Hematopoietic Stem Cell Development and Transcriptional Regulation

The continuous production of blood cells, a process termed hematopoiesis, is sustained throughout the lifetime of an individual by a relatively small population of cells known as hematopoietic stem cells (HSCs). HSCs are unique cells characterized by their ability to self-renew and give rise to all types of mature blood cells. Given their high proliferative potential, HSCs need to be tightly regulated on the cellular and molecular levels or could otherwise turn malignant. On the other hand, the tight regulatory control of HSC function also translates into difficulties in culturing and expanding HSCs in vitro. In fact, it is currently not possible to maintain or expand HSCs ex vivo without rapid loss of self-renewal. Increased knowledge of the unique features of important HSC niches and of key transcriptional regulatory programs that govern HSC behavior is thus needed. Additional insight in the mechanisms of stem cell formation could enable us to recapitulate the processes of HSC formation and self-renewal/expansion ex vivo with the ultimate goal of creating an unlimited supply of HSCs from e.g. human embryonic stem cells (hESCs) or induced pluripotent stem cells (iPS) to be used in therapy. We thus asked: How are hematopoietic stem cells formed and in what cellular niches does this happen (Papers I, II)? What are the molecular mechanisms that govern hematopoietic stem cell development and differentiation (Papers III, IV)? Importantly, we could show that placenta is a major fetal hematopoietic niche that harbors a large number of HSCs during midgestation (Paper I)(Gekas et al., 2005). In order to address whether the HSCs found in placenta were formed there we utilized the Runx1-LacZ knock-in and Ncx1 knockout mouse models (Paper II). Importantly, we could show that HSCs emerge de novo in the placental vasculature in the absence of circulation (Rhodes et al., 2008). Furthermore, we could identify defined microenvironmental niches within the placenta with distinct roles in hematopoiesis: the large vessels of the chorioallantoic mesenchyme serve as sites of HSC generation whereas the placental labyrinth is a niche supporting HSC expansion (Rhodes et al., 2008). Overall, these studies illustrate the importance of distinct milieus in the emergence and subsequent maturation of HSCs. To ensure proper function of HSCs several regulatory mechanisms are in place. The microenvironment in which HSCs reside provides soluble factors and cell-cell interactions. In the cell-nucleus, these cell-extrinsic cues are interpreted in the context of cell-intrinsic developmental programs which are governed by transcription factors. An essential transcription factor for initiation of hematopoiesis is Scl/Tal1 (stem cell leukemia gene/T-cell acute leukemia gene 1). Loss of Scl results in early embryonic death and total lack of all blood cells, yet deactivation of Scl in the adult does not affect HSC function (Mikkola et al., 2003b. In order to define the temporal window of Scl requirement during fetal hematopoietic development, we deactivated Scl in all hematopoietic lineages shortly after hematopoietic specification in the embryo . Interestingly, maturation, expansion and function of fetal HSCs was unaffected, and, as in the adult, red blood cell and platelet differentiation was impaired (Paper III)(Schlaeger et al., 2005). These findings highlight that, once specified, the hematopoietic fate is stable even in the absence of Scl and is maintained through mechanisms that are distinct from those required for the initial fate choice. As the critical downstream targets of Scl remain unknown, we sought to identify and characterize target genes of Scl (Paper IV). We could identify transcription factor Mef2C (myocyte enhancer factor 2 C) as a novel direct target gene of Scl specifically in the megakaryocyte lineage which largely explains the megakaryocyte defect observed in Scl deficient mice. In addition, we observed an Scl-independent requirement of Mef2C in the B-cell compartment, as loss of Mef2C leads to accelerated B-cell aging (Gekas et al. Submitted). Taken together, these studies identify key extracellular microenvironments and intracellular transcriptional regulators that dictate different stages of HSC development, from emergence to lineage choice to aging.

The impact of the metabolic syndrome and parental risk factors in patients with type 1 diabetes

Background: One-third of patients with type 1 diabetes develop diabetic complications, such as diabetic nephropathy. The diabetic complications are related to a high mortality from cardiovascular disease, impose a great burden on the health care system, and reduce the health-related quality of life of patients. Aims: This thesis assessed, whether parental risk factors identify subjects at a greater risk of developing diabetic complications. Another aim was to evaluate the impact of a parental history of type 2 diabetes on patients with type 1 diabetes. A third aim was to assess the role of the metabolic syndrome in patients with type 1 diabetes, both its presence and its predictive value with respect to complications. Subjects and methods: This study is part of the ongoing nationwide Finnish Diabetic Nephropathy (FinnDiane) Study. The study was initiated in 1997, and, thus far, 4,800 adult patients with type 1 diabetes have been recruited. Since 2004, follow-up data have also been collected in parallel to the recruitment of new patients. Studies I to III have a cross-sectional design, whereas Study IV has a prospective design. Information on parents was obtained from the patients with type 1 diabetes by a questionnaire. Results: Clustering of parental hypertension, cardiovascular disease, and diabetes (type 1 and type 2) was associated with diabetic nephropathy in patients with type 1 diabetes, as was paternal mortality. A parental history of type 2 diabetes was associated with a later onset of type 1 diabetes, a higher prevalence of the metabolic syndrome, and a metabolic profile related to insulin resistance, despite no difference in the distribution of human leukocyte antigen genotypes or the presence of diabetic complications. A maternal history of type 2 diabetes, seemed to contribute to a worse metabolic profile in the patients with type 1 diabetes than a paternal history. The metabolic syndrome was a frequent finding in patients with type 1 diabetes, observed in 38% of males and 40% of females. The prevalence increased with worsening of the glycemic control and more severe renal disease. The metabolic syndrome was associated with a 3.75-fold odds ratio for diabetic nephropathy, and all of the components of the syndrome were independently associated with diabetic nephropathy. The metabolic syndrome, independent of diabetic nephropathy, increased the risk of cardiovascular events and cardiovascular and diabetes-related mortality over a 5.5-year follow-up. With respect to progression of diabetic nephropathy, the role of the metabolic syndrome was less clear, playing a strong role only in the progression from macroalbuminuria to end-stage renal disease. Conclusions: Familial factors and the metabolic syndrome play an important role in patients with type 1 diabetes. Assessment of these factors is an easily applicable tool in clinical practice to identify patients at a greater risk of developing diabetic complications.

The effect of blood glucose on the vasculature in young patients with type 1 diabetes

Background. Patients with type 1 diabetes are at markedly increased risk of vascular complications. In this respect it is noteworthy that hyperglycaemia that is shown to cause endothelial dysfunction, has clearly been shown to be a risk factor for diabetic microvascular disease. However, the role of hyperglycaemia as a predictor of macrovascular disease is not as clear as for microvascular disease, although type 1 diabetes itself increases the risk of cardiovascular disease substantially. Furthermore, it is not known whether it is the short-term or the long-term hyperglycaemia that confers possible risk. In addition, the role of glucose variability as a predictor of complications is to a large extent unexplored. Interestingly, although hyperglycaemia increases the risk of pre-eclampsia in women with type 1 diabetes, it is unclear whether pre-eclampsia, a condition characterized by endothelial dysfunction, is also a risk factor for microvascular complication, diabetic nephropathy. Aims. This doctoral thesis investigated the role of acute hyperglycaemia and glucose variability on arterial stiffness and cardiac ventricular repolarisation in male patients with type 1 diabetes as well as in healthy male volunteers. The thesis also explored whether acute hyperglycaemia leads to an inflammatory response, endothelial dysfunction and oxidative stress. Finally, the role of pre-eclampsia, as a predictor of diabetic nephropathy in type 1 diabetes was examined. Subjects and methods. In order to study glucose variability and the daily glycaemic control, 22 male patients with type 1 diabetes, without any diabetic complications, were monitored for 72-h with a continuous glucose monitoring system. At the end of the 72-h glucose monitoring period a 2-h hyperglycaemic clamp was performed both in the patients with type 1 diabetes and in the 13 healthy age-matched male volunteers. Blood pressure, arterial stiffness and QT time were measured to detect vascular changes during acute hyperglycaemia. Blood samples were drawn at baseline (normoglycaemia) and during acute hyperglycaemia. In another patient sample, women with type 1 diabetes were followed during their pregnancy and restudied eleven years later to elucidate the role of pre-eclampsia and pregnancy-induced hypertension as potential risk factors for diabetic nephropathy. Results and conclusions. Acute hyperglycaemia increased arterial stiffness as well as caused a disturbance in the myocardial ventricular repolarisation, emphasizing the importance of a strict daily glycaemic control in male patients with type 1 diabetes. An inflammatory response was also observed during acute hyperglycaemia. Furthermore, a high mean daily blood glucose but not glucose variability per se is associated with arterial stiffness. While glucose variability in turn correlated with central blood pressure, the results suggest that the glucose metabolism is closely linked to the haemodynamic changes in male patients with uncomplicated type 1 diabetes. Notably, the results are not directly applicable to females. Finally, a history of a pre-eclamptic pregnancy, but not pregnancy-induced hypertension was associated with increased risk of diabetic nephropathy.

Growth and Modification of Cluster-Assembled Thin Films

Thin film applications have become increasingly important in our search for multifunctional and economically viable technological solutions of the future. Thin film coatings can be used for a multitude of purposes, ranging from a basic enhancement of aesthetic attributes to the addition of a complex surface functionality. Anything from electronic or optical properties, to an increased catalytic or biological activity, can be added or enhanced by the deposition of a thin film, with a thickness of only a few atomic layers at the best, on an already existing surface. Thin films offer both a means of saving in materials and the possibility for improving properties without a critical enlargement of devices. Nanocluster deposition is a promising new method for the growth of structured thin films. Nanoclusters are small aggregates of atoms or molecules, ranging in sizes from only a few nanometers up to several hundreds of nanometers in diameter. Due to their large surface to volume ratio, and the confinement of atoms and electrons in all three dimensions, nanoclusters exhibit a wide variety of exotic properties that differ notably from those of both single atoms and bulk materials. Nanoclusters are a completely new type of building block for thin film deposition. As preformed entities, clusters provide a new means of tailoring the properties of thin films before their growth, simply by changing the size or composition of the clusters that are to be deposited. Contrary to contemporary methods of thin film growth, which mainly rely on the deposition of single atoms, cluster deposition also allows for a more precise assembly of thin films, as the configuration of single atoms with respect to each other is already predetermined in clusters. Nanocluster deposition offers a possibility for the coating of virtually any material with a nanostructured thin film, and therein the enhancement of already existing physical or chemical properties, or the addition of some exciting new feature. A clearer understanding of cluster-surface interactions, and the growth of thin films by cluster deposition, must, however, be achieved, if clusters are to be successfully used in thin film technologies. Using a combination of experimental techniques and molecular dynamics simulations, both the deposition of nanoclusters, and the growth and modification of cluster-assembled thin films, are studied in this thesis. Emphasis is laid on an understanding of the interaction between metal clusters and surfaces, and therein the behaviour of these clusters during deposition and thin film growth. The behaviour of single metal clusters, as they impact on clean metal surfaces, is analysed in detail, from which it is shown that there exists a cluster size and deposition energy dependent limit, below which epitaxial alignment occurs. If larger clusters are deposited at low energies, or cluster-surface interactions are weaker, non-epitaxial deposition will take place, resulting in the formation of nanocrystalline structures. The effect of cluster size and deposition energy on the morphology of cluster-assembled thin films is also determined, from which it is shown that nanocrystalline cluster-assembled films will be porous. Modification of these thin films, with the purpose of enhancing their mechanical properties and durability, without destroying their nanostructure, is presented. Irradiation with heavy ions is introduced as a feasible method for increasing the density, and therein the mechanical stability, of cluster-assembled thin films, without critically destroying their nanocrystalline properties. The results of this thesis demonstrate that nanocluster deposition is a suitable technique for the growth of nanostructured thin films. The interactions between nanoclusters and their supporting surfaces must, however, be carefully considered, if a controlled growth of cluster-assembled thin films, with precisely tailored properties, is to be achieved.

Macroseismology as a Component of Seismicity Assessments in an Intraplate Region: Studies of Northern Europe with Emphasis on Finland

This work focuses on the role of macroseismology in the assessment of seismicity and probabilistic seismic hazard in Northern Europe. The main type of data under consideration is a set of macroseismic observations available for a given earthquake. The macroseismic questionnaires used to collect earthquake observations from local residents since the late 1800s constitute a special part of the seismological heritage in the region. Information of the earthquakes felt on the coasts of the Gulf of Bothnia between 31 March and 2 April 1883 and on 28 July 1888 was retrieved from the contemporary Finnish and Swedish newspapers, while the earthquake of 4 November 1898 GMT is an example of an early systematic macroseismic survey in the region. A data set of more than 1200 macroseismic questionnaires is available for the earthquake in Central Finland on 16 November 1931. Basic macroseismic investigations including preparation of new intensity data point (IDP) maps were conducted for these earthquakes. Previously disregarded usable observations were found in the press. The improved collection of IDPs of the 1888 earthquake shows that this event was a rare occurrence in the area. In contrast to earlier notions it was felt on both sides of the Gulf of Bothnia. The data on the earthquake of 4 November 1898 GMT were augmented with historical background information discovered in various archives and libraries. This earthquake was of some concern to the authorities, because extra fire inspections were conducted in three towns at least, i.e. Tornio, Haparanda and Piteå, located in the centre of the area of perceptibility. This event posed the indirect hazard of fire, although its magnitude around 4.6 was minor on the global scale. The distribution of slightly damaging intensities was larger than previously outlined. This may have resulted from the amplification of the ground shaking in the soft soil of the coast and river valleys where most of the population was found. The large data set of the 1931 earthquake provided an opportunity to apply statistical methods and assess methodologies that can be used when dealing with macroseismic intensity. It was evaluated using correspondence analysis. Different approaches such as gridding were tested to estimate the macroseismic field from the intensity values distributed irregularly in space. In general, the characteristics of intensity warrant careful consideration. A more pervasive perception of intensity as an ordinal quantity affected by uncertainties is advocated. A parametric earthquake catalogue comprising entries from both the macroseismic and instrumental era was used for probabilistic seismic hazard assessment. The parametric-historic methodology was applied to estimate seismic hazard at a given site in Finland and to prepare a seismic hazard map for Northern Europe. The interpretation of these results is an important issue, because the recurrence times of damaging earthquakes may well exceed thousands of years in an intraplate setting such as Northern Europe. This application may therefore be seen as an example of short-term hazard assessment.

Quantum Chemical Studies on Tropospheric Nucleation Mechanisms Involving Sulfuric Acid

Nucleation is the first step of the process by which gas molecules in the atmosphere condense to form liquid or solid particles. Despite the importance of atmospheric new-particle formation for both climate and health-related issues, little information exists on its precise molecular-level mechanisms. In this thesis, potential nucleation mechanisms involving sulfuric acid together with either water and ammonia or reactive biogenic molecules are studied using quantum chemical methods. Quantum chemistry calculations are based on the numerical solution of Schrödinger's equation for a system of atoms and electrons subject to various sets of approximations, the precise details of which give rise to a large number of model chemistries. A comparison of several different model chemistries indicates that the computational method must be chosen with care if accurate results for sulfuric acid - water - ammonia clusters are desired. Specifically, binding energies are incorrectly predicted by some popular density functionals, and vibrational anharmonicity must be accounted for if quantitatively reliable formation free energies are desired. The calculations reported in this thesis show that a combination of different high-level energy corrections and advanced thermochemical analysis can quantitatively replicate experimental results concerning the hydration of sulfuric acid. The role of ammonia in sulfuric acid - water nucleation was revealed by a series of calculations on molecular clusters of increasing size with respect to all three co-ordinates; sulfuric acid, water and ammonia. As indicated by experimental measurements, ammonia significantly assists the growth of clusters in the sulfuric acid - co-ordinate. The calculations presented in this thesis predict that in atmospheric conditions, this effect becomes important as the number of acid molecules increases from two to three. On the other hand, small molecular clusters are unlikely to contain more than one ammonia molecule per sulfuric acid. This implies that the average NH3:H2SO4 mole ratio of small molecular clusters in atmospheric conditions is likely to be between 1:3 and 1:1. Calculations on charged clusters confirm the experimental result that the HSO4- ion is much more strongly hydrated than neutral sulfuric acid. Preliminary calculations on HSO4- NH3 clusters indicate that ammonia is likely to play at most a minor role in ion-induced nucleation in the sulfuric acid - water system. Calculations of thermodynamic and kinetic parameters for the reaction of stabilized Criegee Intermediates with sulfuric acid demonstrate that quantum chemistry is a powerful tool for investigating chemically complicated nucleation mechanisms. The calculations indicate that if the biogenic Criegee Intermediates have sufficiently long lifetimes in atmospheric conditions, the studied reaction may be an important source of nucleation precursors.

Non-Gaussianities and Preheating from N-flation and Magnetogenesis via rotating cosmic string loops

In this thesis we examine multi-field inflationary models of the early Universe. Since non-Gaussianities may allow for the possibility to discriminate between models of inflation, we compute deviations from a Gaussian spectrum of primordial perturbations by extending the delta-N formalism. We use N-flation as a concrete model; our findings show that these models are generically indistinguishable as long as the slow roll approximation is still valid. Besides computing non-Guassinities, we also investigate Preheating after multi-field inflation. Within the framework of N-flation, we find that preheating via parametric resonance is suppressed, an indication that it is the old theory of preheating that is applicable. In addition to studying non-Gaussianities and preheatng in multi-field inflationary models, we study magnetogenesis in the early universe. To this aim, we propose a mechanism to generate primordial magnetic fields via rotating cosmic string loops. Magnetic fields in the micro-Gauss range have been observed in galaxies and clusters, but their origin has remained elusive. We consider a network of strings and find that rotating cosmic string loops, which are continuously produced in such networks, are viable candidates for magnetogenesis with relevant strength and length scales, provided we use a high string tension and an efficient dynamo.

Immigrant Associations in the Metropolitan Area of Finland : Forms of Mobilisation, Participation and Representation

This study examines the role of immigrant associations in the societal and political integration of immigrants into Finnish society. The societal focus is on the ability of immigrant associations to mobilise their ethnic group members to participate in the socio-economic, cultural and political domains of Finnish society and in certain cases even beyond. The political integrative aims are the opportunities of immigrant associations to participate and represent the interests of their ethnic group in local and national policy making. This study focuses on associations in the Metropolitan Area of Finland, (Espoo, Helsinki and Vantaa).The qualitative research consisted of 71 interviews conducted with members of immigrant associations and civil servants. These interviews were mainly semi-structured, including some additional open-ended questions. Additional data consisted of documents, planning reports and of follow-up enquiries. -- In the analysis of the data I categorised thirty-two immigrant associations according to the activity forms and the description of the goals by the members. The four categories consisted of integrative, societal, ethno-cultural and transnational immigrant associations. Most of the immigrant associations belonged to the integrative category (15 of 32 associations). On the one hand the aims of these associations are to provide access for their ethnic group members into Finnish society, while on the other to strengthen the ethnic identity of their members by organising ethno-cultural activities. The societal associations only focused on activities with the objective of including immigrants into the Finnish labour market and educational system. The goal of ethno-cultural associations was to strengthen the ethnic identity of their ethnic group members. The transnational associations aimed at improving the living conditions of women and children in the members' country of origin. The possibilities for immigrant associations to mobilise their members depends partly on external financing. Subsidies have been allocated for societal activities in particular. There remains a risk of the crowding out of ethno-cultural activities: something which has already taken place in several European countries. Immigrant associations aim to strengthen the identity of immigrants mainly by organising social and ethno-cultural activities. Another important target was to provide peer support and therapy courses. Additionally, immigrant women's associations offer assistance to women who have encountered violence by providing counselling and in some cases access to shelter. The data showed that there is an ever growing need to pay heed to the well-being of women, children and elderly immigrants. The participation of immigrant associations in the municipalities' integrative issues takes place mainly through cooperative projects. Until the end of the 1990s there had not been much cooperation. The problem with the projects was that they had mainly been managed by civil servants, whereas members from immigrant associations had remained in a more passive position. Representation of immigrant associations in councils has been fairly weak. Immigrant associations are included in the multicultural councils of Espoo and Vantaa, but only in the planning stages. The municipality of Helsinki does not include immigrant associations due to the large number of organisations which causes problems in finding fair, democratic representation. At the national level, the ‘Advisory Board for Ethnic Relations’ – ETNO didn’t chose its members based on membership of ethnic associations, but based on belongingness to one of the larger language groups spoken by the foreign population in Finland. Since ETNO’s third period (2005-2007), the representatives of immigrant associations and ethnic minority groups have been chosen from proposed candidates. Key words: immigrant associations, integration, mobilisation, participation, representation, the Metropolitan area of Finland, immigrant (women), civil servants

Construing and Defining the Out of Control : Addiction in the Media 1968-2008.

The four scientific articles comprising this doctoral dissertation offer new information on the presentation and construction of addiction in the mass media during the period 1968 - 2008. Diachronic surveys as well as quantitative and qualitative content analyses were undertaken to discern trends during the period in question and to investigate underlying conceptions of the problems in contemporary media presentations. The research material for the first three articles consists of a sample of 200 texts from Finland s biggest daily newspaper, Helsingin Sanomat, from the period 1968 - 2006. The fourth study examines English-language tabloid material published on the Internet in 2005 - 2008. A number of principal trends are identified. In addition to a significant increase in addiction reporting over time, the study shows that an internalisation of addiction problems took place in the media presentations under study. The phenomenon is portrayed and tackled from within the problems themselves, often from the viewpoint of the individuals concerned. The tone becomes more personal, and technical and detailed accounts are more and more frequent. Secondly, the concept of addiction is broadened. This can be dated to the 1990s. The concept undergoes a conventionalisation: it is used more frequently in a manner that is not thought to require explanation. The word riippuvuus (the closest equivalent to addiction in Finnish) was adopted more commonly in the reporting at the same time, in the 1990s. Thirdly, the results highlight individual self-governance as a superordinate principle in contemporary descriptions of addiction. If the principal demarcation in earlier texts was between us and them , it is now focused primarily on the individual s competence and ability to govern the self, to restrain and master one's behaviour. Finally, in the fourth study investigating textual constructions of female celebrities (Amy Winehouse, Britney Spears and Kate Moss) in Internet tabloids, various relations and functions of addiction problems, intoxication, body and gender were observed to function as cultural symbols. Addiction becomes a sign, or a style, that represents different significations in relation to the main characters in the tabloid stories. Tabloids, as a genre, play an important role by introducing other images of the problems than those featured in mainstream media. The study is positioned within the framework of modernity theory and its views on the need for self-reflexivity and biographies as tools for the creation and definition of the self. Traditional institutions such as the church, occupation, family etc. no longer play an important role in self-definition. This circumstance creates a need for a culture conveying stories of success and failure in relation to which the individual can position their own behaviour and life content. I propose that addiction , as a theme in media reporting, resolves the conflict that emanates from the ambivalence between the accessibility and the individualisation of consumer society, on the one hand, and the problematic behavioural patterns (addictions) that they may induce, on the other.

Cystatin C, a measure of renal function, as prognostic risk marker in acute heart failure : Studies on the cardiorenal syndrome

Acute heart failure (AHF) is a complex syndrome associated with exceptionally high mortality. Still, characteristics and prognostic factors of contemporary AHF patients have been inadequately studied. Kidney function has emerged as a very powerful prognostic risk factor in cardiovascular disease. This is believed to be the consequence of an interaction between the heart and kidneys, also termed the cardiorenal syndrome, the mechanisms of which are not fully understood. Renal insufficiency is common in heart failure and of particular interest for predicting outcome in AHF. Cystatin C (CysC) is a marker of glomerular filtration rate with properties making it a prospective alternative to the currently used measure creatinine for assessment of renal function. The aim of this thesis is to characterize a representative cohort of patients hospitalized for AHF and to identify risk factors for poor outcome in AHF. In particular, the role of CysC as a marker of renal function is evaluated, including examination of the value of CysC as a predictor of mortality in AHF. The FINN-AKVA (Finnish Acute Heart Failure) study is a national prospective multicenter study conducted to investigate the clinical presentation, aetiology and treatment of, as well as concomitant diseases and outcome in, AHF. Patients hospitalized for AHF were enrolled in the FINN-AKVA study, and mortality was followed for 12 months. The mean age of patients with AHF is 75 years and they frequently have both cardiovascular and non-cardiovascular co-morbidities. The mortality after hospitalization for AHF is high, rising to 27% by 12 months. The present study shows that renal dysfunction is very common in AHF. CysC detects impaired renal function in forty percent of patients. Renal function, measured by CysC, is one of the strongest predictors of mortality independently of other prognostic risk markers, such as age, gender, co-morbidities and systolic blood pressure on admission. Moreover, in patients with normal creatinine values, elevated CysC is associated with a marked increase in mortality. Acute kidney injury, defined as an increase in CysC within 48 hours of hospital admission, occurs in a significant proportion of patients and is associated with increased short- and mid-term mortality. The results suggest that CysC can be used for risk stratification in AHF. Markers of inflammation are elevated both in heart failure and in chronic kidney disease, and inflammation is one of the mechanisms thought to mediate heart-kidney interactions in the cardiorenal syndrome. Inflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) correlate very differently to markers of cardiac stress and renal function. In particular, TNF-α showed a robust correlation to CysC, but was not associated with levels of NT-proBNP, a marker of hemodynamic cardiac stress. Compared to CysC, the inflammatory markers were not strongly related to mortality in AHF. In conclusion, patients with AHF are elderly with multiple co-morbidities, and renal dysfunction is very common. CysC demonstrates good diagnostic properties both in identifying impaired renal function and acute kidney injury in patients with AHF. CysC, as a measure of renal function, is also a powerful prognostic marker in AHF. CysC shows promise as a marker for assessment of kidney function and risk stratification in patients hospitalized for AHF.

Linguistic grammars with very low complexity

We have presented an overview of the FSIG approach and related FSIG gram- mars to issues of very low complexity and parsing strategy. We ended up with serious optimism according to which most FSIG grammars could be decom- posed in a reasonable way and then processed efficiently.

Hur uppkommer värde för kunden?

Värdeforskningen inom marknadsföringen har traditionellt fokuserat på utbyten och det upplevda värdet av företagets produkter. Den gängse synen på värde har därför också utmärkts av en produktions- och transaktionsorienterad syn där värde anses produceras i företagets processer och sedan överlåts till kunden i samband med ett utbyte. I den här studien betraktas värde i stället ur ett kund- och relationsbaserat perspektiv. Utgångspunkten är att värde för kunden är något som företaget vare sig kan producera eller leverera. Kunden betraktas i den här studien därför som subjekt i sin egen värdeskapande process, medan varor, tjänster och kundens relationer till olika företag betraktas som resurser eller objekt i kundens egna värdeskapande aktiviteter. Tyngdpunkten flyttas från företaget som värdeskapare till kunden som värdeskapare vilket innebär en omarbetad logik för värdeskapande. Det relationsbaserade perspektivet på värde vidgar ytterligare synen på hur värde uppkommer för kunden. Studien visar att kundens värdeskapande kontext omfattar mer än enbart produkten och den värdebedömning som görs i en köpsituation. Detta påtalar behovet av att man analyserar hur värde uppkommer för kunden över tiden och ur ett helhetsperspektiv. Studiens syfte är att analysera hur värde uppkommer för kunden – i vilka aktiviteter och med vilka resurser. Målet är att finna en balans i synen på relationen mellan kund och företag och att lära om hur företagets marknadsföringsprocesser kan utvecklas genom att kundens egna värdeskapande aktiviteter analyseras. Studien är inriktad på konsumentmarknaden och den empiriska miljön utgörs av bilägare som intervjuats med en longitudinell ansats. Avhandlingen utmynnar i en teoretisk referensram om hur värde uppkommer för kunden. Olika dimensioner av värdebegreppet identifieras och analyseras och en kund- och relationsbaserad värdeterminologi utvecklas. I stället för att analysera det upplevda värdet av företagets produkt uppmanas marknadsföraren här att analysera hur värde uppkommer för kunden som individ över tiden. Detta uppnås genom att företaget lär känna kundens värdeskapande kontext i syfte att förstå var (i vilka aktiviteter) och hur (under vilka premisser) värde uppkommer för kunden. På basis av denna information kan företaget ta ställning till sin roll i kundens värdeskapande process och även visionera om vilken roll företaget kunde ha.

Den anonyma seniorkonsumenten identifieras: Om identitetsskapande processer i en marknadsföringskontext

Marknadsföringen till äldre konsumenter har länge varit en grå zon. Konsumtionsvilja och penningstyrka är två sätt att beskriva dagens äldre konsument, och i avhandlingen bildar dessa omdömen och många andra beskrivningar fem diskurser som har benämnts senior, radikal, förlängd ungdom, hedonist och lyx och själfull och erfaren. Diskurserna baserar sig på analysen av intervjuer med reklambyråer och tidskrifter riktade till marknadsförare. Diskurserna är exempel på hur man bygger upp en identitet för den äldre konsumenten i marknadsföringens värld. Identiteterna erbjuder möjligheter till ett mångsidigare åldrande men de kan också skapa nya stereotyper. Resultaten i avhandlingen visar hur vår språkanvändning och vårt sätt att avbilda människor påverkar kategoriseringen och stereotypiseringen av dem. Avhandlingen erbjuder ett sätt att lära sig bemöta den äldre konsumenten, och egentligen vilken konsument som helst, med en så dynamisk uppfattning om denna som möjligt. Tidigare har marknadsförare främst utgått från konsumentens kronologiska ålder och diskussionen har kretsat kring när någon kan klassas som en äldre konsument. Att försöka bestämma när någon är gammal eller äldre utesluter det faktum att ålder skapas och återskapas i vårt sätt att tala om den. I denna skapelseprocess spelar marknadsförarens handlingar en viktig roll. Om ålder enbart ses som ett slags åldersgräns påtvingas vi färdiga kategorier och stereotyper som både stämplar och begränsar. Avhandlingen inför begreppet kulturell ålder där kulturens olika processer som skapar en åldersidentitet för konsumenten poängteras. Åldrande är en pågående, självuppfyllande process som ständigt omformas, definieras och förstärks av de bilder som finns runt omkring oss och sättet att tala om det (språk och representation). När vi känner till de ideologiska skiftningarna kan vi skapa en mera dynamisk kommunikation med konsumenten. Vi förstår också bättre vår roll vid uppkomsten av stereotyper och andra rigida konstruktioner. Avhandlingen har utnyttjat diskursanalytiska begrepp i kombination med ett kultursynsätt. Kombinationen kan utnyttjas då man analyserar sättet att konstruera identiteten hos olika konsumentgrupper i marknadernas olika dialoger. Därför borde man inte fråga ”Hur gammal är den äldre konsumenten?” utan ”Hur åldras konsumenten?”.

Faktorer som initierar och påverkar prat i långsiktiga relationer

Den klassiska situationen där konsumentinformationen på ett ensidigt sätt tidigare har levererats av företagen får ge vika för en ny situation där dagens konsument aktivt sprider information för att påverka andra konsumenters köpbeslut genom att prata med andra om köpupplevelser och specifika tjänsteleverantörer t ex genom diskussionsgrupper på Internet. För företagen är situationen kritisk då de håller på att mista sina maktmonopol på informationen. Innehållet i pratet är mycket viktigt för mottagarna av pratet eftersom de flesta kunder om de inte själva har upplevt företaget, skapar sina åsikter och förväntningar om företaget samt om dess varor och tjänster på basen av vad andra berättar om saken. Man kan då säga att pratet har fått en viktigare roll vid formandet av konsumtionsbeslutet. Syftet med denna studie är att skapa förståelse för vilka faktorer som initierar och påverkar prat hos kunder i långsiktiga relationer. På basis av de olika resultaten konstruerades en modell som förklarar sambandet mellan faktorerna. Modellens första del visar att prat initieras på basis av långvariga upplevelser i relationer mellan tjänsteleverantör och kund. Modellens andra del visar att pratet påverkas av kundens personliga karaktäristika och relationsrelaterade faktorer som upplevt engagemang i tjänstekategorin och i tjänsteleverantören samt i relationslängden. Modellens tredje del visar att kundernas prat varierar i aktivitet och omfång beroende på valensen av upplevelserna och beroende på om prataren har starka eller svaga band till pratmottagaren. Det är viktigt och mycket aktuellt att öka förståelsen för kunders kommunikationsbeteende ur ett relationsperspektiv. Ur företagsledningssynvinkel är det viktigt att förstå hur kunders prat påverkar utvecklingen av verksamhetsmiljön. Ur praktiskt tillämpningsperspektiv kan en ökad kunskap om pratet vidare hjälpa företaget att fokusera på vad kunderna anser vara viktigt i en relation. Genom att veta vad kunderna pratar om kan företaget förbättra svagheter i verksamheten, och därigenom minska på andelen negativt prat eller uppmuntra kunder att prata om fördelar som relationen med företaget ger åt kunden.

Ett steg vidare – Utvecklingen av presentationen av Hufvudstadsbladets huvudyheter 1995–2010

Sedan sekelskiftet har dagstidningar gått igenom stora förändringar och står nu inför fler utmaningar än någonsin förr. Webbmedierna ökar i omsättning i samma takt som dagstidningarna tappar prenumeranter och annonsintäkter. Det nuvarande medieklimatet ställer nya krav på dagstidningarna och tvingar till förändringar. Syftet med den här pro gradu-avhandlingen är att granska förändringar i framställningen av Hufvudstadsbladets (Hbl) huvudnyheten med fem års intervaller under perioden 1995–2010. Från varje undersökt år granskas en månad. Hur har huvudnyheten strukturerats och presenterats under den här tidsperioden? Vilka faktorer har bidragit till förändringen och hur syns förändringarna i tidningen? Studien baserar sig på kvantitativ innehållsanalys av materialet samt intervjuer med Hbl:s chefredaktör Hannu Olkinuora och layoutchef Marita Granroth. I studien granskas antalet ingångar i huvudnyheten och hur väl huvudrubriken och huvudbilden korrelerar. Intervjuerna ger djup för den kvantitativa analysen och belyser hur man på Hbl resonerat kring de förändringar som skett under perioden 1995–2010. Resultatet visar att antalet ingångar har ökat med 21 procent från år 1995 till år 2010. Bland annat upplyfta citat, grafik och faktarutor har ökat avsevärt. Samtidigt har korrelationen mellan bilden och rubriken blivit sämre, endast 39 procent av bilderna år 2010 stod i direkt korrelation till rubriken, då samma siffra år 1995 var 50 procent. På basis av förändringarna i presentationsformerna kan man dra slutsatser om att dagstidningen har fått en ny roll i dagens medievärld. I stället för direkt hårda nyheter ska dagstidningarna erbjuda fördjupningar och bakgrunder till de nyheter som de flesta redan läst på webben. Dagstidningarna är tvungna att komma på nya lösningar och vara redo att gå ett steg vidare för att hänga med i mediekonkurrensen. I stället för att direkt rapportera nyheter blir dagstidningens roll mer kompletterande i förhållande till de övriga medierna. Forskningen inom det här området är liten och den här studien baserar sig i huvudsak på Hannu Pulkkinens och Pekka Mervolas forskning om de finländska dagstidningarna. Pulkkinen har forskat om tidningens arkitektur och uppbyggnad och Mervola har gjort en historisk översikt på den finländska pressen.