched groups are based on classical socio-demographic variables such as economy, education and age. Also, the majority of papers discussed services in use. We conclude by suggesting that future research focuses underrepresented user groups; adds further granularity to the classical sociodemographic variables; identifies groups within groups; targets policies and policy implementation; and changes focus from use to development. We also call for conceptual clarity of the concept ‘diversity’

Management of social isolation and loneliness in Parkinson’s disease: Design principles

Persons with Parkinson’s disease (PwPs) may have difficulty participating in social activities due to motor and non-motor symptoms that may lead to social isolation and loneliness. This paper addresses how to manage social isolation and loneliness among PwPs using digital solutions. Information and Communication Technologies (ICT) have the potential to address social isolation and loneliness, but there are no current solutions that specifically target these issues among PwPs. In this paper, we present an ongoing project based on design science research (DSR) combined with a user-centered approach to identify challenges, requirements, and design objectives. The empirical work includes data from interviews and focus groups with PwPs and healthcare professionals. Based on the empirical material, we formulated design principles on identified challenges and requirements, which were instantiated into a high-fidelity prototype. This initial cycle serves as a foundation for ongoing improvements and evaluations in a continuous DSR process

Teachers Falling off the Cliff Affordances and Constraints of Social Media in School

In a digitalized society our work environment is highly integrated with our home environment making work boundless both in terms of time and space. The digital work environment risks increased stress. Based on a case study in Swedish schools we investigate how teachers experience the use of social media for work-related purposes. We do so by using the Technology Affordance and Constraints Theory to capture the affordances as well as constraints of this use. Findings show that affordances of social media in schools were increased opportunities for learning, transparency and community building. Constraints were distractions from learning, increased isolation, stress and, above all, lack of guidance in how and when to use social media. We end the paper arguing that lack of policies and guidelines governing the use of social media at work is risking an increase in boundary blurring and potentially more stress

A Digital Society for All? – Meanings, Practices and Policies for Digital Diversity

The concept of digital divides has been on the agenda in research and policy making for at least the last 20 years. But it is still, a challenge to grasp this concept that is so elusive and transforming. Inclusion, access and equality are still key values for democratic governance and must be addressed in particular when forming and contributing to a digital government. This paper seeks to intervene in current debates on digital divides and digital inclusion by analyzing two cases of responses among street-level public administration in relation to e-government services in Sweden. The case studies are strategically chosen and conducted in national agencies and in local public libraries. Three lines of contributions are discussed, firstly the importance to care for equality secondly the need to see the non-users, and thirdly to discuss the potential of putting focus on digital diversity