Publikationer från Umeå universitet
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Spatio-temporal modelling and prediction of malaria incidence in Mozambique using climatic indicators from 2001 to 2018
No full textAccurate malaria predictions are essential for implementing timely interventions, particularly in Mozambique, where climate factors strongly influence transmission. This study aims to develop and evaluate a spatial–temporal prediction model for malaria incidence in Mozambique for potential use in a malaria early warning system (MEWS). We used monthly data on malaria cases from 2001 to 2018 in Mozambique, the model incorporated lagged climate variables selected through Deviance Information Criterion (DIC), including mean temperature and precipitation (1–2 months), relative humidity (5–6 months), and Normalized Different Vegetation Index (NDVI) (3–4 months). Predictive distributions from monthly cross-validations were employed to calculate threshold exceedance probabilities, with district-specific thresholds set at the 75th percentile of historical monthly malaria incidence. The model’s ability to predict high and low malaria seasons was evaluated using receiver operating characteristic (ROC) analysis. Results indicated that malaria incidence in Mozambique peaks from November to April, offering a predictive lead time of up to 4 months. The model demonstrated high predictive power with an area under the curve (AUC) of 0.897 (0.893–0.901), sensitivity of 0.835 (0.827–0.843), and specificity of 0.793 (0.787–0.798), underscoring its suitability for integration into a MEWS. Thus, incorporating climate information within a multisectoral approach is essential for enhancing malaria prevention interventions effectiveness
"They will live in an AI-driven world. It is our responsibility to teach them that" : A study on teachers' experiences of changes related to AI in Swedish language teaching.
No full textThis study examines the impact of artificial intelligence (AI) on teaching. AI has developed and been implemented rapidly across various sectors of society,including the educational system. The aim of this study is to explore teachers' perceptions of how AI has influenced their teaching practices. The data for this study was collected through semi-structured interviews and analyzed using thematic content analysis. The theoretical framework in this study is Foucault’s perspectives on power and Biesta’s views on teaching. The results indicate that teachers in this study perceive an increased need for student supervision, due to the potential use of AI. Additionally, grading practices have been adjusted to include more thorough scrutiny for potential academic dishonesty.Teachers in this study also shared their perspectives on the future of teaching in relation to AI. Some anticipated that controlled digital environments would become standard and that assignments would be adapted to incorporate AI use. Others viewed AI as a potential tool to support teachers in their work. Several teachers emphasized their responsibility to educate students on the appropriate and ethical use of AI, given its relevance in their future professional lives. The results indicate that AI has had an impact on teaching and is expected to continue to shape teaching in the future
Landscape and climatic drivers of dengue fever in Lao People’s Democratic Republic and Thailand : a retrospective analysis during 2002–2019
No full textContext: Dengue is a major public health threat in the Lao People’s Democratic Republic (Laos) and Thailand. Dengue transmission is ecologically complex. Concurrently identifying both climate and landscape-based risk factors for dengue virus transmission is necessary to improve dengue prevention and control efforts in Laos and Thailand. Objectives: The objective of this study was to determine how changes in climate (temperature and rainfall), and land use (e.g. built-up areas, agricultural crops, fruit orchards, rubber plantations) and land cover (e.g. evergreen and deciduous forests, permanent and temporary wetlands) affect dengue risk in four provinces in southern Laos and north-eastern Thailand during 2002 to 2019. Methods: A conditional autoregressive Bayesian spatiotemporal modeling framework was used to analyze the risk of dengue by spatiotemporal variations in land use and land cover (LULC) and climatic parameters. Results: The average annual temperatures in the study area increased by 0.44–0.94 °C during the study period. The model indicated that an increase of 1 °C in weekly average temperatures (up to a 29 °C threshold level) increased the average dengue risk by up to 24% in the two Lao provinces and 18.9% in the two Thai provinces. The model suggested that a rainfall increase of 1 mm up to 60 mm increased dengue risk by 1.8–3.2%. A 0.6–1.6% increase in built-up land use increased dengue risk by 1.8–6.9%. Built-up areas and rubber plantations were positively associated with dengue in the Ubon Ratchathani province of Thailand, while wetlands were negatively associated with dengue cases in the Savannakhet province of Laos. Conclusions: Changes in dengue risk were clearly related to increases in rainfall and temperature as well as changes in LULC in both Laos and Thailand. These insights may inform community-based dengue control activities by targeting geographically localized areas (microgeographic scale) to deploy dengue control activities more effectively in these highly endemic regions
Lowering of systolic blood pressure with ESPRIT along the BPROAD : the lower the better?
No full textRecent studies have renewed the debate over optimal systolic blood pressure (SBP) targets in hypertensive patients, particularly those at increased cardiovascular (CV) risk and with type 2 diabetes mellitus (T2DM). The Effects of Intensive Systolic Blood Pressure Lowering Treatment in Reducing Risk of Vascular Events (ESPRIT) and Blood Pressure Control Target in Diabetes (BPROAD) randomized controlled trials, both conducted in Chinese populations, offer new insights into intensive versus standard SBP-lowering strategies. ESPRIT enrolled 11,255 patients with high CV risk (including 38.7% with T2DM), while BPROAD included 12,821 hypertensive patients with T2DM and elevated CV risk. Both trials compared intensive SBP lowering (< 120 mmHg) with standard treatment (< 140 mmHg). Results from both studies showed that intensive treatment significantly reduced the incidence of major adverse cardiovascular events (MACE). ESPRIT reported a hazard ratio (HR) of 0.88 for MACE, along with notable reductions in CV and all-cause mortality. BPROAD similarly found a HR of 0.79 for MACE, although it did not demonstrate a statistically significant benefit in all-cause mortality. However, intensive treatment in both trials was associated with higher—though relatively low—absolute rates of adverse events, including hypotension, syncope, and renal impairment. When considered alongside previous trials, our meta-analysis suggests a consistent reduction in MACE risk with intensive SBP control. Nevertheless, concerns remain regarding the safety profile and generalizability of these findings, particularly given that both ESPRIT and BPROAD were limited to ethnically Chinese cohorts and reported unusually low adverse event rates compared to Western studies. In summary, the cumulative evidence suggests that an SBP target < 140 mmHg may be suboptimal. However, whether a target < 120 mmHg is superior to the current guideline-recommended range of 120–129 mmHg remains uncertain. No trials have directly compared < 120 mmHg with < 130 mmHg. Therefore, future research should determine whether the additional benefits of more aggressive SBP lowering outweigh potential risks, especially in diverse populations with and without diabetes
Compressing regularized dynamics improves link prediction with the map equation in sparse networks
No full textPredicting future interactions or novel links in networks is an indispensable tool across diverse domains, including genetic research, online social networks, and recommendation systems. Among the numerous techniques developed for link prediction, those leveraging the networks' community structure have proven highly effective. For example, the recently proposed MapSim predicts links based on a similarity measure derived from the code structure of the map equation, a community-detection objective function that operates on network flows. However, the standard map equation assumes complete observations and typically identifies many small modules in networks where the nodes connect through only a few links. This aspect can degrade MapSim's performance on sparse networks. To overcome this limitation, we propose to incorporate a global regularization method based on a Bayesian estimate of the transition rates along with three local regularization methods. The regularized versions of the map equation compensate for incomplete observations and mitigate spurious community fragmentation in sparse networks. The regularized methods outperform standard MapSim and several state-of-the-art embedding methods in highly sparse networks. This performance holds across multiple real-world networks with randomly removed links, simulating incomplete observations. Among the proposed regularization methods, the global approach provides the most reliable community detection and the highest link prediction performance across different network densities. The principled method requires no hyperparameter tuning and runs at least an order of magnitude faster than the embedding methods
Worsening asthma at school is associated with poor psychosocial well-being
No full textObjective: To study whether worsening asthma at school was related to generic health-related quality of life (HRQoL) and asthma-related impact and worry among 15-year-olds with current asthma in Sweden. In addition, we studied the association between worsening asthma at school at age 15 and the change in the degree to which asthma interfered with daily activities between ages 15 and 19 years. Methods: Within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a cohort of schoolchildren has been followed from age 8 years until 19 years of age. In the current study, the sample included 266 adolescents with physician-diagnosed asthma, and either wheeze or use of asthma medication during the last 12 months at age 15 years. Results: At age 15, HRQoL scores were lower among those who reported worsening asthma at school (standardised beta (β) = −0.18, p = 0.003), they had more asthma-related worries (β = −0.33, p < 0.001) and asthma impacted their life during activities more (β = −0.46, p < 0.001) than those whose asthma did not worsen. Furthermore, the more adolescents reported that asthma worsened at school at age 15, the more it was associated with the increase in the degree to which asthma interfered with their activities between 15 and 19 years (β = 0.14, p = 0.038). Conclusions: Worsening asthma at school was associated with lower generic health-related quality of life, higher asthma-related worry and impact on daily activities among teenagers with asthma
Tie2 activity in cancer associated myofibroblasts serves as novel target against reprogramming of cancer cells to embryonic-like cell state and associated poor prognosis in oral carcinoma patients
No full textBackground: Myofibroblastic cancer-associated fibroblasts (CAF) in tumor stroma serves as an independent poor prognostic indicator, supporting higher stemness in oral cancer; however, the underlying biology is not fully comprehended. Here, we have explored the crucial role of Tunica Interna Endothelial Cell Kinase (Tie2/TEK) signaling in transition and maintenance of myofibroblastic phenotype of CAFs, and as possible link with the poor prognosis of head and neck squamous cell carcinoma (HNSCC) patients. Methods: Bulk and single cell RNA-sequencing (scRNAseq) methods and in-depth bioinformatic analysis were applied for CAF and cancer cells co-culture for studying molecular relationships. In vitro 3D-spheroid-forming ability, expression of stemness markers, in vivo tumor formation ability in zebrafish embryo and syngeneic mouse allografts formation was conducted to test stemness, upon targeting CAF-specific Tie2 activity by gene silencing or with small molecule inhibitor. Immunohistochemistry analysis was performed to locate the distribution of Tie2 and αSMA in primary tumors of oral carcinoma. Prognosis in HNSCC patient cohort from The Cancer Genome Atlas (TCGA) study was analysed based on single sample gene set enrichment score (ssGSEA) and Kaplan–Meier analysis. Results: Autocrine or exogenous TGFβ-induction in CAF led to the recruitment of histone deacetylase 2 (HDAC2) on the promoter of Tie2-antagonist, Angiopoietin-2 (ANGPT2), resulting in its downregulation, leading to phosphorylation of Tie2 (Y992) and subsequent activation of SRC (Y418). This led to SRC/ROCK mediated αSMA-positive stress-fiber formation with gain of myofibroblast phenotype. The CAF-specific Tie2-signaling was responsible for producing embryonic-like cell state in co-cultured cancer cells; with enhanced tumor initiating ability. Tie2 activity in CAF exerted the dynamic gene expression reprogramming, with the upregulation of ‘cell migration’ and downregulation of ‘protein biosynthesis’ related gene-regulatory-network modules in malignant cells. The AUCell scores calculated for gene signatures derived from these modules showed significant concordance in independently reported scRNAseq studies of HNSCC tumors and significant association with poor prognosis in HNSCC patient cohort. Conclusions: CAF-specific Tie2 activity may serve as direct stromal-target against cancer cell plasticity leading to poor prognosis of oral cancer patients. Overall, our work has provided wider applicability of Tie2-specific functions in tumor biology, along with its known role in endothelial cell-specific function
Barnsjuksköterskans erfarenhet av att bemöta barn med autismspektrumtillstånd vid genomförande av vårdprocedurer.
No full text Bakgrund: Barn med autismspektrumtillstånd (AST) har rätt till individanpassad vård utifrån sina behov, enligt både Barnkonventionen och LSS. Barnsjuksköterskor har ett ansvar att inkludera barnet, ge trygghet och respektera barnets autonomi. Tidig diagnostik och anpassade vårdmiljöer är avgörande för att minska stress och förbättra kommunikationen. Familjesamverkan och ökad kunskap är centrala faktorer för att skapa en trygg och effektiv vårdsituation. Motiv: Barn med AST är en sårbar grupp som ofta upplever oro vid vårdprocedurer, vilket kräver individanpassad vård. Tidigare forskning visar brister i resurser och kunskap hos vårdpersonal.Syfte: Syftet med studien är att undersöka barnsjuksköterskans erfarenhet av att bemöta barn med autismspektrumtillstånd vid genomförande av vårdprocedurer. Metod: Studien har en kvalitativ design med semistrukturerade intervjuer. Åtta barnsjuksköterskor deltog i studien. Datamaterialet analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Huvudfynden mynnade ut i tre kategorier med totalt åtta underkategorier. Kategorin “Att anpassa vårdprocedurer utifrån barnets behov innehöll underkategorierna: “Individanpassade förberedelser som trygghetsskapande strategier”, “Föräldrars roll i att vägleda till trygghet” och “Fysiska vårdmiljön som stöd vid vårdprocedurer.” Kategorin “Att bemästra svåra situationer” innehöll underkategorierna “Barns reaktioner på vårdprocedurer” och “Barnsjuksköterskans känslomässiga påverkan vid vårdprocedur”. Kategorin “Att stärka kunskap och kompetens innehöll underkategorierna “Önskan om mer utbildning i AST”, “Kollegiala erfarenhetsutbyten och handledning” och “Förbättringsområden för tryggare vård av barn med AST”. Konklusion: Individanpassad och strukturerad vård, i kombination med ökad kunskap om barn med AST hos barnsjuksköterskorna är avgörande, för att skapa trygga vårdsituationer för barn med AST och förbättra kvaliteten i vården. Föräldrar har en viktig roll som stöd och vägledare i vårdprocessen. Genom att stärka sjuksköterskans kompetens och implementera anpassade arbetssätt kan vården bli mer inkluderande, förutsägbar och trygg för både barn och personal
Hållbara transporter inom city- och bygglogistik : En kvalitativ studie om hur svenska logistikföretag arbetar med strategier för att vara hållbara i sina transporter.
No full textUrbanisering och klimatförändringar har under de senaste årtiondena blivit centrala delar i samhällsdebatten, detta ställer nya krav på hur transporter bör planeras och utföras inom urbana områden. Samtidigt som städerna växer står transportsektorn inför tuffa klimatmål samt krav från invånarna, vilket har resulterat i ett behov av innovativa och hållbara transportlösningar. Denna studie som är genomförd på Handelshögskolan på Umeå Universitet, syftar till att undersöka hur företag arbetar med hållbara transportstrategier inom citylogistik samt om bygglogistikens leveransprocesser följer denna utveckling. Denna uppsats forskningsfråga är baserad på ett identifierat forskningsgap, det finns omfattande teorier inom citylogistik, som till exempel ruttoptimering, samlastning och användning av elfordon. Dock är det fortfarande oklart hur de svenska företagen använder dessa strategier för att vara hållbara i sina leveranser. Det är även oklart i vilken utsträckning bygglogistiken använder sig av citylogistiska strategier i sina leveranser. Denna uppsats söker svar på hur och i vilken utsträckning dessa olika hållbara strategier används i praktiken av företag som arbetar med leveranser inom urbana områden. För att kunna besvara forskningsfrågan har en kvalitativ forskningsmetod använts där djupgående semistrukturerade intervjuer har genomförts med respondenter från relevanta företag som verkar i Sverige. Dessa intervjuer har möjliggjort och skapat en fördjupad förståelse för de möjligheter och utmaningar företagen handskas med inom deras arbete mot hållbara leveranser. Intervjuerna har genererat en djup empiri som analyserats med hjälp av en tematisk analys vilket skapade möjligheten att identifiera mönster och teman baserat på denna data. Resultaten tyder på att företagen uttrycker en vilja att arbeta med hållbarhet men implementeringen av de olika hållbara leveransstrategierna skiljer sig åt mellan företagen. En del företag har kommit långt i arbetet med ruttoptimeringar och samlastningar via samlastningscentraler medan andra inte ens implementerat strategin eller är i början av arbetet. Företagen uttrycker att en stor utmaning är bristen på samordning mellan olika aktörer samt att det är svårt att mäta effekterna av de åtgärder de gör gällande hållbarhet i leveranserna. Denna uppsats bidrar med praktiska insikter gällande hållbara transportstrategier som kan fungera som en vägledning för företag och beslutsfattare vilka vill främja arbetet med hållbara leveranser i urbana områden. Genom att presentera relevanta exempel samt påvisa möjligheter och utmaningar skapas ett kunskapsunderlag som kan användas för att fortsatt styrka och stödja utvecklingen inom hållbara transporter i Sveriges urbana områden.
Determinants of leadership and management among unit managers in social work : An interview study on the role of unit managers from a structural perspective.
No full textUtifrån strukturella faktorer och styrningsmodeller undersöks, genom intervjuer, hurenhetschefer i socialt arbete i Sverige, upplever sin rolls utrymme för ett chefskap ochledarskap. Vi undersöker även hur rollen uppfattas av anställda under första linjens chef.Utbildning, New Public Management, Evidensbaserad Praktik och tillitsbaserat arbete ärnågra av de faktorer som påverkar enhetschefsrollen. Bland annat visar Arbetsmiljöverket(2018) att det finns brister i enhetschefers arbetsmiljö och Tafvelin et al. (2018) som påtalaratt administrativa arbetsuppgifter hindrar chefer från att interagera med anställda. En artikelfrån fackförbundet Vision menar att problemen som finns i enhetschefers roll framförallt börlösas på en organisatorisk nivå (Lindeberg, 2020). Resultatet visar att det framförallt ärmängden dokumentation och regleringar av budget som intervjupersonerna påverkas av ideras dagliga arbete utifrån ett styrningsperspektiv. Vi undrar utifrån tidigare nämnda faktorer,vart egenskaperna under chefskap och ledarskap får för form och utrymme i rollen. Attintervjua anställda tillförde värdefulla perspektiv till studien och vi kan se att de anställdadelvis önskar ett annat typ av ledarskap än vad chefer erbjuder idag.