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BACKGROUND: The Heart School is a standard component of cardiac rehabilitation after myocardial infarction in Sweden. The group-based educational intervention aims to improve modifiable risks, in turn reducing subsequent morbidity and mortality. However, an evaluation with respect to mortality is lacking. AIMS: Using linked population registries, we estimated the association of attending Heart School with both all-cause and cardiovascular mortality, two and five years after admission for first-time myocardial infarction. METHODS: Patients with first-time myocardial infarction (<75 years) were identified as consecutively registered in the nationwide heart registry, SWEDEHEART (2006-2015), with >99% complete follow-up in the Causes of Death registry for outcome events. Of 192,059 myocardial infarction admissions, 47,907 unique patients with first-time myocardial infarction surviving to the first cardiac rehabilitation visit constituted the study population. The exposure was attending Heart School at the first cardiac rehabilitation visit 6-10 weeks post-myocardial infarction. Data on socioeconomic status was acquired from Statistics Sweden. After multiple imputation, propensity score matching was performed. The association of exposure with mortality was estimated with Cox regression and survival curves. RESULTS: After matching, attending Heart School was associated (hazard ratio (95% confidence interval)) with a markedly lower risk of both all-cause (two-year hazard ratio = 0.53 (0.44-0.64); five-year hazard ratio = 0.62 (0.55-0.69)) and cardiovascular (0.50 (0.38-0.65); 0.57 (0.47-0.69)) mortality. The results were robust in several sensitivity analyses. CONCLUSIONS: Attending Heart School during cardiac rehabilitation is associated with almost halved all-cause and cardiovascular mortality after first-time myocardial infarction. The result warrants further investigation through adequately powered randomised trials.

Heart rate variability (HRV), a measurement of autonomic nervous system (ANS) activity, has been found reduced in schizophrenia. The anterior cingulate cortex (ACC), which is important in regulating the ANS, is structurally and functionally affected in schizophrenia. We investigate the relationship between HRV and functional and structural connectivity of the ACC in patients with schizophrenia and healthy controls. Ten patients with a diagnosis of schizophrenia and ten healthy controls were recruited. Heart rate was monitored in a naturalistic out-of-clinic setting. Magnetic resonance imaging (MRI) was performed, including resting-state functional MRI and diffusion tensor imaging. Patients with schizophrenia had significantly lower HRV compared to controls. A positive correlation between ACC connectivity with the bilateral cerebellum and HRV was found in the patients. HRV was also positively correlated with amplitude of low frequency fluctuations (ALFF) in the cerebellum, and with axial diffusivity in the middle cerebellar peduncle, in the patients. There was a significant negative relationship between antipsychotic medication dosage, HRV and all neuroimaging measures related to HRV. We conclude that ACC connectivity seems to be affected in schizophrenia, both structurally and functionally, and that the ACC-cerebellum connectivity, as well as cerebellar function, is associated with ANS regulation in patients with schizophrenia.

BACKGROUND: The involvement of patient research partners (PRPs) in research aims to safeguard the needs of patient groups and produce new interventions that are developed based on patient input. Myocardial infarction with nonobstructive coronary arteries (MINOCA), unlike acute myocardial infarction (MI) with obstructive coronary arteries, is presented with no significant obstructive coronary artery disease. Patients with this diagnosis are a subset of those diagnosed with traditional MI and often need more psychological support, something that is presently not established in the current treatment scheme in Swedish health care or elsewhere, to our knowledge. An internet-delivered intervention might offer patients with MINOCA the opportunity to access a psychological treatment that is tailored to their specific needs after MINOCA and could therefore supplement the existing medical care in an easily accessible format. OBJECTIVE: This paper aims to describe the development of a therapist-guided, internet-delivered psychological intervention designed specifically for patients with MINOCA. METHODS: The study used a participatory design that involved 7 PRPs diagnosed with MINOCA who collaborated with a team consisting of researchers, cardiologists, and psychologists. Intervention content was developed iteratively and presented to the PRPs across several prototypes, each continually adjusted and redesigned according to the feedback received. The intervention and experience of it were discussed by PRPs in a final meeting and then presented to a panel of 2 clinical psychologists and a cardiologist for further input. RESULTS: The outcome of the collaboration between PRPs and the research group produced a web-based psychological 9-step program focusing on stress, worry, and valued action. The input from PRPs contributed substantially to the therapy content, homework tasks, interactive activities, multimedia, and design presentation. CONCLUSIONS: Working with PRPs to develop an

Aims Dose-dependent effects of β-blockers on survival and cardiovascular outcomes after myocardial infarction (MI) are not well understood. We investigated the long-term risk of cardiovascular events in patients with different doses of β-blockers after MI. Methods and results This was a nationwide observational study linking morbidity, mortality, socioeconomic, and medication data from Swedish national registries. Between 2006 and 2015, 97 575 unique patients with first-time MI were included. In total, 33 126 (33.9%) patients were discharged with ≥50% of the target β-blocker dose and 64 449 (66.1%) patients with <50% of the target β-blocker dose used in previous randomized trials. The primary composite endpoint was re-infarction or all-cause death within 1 year from discharge. Multivariable adjusted 1-year follow-up estimates using mixed effects Cox regression [HR (95% CI)] showed that patients treated with ≥50% of the target dose had a similar risk of the composite endpoint [1.03 (0.99–1.08)] and a somewhat higher risk when stroke, atrial fibrillation, or heart failure hospitalization were added to the composite endpoint [1.08 (1.04–1.12)], compared with patients on <50% of the target β-blocker dose. Results remained similar up to 5 years of follow-up and consistent across relevant patient subgroups, including patients who developed heart failure during the index hospitalization. Conclusions In contrast to doses of β-blockers used in previous trials, ≥50% of the target β-blocker dose was not associated with superior cardiovascular outcomes up to 5 years as compared with <50% of the target dose. Contemporary randomized clinical trials are needed to clarify the optimal dose of β-blockers after MI., De två första författarna delar förstaförfattarskapet

Presently used experimental techniques for the characterization of tensile and compressive behavior of active layers in lithiumionbatteries have limitations of different kinds. This is particularly true for measurements of compressive properties.Furthermore, the characterizations of time-dependent stress-strain behavior are largely missing. In order to characterize thestress-strain relationship for a dry cathode active layer in lithium-ion batteries, a mechanical testing method is presented thatpreviously has been applied to the testing of optical fibers. The method is based on U-shaped bending of single-side coatedaluminum foils, which enables separate measurements of tensile and compressive properties. In particular, the method has clearadvantages for measurements of compressive properties in comparison to previously reported techniques. Relaxation experimentsare also conducted in order to characterize the time-dependent properties of the dry active layer and to check if these effectscould explain the measured hysteresis. It is found that the elastic modulus in compression is significantly larger than the elasticmodulus in tension and that the compressive modulus increases with strain level. Contrary, the tensile modulus is approximatelyindependent of strain. Furthermore, hysteresis effects are present at loading-unloading measurements, both for tension andcompression. The low values of the measured elastic moduli show that the electrode properties are largely controlled by thebinder and carbon additives. It is concluded that the development of particle-particle contacts most likely is the reason for thehigher modulus in compression in comparison to tension. The time-dependent effects are significant, primarily for shorter timescales, which explains the relaxation behavior, but they cannot fully explain the hysteresis effects. Most likely non-linear micromechanismsdo contribute as well., QC 20201021

Material parameter curves in an advanced material model describing compaction of spraydried cemented carbide powder are determined successfully based on a general approach formaterial characterization of powder materials. Pressing forces from a production machineand equivalent finite element (FE) calculations are used in inverse modelling. A pressingmethod that includes multiple unloading steps is used. The material model is of DruckerPrager CAP kind and friction between powder and pressing tool is modelled as a function ofnormal pressure. The results are verified with density gradient measurements using aneutron source. The method is proven to be robust and the results show good agreementbetween experiment and simulation. Effects that have not been captured numericallypreviously are captured due to the high accuracy of material characterization. The presentapproach is detailed for tungsten carbide powders but is valid for other powder materialswhen properly calibrated for constitutive and frictional effects in the same manner asoutlined here., QC 20200221

Artikeln baseras på intervjuer med 32 framgångsrika personer inom affärsvärlden och högskolan som alla invandrat till Sverige från Mellanöstern. Deras berättelser handlar om framgång trots att ursprunget gett dem sämre utgångslägen. De berättar om en uppväxt i samhällen med stor respekt för utbildning och om vikten av att ha ett bra kontaktnät. Detta kapital hade emellertid liten betydelse efter migrationen och en framgångsrik strategi var i stället att pragmatiskt mobilisera nytt kapital i form av ny utbildning, nya nätverk, hårt arbete och kunskap om spelets regler inom respektive profession. Eftersom framgångsrika karriärer på detta sätt ensidigt betingas av villkoren i det nya samhället, blir framgång för migranter beroende av att individerna anlägger en pragmatisk inställning till skillnader mellan samhällen. Detta innebär bland annat att migranter ofta får bortse från olika slags orättvisor och diskriminering., Pathways to Success

This article examines the career narratives of entrepreneurs with migrant background in the Swedish business sector. Statistics show that the proportion of individuals with a migrant background who reach so-called top-positions in Swedish society is in general low. Migrants with Iranian background is an exception as many of them have reached high positions as professionals in business corporations and themselves established high-profile businesses in Sweden. Based on in-depth interviews with entrepreneurs and managers with Iranian origin, we will in this article look at how their background is made relevant when reflecting upon professional success and failure. The article is concerned with their exceptional professional achievements and, in particular, the individuals' positioning in relation to their 'society of migration', their society of origin, and the social networks are embedded in as migrants with an Iranian origin. The article shows how narratives of success tend to emphasize the struggles of a 'lonely fighter' while at the same time dismiss discrimination as an explanatory factor. The entrepreneurs' success stories nevertheless focus on how one's career path as innovators and 'agents of social change' is intimately linked with a migrant past and experience.

This is a study about graffiti as an artform and as a culture and whether it can be considered as cultural heritage. The purpose of this study was to get a greater understanding of what graffiti is, both as an artform and as a culture. The method used in this study was both descriptive and explorative, describing the style of graffiti as an artform against the concepts of cultural heritage and cultural policy. The results of this study were that there are aspects of graffiti as an artform and culture that can be recognized as cultural heritage. The conclusion of this study is that some types of graffiti that are more likely to be considered a culture heritage than other types and that the line between art and vandalism can be very thin.

Bakgrund: Demens är en kronisk obotlig sjukdom som drabbar uppskattningsvis 20 000 – 25 000 personer i Sverige varje år. För att personer med demens ska få en så god livskvalitet som möjligt får de hjälp genom individanpassade omvårdnadsåtgärder. Intervention med vårdhund kan vara en sådan. Syfte: Att undersöka vårdhundars effekt på personer med en demenssjukdom. Metod: En litteraturstudie med utgångspunkt i Polit och Beck (2017) niostegsmodell. Databaserna som användes för att få fram artiklarna var Cinahl, Pubmed och PsycInfo. Totalt 14 artiklar inkluderades och databearbetningen utfördes med en induktiv ansats. Resultat: tre huvudteman framkom, ”Effekten av vårdhundar som gruppintervention”, ”Effekten av vårdhundar som individuellt anpassad intervention” och ”Effekten av vårdhundar som intervention över tid”. Flera studier har kunnat visa på goda effekter under interventionstiden, långsiktiga effekter har varit svåra att påvisa. Slutsats: Vårdhundar kan genom sin blotta närvaro eller individuellt planerade interventioner lindra lidandet orsakat av oro för personer med demens. Detta gör att en bättre livskvalitet kan uppnås. Samtliga inkluderade artiklar framhåller att evidensgraden är för låg för att kunna dra säkra slutsatser. Mer forskning behövs.

Det har skett en kraftig ökning kring intresset för hållbarhet de senaste två decennierna hos konsumenter. Företag har även insett att nyttjande av marknadsföring där de hållbara aspekterna lyfts fram lett till en ökad lönsamhet. I takt med att fler företag marknadsför grönt har det lett till att konsumenter översköljs av information kring hållbara tjänster, produkter och företag. Konsumenter vet inte längre vilket alternativ som är mest hållbart eller vilket företag de kan lita på. Uppmärksammade fall av felaktig grön marknadsföring har också bidragit till det sänkta förtroende hos konsumenter. Syftet med uppsatsen är därför att öka förståelsen kring utformandet av förtroendeingivande grön marknadsföring. För att uppfylla uppsatsens syfte har litteratur, artiklar och rapporter kring ämnet förtroende i grön marknadsföring samlats in. Teorin kompletterades med semistrukturerade intervjuer där personer på marknadsföringsbyråer med bred kompetens och erfarenhet inom grön marknadsföring valdes ut. Inom marknadsföring definieras förtroende som konsumenters tillförlitlighet och välvilja till ett varumärke. När konsumenters förtroende för ett varumärke ökar så minskar även deras oro samt osäkerhet och därför stärks varumärket som helhet. För att genomföra grön marknadsföring som inger förtroende är strategierna cause marketing, influencer marketing samt grön demarketing frekvent återkommande. Uppsatsen visar att faktorerna transparens, trovärdighet samt faktabaserade påståenden var grundläggande för förtroendeingivande grön marknadsföring. Den visar också att användandet av cause marketing kräver ett högt förtroende hos konsumenter samt en image som är i linje med problemet som ska bistås. I användandet av influencer marketing krävs även här ett befintligt högt förtroende, men också en analys av influencerns sociala medier och värderingar. Inom grön demarketing behövs också ett högt befintligt förtroende hos konsumenter, men också en tydlighet i budskapet samt en image so

The service life of a road is to great extent controlled by the performance of the unbound layers. Assessing the constitutive behavior of these layers is thus imperative for a sustainable pavement design. Adequate description and measurement of unbound materials resistance to aggregate crushing is an issue, in terms of the measured response coupled to intrinsic properties of the aggregates and unbound materials gradation. In this study, a new Discrete Element Method (DEM)—based model is developed to investigate aggregate damage in unbound road materials. In order to get better insight into micro-mechanics of aggregate crushing, the developed model incorporates granular mechanics-based particle contact and damage laws. By numerical analysis with the DEM, several unbound granular materials have been examined investigating the effect of the materials gradation and aggregates toughness properties on their performance in crushing tests. The capability of the model to capture the effect of unbound material properties on its crushing performance, is evaluated based on comparison with experimental findings., QC 20211002