Kommunal marknadsföring- Competitive identity och institutionell problematik : En komparativ fallstudie om två svenska kommuner och deras marknadsföring

Historiskt sett finns det etablerade normer i samhället som säger att en kommun endast ska bedriva traditionell kommunal verksamhet som innefattar att tillgodose välfärden (vård, skola & omsorg). Dock så har globaliseringen och urbaniseringen skapat en konkurrens om invånare vilket har lett till att kommuner idag bedriver en allt mer utvecklad marknadsföring för att attrahera fler invånare. Den här fallstudien innehåller två objekt (kommuner). Vi vill undersöka den kommunala marknadsföringen genom att fokusera på begreppen competitive identity (CI) och institutionell problematik (IP). Begreppet CI innehåller en teoretisk genomgång av komponenter i kommunal marknadsföring och IP beskriver kommunernas komplexa situation med olika institutionella krav. Genom att analysera dessa begrepp mot praktiska fall kan vi bidra till ökad förståelse om kommunal marknadsföring som är vårt syfte. Vi presenterar även en egen modell i samband med begreppet CI som ger en nyanserad bild av ämnet. Studiens resultat identifierar att kommunerna har speciella målgrupper som likt ett företag varierar beroende på deras ställning på marknaden. Genom skapandet av en CI deklarerar kommunen en önskvärd image där företeelser som inte bidrar till den blir exkluderade. Det gestaltar sig på olika sätt vilket analyseras grundligt i studien. Samtidigt illustreras motsägelsen när respondenterna i fallen säger att det är medborgarna som håller uppe imagen. Studien visar att det inte finns en enhetlig bild hur man som kommun ska hantera den institutionella komplexitet som uppstår. Fallen presenterar två olika synsätt som de finner mer lämpligt.

Patienters upplevelser av livskvalitet vid nydiagnostiserad typ 2 Diabetes Mellitus : En intervjustudie

Syfte: Att undersöka patienters upplevelser av livskvalitet vid nydiagnostiserad typ 2 Diabetes Mellitus. Metod: En empirisk studie med en kvalitativ ansats som innefattade tio deltagare med nydiagnostiserad typ 2 Diabetes Mellitus. Semistrukturerade intervjuer genomfördes utifrån en intervjuguide där insamlad data analyserades med kvalitativ manifest innehållsanalys. Resultat: Studien resulterade i fyra huvudkategorier och tio subkategorier. Upplevelsen av att få ett diagnosbesked varierade mellan deltagarna, för vissa deltagarna var beskedet inte förvånande medan andra upplevde känslor av chock och förnekelse. Deltagarna upplevde positiva förändringar, exempelvis viktnedgång och förbättrad hälsa men även negativa förändringar, exempelvis att vara beroende av läkemedel. Vissa upplevde ingen förändring alls. Typ 2 Diabetes Mellitus påverkade inte deltagarnas fysiska eller psykiska hälsa i de flesta fall. Deltagarna ansåg det som viktig att få stöd från både omgivningen och hälso- och sjukvården. Konklusion: Känslorna över ett diagnosbesked kunde variera men upplevelsen av livskvalitet påverkades inte av Typ 2 Diabetes Mellitus i de flesta fall i studien. Patientens inställning till att leva med Typ 2 Diabetes Mellitus inverkade på förmågan till att utföra egenvård, och distriktsköterskans stöd och engagemang ansågs vara betydelsefullt i sjukdomsprocessen.

Användning av information och kommunikationsteknologi för att främja egenvård på distans för patienter med diabetes typ 2 En litteraturöversikt

Bakgrund: Diabetes Mellitus är kronisk sjukdom som är kopplat till lidande och förlust av livskvalitet. Egenvård är avgörande för att minska de negativa konsekvenserna. Mindre än hälften av alla diabetespatienter uppnår god egenvård. Anledningen är bland annat begränsad kunskap om diabetes och bristande egenvårdsföljsamhet. Införandet av Informations- och kommunikationsteknologi i diabetesvården påbörjades för att förbättra det kliniska resultatet och livskvaliteten för patienter med diabetes typ 2. Syfte: Att beskriva hur information och kommunikationsteknologi kan främja egenvård på distans för patienter med diabetes mellitus typ 2. Metod: Litteraturstudie, där artiklarna söktes i CINAHL, PubMed och Web of Science. Artiklarna som inkluderades var 15 artiklar med kvantitativ, kvalitativ samt mixed metod. Resultat: Resultatet visade att Information och kommunikationsteknologi såsom internet, dator och mobiltelefonbaserade egenvårdsprogram främjade egenvård hos patienter med diabetes typ 2 genom ökad kunskap, ökad medvetenhet, ökad motivation samt förbättrad livsstilsförändring i kost och motion. Slutsats: IKT som hjälpmedel kan underlätta dagliga utmaningarna för patienter med diabetes typ 2 eftersom den täcker kunskapsluckan och därtill ökar patienternas medvetenhet och motivation till egenvård.

Patienters upplevelser av att leva med Amyotrofisk LateralSkleros, ALS

Syfte: Syftet med litteraturöversikten var att sammanställa aktuell forskning som beskriver hur det är att leva med Amyotrofisk Lateral Skleros (ALS). Metod: Vetenskapliga artiklar söktes i databaserna CINAHL och PubMed. Tolv artiklar med kvalitativ ansats valdes ut och kvalitetsgranskades enligt granskningsmall för kvalitativa studier. Huvudresultat: Resultatet visade att de som drabbades av ALS, en obotlig sjukdom, och deras närstående utsattes för stora psykologiska påfrestningar. Det fanns en rädsla och oro över att förlora kroppsfunktioner utan förvarning och detta medförde att patienter med ALS kände sig som fångar i den egna kroppen. Självförtroende och självkänsla rubbades negativt och bidrog till stunder av isolering, uppgivenhet och frustration. För att hantera sin livssituation använde sig patienter med ALS av olika strategier och livsstilsförändringar för att underlätta och möjliggöra ett oberoende i vardagen. Känslor av skuld och skam över familjens lidande i samband med sjukdomen ALS kunde bli en börda att bära för patienter med ALS och dessa känslor kunde generera till ett ökat kontrollbehov av omgivningen. Patienter med ALS hade kvar en känsla av hopp inför framtiden. Slutsats: Litteraturöversikten kan öka förståelsen hos sjuksköterskan och de närstående hur det är att leva med sjukdomen ALS och därmed skapa bättre individuella förutsättningar för god omvårdnad och god omsorg för patienter med ALS.

Sympatistress : En kvalitativ intervjustudie om socialarbetares upplevelser av sekundär traumatisk stress och utbrändhet

The purpose of the study is to investigate social workers experiences of compassion fatigue as well as their thoughts about health and risk factors in the area. The method used is a qualitative interview study in which eight social workers, investigating child welfare matters, were individually interviewed. The study shows that most of the social workers describe their own experiences of burnout but not of secondary traumatic stress. The most important support for not suffer from compassion fatigue is to be supported and the possibility to ventilate with colleagues and managers. However, the social workers consider that the risk of burnout is primarily due to a heavy workload in terms of the number of cases and high staff turnover. Finally, the study indicates that social workers do not have experience of secondary traumatic stress because they are using tools that prevent this. However, the risk of experiencing burnout is high since they have not found strategies for managing workplace stress.

Den moderna frälsaren : En komparativ analys av Harry Potter och Jesus

The books about Harry Potter have been read by people all over the world, but is there some-thing more to them than just the magical adventure novels they first appear to be? Many have discovered the multiple layers of understanding that the author J. K. Rowling has put in her famous books, and since I was curious about a few features in the story that reminded me of certain elements which can be found in the Bible, I decided to find out more. The following essay investigates which specific features in the books about Harry Potter that can be traced to which specific parts of the Bible. The main focus is the comparison between the character Harry Potter and Jesus Christ. I use a comparative analyzing method and secure my theory with quotes from both Harry Potter and the Bible. In the end, I found a wide range of similarities between the two characters, and in my discus-sion, I raised the question whether or not the likenesses were intentional by Rowling. I reached the conclusion that the authors intention is not as important as the reader’s interpreta-tion and what they can learn from it.

Effect of electroless nickel interlayer on the fatigue strength of chromium electroplated AISI 4340 steel

Deposition of wear-resistant hard chromium plating leads to a decrease in the fatigue strength of the base material. Despite the effective protection against wear and corrosion, fatigue life and environmental requirements result in pressure to identify alternatives or to improve conventional chromium electroplating mechanical characteristics. An interesting, environmentally safer and cleaner alternative for the replacement of hard chronic plating is tungsten carbide thermal spray coating, applied by high velocity oxyfuel (HVOF) process.To improve the fatigue strength of aeronautical steel chromium electroplated, shot peening is a successfully used method. Multiple lacer systems of coatings are considered to have larger resistance to crack propagation in comparison with simple layer.The aim of this study was to analyze the effect of nickel underplate on the fatigue strength of hard chromium plated AISI 4340 steel in two mechanical conditions: HRc 39 and HRc 52.Rotating bending fatigue tests results indicate that the clectroless nickel plating underlayer is responsible for the increase in fatigue strength of AISI 4340 steel chromium electroplated. This behavior may be attributed to the largest toughness/ductility and compressive residual stresses which, probably, arrested or delayed the inicrocrack propagation from the hard chromium external layer. The compressive residual stress field (CRSF) induced by the electroplating process was determined by X-ray diffraction method. The evolution of fatigue strength compressive residual stress field CRSF and crack sources are discussed and analyzed by SEM. (c) 2006 Elsevier Ltd. All rights reserved.

Systematic review of the effects of fatigue on spatiotemporal gait parameters

PURPOSE: This systematic review aimed to assess changes on spatiotemporal gait parameters due to fatigue. MATERIAL AND METHOD: A search was carried out in literature published from 1950 to December 2010 and retrieved 771 articles using terms referring to walking and fatigue in the title, abstract or keywords. Two researchers assessed the selection and quality of each article independently. RESULTS: Seven studies were selected for this systematic review, two of which reported on the same data set. Several spatiotemporal parameters were reported to change with fatigue, but the few variables studied in multiple studies, gait speed and stride or step length and stride time, were affected only in single studies. Fatigue appears to modulate spatiotemporal gait parameters, but the effects of fatigue appear to be dependent on the muscles that were fatigued, and age that appears to be a moderator of the effects of fatigue on gait. © 2013 - IOS Press and the authors. All rights reserved.

Corrosion-fatigue life of commercially pure titanium and Ti-6Al-4V alloys in different storage environments

Statement of problem. Removable partial dentures are affected by fatigue because of the cyclic mechanism of the masticatory system ansi frequent insertion and removal. Titanium and its alloys have been used in the manufacture of denture frameworks; however, preventive agents with fluorides are thought to attack titanium alloy surfaces.Purpose. This study evaluated, compared, analyzed the corrosion-fatigue life of commercially pure titanium and Ti-6Al-4V alloy in different storage environments.Material and methods. For each metal, 33 dumbbell rods, 2.3 mm in diameter at the central segment, were cast in the Rematitan system. Corrosion-fatigue strength test was carried out through a universal testing machine with a load 30% lon er than the 0.2% offset yield strength and a combined influence of different: environments: in air at room temperature, with synthetic saliva, and with fluoride synthetic saliva. After failure, the number of cycles were recorded, and fracture surfaces were examined with on SEM.Results. ANOVA and Tukey's multiple comparison rest indicated that Ti-6Al-4V alloy achieved 21,269 cycles (SD = 8,355) against 19,157 cycles (SD = 3,624) for the commercially purr Ti. There were no significant differences between either metal in the corrosion-fatigue life for dry specimens, but when the solutions were present, the fatigue life was significantly reduced, probably because of the product-ion of corrosion pits caused by superficial reactions.

Multiple Intravenous Administrations of Human Umbilical Cord Blood Cells Benefit in a Mouse Model of ALS

Background: A promising therapeutic strategy for amyotrophic lateral sclerosis (ALS) is the use of cell-based therapies that can protect motor neurons and thereby retard disease progression. We recently showed that a single large dose (25x10(6) cells) of mononuclear cells from human umbilical cord blood (MNC hUCB) administered intravenously to pre-symptomatic G93A SOD1 mice is optimal in delaying disease progression and increasing lifespan. However, this single high cell dose is impractical for clinical use. The aim of the present pre-clinical translation study was therefore to evaluate the effects of multiple low dose systemic injections of MNC hUCB cell into G93A SOD1 mice at different disease stages. Methodology/Principal Findings: Mice received weekly intravenous injections of MNC hUCB or media. Symptomatic mice received 10(6) or 2.5x10(6) cells from 13 weeks of age. A third, pre-symptomatic, group received 10(6) cells from 9 weeks of age. Control groups were media-injected G93A and mice carrying the normal hSOD1 gene. Motor function tests and various assays determined cell effects. Administered cell distribution, motor neuron counts, and glial cell densities were analyzed in mouse spinal cords. Results showed that mice receiving 10(6) cells pre-symptomatically or 2.5x10(6) cells symptomatically significantly delayed functional deterioration, increased lifespan and had higher motor neuron counts than media mice. Astrocytes and microglia were significantly reduced in all cell-treated groups. Conclusions/Significance: These results demonstrate that multiple injections of MNC hUCB cells, even beginning at the symptomatic disease stage, could benefit disease outcomes by protecting motor neurons from inflammatory effectors. This multiple cell infusion approach may promote future clinical studies.

Survival, Causes of Death, and Prognostic Factors in Systemic Sclerosis: Analysis of 947 Brazilian Patients

Objective. To analyze survival, prognostic factors, and causes of death in a large cohort of patients with systemic sclerosis (SSc). Methods. From 1991 to 2010, 947 patients with SSc were treated at 2 referral university centers in Brazil. Causes of death were considered SSc-related and non-SSc-related. Multiple logistic regression analysis was used to identify prognostic factors. Survival at 5 and 10 years was estimated using the Kaplan-Meier method. Results. One hundred sixty-eight patients died during the followup. Among the 110 deaths considered related to SSc, there was predominance of lung (48.1%) and heart (24.5%) involvement. Most of the 58 deaths not related to SSc were caused by infection, cardiovascular or cerebrovascular disease, and cancer. Male sex, modified Rodnan skin score (mRSS) > 20, osteoarticular involvement, lung involvement, and renal crisis were the main prognostic factors associated to death. Overall survival rate was 90% for 5 years and 84% for 10 years. Patients presented worse prognosis if they had diffuse SSc (85% vs 92% at 5 yrs, respectively, and 77% vs 87% at 10 yrs, compared to limited SSc), male sex (77% vs 90% at 5 yrs and 64% vs 86% at 10 yrs, compared to female sex), and mRSS > 20 (83% vs 90% at 5 yrs and 66% vs 86% at 10 yrs, compared to mRSS <20). Conclusion. Survival was worse in male patients with diffuse SSc, and lung and heart involvement represented the main causes of death in this South American series of patients with SSc. (First Release Aug 15 2012; J Rheumatol 2012;39:1971-8; doi:10.3899/jrheum.111582)

Motivationsutbildning som påverkansfaktor av livskvalitet – några elevers upplevelser

På en Folkhögskola finns en motivationsutbildning som vänder sig till tjejer som av olika orsaker har varit borta från studier och arbetsmarknad under lång tid. Syftet med denna undersökning var att undersöka huruvida motivationsutbildningen påverkade några elevers livskvalitet vad gäller upplevelsen av självbestämmande, förmågan att göra sina egna val och ett psykiskt välbefinnande. En kvalitativ metod användes. Jag har gjort en tolkande och reflexiv undersökning i form av en gruppintervju med nuvarande studiegrupp. Det genomfördes också fem telefonintervjuer med elever som avslutat utbildningen. Min tolkning av helheten av såväl telefonintervjuerna som gruppintervjun, var att utbildningen har haft en påverkan på både nuvarande och tidigare elevers upplevelse av självbestämmande, förmågan att göra sina egna val och förbättrat deras psykiska välbefinnande och att dessa personers livskvalitet har påverkats av utbildningen.

Excitability properties of mouse motor axons in the mutant SOD1(G93A) model of amyotrophic lateral sclerosis

Non-invasive excitability studies of motor axons in patients with amyotrophic lateral sclerosis (ALS) have revealed a changing pattern of abnormal membrane properties with disease progression, but the heterogeneity of the changes has made it difficult to relate them to pathophysiology. The SOD1(G93A) mouse model of ALS displays more synchronous motoneuron pathology. Multiple excitability measures of caudal and sciatic nerves in mutant and wild-type mice were compared before onset of signs and during disease progression (4-19 weeks), and they were related to changes in muscle fiber histochemistry. Excitability differences indicated a modest membrane depolarization in SOD1(G93A) axons at about the time of symptom onset (8 weeks), possibly due to deficient energy supply. Previously described excitability changes in ALS patients, suggesting altered sodium and potassium conductances, were not seen in the mice. This suggests that those changes relate to features of the human disease that are not well represented in the animal model.

The potential of a mindfulness-enhanced, integrative neuropsychotherapy program for treating fatigue following stroke: A preliminary Study

Fatigue is a frequently reported symptom after a stroke. Although the phenomenology of poststroke fatigue is well known, clear definitions as well as diagnostic and therapeutic guidelines are missing. Poststroke fatigue can be regarded as a multidimensional phenomenon that might be influenced by neurological, physical, psychological, and cognitive factors. It can range from mild to severe and can affect every area of the activities of daily life. The objective of our preliminary study was to outline aspects of a specific treatment program for the management of poststroke fatigue. Eight patients were recruited for a mindfulness-enhanced, integrative neuropsychotherapy program. The treatment was a combination of neuropsychological interventions, psychoeducation, cognitive-behavioral therapy, and mindfulness techniques. The main treatment foci were (a) to facilitate an increased awareness of fatigue symptoms, (b) to help the patient detect and manage triggers of fatigue, and (c) to equip the patient with multiple self-help tools. Measures were assessed at the beginning, during, and at the end of treatment using self-assessment questionnaire for mental fatigue and related symptoms after neurological disorders and injuries. Significant pre- to post-assessment differences were observed. These findings suggest that patients may benefit from a specific treatment program in order to better adapt to poststroke fatigue. These findings encourage further investigation of this integrative treatment in larger samples that include adequate control treatments.

Prevalence and predictors of fatigue in glioblastoma: a prospective study.

BACKGROUND The main goal of this study was to assess frequency, clinical correlates, and independent predictors of fatigue in a homogeneous cohort of well-defined glioblastoma patients at baseline prior to combined radio-chemotherapy. METHODS We prospectively included 65 glioblastoma patients at postsurgical baseline and assessed fatigue, sleepiness, mean bedtimes, mood disturbances, and clinical characteristics such as clinical performance status, presenting symptomatology, details on neurosurgical procedure, and tumor location and diameter as well as pharmacological treatment including antiepileptic drugs, antidepressants, and use of corticosteroids. Data on fatigue and sleepiness were measured with the Fatigue Severity Scale and the Epworth Sleepiness Scale, respectively, and compared with 130 age- and sex-matched healthy controls. RESULTS We observed a significant correlation between fatigue and sleepiness scores in both patients (r = 0.26; P = .04) and controls (r = 0.36; P < .001). Only fatigue appeared to be more common in glioblastoma patients than in healthy controls (48% vs 11%; P < .001) but not the frequency of sleepiness (22% vs 19%; P = .43). Female sex was associated with increased fatigue frequency among glioblastoma patients but not among control participants. Multiple linear regression analyses identified depression, left-sided tumor location, and female sex as strongest associates of baseline fatigue severity. CONCLUSIONS Our findings indicate that glioblastoma patients are frequently affected by fatigue at baseline, suggesting that factors other than those related to radio- or chemotherapy have significant impact, particularly depression and tumor localization.