Fibromyalgi (FM) är en kronisk sjukdom som innebär långvarig smärta, fatigue och hjärntrötthet. Symtomen leder till kognitiva begränsningar som koncentrationssvårigheter och minnessvårigheter samt psykiska ohälsa som ångest och depression. Behandlingen är både farmakologisk och icke-farmakologisk. FM vårdas antigen via primärvården eller via smärtrehabiliterings team. Sjuksköterskor upplever svårigheter vid vården av denna grupp dels på grund av smärtproblematiken dels på grund av bristande kunskap. Syftet var att beskriva personers upplevelse av att leva med fibromyalgi. Litteraturstudien har en beskrivande design. Sökningen genomfördes på Medline via Pubmed och gav 22 vetenskapliga artiklar med kvalitativ ansats. Sedan har11 artiklar tagits fram genom relevans- och kvalitetsgranskning. I resultatet framkom fyra teman; utmaningar i arbetslivet, bristande bemötande från sjukvården, komplexa relationer och svårigheter i det sociala livet och begränsningar i vardagen. Dessa teman visade att FM har en stor inverkan på flera områden i människors liv och har en stor effekt på hur dessa personer upplever livet. Det framkom även att patientgruppen upplever undermåligt bemötande från omvårdnadspersonal däremot när vården är gynnsam upplever patientgruppen en bättre psykisk hälsa. Upplevelsen av att leva med fibromyalgi innebär stora utmaningar inom flera områden i livet. Personer med FM upplever bristande bemötande i sjukvården, däribland ifrågasättande attityder och undermålig kunskap från vårdpersonal. Däremot när vården fungerar fördelaktigt leder den till en bättre psykisk hälsa. Därför är det viktigt att förbättra sjuksköterskors kunskap och förståelse för upplevelsen av att leva med fibromyalgi. / Fibromyalgia (FM) is a chronic disease with chronic pain, fatigue, and brain fog. The symptoms often result in cognitive difficulties such as concentrations and memory difficulties as well as mental illness such as anxiety and depression. Intervention can be both pharmaceuticals as non-pharmaceutical. Healthcare is generally provided through primary care and pain rehabilitation teams for patients with FM. Nurses experience difficulties treating these individuals, partly because of the chronic pain difficulties and partly due to lack of knowledge. The aim was to describe the experience to live with fibromyalgia. This literature review had a descriptive design. The search was conducted on Pubmed and produced 22 qualitative articles. Thereafter the qualitative articles have been exanimated with relevance- and quality templets, 11 articles were selected for the literature review. The main findings are presented as four themes. These were challenges in the workplace, inadequate care from healthcare staff, complex relationships and difficulties in social life and limitations in everyday life. These themes indicate that FM have a great impact on several aspects in an individual’s life thus FM has a major impact on the experience of life. Another finding indicated substandard care from the healthcare staff regarding patients with FM, when the care is favourable these patients experience better mental health. The experience of living with FM consist of challenges in all areas of life. They experience substandard care such as condescending attitudes and a lack of understanding. Beneficial care leads to better mental health. Therefore it´s important to improve nurses’ knowledge and understanding regarding the experience of living with FM.

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<p>Aging involves the progressive decline of physical performance and effective metabolic regulation. To date, dietary interventions to slow this deterioration have shown limited success. I tested the effectiveness of a complex dietary supplement (that targets five key mechanisms of aging) for ameliorating age-related declines in physical activity, metabolism and energetic efficiency in mice. Supplemented mice maintained youthful levels of daily physical activity in old age, compared with a progressive decline in untreated controls. The diet also influenced aspects of metabolic rate, as supplemented mice showed age-related increases in fasting oxygen consumption and respiratory quotient compared to declines in these biomarkers in untreated mice. Furthermore, oxygen consumption over 24-h was significantly lower in supplemented mice in spite of being more active than untreated mice. Taken in conjunction with higher resting respiratory exchange ratios across age, this suggests that supplemented mice may utilize more carbohydrate than lipid as an energy substrate and they may express increased metabolic efficiency. These results hold promise for augmenting youthful athleticism and extending geriatric functionality. I also assessed the impact of the supplement on age- related changes in biomarkers of oxidative stress in heart and kidney samples from normal (Nr) and transgenic (Tg) mice that over-express growth hormone. Measures of whole-tissue H2O2 in the heart showed no significant changes in Nr or Tg mice, but catalase activity was ~33% higher in supplemented Nr and Tg compared to untreated controls. Kidney tissue from Nr mice showed significant and opposite age-related trends of H2O2, increasing in supplemented mice and decreasing in untreated controls, however, no changes were observed in Tg mice. Catalase activity in kidney tissue remained unchanged in both genotypes regardless of diet. Furthermore, the ratio of reduced to oxidized glutathione was 43% higher in urine from older (>12 months-old) supplemented mice, indicative of substantially lower whole-body oxidative status. Lastly, older supplemented mice showed improved whole-body glucose tolerance compared with untreated counterparts. These results confirm that the supplement reduces aspects oxidative stress and improves insulin sensitivity, two of the key design criteria for formulating the supplement. This work represents proof of principle that complex dietary supplements can extend functional capacities associated with metabolism and energetic efficiency into older ages.</p> / Master of Science (MSc)

<p>Minimally invasive operations have gained popularity over open surgical procedures in the recent years. These procedures, require the surgeon to perform highly specialized tasks including manipulation of tools through small incisions on the surface of the skin while looking at the images that are displayed on a screen. Therefore, effective training is required for the surgeons prior to performing such procedures on patients.</p> <p>In this thesis I explored a novel idea for creating a training system for arthroscopic surgery. Previously obtained CT images of a patient model and the surgical tools are manipulated to create a library of fluoroscopy images. The surgical tools are tracked (a mechanical tracker and an electromagnetic tracker used in each iterations) in order to generate a spacial relationship between the patient model and the surgical tools. The position and orientation information from the tracking system is translated into the image coordinate frame. These homologous points in the two images (of surgical tools and the patient model), are used to co-register and overlay the two images and create a virtual fluoroscopy image.</p> <p>The output image and the system performance was found to be very good and quite similar to that of a fluoroscopy system. The registration accuracy was evaluated using Root Mean Square Target Registration Error (RMS TRE). The RMS TRE for the system setup with the mechanical tracker was evaluated at 2:0 mm, 2:1 mm, and 2:5 mm, for 4, 5, and 6 control points, respectively. In the system setup with the electromagnetic tracking system the RMS TRE was evaluated at 7:6 mm, 12:4 mm, and 11:3 mm, for 5, 7, and 9 control points, respectively. The acceptable range of error for arthroscopy procedures has been proposed to be 1-2 mm.</p> <p>It was concluded that by using a tracking system, which is not prone to interference and allows for a wide range of motion this system can be completed to the point of manufacturing and use in training new surgeons.</p> / Master of Applied Science (MASc)

The impact of the learner flow experience (LFE) on learning outcomes has been studied for over four decades in a variety of formal and informal instructional settings, including the digital game-based learning (DGBL) environment. Since 2011, the examination of the LFE and its impact on learning outcomes has expanded to computer science-related disciplines, as well as other research communities. During this expansion, an increase in the number and definitions of terms related to the LFE has occurred. Likewise, the number of assessment tools used to capture evidence of the flow experience in learners playing DGBLs has increased. This integrative review examined 66 peer-reviewed articles published between 2011 and 2021, which reported the results of empirical studies seeking to identify and measure the learner experience of flow during DGBL gameplay. More specifically, this study sought to understand how the LFE and its dimensions were conceptualized and assessed in those articles. To do this, the relevant data was extracted from the articles, and, via iterative processes of analyses, the information related to the conceptualization and assessment of the LFE during DGBL game play was identified, analyzed, and organized. The study's findings demonstrated that the number of terms used to describe the LFE dimensions increased during the time period studied, and that there is seemingly little consensus with regard to the conceptualization of the terms or their use in the assessment instruments applied. However, this study also revealed that these terms and the methods by which they were assessed may be examined within the theoretical structure defined by Csikszentmihalyi in 1990, in which he codified nine dimensions to explain the flow experience. These dimensions are: (1) balance of skills and challenge; (2) clear goals; (3) swift, unambiguous feedback; (4) merging of action and awareness; (5) concentration on the task at hand; (6) sense of control; (7) distorted sense of time; (8) loss of ego; and (9) autotelic experience. Organizing the research question findings within this structure enabled the identification of themes of and synonyms for the nine flow dimensions with the addition of the construct flow experience. To encourage future researchers' ability to interpret, compare, and contrast studies of the experience of the LFE during gameplay in the DGBL learning environment, a set of researcher guides was developed following an iterative process of comparisons and analysis across the research questions' findings. These guides present a description of each of the flow dimensions, associated key words and/or key phrases, synonyms for the dimension, and statements or questions used to solicit information from learners regarding their experience of each of the flow dimensions, organized by theorist. The goal for these researcher guides is that they will be used as references for future studies of the impact of flow on learning outcomes for DGBL players through providing a common vocabulary and set of assessment items. They also may help encourage and enhance collaboration between instructional designers and DGBL game designers in creating effective DGBLs that increase learning or user engagement and enjoyment through the fostering of conditions that enable the LFE phenomenon. / Doctor of Philosophy / Many adults recall losing track of time during play as children. Achieving the feeling of being in "the zone" during play or competition was anticipated and relished. As adults, the desire to recapture that state of being blissfully unaware of time, focused only in the moment and free from any concerns frequently drives sales of sporting equipment, leisure activities, and electronically-based games. This experience, called the flow state, can happen when engaging in a wide variety of activities, including learning. Research has shown that if a student reaches the flow state while learning, they learn more and derive greater satisfaction throughout the learning process. This has also been found to be the case for students engaging with digital game-based learning (DGBL) applications. But how do we know if a DGBL player has entered the flow state? Researchers in the fields of instructional design and game design have asked and sought to answer this very question. This study examined the works of these researchers to understand specifically how the flow state was defined and measured in their studies. As a result of this study, researcher guides were created to explain how the learner flow experience and its component dimensions are identified and described, as well as to provide questions that could be posed to students to help evaluate if the flow state was achieved during DGBL gameplay. The goal for these guides is that they will be used as references for future studies of the impact of flow on learning outcomes for DGBL players through providing a common vocabulary and set of assessment items. They also may help encourage and enhance collaboration between instructional designers and DGBL game designers to create effective, enjoyable games for learning.

With the recent release of the Next Generation Science Standards (NGSS) (NGSS Lead States, 2014b) science educators were expected to teach engineering content and practices within their curricula. However, technology and engineering (T&E) educators have been expected to teach content and practices from engineering and other disciplines since the release of the Standards for Technological Literacy (ITEA/ITEEA, 2000/2002/2007). Requisite to the preparation of globally competitive STEM literate individuals is the intentional, concurrent teaching of science, technology, and engineering concepts. Many studies have examined the pedagogical content knowledge (PCK) (Shulman, 1987) of science and T&E educators, but none have examined the science PCK of T&E educators. The purpose of this study was to examine the extent of the relationship between T&E educator’s science and T&E preparation experiences, and their teaching of science content and practices. This study, which employed a fully integrated mixed methods design (Teddlie & Tashakkori, 2006), was conducted to inform the pre- and in-service preparation needs for T&E educators. A random sample of 55 Foundations of Technology (FoT) teachers across 12 school systems within one state participated in an online survey, leading to eight teachers being purposefully selected for classroom observations. Data collected from the surveys and classroom observations were analyzed through Spearman’s rho tests to examine relationships between preparation factors and teaching of science content and practices. These data were corroborated with curriculum content analyses, classroom observations, and interview responses to validate the results. Analyses of the data across all three methods revealed significant correlations between many preparation factors and the teaching of science content and practices. Specifically the amount of high school and undergraduate physics courses, and T&E and science in-service delivered were found to have statistically significant, strong positive correlations. These findings suggest T&E educators with increased amounts of these preparation experiences can be expected to teach science content and practices more proficiently. The findings and conclusions drawn from the data analyses provide implications for science and T&E educators, researchers, preservice programs, and in-service professional development efforts. The discussion and implications suggest the need to conduct replication studies in different contexts. / Ph. D.

In response to STEM (science, technology, engineering, mathematics) educational reform, pedagogical approaches such as technological/engineering design-based learning (T/E DBL) have received increased emphasis as a means to enrich student learning and develop their higher-order cognitive competencies. Despite students exposure to the T and E of STEM as a means to make connections and improve learning (NAE and NRC, 2009), there still exists minimal evidence such experiences have a positive impact on their cognition and achievement (Honey, Pearson, and Schweingruber, 2014). Additionally, although research has well illustrated the design cognition of professional designers, and even students at the collegiate level, few investigations of high school students' cognitive activity during designing has been undertaken (Crismond and Adams, 2012; Hynes, 2012; Lammi and Becker, 2013). Furthermore, as researchers have begun to address this gap, broad coding schemes have been employed, describing students' cognitive efforts in terms of comprehensive categories such as formulation, analysis, and synthesis. However, as previous research has demonstrated nuances among existing categories (Purcell, Gero, Edwards, and McNeill, 1996), what has yet to be done is describe K-12 students' cognitive behaviors in terms of these underlying mechanisms. The purpose of this study was to characterize students' cognitive processes during engineering design at a more distinct level, which can increase understanding and begin to address the minimal attempts to 'connect research findings on how people design with what teachers need to understand and do to help K-16 students improve their design capability and learn through design activities" (Crismond and Adams, 2012, p. 738). The methodology of this study was informed by procedures of cognitive science and verbal protocol analysis. The primary form of data analyzed was audio and video recordings of the design task. The recorded data, in transcript form, was coded using the Purcell, Gero, Edwards, and McNeill (1996) framework. These coded data were then analyzed using descriptive and inferential statistics. Findings from this study revealed that significant differences existed between high school seniors who took pre-engineering courses, and those who did not when engaged in Consulting Information about the Problem (Cp) and in considering System issues, which examined the problem from the point of view of the user. Additionally, Proposing a Solution (Ps), Postponing a Design Action (Pd), and Looking Back (Lb) approached a value of statistical significance in differences between the groups of participants. Findings also characterized how students exert the most and least amount of their cognitive effort in relation to the Problem Domain: Degree of Abstraction and Strategy Classification coding schemes. / Ph. D.