En typ av beskattningsregler som finns i de flesta av EU:s medlemsstater är Controlled Foreign Corporation(CFC)-lagstiftning. CFC-lagstiftningen reglerar beskattning av delägare i utländska juridiska personer med lågbeskattade inkomster. Den svenska CFC-lagstiftning är bl.a. till för att motverka och hindra internationell skatteflykt. Det kan t.ex. handla om svenska företag som äger företag med säte i s.k. skatteparadis eller lågskatteländer. CFC-lagstiftning har länge kritiserats för att strida mot dels etableringsfriheten, dels fri rörlighet för kapital. Redan under arbetet med den nya svenska CFC-lagstiftningen som trädde i kraft 1 januari 2004 ifrågasattes reglernas kompatibilitet med EG-rätten. I september 2006 avgjorde EG-domstolen ett mål, det s.k. Cadbury Schweppes-målet, rörande den brittiska CFC-lagstiftningens kompatibilitet med gemenskaprätten. Detta avgörande kan antas komma att ha stor betydelse i framtiden, inte bara för Storbritannien, utan även för övriga EU-medlemsländer. I uppsatsen analyseras hur den svenska CFC-lagstiftningen kan anpassas efter EG-rätten. Vidare utreds och identifieras de problemområden som finns i dagens uppbyggnad av CFC-lagstiftningen samt analyseras betydelsen och konsekvenserna av Cadbury Schweppes-fallet gällande CFC-lagstiftning som EG-domstolen har avgjort.

Understanding of plasma confinement modes is an essential component in development of a fusion reactor. Plasma confinement directly relates to performance of a fusion reactor in terms of energy replacement time requirements on other design parameters. Although a variety of levels of confinement have been achieved under different operating conditions in tokamaks, tokamak confinement is generally identified as being either Low (L-mode--poor confinement) or High (H-mode--good confinement) In operation of a tokamak experiment, the plasma confinement condition generally changes from L-mode to H-mode over a few hundred milliseconds, sometimes quite sharply. Such a difference in transition period seems to be largely due to operating conditions of the plasma. Comparison of experimental data exhibits various distinctions between confinement modes. One noteworthy distinction between confinement modes is development of steep density and temperature gradients of electrons and ions in the plasma edge region of High confinement, H-modes, relative to Low-confinement, L-modes. The fundamental reason for the change for L-mode to H-mode is not understood. Previous studies have suggested i) the development of reduced diffusive transport coefficients that require a steepening of the gradients in a localized region in the edge plasma, the "transport barrier" in H-mode confinement ii) the radial force balance between pressure gradient forces and electromagnetic (radial electric field and VxB) forces require radial particle fluxes to satisfy a pinch-diffusion relation. A recent study suggests that the major difference between L-mode and H-mode are associated with the electromagnetic forces in the "pinch velocity" and the pressure gradient, not in the diffusion coefficients that multiplies the pressure gradient. The research will examine in detail the time evolution of the radial force balance and the particle and energy transport during the L-H transition. For the analysis, DIII-D shot #118897 is selected for transition between L- and H-mode confinements. Plasma conditions in L-mode, near the L-H transition and following the transition are selected for analysis of various parameter profiles. The initial analysis will be based on the four principal equations for plasma: particle balance, momentum balance, force balance and heat conduction. Based on these equations, specific equations have been derived: toroidal and radial momentum balances, diffusion coefficient, pinch velocity and heat conduction relation for calculation of parameters. The analysis of these equations, using the measured data, will establish how various terms in the radial force balance (radial electric field, VXB (electromagnetic) force, and pressure gradient) and the diffusive transport coefficients evolve over the confinement mode transition.

Gegenstand der Dissertationsschrift ist die Untersuchung des Effektes einer Hemmung der Leukotrienbiosynthese auf die Entwicklung des Schädel-Hirn-Traumas (SHT) nach experimenteller fokaler Kontusionsverletzung im Rattenmodell. Die Ergebnisse der Arbeit wurden im Jahre 2011 in einer Publikation veröffentlicht. Das SHT ist eine schwerwiegende globale Erkrankung mit hoher Inzidenz und Mortalität. Diese führt zu hohen Kosten für das Gesundheitssystem, zum einen durch die akute Behandlung im Krankenhaus, zum anderen durch die sich daran anschließenden rehabilitativen Maßnahmen. Nach der primär biomechanischen Verletzung des Hirns, die nicht beeinflussbar ist, bietet die anschließende sekundäre Hirnschädigung aufgrund verschiedener Stoffwechselprozesse Angriffspunkte für eine (medikamentöse) Therapie des SHT. Die sekundären Hirnschäden werden maßgeblich durch die Entwicklung eines perikontusionellen Hirnödems und dem daraus resultierenden Anstieg des intrakraniellen Druckes beeinflusst. Wie in vorangegangenen Untersuchungen gezeigt werden konnte, kam es nach experimentellem SHT zu einem signifikanten Anstieg der Leukotrienwerte im Liquor von Ratten. Dies warf die Frage nach der Rolle der Leukotriene (LT) im posttraumatischen Hirnstoffwechsel bezüglich der Ödementwicklung auf. Ziel dieser Arbeit war der Nachweis einer direkten Beteiligung von Leukotrienen an der sekundären Hirnschädigung und das Aufzeigen eines möglichen therapeutischen Zuganges durch Substitution von Leukotrienbiosynthesehemmern. Dafür wurde bei adulten Ratten ein fokales SHT induziert. Anschließend wurden in zwei Therapiegruppen zwei unterschiedlich wirkende Leukotrieninhibitoren mehrmalig oral verabreicht und die Ausprägung des SHTs nach 24 bzw. 72 Stunden mittels Magnetresonanztomographie (MRT) und immunhistochemischen Aufarbeitung der Hirne mit einer nicht therapierten Kontrollgruppe verglichen. Bei einem dieser LT-Inhibitoren handelte es sich um ein Weihrauchpräparat, das als Nahrungsergänzungsmittel bereits zu erhalten ist und somit auch potentiell am Menschen zur Anwendung kommen kann. Die Ergebnisse waren vielversprechend und zeigten in beiden Therapiegruppen ein verringertes Kontusionsvolumen im MRT und immunhistochemisch einen geringeren Verlust von Neuronen im perikontusionellen Bereich. Somit scheinen Leukotriene einen Anteil an den sekundären Schädigungsprozessen nach SHT zu tragen. Weitere Untersuchungen, vor allem bezüglich eines eventuell verbesserten klinischen Outcome durch Leukotrienbiosynthesehemmung, erscheinen sinnvoll um den potentiellen Einsatz von LT-Synthesehemmstoffen in der Therapie des SHT in Erwägung ziehen zu können.

This thesis presents empirical research in the field of software development with a focus on handling semantic aspects. There is a general lack of empirical data in the field of software development. This makes it difficult for industry to choose an appropriate method for their particular needs. The lack of empirical data also makes it difficult to convey academic results to the industrial world. This thesis tries to remedy this problem by presenting a number of empirical evaluations that have been conducted to evaluate some common approaches in the field of semantics handling. The evaluations have produced some interesting results, but their main contribution is the addition to the body of knowledge on how to perform empirical evaluations in software development. The evaluations presented in this thesis include a between-groups controlled experiment, industrial case studies and a full factorial design controlled experiment. The factorial design seems like the most promising approach to use when the number of factors that need to be controlled is high and the number of available test subjects is low. A factorial design has the power to evaluate more than one factor at a time and hence to gauge the effects from different factors on the output. Another contribution of the thesis is the development of a method for handling semantic aspects in an industrial setting. A background investigation performed concludes that there seems to be a gap between what academia proposes and how industry handles semantics in the development process. The proposed method aims at bridging this gap. It is based on academic results but has reduced formalism to better suit industrial needs. The method is applicable in an industrial setting without interfering too much with the normal way of working, yet providing important benefits. This method is evaluated in the empirical studies along with other methods for handling semantics. In the area of semantic handling, further contributions of the thesis include a taxonomy for semantic handling methods as well as an improved understanding of the relation between semantic errors and the concept of contracts as a means of avoiding and handling these errors.

Hypertension occurs in nearly 10% of pregnancies, and is associated with infant and maternal morbidity and mortality. Prior studies of non-pregnant adults have demonstrated the effectiveness of a variety of relaxation therapies in reducing blood pressure. A pilot randomized controlled trial was conducted, the purposes of which were 1) to provide preliminary evidence regarding the usefulness of guided imagery (GI) in reducing blood pressure in hypertensive pregnant women, and 2) to answer feasibility questions for a larger trial. Pregnant women with hypertension prior to 37 weeks gestation (n = 69) were randomized to either 15-minute periods of guided imagery (n = 34), or of quiet rest (QR) (n = 35), twice daily for four weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure (MAP), systolic and diastolic blood pressures, anxiety, rest and GI use were measured weekly, to a maximum of four weeks. Sixty women completed at least one week in the study; 46.4% completed four weeks. Compliance was excellent. Intention to treat analysis was used. In the unadjusted analysis, women allocated to GI had significantly lower average daytime ambulatory mean MAP elevations from baseline to their last week of study participation than women allocated to quiet rest (GI: M = 1.58 mmHg, SD = 7.63; QR: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = .02). However, the effect was no longer statistically significant (p = 0.14) when adjusted for baseline mean arterial pressure and gestation. There was no statistically significant difference in the numbers of women who were prescribed antihypertensive medication after randomization (GI: n = 16, QR: n = 13, X2 = 0.74, p = .46). There was also no evidence of an effect of guided imagery on anxiety. Nearly 90% (n = 26) of the guided imagery group indicated they would use it again, either in a subsequent pregnancy or during stressful life events. Given the ease of use, low cost, acceptability to women, and lack of risk of guided imagery, an adequately-powered randomized controlled trial is warranted.

The main purposes of this thesis were to evaluate a high-intensity functional weight-bearing exercise pro­gramme, regarding its applicability (attendance, achieved intensity, adverse events) as well as its effect on physical functions and activities of daily living (ADL) among older people living in residential care facilities, with a special focus on people with dementia. Furthermore, a main purpose was to systematically review the applicability and effects of physical exercise on physical functions, cognitive functions, and ADL among people with dementia. A high-intensity functional weight-bearing exercise programme that includes lower-limb strength and balance exercises in standing and walking, was evaluated in a randomised controlled trial among 191 older people, dependent in ADL, living in residential care facilities, and with a Mini-Mental State Examination (MMSE) score of ten or more. One hundred (52.4%) of the participants had dementia. Participants were randomised to an exercise programme or a control activity, consisting of 29 supervised sessions over 3 months, as well as to an intake of a protein-enriched energy supplement or a placebo drink immediately after each session. The effect on physical functions was evaluated using the Berg Balance Scale, usual and maximum gait speed, and one-repetition maximum in a leg press machine measuring lower-limb strength. The effect on ADL was evaluated using the Barthel Index. These outcome measures were followed up at 3 and 6 months by blinded assessors and analysed using the intention-to-treat principle. The evaluation of the applicability of the high-intensity functional weight-bearing exercise programme showed that there was a high rate of attendance, a relatively high achieved intensity in the exercises, and all except two adverse events were assessed as minor or temporary and none led to manifest injury or disease. No statistically significant differences were observed in applicability when comparing participants with dementia and participants without dementia. In addition, the applicability of the programme was not associated with the participants’ cognitive function. Significant long-term effects of the exercise programme were seen regarding functional balance, gait ability and lower-limb strength in comparison with the control activity. The intake of the protein-enriched energy supplement did not increase the effect of the training. Age, sex, depression, dementia disorder, nutritional status, and level of functional balance capacity did not influence the effect on functional balance of the high-intensity functional weight-bearing exercise programme. There were no significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a significantly smaller proportion of participants in the exercise group had deteriorated regarding indoor mobility at 3 and 6 months. For people with dementia, there was a significant difference in overall ADL performance in favour of the exercise group at 3 months, but not at 6 months. In a systematic review, randomised controlled trials, evaluating the effects of physical exercise among people with dementia, were identified according to pre-defined inclusion criteria. Two reviewers independently extracted predetermined data and assessed methodological quality. Ten studies were included in the review and the majority of the participants were older people with Alzheimer’s disease living in residential care facilities. Four studies reached “moderate” methodological quality and six “low”. The results showed that among older people with Alzheimer’s disease in residential care facilities, combined functional weight-bearing exercise over 12 months at an intended moderate intensity seems applicable for use regarding attendance and adverse events and there is some evidence that the exercise improves walking performance and reduces ADL decline. Furthermore, there is some evidence that walking exercise over 16 weeks performed individually, where the participant walks as far as possible during the session, reduces decline in walking performance, but adverse events need to be evaluated. In conclusion, among older people who are dependent in ADL, living in residential care facilities, and have an MMSE score of 10 or more, a high-intensity functional weight-bearing exercise programme is applicable for use and has positive long-term effects on functional balance, gait ability, and lower-limb strength and seems to reduce ADL decline related to indoor mobility. An intake of a protein-enriched energy supplement immediately after the exercise does not appear to increase the effect of the training. In people with dementia, the exercise programme may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect. The positive results regarding applicability and effects of combined functional weight-bearing exercise among people with dementia is confirmed when the scientific literature is systematically reviewed. It seems to be important that exercise interventions among people with dementia last for at least a few months and that the exercises are task-specific and intended to challenge the individual’s physical capacity. Whether physical exercise can improve cognitive functions among people with dementia remains unclear. There is a need for more exercise studies of high methodological quality among people with dementia disorders.

Aims: To introduce the concepts “quality assurance”, “rational drug prescribing” and “outreach visits” in general practice in Storstrøm County, Denmark and study the effect of unsolicited mailed feedback and outreach visits on drug prescribing. Methods: The first step was to generate standardised charts displaying the county variations of drug volume prescribing within 13 major drug groups at the second ATC-level. The charts were mailed unsolicited to the 94 general practices in the county. Each practice could identify its position within the county prescribing variation. This procedure was repeated every six months from 1992 to 1998. In 1998 annual outreach visit were offered to general practice and 88 of 94 practices accepted. The awareness of prescribing profiles was monitored during the visits in 1998 and 1999. In 2000 a randomised controlled trial allocating practices into two parallel arms was launched. Effects of two desk guides on rational drug prescribing promoted during outreach visits were evaluated. Results: During the period of mailed feedback, there was a large variation in drug prescribing volumes between practices but little within-practice variation over time. No significant change was detected. Practitioners’ assessment of their own prescribing profiles improved significantly through the outreach visits. The prescribing of antibiotics was significantly affected by the desk guide whereas no effect was detected on the prescribing of non-steroid anti-inflammatory drugs. Conclusions: Semi-annually mailed feedback over a seven-year period had no significant effect on prescribing volumes or variations in prescribing volumes, but some effect on the practitioners’ awareness of their own prescribing profiles. Outreach visits significantly improved the awareness. A randomised controlled trial using outreach visits combined with a simple desk guide affected the prescribing of some antibacterial drugs as intended whereas the similar intervention had no detectable effect on the prescribing of non-steroid anti-inflammatory drugs.

This dissertation has two main objectives. First, we investigate the effectiveness of penalties and other enforcement tools on regulatory compliance, and comprehensively address problems that exist in previous regulatory compliance studies. Second, we develop a model that explains why most empirical studies of regulatory compliance yield results that seem to be inconsistent with the theoretical predictions of Harrington’s (1988) seminal article on regulatory compliance. Thus the dissertation comprises two essays. In Essay One, we estimate facility compliance with the Clean Water Act (CWA) by comprehensively addressing the problems that exist in previous studies. The first problem is the failure to take into account undetected violations. To address this problem, we employ Detection Controlled Estimation (DCE) model, developed by Feinstein (1990). The DCE variant that we use is the two-sided expectation simultaneity version. We use this version because we assume that potential violators will react to what the regulator would do, and vice versa. The second problem that we address is in the measurement of regulatory penalties. Previous studies use dummy variables, but using a continuous measure of penalty enables us to differentiate the responses of minor from substantial violators, and avoid measurement error. Finally, we use a richer set of covariates. We include variables that were found to be statistically and economically significant in different previous studies, but which have never been estimated jointly. The results in Essay One indicate that facilities do respond to penalties, but the effect is economically insignificant. We argue that the small effect of penalties in reducing noncompliance comes from the way regulators enforce the regulations: penalties are rarely imposed on detected violators, or if imposed, the amount is usually negligible. The policy implication that arises from our findings is that if regulators want to see a substantial increase in the probability of compliance, it should consider imposing more frequent and severe penalties. The positive effects of more stringent enforcement on compliance rates come from three sources: (1) through specific deterrence effect; (2) through general deterrence effect; and (3) through an increase in the probability of self-reported violations, which allows for more efficient use of inspection budgets. In Essay Two, we extend Harrington’s (1988) theoretical model by (1) introducing an imperfect detection parameter, and (2) relaxing the movement between the groups, as in Friesen (2003). The extended model shows that when detection is imperfect, the zone for the “always-violate” strategy expands. This expansion has two implications. First, when firms are uniformly distributed in cost space, the number of firms that choose the “always-violate” strategy increases. Second, any empirical study that uses major facilities will be more likely to confirm “always-violate” strategy, but fail to confirm the other two strategies discussed in Harrington (1988). We also discuss other possibilities that can contribute to the difference between empirical results and theoretical predictions.

Hypertension occurs in nearly 10% of pregnancies, and is associated with infant and maternal morbidity and mortality. Prior studies of non-pregnant adults have demonstrated the effectiveness of a variety of relaxation therapies in reducing blood pressure. A pilot randomized controlled trial was conducted, the purposes of which were 1) to provide preliminary evidence regarding the usefulness of guided imagery (GI) in reducing blood pressure in hypertensive pregnant women, and 2) to answer feasibility questions for a larger trial. Pregnant women with hypertension prior to 37 weeks gestation (n = 69) were randomized to either 15-minute periods of guided imagery (n = 34), or of quiet rest (QR) (n = 35), twice daily for four weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure (MAP), systolic and diastolic blood pressures, anxiety, rest and GI use were measured weekly, to a maximum of four weeks. Sixty women completed at least one week in the study; 46.4% completed four weeks. Compliance was excellent. Intention to treat analysis was used. In the unadjusted analysis, women allocated to GI had significantly lower average daytime ambulatory mean MAP elevations from baseline to their last week of study participation than women allocated to quiet rest (GI: M = 1.58 mmHg, SD = 7.63; QR: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = .02). However, the effect was no longer statistically significant (p = 0.14) when adjusted for baseline mean arterial pressure and gestation. There was no statistically significant difference in the numbers of women who were prescribed antihypertensive medication after randomization (GI: n = 16, QR: n = 13, X2 = 0.74, p = .46). There was also no evidence of an effect of guided imagery on anxiety. Nearly 90% (n = 26) of the guided imagery group indicated they would use it again, either in a subsequent pregnancy or during stressful life events. Given the ease of use, low cost, acceptability to women, and lack of risk of guided imagery, an adequately-powered randomized controlled trial is warranted.

No description available.