Background: Patients with Parkinson’s disease (PD) and Essential tremor (ET) who havebeen treated with Deep Brain Stimulation (DBS) generally experience a positive effect,particularly regarding the motor symptoms. However, the patients’ communication skillsare often negatively affected and the assessment instrument currently used withinneurological clinical care is not sufficiently sensitive to assess these patients’ speechclarity, voice and intelligibility satisfactorily.Aim: This study’s purpose was to develop a prototype assessment tool for speech clarity,intelligibility and voice, with speech and language pathology (SLP) validity, that isadaptable to a neurological clinical care setting.Method: The assessment tool was designed using general design methodology. Aprototype was constructed and tested on speech samples of read text for reliability. ThreeSLP’s, three DBS nurses and three naive listeners (NL) were represented in the test group.Levels of agreement were calculated using Percent Close Agreement, PCA.Results: The results indicate a relatively high level of agreement between the groups, inparticular the SLP group and the DBS group (μ: 0.82, 0.79, and 0.74).Conclusion: The results demonstrate the need for an assessment tool with SLPcompetence to assess speech clarity, intelligibility and voice within neurological clinicalcare. The assessment tool was shown to be a useful and adequate prototype that can easilyevolve into a truly useful and versatile perceptual speech assessment tool. The results ofthis study should be treated cautiously, considering the test groups’ modest size. / Bakgrund: Patienter med Parkinsons sjukdom (PD) och patienter med Essentiell tremor(ET) som behandlats med Deep Brain Stimulation (DBS) upplever i allmänhet en positiveffekt, framför allt gällande de motoriska symtomen. Emellertid påverkas oftapatienternas kommunikativa färdigheter negativt. De bedömingsmaterial som användsinom den kliniska nerurologiska vården; UPDRS/ETRS är alltför trubbiga för att kunna geen tillfredsställande bild av patientens tal, röst och förståelighet.Mål: Skapa ett bedömningsverktyg för tal, förståelighet och röst med logopedisk validitet,och som kan användas inom den kliniska neurologiska verksamheten i samband medDBS-behandling.Metod: Bedömningsverktyget designades enligt generell designmetodik. En prototypskapades och testades för reliabilitet på röstexempel av en läst text. Tre logopeder, treDBS-sköterskor och tre naiva lyssnare deltog i testningen. Grad av samstämmighetberäknades med Percent Close Agreement, PCA.Resultat: Resultaten indikerar en relativt hög grad av samstämmighet mellan grupperna(μ: 0.82, 0.79, respektive 0.74). Logopederna bedömde nästan alla röstexempel sompatienter i behov av logopedhjälp. DBS-gruppen och gruppen med naiva lyssnarebedömde ett mindre antal ha behov av logoped.Slutsats: Resultaten belyser behovet av ett bedömningsverktyg med logopedisk validitetför bedöming av tal, förståelighet och röst inom den kliniska neurologiska verksamheten.Bedömingsverktyget som framtagits i denna studie är en användbar och adekvat prototypsom enkelt skulle kunna utvecklas till ett verkligt användbart och mångsidigt perceptuelltbedömningsmaterial. Dock ska resultaten i denna studie tolkas en smula försiktigt medtanke på de låga antalet deltagare.

Bakgrund: Människor med funktionsnedsättning rapporterar i högre grad missnöje med omvårdnad och sjukvårdspersonalens förståelse för deras funktionsnedsättning. Många funktionsnedsättningar medför också kommunikationsnedsättningar vilket bidrar till svårigheter i vårdsammanhang. Då kommunikationen inte fungerar mellan patient och sjukvårdspersonal är det svårt att skapa en vårdrelation. Syfte: Syftet med uppsatsen är att beskriva erfarenheter av kommunikationen mellan sjukvårdspersonal och patienter med komplexa kommunikationsbehov [CCN]. Metod: Studien är en litteraturöversikt där vetenskapliga artiklar har granskats. Till resultatet har nio artiklar analyserats och teman har identifierats. Resultat: Fyra teman som är kopplade till svårigheter med att kommunicera med människor med CCN lyfts fram i resultatet. Dessa teman är; kunskapsbrist, tid, anhörigvårdare och vårdrelation. Diskussion: Resultatet diskuteras utifrån syftet med stöd i ytterligare studier. Resultatet kopplas också till Travelbees teori om stegen till en mellanmänsklig relation och hennes syn på kommunikation. / Background: People with disabilities report greater dissatisfaction with care and with the medical staff’s understanding of their disability. Many disabilities also brings communication impairments which contributes to difficulties in health care contexts. When communication fails between the patient and health care professional, it is difficult to create a healthcare relationship. Aim: The aim of this study was to describe the experiences of communication between health care personal and patients with complex communication needs [CCN]. Methods: The study is a literature review where scientific reports have been analyzed. In the result nine articles were analyzed and themes identified. Results: Four themes related to difficulties in communicating with people with CCN are highlighted in the result. These themes are: lack of knowledge, time, carers and care relationship. Discussions: The results are discussed from the purpose of the aim with support in further studies. The result is also linked to Travelbees theory of stages of an interpersonal relationship, and her view of communication.

Powered wheelchairs offer a means of independent mobility for older adults who are unable to walk and cannot propel a manual wheelchair. Unfortunately, cognitively impaired older adults may be denied this means of independent mobility. There is concern that these adults are unable to drive a powered wheelchair safely or properly. Intelligent wheelchairs offer an approach to address this problem. This research outlines the development and evaluation of an Intelligent Wheelchair System (IWS) that is proposed to make powered wheelchairs safer and easier to use for cognitively impaired older adults. The IWS has anti-collision and navigation functions. Hardware results show a 1000% increase in computational speed compared to the previous IWS. Clinical results with dementia patients show that the IWS has the potential to increase safety by reducing frontal collisions, and by promoting safe completion of movement tasks. Usability of the system may be an issue.

Title: “A comparative study of the impact of sustained and intermittent docetaxel chemotherapy in brain in a mouse model” Ji Zhang Master of Science Graduate Department of Pharmaceutical Sciences, University of Toronto November, 2011 Abstract A subset of patients suffers cognitive impairment during or long after chemotherapy. This may result from chemotherapeutic agents crossing the blood brain barrier (BBB). This thesis examined the effects of docetaxel (DTX) on brain toxicity, and the effects of different dosing schedules on brain DTX concentrations and neurotoxicity. Examination of DTX treated mice (total dose of 32mg/kg) revealed appreciable amounts of DTX crossed the BBB after either intermittent (four weekly doses) or sustained (one injection of DTX-PoLigel) administration despite differences in peak drug concentrations and overall exposure profiles. Measurements of autophagy and astrocytes activation not only provided evidence of DTX caused neurotoxicity in the central nervous system, but also revealed a link between dosing schedule and neurotoxicity. Furthermore, the discovery suggested connections between DTX brain exposure, diverse biological events (such as BBB permeability and reactive oxygen species activity), and the microenvironment at synapse-neuron junctions, which should be further explored.

Powered wheelchairs offer a means of independent mobility for older adults who are unable to walk and cannot propel a manual wheelchair. Unfortunately, cognitively impaired older adults may be denied this means of independent mobility. There is concern that these adults are unable to drive a powered wheelchair safely or properly. Intelligent wheelchairs offer an approach to address this problem. This research outlines the development and evaluation of an Intelligent Wheelchair System (IWS) that is proposed to make powered wheelchairs safer and easier to use for cognitively impaired older adults. The IWS has anti-collision and navigation functions. Hardware results show a 1000% increase in computational speed compared to the previous IWS. Clinical results with dementia patients show that the IWS has the potential to increase safety by reducing frontal collisions, and by promoting safe completion of movement tasks. Usability of the system may be an issue.

Title: “A comparative study of the impact of sustained and intermittent docetaxel chemotherapy in brain in a mouse model” Ji Zhang Master of Science Graduate Department of Pharmaceutical Sciences, University of Toronto November, 2011 Abstract A subset of patients suffers cognitive impairment during or long after chemotherapy. This may result from chemotherapeutic agents crossing the blood brain barrier (BBB). This thesis examined the effects of docetaxel (DTX) on brain toxicity, and the effects of different dosing schedules on brain DTX concentrations and neurotoxicity. Examination of DTX treated mice (total dose of 32mg/kg) revealed appreciable amounts of DTX crossed the BBB after either intermittent (four weekly doses) or sustained (one injection of DTX-PoLigel) administration despite differences in peak drug concentrations and overall exposure profiles. Measurements of autophagy and astrocytes activation not only provided evidence of DTX caused neurotoxicity in the central nervous system, but also revealed a link between dosing schedule and neurotoxicity. Furthermore, the discovery suggested connections between DTX brain exposure, diverse biological events (such as BBB permeability and reactive oxygen species activity), and the microenvironment at synapse-neuron junctions, which should be further explored.

Hormone replacement therapy (HRT) has been studied as a protective factor for cognitive decline and dementia. However, study findings have been inconsistent. Variation in study findings may be due to differences in study designs, small sample size, exposure ascertainment, diagnostic procedures, and inclusion of relevant risk and confounding factors. Moreover, there may be significant differences between the characteristics of women choosing to use HRT and those opting not to use the therapy. Using a large-scale, population-based, cohort study, we examined the relationship between HRT and cognition while paying particular attention to moderating and confounding factors. The main outcomes of interest were to assess differences in risk for cognitive impairments and dementia between HRT user and never user groups; examine HRTs impact on age of onset of dementia; and explore the relationship between duration of HRT and cognitive decline. Logistic regression and Cox Proportional Hazards models were used to test HRT as a predictor for cognitive impairments, Alzheimers disease and vascular dementia, as well as to assess the effect of duration. Linear regression was used to consider the putative relationship between age at onset of dementia and HRT status. HRT use was found to be a statistically significant predictor for Alzheimers disease and vascular dementia. Overall, HRT use did not significantly predict for milder cognitive impairments, although significant interaction effects indicate that HRT may be protective at least for specific sub-groups of women. No durational effect was found for any of the outcomes. Neither did HRT appear to predict for age at onset of dementia. Notably, a large proportion of women in the current study reported using estrogen-only hormone supplements, and therefore generalizations regarding the findings are likely limited to estrogen-only preparations, not combination estrogen-progestin therapies. These findings must be considered within the context of the other known and potential risks and benefits that HRT may afford.

Hormone replacement therapy (HRT) has been studied as a protective factor for cognitive decline and dementia. However, study findings have been inconsistent. Variation in study findings may be due to differences in study designs, small sample size, exposure ascertainment, diagnostic procedures, and inclusion of relevant risk and confounding factors. Moreover, there may be significant differences between the characteristics of women choosing to use HRT and those opting not to use the therapy. Using a large-scale, population-based, cohort study, we examined the relationship between HRT and cognition while paying particular attention to moderating and confounding factors. The main outcomes of interest were to assess differences in risk for cognitive impairments and dementia between HRT user and never user groups; examine HRTs impact on age of onset of dementia; and explore the relationship between duration of HRT and cognitive decline. Logistic regression and Cox Proportional Hazards models were used to test HRT as a predictor for cognitive impairments, Alzheimers disease and vascular dementia, as well as to assess the effect of duration. Linear regression was used to consider the putative relationship between age at onset of dementia and HRT status. HRT use was found to be a statistically significant predictor for Alzheimers disease and vascular dementia. Overall, HRT use did not significantly predict for milder cognitive impairments, although significant interaction effects indicate that HRT may be protective at least for specific sub-groups of women. No durational effect was found for any of the outcomes. Neither did HRT appear to predict for age at onset of dementia. Notably, a large proportion of women in the current study reported using estrogen-only hormone supplements, and therefore generalizations regarding the findings are likely limited to estrogen-only preparations, not combination estrogen-progestin therapies. These findings must be considered within the context of the other known and potential risks and benefits that HRT may afford.

7 % of children in preschool have some sort of language disorder. How should preschool teachers best help these children? In a small special group where they can focus on the child´s individual linguistic development or in an ordinary group were the other children can be linguistic models for the child and help his or hers development? The purpose of this paper is to see what preschool teachers, who work with children who has language impairment, says about working with these children in a special group as compared with working with them in an ordinary group together with children without language impairment. What are the advantages and the disadvantages related to the different ways of working? Another focus point is how the children collaborate with each other. I have used theories about integration and peer collaboration to understand the results. I have conducted interviews with two preschool teachers with experience in both working with solely language impaired children in a small group as well of work in a mixed group of children with and without language impairment. Furthermore, I have also observed how the children collaborate with each other. The result of the interviews and observations show that there is not an easy way to answer the question about which way is better. One conclusion I can make is that it requires more work from the teachers working in a mixed group. They have to be aware of the variation in the children´s needs and they have to work active with the children´s collaboration in order to prevent that language impaired children are excluded in play.

Syfte: Syftet med studien är att undersöka och förklara hur olika egenskaper hos ledarskapsfigurer (Verkställande direktör, ekonomichef) kan påverka goodwillnedskrivningar samt det redovisade värdet av goodwill. Metod: Studien tar en deduktiv ansats och grundas på en dokumentstudie, hypoteser har formats och analyserats samt därefter accepterats eller förkastats. Teoretiskt perspektiv: Studiens grundläggande teoretiska perspektiv är agentteorin samt den positiva redovisningsteorin. Andra teorier som belyses i studien är bland annat teorin om verkligt värde och beteende teorin inom bolag. Empiri: Studien är kvantitativ och består av data som insamlats från årsredovisningar av bolag noterade på Stockholmsbörsen. Slutsats: Datamaterialet kunde inte påvisa någon signifikans mellan nyckelpersonernas beteende och deras påverkan på goodwillnedskrivningar samt det redovisade värdet av goodwill. / Purpose: The purpose of this paper is to explain how different individual factors at an executive level (CEO, CFO) has an effect on goodwill impairments and the accounted value of goodwill. Methodology: The paper has an deductive approach and is based upon a document study at firms listed at Nasdaq OMX Stockholm. Theoretical perspective: The essential theoretical perspective is positive accounting theory and the agency theory. Other theoretical perspectives in this paper are fair-value theory and the behavioral theory of the firm. Empiric foundation: The empirical foundation in this paper is quantitative and is based on data collected from annual reports from the firms that are listed at the Nasdaq OMX Stockholm. Conclusions: The collected data couldn’t find any significance between the behavior of the key persons and goodwill impairment and the accounted value of goodwill.