The kidney in different stages of the cardiovascular continuum

Patients with chronic kidney disease are at higher risk of developing cardiovascular disease. The complex, interaction between the kidney and the cardiovascular system is incompletely understood, particularly at the early stages of the cardiovascular continuum. The overall aim of this thesis was to clarify novel aspects of the interplay between the kidney and the cardiovascular system at different stages of the cardiovascular continuum; from risk factors such as insulin resistance, inflammation and oxidative stress, via sub-clinical cardiovascular damage such as endothelial dysfunction and left ventricular dysfunction, to overt cardiovascular death. This thesis is based on two community-based cohorts of elderly, Uppsala Longitudinal Study of Adult Men (ULSAM) and Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). The first study, show that higher insulin sensitivity, measured with euglycemic-hyperinsulinemic clamp technique was associated to improve estimated glomerular filtration rate (eGFR) in participants with normal fasting plasma glucose, normal glucose tolerance and normal eGFR. In longitudinal analyses, higher insulin sensitivity at baseline was associated with lower risk of impaired renal function during follow-up. In the second study, eGFR was inversely associated with different inflammatory markers (C-reactive protein, interleukin-6, serum amyloid A) and positively associated with a marker of oxidative stress (urinary F2-isoprostanes). In line with this, the urinary albumin/creatinine ratio was positively associated with these inflammatory markers, and negatively associated with oxidative stress. In study three, higher eGFR was associated with better endothelial function as assessed by the invasive forearm model. Further, in study four, higher eGFR was significantly associated with higher left ventricular systolic function (ejection fraction). The 5th study of the thesis shows that higher urinary albumin excretion rate (UAER) and lower eGFR was independently associated with an increased risk for cardiovascular mortality. Analyses of global model fit, discrimination, calibration, and reclassification suggest that UAER and eGFR add relevant prognostic information beyond established cardiovascular risk factors in participants without prevalent cardiovascular disease. Conclusion: this thesis show that the interaction between the kidney and the cardiovascular system plays an important role in the development of cardiovascular disease and that this interplay begins at an early asymptomatic stage of the disease process.

Fakalakalaka : The impact of a Tongan notion of development in a contemporary transnational world

This paper aims to explore a Tongan notion of development –'fakalakalaka' – in light of Western notions of development. Two case studies of international development aid schemes illustrate the impact of Tongan development ideas in practice. Drawing on a number of ethnographers' work on Tonga, 'fakalakalaka' appears broader than the Western notion of development. The latter is characterised by influential ideals of controllability and industrialisation. The notion of development among Tongans, on the other hand, tends to be directed by an underlying persistence that, for instance, reflects Tongan core values regarding social organisation. The production of textile 'koloa', controlled by women, emerges as central to the accomplishment of this three-dimensional development notion of intertwined physical, mental and spiritual aspects. The importance attributed to this specific kind of textile has increased in recent years and found two additional roles, or development strategies, in Tongans' contemporary transnational world.

Humor in Pride and Prejudice : The Role of Humor in Austen’s Novel of Development

engelska

Passive MVC och MVVM designmönster i Android : En jämförelse av kodkomplexitet mellan Passive MVC och MVVM

Det mobila operativsystemet Android är idag ett ganska dominerande operativsystem på den mobila marknaden dels på grund av sin öppenhet men också på grund av att tillgängligheten är stor i och med både billiga och dyra telefoner finns att tillgå. Men idag har Android inget fördefinierat designmönster vilket leder till att varje utvecklare får bestämma själv vad som ska användas, vilket ibland kan leda till onödigt komplex kod i applikationerna som sen blir svårtestad och svårhanterlig. Detta arbete ämnar jämföra två designmönster, Passive Model View Controller (PMVC) och Model View View-Model (MVVM), för att se vilket designmönster som blir minst komplext med hjälp av att räkna fram mätvärden med hjälp av Cyclomatic Complexity Number (CCN). Studien är gjord utifrån arbetssättet Design & Creation och ämnar bidra med: kunskap om vilket mönster man bör välja, samt om CCN kan peka ut vilka delar i en applikation som kommer att ta mer eller mindre lång tid att testa. Under studiens gång tog vi även fram skillnader på om man anväder sig av den så kallade Single Responsibilyt Principle (SRP) eller inte. Detta för att se om separerade vyer gör någon skillnad i applikationernas komplexitet. I slutändan så visar studien på att komplexiteten i små applikationer är väldigt likvärdig, men att man även på små applikationer kan se skillnad på hur komplex koden är men också att kodkomplexitet på metodnivå kan ge riktlinjer för testfall.