This thesis is a case study of the Swedish Rehabilitation Reform of 1992. Vocational rehabilitation is described as an organizational activity which takes place in the interaction between social policy regulations and organizational execution. The analytical point of departure is made up of two complementary theoretical perspectives (Chapter 3): New institutional theory and the concept of 'negotiated order'. New institutional theory can aid inter-organizational analysis as it assumes that organizations are not only influenced, but also permeated by institutional and technical frameworks. The 'negotiated order' perspective can provide an understanding of actors' motives when they work together. This perspective also acknowledges that actors are able to exercise 'episodic power', and that this differs from 'formal power'. The first empirical study (Chapter 4) analyses the political motives behind the Rehabilitation Reform of 1992. It shows that at the time of the Rehabilitation Reform economical and political interests were pushing for a tighter regulations in Swedish social policy. The following three empirical studies focus on the 'organizational field' in which rehabilitation is practised. This field consists of the social insurance office, employment agencies, primary health care centres and occupational health service centres. Chapter 5 deals with the regulations and environmental factors influencing the various organizations and their representatives. It points to five external forces that influence the performance of the four type of actors. The social insurance office is influenced by a judicial social insurance logic, the employment agencies by a holistic labour market policy logic, and the physicians in primary health care centres and in occupational health centres by a 'holistic' medical frame of reference, which contrasts with that often found in other medical sub-specialities. Finally, employers are influenced first, by a logic of profit which has a technical and institutional dimension and second, by an institutional welfare state logic. Chapter six shows that the largest 'domain conflict' in the initial phase of the rehabilitation trajectory has to do with defining 'capacity to work'. Domain conflicts are seen as resulting from different institutional logics, implying different views on illness and capacity to work. Numerous and frequent personal interaction make it possible for physicians and rehabilitation officials to avoid conflict. The operative phase is associated with two major domain conflicts. The first is related to negotiations between the social insurance office and the employers about transferring employees to other duties. Both sides avoid exercising power that may damage clients and future trust. Episodic power resources are used to exercise the strategy of 'the golden middle path'. The other domain conflict is related to the judgement of work capacity. The labour market officials' view of work capacity differs from that of the officials at the social insurance office. Chapter seven compares cooperative rehabilitation projects with regular rehabilitation activity. The results show that actors in cooperative projects break the sequential work order used in regular rehabilitation activity and thereby projects quickly collect comprehensive information about individuals. Cooperative projects can also achieve flexible solutions tailored to an individual clients needs. Further, cooperative projects allow time for unconventional initiatives, which regular activity do not. The process of 'returning to work' poses a challenge both kinds of work organizations. Individuals who are disabled in some way are required to meet the same labour market demands as healthy and well educated are expected to meet. Finally, regular rehabilitation work tends uses standardize clients while cooperative projects tend to treat them as individuals. / digitalisering@umu

In the present thesis, three empirical studies investigate autobiographical odor memory with regard to: (a) whole life-span age distributions, (b) phenomenological experience, (c) semantic processing, and (d) odor imagery. Study I explored potential influences of cue type (words, pictures, odors) on the retrieval of autobiographical memories. The results indicated that odor-evoked events were older than memories evoked by words and pictures. The bump for olfactory evoked information peaked in the first decade of life (<10 years of age), whereas the bump of the word- and picture-evoked age distributions peaked in the second decade (i.e., 11-20 years of age). Also, olfactory evoked events were associated with stronger feelings of being brought back in time. Study II investigated the influence of verbal processing on the retrieval of autobiographical olfactory information. The results revealed that semantic knowledge (i.e., the odor name) affected both the age distribution and phenomenological experience. Also, olfactory memories were associated with a higher emotional arousal. Study III addressed the influences of olfactory imagery on the age distribution and phenomenological experiences. The results showed that events evoked by odor imagery were older than memories evoked by words. No differences in phenomenological experiences were found between the two cue conditions. Based on these findings, it is suggested that (a) memories evoked by olfactory information are older than memories evoked by verbal and visual information, (b) odor memories are more emotional and associated with stronger feelings of being brought back in time, (c) knowledge of an odor’s name produces a shift from a more perceptually to a more conceptually driven retrieval, and that (d) imagined odor cues mimic the age distribution of events evoked by real odors. Overall, the results suggest that memories triggered by the olfactory sensory system are different from memories evoked by verbal or visual information.

Avhandlingen handlar om prospektivt minne (PM) hos personer med utvecklingsstörning. PM syftar på att formulera intentioner och genomföra dessa någon gång i framtiden, antingen inom en definierad tidsram eller i samband med en specifik händelse. Frågeställningar: 1. Finns det en kvalitativ och kvantitativ skillnad mellan prospektivt minne hos personer med utvecklingsstörning och en kontrollgrupp? (Artikel I – II) 2. Hur ser sambandet mellan prospektivt minne, arbetsminne och episodiskt minne ut hos personer med utvecklingsstörning och, skiljer sig detta åt jämfört med kontrollgruppen? (Artikel II) 3. Vilka förutsättningar vid inkodning och hågkomst är kompatibla? (Artikel III) 4. På vilket sätt kan svag association mellan olika delar av information bidra till prospektiva minnesfel? (Artikel IV) 5. Går det att särskilja en hög- respektive lågpresterande grupp personer med utvecklingsstörning med avseende på prospektiv minnesprestation? (Artikel II) Personer med utvecklingsstörning begår fler prospektiva minnesfel än personer i kontrollgruppen. Motsvarande gruppskillnad finns inte för självskattat minne. Prospektiv minnesprestation är bättre med bilder jämfört med ord som prospektiva ledtrådar, mest tydligt för personer med utvecklingsstörning. Arbetsminneskapacitet visade ett samband med både prospektivt minne och antalet falska minnen i kognitivt krävande situationer, till exempel, situationer med flera parallella prospektiva minnesuppgifter. Falska minnen och prospektivt minne hade ett samband hos personer med utvecklingsstörning. Att felaktigt känna igen bilder med bara delvis bekanta delar och att känna igen prospektiva ledtrådar utan att komma ihåg själva intentionen hade ett samband hos personer med utvecklingsstörning. Personer med utvecklingsstörning var också sämre än kontrollgruppen på att upprepa tidsintervall. Detta kan till exempel bero på bristande episodiskt minne och begränsade strategier för att lösa den här typen av uppgifter. Resultaten diskuteras i relation till träning av prospektivt minne och val av hjälpmedel. / This thesis deals with prospective memory (PM) in individuals with intellectual disability. The term refers to planning and executing actions that cannot be performed immediately and have to be stored in memory and retrieved either within a specified timeframe or to be associated with a specific event. Following research questions were explored: 1. Does prospective memory performance in the intellectual disability group differ quantitatively and qualitatively compared to a control group of individuals without intellectual disability? (Paper I – II) 2. What are the relations between prospective memory, working memory and episodic memory in individuals with intellectual disability, and how are these relations different from the relations found in individuals without intellectual disability? (Paper II) 3. What conditions constitute compatibility between encoding and retrieval of prospective memory tasks? (Paper III) 4. In what way might weak binding contribute to PM failure? (Paper IV) 5. Is it possible to identify high and low PM-performing groups of individuals with intellectual disability? (Paper II) The results of the studies demonstrated that individuals with intellectual disability commit more PM errors than individuals in the control group, despite similarities in self-rated memory. Pictures as PM cues improved PM performance in comparison to words in both groups. This may be important primarily for recognition of the PM cue, particularly in the intellectual disability group. As to working memory capacity, it also shows a relation to both PM performance and binding performance in cognitively demanding situations (e.g., tasks with multiple parallel PM tasks). Furthermore, it was found that binding is related to PM performance in the intellectual disability group as there is a relationship between feature errors and recognition of cues, though not retrieving the correct intention. Finally, time reproduction was found to be weak in the intellectual disability group compared to the control group. This may be due to, for example, weak episodic memory and limited strategies for solving this type of task. These findings are discussed in relation to PM training and PM aids.

The general aim of the thesis was to investigate potential differences in memory performance between participants across the adult life span with and without self-reported musculoskeletal pain. Chronic musculoskeletal pain is a major health related problem in our society. A common complaint related to chronic pain is about cognitive difficulties in attention, memory, and decision making. A number of studies have demonstrated that people with pain also perform wors on tasks measuring, for example episodic memory, semantic memory, and working memory. The present thesis aimed at replying these findings, by using a non-clinical population based sample. the potential differences in memory performance between people with and without pain were examined across the adult life span, in order to disentangle potential pain by age interactions. This was made by using both cross-sectional and longitudinal data. Study I aimed at studying differences in episodic memory performance, semantic memory performance, and implicit memory performance, between people with and without musculoskeletal pain. Differences were found for all three memory systems, but disappeared after controlling for years of formal education. In Study II an extension of the first study was made, in which performance on a range of cognitive tests were analysed. General differences were demonstrated , but yet again, years of education together with depression ruled out the effects. The most robust effects were found for word comprehension and construction ability. Finally, Study III used 5- and 10 year follow up studies to examine change over time in cognitive performance as a function of pain. The main finding from this study was that semantic memory for the oldest is impaired over time as a function of pain. An additional analysis showed similar patterns, regardless of age, for construction ability.

Remembering previously experienced events can happen as a result of an effortful retrieval attempt. At other occasions, a memory can enter our minds without any apparent effort – or, indeed, intention - to retrieve. Although it has long been appreciated that retrieval from episodic memory is intertwined with cognitive control, the neural mechanisms of memory-control interactions remain unclear. In this thesis I have used functional magnetic resonance imaging (fMRI) and scalp-recorded event-related potentials (ERP) to study the neural basis of episodic retrieval at varying levels of cognitive control. The dorsolateral prefrontal cortex (dlPFC) has been suggested to support a cognitive control mechanism (context processing) which is relevant during various situations that demand maintenance of current goals and rules. Although increased dlPFC recruitment with increasing context processing demands has been demonstrated during episodic retrieval, there are relatively few studies directly comparing the engagement of dlPFC during episodic retrieval with that during other task domains. In Study I, context processing demands were amplified in episodic retrieval, auditory attention and emotion regulation tasks. This led to overlapping dlPFC recruitment in the first two domains and a divergent reliance on ventromedial prefrontal cortex in the emotion domain. Thus, when selection between competing representations needs to be carried out in accordance with the currently relevant goals and task rules, the episodic memory system interacts with domain-general cognitive control mechanisms. Studies II and III explored the reactive nature of retrieval-specific control mechanisms: can we flexibly switch between semantic and episodic retrieval based on the information extracted from a retrieval cue? This was studied using a recognition memory task where the relevant information could with equal probability be supplied by the semantic or the episodic memory system. The fMRI results (Study II) showed that the brain activation during the ‘episodic’ but not the ‘semantic’ trials was expressed in the right prefrontal cortex. As the order of trials was unpredictable, the corresponding changes in brain activation might be evoked by differences in early cue-trace interactions. An event-related potential study (Study III) with the same experimental protocol as in Study II showed that neural processing corresponding to the two trial types diverged as early as in the time window 100-140 ms post-cue onset, thus highlighting the importance of early cue-trace matching in the selection of further retrieval processing. Study IV explored incidental episodic retrieval. Although this form of retrieval is a common experience in everyday life and a disturbing symptom in some psychiatric conditions, it is not clear how such spontaneous expressions of memory are initiated and to what extent the prefrontal cortex is engaged. The fMRI results showed, consistent with Study I, that dlPFC is specifically associated with the intention to retrieve, independently of success. Retrieval success engaged similar networks for incidentally as well as intentionally retrieved memories, comprising the hippocampus, precuneus, ventrolateral PFC, and the anterior cingulate cortex. Collectively, the fMRI and ERP results indicated that incidental retrieval was initiated by early (< 200 ms) oldness estimation carried out on the semantic information extracted from the retrieval cues. Taken together, the results of this thesis indicate that episodic retrieval can be initiated via two routes:  a bottom-up input rising early during the cue processing, and a top-down input provided by the cognitive control processes mediated by the prefrontal cortex.

The aim of this doctoral thesis was to study neuropsychological function in relation to structural and functional brain changes in Alzheimer´s disease (AD). In the first study relations between hippocampal volume, neuropsychological function and limbic-hypothalamic-pituitary-adrenal (LHPA) axis disturbances in AD were investigated with magnetic resonance imaging (MRI). Reduced hippocampal CA1 volume and suppressed cortisol levels in combination, best predicted the variation in neuropsychological performance. The conclusion was that reduced hippocampal volume and LHPA axis disturbances are associated to level of cognitive function in AD. The second study focused on whether patients with early AD showed an altered regional cerebral blood flow (rCBF) pattern compared to control persons, correlation between performance on memory tests and rCBF in sub-lobar volumes of the brain were investigated. The rCBF was measured with single photon emission computed tomography (SPECT). AD-patients showed a significantly lower rCBF in temporoparietal regions including left hippocampus compared to controls. The diagnostic sensitivity and specificity for AD was high in temporoparietal regions. AD-patients had significantly lower performance on semantic and, in particular, episodic memory-tests compared to the controls, and their performance on several episodic tests correlated with rCBF in parietal and temporal regions including left hippocampus, which suggest that abnormalities in the rCBF pattern underlie impaired episodic memory functioning in AD. The conclusion was that an observer-independent analyzing method for SPECT with sub-lobar volumes VOI´s is promising in the diagnosis of AD. In a third study possible differences in memory-related functional brain activation between persons with high versus low risk for AD were examined with functional magnetic resonance imaging (fMRI). The high-risk individuals performed worse than low-risk individuals on tests of episodic memory. Patterns of brain activity during episodic encoding and retrieval showed significant group differences. During both encoding and retrieval, the low-risk persons showed increased activity relative to a baseline condition in prefrontal and hippocampal brain regions that previously have been implicated in episodic memory. By contrast, the high-risk persons did not significantly activate any prefrontal regions, but instead showed increased activity in visual occipito-temporal regions. The conclusion was that patterns of prefrontal brain activity related to episodic memory differed between persons with high versus low risk for AD, and lowered prefrontal activity may predict subsequent disease. In a final study SPECT was used to map patterns of rCBF in an activated state (an episodic encoding task) and in a rest condition in persons with mild AD and in healthy elderly control persons. A reduction of rCBF in temporoparietal regions that was more pronounced in mild AD in the activated encoding task was observed. The conclusion was that there are rCBF differences between mild AD patients and healthy controls in temporoparietal regions, and the temporoparietal reduction is more pronounced during activation than during rest which might be important in the early diagnosis of AD. Taken together, these findings show that level of neuropsychological function, notably episodic memory, can be systematically related to functional disturbances in the LHPA axis and to the function of temporoparietal and prefrontal brain regions in AD patients. These changes are detectable in patients with risk for AD and in an early phase of AD which suggests that the obtained results might be important for early diagnosis of AD.

The capacity to form olfactory images has received less attention than the formation of visual and auditory images. The evidence in favor of such ability is also inconsistent. This thesis explored some of the characteristics of olfactory imagery through three empirical studies. Study I investigated the effects of blocking spontaneous sniffing during olfactory imagery. The results indicated that the prevention of spontaneous sniffing reduced olfactory but not visual imagery capacity. Study II studied the relation between olfactory awareness (as indexed by olfactory dreams, olfactory imagery, and olfactory interest) and olfactory functions (i.e., odor threshold, episodic odor memory, and odor identification). The main findings were that compared to low, high olfactory awareness was associated with better episodic odor memory and identification, but not with higher olfactory sensitivity. Study III investigated the neural correlates of odor evoked autobiographical memories (OEAMs) as (a) a function of cue modality (i.e., odors and their verbal referents), and (b) a function of memory remoteness. The results from Study III showed that OEAMs activated regions generally associated with autobiographical memory. In addition, verbally cued OEAMs were associated with activity linked to olfactory imagery. Odor cues activated the limbic and temporal polar regions more than verbal cues; a result that may explain the phenomenological differences found between the cued memories. Moreover, OEAMs from the first decade of life were associated with higher activity in the secondary olfactory cortex, whereas memories from young adulthood were related to areas linked to semantic memory processing. Taken together these studies favor the notion of a human capacity to form olfactory images.

This thesis is primarily concerned with Caryl Churchill and Edward Bond&rsquo / s attempts to implement Brechtian methods of Verfremdungseffekt with the same artistic intent of social change in their plays, Mad Forest and Red, Black and Ignorant. In order to provoke critical and objective thinking, and action for positive change, both of the playwrights make use of Brechtian Verfremdungseffekt techniques of characterization, open-endedness, episodic structure, and audio-visual aids. These techniques let the playwrights present familiar situations, actions and attitudes as if they were unfamiliar so that they could be alienated and evaluated with a critical eye by the audience and the reader. In addition to studying the Brechtian elements in these two plays, this thesis argues that there is a point which drifts Bond&rsquo / s Red, Black and Ignorant from Brechtian dramaturgy and Churchill&rsquo / s Mad Forest / the point is that Red, Black and Ignorant includes non-Brechtian character design aspects and lack of Brechtian audio-visual aids.

Memory impairments are common in individuals with temporal lobe epilepsy (TLE). This is understandable given that temporal lobe brain structures involved in TLE play a central role in encoding memories. It is widely accepted that individuals whose seizure focus is in the left temporal lobe (LTLE) tend to have verbal memory impairments, whereas individuals whose seizure focus is in the right temporal lobe (RTLE) tend to have visuospatial memory impairments. However, evidence of functional subdivisions within the left and right temporal lobes in both the animal and human literature suggest that more specific subtypes of memory impairment may exist in TLE based on differences in seizure foci. The aim of this study was to identify more specific subtypes of memory-impairments in patients with intractable TLE using several measures of memory functioning and cluster analysis. Identification of more specific memory subtypes in TLE could have prognostic significance for patients and contribute to our knowledge about the organization of memory systems of the human brain. Four memory subtypes were identified in this sample: 1) patients with mild to moderate figural memory deficits; 2) patients with moderate to severe figural memory deficits, mild facial recognition deficits, and mild attention/concentration deficits; 3) patients with severe figural memory deficits and mild verbal episodic memory deficits; and 4) patients with no episodic or semantic memory deficits. Unexpectedly, the subtypes found did not exhibit the expected pattern of verbal memory impairments with left temporal lobe damage/dysfunction or visuospatial memory impairments with right temporal lobe damage/dysfunction. However, consistent with the literature, there was a trend towards some clusters with better verbal memory having higher left hippocampal volumes; and a trend towards one cluster with facial recognition deficits having lower anterior temporal lobe volumes. Small sample sizes in this study limited the ability to clearly validate many of the cluster differences, particularly differences in brain volumes. Nevertheless, the results of this study support the hypothesis that subtypes of memory impairment do exist in patients with TLE. With larger sample sizes, it is plausible that additional subtypes may be found, or the characteristics of the subtypes found may become clearer.

Several lines of evidence from rapid serial visual presentation, attentional blink, and dual-task interference phenomena propose that human beings have a significant limitation on the short-term consolidation process. Short-term consolidation is transferring early representations to more durable forms of memory. Although previous research has shown that masks presented after targets interrupt the consolidation process of information, there is not enough evidence for the role of attention in consolidation for episodic memory. One electrophysiological and five behavioral experiments were conducted to investigate the effects of attention and stimulus onset asynchrony (SOA) between targets and masks on episodic memory. Masks were presented after targets with varying SOAs. The participants in the divided attention condition but not the ones in the full attention condition performed the attention-demanding secondary task after the presentation of the masks. The results showed that reducing SOA between targets and masks caused an impairment in memory performance for divided attention but not for full attention, providing evidence for the necessity of attention for the short-term consolidation process. Electrophysiological results demonstrated that this impairment did not result from perceptual processes.