| 1. |
- Jonsson, Ing-Marie, 1960-
(författare)
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Social and Emotional Characteristics of Speech-based In-Vehicle Information Systems : Impact on Attitude and Driving Behaviour
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Modern vehicles use advanced information systems in vehicles to provide and control a wide variety of functions and features. Even modest vehicles today are equipped with systems that control diverse functions from air-conditioning to high quality audio/video systems.Since driving requires the use of eyes and hands, voice interaction has become more widely used by in-vehicle systems. Due to the technical complexity involved in voice recognition, focus has been on issues of speech ecognition. Speech generation is comparatively simple, but what effect does the choice of voice have on the driver? We know from human-human interaction that social cues of the voice itself influence attitude and interpretation of information. Introducing speech based communication with the car changes the relationship between driver and vehicle. So, for in-vehicle information systems, does the spoken voice matter?The work presented in this thesis studies the effects of the voice used by invehicle systems. A series of studies were used to answer the following questions: Do the characteristics of voices used by an in-vehicle system affect driver’s attitude? Do the characteristics of voice used by an in-vehicle system affect driver’s performance? Are social reactions to voice communication the same in the car environment as in the office environment?Results show that voices do matter! Voices trigger social and emotional effects that impact both attitude and driving performance. Moreover, there is not one effective voice that works for all drivers. Therefore an in-vehicle system that knows its driver and possibly adapts to its driver can be the most effective. Finally, an interesting observation from these studies is that social reactions to voice communication in the car are different than in the office, Similarity attraction, an otherwise solid finding in social science, did not hold all studies. It is hypothesized that this difference can be related to the different kinds of task demands when driving a car or working in an office environment.
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| 2. |
- Eriksson, Marie, 1970-
(författare)
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Aspects on stroke outcome : survival, functional status, depression and sex differences in Riks-Stroke, the National Quality Register for Stroke Care
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stroke is a major cause of death and disability worldwide. In Sweden, about 30 000 strokes occur each year. The aim of this thesis was to analyse survival, functional outcome and self-reported depression after stroke, and to explore possible differences between men and women in stroke care and outcome. These studies were based on Riks-Stroke, the Swedish national quality register for stroke care. Information on background variables and treatment were collected during the hospital stay. The patient’s situation and outcome after stroke were followed-up after 3 months. Long term survival was retrieved from the Swedish Population Register (Folkbokföringen). Possible sex-differences in stroke care and outcome 3 months after stroke were explored in 24 633 strokes, registered during 2006. In conscious patients, the proportions treated at stroke units were similar for men and women. Men and women had equal chance to receive thrombolytic therapy or secondary prevention with oral anticoagulants. Compared to men, women were less likely to develop pneumonia, but more likely to experience deep venous thromboses and fractures during hospital stay. Women had worse 3-month survival and functional outcome, differences that were explained by their higher age and impaired level of consciousness on admission. Women felt more depressed and perceived their health as worse than men did. Women were also less satisfied with the care they had received in the hospital. The agreement between self-reported functional outcome 3 months after stroke and the commonly used modified Rankin Scale (mRS) was explored in 555 stroke survivors from 4 hospitals during May-September 2005. Riks-Stroke’s self-reported questions classified 76% of the patients into correct mRS grade. The association between functional outcome 3 months after stroke and 3-year survival was assessed in 15 959 men and women who had had a stroke during 2001-2002. Patients with estimated mRS grades 3, 4 and 5 had hazard ratios for death of 1.7, 2.5 and 3.8, respectively, as compared with patients with lower grades, 0-2. Depressed mood, male sex, high age, diabetes, smoking, antihypertensive therapy at onset and atrial fibrillation were also identified as predictors of poor survival. Self-reported depression 3 months after stroke and use of antidepressants were analysed in 15 747 stroke survivors from 2002. Fourteen percent felt depressed 3 months after stroke. Female sex, age <65, previous stroke, living alone or in institution, or being dependent in activities of daily living (ADL) were factors associated with self-reported depression. At the follow-up, 22% of the men and 28% of the women were using antidepressant medication, which were approximately twice as many as in the general population. Still, 8% of all patients in Riks-Stroke reported depressive mood but no treatment with antidepressants. In conclusion, men and women with stroke in Sweden experience similar treatment and outcome in most aspects. Patient-reported functional outcome can be reliably transformed to a standard disability scale. Impaired functional outcome three months after stroke is an independent predictor of poor long-term survival. Depressive mood is common after stroke and is associated with poor survival and impaired functional outcome.
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| 3. |
- Sund, Fredrik, 1969-
(författare)
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Cytomegalovirus Infection in Immunocompetent and Renal Transplant Patients : Clinical Aspects and T-cell Specific Immunity
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cytomegalovirus (CMV) is a β-herpesvirus that, after primary infection, establishes a life-long persistence in the human host. Up to 90% of humans are infected with CMV, that is kept under control by CMV-specific CD8+ and CD4+ T cells. In patients with an impaired cellular immunity, however, CMV infections can be life-threatening. Thus, it is vital to identify risk factors and target high-risk patients. In this thesis we have evaluated low-dose valacyclovir prophylaxis in renal transplant patients and studied CMV-specific T cell immunity in healthy and renal transplant patients. In renal transplant patients, the CMV serostatus of both the recipient (R) and the donor (D) has a major impact on the risk of developing CMV disease. In the high-risk D+/R- population, >50% are likely to develop CMV disease in the absence of prophylaxis and/or pre-emptive therapy. We have used low-dose valacyclovir prophylaxis for high-risk renal transplant patients, and graft and patient survival up to 5 years after transplantation was comparable to data reported for other prophylactic protocols. The incidence of CMV disease and graft rejection during the first year after transplantation was also comparable to that achieved with other protocols, and without the adverse effects reported for other therapies. In the D+/R+ population, with a 15-35% risk of developing CMV disease, it is important to identify those individuals that are subject to a higher risk because of risk factors other than CMV serostatus. We therefore measured several immunologic parameters in renal transplant patients and in immunocompetent individuals with latent and primary CMV infection. In patients with a primary symptomatic CMV infection, CMV-specific CD8+ T cells peaked within a month after onset of symptoms but declined rapidly. In renal transplant patients, we found that the reduction in IFNγ-producing CMV-specific CD4+ T cells at 2 months post-transplantation may predict high-grade CMV DNAemia.
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| 4. |
- Öhman, Marie, 1958-
(författare)
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Kropp och makt i rörelse
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Body and Power in MotionThis dissertation is concerned with body and politics, or, more specifi cally body, power and governance. The central question is how specifi c individuals and bodies are constituted in the teaching of Physical Education (PE) in school. Inspired by Foucault’s work and the research fi eld that emanates from the concept of governmentality, one of the ambitions is to develop a method that facilitates the study of power and governance processes in teachers’ and students’ interactive actions and dealings. With the aid of this approach, 15 video-recorded physical education lessons in 5 Swedish nine-year compulsory schools are analysed in order to demonstrate how governance processes are included in the work and activities in terms of how the processes of governance–self-governance are staged, and the direction this takes. In using the term direction I am here referring to the content the governance is aiming towards, where the question of which subjects and bodies are constituted is of substantial interest. This means that the study not only focuses on what is done, but also on the way in which it is done, i.e. it analyses both process and content.The results show that physical exertion and the desire for physical work is a thread that runs though the analysed material. It is mainly scientifi c knowledge about the body that is referred to in actual teaching practice. This is displayed through the use of a scientifi cally inspired language when talking about the body, where effects on muscles and degrees of oxygen intake are considered in connection with the physical activities. In connection with physical exertion, pupils are encouraged to do their best, try the activities on offer, cooperate with others and face challenges. In line with the governmentality perspective’s problematisation of the process governance–self-governance, the study highlights a governance mentality that is not characterised by coercion, but is rather directed towards different components of willingness where the students are expected to be participatory, take responsibility and govern their own actions in the direction of that which is most desirable and reasonable. The willingness component appears as the actual hub of character-building, were the students ought to be physically active, should want to do their best, be willing to try, should want to show solidarity and should want to defeat the others. The process of governance–self-governance is staged as different ways of appealing to one’s willingness in the activities studied. Specifi c governance techniques are used to support and promote self-governance work, i.e. different forms of encouragement strengthen the correct action, emphasising physical exertion as pleasurable and focuses on the fact that we are all involved in a common project. In the dissertation it is shown how the body is included in a socio-political context. Through the body the individual is turned into a participant of physical projects concerned with becoming a certain kind of social citizen. The body thus symbolises the complex encounter between the individual and society. In this way the study demonstrates and highlights tendencies that are evident in modern society. It is thus a narrative that indicates how we all become part of a discourse system.
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| 5. |
- Cullberg, Marie, 1958-
(författare)
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Direct Thrombin Inhibitors in Treatment and Prevention of Venous Thromboembolism: Dose – Concentration – Response Relationships
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- For prevention and treatment of thrombotic diseases with an anticoagulant drug it is important that an adequate dose is given to avoid occurrence or recurrence of thrombosis, without increasing the risk of bleeding and other adverse events to unacceptable levels. The aim of this thesis was to develop mathematical models that describe the dose-concentration (pharmacokinetic) and concentration-response (pharmacodynamic) relationships of direct thrombin inhibitors, in order to estimate optimal dosages for treatment and long-term secondary prevention of venous thromboembolism (VTE).Population pharmacokinetic-pharmacodynamic models were developed, based on data from clinical investigations in healthy volunteers and patients receiving intravenous inogatran, subcutaneous melagatran and/or its oral prodrug ximelagatran. The benefit-risk profiles of different ximelagatran dosages were estimated using clinical utility functions. These functions were based on the probabilities and fatal consequences of thrombosis, bleeding and elevation of the hepatic enzyme alanine aminotransferase (ALAT).The studies demonstrate that the pharmacokinetics of melagatran and ximelagatran were predictable and well correlated to renal function. The coagulation marker, activated partial thromboplastin time (APTT), increased non-linearly with increasing thrombin inhibitor plasma concentration. Overall, the systemic melagatran exposure (AUC) and APTT were similarly predictive of thrombosis and bleedings. The identified relationship between the risk of ALAT-elevation and melagatran AUC suggests that the incidence approaches a maximum at high exposures. The estimated clinical utility was favourable compared to placebo in the overall study population and in special subgroups of patients following fixed dosing of ximelagatran for long-term secondary prevention of VTE. Individualized dosing was predicted to add limited clinical benefit in this indication.The models developed can be used to support the studied dosage and for selection of alternative dosing strategies that may improve the clinical outcome of ximelagatran treatment. In addition, the models may be extrapolated to aid the dose selection in clinical trials with other direct thrombin inhibitors.
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