Risk of developing diabetes is inversely related to lung function: a population-based cohort study.

AimTo investigate whether reduced lung function is a risk factor for developing diabetes. MethodsNon-diabetic men (n = 382) from the population-based cohort 'Men Born in 1914' were examined with spirometry at age 55 years. The cohort was re-examined at 68 years. Diabetes and fasting plasma glucose at follow-up were studied in relation to vital capacity (VC) and forced expiratory volume (FEV1.0) at baseline. ResultsFifteen men developed diabetes during the follow-up. The percentage with diabetes in the 1st, 2nd, 3rd and top quartile of vital capacity were 7%, 5%, 2%, and 1%, respectively (P for trend = 0.01). Fasting glucose (log transformed, mmol/l) at follow-up was 1.63 ± 0.16, 1.62 ± 0.18, 1.61 ± 0.11 and 1.60 ± 0.11, respectively (P for trend = 0.11). The longitudinal associations between VC and diabetes (P = 0.001) and log glucose (P = 0.036) were significant after adjustments for several potential confounders. FEV1.0 at baseline showed similar associations with diabetes at follow-up. ConclusionsThe risk of developing diabetes is inversely associated with pulmonary function among middle-aged men

Successful Process Improvement

The complex task of managing change and assuring sustained change can be supported with simple straightforward tools. This paper describes how a combination of simple two way communication tools geared for support of four key success factors, facilitate resistance to change and support the building of sustained improvement

The Communicating Home - Definition, Evaluation and Business Opportunities for TeliaSonera in a 3-5 years perspective

The communicating home concept has been defined by identifying the dominating communication technologies to/from and in the homes, the most important customer behavior and user needs, the dominating products and the dominating actors of the industry. The evaluation of the communicating home industry has been performed with a five forces framework analysis and theories regarding value migration and value structures of industries. It has been concluded that actors of communication technologies, goods and access services will compete fiercely. The barriers of entry will however be high. When it comes to content services the situation is completely different. These actors will, to the largest extent, meet lower competition and low barriers of entry. As a consequence a value migration from communication technologies, goods and access services to content services will occur. TeliaSonera is suggested to develop a content service portal. It should, in its first version, contain IPTV, music on demand, video on demand, data security, online storing and online gaming in the first place. The TeliaSonera group has the right prerequisites to implement and capitalize on a content service portal. In addition to the content service portal some other business opportunities have also been addressed in the business model

Rising incidence of breast cancer among young women in Sweden.

The national Swedish cancer registry was used to analyse the age-specific time trends in breast cancer incidence in Sweden from 1970 to 1984. The analysis included both a calendar year and a birth cohort approach to estimate time trends in disease occurrence. According to the birth cohort approach there was a statistically significant increase in the incidence with an average annual increase of the incidence of 3.2% (P = 0.0114), 3.4% (P = 0.0002) and 2.2% (P = 0.0264) in the age groups 25-29, 30-34 and 35-39, respectively. Possible causes of the observed increasing incidence are discussed

Prevalence and Prognostic Significance of Asymptomatic Peripheral Arterial Disease in 68-year-old Men with Diabetes. Results from the Population Study 'Men Born in 1914' from Malmo, Sweden.

AbstractObjectiveTo assess the prevalence of asymptomatic peripheral arterial disease (PAD) in older men with diabetes and to compare the incidence of cardiac events and deaths in diabetic and non-diabetic men with abnormal and normal systolic ankle–brachial pressure index, respectively.Research design and methodsPopulation-based cohort of 68-year-old men (n=474). Diabetes was defined as history of diabetes or a fasting blood glucose ≥6.1mmol/l. PAD was defined as an ankle–brachial pressure index (ABI) <0.9 in either leg. Fourteen-year mortality and cardiac event rates were based on record linkage with regional and national registers.ResultsThe prevalence of PAD in men with and without diabetes was 29 and 12%, respectively (p=0.003). The incidence of cardiac events was 22.9/1000 person years in men free from both diabetes and PAD. In the absence of an abnormal pressure index, diabetes was associated with an event rate of 28.4 (p=0.469). In the presence of an abnormal index the incidence was 102 (p<0.001). This pattern remained in the multivariate analysis when other atherosclerotic risk factors were taken into account. Cardiovascular mortality rates similarly differed substantially between diabetic men with and without PAD.ConclusionsA fasting blood glucose value above 6.1mmol/l even in the absence of symptoms indicating diabetes was associated by an increased prevalence of asymptomatic PAD. The cardiovascular risk in diabetes varied widely between men with and without abnormal ankle–brachial pressure index

”… men han forstår meg bare ikke, og jeg forstår ikke ham, og da blir det jo slik...” : en kvalitativ studie om personer med Asperger syndroms erfaringer fra attføringsprosessen i NAV

Relativt få personer med Asperger syndrom er i inntektsgivende arbeid, og det antas at langt flere kan være i stand til å delta i arbeidslivet. Flere søker NAV for å få bistand til å komme i arbeid. Hensikten med denne studien er å undersøke brukerperspektivet til personer med Asperger syndrom, med fokus på deres opplevelser av samarbeidet med NAV for å komme ut i arbeid. Problemstillingen for oppgaven er: Hvordan beskriver personer med Asperger syndrom den bistand og oppfølging de får av ansatte i NAV for å komme seg i arbeid, og hva opplever de fører til eventuelle endringer i attføringsprosessen? Det empiriske materialet består av kvalitative semi-strukturerte intervjuer med tre kvinner og seks menn med Asperger syndrom i alderen 18 til 46 år, fra åtte ulike fylker, som alle er, eller har vært i kontakt med NAV for å få hjelp til å komme seg i arbeid, eller i arbeidsliknende forhold. Analysearbeidet er tuftet på en grounded theory tilnærming, med et statisk empirisk materiale, og utgangspunkt for analysen har vært hva informantene opplever som mest problematisk, og hvordan de håndterer dette. Resultatene bygger således på informantenes subjektive erfaringer. Studiens resultater viser at for de fleste av informantene har avstanden til arbeidslivet i liten grad blitt redusert, for noen heller økt. Mer enn halvparten har søkt, eller er innvilget hel eller delvis uførepensjon, og resten har arbeidsavklaringspenger (AAP). Det er kun én som ser ut til å nærme seg et inntektsgivende arbeid. Det er store variasjoner mellom de ulike informantenes opplevelser og erfaringer, både kvalitativ og kvantitativt i deres kontakt med ansatte i NAV. Flere av informantene opplever i stor grad en manglende tilstedeværelse av anerkjennelse av den enkelte, kunnskap og forståelse av deres situasjon, brukermedvirkning og oppfølging i samarbeidet med ansatte i NAV, og gir uttrykk for at dette vanskeliggjør deres attføringsprosess. Noen få har for det meste positive erfaringer. Alle informantene etterlyser kunnskap om og kompetanse på Asperger syndrom. Studien kommenterer avslutningsvis om organiseringen rundt bistand og oppfølging av denne gruppen bør revurderes, da de har et langt større behov for individualisert oppfølging enn det som kan gis av ansatte i NAV som følger opp personer på AAP og med uførepensjon på generelt basis.Relatively few people with Asperger syndrome are in paid work, and there are reasons to believe that they are capable of entering the workforce in far greater numbers. People often contact The Norwegian Labour and Welfare Service (NAV) for support in finding work. The aim of this study is to gather the perspectives of individuals with Asperger syndrome, focusing on their experiences of collaboration with NAV in finding suitable work opportunities. The topic of this research is: How do people with Asperger syndrome describe the assistance and support they receive from employees in NAV with regards to getting work, and what experiences lead to changes (if any) in the rehabilitation process? The empirical data is based on qualitative semi-structured interviews with three women and six men with Asperger syndrome, between 18 and 46 years of age, living in eight different counties (fylker). They all are, or have been, in contact with their local NAV office in order to get support for in finding a job or work-related placement. The analysis is based on a grounded theory approach. The analysis took place after (rather than parallel to) data collection and focused on topics that research participants described as most significant and problematic for them, and the practical and emotional implications of this. The results are based on the participants' subjective experiences. In the case of the majority of the research participants, the distance to the labour market seems to have increased, rather than decreased. The research participants' experiences of unemployment services vary widely, both qualitatively and quantitatively, in terms of their contact with NAV- caseworkers. Most participants report various shortcomings displayed by NAV-caseworkers: lack of recognition of the client as an individual, lack of knowledge and understanding of their special needs and circumstances, limited client involvement, and limited follow-up. They state that this complicates their vocational rehabilitation. A few have mostly positive experiences. All participants call for increased knowledge of and competence in Asperger syndrome. The study raises the need for a reorganization NAV-services rendered to people with Asperger syndrome, as they have a greater need for individualized support compared to unemployed individuals in the general population.Master i sosialt arbei

Electron transfer between complex III and IV of the respiratory chains of Paracoccus denitrificans and Thermus thermophilus : a functional and kinetic characterization of interactions using soluble fragments

Adenosintriphosphat (ATP) als universelles Energieäquivalent der Zelle wird durch die oxidative Phosphorylierung synthetisiert, bei der Elektronen entlang des elektrochemischen Gefälles der Atmungskette über verschiedene Redoxkomplexe transferiert und durch die chemiosmotische Kopplung Protonen über die Membran gepumpt werden. Der Protonengradient wird dann von der ATP-Synthase genutzt, um ADP zu ATP zu phosphorylieren. Zentraler Redoxkomplex der Atmungskette vieler Pro- und Eukaryonten ist der bc1-Komplex, der Elektronen von Ubichinol auf Cytochrom c überträgt, von wo sie nachfolgend auf die Cytochrom c-Oxidase transferiert werden. Das mesophile Bodenbakterium Paracoccus denitrificans wird als Modellsystem für den mitochondrialen Elektronentransfer (ET) verwendet, da es eine aerobe Atmungskette exprimiert, die der mitochondrialen homolog ist, allerdings einen wesentlich einfacheren Aufbau der einzelnen Redoxkomplexe aufweist. Auch Thermus thermophilus als extrem thermophiles Bakterium bildet eine vergleichbare aerobe Atmungskette aus, wobei deren Proteine allerdings eine hohe Thermostabilität aufweisen, wodurch sie in das Interesse der Forschung gerückt sind. Ziel dieser Arbeit war die funktionelle Charakterisierung des ET zwischen Komplex III und IV der Atmungsketten von P. denitrificans und T. thermophilus, die aufgrund ihrer mesophilen und thermophilen Eigenschaften unterschiedliche Mechanismen in der Wechselwirkung ihrer Redoxproteine aufweisen. Es wurden lösliche Redoxfragmente verwendet, um anhand von Mutagenesestudien, Stopped-Flow (SF)- und Laserflash-Kinetiken (LF) unter pre-steady state-Bedingungen sowie FRET-Experimenten den ET zu untersuchen. Für die LF-Experimente wurde eine photoaktive Rutheniumverbindung kovalent an Cyt c552 gekoppelt, durch die bei Laseranregung das Häm photooxidiert und dadurch der ET von einem reduzierten Redoxpartner induziert werden kann. Die Strukturdaten des bc1/Cyt c-Cokomplexes aus Hefe zeigen, dass direkte Kontakte zwischen Cyt c1 und Cyt c durch unpolare Wechselwirkungen und eine zentrale Kation-p-Interaktion vermittelt werden. Daher wurden anhand von Sequenz- und Struktur-alignments äquivalente Aminosäurepositionen im Paracoccus Cyt c1 identifiziert, die an der Wechselwirkung zu Cyt c552 beteiligt sein könnten. Diese wurden durch gerichtete Mutagenese in ihrem Raumvolumen, ihrer Polarität oder Ladung variiert und in kinetischen Studien untersucht. Für die LF-Kinetiken sowie für die FRET-Experimente wurden Oberflächen-Cysteinmutanten des Cyt c1 bzw. c552 generiert, über deren SH-Gruppen kovalent der Rutheniumkomplex bzw. Fluorophore gekoppelt werden konnten. Die ET-Reaktion zeigt zwei Phasen in Abhängigkeit von der Ionenstärke. Bei niedrigen Ionenstärken ergeben sich Geschwindigkeitskonstanten von 109 M -1s-1 und eine geringe Ionenstärkeabhängigkeit (etwa eine effektive Ladung), wohingegen bei Ionenstärken ab 35 mM 2-3 effektive Ladungen pro Redoxpartner beteiligt sind und bimolekulare Geschwindigkeitskonstanten von 107 bis 109 M-1s-1 erhalten werden. Diese Ergebnisse deuten auf die Bildung eines Encounter-Komplexes bei niedrigen Ionenstärken hin, der ein Ensemble verschiedener Distanzen und relativer Orientierungen der Redoxpartner zueinander darstellt. Diese Annahme wurde ebenfalls durch FRET-Experimente bestätigt, durch die selbst bei niedrigen Ionenstärken keine definierten Abstände erhalten werden konnten. Die Geschwindigkeitskonstanten der bimolekularen Reaktion weisen auf einen diffusionskontrollierten Prozess hin, an dem 2 bis 3 effektive Ladungen an der elektrostatischen Annäherung der beiden Redoxpartner beteiligt sind. Diese Ergebnisse werden durch vorherige kinetische Untersuchungen und EPR-Studien des ET von Cyt c552 zum CuA-Fragment der aa3-Oxidase bekräftigt, für den die gleiche Anzahl effektiver Ladungen und die Bildung eines Encounter-Komplex gefunden wurden. Lediglich c1-Mutanten, deren variierte Aminosäuren sich direkt oberhalb der Hämspalte und in der Sequenz um bzw. innerhalb des Hämbindemotivs befinden, bewirken eine Verlangsamung der Gesamtreaktion und ein leicht verändertes Ionenstärkeverhalten, das auf eine leicht verschobene Interaktionsfläche hindeutet. Es wurde durch Sequenz- und Strukturalignments kein aromatischer Rest in direkter Nähe der entsprechenden Position im Paracoccus Cyt c1 gefunden, der wie im Hefekomplex eine stabilisierende Kation-p-Interaktion zwischen den Redoxpartnern vermittelt. Zur Untersuchung des ET zwischen Komplex III und Komplex IV aus T. thermophilus wurde die hydrophile Cytochrom c-Domäne der caa3-Oxidase in Analogie zum Paracoccus-System als lösliches Redoxfragment kloniert, heterolog exprimiert und charakterisiert. Dieses Fragment wurde in SF-Studien eingesetzt, um den ET zu seinen potentiellen Redoxpartnern Cyt cbc des bc-Komplexes und Cyt c552 zu charakterisieren. Es konnte gezeigt werden, dass das ccaa3-Fragment Elektronen von beiden Redoxpartnern empfängt, wobei die ET-Reaktion mit Cyt c552 so schnell verläuft, dass sie durch SF-Techniken nur schlecht aufgelöst und lediglich eine Größenordnung der Geschwindigkeitskonstanten abgeschätzt werden kann (kon ~ 1010 M-1s-1). Die Reaktion mit Cyt cbc verläuft auch noch schnell (kon = 108-109 M-1s-1) und ist nahezu unabhängig von der Ionenstärke, was eine hydrophobe Wechselwirkung zwischen beiden Redoxpartnern bestätigt. Die Ergebnisse deuten erstmals darauf hin, dass ein ET direkt zwischen zwei Redoxproteinkomplexen (bc-Komplex und caa3-Oxidase) stattfindet, ohne dass ein Elektronenüberträger (wie z. B. Cyt c552) zwischengeschaltet ist. Um die Übertragbarkeit der Erkenntnisse, die hier über den ET an löslichen Redoxfragmenten gewonnen wurden, in einem Proteinkomplex zu verifizieren, wurde ein bc1-Komplex verwendet, in dem die für P. denitrificans einzigartige saure Cyt c1-Domäne deletiert ist. Der Komplex wurde für eine erleichterte Aufreinigung mit einem His-tag versehen, homolog exprimiert und erste Aufreinigungs- und Charakterisierungsschritte unternommen. Er soll zukünftig eingesetzt werden, um die Mutationen des löslichen c1-Fragmentes in den Komplex zu überführen und die Mutanten kinetisch mittels pre-steady state- und steady state-Techniken im Vergleich zum bc1WT-Komplex zu untersuchen, ohne dass die Effekte der Punktmutationen durch die hohe negative Ladungsdichte der sauren Domäne überlagert werden.Adenosine triphosphate as the universal energy source of cells is produced by oxidative phosphorylation, where electrons are passed through different transmembrane redox complexes along the electrochemical gradient of the respiratory chain. This electron transfer (ET) is coupled to proton pumping across the membrane to generate a gradient which is then used by the ATP-synthase to drive phosphorylation of ADP to ATP. The cytochrome bc1-complex represents the central part of this aerobic respiratory chain of many pro- and eukaryotic organisms and transfers electrons from ubiquinol to cytochrome c, from where they are passed subsequently to cytochrome c-oxidase. The mesophilic soil bacterium Paracoccus denitrificans is used as a model system for mitochondrial electron transfer processes because it has an aerobic respiratory chain which is homologous to the mitochondrial one, but with a much simpler subunit composition of its redox complexes; this bacterium is a member of the a-subdivision of the proteobacteria, presumably harbouring the mitochondrial precursor. Also the extremely thermophilic genus Thermus thermophilus provides a similar aerobic respiratory chain. Proteins of T. thermophilus have gained interest because of their thermostability and their decreased sensitivity against extreme pH-values and proteolytic degradation. The aim of this work was the characterization of the electron transfer between complex III and complex IV of the aerobic respiratory chains of P. denitrificans and T. thermophilus. Because of their mesophilic or thermophilic properties both organisms show different mechanisms of interaction between their redox components.Soluble redox fragments have been successfully used before to study the electron transfer reactions of P. denitrificans and T. thermophilus (Lappalainen, Watmough et al. 1995; Reincke, Thony-Meyer et al. 1999; Maneg, Ludwig et al. 2003; Maneg, Malatesta et al. 2004; Mooser, Maneg et al. 2005). In this work soluble fragments of cytochrome c1 (c1CF) (Eichhorn, Dissertation 2003) and cytochrome c552 (c552F) (Reincke, Thony-Meyer et al. 1999) were used to determine the interaction of both redox partners in a dynamic and functional approach by mutagenesis studies, pre-steady state kinetics and fluorescence resonance energy transfer (FRET) experiments

Finlands utlänningsförvaltning : en empirisk, normativ och konstruktiv förvaltningsanalys

Only abstract. Paper copies of master’s theses are listed in the Helka database (http://www.helsinki.fi/helka). Electronic copies of master’s theses are either available as open access or only on thesis terminals in the Helsinki University Library.Vain tiivistelmä. Sidottujen gradujen saatavuuden voit tarkistaa Helka-tietokannasta (http://www.helsinki.fi/helka). Digitaaliset gradut voivat olla luettavissa avoimesti verkossa tai rajoitetusti kirjaston opinnäytekioskeilla.Endast sammandrag. Inbundna avhandlingar kan sökas i Helka-databasen (http://www.helsinki.fi/helka). Elektroniska kopior av avhandlingar finns antingen öppet på nätet eller endast tillgängliga i bibliotekets avhandlingsterminaler.Migration och immigration utgör känsliga frågor i värt samhälle och vidare i hela 'västvärlden'. Å ena sidan skall irreguljär invandring bekämpas med allt strängare medel medan man å andra sidan strävar efter att driva en human flyktingpolitik och främja en behärskad invandring. Vi har således politiker som vill ha tuffare tag mot illegal invandring som de facto drivs av den organiserade brottsligheten medan vi har folkvalda som vill se Finland (EU) ta in mera invandrare och flyktingar, utan att på ett ansvarsfullt sätt argumentera för hur integrationen framgångsrikt skulle skötas. Vi ställs med andra ord meddetsamma inför följande problematik: Hur korrelerar en effektiv utlänningsförvaltning med kravet på etik? Hur skall illegal invandring bekämpas med 'hårdhandskar' samtidigt som vi skall erbjuda skydd och visa förståelse för dem som är i behov av det? Det är bl.a. dessa frågor som gör vad som också enligt min uppfattning kan kallas för evighetsfrågan kring migrationsärenden intressant att 'lösa' och alltså värd att forska i. Jag skall dessvärre inte som statsvetare dra mig längre in i moralfilosofiska och utlånningspolitiska debatter, utan ämnar enbart att i denna pro gradu -avhandling koncentrera mig på att granska förvaltningen, i detta fall utlänningsförvaltningen, ur ett organiseringsperspektiv. I Finland implementeras landets invandrings- och asylpolitik av ett nätverk självständiga organisationer, ett konglomerat om man så vill. Som en erfaren gränsbevakningsman med utredningsbakgrund har jag fått en rejäl inblick i Finlands utlänningsförvaltning och anser att dess struktur är alltför komplex. Det breda fältet av organisationer som deltar i utformningen och verkställigheten av Finlands invandrings- och asylpolitik är således värt att analyseras noggrannare. Behövs det så mänga olika aktörer? Som vi ju alla torde veta har Finland en tämligen (tillsvidare)liten utlånningspopulation

Tobacco and myocardial infarction in middle-aged women: a study of factors modifying the risk.

Background. Although myocardial infarction (MI) is strongly related to smoking, few have studied why some smokers are more vulnerable than others. This study explored how the risk of MI in current and former smokers is modified by other cardiovascular risk factors. Methods. Incidence of MI (fatal and nonfatal) amongst 10619 women, 48.3 ± 8.2 years old, were studied in relation to smoking, hypertension, hypercholesterolaemia, diabetes, marital status and occupational level over a mean follow-up of 14 years. Results. Of the 3738 smokers, one-third had at least one major biological risk factor besides smoking; 228 women had MI during follow-up. Smoking and hypertension showed a synergistic effect on incidence of MI. The adjusted relative risks (RR) were 12.2 (95% CI: 7.5-19.8) for smokers with hypertension, 5.3 (CI:3.3-8.1) for smokers with normal blood pressure and 2.4 (CI:1.4-4.3) for never-smokers with hypertension (reference: normotensive never-smokers). The corresponding RRs for diabetic smokers and diabetic never-smokers were 19.0 (CI: 10.2-35.4) and 8.8 (CI: 4.4-17.4), respectively (reference: nondiabetic never-smokers). In terms of attributable risks, hypertension, hypercholesterolaemia and diabetes accounted for 12.9, 11.5 and 7.2%, respectively, of MI in female smokers. Low socio-economic level and being unmarried accounted for 19.6 and 1.6%, respectively. Conclusions. Although smoking is a major risk factor for MI, the risk varies widely between women with similar tobacco consumption. The results illustrate the need of a global risk factor assessment in female smokers and suggest that female smokers should be targets both for intensified risk factor management and programmes to stop smoking