Multiple myeloma is a painful and uncurable malignant disease with an increasing incidence and mortality in several countries, e.g., Sweden. Some factors are suspected to be of aetiological significance, such as ionising radiation and chronic antigenic stimulation in certain inflammatory diseases. A familial factor has also been indicated. Furthermore, some studies have demonstrated farming as an occupation entailing an increased risk for the disease. The aim of this investigation was to further elucidate the impact of different aetiological factors in relation to multiple myeloma. The knowledge of aetiology is always a prerequisite for prevention. A case-control study on multiple myeloma was performed in a high-inddence area, the northern part of Sweden. One part of this study dealt with occupations and different exposures. The results supported farming as being an occupation with an increased risk. Within farming two kinds of pesticides, phenoxyacetic adds and DDT, and contact with certain domestic animals, i.e., cattle, horses and goats, were assodated with multiple myeloma. Farming as a risk factor was also confirmed by a register-based linkage study using the Swedish Cancer Environment Register. In this study a time trend was indicated, with increasing standardized inddence ratios over the different time periods studied. Another part of the case-control study showed that rheumatoid arthritis entailed an increased risk for multiple myeloma, a finding earlier suggested from register-based linkage studies, but not from any çase-control study. A third part of the case-control study indicated an increased risk for multiple myeloma if any first-degree relative had a history of haematological malignancy, or other malignant tumour, espedally prostatic cancer, brain tumour, and renal cancer. A case study encompassing 942 patients with haematological malignandes in the county of Jämtland, Sweden, during a 22-year period showed that about 5% of the patients had at least one relative who also suffered from such a disease. An espedally strong familial occurrence was found in the group of chronic lymphoprohferative diseases, including multiple myeloma. / <p>S. 1-69: sammanfattning, s. 71-129: 5 uppsatser</p> / digitalisering@umu

Technology has been developing over the last decades and the phenomenon of digitalization is becoming a reality for all industries. For supply chain managers, it is becoming a necessity to use the new technology to create interoperable systems that can increase responsiveness, transparency and cost efficiency of their supply chains, in order to meet the more demanding customer expectations and business environments. Changing business environments force companies to enter new markets where margins might be lower, which requires more cost efficient supply chains. Company X, the commissioning company for this research is an example of a company struggling with this. They are starting to develop Information and Communication Technology (ICT) products, which have lower margins than previous products. Company X, who is about to start the journey of digitalizing their supply chains, would therefore benefit from knowing what value adds that digitalization can bring. There is currently a gap within the field of supply chain management regarding evaluation of digitalization projects. Therefore, this study investigates the main drivers, factors that enable changes and affect value adds, of digitalization of supply chains, the changes these drivers result in and the value adds of these. The study also contributes with a framework for future evaluation of digitalization projects.The study was conducted with case studies at three companies, which are all comparable to Company X in both size and business. The investigated companies are all global producers of ICT-products who have conducted a digitalization of their supply chains.The main finding of this study is that the overall driver for digitalization according to the case companies is Standardization and Simplification, and all case companies state that this is the main goal for digitalizing the supply chain. Furthermore, automatization from tender to invoice is one of the major changes that standardization and simplification of the Supply Chain Information Technology (SCIT) enables. This improves the information flow between all silos within the supply chain and also helps increase order reliability, responsiveness and scalability as well as improve integration and collaboration with partners and suppliers, and it increases the overall process and cost efficiency. This all helps to increase the customer experience and satisfaction, which is stated as the major value add from digitalization of the supply chain according to the case companies.