Sjuksköterskeledda mottagningar har blivit ett framgångsrikt sätt att ta hand om stora patientgrupper som lider av kroniska sjukdomar som diabetes, astma och hjärtsvikt (Eklund, 2009). I Sverige lider fyra av tio kvinnor och fem av tio män, av övervikt eller fetma (SCB, 2012). Fetma är ett globalt folkhälsoproblem som leder till en mängd allvarliga konsekvenser, både fysiska, psykiska och sociala, och har blivit en allt större utmaning för vårt samhälle att finna lösningar och effektiva behandlingar till (WHO, 2013). På senare tid har sjuksköterskeledda överviktsmottagningar etablerats. Syftet med denna uppsats är att beskriva omvårdnadsåtgärder vid sjuksköterskeledd överviktsmottagning. Uppsatsen är en litteraturstudie baserad på både kvalitativa och kvantitativa artiklar. De resultat som framkommit talar för att sjuksköterskeledda omvårdnadsåtgärder på överviktsmottagning utgår från ett holistiskt synsätt där sjuksköterskans uppgift är att stödja patienten och i partnerskap med denne utarbeta en personcentrerad omvårdnad som omfattar både kropp och själ. / Nurse led clinics have successfully been taking care of large groups of patients suffering from chronic diseases such as diabetes, asthma and heart failure (Eklund, 2009). In Sweden today, four out of ten women and five out of ten men, suffers from overweight or obesity (SCB, 2012). Obesity is a global public health problem leading to a host of serious consequences, physical, psychological and social, and has become an ever greater challenge for our society to find solutions and effective treatments for (WHO, 2013). Recently nurse led obesity clinics has been established. The purpose of this paper is to describe nursing interventions in nurse led obesity clinic. The thesis is a literature study based on both qualitative and quantitative items. The results obtained suggest that nurse led interventions in overweight clinic is based on a holistic approach where the nurse's role is to support the patient and in partnership with him or her develop a person-centered care that encompasses both body and soul.

There is a need for better predictive model that reduces the number of malicious URLs being sent through emails. This system should learn from existing metadata about URLs. The ideal solution for this problem would be able to learn from its predictions. For example, if it predicts a URL to be malicious, and that URL is deemed safe by the sandboxing environment, the predictor should refine its model to account for this data. The problem, then, is to construct a model with these characteristics that can make these predictions for the vast number of URLs being processed. Given that the current system does not employ machine learning methods, we intend to investigate multiple such models and summarize which of those might be worth pursuing on a large scale.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

This is a project that explores how design can integrate medical treatment and community support. The high prevalence of chronic disease is creating a national healthcare crisis. Chronic disease is the leading cause of death and disability in the United States. Consideration of a holistic sense of well-being that focuses on disease resistance, resilience, and self-management is necessary to realize and sustain health outcomes. Community engagement is imperative to improve adherence rates for lifestyle changes. This project aims to design a community wellness space that is focused on prevention, resilience and self-management. A new typology of a community-anchored wellness clinic could provide an environment to support positive change. This clinic will be a new model of care by combining the necessary access to fitness, healthy food and health care while fostering community, and providing patient education and emotional support.

This study explores the needs of teen and young adult cancer patients undergoing long-term chemotherapy treatments and the design of an outpatient clinic that accommodates this population’s unique needs. Most teens endure long-term treatments in a pediatric facility targeted primarily for children, while others are treated in adult facilities. Teens have different privacy and social needs than children, and while they are not adults, they are involved in their own treatment decisions, unlike children. The target age group for this study is teens and young adults, ages thirteen to twenty-two. A common theme emerged from research and interviews conducted in the project: these young patients feel an overwhelming sense of isolation. This informed the design of the clinic, which includes spaces where teens and young adults have private spaces for treatment, but larger group spaces that promote connections among each other. Pathways between the various spaces are important. Incorporating nature, environmentally conscious and healthy materials, accessibility, and comfort were essential considerations for the design. The design hypothesis for this project is that a place that targets the unique needs of teens and young adults could make a difference in their experience and ultimately in their healing.

Les facteurs déterminant l’épidémiologie et la sévérité de la Dengue restent mal connus. La compréhension de la dynamique des épidémies est indispensable au management de la lutte anti-vectorielle et des futures stratégies vaccinales. Dans un premier travail, la caractérisation moléculaire de 181 souches de Dengue-1 a permis de déterminer l’origine des épidémies en Polynésie Française (2001, 2006) et d’identifier un phénomène de ré-émergence. La fixation d’une mutation (E-S222T) en période endémique pourrait refléter une adaptation du virus au moustique. A l’échelle intra-hôte, la diversité des populations virales était significativement inférieure en cas de forme sévère suggérant une relation entre diversité génétique virale et clinique.Dans un second travail, cette relation a été confirmée (Bolivie, épidémie de Dengue-1, 2009) et l’importance de la composition des populations virales dans le sang capillaire a été soulignée. Dans un troisième travail, nous avons étudié l’influence du climat sur les épidémies de Dengue (Nouvelle Calédonie, 1971-2010) et développé un modèle prédictif de risque épidémique utilisable par les autorités de santé. / The determinant factors of Dengue epidemiology and severity remain unclear. Understanding the epidemic dynamics is crucial to manage vector control and vaccine strategies in the future. In a first work, the molecular characterization of 181 Dengue-1 strains allowed to determine the origin of Dengue outbreaks in French Polynesia (2001, 2006) and to identify a phenomenom of re-emergence. A mutation (E-S222T) has been fixed during the endemic period that may reflect viral adaptation to the mosquito. At the intra-host scale, the genetic variability was significantly lower in patients experiencing severe forms. This suggests a relationship between the diversity of viral populations within hosts and the clinical presentation of the disease.In a second work, this connection has been confirmed (Bolivia, 2009 Dengue-1 outbreak) and the importance of the composition of viral populations in the capillary blood has been underlined.In a third work, the influence of climate on Dengue epidemics has been studied (New Caledonia, 1971-2010) and a predictive model of epidemic risk usable by the health authorities has been developed.

Sammanfattning Bakgrund: Kronisk ledgångsreumatism eller Reumatoid Artrit (RA) är en kronisk inflammatorisk ledsjukdom och är den vanligaste artritsjukdomen vars huvudsymtom är ledvärk. RA finns i alla folkgrupper, dock med varierande prevalens. I Skandinavien ligger prevalensen på ca 0,7 %. Etnologin till RA är en blandning av genetiska och omgivningsrelaterade faktorer. Att leva med RA påverkar patienten fysiskt, känslomässigt, psykologiskt och även socialt vilket leder till att hela livssituationen påverkas. Syfte: Syftet med litteraturstudien var att beskriva erfarenheter av sjuksköterskeledd mottagning hos patienter med reumatoid artrit samt beskriva undersökningsgruppen i de inkluderade artiklarna. Metod: En litteraturstudie med beskrivande design. Huvudresultat: Patienternas erfarenhet av sjuksköterskeledd mottagning var möten i en varm, vänlig och familjär atmosfär. Vården beskrevs som personcentrerad och kompetent och var baserad utifrån varje individs speciella behov. Sjuksköterskans specialistkunskaper värderades högt och uppgavs skapa en känsla av trygghet hos patienten. Den sjuksköterskeledda mottagningen upplevdes som lättillgänglig, flexibel och skapade kontinuitet i vården. Tillgängligheten medförde också att patienten visste när och hur de skulle kontakta sjuksköterskan. Patientens erfarenhet var att en god kommunikation med vårdpersonalen, gav en ömsesidig respekt och ingav patienten ökat förtroende. Slutsats: Slutsatsen av denna studie är att sjuksköterskeledd mottagning kan skapa ett mervärde för patientens omvårdnad. Den erbjudna vården representerade för deltagarna trygghet, hopp och förtroende. För att ett mervärde ska skapas är det av största vikt med god kommunikation och relationskapande, vilket i sin tur ger trygghet och skapar en grundläggande möjlighet för hälsofrämjande omvårdnad. / Abstract Background: Chronic arthritis rheumatism or rheumatoid arthritis (RA) is a chronic inflammatory joint disease and is the most common arthritis disease, in which headache is joint pain. RA is present in all populations, with varying prevalence. In Scandinavia, the prevalence is approximately 0.7%. The ethnology of RA is a combination of genetic and environmental factors. Living with RA affect the patient physically, emotionally, psychologically and socially, meaning that the whole life situation is affected. Aim: The purpose of the literature study was to describe the experiences of nurse-led clinics for patients with rheumatoid arthritis and to present the study groups described in the articles included. Methods: A descriptive literature study Main results: Patients' experiences of nurse-led clinics were encounters in a warm, friendly and familiar atmosphere. The care was described as person-centered and competent provided and based on each individual's special needs. The nursing specialist skills were highly valued and described to create a sense of security for the patient. The nurse-led clinic was reported readily available, flexible and to create stability in the care. The accessibility also meant that the patients were aware of when and how to contact the nurse. The patient's experience was that good communication with the healthcare staff provided a mutual respect and instilled an increased patient confidence. Conclusion: The conclusion of this study was that nurse-led clinics could add value for the patient nursing care. This offered care represented familiarity, hope and confidence for the patients. To achieve added value, good communication and relationship are of the utmost importance, which in turn provide security and create a fundamental possibility in health-promoting care.

Master of Landscape Architecture / Department of Landscape Architecture/Regional and Community Planning / Anne Beamish / Human nature compels us to remember the past. A society’s collective memory creates meaning in our lives, establishing individual and group identity and contextualizing cultural values. Commemorative landscapes give physical form to loss and memory, providing a space for public awareness and remembrance while acting as a sanctuary for dealing with loss. Over time, memorials face a loss of relevance as generations pass and society evolves to embody different shared memories and values. At the same time, our environment directly affects our physical and psychological well-being. Restorative environments benefit the individual by reducing stress. If the well-being of the individual and his or her environment are directly linked, landscape architecture can be utilized to restore mental well-being. A commemorative space combining the characteristics of memorials and restorative environments will act as a “restorative memorial”. Beyond remembering the events, people, or circumstances that establish cultural identity and values, restorative memorials would improve mental well-being, reminding the individual of their cultural identity while reducing psychological stress. Synthesizing literature understanding the importance of memorials, restorative environments, loss, stress, and environmental psychology with experiential observations of memorials and restorative environments generated a set of design guidelines for restorative memorials. These design guidelines were applied to a design commemorating the legacy of the Menninger Clinic in Topeka, Kansas. The Menninger family formed the first group psychiatric practice in the country. They became world-renowned leaders in psychiatric and behavioral health treatments, believing a patient’s physical and social environment was instrumental to improve mental health. In 2003, the Menninger Clinic relocated to Houston, Texas, vacating a campus which played a great role in the history of Topeka, Kansas, and psychiatry. A restorative memorial commemorating the Menninger legacy could reconnect the citizens of Topeka with the history of the former campus and would pay homage to the ideals of the Menningers, using the designed environment to continue improving mental health. Restorative memorials can become landmarks in the urban fabric, providing an engaging built environment, imbued with meaning. They will transcend generational significance, serving the past, present, and future.

Master of Public Health / Public Health Interdepartmental Program / Patricia A. Payne / Capstone field experience project with the Fort Riley Department of Public Health (FRPH). This project was two-fold. The first part of the project was to observe, assist with, and develop an understanding of the different areas of the department of public health at Fort Riley. The second was to organize, manage, and analyze a vaccination clinic at the Fort Riley Middle School. The vaccination clinic offered vaccines for chicken pox, tetanus/diphtheria/pertussis, meningococcal disease, human papillomavirus, and the flu.