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Coming dissertations at Uppsala university

Please note that the date and time given on these pages is the time of electronic publication, and not the date of the public defense. To find the time and venue of the public defense, please follow the link to DiVA of the thesis in question.
  • Self-sampling by elderly women for the detection of HPV and cervical dysplasia

    Author: Ruth S. Hermansson
    Publication date: 2021-03-01 13:04

    In Sweden, about 30% of the cervical cancer cases occur in women older than 60 and the mortality rate is as high as about 70% in this age group. There is a lack of knowledge concerning the prevalence of infection with oncogenic types of HPV, and cervical dysplasia in women of 60 years and older. Screening for oncogenic types of HPV is more effective than cytology in reducing the incidence of cervical cancer. It is established that self-collected samples are equally accurate as clinician-taken cervical samples when a validated PCR-based test is used for analysis. 

    Objectives: The overall aim was to gain knowledge about HPV infection and cervical dysplasia prevalence in elderly women and to evaluate the acceptability of repeated self-sampling at home for HPV testing.

    Material and Methods: In Paper I, we investigated the prevalence of HPV and HPV-related cervical dysplasia in 1051 elderly women aged 60 to 89 attending an outpatient gynecology clinic. A gynecologist collected these samples. In Paper II, repeated self-sampling at home for HPV testing was offered to 375 women in each of the four age groups 60, 65, 70, and 75. In Paper III, we carried out a descriptive study with quantitative and qualitative methods to describe older women’s experiences of self-sampling. In Paper IV, we investigated the incidence of oncogenic HPV and HPV-related dysplasia among 632 women aged 65 to 80 years who five years earlier had a negative HPV test.

    Results: The prevalence of HPV was just over 4% both when the samples were collected by a clinician (Paper I) and by self-sampling (Paper II). The majority of women positive in both the first and second HPV tests had dysplasia in histology. Of the women with dysplasia in histology, more than 80% had normal cytology. In Paper II, a self-collected sample was provided by 59.5% of the invited women. In Paper III, 97.2% of eligible women answered the survey, and 13 of 16 invited women participated in the interviews. Most of them reported that they prefer self-sampling because it was easy to perform, less embarrassing, and less time-consuming than a clinic visit. In Paper IV, the incidence of oncogenic HPV was 2.8% in the first test and 1.3% in the second test, and mild cervical dysplasia was found in 50% of women with persistent HPV infection.

    Conclusions: A significant proportion of elderly women were found to have a persistent HPV infection. Among them, there was a high prevalence of dysplasia as diagnosed by histology. Cytology showed extremely low sensitivity. Self-sampling at home combined with repeat HPV testing was well accepted among older women.  

  • Voltage Transients in the Field Winding of Salient Pole Wound Synchronous Machines : Implications from fast switching power electronics

    Author: Roberto Felicetti
    Publication date: 2021-02-26 10:24

    Wound Field Synchronous Generators provide more than 95% of the electricity need worldwide. Their primacy in electricity production is due to ease of voltage regulation, performed by simply adjusting the direct current intensity in their rotor winding. Nevertheless, the rapid progress of power electronics devices enables new possibilities for alternating current add-ins in a more than a century long DC dominated technology. Damping the rotor oscillations with less energy loss than before, reducing the wear of the bearings by actively compensating for the mechanic unbalance of the rotating parts, speeding up the generator with no need for additional means, these are just few of the new applications which imply partial or total alternated current supplying of the rotor winding.

    This thesis explores what happens in a winding traditionally designed for the direct current supply when an alternated current is injected into it by an inverter. The research focuses on wound field salient pole synchronous machines and investigates the changes in the field winding parameters under AC conditions. Particular attention is dedicated to the potentially harmful voltage surges and voltage gradients triggered by voltage-edges with large slew rate. For this study a wide frequency band simplified electromagnetic model of the field winding has been carried out, experimentally determined and validated. Within the specific application of the fast field current control, the research provides some references for the design of the rotor magnetic circuit and of the field winding. Finally the coordination between the power electronics and the field winding properties is addressed, when the current control is done by means of a long cable or busbars, in order to prevent or reduce the ringing.

  • The Monoamine Oxidase A Gene and Antisocial Outcomes : An Examination of Genetic, Epigenetic, and Environmental Factors

    Author: David Checknita
    Publication date: 2021-02-23 10:04

    Background. Antisocial behaviour involves violation of the basic rights of others or social norms or rules. Such behaviours are indexed in diagnoses such as conduct disorder (CD) in adolescence and antisocial personality disorder (ASPD) in adulthood, which are typified by comorbidity with mood, anxiety, and substance misuse disorders. Alcohol misuse is strongly associated with antisocial behaviour and persistent aggressive behaviours. How environmental and biological factors interface to modulate risk for these outcomes is not yet understood, however, the interaction of adversity with a variable number tandem repeat (uVNTR) polymorphism of the monoamine oxidase gene A (MAOA) gene associates with antisocial behaviour and mental disorders. Further, DNA methylation in a region of interest (ROI) spanning MAOA’s first exonic/intronic junction associates with ASPD in men as well as other mood, anxiety, and substance misuse disorders. 

    Aim and Methods. We characterized methylation of the MAOA ROI by sex and age and examined how negative and positive environmental factors interact with MAOA genotype and methylation on antisocial phenotypes and mental disorders. Participants included men and women from a clinical population of young adults recruited in adolescence at a substance misuse clinic and a community sample of adolescents. 

    Findings. (1) Sex but not age was associated with methylation levels such that high methylation levels among women likely represent X-chromosome inactivation, and sexual abuse was associated with hypermethylation of the MAOA first exon, (2) high methylation levels mediated associations between sexual abuse and current depression diagnosis in women, (3) the highest levels of aggressive behaviour were found among maltreat male carriers of the low-expressing MAOA-uVNTR allele and displayed high levels of exonic methylation, while no interactions were shown in women, and (4) among adolescent girls, but not boys, positive parent-child relationship attenuated the interaction of maltreatment and the high-expressing MAOA-uVNTR allele on alcohol consumption, though the interactions were not robust to adjustments for tobacco use, substance misuse, and delinquent behaviours.

    Conclusion. The findings presented here advance our understanding of how maltreatment interfaces with genotypic and epigenetic factors, in a sex-dependent manner, to promote aggressive behaviour and mental disorders among susceptible individuals.

     

  • Ultra-wideband Millimeter-wave Antenna Arrays and Front-end Systems : For high data rate 5G and high energy physics applications

    Author: Imran Aziz
    Publication date: 2021-02-22 09:58

    The demand for wireless data communications is rapidly increasing due to several factors including increased internet access, increasingly growing number of mobile users and services, implementation of the Internet of Things (IoT), high-definition (HD) video streaming and video calling. To meet the bandwidth requirement of new and emerging applications, it is necessary to move from the existing microwave bands towards millimeter-wave bands. 

    This thesis presents different antenna arrays at 60 GHz and 28 GHz that are integrated with the front-end RFIC to steer the beam in ≈ ±50° in the azimuth plane. The 5G antenna arrays at 28 GHz are designed to provide broadband high data rate services to the end users. In order to transport this high-volume data to the core network, a fixed wireless access (FWA) link demands the implementation of a broadband, high gain and steerable narrow-beam array. The 60 GHz antenna arrays, presented in this thesis, are good candidates for both FWA as well as backhaul communications. The two proposed arrays at 60 GHz (57-66 GHz) are i) a stacked patches array and ii) a connected slots array feeding a high gain lens antenna. The 2×16 stacked patches antenna array shows more than 20 dBi realized gain. The array is integrated with the front-end RFIC and the resulting module shows > 40 dBm measured effective isotropic radiated power (EIRP). The other 60 GHz antenna array is designed as linear connected slots with sixteen equidistant feeding points. The latest is then used as a feeder of a high gain dielectric lens. Peak measured gain of 25.4 dBi is achieved with this antenna.  Moreover, instead of experiencing scan loss, the lens is designed to get higher gain when the beam is steered away from the broadside direction.

    Furthermore, two compact antenna arrays are designed at 28 GHz (24.25 - 29.50 GHz). A linear polarized (LP) and a circular polarized (CP) array are realized in the fan-out embedded wafer level ball-grid-array (eWLB) package. In comparison with the PCB arrays, this antenna in package (AiP) solution is not only cost-effective but it also reduces the integration losses because of shorter feed lines and no geometrical discontinuity.  The LP array is realized as a dipole antenna array feeding a novel horn-shaped heatsink.  The RF module gives 34 dBm peak EIRP with beam-steering in ±35°. Besides, the CP antenna array is realized with the help of crossed dipoles and the RF module provides 31 dBm peak EIRP with beam-steering in ±50°.

    The data demands are not limited to the telecom industry as the upgradation of accelerators and experiments at the large hadron collider (LHC) at CERN will result in increased event rate thus demanding higher data rate front-end readout systems. This work thus investigates the feasibility of 60 GHz wireless links for the data readout at CERN. For this purpose, the 60 GHz wireless chips are irradiated with 17 MeV protons [dose 7.4 Mrad (RX) & 4.2 Mrad (TX)] and 200 MeV electrons [dose 270 Mrad (RX) & 314 Mrad (TX)] in different episodes. The chips have been found operational in the post-irradiation investigations with some performance degradation. The encouraging results motivate to move forward and investigate the realization of wireless links in such a complex environment.

  • Embodied Citizenship in the Making : Bolivian Urban Youth at the Crossroads of Social Hierarchies

    Author: Nika Rasmussen
    Publication date: 2021-02-18 12:26

    This thesis analyses the body as a nexus for playing out power relations and feelings of belonging. Based upon twelve months of fieldwork amongst young urban people living in La Paz and El Alto, it examines the connections between bodily conceptions, social hierarchies and societal inclusions. During the fieldwork in 2014-2015, Evo Morales and his MAS Party had been in power for almost a decade. The young people had thus grown up with the “process of change”, the project of decolonizing the society and building a plurinational state. This served as the study’s backdrop. 

    The material shows that despite the government’s “process of change”, old and discriminatory structures and notions prevailed amongst the youth. Social hierarchies and the production of differences were integral parts of their everyday life. The young people, engaged in an organization working for sexual and reproductive rights, navigated complex and contradictory norms and values in a conflictive socio-political landscape. With political practices at the micro-level of everyday life, they questioned, negotiated and reproduced old notions and developed their political subjectivities. The topic of sexuality emerged as a particularly intense site for interrelational struggles between adults and young people. A new political position surfaced, claiming space in the nation’s body politic – the political subject of youth. The study of youth fruitfully unravelled social and political developments and adults’ interests, highlighting constructions of temporalities and the need to consider age.

    The thesis makes evident how notions of race, class, gender, age, sexuality and place materialize bodies. Some bodies merged with salient norms, whereas others “stood out” and felt “out of place”. It is suggested that the relationship between society, state and the individual is productively studied with the framework of “embodied citizenship”. Embodied citizenship is theoretically and analytically uncovered by linking projects of nationhood, how belongings at different societal levels and social hierarchies are produced and interrelated, together with an intersectional gaze on power relations. This elucidates that citizenship is an ongoing, embodied and lived experience in everyday life. It develops in relation to social hierarchies and projects of nationhood whose inherent power relations work to materialize bodies. 

  • Officialprincipen i migrationsprocessen : Domstolens utredningsansvar

    Author: Isa Cegrell Karlander
    Publication date: 2021-02-18 10:47

    The dissertation analyses the court’s duty to investigate when adjudicating migration cases, particularly asylum cases. The duty is stipulated in Section 8 of the Administrative Court Procedure Act. The dissertation aims to clarify the meaning of the provision. The court shall ensure that a case is as well investigated as its nature requires. In doing so, the court needs to decide whether there are relevant circumstances and evidence beyond what the parties have presented. If so, the court must ex officio take the necessary investigative measures to ensure the case can be considered ready for a ruling.

    To determine whether an investigation is robust, the court must consider the parties’ claims in light of the substantive rules and decide what factual circumstances, are to be proven. In asylum cases, the court must apply the provisions of the Aliens Act to determine whether the asylum seeker should be granted a residence permit or be deported - two alternative legal consequences. According to the principle of non-refoulement, the court must decide whether the asylum seeker is at risk of being subjected to treatment that would serve as grounds for protection, if repatriated. Examination of the case is thus forward-looking, which is one of several factors that place special requirements on the court when assessing the robustness of the investigation. I argue that the Migration Court of Appeal pays insufficient attention to the dual legal consequences; residence permits are often emphasised rather than deportation, which places the state's responsibility to respect the principle of non-refoulement in the background.

    In its case law, the Migration Court of Appeal has identified a number of investigation deficiencies. A case analysis of some 40 rulings, in which the duty to investigate is addressed, shows inter alia that the Migration Court of Appeal adduces both legal facts and evidence ex officio, issues injunction to parties and, many times, overturns the appealed decision and remands the case to the lower court for further proceedings. Since explicit reference to Section 8 of the Administrative Court Procedure Act is occasionally lacking, it is somewhat difficult to adequately review precedent setting.

  • The Swedish Abortion Pill : Co-Producing Medical Abortion and Values, ca. 1965–1992

    Author: Morag Ramsey
    Publication date: 2021-02-18 09:10

    Abortion pills have had a large impact. Since their introduction to national markets in the 1990s, scholars have examined how abortion pills have changed medical practices, illegal abortion, and reproductive activism. What has gone unstudied, however, has been the development and the history of abortion pills. This dissertation addresses this gap by examining how abortion pills were developed in Sweden. What political, legal, and moral processes were included in their development? What specific conditions in Sweden helped to support this research and what was its impact? Answering these questions further develops scholarship on medical abortion as well as the history of the Swedish welfare state’s reproduction management. The dissertation argues that the development of abortion pills co-produced new ways of understanding and valuing abortion 

    Beginning in 1965, Swedish researchers clinically tested compounds on pregnant women, hoping to induce abortion. This dissertation follows abortion pill research in Sweden by concentrating on clinical trial practices in the period between 1965 and 1992. An intricate web of actors is highlighted, showing collaboration between state institutes, pharmaceutical companies, non-profit organizations, media, researchers, and trial participants. Using perspectives from science and technology studies and by introducing the concept of abortion scripts, the book traces how abortion was made in these expanding research networks. Whereas earlier scholarship has focused on contraceptive pills, intrauterine devices, and emergency contraceptives, this dissertation shows how abortion pills also contested reproductive concepts during the mid-20th century. Abortion pill research challenged reproductive boundaries, moved medical procedures from the hospital to the home, and expanded family planning initiatives.

    As abortion access impacts people’s reproductive choices, it is important to understand how concepts of abortion are made. The Swedish Abortion Pill maps a multitude of abortion scripts, detailing both change and continuity over time and makes visible the extent of the practical work that went into the development of medical abortion. While the technology is often attributed to research done by French researchers, this study reveals that decades of work in Sweden also contributed to the success of abortion pills. 

  • Antibiotic Resistance: A Multimethod Investigation of Individual Responsibility and Behaviour

    Author: Mirko Ancillotti
    Publication date: 2021-02-17 09:48

    The rapid development of antibiotic resistance is directly related to how antibiotics are used in society. The international effort to decrease and optimise the use of antibiotics should be sustained by the development of policies that are sensitive to social and cultural contexts.

    The overarching aim of the thesis was to explore and discuss the Swedish public’s beliefs, values and preferences influencing engagement in judicious antibiotic behaviour.

    Study I explored through focus group discussions lay people’s perceptions and beliefs about antibiotics and antibiotic resistance. The Health Belief Model was used to identify factors that could promote or hinder engagement in judicious antibiotic behaviour. Participants found antibiotic resistance to be a serious problem but were not equally worried about being affected by it. There was a tension between individual and collective reasons for engaging in judicious behaviour.

    Study II explored lay people’s views on the moral challenges posed by antibiotic resistance through focus group discussions. Participants identified in the decreasing availability of effective antibiotics a problem of justice, which involves individual as well as collective moral responsibility. Different levels of policy demandingness were discussed in light of these results.

    Study III investigated, through an online Discrete Choice Experiment, public preferences regarding antibiotic treatment and the relative weight of antibiotic resistance in decision-making. Public behaviour may be influenced by concerns over the rise of antibiotic resistance. Therefore, stressing individual responsibility for antibiotic resistance in clinical and societal communication may affect personal decision-making.

    Study IV clarified the notions of collective and individual moral responsibility for antibiotic resistance and suggested a virtue-based account thereof. While everyone is morally responsible for minimising his/her own contribution to antibiotic resistance, individuals do or do not engage in judicious antibiotic behaviour with different degrees of voluntariness.

    The findings suggest that people could change their behaviour due to concerns over their own contribution to antibiotic resistance. Effective health communication should be developed from an appraisal of people’s attitudes, beliefs and social norms that influence antibiotic resistance related behaviours. Policy demandingness should take into account socioeconomic factors characterising local realities. 

  • With Lives on the Line : How Users Respond to a Highly Mandated Information System Implementation - A Longitudinal Study

    Author: Andreas Hedrén
    Publication date: 2021-02-16 12:37

    Some people are forced to use a specific technology in their work. Should they resist, people die. This thesis examines the implementation of a Patient Data Management System for the critical care departments at two Swedish hospitals. The degree of mandate to use a technology varies along a spectrum anchored between none and absolute. This thesis focuses on the context of absolute mandated use, an area unexplored by Information System (IS) research.

    Use of technology is a well-established indicator of the success of IS implementation. Nonetheless, when IS is required, use is not a suitable indicator of success. Instead, affectual responses, such as attitudes regarding use and satisfaction, are appropriate indicators of success. This thesis recognizes the process nature of implementation and develops a longitudinal four-stage research model to predict the attitude of individual end-users during the implementation of an IS. The model’s first part considers the stage where users do not yet have first-hand experiences of using the system. The following parts of the model relate to different stages of the implementation process and the final part addresses the stage of the implementation process where IS use has become routine.

    To test the research model, this research used data collected through field surveys. Non-parametric covariance based (CB) structural equation modelling (SEM) analyses revealed that the users’ perceptions of IS use changed over time and kept changing for months. The results further indicate that both the set of variables and the degree of their influence on a users’ perceptions vary during the implementation process. Furthermore, the users’ trust in the adequate functioning of the system is a persistent predictor of the users’ attitudes. In contrast to many reported findings in the literature, users’ resistance to change is not an influential factor at any stage of the implementation process. Finally, the influence of communication through the organisational channels only affects the users’ perceptions before they have first-hand experience with the IS. 

    This research contributes to the IS literature by uncovering mechanisms of the increasingly ubiquitous although un-investigated phenomenon of highly mandated use. This research reports on causal drivers of users’ attitude towards highly mandated use and how the influence of these drivers develops throughout an implementation process.

  • Wealth and the economic vote : How assets and liabilities shape election outcomes

    Author: Anton Brännlund
    Publication date: 2021-02-15 10:18

    This thesis contributes to the literature on economic voting, especially the subfield of the electoral impact in relation to wealth. The thesis consists of an introductory chapter and four independent research articles based on data from Sweden. Based on the first article, I find that the support for right-wing parties decreases in areas where voters are heavily invested in financial assets when there is a large amount of volatility in the world markets. Such patterns suggest that voters are responsive to financial risks. Through the second study, I illustrate that voters are sensitive to changes in monetary policies as well. More precisely, I show that voters tend to reward governments for decreases in interest rates. With the third study, I investigate the interplay of markets in a more direct way, estimating the effect of unemployment on voting in relation to household wealth. I find that the Swedish left-wing parties gain electoral advantage when the unemployment rates rise in less wealthy areas but that they lose support where voters are comparatively well-off. Finally, based on the fourth study, I investigate whether wealth has an impact on how voters behave with individual level data. The findings in this study suggest that wealthy citizens vote for right-wing parties to a grater extent. However, the estimated effect is small.

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