Stroke is a common multi factorial cerebrovascular disorder with a large impact on global health. It is a disorder primarily associated with old age but environmental factors, lifestyle choices and medical history are all important for the risk of developing the disorder. It is also known that heritability is important for predisposition to the disorder. The aim of this work has been to identify genetic variations that increase the risk of being affected by stroke in the population of northern Sweden, a population well apt for genetic studies due to well kept church and medical records together with limited genetic diversity. In the first paper we used linkage analysis in families with early onset of stroke. By this approach we identified a region on chromosome 5q to be linked to an increased risk of developing stroke, a region previously identified as a susceptibility locus for stroke in the Icelandic population. In the second study we used genealogy to identify common ancestry and thereby identify common susceptibility to stroke. The seven families we connected showed significant linkage to the chromosome 9q31-33 region and four of the families shared a common haplotype over 2.1 megabases. In the third manuscript we investigated sequence variation of two candidate genes, TNFSF15 and TLR4. Sequencing of the TLR4 gene revealed previously identified variations in affected individuals from two of the families. Further SNP analysis showed five separate haplotypes among the investigated families and four haplotypes for TNFSF15. However none of these co-segregated with stroke among the investigated families. In the final paper we used a case-control stroke cohort to ascertain association for genetic variation in five genes and genetic regions previously suggested to be linked with stroke. Initial analyses showed association for the 9p21 chromosomal region and a variant in Factor 5 that showed protection against stroke, but after adjustments for common risk factors for stroke, the findings were no longer significant. In conclusion, by studying selected families we have been able to show linkage to two chromosomal regions, 5q and 9q31-33, that indicate genetic predisposition for developing stroke. Further we have shown that family based studies are still an important tool in deciphering the underlying mechanisms for complex disease.

“Telemedicine” denotes medicine at a distance using telecommunications and information technologies. The aim of the thesis is to reveal determinants and outcomes of telemedicine diffusion—that is, the spread of telemedicine in time and space. Telemedicine is examined both at the national level and in a regional case study. At the national level, quantitative methodology is utilized to analyze the emergence of health care facilities using telemedicine to receive medical assistance. The regional case study examines the diffusion and outcomes of telemedicine networks in Northern Sweden based on non-quantitative data sources. The first telemedicine applications in Sweden emerged between hospitals in southern Sweden in the 1970s. It was in the 1990s, however, that the practice of telemedicine took off on a larger scale. By the year 2000, the number of remote sites was quite evenly distributed across the country and between specialist and primary care facilities. In northern Sweden, telemedicine was first implemented in the mid-1980s, and is now carried out in all counties in the region. The telemedicine networks in northern Sweden primarily concern teleradiology, general telemedicine, and telepathology. Commonly, telemedicine is carried out within counties in hierarchical hub and spoke-type networks connecting specialist and primary care facilities. The study shows that existing telemedicine facilitates its further diffusion at the regional level, but shows a lack of the obvious neighborhood effect that could be expected in light of many previous diffusion studies and geographical diffusion theory. The health care system in Sweden is characterized by a high degree of regional autonomy. Contacts between medical staff, and thus dissemination of information and opinions concerning telemedicine, are therefore likely to be more prevalent within than between the regional health care organizations. The health care organizations are also decision-making bodies with different telemedicine policies. In addition, already implemented telemedicine programs tend to expand within the health care organization in which they originated. Although no traditional neighborhood effect to speak of can be noticed in Swedish telemedicine diffusion, distance matters in the diffusion process in a quite different respect. The study shows that health care facilities located far from more specialized care are especially likely to adopt telemedicine. Another local factor, facility size, is also positively correlated with telemedicine diffusion. This correlation between facility size and telemedicine adoption, as well as the circumstance that the diffusion process started with, and has progressed the furthest in, specialist care, suggest that the diffusion of telemedicine exhibits hierarchical characteristics. The development of telemedicine technology significantly influences the rate of telemedicine diffusion. In a simulation of the diffusion process, it is shown that—given that computers and information technology continue to develop according to the present trend—there will be a significant increase in the number of primary care facilities functioning as remote telemedicine sites during the first decade of the 21st century. / digitalisering@umu

The main objectives of this investigation were to determine the impact of climate on mountain birch (Betula pubecens ssp. czerepanovii (Orlova)) growth and to develop a regional chronology of autumnal moth outbreaks. To accomplish the objective, cores of mountain birch were taken from 21 sites in Norrbotten, Sweden. Tree-ring chronologies were developed for each site. Climatic influences were determined by correlating ring widths to climatic variables (average monthly temperature, average monthly precipitation and NAO). Outbreaks were recovered from the ring width indices using the non-host method with Scots pine (Pinus sylvestris (L.)) as the non-host. This method removes the climatic influence on growth to enhance other factors. Patterns of synchrony and regional outbreaks were detected using regression and cluster analysis techniques. The primary climatic influences on the tree ring growth of mountain birch are June and July temperatures; precipitation during October is of secondary importance. Climate explained 46% of yearly tree ring width variation. Outbreaks of the autumnal moth occur at varying time intervals depending on the scale of study. Intervals between outbreaks on the tree level are twice as long as at the plot level. On the regional scale plots within the same valley had more similar outbreak intervals and magnitudes of outbreaks. Elevation is a driver in determining the length of outbreaks and length between outbreaks. The percent monocormicity of a plot is also a determining factor of the length between outbreaks. This study is the first regional scale study on climate and outbreaks of the autumnal moth on mountain birch. The results complement research being conducted on autumnal moth larval densities and will help in modeling and assessing the effects of outbreaks with increasing climatic change.

Media affects our views of the world and plays a large part in creation and dissemination of social representations. Through media’s increasing importance, people and organizations need to work harder to stand out among the large amounts of brands that exists today.In 2013, Umeå Energi launched a commercial concept about Dolf and Järven, two characters living in Lill-Grobban, a fictional village outside of Umeå. The aim of this qualitative study is to examine how Umeå Energi uses stereotypes in the commercial concept Dolf and Järven and how this affects the respondents, and in the long run the stereotypification of norrlandians. To achieve this aim the following theories have been applied: stereotypes, identity and storytelling. The study was conducted through three focus group interviews with students, professionals and senior citizens, plus one informant interview with a marketer at Umeå Energi.The results and analysis of the study shows that students and professionals thinks the commercials are entertaining, while senior citizens are of a negative opinion; they believe it’s an outrageous and parodic image of locals represented in the commercials. The study also shows that the dialect of the northern Sweden is a large part in creating the stereotypical local in northern Sweden. Professionals and students have a positive image of Umeå Energi after watching the commercials while senior citizens are skeptical. Overall, the study's results show large differences in how the commercials about Dolf and Järven is being received by the respondents. Students and professionals think that the commercials are entertaining, while senior citizens disagree. They are of the opinion that the commercials show an exaggerated and negative image of norrlandians. / Medierna påverkar vår världsbild och spelar en stor roll för utformningen och spridningen av sociala representationer. I och med mediernas allt större plats i våra liv ökar behovet hos både människor och organisationer att sticka ut för att synliggöra sig i bruset av alla varumärken som finns.Umeå Energi lanserade 2013 ett reklamkoncept med karaktärerna Dolf och Järven som bor i Lill-Grobban, en fiktiv ort någonstans utanför Umeå. Syftet med denna kvalitativa studie är att undersöka hur Umeå Energi använder sig av en stereotyp bild av norrlänningar i sitt reklamkoncept Dolf och Järven och hur detta påverkar mottagarna, samt i förlängningen även bilden av den stereotypa norrlänningen. Teorierna som används är stereotyper, identitet och storytelling. För studien genomförs tre fokusgruppintervjuer med studenter, yrkesverksamma respektive pensionärer, samt en enskild intervju med marknadsförare på Umeå Energi.Studien visar att studenter och yrkesverksamma upplever reklamfilmerna om Dolf och Järven som underhållande medan pensionärerna är negativt inställda; de anser att det är en överdriven och parodisk bild av norrlänningen som förmedlas. Av studien framgår även att den norrländska dialekten är en stor del i skapandet av den stereotypa norrlänningen. Yrkesverksamma och studenter har en positiv inställning till Umeå Energi efter att ha sett reklamfilmerna medan pensionärerna är skeptiska. Överlag visar studiens resultat stora skillnader i hur reklamfilmerna om Dolf och Järven mottas bland äldre och yngre personer. Studenter och yrkesverksamma anser att reklamfilmerna är underhållande, något som inte pensionärerna håller med om då de tycker att reklamfilmerna förmedlar en överdriven och negativ bild av norrlänningen.

Northern Sweden shows a unique population structure with remarkable geographical variations in the distribution of genetic disorders as well as genetic markers like blood groups, serum groups and red cell enzyme types. The present-day population of northern Sweden is a mixture of people of Finnish, Saamish (Lappish) and Central-Swedish origin. In this thesis the ethnic heterogeneity of the North-Swedish population (counties of Västerbotten and Norrbotten) was studied using genetic blood markers, and the epidemiological impact of the ethnic heterogeneity was exemplified by studying the geographical correlation between Finnish admixture and risk factors for cardiovascular diseases. The following results were found: 1 Two new ethnic marker genes were discovered: the GC*1F allele (GC serum groups) for Saamish influence and the TF*C3 allele (transferrin serum groups) for Finnish influence. 2 Regional gene frequency variations in the A1A2B0 blood groups, 6-phosphogluconate dehydrogenase (6-PGD) types and transferrin and GC serum groups were studied in a sample of 4100-5600 individuals from northern Sweden distributed according to birth place into 23 subpopulations. A significant regional heterogeneity was found in all systems. The ethnic marker genes (AB0*A2, GC*1F, TF*C3, PGD*C) showed clineal variations consistent with the expected patterns of Finnish and Saamish admixture. 3 Finnish and Saamish admixture was estimated in the 23 subpopulations using AB0*A2, GC*1F and PGD*C as Saamish markers and TF*C3, TF*DCHI, TF*B0-1 and SODI*2 as Finnish markers. The Saamish admixture varied between 0 and 34% and was strongest in the northern and northwestern parts of northern Sweden. The Finnish influence varied between 0 and 84% and was strongest in the northern and northeastern parts of the area. The ethnic marker genes showed significant geographical intercorrelations. 4 Hypercholesterolemia showed a significant heterogeneity between the 23 subpopulations, and there was a significant geographical covariation with the degree of Finnish admixture. These results are consistent with the hypothesis that Finnish genetic influence may contribute to the development of hypercholesterolemia and thereby to the increased rate of cardiovascular diseases found in northern Sweden. The results of this study suggest that in addition to the founder effect ethnic heterogeneity is an important determinant of the structure of the North-Swedish population. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1992, härtill 7 uppsatser.</p> / digitalisering@umu.se

Photography and tourism have been developing in parallel with each other and leaving memories of the trip in photographs still remains as a significant part of traveling today. Tourist photograph is an effective tool to display the way tourists see the destination they visited. However, while there are studies regarding general relationships between photography and tourism, what tourists see and photograph in each destination has not yet profoundly been investigated.This study first investigates images of Kiruna, Sweden, utilized in its promotion as atourist destination to understand how it is expected to be perceived by tourists. Then these images are compared with tourist photographs to understand how they actually respond to this expectation.Also, this thesis aims to add a new perspective to the concept of ‘hermeneutic circle’ proposed by John Urry (1990). Specifically, it takes particular note of ‘nationality’ and ‘culture’, and focuses on two specific tourist groups in Kiruna, Japanese and German tourists, to investigate differences between these nationality groups in the way they perceive Kiruna as a tourist destination. In order to fulfill this aim, Volunteer Employed Photography (VEP) was applied and photographs they took in Kiruna were collected. In order to enrich the photographic data, semi-structured interviews were also conducted with each study participant.The results revealed that the study participants photographed subjects that were both appeared and not appeared in the promotional images of Kiruna. The study also revealed that there were certain differences between Japanese and German tourists in the way they perceived Kiruna and each nationality group has its own hermeneutic circle.

The goal of this study was to identify and describe different microstructures observed in samples from two major shear zones in the Gällivare area, namely the Nautanen Deformation Zone (NDZ), and the Fjällåsen deformation zone (FDZ). Thirteen samples were examined during this study. The samples represent metavolcanic sedimentary rocks with felsic composition containing mostly quartz, K-feldspars and plagioclase with some accessory minerals such as allanite, monazite, biotite, muscovite, calcite, chlorite etc. and these rocks preserve in some cases mylonitic textures. Two metamorphic events (M1 and M2) and four deformation phases (D1, D2, D3 and D4) were identified. Beginning with the regional metamorphic event M1, which also is peak metamorphism (greenschist to amphibolite facies), resulting in D1, a compressional deformation creating the penetrative foliation S1 from a N-S to NNW-SSE shortening direction. A tectonic pause is followed by M2 synchronous with intrusions of Lina granites resulting in widespread contact metamorphism and reactivation of the shear zones. This new compression has tilted the foliations with a dip of ~60°W of FDZ and ~60°E of NDZ. This also created a SC-fabric, a related S2 foliation which shows a slight WSW tilting, and records reverse dip-slip, ENE dextral movement. A last compressional deformation, D3, generated brittle-plastic deformations observed W of FDZ as a reverse thrust of the Gällivare block upon the W block. The last deformation described, D4, has resulted in a set of fractures, some of which have been quartz filled. These are only observed E of NDZ and were interpreted as post metamorphic brittle deformation in a normal fault motion.

Along the northern coast of the Bothnian Gulf between Umeå and Luleå live 65 percent of northern Norrland's population, yet there is no coastal railway that connects these cities with each other. In 2010, Botniabanan was completed, partially a new coastal railway between the cities of Sundsvall and Umeå. This was the first railway construction in Norrland in 80 years. Now it's time again, 2018 started the first construction phase of the Norrbotniabanan from Umeå in direction towards the city of Luleå. When the railway is completed, the line will pass through places that have not previously had a railway connection, including the small town Robertsfors. Robertsfors, with its strategic location between Umeå and Skellefteå, has a unique opportunity to expand its local labor market and increase its population when the railway arrives and shortens the time distance to Umeå and Skellefteå. This essay addresses how Robertsfors may change and develop with the establishment of a train station inside Robertsfors' central town. The result is based on assumptions by politicians and officials in the municipality and addresses issues such as work commuting and what makes Robertsfors attractive. The results show that the establishment of the railway raises hopes for an increase in population and has much to do with the increased freedom of movement and proximity to a larger labor market. However, there are also major challenges such as investment opportunities and accessibility to labor resources. Changes in Skellefteå and Umeå with increased housing prices and a shortage of housing and building land also open up opportunities for Robertsfors municipality as people can be expected to apply for housing in Robertsfors but work in Umeå or Skellefteå and commute to work by train.

In January this year, Region Västerbotten announced that the maternity ward in Lycksele would be closed until further notice. This paper is a case study of the closure of the maternity ward in Lycksele, located within the rural parts of northern Sweden. Previous research has focused on maternity ward closures in Canada and Australia whereas studies on maternity wards in northern Sweden is limited. Since large parts of northern Sweden consist of sparsely populated areas, the closure of Lycksele BB has resulted in women having to travel long distances to receive care. This paper seeks to provide a deeper understanding of the consequences of the closure of Lycksele BB by examining (1) what feelings women experience and how they manage these feelings, (2) the consequences of the maternity ward closure on women’s physical and mental health and (3) the consequences of the maternity ward closure in relation to the rural parts of northern Sweden. This study has been carried out by using a qualitative approach by conducting semi-structured interviews with two pregnant women, two mothers, and two midwives. The findings in this study show that women develop strategies to mitigate feelings of insecurity and anxiety. Both pregnant women and midwives create strategies to feel a stronger sense of control in an otherwise unpredictable situation. This contributes to major consequences for women’s mental and physical health as women are faced with new challenges, affecting their reproductive health and care. The findings also show that the closure of Lycksele BB is only a stepping stone for further welfare cuts which can result in people moving away from these sparsely populated areas. This study concludes that the issue goes beyond the closure of the maternity ward in Lycksele and raises bigger questions around the future of the rural parts of northern Sweden.

The dominant discourse often presents green growth as a solution to the ongoing environmental and climate crisis. However, it exists an unclear understanding of what green growth means in various contexts. This thesis aims to explore re-industrialization in Northern Sweden as an example of green growth, focusing on understanding the meaning and spatial implications of green growth within the context of Norrland. Tworesearch questions are put forward to study the framing of the re-industrialization and how it reproduces Norrland as space and place. 68 Swedish media articles from 2010 to 2023 covering different geographical scales were selected and processed with a qualitative content analysis method, using framing theory. The results show that reindustrialization in Norrland is framed in plural ways, emphasizing growth and development opportunities as well as concerns for Indigenous rights, human well-being, and justice. The dominant framing reinforces Norrland´s subordination to growth centers, while alternative framings highlight a broader understanding of the region’s multifaceted dimensions, raising questions about equitable distribution and the spatial power dynamics of green growth, moving the discussion away from urban-rural dichotomies. The study contributes to an understanding of the spatial implications of green growth in Norrland, challenging rural-urban dichotomies and highlighting contested values.