Service screening with mammography was implemented in Northern Sweden between 1989 and 1998, covering 190,000 women aged 40-74 years constituting the target population in the area. The aim of this thesis was the evaluation of mammography screening in Northern Sweden with special focus on selected screening performance indicators and on the disease outcome. We analysed interval cancer (IC) incidence and episode sensitivity in the Norrbotten Mammography Screening Programme (NMSP) for the period 1989-2002. An overall IC rate at 1.1/1000 and IC rate ratio at 38% was found and epsiode sensitivity was estimated at 62-73%, in concert with reference values of the European guidelines. Radiological classification of the IC cases in three rounds of the NMSP showed that true, occult, missed and minimal signs IC, were present in 48%, 10%, 14% and 28% of the cases. We analysed early death from breast cancer (n=342) in Northern Sweden during the first five years of mammography service screening. Most fatal cases were advanced and incurable on diagnosis. In a few screen-detected cases with favourable prognostic factors the fatal outcome was unexpected. We estimated breast cancer survival by detection mode in 5120 women with breast cancer. We found a significantly favourable survival among IC cases compared to cases among uninvited. We studied breast cancer mortality in relation to mammography screening. Our findings indicated a long-term reduction of breast cancer mortality by 26-30% among women invited to screening and by 31-35% among women screened compared to not screened. We conclude from our evaluation of the mammography screening in Northern Sweden that women benefited from this public health intervention in form of improved survival and reduced mortality.

Accurate forecasts of tropical cyclone surface wind fields are essential for decisions involving evacuation preparation and damage potential. Towards addressing these actions, a comparison of the CFAN tropical cyclone surface wind field model with the H*Wind wind field reanalyzes is done to assess the accuracy of the CFAN algorithm and to determine potential limitations of its use. 16 tropical cyclones were assessed through correlation coefficient, mean bias, and root mean square error. The resolution of initial conditions to be ingested into the model was also analyzed, along with storm type and whether or not wind shear was a limiting factor. Results suggest that the CFAN wind model accurately predicts the H*Wind analyses in most regions of the TC. The center of circulation has the highest error due to the CFAN wind model treating the center of circulation as a point rather than having finite lateral extent. Results from the sensitivity analysis based on input resolution show that the minimum input resolution for the CFAN wind model to produce fine spatial resolutions with high fidelity is 0.25°. It is shown that the reproductions of weaker tropical cyclones have lower accuracy due to wind field asymmetries within these systems, while stronger TCs are better reproduced, as these systems are usually better organized. Finally, through the wind shear analysis, it is shown that the accuracy of reconstruction is not dependent on the magnitude of vertical wind shear.

Under normotensive conditions, the progressive loss of renal function in diabetes mellitus is very slow. Since hypertension accelerates many forms of renal disease, we assessed the progression of nephropathy in Streptozotocin-induced type 1 diabetes mellitus under renin-mediated hypertension condition. We investigated the diabetic “salt paradox” as a modifiable susceptibility factor for renal damage. Since hyperfiltration occurs in early diabetes, the reduction of glomerular filtration rate due to an increased salt intake could be mediated by increased tubuloglomerular feedback sensitivity. We compared intact-hypertensive versus diabetic-hypertensive Long-Evans rats under normal and increased salt intake, 1 and 2.5% by weight of food eaten, respectively. Weekly 24-h blood pressure records were acquired by telemetry during the six months of the experiment. Target mean blood glucose of ~ 25 mmol/L was maintained by suboptimal insulin implants. Systolic blood pressure increased after induction of hypertension but was not affected by diabetes or increased salt intake, either alone or together. Autoregulation was highly efficient in both intact and diabetic rats. Nephropathy was scored by histology in the clipped and non-clipped kidneys at the end of the protocol. The non-clipped kidney, which was exposed to hypertension, showed a linear pressure-dependent glomerular injury in both intact and diabetic rats. The best fit line describing the linear relationship between pressure load and injury was shifted toward lower blood pressure in diabetic rats. Over the time course of our experiments, injury was entirely pressure dependent in intact and diabetic rats. Diabetes mellitus increased the susceptibility of the kidney to injury, but independent of blood pressure. Increased salt intake affected neither blood pressure nor renal susceptibility to hypertensive injury. / Graduate

The aim of this study was to describe and analyze the problems caused by students that characterize themselves as highly sensitive. The issue of high sensitivity and other categorizations are fiercely debated in the research. This empirical study was conducted in light of literature about high sensitivity, pedagogies, and interview methods. The students answered questions about what makes them categorize themselves and how they believe that the categorization affects their learning and social development. They also responded to questions about what they consider appropriate measures to improve their situation. The most obvious outcome is that students do not feel safe in the large classes that they are a part of-, as the learning environment is perceived too large and tough. The students can not do themselves justice despite their ability and willingness to learn. Students also feel that they are placed into incorrect categorizations such as shy, introverted or different. This fact show links to the ongoing debate related to inclusion and appears to provide a critical illumination of it. The study was completed by a comprehensive discussion of the inquiry results from a special education perspective.

In this study, we examined the effect of cool roofs on commercial and residential buildings in each climate zone, by looking at monitored case studies and DOE-2 simulations from various sources of literature; and using an online tool - the Cool Roof Calculator and a simple COP ratio model to validate the results of the case studies. It was found that the Cool Roof Calculator does not take building form into account, hence a sensitivity analysis was first conducted to rank the importance of various building parameters against one another. The analysis was conducted on the EPC normative building energy model. Results indicated that roof absorptance coefficient, aspect ratio and number of floors were the three parameters that either ranked highest or were important parameters, and were chosen for further parametric analysis to evaluate the impact of these building parameters on total building loads. A simple COP ratio model was also developed to validate the results from the literature review and Cool Roof Calculator, and it was found that in terms of cost, for a prototype medium-sized commercial building, it is always beneficial to use a white roof, but cities in northern climates may have little advantage, and insulation may be a better choice.

The purpose of these studies was to examine mediation and moderation processes for the influence of early adversity and current stressful circumstances on maternal sensitivity. Evidence of mediation was found in Study 1 where maternal depression and mothers’ negative appraisal of their infant mediated the influence of early adversity and low family income on maternal sensitivity. Study 1 also examined the influence of the neighborhood. A moderate-mediation model was tested where the mediating influence afore-stated was hypothesized to vary across levels of neighborhood quality. Partial evidence of moderation was found. In the context of a high quality neighborhood, mothers’ early adversity was not associated with maternal depression. Across levels of neighborhood quality, complex relationships emerged between the variables low family income, maternal depression and mothers’ appraisal of infant temperament. In a context of low neighborhood quality, there was no evidence of a direct association between low family income and maternal sensitivity, rather, low family income operated indirectly through maternal depression. In a context of high neighborhood quality, there was evidence for a direct and indirect association between low family income and maternal sensitivity. Study 2 examined associations between variation in the Arginine Vasopressin 1a receptor gene (AVPR1a) and maternal sensitivity, and whether variation in this gene moderated the influence of mothers’ early adversity on sensitivity. Mothers homozygous for the long alleles of the RS3 microsatellite were significantly less sensitive than mothers heterozygous for the long alleles and those homozygous for the short alleles. Homozygosity for the RS3 long alleles moderated the influence of mothers’ early adversity on their sensitivity; the influence of early adversity on maternal sensitivity was most pronounced for mothers with the RS3 long/long genotype. These results suggest that variation in the AVPR1a gene may be important not only for human maternal behavior, but also for stress reactivity.

The purpose of these studies was to examine mediation and moderation processes for the influence of early adversity and current stressful circumstances on maternal sensitivity. Evidence of mediation was found in Study 1 where maternal depression and mothers’ negative appraisal of their infant mediated the influence of early adversity and low family income on maternal sensitivity. Study 1 also examined the influence of the neighborhood. A moderate-mediation model was tested where the mediating influence afore-stated was hypothesized to vary across levels of neighborhood quality. Partial evidence of moderation was found. In the context of a high quality neighborhood, mothers’ early adversity was not associated with maternal depression. Across levels of neighborhood quality, complex relationships emerged between the variables low family income, maternal depression and mothers’ appraisal of infant temperament. In a context of low neighborhood quality, there was no evidence of a direct association between low family income and maternal sensitivity, rather, low family income operated indirectly through maternal depression. In a context of high neighborhood quality, there was evidence for a direct and indirect association between low family income and maternal sensitivity. Study 2 examined associations between variation in the Arginine Vasopressin 1a receptor gene (AVPR1a) and maternal sensitivity, and whether variation in this gene moderated the influence of mothers’ early adversity on sensitivity. Mothers homozygous for the long alleles of the RS3 microsatellite were significantly less sensitive than mothers heterozygous for the long alleles and those homozygous for the short alleles. Homozygosity for the RS3 long alleles moderated the influence of mothers’ early adversity on their sensitivity; the influence of early adversity on maternal sensitivity was most pronounced for mothers with the RS3 long/long genotype. These results suggest that variation in the AVPR1a gene may be important not only for human maternal behavior, but also for stress reactivity.

Purpose: There is little agreement on the age at which visual acuity (VA) and contrast sensitivity (CS) become adult-like. The ultimate purpose of this thesis was to determine whether VA and CS are adult-like at the age of 6-8 or 9-12 years by using both objective and subjective methods in the same individuals. The objective method (sweep visually evoked potentials [sVEP]) has many parameters that may affect the measurement of VA or CS and previously these had not been studied systematically, especially in children. Therefore, a second purpose was to study the effects of these parameters on VA and contrast thresholds and to determine the parameters that give the most repeatable measurements and the greatest number of viable readings in children, to be compared to previous data obtained in adults. Methods: The effect of five criteria (C0-C4) for choosing the endpoint for the regression line fitting and three luminance levels (25, 50, and 100 cd/m2) on the sVEP VA and contrast thresholds (at 1 and 8 cpd) was investigated in six 6-8 year old children. Additionally, the effect of these parameters on the number of viable readings obtained from five active electrodes was investigated. C0 was derived from the sVEP software (PowerDiva), C1 used the best fit by eye to determine the range over which the regression line was fitted, C2 used the data point between signal peak and the last data point with an SNR ≥ 1, C3 was similar to C2 but was defined so that the threshold should be within the sweep range, and C4 was similar to C2 except that the SNR should not fall below one at any point within the range used for the regression line fitting. The effects of two electrode placements, three temporal frequencies (6, 7.5, and 10 Hz), sweep direction (low to high and high to low), presence or absence of a fixation target, three stimulus areas (6, 4, and 2° for VA and 15, 10, and 6° for contrast thresholds) and three sweep durations (10, 15, and 20 sec) on VA and contrast thresholds (at 1, 4, or 8 cpd) measured with sVEP were also investigated in six 6-8 year-old children and six adults with normal vision. Additionally, the effect of these parameters on the number of viable readings obtained from five active electrodes was investigated. The sVEP parameters that were found to give the best threshold measurements were employed in a cross sectional study of the development of VA and CS. In this study the objective sVEP technique and two psychophysical techniques were used. The psychophysical techniques were comprised of a two-alternative forced choice (2AFC) staircase for measuring VA and contrast thresholds and signal detection theory (SDT) for measuring contrast threshold. Crowded and uncrowded logMAR VA were also measured with a Bailey-Lovie logMAR chart. The study included three age groups (6-8, 9-12 year olds and adults). The criterion employed by each age group as indicated by the SDT was compared. Results: There was a significant effect of the criterion for choosing the endpoint for the regression line fitting (p < 0.05) on all the measures and a significant effect of luminance (p = 0.036) on contrast threshold at 1 cpd. Criterion C2 (in which the range for the regression line fit was defined to include all the data between the signal peak and the last data point [furthest from the peak] with an SNR ≥ 1) consistently gave more viable readings and better thresholds (i.e. higher VA and lower contrast thresholds) than the other criteria. Also C2 was the best criterion in terms of repeatability in children, and repeatability and validity in adults (Yadav et al., 2009). The luminance of 25 cd/m2 gave higher contrast thresholds than 50 or 100 cd/m2. There was a significant effect of temporal frequency on the number of viable readings for VA (p < 0.0001) and for contrast thresholds (p = 0.0001), with more viable readings at 7.5 Hz than at either 6 or 10 Hz. The adults gave more readings with the fixation target than without it (p = 0.04) for contrast threshold at 1 cpd. The smallest stimulus area used gave rise to fewer viable readings in both adults and children (p = 0.022 for VA and 0.0001 for contrast threshold). The other parameters (electrode placement, sweep direction and sweep duration) did not result in significant differences. There was a significant effect of age on crowded (p = 0.0001) and uncrowded (p < 0.0001) VA. The 6-8 year olds gave poorer VA than the 9-12 year olds or adults for both crowded and uncrowded VA. For the grating VA (sVEP and 2AFC staircase) there was a significant effect of age (p = 0.002). The 6-8 year olds had poorer VA than the 9-12 year olds or adults. For contrast threshold at 1 cpd, a significant effect of age was found for the 2AFC (p = 0.008) and SDT (p = 0.0003). The 6-8 year olds gave poorer contrast thresholds than adults with each procedure. For contrast thresholds at 8 cpd, there was a significant effect of age with the 2AFC staircase (p = 0.036). The 6-8 year olds gave poorer contrast thresholds than the 9-12 year olds. For SDT, there was a significant effect of age on criterion (p < 0.05), with adults being more likely to say “no” in the yes-no SDT procedure than both the 6-8 year olds and the 9-12 year olds for contrast threshold at 1 cpd. Adults were also more likely to say “no” than the 9-12 year olds for contrast thresholds at 8 cpd. Conclusions: This thesis has shown that VA and CS are not adult-like until the age of 9-12 years by these measures and that children do show differences in criterion compared to adults in psychophysical testing. This difference in criterion indicates the use of SDT or force-choice procedures to avoid this problem in any psychophysical developmental study. It has also shown that criterion for choosing the endpoint for the regression line fitting in the sVEP technique has the greatest effect on VA and contrast thresholds measurements and viable readings, while the other sVEP parameters have little effect on the thresholds.

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Relationship violence is a serious social problem. Given the prevalence and detrimental effects of relationship violence, much research has been undertaken to investigate the various risk factors that may be associated with this type of violence. In the present research, I examined the interrelationships among several correlates of violence (including rejection sensitivity, cognitive biases, decoding deficits and attachment style) in order to understand what differentiates physically abusive from non-abusive individuals. Hence, the current program of studies examined aggressive behaviours between partners with a focus on risk factors for violent behaviour in men and women and in particular on the role of rejection sensitivity in physically aggressive behaviour. In order to examine these constructs, the thesis includes six chapters. Following a review of the literature, a rationale was provided for the creation of an amended measure of rejection sensitivity as Downey and Feldman’s (1996) Rejection Sensitivity Questionnaire was not suitable for the purposes of the current thesis. Hence, a series of validation studies were conducted in Chapter 2 to test and develop a revised measure of rejection sensitivity that would be applicable to a wider range of intimate relationships (dating, cohabiting and married) and contexts. The study reported in Chapter 3, investigated the role of rejection sensitivity, hostile attributions and attachment patterns in the etiology of intimate partner violence. This study provided preliminary support for insecure attachment and negative attributions as the link between expectations of rejection and intimate partner violence, with a stronger link for male-perpetrated violence compared to female-perpetrated violence. Consistent with the marital violence literature, when mediator and moderator relationships existed, these occurred predominantly in married relationships (as opposed to dating or defacto relationships). The studies reported in Chapters 4 and 5 built on the foundations of Chapter 3 by incorporating two constructs, the ‘overattribution bias’ and empathic accuracy into the investigation of the associations between rejection sensitivity and violence. Specifically, the study reported in Chapter 4 examined the decoding deficits and inferential biases of maritally-violent and maritally-violent rejection-sensitive men when interpreting their own partner’s messages whilst engaging in a laboratory-based decoding task. Overall, results showed that maritally-violent partner rejection-sensitive men were less accurate than were maritally non-violent partner rejection-sensitive men when interpreting their wives’ positive messages and more accurate when interpreting their wives’ negative messages. Likewise, maritally-violent rejection-sensitive men displayed an inferential bias to perceive their wives’ messages as being more negative, critical and rejecting in intent than did maritally non-violent rejection-sensitive men. In addition, maritally-violent men as a group were less accurate for their own partner’s positive and neutral messages than were maritally non-violent men and more accurate for their own wives’ negative messages than were maritally non-violent men. Finally, maritally-violent men tended to attribute their wives’ messages as being significantly more negative, critical and rejecting in intent than did maritally non-violent men. Overall, the data suggested that both rejection sensitivity and marital violence were key factors that were associated with married men’s decoding problems and biased interpretation of their own wives’ messages. In extending the previous findings, the study reported in Chapter 5 examined the decoding accuracy and inferential biases of both maritally-violent and maritally-violent rejection-sensitive men and women in relation to female strangers’ messages. There were no differences between maritally-violent rejection-sensitive women and maritally non-violent rejection-sensitive women on decoding deficits and inferential biases for female strangers. However, there was a trend for maritally-violent women to be more negatively biased than were maritally non-violent women when interpreting female strangers’ messages. Additionally, in contrast to the findings of Chapter 4, the data pointed to independent relationships among rejection sensitivity, violence and married men’s decoding deficits and biases for female strangers’ messages. In particular, there were no differences in decoding deficits or inferential biases between maritally violent rejection-sensitive and maritally non-violent rejection-sensitive men when decoding female strangers’ messages. Instead, the data revealed that maritally-violent men were poor decoders of female strangers’ positive messages compared to maritally non-violent men and maritally-violent women. In relation to negative messages, maritally-violent men were more accurate for female strangers’ negative messages than were maritally non-violent men. Maritally violent men had the highest decoding accuracy for negative messages. Maritally-violent men also tended to attribute female strangers’ messages as being significantly more negative, critical and rejecting in intent than did maritally non-violent men and maritally-violent women. Finally, the results showed that maritally-violent rejection-sensitive men’s decoding deficits and biases were relationship specific whereas maritally-violent men’s decoding deficits and cognitive biases were global deficits that extended to women other than the men’s wives. Implications of the findings were discussed, as well as the strengths and limitations of the study. The discussion concludes with implications for theory and practice and suggestions for future research.