Due to the costly and technically challenging nature of genetic testing, methods have been developed to target more specifically those who are at increased risk of carrying the Hereditary Non-Polyposis Colorectal Cancer (HNPCC) mutation. HNPCC is an inherited colorectal cancer syndrome. Testing of tumour material (which has previously been removed during surgery) for features of HNPCC has been found to be an effective and economic method of identifying those at higher risk of having a mutation. Only those at higher risk of having a mutation will undergo genetic testing. This practice of “tumour testing” has become widespread. / There is currently no clarity about requirements for consent prior to testing of stored tumour tissue. The person giving consent to tumour testing does not always have an appointment with a genetics service prior to giving consent. This can be contrasted to genetic testing on blood samples where laws and guidelines state that informed consent is required prior to genetic testing and that comprehensive genetic counselling and support should be provided as part of this process. Protocols for genetic testing have been developed as a result of extensive research around the impact and implications of genetic testing. / Consumer opinion and participation through research is an important aspect of health policy and guideline development. Accordingly the purpose of this study was to contribute to such development by gaining insight into the experiences, understandings, decision making processes and opinions of those who had given consent to have their own or their relatives tumour tested. Seventeen people who had given consent for tumour testing either for themselves, or on behalf of a deceased relative were recruited through a Familial Cancer Centre and in-depth interviews conducted. The interviews were transcribed and analysed using thematic analysis. / Some participants had no memory of consenting to tumour testing. Others remembered basic concepts. Negative implications of testing were unknown or viewed as unimportant. Participants did not understand the difference between tumour testing and germline testing. Despite lack of memory or understanding participants did not want additional or more detailed pre-test information although they did want more follow-up and support after receipt of results. The decision to consent to testing was made as soon as participants were informed of the availability of tumour testing - the major reason being to provide information for the family that would aid in cancer prevention. Participants were more concerned with accessibility to testing than pre test information and counselling. / Findings in this study indicated participants made decisions heuristically rather than systematically and this as well as participants’ opinions and other decision-making research has implications for the traditional view of informed consent around genetic related decisions. This in turn has implications for policy and guidelines in the area. Implications for current practise as a result of findings from this study include ensuring participants understand negative implications of testing and follow up and support of those with negative as well as positive results to tumour testing.

<p>Purpose: The aim of this thesis is to study the European (ESTRO/EAU/EORTC) and American (ABS) guidelines how to report the permanent seed implant and the most significant dosimetric parameters. It will also report on the permanent seed implant at Södersjukhuset, Karolinska University Hospital according to the guidelines. A large number of studies on pre- and post-implant dosimetry on permanent seed implants have recently been published but none is considered a standard. This makes it difficult, if not impossible, to compare data from different centres. The differences in reporting will also be discussed in this thesis. Another part of the study is to investigate how the morbidity correlates with the dose. The results in this report will give an overview of the experience at Södersjukhuset.</p><p>Matherials and Methods: This study includes 198 patients who received implants between 2004-2007 with I-125 seeds under transperineal ultrasound at Södersjukhuset (to a prescribed dose of 145 Gy). The dose-planning system VariSeed 7.1 was used with an online connection to the ultrasound system with real-time verification. Dose constraints for the planning system are V(100)>99%, V(150)>60%, V(200)>25%, UrD(10)<130% and UrD(30)<125%. Outer and inner wall of rectum was outlined for 55 patients as recommended by ESTRO/EAU/EORTC and doses to rectum were also computed.</p><p>Results: The median value for dosimetric parameters at Södersjukhuset, Karolinska University Hospital are for the prostate; D(90)=174Gy (153-194Gy), V(100)= 99% (93-100%), V(150)= 57% (40-74%), for the urethra; UrD(30) = 130% (112-147%), UrD(10) = 124% (107-142%) and for the rectum; RD2cc= 98Gy (73-128Gy), RD0.1cc=164Gy (119-240Gy), RV(100)=0.3cc (0.0-1.3cc), RV(150)=0.0cc (0.0-0.2cc). These values correspond to recommended data, except for the V(150) value. Regarding the clinically observed results, 3 patients had a relapse in their cancer, 2 patients had mild proctitis and 15 patients had urinary problems.</p><p>Discussion and Conclusions: The significant dosimetric parameters for reporting according to ESTRO/EAU/EORTC and ABS for prostate are D90[Gy], V(100)[%] and V(150)[%], for urethra are D(30) and D(10), and for rectum RD2cc and RD0.1cc. These parameters consider as a minimum to use and they further recommend secondary parameters to report. Other authors have also recommended to report RV(100) and RV(150) for rectum. This study did not show any relationship between UrD(10), UrD(30) and urinary morbidity. According to the recommendations every patient should undergo a CT-based evaluation. Further investigations are needed on whether a post-implant CT-study is necessary for real-time implantation, as there is not enough published data on this aspect.</p>

<p>Information systems form the backbone of many organizations today and are vital for their daily activities. For each day these systems grows bigger and more customized to the point where it is heavily integrated in the current platform. However, eventually the platform grows obsolete and the system itself becomes an obstacle for further development. Then the question arises, how do we upgrade the platform while retaining customizations and data? One answer is data migration which essentially is the process of moving data from one device to another. The problems of data migration becomes evident with extensive and heavily customized systems which effectively lead to the absence of any general guidelines for data migration.This thesis attempts to take a first step in finding and testing a set of general migration guidelines that might facilitate the creation of future migration projects. This is achieved using a comparative analysis of the general migration guidelines contra the process of migrating data between different editions of the Microsoft SharePoint framework. The analysis attempts to find out if the general guidelines are general enough for this migration process and leave it to future research to further assess their generality. This paper will also investigate the importance of using incremental migration and the ability to perform structural change during migration as well as how these issues is handled by the built in migration tool of SharePoint. In the end the general guidelines proved to be sufficient to express the SharePoint migration process and should therefore be used for further research to assess their worth in other projects. In terms of the second issue, the built-in migration tool proved weak in handling either incremental migration nor structural change which is unfortunate due to the benefits these features bring.</p>

<p><strong>Background</strong></p><p>International transfer pricing has been a highlighted issue during the last decades as country after country has revised and introduced new transfer pricing laws as a respond to the expanded globalization. Several countries are adopting similar approaches and the prime guiding principles are provided by the Organization for Economic Co-Operation (OECD). The international law as well as the laws of all 30 member countries is based on the OECD Guidelines.</p><p><strong>Purpose</strong></p><p>The purpose of this master’s thesis is to describe differences and similarities regarding the transfer pricing regulations in China and Sweden and to explain how a Swedish multinational enterprise (MNE) have to utilize and adjust their transfer pricing strategy when trading with group companies in China. The results then conclude into a step model for strategic transfer pricing.</p><p><strong>Result</strong></p><p>The differences between the regulations are mainly uncovered in the definition of associated parties and associated interest. The differences in the regulations are thus of minor importance and does not affect a Swedish MNE to any major extent. The challenging area is instead the conflict between the tax authority and the customs service. To enable this study, three Swedish MNEs are used as a case study. We discovered that all had very different transfer pricing strategies even though they are within the same industry and two of them even within same range of products. Out of this we made the conclusion that the strategy chosen is not just depending on what product or service you trade with but also the aim and purpose, the range of products and the structure of the company. International transfer pricing is a very complex issue that goes into nearly all business operations. The concept of transfer pricing can thus be broken down and simplified if the demands from the company is minor.</p>

<p>Syftet med studien var att undersöka om sjuksköterskans information till patienter, vid inläggning av perifer venkateter, följde gällande riktlinjer från Handbok för hälso- och sjukvårdspersonal. Författarna samlade in data genom att delta vid 60 inläggningar av perifer venkateter vilka genomfördes av femton olika sjuksköterskor. Insamlingen ägde rum på en dagkirurgiavdelning. Man observerade ett antal områden, resultatet på dessa kunde bli ja eller nej, där ja var det resultat man eftersökte. Antal ja-svar summerades och analyserades med oberoende t-tester för att se eventuella skillnader i yngre/äldre och män/kvinnor, inga skillnader påfanns. Resultatet visade att sjuksköterskornas information till patienter vid insättande av perifer venkateter hade uppenbara brister och inte följde gällande riktlinjer. I över hälften av observationsmomenten gavs bristande information eller ingen information alls. Det som sjuksköterskorna flitigast informerade om var att patienten vid insticket kunde känna smärta, denna information gavs till så gott som alla patienter. Två foldrar, en gällande patientinformation och en gällande sjuksköterskeinformation, har utformats av författarna för att kunna urskilja vad som kan vara nödvändigt när det gäller patientinformation.</p> / <p>The aim of this study was to investigate if given information to patients regarding insertion of a peripheral intravenous line was following national guidelines. The writers collected data by observing 60 insertions of peripheral intravenous lines that was performed by fifteen different nurses. The observations took place on a surgical ward. A specific number of areas were observed and the result of each observation could be answered with a yes or no, where yes was the result that was preferred. The yes-answers were summarized and analyzed using independent t-tests to find possible differences regarding gender and age, no differences were found. The result showed that given information to patients regarding the insertion of a peripheral intravenous line had obvious limitations and did not follow the national guidelines. In almost half of the observation areas the information was limited or none existing. The most common information that was given by the nurses was how the insertion of the peripheral intravenous line would feel, this information were given to almost every patient. Two information folders, one to the patients and one to the nurses, have been made by the writers to discern what can be necessary to inform the patient of.</p>

<p>Ventilator-associerad pneumoni (VAP) är den vanligaste infektionen på intensivvårdsavdelningar. Det är en komplikation som orsakar stort lidande, ökad mortalitet och medför höga vårdkostnader. Det finns många evidensbaserade riktlinjer för att förhindra att VAP uppstår, där sjuksköterskan har en betydande roll. Flera studier har visat att det finns brister i sjuksköterskans kunskap att tillämpa de evidensbaserade riktlinjerna för att förhindra uppkomsten av VAP. Syftet med studien var att beskriva intensivvårdsjuksköterskors tillämpning av de evidensbaserade riktlinjerna för att förhindra uppkomsten av ventilatorassocierad pneumoni hos intensivvårdspatienter samt att jämföra tillämpningen av riktlinjer mellan subgrupper. En strukturerad enkät delades ut till alla intensivvårdsjuksköterskor (N=40) på en intensivvårdsavdelning i mellansverige, varav 30 besvarade enkäten. Resultatet visade att intensivvårdsjuksköterskorna tillämpar de evidensbaserade riktlinjerna i hög utsträckning utifrån självskattningar. Det framkom inga signifikanta skillnader mellan de med kort (0-5 år) och lång (>5 år) erfarenhet som intensivvårdsjuksköterska, vad gäller i vilken utsträckning de använder de evidensbaserade riktlinjerna för att förhindra uppkomsten av VAP. Kunskapen och tillämpningen av de evidensbaserade riktlinjerna kan anses vara god hos respondenterna i föreliggande studie utifrån självskattningar. I det närmaste alla respondenter hade fått utbildning/information om VAP vilket kan vara orsaken till det resultat som framkom. Många tidigare studier har visat att utbildning ökar tillämpningen av de evidensbaserade riktlinjerna.</p> / <p>Ventilator-associated pneumonia is the most common infection in the intensive care unit. It is a complication that causes major morbidity, increased mortality and growing healthcare costs. There are many evidence-based clinical practice guidelines in order to prevent that VAP arises, where the nurse has a significant role. Several studies have established that there is deficiencies in the nurse's knowledge to apply to the evidence-based guidelines in order to prevent the origin of VAP. The aim with the study was to describe intensive care unit nurses' application of the evidence-based guidelines in order to prevent the origin of VAP at intensive care patients and to compare the application of the evidence-based guidelines between subgroups. A structured questionnaire was distributed out to all intensive care nurses (N=40) on an intensive care unit in the middle of Sweden, of which 30 responded to the questionnaire. The result showed that the intensive care nurses apply to the evidence-based guidelines in a high extent on the basis of self-reports. There were no significant differences between they with short (0-5 year) and long (> 5 year) experience as an intensive care nurse, as regards in what extent they use the evidence-based guidelines in order to prevent the origin of VAP. The respondents knowledge and application of the evidence-based guidelines can be considered to be good in this study, on the basis of self-reports. Most of the respondents had got education/information about VAP, what can have caused the result that appeared. Many previous studies have shown that education increases the application of the evidence-based guidelines.</p>

<p>Several cities have implemented various projects to improve traffic safety in city centers.During 1970s and 1980s the city centers changed as the suburbs grew and large shopping centers were located outside the center. At the same time, several projects were initiated with construction of pedestrian streets and restriction of traffic in the center. In year 1994,shared-used areas were introduced in Sweden and these areas are often used in center environments.</p><p>In Sweden, municipalities are responsible for integrating security in public places and in comprehensive plans and detailed development plans. The National Board of Housing,Building and Planning is the authority for administrating planning issues and develop general guidance about planning. Traffic is one of their key issues, although today there are no concrete guidelines from the National Board of Housing, Building and Planningfor the design of traffic safety in city centers.</p><p>Traffic safety in city centers affects many people because the city center is a public place.It is therefore important that there are current guidelines available that are helpful for changes and improvements in traffic safety in the city center.</p><p>The purpose of this report is to formulate guidelines for planning city centers from a traffic safety perspective. The aim is that the guidelines can be applied in the design of smaller city centers for improving traffic safety. For this report two case studies were implemented that included inventories and observations of Bollnäs and Sandviken city centers. The results showed that many of the streets did not function well and that there was a lack of design in the city centre center from a traffic safety perspective, for example pedestrian crossings and car parks.</p><p>Inventories and observations are good methods to see how the traffic environment in the city center varies in use and function. The observations and inventories resulted in guidelines with recommendations for the design of streets and traffic in small city centers.</p> / <p>Flera städer har genomfört olika projekt för att öka trafiksäkerheten i stadscentrumen.Under 1970-talet och 1980-talet förändrades stadscentrum i takt med att förorter växte fram och externa köpcentrum etablerades utanför centrum. Samtidigt påbörjades flera projekt med att anlägga gågator och begränsa biltrafiken i centrum. År 1994 infördes gårdsgator i Sverige och dessa används ofta i centrummiljöer.</p><p>I Sverige är det kommunerna som ansvarar för att säkerhet integreras planering av offentliga platser. Boverket är den myndighet som förvaltar frågor och tar fram allmänna råd angående planering. Trafik är en av deras viktigaste planeringsfrågor men idag finns inga konkreta råd från Boverket för utformning av trafiksäkra centrum.</p><p>Trafiksäkerhet i stadscentrum påverkar många människor eftersom att centrum är enoffentlig plats. Därför är det viktigt att det finns aktuella riktlinjer som är till hjälp vid förändringar och förbättringar i trafiksäkerheten i centrum.</p><p>Rapportens syfte var att utforma riktlinjer för planering av mindre stadscentrum ur ett trafiksäkerhetsperspektiv. För att kunna upprätta riktlinjer genomfördes två fallstudier.Dessa innefattade inventering och observation av Bollnäs och Sandvikens centrum.Bollnäs och Sandvikens centrum hade liknande funktioner av gatorna. Centrumens kärna fungerade till stor del som transportsträckor men även som promenadgator. Resultaten visade att många av gatornas tänka funktioner inte fungerade och att det fanns bristandeutformning av olika målpunkter, exempelvis övergångsställen och bilparkeringar.</p><p>Inventeringar och observationer är bra metoder för att se hur trafikmiljön i centrumfungerar eftersom användning och funktion av olika målpunkter varierar.Observationerna och inventeringen resulterade i riktlinjer med rekommendationer för utformning av gator och trafikmiljö i mindre stadscentrum.</p>

<p>Nosokomiala infektioner förekommer världen över och är en stor orsak till sjukdomar och dödlighet. Även i Sverige är nosokomiala infektioner ett problem, både på sjukhus och i andra vårdformer. Basala hygienrutiner är den viktigaste åtgärden för att förebygga uppkomst av infektionssjukdomar.  Syftet med denna studie var att undersöka och jämföra hemtjänstens undersköterskor och vårdbiträden, gällande deras kunskaper och följsamhet till basala hygienrutiner, samt deras kunskaper angående den vanligaste smittvägen inom vården. Datainsamlingen gjordes med en enkät som innehöll 22 frågor. Fyra hemtjänstgrupper ingick i studien, där totalt 66 vårdbiträden och 30 undersköterskor inkluderades. Resultatet visade att följsamheten till handtvätt och handdesinfektion efter ett omvårdnadstillfälle var hög, dock var följsamheten till handdesinfektion före ett omvårdnadstillfälle mindre bra. Följsamheten till handskar vid personlig hygien var mycket god, resultatet visade dock att de flesta endast använde plastförkläde/skyddsrock ibland. Många av respondenterna i båda undersökningsgrupperna kände inte till vilka områden som ingår i begreppet basala hygienrutiner, däremot kände många till den vanligaste smittvägen inom vården. Endast en statistisk signifikant skillnad kunde påvisas mellan undersköterskor och vårdbiträden. Slutsatsen var att begreppet basala hygienrutiner måste tydliggöras och att mer information behövs om vid vilka tillfällen händerna ska tvättas eller desinficeras. Ytterligare information behövs även om varför och vid vilka tillfällen plastförkläde eller skyddsrock ska användas.<strong></strong></p><p> </p> / <p>Nosocomial infections is a big cause of disease and mortality worldwide. In Sweden nosocomial infections also is a big problem, both in hospitals and other care facilities. Hygiene guidelines is the most important measure to prevent infection diseases. The aim of this study was to measure and compare licensed practical nurses and nursing assistants in homemaker services, concerning their knowledge and compliance to hygiene guidelines and their knowledge about the most common way of spread of infection in healthcare. The data collection was conducted with a questionnaire including 22 questions. Four groups in homemaker services were included in the study, totally 66 nursing assistants and 30 licensed practical nurses. The result showed that the compliance to hand washing and hand disinfection after a  care opportunity was high, however the result showed that hand disinfection before a  care opportunity was less good. The compliance of using gloves was very good in personal hygiene opportunities. The result also showed that most of the respondents only used aprons occasionally. Many of the respondents didn’t know which areas are included in hygiene guidelines, however many had knowledge about the most common way of spread of infection in healthcare. Only one statistical significant distinction was established between nursing assistants and licensed practical nurses. The conclusion showed that hygiene guidelines must be elucidate and that more information is needed about when hands should be washed or disinfected. Further information is also needed about why and in which occasions aprons should be used.</p><p> </p>

<p>Denna uppsats syfte är att undersöka hur man arbetar med nyanlända elever i en förberedelseklass i en söderförort i Stockholm och hur detta stämmer överens med styrdokumenten och Skolverkets mål och riktlinjer för nyanlända elever. För att uppnå detta syfte har det gjorts två kvalitativa forskningsintervjuer med två förberedelseklass lärare varv en veckas strukturerad icke deltagande observationer i förberedelseklassen. Skolverket har format mål och riktlinjer för de nyanlända eleverna som ska fungera som en läroplan för dessa elever. Det har visat sig i studien att även om Skolverket säger att man ska ta hänsyn till varje nyanländ elevs bakgrund, tidigare erfarenhet, kunskap och språk är det inte lika lätt att göra detta i praktiken. Det har även framkommit att det är svårt att utgå från Skolverkets mål och riktlinjer när det gäller alla nyanlända elever eftersom eleverna i förberedelseklassen kommer från olika förhållanden. Huvudresultatet för studien är att man i den undersökta skolans förberedelseklass försöker följa Skolverkets mål och riktlinjer med de resurser som skolan har för att få det bästa resultatet. Man utgår även från att arbeta med den enskilda individen beroende på vad den har med sig för upplevelser från sitt hemland och beroende på vart den befinner sig i sin utveckling.</p>

<p>This study aims to investigate associations in two areas in Stockholm County with diverse socio-economic conditions. The study intends to examine the impact these differences have on what role the bureaucrats and politicians in the two areas think that the associations should have. Bureaucrats are those who design guidelines for associations and that is why they have an important role in the conditions of the associations. A comparison between the two areas has been made to see if the requirement in the guidelines for the areas are different according to where the members live. The two areas that have been used to compare the guidelines of associations are Danderyd municipal and the district Spånga-Tensta. These two areas have economic and social resource differences. The study is based on qualitative approach in which interviews with bureaucrats and local politicians from each area were used to obtain a deeper understanding of what impact socio-economic conditions have on the associations. There are major differences in the range of associations between these two areas, this may be because of the different demands that the bureaucrats and politicians have on the associations. Guidelines for associations show clear differences in the role that the bureaucrats and politicians believe that the associations will play in the area.</p> / <p>Denna studie syftar till att undersöka förutsättningarna för föreningslivet i två områden i Stockholms län med skilda socioekonomiska förhållanden. Studien ämnar till att undersöka vilken inverkan dessa skillnader har på hur byråkraterna och politikerna i de båda områdena ställer sig till föreningslivets roll i respektive område. Byråkraterna är de som utformar riktlinjerna för föreningsbidrag, därför har de en viktig roll i föreningslivets förutsättningar. För att se om det ställs olika krav på föreningsmedlemmar beroende på vilket område de bor i har en jämförelse gjorts mellan riktlinjerna för respektive område. De två områden som har använts för att jämföra riktlinjerna för föreningsbidrag är Danderyds kommun och stadsdelen Spånga-Tensta. Dessa två områden skiljer sig gällande ekonomiska och sociala resurser. Studien är baserad på kvalitativ metod där intervjuer med byråkrater och lokalpolitiker från respektive område har använts för att få en djupare förståelse för vilken inverkan de socioekonomiska förhållandena har på föreningslivet. Det råder stora skillnader i utbudet av föreningar mellan dessa två områden, detta kan bero på att de krav som ställs på föreningarna skiljer sig åt. Riktlinjerna för föreningsbidrag visar tydliga skillnader i den roll som byråkraterna och politikerna anser att föreningarna ska fylla för området.</p>