Bakgrund och syfte: Personer som drabbas av en höftfraktur är en stor patientkategori, och till följd av en ökande andel äldre i befolkningen kommer den att bli ännu större. Majoriteten av dessa patienter kommer att åka in till sjukhus med ambulans. För att minska patientens lidande och uppkomst av komplikationer är det prehospitala omhändertagandet viktigt. Syftet med denna studie var att jämföra ambulanssjuksköterskans specifika omvårdnadsåtgärder vid vård av patient med höftfraktur före respektive efter införandet av en ny vårdkedja, ”Raka spåret”, och då framförallt se om givandet av smärtlindring förändrats. ”Raka spåret” innebär att ambulanspersonalen utför en del av de åtgärder som tidigare gjorts på akutmottagningen och transporterar patienten direkt till röntgen.   Metod: Metoden var en retrospektiv studie med komparativ design där två grupper med 15 patienter i varje grupp jämfördes mot varandra. Patienterna i båda grupperna hade haft en höftfraktur och förts in med ambulans mellan klockan 0800-2200. Den ena gruppen fördes in innan ”Raka spåret” fanns och den andra gruppen fördes in efter införandet. En anledning till ”Raka spåret” var att öka förståelsen hos ambulanspersonalen för att ett strukturerat omhändertagande, där särskilt smärtlindring och trycksårsprofylax betonades, har stor betydelse för patientens fortsatta vård.   Resultat: Resultatet visade att efter införandet av ”Raka spåret” utfördes fler prehospitala omvårdnadsåtgärder av ambulanssjuksköterskorna. Alla patienter i gruppen år 2010 fick perifer venkateter (PVK) och på 13 patienter togs EKG. Fler patienter fick smärtlindring efter införandet av ”Raka spåret”, innan fick 60 % smärtlindring mot 93 % efter ”Raka spåret. Att införa ”Raka spåret” antydde en förbättring i omhändertagandet av patienter med höftfraktur och det framkom med tydlighet att detta ledde till ett mer homogent omhändertagande.  Det visade också, att när det fanns riktlinjer för att patienten ska smärtlindras, skedde smärtlindring i större utsträckning. Detta var en pilotstudie utan möjlighet till generaliseringar av resultatet, för att kunna göra detta krävs ett större antal patienter. / Background and purpose:People who suffer from a hip fracture are a large category of patients, and as a result of an increasing proportion of older people, it will be even greater. The majority of these patients will go to the hospital by ambulance. To reduce the suffering of the patient and the occurrence of complications the prehospital care is important. The purpose of this study was to compare the specific prehospital nursing interventions for patients with hip fracture before and after the introduction of a new chain of care, "Straight track". Especially to see if the initiation of pain management has changed. "Straight track" means that ambulance nurses carry out some of the measures that earlier was done in the emergency room and transporting the patient directly to radiology.   Method:The method was a retrospective study of comparative design in which two groups with 15 patients in each group were compared against each other. Patients in both groups had a hip fracture and went in by ambulance between 08 am to 10 pm. One group was transported before the "Straight track" began and the second group was transported after the introduction. One purpose of the direct route was to increase understanding, of the ambulance nurses, that a structured treatment, especially with relief of pain and pressure ulcer prophylaxis, has great significance for the patients continued care.   Result: The results showed that after the introduction of the "Straight track" there was more pre-hospital care measures carried out by emergency nurses. All patients in the group from 2010 had peripheral venous catheter and 13 patients undergoing an ECG. More patients got pain relief after the introduction of the "Straight track". Before there were 60% that got pain relief and after there were 93% that got pain relief.Introducing “Straight track” suggested an improvement in the care of patients with hip fracture and it showed with clarity that this led to a more homogeneous treatment. It also showed that when there were guidelines for the patient to get pain relieve then it was given to a greater extent. This was a pilot study without possibility to draw any general conclusions, this requires a larger number of patients.

The microstructure-property relationship for interpenetrating phase composites (IPCs) is currently poorly understood. In an attempt to improve this understanding this study focused on one particular part of this relationship: the effect of phase shape on the elastic and plastic behaviour. A review of previous research showed that investigations had linked phase shape to the elastic and plastic behaviour of various inclusion reinforced composites, but that no similar work had been completed for IPCs. <p> To study the complex response of the IPC microstructure under load, a numerical modelling analysis using the finite element method (FEM) was undertaken. Two three-dimensional models of IPCs were created, the first consisting of an interconnected spherical phase with the interstitial space forming the other interconnected phase, and the second replacing the spherical phase with an interconnected cylindrical phase. With the simulation of a uniaxial tension test under elastic and plastic conditions, these two models exhibited different responses based on the shape of the phases. <p> Results from an analysis of the macroscopic behaviour identified that the cylindrical model produced greater effective properties than the spherical model at the same volume fraction. The influence of phase shape was connected to the increased contiguity of the superior phase within the IPC for the cylindrical model, which allowed similar levels of long-range continuity with smaller amounts of the superior phase (compared to the spherical model). <p> An examination of microstructural stress distributions showed that preferential stress transfer occurred along paths of low compliance. This provided an explanation of how the improved contiguity of the stiffer (or stronger) phase could enhance the macroscopic effective properties of an IPC. Contiguity of the stronger phase was particularly important for plastic behaviour, where early yielding of the weaker phase requires the stronger phase to carry nearly all the load within itself.

Pope Benedict XVI, since his election to the papacy, has urged Catholic clergy and theologians to interpret the documents of the second Vatican Council using a "hermeneutic of continuity." This thesis seeks to answer whether such a hermeneutic is possible by focusing on one aspect of the Dogmatic Constitution on the Church, Lumen Gentium. The methodology here employed is a critical analysis of one of the major patristic sources of Lumen Gentiums teaching, St. Augustine of Hippo. In claiming St. Augustines support for its doctrine, Lumen Gentium also offers an interpretation of his thought. For Lumen Gentiums teaching to be plausible, we must be able to conclude that Augustines teaching is essentially identical to it. In that connection, Lumen Gentiums claim that the Church is both a spiritual and visible reality forces us to consider a controverted topic in Augustinian studies: can Augustines city of God be identified with the hierarchical Church? In order to resolve that question, we will examine both the historical and eschatological aspects of the Church in Augustines thought, with some reference (treated in an appendix) to the compatibility between his theory of predestination and his ecclesiology. Further, what the Council meant when it said that the Church of Christ subsists in the Catholic Church, and whether this change in terminology, along with its implications in the field of ecumenism, can be reconciled with St. Augustines ecclesiology must be determined with a view to establishing the continuity between pre and post conciliar Catholic ecclesiology. St. Augustine developed his understanding of the nature of the Church in the early years of his ecclesiastical career through his polemical battles with the Donatist schismatics, and so the history of that schism is related in an appendix.

The intent with this paper is to investigate the medieval habitation in central Old Uppsala. This time-period has over the years been neglected. Therefore I wish to summarize and ana-lyze the medieval habitation to see what can be said about its continuity, and also to investi-gate why it is located in certain areas. Due to the amount of source material I have limited my investigation area to the central Old Uppsala. It is possible that this limitation will affect the result of the research but without the limitations the investigation area would have been too large to handle. The source material has been collected from excavation reports and the summarized. My theory is material culture and material agency. It is the material culture that I analyze. The result of the investigation is that it is possible to see a continuity of the habitation in the area but that it’s hard to get an exact date on many of the structures. One of the reasons for this is because of how the medieval time period have been handled by archaeologist. As to where in the landscape the buildings have been placed there seem to be some places that have been avoided and others that have a long continuity of buildings over time. / Gamla Uppsala - framväxten av ett mytiskt centrum

This paper discusses an osteological- and archeological analysis of a cairn from the Bronze Age on Gotland. The osteological material consists of both burnt and and unburnt bones from both human and animal. The objective of this paper is to shed light on the individuals who were buried in the cairn. It is also to generate information about continuity in its use and patterns of distribution of the bones and grave-goods in the cairn. The osteological analysis show that a minimum of five human individuals is present in the osteological material. The result also indicate that a wide range of agegroups are represented in the human bonematerial, ranging between; Infans 2 (5-14 years), Adultus (18-44 years) and Adultus/Maturus (18-64 years). The osteological analysis also show a presence of horse, pig, sheep/goat, dog and rabbit in the cairn. Due to high fragmentation and erosion no gender assessment based on the human bonematerial was made. Grave findings connected to the cairn include among other things a razor in bronze,  a pin in bronze with a spiralshaped head, a tweezer- and a miniaturesword in bronze, ceramics, coal and flint. Some of the bronze findings indicate that one of the buried individuals in the grave is of male gender. The possible meaning and role of the grave-goods in connection to the cairn and the buried individuals is discussed further in the paper. The continuity of the cairn and its roll and meaning in the society is also discussed in this thesis.

A b-coloring of G is a proper vertex coloring such that there is a vertex in each color class, which is adjacent to at least one vertex in every other color class. Such a vertex is called a color-dominating vertex. The b-chromatic number of G is the largest k such that there is a b-coloring of G by k colors. Moreover, if for every integer k, between chromatic number and b-chromatic number, there exists a b-coloring of G by k colors, then G is b-continuous. Determining the b-chromatic number of a graph G and the decision whether the given graph G is b-continuous or not is NP-hard. Therefore, it is interesting to find new results on b-colorings and b-continuity for special graphs. In this thesis, for several graph classes some exact values as well as bounds of the b-chromatic number were ascertained. Among all we considered graphs whose independence number, clique number, or minimum degree is close to its order as well as bipartite graphs. The investigation of bipartite graphs was based on considering of the so-called bicomplement which is used to determine the b-chromatic number of special bipartite graphs, in particular those whose bicomplement has a simple structure. Then we studied some graphs whose b-chromatic number is close to its t-degree. At last, the b-continuity of some graphs is studied, for example, for graphs whose b-chromatic number was already established in this thesis. In particular, we could prove that Halin graphs are b-continuous.

We provide contributions to two classical areas of queueing. The first part of this thesis focuses on finding new conditions for a Markov chain on a general state space to be Harris recurrent, positive Harris recurrent or geometrically ergodic. Most of our results show that establishing each property listed above is equivalent to finding a good enough feasible solution to a particular optimal stopping problem, and they provide a more complete understanding of the role Foster's criterion plays in the theory of Markov chains. The second and third parts of the thesis involve analyzing queues from a transient, or time-dependent perspective. In part two, we are interested in looking at a queueing system from the perspective of a customer that arrives at a fixed time t. Doing this requires us to use tools from Palm theory. From an intuitive standpoint, Palm probabilities provide us with a way of computing probabilities of events, while conditioning on sets of measure zero. Many studies exist in the literature that deal with Palm probabilities for stationary systems, but very few treat the non-stationary case. As an application of our main results, we show that many classical results from queueing (in particular ASTA and Little's law) can be generalized to a time-dependent setting. In part three, we establish a continuity result for what we refer to as jump processes. From a queueing perspective, we basically show that if the primitives and the initial conditions of a sequence of queueing processes converge weakly, then the corresponding queue-length processes converge weakly as well in some sense. Here the notion of convergence used depends on properties of the limiting process, therefore our results generalize classical continuity results that exist in the literature. The way our results can be used to approximate queueing systems is analogous to the way phase-type random variables can be used to approximate other types of random variables.

We will study the solution stability of a parametric quasi-variational inequality without the monotonicity assumption of operators. By using the degree theory and the natural map we show that under certain conditions, the solution map of the problem is lower semi-continuous with respect to parameters.

Advance directives are instructions given by patients – or potential patients – specifying what actions ought to be taken for their health in the event that they are no longer capable to make decisions due to illness or incapacity. Over the last decades, there has been a rising tide in favour of advance directives: not only is the use of such directives recommended by most medical and advisory bodies, they are also gaining increasing legal recognition in many parts of the world. This book, however, takes as its point of departure one of the most commonly discussed medical-ethical arguments against granting advance directives moral force: the Objection from Personal Identity. The adherers of this objection basically asserts that when there is lacking psychological continuity between the person who formulated the advance directive and the later patient to whom it supposedly applies, this seriously threatens the directive’s moral authority. And, further, that this is so because lacking sufficient psychological continuity implies that the author of the advance directive is numerically distinct from the later patient. Although this argument has some initial appeal, most philosophers in the advance directives debate maintain that the Objection from Personal Identity fails, but suggest different reasons as to why. Whereas some argue that the objection has no force because it rests on faulty beliefs about personal identity, others argue that we ought to grant advance directives moral authority even if the author and the later patient are numerically distinct beings. This book investigates some of the most influential of these arguments and reaches the conclusion that the Objection from Personal Identity has more to it than is usually recognized in the medical-ethical debate. Lacking sufficient psychological continuity between author and later patient, it is concluded, does threaten the moral authority of the advance directive.

This thesis presents results of research aimed at developing an improved understanding of the behavior of column panel zones reinforced with doubler plates in seismic resistant steel moment frames. A primary goal of the research was to develop data to support the development of improved design guidelines for welding doubler plates to columns, with and without the presence of continuity plates. The research addressed several issues and questions related to welding and detailing of doubler plates. This included evaluation of the effects of welding the top and bottom of the doubler plate in addition to the vertical edges, the effects of extending the doubler plate beyond the panel zone, and the impact of welding a continuity plate to a doubler plate. These issues were investigated through detailed finite element models of a simplified representation of the panel zone region, subjected to monotonic loading. The results of the research suggest that, in general, there is little benefit in welding the top and bottom edges of a doubler plate if the vertical edges are welded, particularly in terms of overall panel zone strength and stiffness. However, the top and bottom welds provide some benefit in reducing stresses on the vertical welds. The results also suggest that extending the doubler plate above and below the panel zone has little benefit for heavy columns of shallow depth, such as the W14x398 considered in this analysis. However, extending the doubler plate did result in approximately a 10-percent increase in panel zone strength for deeper columns, such as the W40x264 considered in this analysis. Finally, the results showed that welding a continuity plate directly to a doubler plate had no adverse effects on the doubler plate in terms of increased forces or stresses. Interestingly, welding the continuity plate to the doubler plate simply changed the load path for transfer of load from the beam flange to the column web and doubler plate, but did not change the stresses in the doubler plate. Further research is needed to validate these findings for more accurate representations of the panel zone region of the column and for cyclic loading. / text