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Introduction Few studies with controls from the same cohort have investigated the impact of stroke on the ability to live an independent life at old age. We aimed to analyze how great an impact being a stroke survivor would have on cognition and disability. We also analyzed the predictive value of baseline cardiovascular risk factors. Methods We included 1147 men, free from stroke, dementia, and disability, from the Uppsala Longitudinal Study of Adult Men, between 69–74 years of age. Follow-up data were collected between the ages of 85–89 years and were available for 481 of all 509 survivors. Data on stroke diagnosis were obtained through national registries. Dementia was diagnosed through a systematic review of medical charts and in accordance with the current diagnostic criteria. The primary outcome, preserved functions, was a composite outcome comprising four criteria: no dementia, independent in personal activities of daily living, ability to walk outside unassisted, and not living in an institution. Results Among 481 survivors with outcome data, 64 (13%) suffered a stroke during the follow-up. Only 31% of stroke cases, compared to 72% of non-stroke cases (adjusted OR 0.20 [95% CI 0.11–0.37]), had preserved functions. The chance of being free of dementia was 60% lower in the stroke group, OR 0.40 [95% CI 0.22–0.72]. No cardiovascular risk factors were independently able to predict preserved functions among stroke cases. Conclusion Stroke has long lasting consequences for many aspects of disability at very high age.

Peer reviewed: True, Funder: King Gustav V and Queen Victoria’s Foundation of Freemasons, Funder: stroke-riksförbundet; FundRef: https://doi.org/10.13039/501100008590, OBJECTIVE: Apathy is a common and disabling symptom after stroke with no proven treatments. Selective serotonin reuptake inhibitors are widely used to treat depressive symptoms post-stroke but whether they reduce apathetic symptoms is unknown. We determined the effect of fluoxetine on post-stroke apathy in a post hoc analysis of the EFFECTS (Efficacy oF Fluoxetine-a randomized Controlled Trial in Stroke) trial. METHODS: EFFECTS enrolled patients ⩾18 years between 2 and 15 days after stroke onset. Participants were randomly assigned to receive oral fluoxetine 20 mg once daily or matching placebo for 6 months. The Montgomery-Åsberg Depression Rating Scale (MADRS) was administered at baseline and 6 months. Individual items on this scale were divided into those reflecting symptoms of apathy and depression. Symptoms were compared between fluoxetine and placebo groups. RESULTS: Of 1500 participants enrolled, complete MADRS data were available for 1369. The modified intention-to-treat population included 681 patients in the fluoxetine group and 688 in the placebo group. Confirmatory factor analysis revealed that apathetic, depressive, and anhedonic symptoms were dissociable. Apathy scores increased in both fluoxetine and placebo groups (both p ⩽ 0.00001). In contrast, fluoxetine was associated with a reduction in depressive scores (p = 0.002). CONCLUSION: Post-stroke apathetic and depressive symptoms respond differently to fluoxetine treatment. Our analysis suggests fluoxetine is ineffective in preventing post-stroke apathy.

OBJECTIVE: Apathy is a common and disabling symptom after stroke with no proven treatments. Selective serotonin reuptake inhibitors are widely used to treat depressive symptoms post stroke but whether they reduce apathetic symptoms is unknown. We determined the effect of fluoxetine on post stroke apathy in a post-hoc analysis of the EFFECTS (Efficacy oF Fluoxetine - a randomisEd Controlled Trial in Stroke) trial. METHODS: EFFECTS enrolled patients >=18 years between 2-15 days after stroke onset. Participants were randomly assigned to receive oral fluoxetine 20 mg once daily or matching placebo for 6 months. The Montgomery-Åsberg Depression Rating Scale (MADRS) was administered at baseline and 6 months. Individual items on this scale were divided into those reflecting symptoms of apathy and depression. Symptoms were compared between fluoxetine and placebo groups. RESULTS: Of 1500 participants enrolled, complete MADRS data was available for 1369. The modified intention-to-treat population included 681 patients in the fluoxetine group and 688 in the placebo group. Confirmatory factor analysis revealed that apathic, depressive, and anhedonic symptoms were dissociable. Apathy scores increased in both fluoxetine and placebo groups (both P≤0.00001). In contrast fluoxetine was associated with a reduction in depressive scores, (P=0.002)Conclusions. Post-stroke apathetic and depressive symptoms respond differently to fluoxetine treatment. Our analysis suggests fluoxetine is ineffective in preventing post-stroke apathy.

Additional file 1.

OBJECTIVE: The primary objective was to develop a Swedish short version of the Montreal Cognitive Assessment (s-MoCA-SWE) for use with patients with stroke. Secondary objectives were to identify an optimal cut-off value for the s-MoCA-SWE to screen for cognitive impairment and to compare its sensitivity with that of previously developed short forms of the Montreal Cognitive Assessment. DESIGN: Cross-sectional study. SUBJECTS/PATIENTS: Patients admitted to stroke and rehabilitation units in hospitals across Sweden. METHODS: Cognition was screened using the Montreal Cognitive Assessment. Working versions of the s-MoCA-SWE were developed using supervised and unsupervised algorithms. RESULTS: Data from 3,276 patients were analysed (40% female, mean age 71.5 years, 56% minor stroke at admission). The suggested s-MoCA-SWE comprised delayed recall, visuospatial/executive function, serial 7, fluency, and abstraction. The aggregated scores ranged from 0 to 16. A threshold for impaired cognition ≤ 12 had a sensitivity of 97.41 (95% confidence interval, 96.64-98.03) and positive predictive value of 90.30 (95% confidence interval 89.23-91.27). The s-MoCA-SWE had a higher absolute sensitivity than that of other short forms. CONCLUSION: The s-MoCA-SWE (threshold ≤ 12) can detect post-stroke cognitive issues. The high sensitivity makes it a potentially useful "rule-out" tool that may eliminate severe cognitive impairment in people with stoke.

Additional file 1. List of imaging variables in the tenecteplase in wake up ischeamic stroke trial (TWIST).

Additional file 2. Proposed tables and figures for main publication of the tenecteplase in wake up ischeamic stroke trial (TWIST).

Supplemental material, sj-docx-1-wso-10.1177_17474930221120349 for Predictors of post-stroke cognitive impairment using acute structural MRI neuroimaging: A systematic review and meta-analysis by Emily L Ball, Mahnoor Shah, Eilidh Ross, Rachel Sutherland, Charlotte Squires, Gillian E Mead, Joanna M Wardlaw, Terence J Quinn, Dorota Religa, Erik Lundström, Joshua Cheyne and Susan D Shenkin in International Journal of Stroke

Supplemental material, sj-docx-1-wso-10.1177_17474930221120349 for Predictors of post-stroke cognitive impairment using acute structural MRI neuroimaging: A systematic review and meta-analysis by Emily L Ball, Mahnoor Shah, Eilidh Ross, Rachel Sutherland, Charlotte Squires, Gillian E Mead, Joanna M Wardlaw, Terence J Quinn, Dorota Religa, Erik Lundström, Joshua Cheyne and Susan D Shenkin in International Journal of Stroke

Supplemental material, sj-docx-1-wso-10.1177_17474930221124760 for Does fluoxetine reduce apathetic and depressive symptoms after stroke? An analysis of the Efficacy oF Fluoxetine—a randomized Controlled Trial in Stroke trial data set by Jonathan Tay, Björn Mårtensson, Hugh S Markus and Erik Lundström in International Journal of Stroke

Additional file 3.

Background and Purpose: The EFFECTS (Efficacy of Fluoxetine—a Randomised Controlled Trial in Stroke) recently reported that 20 mg fluoxetine once daily for 6 months after acute stroke did not improve functional outcome but reduced depression and increased fractures and hyponatremia at 6 months. The purpose of this predefined secondary analysis was to identify if any effects of fluoxetine were maintained or delayed over 12 months. Methods: EFFECTS was an investigator-led, randomized, placebo-controlled, double-blind, parallel group trial in Sweden that enrolled adult patients with stroke. Patients were randomized to 20 mg oral fluoxetine or matching placebo for 6 months and followed for another 6 months. The primary outcome was functional outcome (modified Rankin Scale), at 6 months. Predefined secondary outcomes for these analyses included the modified Rankin Scale, health status, quality of life, fatigue, mood, and depression at 12 months. Results: One thousand five hundred patients were recruited from 35 centers in Sweden between 2014 and 2019; 750 were allocated fluoxetine and 750 placebo. At 12 months, modified Rankin Scale data were available in 715 (95%) patients allocated fluoxetine and 712 (95%) placebo. The distribution of modified Rankin Scale categories was similar in the 2 groups (adjusted common odds ratio, 0.92 [95% CI, 0.76–1.10]). Patients allocated fluoxetine scored worse on memory with a median value of 89 (interquartile range, 75–100) versus 93 (interquartile range, 82–100); P =0.0021 and communication 93 (interquartile range, 82–100) versus 96 (interquartile range, 86–100); P =0.024 domains of the Stroke Impact Scale compared with placebo. There were no other differences in secondary outcomes. Conclusions: Fluoxetine after acute stroke had no effect on functional outcome at 12 months. Patients allocated fluoxetine scored worse on memory and communication on the Stroke Impact Scale compared with placebo, but this is likely to be due to chance. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02683213.

Revision innebär ett granskande av ett företags finansiella yttranden för att säkerställa en rättvisande bild av dess ställning och resultat(FAR, u.å). Utöver denna granskning måste en revisor även tillhandahålla revisionsnära rådgivning till företagsledningen (SFS 2001:883). Sedan 2010 har revision varit frivilligt för små företag under satta gränsvärdenmed motivering att vissa företag borde få välja.Tidigare forskning visar ett samband mellan frivillig revision och lägre räntekostnader (Blackwell, 1998; Kim et al., 2011; Minnis, 2011),minskning av agentproblem mellan företag och kreditgivare(Collis, 2004), och att revisionhar en intern effekt genom revisionsnära rådgivning (Arruñada, 1999; Svanström, 2008; EFAA, 2019).Denna uppsats undersöker om den sammanlagda effekten av revision skapar ett mervärde som överstiger dess kostnader för små företag i Sverige. Studiens syfteär således att undersöka omdet föreliggerett samband mellan frivillig revision och ett företags lönsamhet respektive tillväxt.Denna studie har använt arkivdata, i form av finansiella rapportermellan åren 2015–2019, från10 074 stycken svenska aktiebolag grundade år 2014 som idag är undantagna revisionsplikten.Med utgångspunkt i Agency Theory, Stakeholder Theory och Resource Dependency Theoryämnar denna uppsats till att undersöka revisionens sammanlagda värdeskapande effekt på små aktiebolag i Sverige med avseende på tillväxt och lönsamhet. Med en kvantitativ metod undersöks sambandet med en Ordinary Least Squaresregression med både matchade och omatchade observationer.Resultaten från denna undersökning visar på ett positivt samband mellan frivillig revision och ett företagstillväxtmen kan inte påvisa något samband mellan frivillig revision och lönsamhet.

Supplemental material, sj-pdf-1-wso-10.1177_17474930211045836 for Predicting post-stroke cognitive impairment using acute CT neuroimaging: A systematic review and meta-analysis by Emily L Ball, Rachel Sutherland, Charlotte Squires, Gillian E Mead, Dorota Religa, Erik Lundström, Joshua Cheyne, Joanna M Wardlaw, Terence J Quinn and Susan D Shenkin in International Journal of Stroke

Background Three large trials of fluoxetine for stroke recovery (FOCUS (fluoxetine or control under supervision), AFFINITY (the Assessment oF FluoxetINe In sTroke recovery) and EFFECTS (Efficacy oF Fluoxetine—a randomisEd Controlled Trial in Stroke)) have been collaboratively designed with the same basic protocol to facilitate an individual patient data analysis (IPDM). The statistical analysis plan for the three individual trials has already been reported in Trials, including a brief description of the IPDM. In this protocol, we describe in detail how we will perform the IPDM. Methods/design Data from EFFECTS and AFFINITY will be transferred securely to the FOCUS statistician, who will perform a one-stage IPDM and a two-stage IPDM. For the one-stage IPDM, data will be combined into a single data set and the same analyses performed as described for the individual trials. For the two-stage IPDM, the results for the three individual trials will be combined using fixed effects meta-analyses. The primary and secondary outcome domains for the IPDM are the same as for individual trials. We will also perform analyses according to several subgroups including country of recruitment, ethnicity and trial. We will also explore the effects of fluoxetine on our primary and secondary outcomes in subgroups defined by combinations of characteristics. We also describe additional research questions that will be addressed using the combined data set, and published subsequently, including predictors of important post-stroke problems such as seizures, low mood and bone fractures. Discussion An IPDM of our three large trials of fluoxetine for stroke recovery will allow us to provide the most precise estimates of any risks and benefits of fluoxetine vs placebo, to detect reliably a smaller overall effect size than those detectable by the individual trials, to better determine the effects of fluoxetine vs placebo in subgroups of patients and outcomes and to broaden the generalisability of the results. Also, we may identify differences in treatment effects between studies. Trial registration FOCUS: ISRCTN ISRCTN83290762. Registered on 23 May 2012. EudraCT 2011-005616-29. Registered on 3 February 2012. AFFINITY: Australian New Zealand Clinical Trials Registry ACTRN12611000774921. Registered on 22 July 2011. EFFECTS: ISRCTN ISRCTN13020412. Registered on 19 December 2014. ClinicalTrials.gov NCT02683213. Registered on 2 February 2016. EudraCT 2011-006130-16. Registered on 8 August 2014.

Objective: To determine whether fluoxetine, at any dose, given within the first year after stroke to patients who did not have to have mood disorders at randomisation led to a reduction in disability, dependency, neurological deficits and fatigue; improved motor function, mood, and cognition at the end of treatment and follow-up, with the same number\ud or fewer adverse effects.\ud Methods: Searches in July 2018 included several databases, trials registers, reference lists, contact with experts. We excluded RCTs requiring patients to have mood disorder at randomisation. Co-primary outcomes were dependence and disability. Dichotomous data were synthesised using risk ratios (RR) and continuous data using standardised mean\ud differences (SMD). Quality was appraised using Cochrane risk of bias methods. Sensitivity analyses explored influence of study quality.\ud Results: The searches identified 3412 references of which 491 full texts were assessed for eligibility. Six new completed RCTs (n=3710) were eligible, making a total of 13 trials (n=4145). There was no difference in the proportion independent at the end of treatment (3 trials, n=3249, 36·6% fluoxetine vs 36·7% control; RR 1·00, 95% confidence interval 0·91 to\ud 1.09, p=0·99, I2 78%) and no difference in disability (7 trials n=3404, SMD 0·05, -0·02 to 0·12 p=0·15, I2=81%). Fluoxetine was associated with better neurological scores and less depression but more seizures. Among the four (n=3283) high quality RCTs, the only difference between groups was lower depression scores with fluoxetine.\ud Conclusion: Fluoxetine does not reduce disability and dependency after stroke. It improves depression scores but increases seizures. Ongoing RCTs will determine its effects in stroke vary depending on ethnicity, background treatment and other factors.\ud Classification of evidence: meta-analysis

Den här uppsatsen använder hederskulturbegreppets teorier för att undersöka hederskultur inom det pentekostal-karismatiska fältet i Sverige. Materialet består av intervjuer med personer som växt upp i en pentekostal-karismatisk miljö samt av predikningar, litteratur och inlägg i sociala medier. Jag finner att materialet delvis innehåller sådant som kan sägas vara en annan i forskning belagd hederskultur, enkelt uttryckt »traditionell hederskultur« – det vill säga att leva med hedersrelaterade normer och begränsningar. Jag kallar denna variant av hederskultur för »kristen hederskultur«, ett begrepp jag gör ett försök att definiera. Uppsatsens ärende är att granska relationen mellan hederskulturen och kyrkosynen i dessa församlingsmiljöer. Jag finner att renhetsidealen i kyrkosynen – som jag bland annat kallar »fromhetsheder« – bidrar till hederskulturen. Dessa ideal tar i sin tur utgångspunkt i en föreställning om Bibelns auktoritet som rättesnöre för livet vilket gör föräldrarnas uppfostran av barnen i min studie strängare. Den karismatiska förståelsen av världen kan också leda till en alternativ barnuppfostran. Vikten av helighet komplicerar och begränsar även de ungas liv i mitt material. Jag avslutar med att föreslå begreppet »hedersrelaterad ecklesiologi«, en kyrkosyn som jag menar karakteriseras av en ortodox lära, en gemenskap som kräver Guds renhet, en stark församlings-identitet som missionerande, samt en karismatisk praktik.

Supplemental material, Table_S1 for Effects on walking performance and lower body strength by short message service guided training after stroke or transient ischemic attack (The STROKEWALK Study): a randomized controlled trial by Birgit Vahlberg, Erik Lundström, Staffan Eriksson, Ulf Holmbäck and Tommy Cederholm in Clinical Rehabilitation

Supplemental material, ESO863606 Supplemental Material for Consensus statements and recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 11–13 November 2018 by Niaz Ahmed, Heinrich Audebert, Guillaume Turc, Charlotte Cordonnier, Hanne Christensen, Simona Sacco, Else Charlotte Sandset, George Ntaios, Andreas Charidimou, Danilo Toni, Christian Pristipino, Martin Köhrmann, Joji B Kuramatsu, Götz Thomalla, Robert Mikulik, Gary A Ford, Joan Martí-Fàbregas, Urs Fischer, Magnus Thoren, Erik Lundström, Gabriel JE Rinkel, H Bart van der Worp, Marius Matusevicius, Georgios Tsivgoulis, Haralampos Milionis, Marta Rubiera, Robert Hart, Tiago Moreira, Maria Lantz, Christina Sjöstrand, Grethe Andersen, Peter Schellinger, Konstantinos Kostulas, Katharina Stibrant Sunnerhagen, Boris Keselman, Eleni Korompoki, Jan Purrucker, Pooja Khatri, William Whiteley, Eivind Berge, Michael Mazya, Diederik WJ Dippel, Satu Mustanoja, Mads Rasmussen, Åsa Kuntze Söderqvist, Irene Escudero-Martínez and Thorsten Steiner in European Stroke Journal

Återinsättning av trombocythämmare efter en spontan intrakraniell blödning ökar inte risken för en ny blödning jämfört med att avstå. Tvärtom. Återinsättning verkar till och med minska risken för framtida blödningar. Det är det oväntade resultatet av RESTART-studien som pre-senterades på den europeiska strokekongressen ESOC i Milano, maj 2019. I denna artikel sammanfattas RESTART av Erik Lundström, överläkare vid Akademiska sjukhuset. Pågåen-de studier (RESTART-Fr och STATICH) kommer sannolikt att kunna ge oss ett definitivt svar på denna viktiga kliniska fråga.

Supplemental material, WSO879655 Supplemental Material for Fluoxetine for stroke recovery: Meta-analysis of randomized controlled trials by Gillian E Mead, Lynn Legg, Russel Tilney, Cheng Fang Hsieh, Simiao Wu, Erik Lundström, Ann Sofie Rudberg, Mansur Kutlubaev, Martin S Dennis, Babak Soleimani, Amanda Barugh, Maree L Hackett and Graeme J Hankey in International Journal of Stroke

Supplemental material, WSO879655 Supplemental Material for Fluoxetine for stroke recovery: Meta-analysis of randomized controlled trials by Gillian E Mead, Lynn Legg, Russel Tilney, Cheng Fang Hsieh, Simiao Wu, Erik Lundström, Ann Sofie Rudberg, Mansur Kutlubaev, Martin S Dennis, Babak Soleimani, Amanda Barugh, Maree L Hackett and Graeme J Hankey in International Journal of Stroke

BACKGROUND AND PURPOSE: Computed tomographic angiography and magnetic resonance angiography are used increasingly to assess arterial patency in patients with ischemic stroke. We determined which baseline angiography features predict response to intravenous thrombolytics in ischemic stroke using randomized controlled trial data. METHODS: We analyzed angiograms from the IST-3 (Third International Stroke Trial), an international, multicenter, prospective, randomized controlled trial of intravenous alteplase. Readers, masked to clinical, treatment, and outcome data, assessed prerandomization computed tomographic angiography and magnetic resonance angiography for presence, extent, location, and completeness of obstruction and collaterals. We compared angiography findings to 6-month functional outcome (Oxford Handicap Scale) and tested for interactions with alteplase, using ordinal regression in adjusted analyses. We also meta-analyzed all available angiography data from other randomized controlled trials of intravenous thrombolytics. RESULTS: In IST-3, 300 patients had prerandomization angiography (computed tomographic angiography=271 and magnetic resonance angiography=29). On multivariable analysis, more extensive angiographic obstruction and poor collaterals independently predicted poor outcome (P1 indicates benefit) in patients with (odds ratio, 2.07; 95% confidence interval, 1.18-3.64; P=0.011) versus without (odds ratio, 0.88; 95% confidence interval, 0.58-1.35; P=0.566) arterial obstruction (P for interaction 0.017). CONCLUSIONS: Intravenous thrombolytics provide benefit to stroke patients with computed tomographic angiography or magnetic resonance angiography evidence of arterial obstruction, but the sample was underpowered to demonstrate significant treatment benefit or harm among patients with apparently patent arteries. CLINICAL TRIAL REGISTRATION: URL: http://www.isrctn.com. Unique identifier: ISRCTN25765518. Erik Lundström was part of the The IST-3 Collaborative Group, hence part as group author.

Samhället växer i allt snabbare takt och åldergruppen 80 år eller äldre väntas öka med 76 %mellan åren 2015 och 2035, från cirka 500 000 personer till närmare 890 000. Kombineradetta med en rapport från IVO (Inspektionen för vård och omsorg) om redan nu växandeköer till specifika äldreboenden så förstår man snabbt hur brådskande situationen är ochvarför det behövs fler attraktiva äldreboenden.Denna rapport har uppförts i sammarbete med Kod Arkitekter och på uppdrag av KTH medsyfte att driva utvecklingen av äldreboenden framåt. Detta har gjorts genom att inventera ochanalysera befintliga äldreboendens problem och brister relaterade till fastighetensgestaltning. Vanligt förekommande problem har lyfts fram i rapporten tillsammans medförbättringsförslag. Som del i arbetet har även en undersökning genomförts med syfte attstudera vilka framtida behov och förväntningar som kommer finnas.Resultaten visar på flera gemensamma problem som oftast enkelt hade kunnat undvikasgenom utförligare projektering tillsammans med djupare kunskap inom ämnet. Sett tillframtiden så visar undersökningen hur den invändiga inredningen kontinuerligt måsteuppdateras för att locka hyresgäster. Även boendets utomhusmiljö bör få större fokus dånärhet till naturen är något som värdesätts mycket högt enligt rapportens enkätundersökningoch intervjuer under platsbesök. Our society is continuously growing and the age-group of 80 years or older is suspected toincrease by 76 % between year 2015 and 2035, from approximately 500 000 persons closer to890 000. This in combination with a report from IVO (Inspektionen för vård och omsorg)about an already growing queue to specific retirement homes and one soon realizes howurgent the situation is and why there is a need of new and attractive retirement homes.This report has been commissioned by Kod Arkitekter and aims to push the development ofretirement homes forward. This has been done by inventory and analysis of existingproblems and shortcomings related to the property and its conformation. Frequentlyoccurring problems have been highlighted together with improvement proposals. As part ofthe work, a survey has also been conducted with the aim of studying future needs andexpectations in regards to retirement homes.The results show several common problems that could most easily have been avoidedaltogether through better planning and with deeper knowledge of the subject. Looking intothe future, the survey shows how the interior decor must constantly be updated in order toattract new tenants. The outdoor environment of the accommodation should also receivefocus as proximity to nature is something we value very high.

In this thesis an investigation and modelling of the fatigue crack propagation in the nickel based superalloy Inconel 718, with a special emphasis on the effect of hold times, is presented. The modelling work has been concentrated on describing the hold time fatigue crack propagation by using the concept of a damaged zone in front of the crack tip, which is believed to have a lowered resistance against crack propagation. The modelling framework is built on physically motivated parameters, which are all easy to calibrate through one specially designed test type. Later evaluation through many experimental tests has also shown that the model is capable, within reasonable scatter level to predict, the hold time fatigue crack propagation for many different temperatures and loading conditions. Further evaluation of a complex flight spectrum, with the incorporation of crack closure within the model, was also predicted with a satisfying result. This thesis is divided into two parts. First, a background and a somewhat deeper discussion of the modelling of fatigue crack growth under hold time conditions is presented. The second part consists of ve appended papers, which describe the work completed so far in the project.

I den här studien intervjuas 13 diakoner i Svenska kyrkan om profetisk diakoni och vadde behöver för att utföra den. Syftet med studien är att undersöka diakoners syn påprofetisk diakoni och dess dilemman, kostnader och utmaningar. Slutsatsen är att diakonerna är mycket positivt inställda till profetisk diakoni, men de harsällan tid att ägna sig åt den – kyrkans struktur och ledarskap komplicerar arbetet. Dessutom upplever diakonerna att deras vigningslöften om att arbeta profetiskt kan varamycket tunga att bära och svåra att leva efter, vilket kan utlösa moralisk stress. Diakonerna vill att diakonrollen uppgraderas och ges större frihet, samt att kyrkansledare gå före och visar vägen. En artikelversion av uppsatsen publicerades i Svensk Kyrkotidning 9/2014, sid 271-273.

Begreppet sponsring har förändrats över tid från det som tidigare mer betraktades somvälgörenhet. Utvecklingen inom området har medfört att sponsring idag kan ses som ett viktigt marknadsföringsinstrument där företagen har en väl bearbetad plan för hur verktyget ska användas. Kravet på motprestationer har ökat och idag uppfattas begreppet mer som ett affärsmässigt samarbete. Syftet med studien är att, utifrån en kvalitativ undersökning, undersöka hur företag i Umeå med omnejd behandlar området sponsring. Närmare bestämt hur sponsring som verktyg påverkar varumärkeskapitalet samt om mindre och större företag uppvisar några skillnader i deras sätt att arbeta med sponsring. Vår förhoppning är att studiens resultat ska generera värdefull information inom området samt bidra med underlag till framtida studier. Vi hoppas också kunna vara till hjälp för Idrottshögskolan på Umeå Universitet i deras konstruktion av ett elitidrottsstipendium. Inom varumärkesbyggande finns omfattande studier med olika inriktningar. En central del är däremot varumärkeskapitalet vilket det också finns många studier om. I dessa appliceras och vidareutvecklas flertalet modeller, dock förhåller de sig till stor del till de ursprungliga tolkningarna av varumärkeskapitalet. Litteratursökningen visar också att flertalet studier inom sponsring tidigare genomförts. Däremot menar vi att i förhållande till sponsringens framfart är utbudet av forskningsområdet relativt tunt. Vad vi anser saknas är en tydlig förståelse för hur sponsring som verktyg kan kopplas samman med varumärkesbyggande. Vår forskningsfråga och det vi ämnar undersöka är därmed hur företag använder sponsring som verktyg för att påverka sitt varumärkeskapital, och om synen på- och arbetet med sponsring skiljer sig mellan större och mindre företag. Utifrån vårt syfte och för att besvara forskningsfrågan tillämpar vi vår interpretativistiska kunskapssyn tillsammans med ett abduktivt angreppssätt. Vidare utgår vi från en jämförande multipel fallstudie där vi valt att intervjua sju mindre och större företag i Umeå med omnejd. Den teoretiska referensramen består av tre huvudsakliga områden; strategiskt varumärkesbyggande, varumärkeskapital och sponsring. Dessa täcker olika områden men kan kopplas till varandra för att skapa en helhetsbild och effektivt användas för analys och diskussion. Våra empiriska observationer analyseras sedan med hjälp av den teoretiska referensramen. Resultat från studien visar att företag i stor utsträckning använder sponsring som ett verktyg för att påverka varumärkeskapitalet. De viktigaste faktorerna är exponering och associering med vilka företagen syftar att öka sin varumärkeskännedom och skapa känslor associerade till varumärket.

In recent years, criticism has been raised against the Swedish fire brigades both from their own staff and from researchers regarding deficiencies in learning and experience feedback within the organizations. Among other things, they have been criticized for that the documentation is only proliferating paper work because there is no system available for deriving advantage from the experience. A researcher who has studied the area is Anna-Karin Lindberg, who reviewed the learning from the fire brigades operating reports. She concludes, among other things, that the spreading of knowledge and lessons learned from the operating reports do not work particularly well. At the Greater Stockholm Fire Brigade there were suspicions that the same problems regarding the operating reports also applied to the fire investigations. We have in this thesis reviewed parts of the process of fire investigations to identify deficiencies, mainly with regard to experience feedback from the suggestions for improvement put forward in fire investigations. The work was conducted in three steps encompassing: 1) analyzing various theoretical models to be used in fire/accident investigations, 2) reviewing fire investigations to examine their coherence with theory, and, 3) reviewing the content, quality and extent of the suggestions for improvement contained in fire investigations. The completed study covers a total of 130 fire investigations, written by Stockholm / the Greater Stockholm Fire Brigade in the years 2006 to 2010. Fire investigations have been reviewed and the various suggestions for improvement have then been indexed in a database. From this database, and through interviews and literature studies, we note that there are deficiencies in the process of experience feedback from fire investigations, mainly referring to the suggestions for improvement which only reach out to a small number of people, both internally and externally. The external distribution is more or less exclusive to the Swedish Civil Contingency Agency (MSB) and the suggestions for improvement that primarily should be handled locally may not be carried out. There are also uncertainties regarding whom or what part of the organization that is responsible for passing on the suggestions for improvement and there is a lack of effective channels for disseminating the information to the most crucial recipients. In conclusion, it is recommended that the Greater Stockholm Fire Brigade: - develops a system for how the suggestions for improvement and experiences best should be handled and pin down which part of the organization that is responsible for communicating them. - customizes the report template so that it aims at concrete suggestions for improvement and introduces a mailing list or something equivalent. - initiate contacts with the most frequent recipients of suggestions for improvement and examines how these should be performed. Validerat; 20110905 (anonymous)

While the dark matter has so far only revealed itself through the gravitational influence it exerts on its surroundings, there are good reasons to believe it is made up by WIMPs – a hypothetical class of heavy elementary particles not encompassed by the Standard Model of particle physics. The Inert Doublet Model constitutes a simple extension of the Standard Model Higgs sector. The model provides a new set of scalar particles, denoted inert scalars because of their lack of direct coupling to matter, of which the lightest is a WIMP dark matter candidate. Another popular Standard Model extension is that of supersymmetry. In the most minimal scenario the particle content is roughly doubled, and the lightest of the new supersymmetric particles, which typically is a neutralino, is a WIMP dark matter candidate. In this thesis the phenomenology of inert scalar and supersymmetric dark matter is studied. Relic density calculations are performed, and experimental signatures in indirect detection experiments and accelerator searches are derived. The Inert Doublet Model shows promising prospects for indirect detection of dark matter annihilations into monochromatic photons. It is also constrained by the old LEP II accelerator data. Some phenomenological differences between the Minimal Supersymmetric Standard Model and a slight extension, the Beyond the Minimal Supersymmetric Standard Model, can be found. Also, supersymmetric dark matter models can be detected already within the early LHC accelerator data.

The prevalence of spasticity after first-ever stroke is approximately 20%, but there are no data on the prevalence of disabling spasticity.The reported prevalence of pain after stroke varies between 19% and 74%, whether pain is associated with spasticity is not known. Until now, there is no health economic analysis of patients with spasticity after stroke. Methods: Two groups of patients were studied. Cohort I was a cross-sectional survey. A representative sample of 140 patients was investigated 1 year after their first-ever stroke. Spasticity was defined as ≥ 1 score on the modified Ashworth scale, disabling spasticity was defined as spasticity having such an impact that intervention, e.g. intensive physiotherapy, orthoses or pharmacological treatment, should be offered. Pain was assesed with the Visual Analogue Scale. All direct costs during one year were identified and converted into Purchasing Power Parities US dollar (PPP$). Cohort II was a prospective cohort study. Forty-nine patients were examined at day 2–10, at one month, and at six months after their first-ever stroke. Assessment and definitions were similar as for cohort I. Results: Spasticity occurs within 1 month and disabling spasticity occur within 6 months. After one year, the prevalence of spasticity was 17% and that of disabling spasticity 4%. Disabling spasticity was more frequent in the upper extremity. There was an independent effect of severe upper extremity paresis (OR 22, CI 3.9–125) and age below 65 years (OR 9.5, CI 1.5–60). The prevalence of stroke-related pain was 21% after one year. Stroke-related pain was associated with paresis (OR 3.1, 95% CI 1.2–7.7), sensory disturbance (OR 3.1, 95% CI 1.1–8.9) and depression (OR 4.1, 95% CI 1.4–13), but not with spasticity as an independent variable. The majority of the direct costs for one year (78%) were associated with hospitalization, whereas 20% was associated with municipality services. Only 1% of all direct costs were related to primary health care and 1% to medication. The mean (median, inter-quartile range) direct cost for stroke patients with spasticity was PPP$ 84 195 (72 116, 53 707) compared to PPP$ 21 842 (12 385, 17 484) for stroke patients without spasticity (P