Introduktion: Smärta, smärtskattning samt smärtbehandling är centrala begrepp inom hematologin. Intresset att genomföra en studie huruvida kvalitetsmål för smärtbehandling som finns utarbetade på Akademiska sjukhuset (AS) i Uppsala följs, väcktes med anledning av detta. Syfte: Författarna valde i denna uppsats att undersöka om gällande kvalitetsmål för smärtbehandling uppnås på hematologen på AS för patienter med maligna blodsjukdomar. De mål som undersöks är dokumentation, kunskap hos behandlande personal på avdelningen, smärtskattning samt smärtbehandling.Metod: Studien är en journal- och enkätstudie med deskriptiv design. 30 journalers dokumentation på inneliggande patienter från november 2008 har granskats under en period med fokus på smärta. Utöver journalgranskning har en enkätstudie med smärtrelaterade frågor gjorts bland läkare och sjuksköterskor på avdelningen. Resultat: Resultatet från studien påvisar en del brister i smärtskattning, i dokumentation samt kännedom av sjukhusets kvalitetsmål för smärtbehandling. Dock tror sig både sjuksköterskor och läkare att de har den kunskap som krävs för en god vård.Slutsats: Om sjukhusövergripande kvalitetsmål för smärtbehandling implementeras på rätt sätt är de till hjälp i vården. Väl utförd smärtskattning, bra dokumentation och tydlig utvärdering hjälper vårdpersonalen att få inblick i patientens smärtstatus. / Introduction: Pain, pain estimation and pain treatment is central concepts within hematology. The interest to conduct a study whether quality of Pain Medicine, which is prepared in the Academic hospital (AS) in Uppsala are followed, brought with it. Aim: The authors chose in this paper to examine whether the existing quality of Pain Medicine achieved in the Department of Hematology at AS in patients with malignant blood diseases. The targets under investigation are the documentation, knowledge of the treating staff, pain estimation and Pain Medicine.Methods: The study is a record and a survey-study with descriptive design. 30 journals documentation of indwelling patients from November 2008 have been reviewed in a period with a focus on pain. In addition to record review, a survey of pain-related issues among doctors and nurses in the department has also been done.Results: Showing some weaknesses in the painfully estimation, in documentation and knowledge of hospital quality of Pain Medicine. However, both nurses and doctors believe they have the knowledge required for good health care.Conclusion: If the hospital overall quality objectives for Pain Medicine is implemented correctly, they are helpful in care. Well done pain estimation, good documentation and clear evaluation helps the nursing staff to gain insight into the patient's pain status.

Even if software handover is a critical process in the lifecycle of a software system, there is still very little research   done within its domain. In this paper, we evaluate the taxonomy of handover activities as defined in EM3: Handover Process Model. We do it in an industrial setting in a context where a software system is handed over from a vendor conducting system development, evolution and maintenance to an acquirer using the system and conducting front-end support. Our results show that the taxonomy is realistic in the context studied. However, it misses some important deployment and training activities. / © 2010 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other uses, in any current or future media, including reprinting/republishing this material for advertising or promotional purposes, creating new collective works, for resale or redistribution to servers or lists, or reuse of any copyrighted component of this work in other works.QC 20120223

Bakgrund: SFOG har tillsammans med SBF, SNS och LÖF upprättat riktlinjer för förlossningsvården som bland annat berör dokumentation av CTG. Dessa har tagits fram genom ”Projekt säker förlossningsvård” och antagits av Blekingesjukhuset Karlskrona år 2008. Syfte: Syftet var att undersöka barnmorskors och läkares följsamhet av CTG-dokumentation, vid aktivt förlossningsförlopp, i förhållande till lokala PM, aktuella riktlinjer och nationella styrdokument på förlossningsavdelningen, Karlskrona. Metod: Retrospektiv journalgranskningmed deskriptiv design har använts.  Datainsamling omfattar tidsperioden 2011-07-01 t.o.m. 2012-03-04. Totalt ingick 748 journaler och 1547 dokumentationer i studien. Dataanalys har skett med hjälp av statistikprogrammet SPSS. Resultat: Av journalerna hade 22% ingen dokumentation om CTG och 46% av dokumentationerna innehöll en klassifikation. Åtgärd har dokumenterats i 80% och dokumentationerna var skriven utan förkortning i 45%. Följsamheten av klassificering och åtgärd tillsammans var totalt 44%medan barnmorskors var 38% och läkares 8%. Konklusion: Följsamheten av CTG-dokumentationbehöver förbättras på förlossningsavdelningen i Karlskrona. Majoriteten av vad som dokumenteras följer inte PM, riktlinjer och nationella styrdokument. / Background: SFOG, SBF, SNS and LÖF have conducted guidelines for obstetric care including documentation of CTG. These have been developed during “Projekt säker förlossningsvård” and adopted 2008 by the hospital in Blekinge, Karlskrona. Aim: The aim of this study was to examine the compliance of CTG documentation by midwives and physician, during active labor, in relation to local PM, current guidelines and national policy at the labor ward Karlskrona. Method: Retrospective study using descriptive design was used. Data collection covers the time period 2011-07-01 to 2012-03-04. Totally 748 records and 1547 documentations were reviewed. Data analysis was progressed in SPSS. Result: Of the total records, 22% did not have any documentation about CTG and 46% of the collected documentations had a classification. Action was documented in 80%, and the documentations were written without an abbreviation in 45%. Compliance of classification and action together was 44%, midwives had  38% and physicians 8%. Conclusion: The compliance of CTG documentation needs improvement in the labor ward in Karlskrona. The majority of documents are not followed by PM, guidelines and national policy documents.

Background: In situations of care transfer of older people from hospital to home care at discharge, exchanging relevant and necessary information about the patient’s health status and individual needs are of importance to ensure continuity and appropriate nursing follow-up care. Objective: The objectives of the study were to: 1) examine the content of nurses’ discharge notes of older patients’ discharged from hospital to home care, and 2) investigate the association between the content of discharge notes and characteristics of patient and transfer. Methods: The nursing discharge notes of 70 older patients admitted to a geriatric unit and a general medicine ward at a local hospital in central Norway were analysed. The discharge notes were structured in accordance with the Well-being, Integrity, Prevention, and Safety (VIPS) model. Mean, standard deviations, and independent sample t-tests were performed to show and examine differences in use of VIPS keywords in relation to patient and transfer characteristics. To examine if use of VIPS keywords could be predicted by patient and transfer characteristics, linear multiple regression analyses were used. Results: Significant differences for mean scores on used VIPS keywords in the discharge note were found for gender, age, and medical department facility. While gender and medical department facility were significant predictors of mental related keywords in the discharge note, medical department facility was a significant predictor of physical related keywords. Conclusions: The result of this study indicate that documentation of patient status in the nursing discharge note of older patients transferred from hospital to home care is incomplete and are influenced by patient and transfer characteristics. In order to ensure continuity and appropriate nursing follow-up care, we emphasize the need for a more comprehensive approach to older patients, and that this must be reflected in the nursing discharge note.

In 2008 the Committee of Fiscal Affairs of OECD published its report on profit attributable to a permanent establishment. In 2010 article 7 of the OECD model tax convention was reformed, and the report was revised to better conform to the article. The authorised OECD approach is that a permanent establishment is a separate and independent entity, engaged in the same or similar activities under the same or similar conditions, taking into account the functions performed, assets used and risks assumed by the enterprise through the permanent establishment and through other parts of the enterprise. The approach is built on a two step analysis, the first is a functional and factual analysis and the second is determining the income of the permanent establishment. The authorised OECD approach is that the Transfer Pricing Guidelines should be applied by analogy in transactions between the permanent establishment and the rest of the enterprise. The Swedish Income Tax Law has the view that the permanent establishment is a separate and independent entity. The Swedish approach is a two step analysis; the basis is the accountings of the enterprise adjusted for internal dealings, and the second step is a functional analysis. The Swedish law does not allow allocation of “free” capital to a permanent establishment, nor does it allow a permanent establishment to deduct royalty payments to other parts of the enterprise. The Swedish provision regarding documentation of transactions between enterprises with economic interest in each other does not apply to permanent establishments. For reasons of certainty and predictability, the best thing would be for the legislator to reform the Swedish Income Tax Law. Seeing that a permanent establishment is obliged to have its own accounting, the burden and cost of obliging it to document internal dealings would not be that big.

Syftet med denna studie är att skapa ett underlag och sammanställning till vad som kan utgöra en utbildningsbok som kan följa elever som går transportteknisk inriktning av fordonsprogrammet i GY11. En elev som genomgår en gymnasial utbildning för att bli yrkeschaufför får, under förutsättning att eleven klarat av utbildningen och bedöms lämplig, med sig ett antal körkortsbehörigheter samt särskilda förarbevis eller yrkesbevis. Dessa olika körkort och bevis är nödvändiga för att eleven ska med laglig rätt få utöva sitt arbete efter genomgången utbildning. Det är också nödvändigt för att eleverna ska kunna möta branschens krav och för att de ska bli anställningsbara. I skolans vardag är dokumentation ett naturligt inslag och hur mycket den tar av lärarens tid är olika beroende på typ av utbildning. Det som står helt klart är att läraren måste dokumentera elevens olika framsteg. Undersökningens slutresultat strävar efter att få fram förslag till ett dokumentationssystem som kan hjälpa läraren i arbetet med dokumentation. Undersökningen genomfördes med hjälp av dokumentanalys som metod. Dokumentanalys är ett verktyg för att ta del av offentlig information på ett alternativt sätt till att läsa det från pärm till pärm. . Denna metod hjälper till att plocka ut de viktigaste komponenterna i det önskade ämnet och underlättar sammanställning av information. Denna rapport innehåller ett förslag till ett dokumentationssystem som klarar kraven på dokumentation från Skolverket, Transportstyrelsen och TYA(Transportfackens Yrkes- och Arbetsmiljönämnd) inför nya GY11. Materialet i denna rapport är ej ännu testat i praktiken. Efter praktiska test bör en utvärdering ske av dokumentationsförslagen som presenteras i rapporten för att se om förändringar behöver göras. / The purpose of this study is to create a foundation and a summary to what could be an education book which can follow those students attending the vehicle program with direction of transport engineering in GY11. A student who is attending a high school education to become a professional driver gets, under the condition that the student completes the education, a number of different driving licenses and professional certificates. These different licenses and certificates are necessary for the student to possess for a legal reason in their future line of work. These certificates are also necessary for the students to be able to meet the business demands and to make the students attractive to the business market. In the school world, documentation is a natural element and the amount of time that is possible for the teacher to dedicate to documentation is depending on the kind of education. What is perfectly clear though, is that teachers must document their students’ progresses. The essence of this study is to create suggestions for a tool to help the teacher in his or her daily work with documentation. The study was made with the help of document analysis. Document analysis is a tool for getting hold of public information as an alternative to be reading it page by page. This method defines the major facts in the actual topic and simplifies the compilation of information.  The result of this study contains suggestions of documentation opportunities which could live up to the demands from Skolverket, Transportstyrelsen and TYA (the board of transport and professional environment unions) in the new GY11. The material in this study has not yet been tried in real life. After practical tests an evaluation of the documentation suggestions in the report should be done to discover if any changes are necessary.

During the practical use of Design Automation (DA) System in a company, the lack of assistance from either documentation work about the whole system or management of knowledge could bring out some obstacles when engineers reuse existing knowledge and information. The purpose of this project is to explore an approach of documentation and knowledge management in DA System. The study is mainly based on the actual case of seat heater DA system developed by JTH. Based on preset functional requirement for the potential solution, several principles and methods of documentation and knowledge management are introduced such as MOKA, CommonKADS, SysML and PVM. A number of useful applications such as DRed (Design Rationale Editor), PC PACK, Sementic MediaWiki and Product Model Manager became candidates solutions for this project. The selection of final approach was Sementic MediaWiki, and this is based on the comparison of the result from evaluation of functionality of each application. Due to specificity of documentation on the DA system, the “process based” approa­ch­ had been used for structuring system included knowledge instead of using a systematical method like either MOKA or CommonKADS completely. Setting up interconnection between different knowledge objects was one of the most important tasks in this project because it enables capturing and retrieving of knowledge. Sementic MediaWiki, a powerful text representative and web-based tool has been used as a platform of representing the whole knowledge and information. With its implementation, the performance of Sementic MediaWiki had been tested accor­ding to the preset functional requirement. After a slight refine process to the solution, the satisfactory result had been achieved, and also proved the applicability of Sementic Wiki in such kind of project.

The objective of the study was to gain new insight into archival building documentation in the United States since 1933 focusing on Historic American Buildings Survey (HABS) as a case study. It sought to help explain how individuals with different levels of involvement with the HABS program, and throughout its entire history, understood the development, current operational context, and future direction of HABS. Seven general philosophical and practical issues were explored: 1) how HABS documentation standards were understood and applied, 2) the relative values of the process and products of documentation, 3) the understanding and application of the objective and subjective natures of the documentation process, 4) whether the mission of the program had changed with changes in the operation of the program since its inception, 5) the role of technology in the process of HABS documentation and how it shapes the end products, 6) defining broader historical epochs with the goal of adding to existing understandings of the history of the program, and 7) the causes and effects of HABS drawing style changes over time.

<p>BAKGRUND: Omvårdnadsdokumentationen har varit lagstadgad sedan 1986. Tidigare studier visar på brister i omvårdnadsdokumentationens omfattning och att omvårdnadsprocessen inte följs. VIPS-modellen används i stor utsträckning i Sverige för att dokumentera omvårdnaden. VIPS står för Välbefinnande, Integritet, Prevention och Säkerhet. SYFTE: Syftet med denna litteraturöversikt var att få en överblick över vad och i vilken utsträckning svenska sjuksköterskor dokumenterar i omvårdnadsjournalen. METOD: En litteraturöversikt har gjorts med åtta vetenskapliga artiklar. RESULTAT: Resultatet visar att sjuksköterskor i Sverige främst dokumenterar status och åtgärder. Diagnoser, mål, resultat och epikriser förekommer betydligt mer sporadiskt. Omfattningen av dokumentationen är undermålig och fullständig dokumentation enligt omvårdnadsprocessen förekommer sällan. DISKUSSION: Sjuksköterskor behöver kontinuerlig utbildning för att förstå vikten av en väldokumenterad patientjournal som följer omvårdnadsprocessen. Nya system som NANDA och NIC skulle i framtiden kunna underlätta dokumentationen genom att ett standardiserat språk tillämpas.</p> / <p>BACKGROUND: Nursing documentation has been a legal obligation in Sweden since 1986. Many earlier studies show that the documentation lack comprehensiveness and that the nursing process is not followed. In Sweden many nurses uses the VIPS-model when documenting. VIPS is acronym for the Swedish spelling words Well-being, Integrity, Prevention and Security. PURPOSE: The purpose of this study was to examine what and to what extent nurses in Sweden document in the patient-journal. METHOD: A literature review was chosen for this study. RESULT: The result shows that nurses in Sweden document nursing status and interventions the most. There is less documentation about diagnosis, goals, outcome and discharge notes. The comprehensiveness of the patient records is poor and complete documentation occurs rarely. DISCUSSION: Nurses need education to understand the importance of having a clear structure in the patient record following the nursing process. In the future a standardized language can help the nurses to document according to the nursing process by using systems as NANDA and NIC.</p>

<p>Utgångspunkten för denna magisteruppsats är en komparativ studie av internationella riktlinjer för dokumentation av internprissättning.</p><p>Internprissättning reglerar hur närståendetransaktioner inom internationella koncerner skall värderas. Då de inblandade parterna står i intressegemenskap med varandra kan villkoren bakom transaktionerna skilja sig från vad oberoende parter skulle kommit överens om. Det är därmed svårt att bestämma ett korrekt pris på de besläktade transaktionerna, varför internpriser skall bedömas i enlighet med armlängdsprincipen.</p><p>För att kunna bevisa att aktuella transaktioner gjorts på armlängds avstånd måste en internationell kon-cern upprätta dokumentation som visar hur priserna bestämts och varför de skall anses vara armlängdsmässiga. Dokumentation är därmed ett försök att bestämma internpriser i överensstämmelse med armlängdsprincipen.</p><p>Trots att armlängdsprincipen följs av de flesta skattemyndigheter i bedömningen av internpriser, appliceras den på olika sätt. Kravet att möta flertalet olika nationella regelverk skapar ökade kostnader för de internationella företagsgrupperna. De löper dock stor risk att bli utsatta för dubbelbeskattning eller dokumentationsrelaterade sanktioner om de inte uppfyller respektive lands krav.</p><p>För att underlätta den administrativa bördan samt de kostnader som uppstår har OECD utvecklat rikt-linjer gällande internprissättning, “The OECD Transfer Pricing Guidelines”, där kapitel V reglerar do-kumentation. Riktlinjerna grundar sig på principer om en sund företagsanda (prudent business manage-ment), vilket betyder att skattemyndigheters behov av information skall vägas mot den kostnad och börda det innebär för skattebetalaren att samla in eller upprätta dokumenten.</p><p>PATA och EU har i respektive handelsområde försökt harmonisera de nationella dokumentationskraven genom att presentera nya internationella föreskrifter inom ramen för OECDs riktlinjer. I en strävan att efterfölja den internationella utvecklingen vad gäller dokumentation av internpriser har Sveriges Regering gett ut en proposition där införande av nationella dokumentationskrav för internprissättning föreslås.</p><p>Ett grundläggande problem gällande det aktuella området är de olika synsätten på armlängdsprincipens fastställande. Harmonisering av endast dokumentationskrav kan därför inte ensamt lösa problemen med armlängdsmässig internprissättning. Vidare innebär de utvärderade instrumenten en harmonisering på högsta nivå, varför syftet att underlätta skattebetalares börda och kostnader ej heller uppfylls.</p> / <p>In this master thesis a comparative study is made regarding the international guidelines on transfer pricing documentation.</p><p>International transfer pricing deals with the valuation of intragroup crossborder transactions. As the involved parties share interests to such an extent that the terms and conditions of their transactions could differ to what unrelated parties would agree on, it is complicated to properly price the controlled transactions. The transactions are therefore to be determined in accordance with the arm’s length principle.</p><p>In order to show the arm’s length nature of controlled cross-border transactions an MNE must provide transfer pricing documentation demonstrating how the prices have been determined and why they are at arm’s length. Documentation is thus an endeavour to determine transfer prices in accordance with the arm’s length principle.</p><p>Even though the arm’s length principle is used by most tax authorities when regulating transfer prices, the application of the principle differs. This imposes massive compliance costs for MNEs trying to meet the transfer pricing documentation requirements of numerous jurisdictions. However, the MNEs are at great risk of being exposed to double taxation or documentationrelated penalties if they do not meet the above mentioned documentation requirements.</p><p>In order to ease the burden on MNEs, OECD has developed transfer pricing guidelines wherein Chapter V deals with the problems of transfer pricing documentation. The OECD Transfer Pricing Guidelines on documentation are founded on the principles of prudent business management, which means that the tax authorities´ need for information should be balanced by the cost and burden for the taxpayer of obtaining or creating the documents in question.</p><p>PATA and the EU have, by presenting new international frameworks, tried to harmonise national documentation requirements for their respective trade areas within the limits of the OECD Transfer Pricing Guidelines. In an attempt to follow the international developments regarding transfer pricing documentation, the Swedish Government has proposed a draft bill for national rules on documentation.</p><p>A fundamental problem within the area is the different approaches in assessing the arm’s length principle and harmonisation of documentation in itself cannot solve this issue. Moreover, since the evaluated frame-works signify harmonisation on the highest level, the efforts to ease the compliance burden for taxpayers cannot be reached.</p>