Background: Sepsis is a condition that can result in death by failure or lack of treatment. Mortality has decreased over the past decade and thus is due to increased awareness and improved management of disease cases. Despite this decline, the death rate is still high and increased knowledge to detect and prevent sepsis in time is needed to reduce the suffering and serious complications. Aim: The aim is to illustrate nursing knowledge of the role in caring for patients with sepsis. Method: A literature review study based on an analysis of eight quantitative and two qualitative articles of research. Results: The result showed that nurses experienced that a lack of knowledge exists, long experience in nurses are valuable and that assessment tools can improve nurses' detection of sepsis. Nurses experienced detection of sepsis as a difficult, defiant and stressful task but it could facilitate trough teamwork. Conclusion Combination of knowledge and exertion of assessment tools improve the quality of care and reduce mortality. The result showed that experience and education among nurses are important for improving the competence to early identification of sepsis. / Sjukdomstillståndet sepsis är ett globalt folkhälsoproblem med högt dödsantal vilket skapar stort lidande. Sepsis framkallar ett stört systemiskt svar av immunförsvaret som utlöser livshotande symtom och ett snabbt utvecklande sjukdomsförlopp. Sjukdomen utvecklar en inflammation i hela kroppen oavsett om infektionen finns i blodet eller inte. Studiens syfte var att belysa sjuksköterskans erfarenheter av att vårda patienter med sepsis. Bristande kunskap påverkar omhändertagandet av patienter med sepsis som leder till förseningar och i värsta fall komplikationer. Sjuksköterskors erfarenheter var att kartläggning av sjukdomsförloppet är utmanande, tidsberoende och att stort ansvar läggs på deras axlar. Det framkom att det inte finns tillräcklig kunskap hos sjuksköterskor och att de inte känner trygghet i hur en patient med sepsis skall handläggas. Utbildning och erfarenhet lyftes fram som stärkande faktorer för att kompensera bristen på kunskap. Genom att utbilda sjuksköterskor om tidiga tecken på sepsis och passande omvårdnadsåtgärder kunde professionen stärkas i vårdandet av dessa patienter. Sjuksköterskans erfarenhet belystes och ansågs vara viktigt för teamarbetet med andra professioner och behandlingen av patienter med sepsis. Lång arbetserfarenhet bland sjuksköterskor kunde effektivisera vården, inge trygghet till kolleger och öka patientsäkerheten. Ett fåtal sjuksköterskor var medvetna om bedömningsverktyg och hur de skulle användas. Resultatet visar på att efter införande av bedömningsverktyg i vårdandet av patienter med sepsis förbättrades handläggningen, vården säkerställdes och dödligheten minskade. Bedömningsverktyg är viktigt för att ställa diagnos och likaså mätning av vitalparametrar. Användning av bedömningsverktygen resulterade i att sjuksköterskor lättare kom ihåg alla omvårdnadsåtgärder och att risken för missar minimerades. Sjuksköterskor upplevde stor arbetsbelastning i vårdandet av patienter med sepsis på grund av högt tempo, stort patientflöde och stressig arbetsmiljö. Patienter fick vänta länge på akutmottagningen innan de fick tillsyn och vårdprioritet som följd av sjuksköterskornas arbetsbelastning. Erfarenheterna var att de inte hade tillräckligt med tid för patienterna och att bedömningarna blev bristfälliga på grund av underbemanning. Det kan leda till komplikationer och ökad dödlighet för patienten vilket medförde att sjuksköterskor upplevde oro och stress. Sjuksköterskor bör ha tillräcklig kompetens att identifiera och handlägga patienter med sepsis då det ofta är de som först möter dessa patienter.

Background: Approximately 25,000 people in Sweden receive a stroke diagnosis annually. Stroke can lead to major consequences such as loss of bodily functions that will affect the daily life of the stroke survivor. Family, and those caregivers who are living closely with the patient play an important role in the stroke survivor’s life and they are often expected to contribute with support. It is important to identify the needs of people close to the patient in an early stage. As well as involving them in their special needs during the process as it increases their sense of manageability. Nurses' area of responsibility is based on enabling participation and seeing both patients and relatives. Relatives have an expectation of contributing support to the patient. Aim: The aim of this study was to describe relatives' experiences of support related to stroke. Method: A literature-based study and an analysis of seven qualitative scientific articles. Results: The analysis resulted in one main theme: the navigation in a new life. The results showed how important information and knowledge is for the relatives to; achieve good support, to not develop an illness as a result of their support efforts, adjusting to their new role and situation in a better way to create a positive environment. Conclusion: Relatives described a difficult situation where they experienced fear and concern. Professional support assisted the relatives in the situation. By observing the situation, a profound understanding can be reached and by involving relatives, thus contributes to an improved health. / Livet efter stroke kan ge omfattande konsekvenser för både patienten och närstående. Ett stort behov av hjälp i hemmet fanns hos patienten, närstående har visat sig vara en stor resurs för den strokedrabbade och i den vårdandeprocessen som följer. Men att stå bredvid en person som drabbats av stroke upplevdes som svårt, eftersom en stroke innebar förändringar i det dagliga livet. Tidigare forskning visade att närstående i samband med stroke ofta upplevde ett sämre mående, de prioriterade patienten och glömde bort sig själva i situationen eftersom patienten hade ett stort behov av hjälp. Från sjuksköterskan kunde de närstående få stöd för att lättare kunna hantera situationen och samtidigt ha en god hälsa själva. Sjuksköterskan har därför en betydelsefull roll gällande att ge god omvårdnad till den drabbade patienten men samtidigt till de närstående. Syftet med detta examensarbete var att beskriva närståendes upplevelser av stöd i samband med strokesjukdom. För att författarna skulle förstå vilka känslor och tankar närstående upplevde användes kvalitativa artiklar. En litteraturbaserad studie utfördes, vetenskapliga artiklar analyserades och bildade resultatet. Resultatet påvisade att närstående som gått igenom denna situation upplevde att stödet var varierat och hade en önskan att vara involverade i mötet tillsammans med patient och sjuksköterska. Huvudtemat kom att bli navigera i det nya livet. Fyra underteman kunde identifieras, bland annat närståendes egna strategier för att kunna hantera vardagen lättare beskrevs i ett undertema. Vidare framkom från resultatet att närståendes behov att vägledas från sjuksköterskan samt hur sjuksköterskor gav information och kunskap och hur detta upplevdes från närstående. Studien visade att närstående upplevde en minskad hälsa och att stödet till närstående varierade, därmed bör närstående involveras i större utsträckning samt att stödet kan preciseras från sjuksköterskor.

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Multiple sclerosis is a commonly diagnosed neurological disease that currently has no cure. Due to the significant physical and emotional impact that this disease has on the course of life, depressive symptoms frequently occurs among its sufferers. Many interventions have been developed and studied in an effort to reduce the depressive symptoms without the use of traditional antidepressant medications. This integrated literature review examines empirical evidence regarding non-pharmacologic interventions for depression published between 2003 and 2008. Cognitive behavioral therapy, complementary therapy, and support interventions were examined. Although no single intervention was shown to completely alleviate depressive symptoms, most interventions had a favorable impact.

Minority-girl education in China is a new field of research. This study seeks to explore into this field through reviewing and analyzing the available studies that have been done. This literature has been collected through searching library holdings, Computer Assisted Research Search, and online searching. The criteria against which the literature is to be reviewed and analyzed are in the form of questions and are divided into six categories of introduction, theoretical framework, method, results, discussion (conclusion/recommendations), and abstract or summary; so that all the aspects of a study can be examined. The research filed of minority-girl education in China is found to be improving. A summary of the current educational practices concerning minoirty-girl education in China and the challenges the minority-girl faces when it comes to education is made after the literature collected has been reviewed. Recommendations on future research orientations are made based on the findings.

The scientific evidence required to make policy decisions that protect human health can be challenging to organize. Primary research is often silo-ed between different agency repositories, the pace of publication is unflagging and wide-spread interdisciplinary collaboration can be logistically difficult. Since 2012, the Organisation for Economic Co-operation and Development (OECD) adverse outcome pathway (AOP) framework has provided solutions for some of the challenges of supplying relevant and accessible scientific data for evidence-based decision-making. Development of AOPs is guided by a crowd-sourced approach in which progressions of adverse outcomes (AO) are distilled into pathways containing only the essential key events (KEs) and the causal key event relationships (KERs) that connect them. The framework has widely been adopted in the toxicology community and more recently projects have applied it to the radiation safety field. Presently, a collaborative effort aims to further expand the use of AOPs through creating a network linking exposure to the space exposome with resulting human health outcomes. The network contains four adverse non-cancer outcomes for which participants of future long-range space missions will be at risk. The work of this thesis has contributed to the construction of the space-health AOP network by accomplishing two main objectives. The first was the creation of a novel protocol for collecting a weight of evidence (WOE) that included the benefits of scoping review and artificial intelligence (AI) tools for literature screening. The scoping review WOE collection strategy was then deployed for collecting data across all four outcomes in the space-health network. The second objective was to identify KEs and KERs and summarize the WOE linking space exposure to one of the four AOs: vascular remodeling. In addition to summarizing the pathway, we have also highlighted important modulating factors and knowledge gaps in the WOE. This thesis work contributes to the future of the AOP framework by formulating a new development protocol and employing it in a novel regulatory context. Using the new protocol, this thesis has furthered biological understanding of the effects of space exposure on the cardiovascular system by collating mechanistic information across scientific disciplines to identify KEs and KERs in occurrence of vascular remodeling.

This paper sought to accomplish three goals. First, it provided a systematic, comparative review of several intelligent tutoring systems (ITS). Second, it summarized problems and solutions presented and solved by developers of ITS by consolidating the knowledge of the field into a single review. Third, it provided a unified language from which ITS can be reviewed and understood in the same context. The findings of this review centered on the 5-Component Framework. The first component, the domain model, showed that most ITS are focused on science, technology, and mathematics. Within these fields, ITS generally have mastery learning as the desired level of understanding. The second component, the tutor model, showed that constructivism is the theoretical strategy that informs most ITS. The tutoring tactics employed in the ITS stem from this paradigm. The third component, the student model, describes the several ways ITS infer what a student knows. It described the variety of data that is collected by an ITS and how it is used to build the student model. The fourth component, the interface, revealed that most ITS are now web-based, but vary in their capacity to interact with students. It also showed that user experience is underreported and ought to be included more in the research. Finally, the fifth component, learning gains, demonstrated that ITS are capable of producing learning gains equivalent to a human tutor. However, reporting learning gains does not seem to be a focus of the literature.

Passive localization of aircraft in flight using signal time of arrival (TOA) poses some unique challenges. The sensors must be deployed in an approximately coplanar configuration, which produces significant vertical uncertainty in the estimated position. This dissertation examines the traditional algorithms used in passive localization. It presents general forms of linear TOA, time difference of arrival (TDOA), angle of arrival (AOA), and frequency difference of arrival (FDOA) equations from the literature and explains how to apply an intuitive geometric interpretation of these equations. It presents two novel algorithms for passive localization. One uses a one dimensional AOA (1AOA) to improve the vertical estimate. The other employs an a priori estimate to approximate the non-linear localization problem as a linear problem and produce a high quality position estimate. A comprehensive survey of the literature is presented. This dissertation provides a summary and classification of passive localization algorithms from the literature with simple descriptions of how the form of the equations relate to their numerical stability. It presents two novel algorithms for passive localization. The hybrid multilateration and triangulation algorithm improves wide area multilateration by using vertical 1AOA to constrain the vertical position. The multilateration with a priori estimates algorithm provides a linear localization method that utilizes previous location estimates.

In the dynamic domain of Development, Security, and Operations (DevSecOps), a quantitative approach is critical, with the usage of metrics being a key method to realize this goal. However, there is a notable absence of a set of metrics and assessment specifically for Cloud-Based Web Microservices (CBWMs) within a DevSecOps framework. This study seeks to fill this void by developing a quantitative assessment framework designed for CBWMs in the context of DevSecOps. Utilizing a Multi-Vocal Literature Review (MLR) methodology, we gathered and analyzed 92 documents from 2018 to 2023, sourced from IEEE Xplore, Springer, and Google, to select twelve effective metrics for CBWM assessment within DevSecOps. These metrics, categorized by scale and interrelationships, were chosen due to the tools available in the market for obtaining them, their general applicability across various CBWMs, and their clearly defined measurements and criteria. Each metric is supported by academic and industry literature, providing a comprehensive basis for their selection. Leveraging the Constructive Cost Model (COCOMO) II and the stages of Development and Operations (DevOps) – Plan, Code, Build, Test, Release, Deploy, Operate, and Monitor – our framework outlines an assessment flow that segments into three phases - Development, Integration, and Post-Deployment, aligning with the iterative Software Development Life Cycle (SDLC). This structure facilitates continuous improvement of CBWMs within a DevSecOps framework using these carefully selected metrics. / 2025-01-08T00:00:00Z

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