The use of hand-held vibrating tools may lead to hand-arm vibration syndrome (HAVS), a condition with vascular, neurological and musculoskeletal symptoms. Vibrating tools are used in several occupations in which women can be found, e.g. by metal- and wood workers, drivers, and dental personnel. The risk of women developing HAVS is hard to estimate, as little research has been done on women exposed to hand-arm vibration. The overall aim of this thesis has been to fill this gap of knowledge. It is based upon one questionnaire study and one interview study on women who have reported an occupational injury related to hand-arm vibration. The thesis also comprises two laboratory studies of female and male subjects exposed to hand-arm vibration from a handle. The questionnaire and the interview study showed that the women had a high prevalence of symptoms, such as numbness, weakness, pain and white fingers. Neurological symptoms were more common and developed after shorter time of exposure compared to vascular symptoms. The symptoms had a considerable impact on all domains of the women’s lives, not only on their physical functioning, such as the ability to work, to participate in leisure activities and to do household activities, but also on their relationships and identity. Forty per cent of the women had retired or retrained due to the injury. Dental personnel had the highest relative risk of vibration injuries. In one of the laboratory studies 12 female and 12 male subjects were exposed to vibration in two vibration directions, (Xh and Zh) and at two vibration levels. The absorbed power was higher in the Zh direction and at the higher vibration level. The volumes of the subjects’ arms affected the power absorption in the Zh direction. There were no indications of a gender difference in the absorption of power. In the other laboratory study, the effect of handle size, vibration level, anthropometric measures and maximal grip force on the ability to perform a precision task was studied in 20 female and 20 male subjects. Ratings of difficulty and discomfort were made after each test round. The results indicate that the male subjects performed better in all the tests, but no gender difference was seen in the ratings. The higher vibration level resulted in higher ratings of discomfort. In the female subjects, the handle size, the anthropometric measures and maximal grip force affected both the performance and the ratings. In conclusion, the studies indicate that vibration injuries are severely disabling and influence many parts of the sufferer’s life. Vibration injuries are preventable, and the extensive consequences found underscore the importance of preventive action. This can be done by informing employees about the risks, and by giving them the opportunity to choose suitable machines and to practice work tasks when starting a new job.

The Arctic mutation in the Amyloid-β (Aβ) domain of the Amyloid-β precursor protein (APP) causes Alzheimer’s disease (AD) and confers unique biochemical characteristics to Aβ peptides. The aims of this thesis were to evaluate a transgenic model with the Arctic mutation, and to use it to gain new insights into the mechanisms of early (pre-plaque) and late-stage Aβ pathogenesis in AD. The Arctic mutation made Aβ more prone to aggregate, to accumulate in intracellular compartments and to form extracellular plaques when the models tg-ArcSwe and tg-Swe were compared. By inhibiting APP processing genetically or pharmacologically, the intraneuronal granular immunoreactivity with antibodies binding the Aβ domain was shown to largely represent Aβ, and not APP or APP-fragments. At two months of age, the intracellularly accumulated Aβ decreased rapidly, likely because it was still accessible to intracellular clearance. Extracellular Aβ deposits emerged at 5-6 months of age and the amyloid fibril structure was more compact than in tg-Swe. Moreover, Aβ deposits in tg-ArcSwe were more resistant to chemical extraction than those of established models carrying the Swedish APP mutation only, e.g. tg-Swe mice. The stability of deposits better reflects the biochemistry of senile plaques in AD. Thus, the tg-ArcSwe model may better predict the outcome of clinical trials, particularly therapies designed to enhance clearance of Aβ aggregates and deposits. Postmortem brain of Arctic mutation carriers contained extensive parenchymal plaque pathology. Differential immunostaining patterns with C- and N-terminal Aβ antibodies revealed a subset of plaques that were unique to the brains of Arctic mutation carriers. Aβ deposits in the cerebral vessel walls were congophilic and mainly composed of full-length Aβ. In contrast, N-terminally truncated Aβ was more prominent in the parenchymal plaques, all of which essentially lacked amyloid cores. A heterogeneous assembly of mutant and wild-type Aβ was shown to favor the formation of diffuse deposits in bitransgenic mice, and such mechanisms may at least partly explain observations of plaques lacking amyloid cores in postmortem Arctic mutant brain. In the bitransgenic mice, a low level of Arctic Aβ was sufficient to facilitate aggregation of wild-type Aβ. This observation, but also our findings of differences in amyloid fibril structure in tg-ArcSwe and tg-Swe, further highlights similarities between AD and prion disorders in which PrPsc refolds PrPc and facilitates fibril formation. / (Faculty of medicine)

SAMMANFATTNING Bakgrund: Livmoderhalscancer orsakas av humant papillomvirus (HPV). De flesta fallen inträffar bland kvinnor som inte deltar i preventionsprogram mot livmoderhalscancer. Syfte: Att undersöka invandrarkvinnors inställning till prevention av livmoderhalscancer. Metod: En explorativ kvalitativ studie. The Health Belief Model har använts som teoretisk modell. Fem fokusgruppintervjuer med 32 kvinnor ålder 18-54 år, som studerade svenska för invandrare. Data analyserades med latent innehållsanalys. Resultat: De temata som kunde urskiljas var svårigheterna med kommunikation med sjukvården, positiva till hälso- kontroll, behov av information för att fatta beslut samt ojämlikhet mellan könen. Kvinnorna i studien var mycket positiva till prevention av livmoderhalscancer och hade hög tilltro till det svenska sjukvårdssystemet. De poängterade i synnerhet kontakten med barnmorska. Deltagarna hade överlag svårigheter med information från sjukvården och saknade kunskap och information om HPV för att kunna fatta beslut om prevention av livmoderhalscancer med HPV- vaccin. Det framkom även att kulturella skillnader och ojämlikhet mellan könen påverkade inställning till prevention av livmoderhalscancer. Slutsats: Informanterna var positiva till prevention av livmoderhalscancer och vill få adekvat kunskap och information om sjukdomen men de har svårigheter med kontakten med sjukvården. Sjukvårdspersonal behöver beakta att kulturella normer påverkar kvinnors inställning till deltagande i det nationella preventionsprogrammet av livmoderhalscancer. / ABSTRACT Background: Cervical cancer is caused by Human papillomavirus (HPV). Most cases occur among women who don’t attend prevention programs. Objective: To explore immigrant women’s attitude towards prevention of cervical cancer. Method: An exploratory qualitative study. The Health Belief Model (HBM) has been used as a theoretical model. Five focus groups interviews with 32 women age 18-54, who studied Swedish for immigrants. Data was analyzed with content analysis. Results: Four main themes were found: difficulties to communicate with healthcare, positive to health control, the need of information to make a decision and inequalities among genders. The informants were positive to prevention of cervical cancer and had high confidence in the Swedish health care system. They appreciated in particular the meeting with the midwife. They had difficulty understanding the information from health care and had inadequate knowledge about HPV to make decisions about prevention of cervical cancer. Cultural differences and inequalities among genders were also related to prevention of cervical cancer. Conclusion: The informants were positive to prevention of cervical cancer and want to have adequate information about the disease. Healthcare professionals should consider that difficulties in contact with healthcare as well as inequalities in gender and cultural aspects have an impact on immigrant women’s attitude to prevention of cervical cancer. / HPV-projektet

Litteraturstudiens syfte var att beskriva om/hur en kvinnas sociala situation och bakgrund inverkar på hennes ohälsosamma alkoholvanor. Datasökningen genomfördes i databasen MedLine (via PubMed). Nio artiklar uppfyllde inklusionskriterierna och bearbetades samt kvalitetsgranskades. Resultatet visade att olika stadier i en kvinnas liv såsom besvärliga uppväxtförhållanden, en tidig alkoholdebut och dåliga relationer i vuxenlivet inverkar negativt på hennes alkoholkonsumtion. Det fanns också ett klass- och genusperspektiv. Resultatet visade att kvinnor som hade en besvärlig uppväxt med våld och övergrepp konsumerade mer alkohol i det vuxna livet än de kvinnor som hade ”normal” uppväxt och vuxenliv. Ohälsosamma alkoholvanor var också relaterat till en tidig alkoholdebut och en tidig alkoholdebut var i sin tur relaterat till flickor som hade en låg självkänsla och ett aggressivt beteende. Kvinnor i relationer där partnern missbrukade, våldtog och misshandlade gjorde att kvinnans alkoholkonsumtion ökade. Klassperspektivet var tydligt sammanlänkat med en högre alkoholkonsumtion hos kvinnor som var skilda eller änkor, kvinnor som hade låg inkomst och låg utbildning, kvinnor som inte hade någon familj eller kvinnor som var deprimerade. Sammanfattningsvis visar resultatet att flera aspekter i en kvinnas liv såsom uppväxtförhållanden och socialsituation inverkar på hennes alkoholvanor. Detta är något som behöver uppmärksammas både i vården och i samhället. / The aim of this literature review was to describe if/how a woman´s social situation and background affects her unhealthy alcohol habits. A search in the Medline database found nine scientific articles. They were thoroughly processed and valued for quality. The results showed that different stages in a woman’s, life, upbringing, age of onset of drinking and relationships in adulthood had a negatively effect on her alcohol consumption. The results also highlighted a class and gender perspective. The results revealed that women, who went through childhood and adulthood with adverse experiences such as, sexually assaulted and abused physically or mentally were more likely to have hazardous high alcohol consumption rates in adulthood. Unhealthy alcohol habits were linked to the age of onset of drinking which also was linked to girls who had an aggressive behavior and a low self-esteem when they grew up. Women who lived in a relationship where the partner abused substance or assaulted her resulted in a more frequent alcohol drinking in more hazardous amounts. The class perspective was strongly associated with a woman’s unhealthy relations’ to alcohol for example; when the woman were widowed, divorced, women with a income around the poverty line, women with low or no education at all, women who had no family or women who were depressed, were more likely to have an high alcohol consumption then women who had a family, a good income and an education. In summary the result showed that several aspects in a woman’s life, upbringing and social situation do affect her alcohol habits. This is knowledge that needs attention both in the health care and in the society.

The genus Enterococcus comprises of a group of commensal organisms of the human gut which has been associated with cases of endocarditis and urinary tract infections. In the present study, 12 Enterococcus isolates were obtained from clinical specimens and characterized using genotyping techniques that have become an integral part of clinical research. There were three different genotyping methods used to identify the enterococci to species level and to determine the level of genetic diversity among the selected strains. These techniques were, randomly amplified polymorphic DNA-PCR (RAPD-PCR), 16S rDNA ribotyping analysis and pulse field gel electrophoresis (PFGE) respectively. The minimum inhibitory concentration (MIC) to penicillin and vancomycin were also determined using a disc diffusion assay and a microtitre plate dilution assay. All twelve strains were found to be vancomycin resistant enterococci (VRE) at a MIC value greater than 100μg/ml. Penicillin growth inhibition based on MIC values were categorized into three groups, susceptible (< 0.25 μg/ml), intermediate (≤ 3μg/ml) and resistant (≥ 4μg/ml) respectively. RAPD-PCR was performed using four random primers. Primers yielding the highest discriminative power were used for phylogenetic analysis. The phylogenetic analysis indicated that all 12 strains yielded clonal dissemination, therefore a low genetic diversity between them. The 16S rDNA of all strains were used to identify the enterococci at species level. The rDNA were sequenced and analysed using the NCBI BLAST algorithm and found to belong to three species of Enterococcus. These were E.faecalis, E.faecium and E.durans. PFGE analysis was performed by restriction of all 12 strain’s genomic DNA with the restriction enzyme SmaI. The PFGE patterns were divided into two groups with low genetic diversity. Compared with the RAPD PCR patterns PFGE gives a higher discriminatory power as a higher dissimilarity between the strains was observed. Similar penicillin MICs for each of the strains in the three categories are grouped together in the phylogenetic trees for both PFGE and RAPD-PCR. RAPDPCR is a sensitive, faster, specific and cost effective technique, PFGE analysis has given a higher discriminatory power, higher reproducibility of the results and the polymorphism seen in the patterns suggest that PFGE has a potential of being an essential tool in clinical diagnostics. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

Thesis (MPhil (Information Science))--University of Stellenbosch, 2006. / The study was conducted to establish whether there is a need at the Medical Research Council for a formal CI function to be implemented. The objective of the investigation was to establish whether the CI techniques and methods, which are traditionally applied in the commercial industry, could be applied to a non-commercial industry, like the medical research industry in which the Medical Research Council operates. The aim is to highlight the benefits that CI could provide to the managerial decision-makers of the organisation. A quantitative study was done. A questionnaire was distributed to the identified target audience to collect empirical data for the study. A combination of random sampling techniques was used, namely simple random sampling and stratified random sampling to identify the potential target audience. Face-to-face interviews were done with the respondents to ensure high quality return due to the small sample size. The survey focused on establishing the needs and the wants of the employees of the Medical Research Council regarding CI functions. A theoretical study was combined with the data collected in the empirical study to achieve the above mentioned objective. By applying the CI techniques the organisation will be able to make sense of scattered bits of data. Data can be collected from the organisation`s surrounding business environments, the customers, the competitors, the market and the stakeholders. The CI Analyst can then make sense of the data by applying different methods of analysis and delivering the information to the decision-makers in a timely manner to ensure that informed decisions are taken. The CI-process should be holistic in nature. The three crucial elements required to perform a successful CI-process are the human intelligence techniques, communication processes and technology. With these elements in place managers will be able to make informed strategic, operational and tactical decisions to ensure competitive advantage is obtained and maintained. It can be concluded from the empirical data of this study that it is possible to apply the CI theory of the commercial industry to the non-profit medical research industry.

This study presents the methodology for estimating the incidence rate from the age specific prevalence data of three different eye diseases. We consider both situations where the mortality may differ from one person to another, with and without the disease. The method used was developed by Marvin J. Podgor for estimating incidence rate from prevalence data. It delves into the application of logistic regression to obtain the smoothed prevalence rates that helps in obtaining incidence rate. The study concluded that the use of logistic regression can produce a meaningful model, and the incidence rates of these diseases were not affected by the assumption of differential mortality.

Orientador: Ricardo Afonso Teixeira / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem / Made available in DSpace on 2018-08-24T09:14:02Z (GMT). No. of bitstreams: 1 Carlini_Marcela_M.pdf: 986349 bytes, checksum: 9d5d894a9176a2161976a4f8cdde685e (MD5) Previous issue date: 2013 / Resumo: OBJETIVO: A divulgação de notícias relacionadas com a saúde por meio de jornais pode influenciar o comportamento dos pacientes e de profissionais da saúde. O objetivo desse trabalho foi analisar as características das pesquisas em saúde publicadas por dois dos principais jornais brasileiros. MÉTODO: Foram avaliadas retrospectivamente notícias relacionadas com a saúde publicadas nas versões eletrônicas dos jornais Folha de São Paulo e O Estado de São Paulo ao longo de um período de três meses ( de julho a setembro de 2009) . apenas artigos que citam pesquisas médicas foram incluídos. Os artigos foram categorizados de acordo com o tema , a fonte , a localização do estudo e natureza do título . Analisamos também a presença de informações básicas sobre o tema, citações de periódicos médicos , contextualização e referências a produtos ou empresas nacionais. RESULTADOS : artigos científicos correspondeu a 57 % e 20 % dos artigos relacionados com a saúde publicados pela Folha de São Paulo e O Estado de São Paulo, respectivamente. A Folha de São Paulo publicou significativamente mais artigos sobre estudos nacionais , e a maioria dos artigos foram escritos por seu próprio pessoal. Em contraste , a maioria dos artigos do jornal O Estado de São Paulo vieram de agências de notícias . A Folha também teve seus textos melhor contextualizados para a sociedade brasileira . O Estado tendeu a citar o nome do periódico em que o estudo foi publicado com mais frequência , mas faltou contextualização nacional em seus artigosl. CONCLUSÃO : Os resultados mostram uma diferença significativa na maneira em que os jornais estudados relataram as pesquisas em saúde. A Folha de São Paulo tendeu a escrever seus próprios artigos e mais frequentemente publicou os resultados da pesquisa nacional , enquanto O Estado de São Paulo publicou artigos originados em agências de notícias , a maioria sem contextualização nacional / Abstract: OBJECTIVES: The dissemination of health-related news through newspapers can influence the behavior of patients and of health care providers. We conducted a study to analyze the characteristics of health-related research published by two leading Brazilian newspapers. METHOD: We retrospectively evaluated health-related news published in the electronic versions of the newspapers Folha de São Paulo and O Estado de São Paulo over a period of three months (July through September, 2009). Only articles mentioning medical research were included. The articles were categorized according to topic, source, study location and the nature of the headline. We also analyzed the presence of background information on the topic, citations of medical periodicals, national contextualization and references to products or companies. RESULTS: Scientific research articles corresponded to 57% and 20% of health-related articles published by Folha de São Paulo and O Estado de São Paulo, respectively. Folha de São Paulo published significantly more articles about national studies, and most articles were written by its own staff. In contrast, most articles in O Estado de São Paulo came from news agencies. Folha de São Paulo also better contextualized its reports for Brazilian society. O Estado de São Paulo tended to cite the name of the periodical in which the study was published more frequently, but their articles lacked national contextualization. CONCLUSION: The results showed a significant difference in the way in which the studied newspapers report on health-related research. Folha de São Paulo tends to write its own articles and more frequently publishes the results of national research, whereas O Estado de São Paulo publishes articles that originate in news agencies, most of which have little national contextualization / Mestrado / Divulgação Científica e Cultural / Mestra em Divulgação Científica e Cultural

State-of-the-art biochemical systems for medical applications and chemical computing are application-specific and cannot be re-programmed or trained once fabricated. The implementation of adaptive biochemical systems that would offer flexibility through programmability and autonomous adaptation faces major challenges because of the large number of required chemical species as well as the timing-sensitive feedback loops required for learning. Currently, biochemistry lacks a systems vision on how the user-level programming interface and abstraction with a subsequent translation to chemistry should look like. By developing adaptation in chemistry, we could replace multiple hard-wired systems with a single programmable template that can be (re)trained to match a desired input-output profile benefiting smart drug delivery, pattern recognition, and chemical computing. I aimed to address these challenges by proposing several approaches to learning and adaptation in Chemical Reaction Networks (CRNs), a type of simulated chemistry, where species are unstructured, i.e., they are identified by symbols rather than molecular structure, and their dynamics or concentration evolution are driven by reactions and reaction rates that follow mass-action and Michaelis-Menten kinetics. Several CRN and experimental DNA-based models of neural networks exist. However, these models successfully implement only the forward-pass, i.e., the input-weight integration part of a perceptron model. Learning is delegated to a non-chemical system that computes the weights before converting them to molecular concentrations. Autonomous learning, i.e., learning implemented fully inside chemistry has been absent from both theoretical and experimental research. The research in this thesis offers the first constructive evidence that learning in CRNs is, in fact, possible. I have introduced the original concept of a chemical binary perceptron that can learn all 14 linearly-separable logic functions and is robust to the perturbation of rate constants. That shows learning is universal and substrate-free. To simplify the model I later proposed and applied the "asymmetric" chemical arithmetic providing a compact solution for representing negative numbers in chemistry. To tackle more difficult tasks and to serve more complicated biochemical applications, I introduced several key modular building blocks, each addressing certain aspects of chemical information processing and learning. These parts organically combined into gradually more complex systems. First, instead of simple static Boolean functions, I tackled analog time-series learning and signal processing by modeling an analog chemical perceptron. To store past input concentrations as a sliding window I implemented a chemical delay line, which feeds the values to the underlying chemical perceptron. That allows the system to learn, e.g., the linear moving-average and to some degree predict a highly nonlinear NARMA benchmark series. Another important contribution to the area of chemical learning, which I have helped to shape, is the composability of perceptrons into larger multi-compartment networks. Each compartment hosts a single chemical perceptron and compartments communicate with each other through a channel-mediated exchange of molecular species. Besides the feedforward pass, I implemented the chemical error backpropagation analogous to that of feedforward neural networks. Also, after applying mass-action kinetics for the catalytic reactions, I succeeded to systematically analyze the ODEs of my models and derive the closed exact and approximative formulas for both the input-weight integration and the weight update with a learning rate annealing. I proved mathematically that the formulas of certain chemical perceptrons equal the formal linear and sigmoid neurons, essentially bridging neural networks and adaptive CRNs. For all my models the basic methodology was to first design species and reactions, and then set the rate constants either "empirically" by hand, automatically by a standard genetic algorithm (GA), or analytically if possible. I performed all simulations in my COEL framework, which is the first cloud-based chemistry modeling tool, accessible at http://coel-sim.org. I minimized the amount of required molecular species and reactions to make wet chemical implementation possible. I applied an automatized mapping technique, Soloveichik's CRN-to-DNA-strand-displacement transformation, to the chemical linear perceptron and the manual signalling delay line and obtained their full DNA-strand specified implementations. As an alternative DNA-based substrate, I mapped these two models also to deoxyribozyme-mediated cleavage reactions reducing the size of the displacement variant to a third. Both DNA-based incarnations could directly serve as blue-prints for wet biochemicals. Besides an actual synthesis of my models and conducting an experiment in a biochemical laboratory, the most promising future work is to employ so-called reservoir computing (RC), which is a novel machine learning method based on recurrent neural networks. The RC approach is relevant because for time-series prediction it is clearly superior to classical recurrent networks. It can also be implemented in various ways, such as electrical circuits, physical systems, such as a colony of Escherichia Coli, and water. RC's loose structural assumptions therefore suggest that it could be expressed in a chemical form as well. This could further enhance the expressivity and capabilities of chemically-embedded learning. My chemical learning systems may have applications in the area of medical diagnosis and smart medication, e.g., concentration signal processing and monitoring, and the detection of harmful species, such as chemicals produced by cancer cells in a host (cancer miRNAs) or the detection of a severe event, defined as a linear or nonlinear temporal concentration pattern. My approach could replace hard-coded solutions and would allow to specify, train, and reuse chemical systems without redesigning them. With time-series integration, biochemical computers could keep a record of changing biological systems and act as diagnostic aids and tools in preventative and highly personalized medicine.

Det framkommer i studiens bakgrund att föreningsidrotten är en viktig aktör som bidrar till att öka fysisk aktivitet och minska stillasittandet i befolkningen. För att undvika låg fysisk aktivitet och avhopp inom föreningsidrotten krävs det att individen känner sig motiverad till att delta i idrottsföreningar. Syftet med studien var att undersöka motivationsaspekter bland äldre tonårsflickor som deltar i motionsaktiviteter i idrottsföreningar. En kvalitativ intervjustudie användes som metod för studien, med ett strategiskt urval som kom att bli lagidrottande tonårsflickor som motionsidrottar. Materialet analyserades med stöd av en kvalitativ innehållsanalys där nyckelord sorterades ut och kategorier bildades. Resultatet visade på att ett flertal aspekter är viktiga för tonårsflickors motivation för motionsidrott: kärlek till idrott, hälsoaspekter, att vara en del av laget, omgivningens betydelse, förutsättningar och bekräftelse. Självbestämmande och samhörighet visade sig vara viktiga komponenter för skapandet av motivation. Utifrån konklusionen borde dessa två komponenter stå centralt i diskussioner om hur föreningsidrotten bör organiseras för att kunna öka intresset för deltagande i idrottsföreningar. / It emerges in the background of the study that club sports are an important player that has the resources to increase physical activity and reduce sedentary population. To avoid low physical activity and defections in club sports requires that the individual feels motivated to participate in sports. The aim of the study was to investigate motivational aspects of older teenage girls participating in exercise activities in sports clubs. A qualitative study was used as a method in the study, with a strategic choice that resulted in team sports by teenage girls who exercise sports. The material was analyzed through a qualitative content analysis where keywords were sorted out and categories formed. The results showed that several aspects are important for teenage girls' motivation for physical exercise: the love of sport, health aspects, to be part of the team, ambient impact, conditions and confirmation. Self-determination and togetherness proved to be important components for creating motivation and should, on the basis of the conclusion, play a vital role in the discussions about how the club sports could be organised in order to increase interest in participating in sports clubs.