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Sökning: WFRF:(Östberg Per) > Doktorsavhandling

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1.
  • Blom Johansson, Monica, 1965- (författare)
  • Aphasia and Communication in Everyday Life : Experiences of persons with aphasia, significant others, and speech-language pathologists
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aims of this thesis were to describe the experiences of persons with aphasia and their significant others of their conversations and use of communication strategies, examine current practice of family-oriented speech-language pathology (SLP) services, and test a family-oriented intervention in the early phase of rehabilitation.The persons with aphasia valued having conversations despite perceiving their aphasia as a serious social disability. They acknowledged the importance of the communication partners’ knowledge and understanding of aphasia and their use of supporting conversation strategies. Their own use of communication strategies varied considerably. The persons with aphasia longed to regain language ability and to be active participants in society.A majority of the significant others perceived their conversations with the person with aphasia as being less stimulating and enjoyable than conversations before stroke onset. Aphasia was considered a serious problem. The significant others took on increased communicative responsibility, where two thirds had changed their communicative behaviour to facilitate conversations. Type and severity of aphasia were especially related to the communicative experiences of the significant others and their motivation to be involved in SLP services.Thirty percent of the speech-language pathologists worked with people with aphasia and typically met with their families. They considered the involvement of significant others in SLP services as very important, especially in providing information about aphasia and communication partner training (CPT). However, involvement of significant others was restricted because of a time shortage and perceived limited skills and knowledge. In addition, there were national differences regarding aphasia rehabilitation services.The intervention consisted of three sessions directed to significant others (primarily emotional support and information) and three directed to the dyads (a person with aphasia and a significant other) (primarily CPT). All six participants (three dyads) felt that their knowledge and understanding of aphasia had increased and that their conversations had improved. These improvements were also evident to some extent with formal assessments.These results suggest the following: CPT should be an integral part of SLP services, national clinical guidelines are needed, and further education of speech-language pathologists and implementation of new knowledge into clinical practice requires consideration.
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2.
  • Hägglund, Patricia, 1989- (författare)
  • Swallowing dysfunction among older people in short-term care : prevalence, effect of intervention, and risk of mortality
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Objectives: Swallowing dysfunction (dysphagia) is a common, but often neglected condition among geriatric patients that can cause severe complications such as malnutrition, aspiration pneumonia and death. The aims of this thesis were to (i) describe the study design and method of the multidisciplinary and multicenter project SOFIA (Swallowing function, Oral health, and Food Intake in old Age), (ii) study the prevalence of and the relationship between swallowing dysfunction and risk of undernutrition among older individuals in short-term care, (iii) study the effect of oral neuromuscular training on swallowing dysfunction among older individuals, and (iv) to investigate the association between poor oral health, swallowing dysfunction and mortality.Methods: This thesis includes four original papers that are all part of the SOFIA project. Paper Iis the study protocol. In total, 391 individuals aged 65 or older, from 36 short-term care units were included in the project. At baseline the participants’ status regarding swallowing function (assessed with the Timed Water Swallow Test, TWST), oral health (using the Revised Oral Assessment Guide, ROAG) and nutrition (assessed with the Minimal Eating Observation and Nutrition Form-version II, MEONF-II) were assessed and collected by calibrated professionals. Clinical data were also collected. Paper IIwas a cross-sectional study where the baseline assessments of the participants’ swallowing function and nutritional status were obtained and the relationship analyzed. Paper IIIwas a cluster randomized, controlled trial (cRCT) that included 116 participants identified with swallowing dysfunction in paper II. These participants were randomly assigned to either usual care (control group) or oral neuromuscular training (intervention group). All participants were assessed at baseline, after five weeks’ training and six months after end-of-treatment, regarding swallowing function and swallowing-related quality of life (QOL). Paper IVwas a prospective cohort study where all participants were followed-up 1-year after inclusion to investigate risk factors for mortality by analysis of the associations between swallowing dysfunction, poor oral health, and 1-year survival. Results: Paper II:The median age of the 391 participants was 84 years (Interquartile range [IQR] 11) and 209 (53%) were females. In total, 248 of the 385 (64%) participants showed swallowing dysfunction, and risk of undernutrition was observed in 91 of 390 (23%) participants. The adjusted logistics regression model revealed that participants with swallowing dysfunction had significantly higher odds of undernutrition than those with normal swallowing (Odds ratio [OR]: 1.74, 95% Confidence interval [CI] 1.04 to 2.92, P=0.034).Paper III: At end-of-treatment, a linear mixed model showed significant between-group differences of changes in swallowing efficacy between baseline and after completed treatment period (Ratio 1.60, 95% CI 1.15 to 2.29, P=0.007); indicating a 60% higher swallowing efficacy in the intervention group compared with the control group. Paper IV: A mixed effects Cox model showed that swallowing dysfunction and poor oral health were both independently associated with 1-year mortality (adjusted Hazard Ratio [aHR]: 1.67, 95% CI 1.02 to 2.75,P=0.041 and aHR: 1.98, 95% CI 1.07 to 3.65, P=0.029, respectively). In addition, swallowing dysfunction and poor oral health in combination predicted the highest mortality rate (35%, P<0.001).Conclusion: Swallowing dysfunction is highly prevalent and a risk factor for undernutrition among older people in short-term care. Oral neuromuscular training improves swallowing dysfunction and is thus a promising method of swallowing rehabilitation for older people with impaired swallowing. Swallowing dysfunction and poor oral health are independent risk factors for 1-year morality among older people in short-term care. Therefore, systematic screening and intervention to improve swallowing dysfunction and poor oral health are important to achieve healthy aging and to prevent undernutrition and early death.
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3.
  • Gonzalo P., Rodrigo, 1980- (författare)
  • HPC scheduling in a brave new world
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Many breakthroughs in scientific and industrial research are supported by simulations and calculations performed on high performance computing (HPC) systems. These systems typically consist of uniform, largely parallel compute resources and high bandwidth concurrent file systems interconnected by low latency synchronous networks. HPC systems are managed by batch schedulers that order the execution of application jobs to maximize utilization while steering turnaround time. In the past, demands for greater capacity were met by building more powerful systems with more compute nodes, greater transistor densities, and higher processor operating frequencies. Unfortunately, the scope for further increases in processor frequency is restricted by the limitations of semiconductor technology. Instead, parallelism within processors and in numbers of compute nodes is increasing, while the capacity of single processing units remains unchanged. In addition, HPC systems’ memory and I/O hierarchies are becoming deeper and more complex to keep up with the systems’ processing power. HPC applications are also changing: the need to analyze large data sets and simulation results is increasing the importance of data processing and data-intensive applications. Moreover, composition of applications through workflows within HPC centers is becoming increasingly important. This thesis addresses the HPC scheduling challenges created by such new systems and applications. It begins with a detailed analysis of the evolution of the workloads of three reference HPC systems at the National Energy Research Supercomputing Center (NERSC), with a focus on job heterogeneity and scheduler performance. This is followed by an analysis and improvement of a fairshare prioritization mechanism for HPC schedulers. The thesis then surveys the current state of the art and expected near-future developments in HPC hardware and applications, and identifies unaddressed scheduling challenges that they will introduce. These challenges include application diversity and issues with workflow scheduling or the scheduling of I/O resources to support applications. Next, a cloud-inspired HPC scheduling model is presented that can accommodate application diversity, takes advantage of malleable applications, and enables short wait times for applications. Finally, to support ongoing scheduling research, an open source scheduling simulation framework is proposed that allows new scheduling algorithms to be implemented and evaluated in a production scheduler using workloads modeled on those of a real system. The thesis concludes with the presentation of a workflow scheduling algorithm to minimize workflows’ turnaround time without over-allocating resources.
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4.
  • Krzywda, Jakub, 1989- (författare)
  • May the power be with you : managing power-performance tradeoffs in cloud data centers
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall goal of the work presented in this thesis was to find ways of managing power-performance tradeoffs in cloud data centers. To this end, the relationships between the power consumption of data center servers and the performance of applications hosted in data centers are analyzed, models that capture these relationships are developed, and controllers to optimize the use of data center infrastructures are proposed.The studies were motivated by the massive power consumption of modern data centers, which is a matter of significant financial and environmental concern. Various strategies for improving the power efficiency of data centers have been proposed, including server consolidation, server throttling, and power budgeting. However, no matter what strategy is used to enhance data center power efficiency, substantial reductions in the power consumption of data center servers can easily degrade the performance of hosted applications, causing customer dissatisfaction. It is therefore crucial for data center operators to understand and control power-performance tradeoffs.The research methods used in this work include experiments on real testbeds, the application of statistical methods to create power-performance models, development of various optimization techniques to improve the power efficiency of servers, and simulations to evaluate the proposed solutions at scale.This thesis makes multiple contributions. First, it introduces taxonomies for various aspects of data center configuration, events, management actions, and monitored metrics. We discuss the relationships between these elements and support our analysis with results from a set of testbed experiments. We demonstrate limitations on the usefulness of various data center management actions for controlling power consumption, including Dynamic Voltage Frequency Scaling (DVFS) and Running Average Power Limit (RAPL). We also demonstrate similar limitations on common measures for controlling application performance, including variation of operating system scheduling parameters, CPU pinning, and horizontal and vertical scaling. Finally, we propose a set of power budgeting controllers that act at the application, server, and cluster levels to minimize performance degradation while enforcing power limits.The results and analysis presented in this thesis can be used by data center operators to improve the power-efficiency of servers and reduce overall operational costs while minimizing performance degradation. All of the software generated during this work, including controller source code, virtual machine images, scripts, and simulators, has been open-sourced.
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5.
  • Lucarelli, Andrea, 1982- (författare)
  • The Political Dimension of Place Branding
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Place branding is commonly understood as the application of marketing and commercial ideas, strategies, measurements and logic to the realm of places such as cities, regions and nations. Nevertheless, place branding is also understood as the locus where political activities – imbued with political impact and political effects – appear and affect the soft and hard infrastructures of urban agglomeration and other spatial environments. In this regard, by performing an analysis that helps unpack the multiple characters and impacts of political structures and processes in relation to place branding activities, the present dissertation aims to offer a conceptualization of the political dimension of place branding. By drawing on the critical assessment of the academic literature on place branding and on a series of studies about the branding processes in the region of Romagna and in the Greater Stockholm, the present dissertation further specifies an alternative conceptual framework (i.e. ecological politics) that suggests how place branding should be seen an empirical and theoretical political apparatus that acts, in praxis, based on an emerging, multifaceted and spatio-temporal enfolding of politics. More specifically, the ecological politics of place branding is characterized by four main aspects: the unfolding of a biopolitical ecology around place-branding practices; the ideological appropriation of place-branding processes; the positioning through politicized actions between the interest groups; and finally place-branding as a process of policy-intervention. Finally, on more general level, the present dissertation, by recognizing the political activities and efforts of place branding as crucial elements to be analyzed, makes the case for a more explicit, complex and manifold political analysis of the political dimension of place branding, which allows attention to be given to the impact that branding processes, practices and activities have on cities, regions and nations
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6.
  • Molander, Susanna, 1965- (författare)
  • Mat, kärlek och metapraktik : En studie i vardagsmiddagskonsumtion bland ensamstående mödrar
  • 2011
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The everyday dinner usually involves a number of different and sometimes conflicting ambitions that may include striving for self-fulfillment and striving to care for one’s family and society at large. To understand the consumption that occurs in connection with these ambitions, consumer researchers must understand the context surrounding the everyday dinner. In this dissertation theories of practice are utilized as a conceptual framework to emphasize the importance of context.Theories of practice have gained renewed interest within the field of consumption. Yet, Consumer Culture Theory (CCT) has neglected practice theories’ ability to operationalize the consumption context. The aim of this dissertation is to develop further CCT’s practice perspective to increase the understanding of the consumption context and thereby better understand consumption as a social and cultural phenomenon. An ethnographic approach is employed to identify what practices operate within a complex consumption situation such as the everyday dinner among single mothers; how these practices incorporate consumption in their strivings and how the different practices operating within the consumption situation interact with one another.This new approach comes to the conclusion that mothering, defined as a meta-practice, dominated the consumption situation and organized the other practices involved. A meta-practice is one with major influence over consumption and thus a type of practice consumption researchers should look for. Furthermore in Western society consumption situations, like the everyday dinner, seem to be especially important when it comes to anchoring meta-practices and thereby the social order. A preliminary characterization of the meta-practice is proposed as consisting of four different traits: I) its impact on the social order; II) its generalizability, density and superiority; III) its regulation and IV) its stability or slow change. However, more studies are necessary to explore these characteristics further.
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8.
  • Östberg, Per (författare)
  • Lexical and articulatory aspects of cognitive decline
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Dementia may be defined as the attenuation of cognitive powers despite preserved basal consciousness. Its most common cause is Alzheimer's disease (AD). Pathoanatomical staging has made it clear that the disease passes through a protracted preclinical phase with slowly emerging symptoms. Such symptoms may include various forms of forgetfulness, such as forgetting the names of people, things, and places. Because word finding also wanes somewhat with normal aging, objective tests of word finding might help in separating benign word lapses from those reductions in lexical ability that may herald dementia. Objectives: The main aim of the thesis was to identify speech production tests of relevance to the diagnosis of AD and mild cognitive impairment (MCI). Material and Methods: The thesis is based on retrospective clinical data obtained from patients admitted to the memory clinic of the Department of Geriatrics, Karolinska University Hospital. All subjects had undergone an examination for possible dementia. Study I explored the interrelationships of three word fluency tests and performance differences between the diagnostic categories. Study II investigated whether reductions in regional brain blood flow affected performance in a verb fluency task and a noun fluency task. Study III examined the production of an automatic word sequence in forward and reverse order as a diagnostic target. Study IV analyzed the capacity for rapid articulatory action in AD and related disorders. Results: Verb, noun, and letter-based fluency were found to be factorially distinct tests although with covariance between factors. Noun fluency was disproportionately impaired in AD. In MCI, however, verb fluency was more decreased than noun or letter-based fluency. Verb fluency performance was predicted by educational level and temporal lobe blood flow, while noun fluency was predicted by age and parietotemporal-occipital blood flow. Forward word sequence production was preserved across diagnostic categories. In contrast, backward word sequence production was impaired in MCI and devastated in AD. The diagnostic predictive power of backward word sequence production was approximately equivalent to that of the widely-used Mini-Mental State Examination. Sequential speech motion rate was modestly reduced in MCI and AD, but more markedly so in frontotemporal dementia and progressive nonfluent aphasia. In semantic dementia, articulatory capacity was at the level of participants without objective cognitive impairment and superior to the other categories. Conclusion: Lexical production tasks have application to the diagnosis of MCI and mild AD. The capacity for rapid articulatory action varies both between and within AD and related disorders. The potential neural correlates of this variation remain to be explored by future studies.
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9.
  • Östberg, Per-Olov, 1973- (författare)
  • Virtual infrastructures for computational science: software and architectures for distributed job and resource management
  • 2011
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • In computational science, the scale of problems addressed and the resolution of solu- tions achieved are often limited by the available computational capacity. The current methodology of scaling computational capacity to large scale (i.e. larger than individ- ual resource site capacity) includes aggregation and federation of distributed resource systems. Regardless of how this aggregation manifests, scaling of scientific compu- tational problems typically involves (re)formulation of computational structures and problems to exploit problem and resource parallelism. Efficient parallelization and scaling of scientific computations to large scale is difficult and further complicated by a number of factors introduced by resource aggregation, e.g., resource heterogene- ity and coupling of computational methodology. Scaling complexity severely impacts computation enactment and necessitates the use of mechanisms that provide higher abstractions for management of computations in distributed computing environments.This work addresses design and construction of virtual infrastructures for scientific computation that abstract computation enactment complexity, decouple computation specification from computation enactment, and facilitate large-scale use of compu- tational resource systems. In particular, this thesis discusses job and resource man- agement in distributed virtual scientific infrastructures intended for Grid and Cloud computing environments. The main area studied is Grid computing, which is ap- proached using Service-Oriented Computing and Architecture methodology. Thesis contributions discuss both methodology and mechanisms for construction of virtual infrastructures, and address individual problems such as job management, application integration, scheduling job prioritization, and service-based software development.I addition to scientific publications, this work also makes contributions in the form of software artifacts that demonstrate the concepts discussed. The Grid Job Manage- ment Framework (GJMF) abstracts job enactment complexity and provides a range of middleware-agnostic job submission, control, and monitoring interfaces. The FSGrid framework provides a generic model for specification and delegation of resource allo- cations in virtual organizations, and enacts allocations based on distributed fairshare job prioritization. Mechanisms such as these decouple job and resource management from computational infrastructure systems and facilitate the construction of scalable virtual infrastructures for computational science.
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