Introduktion: Liverpool Care Pathway (LCP) är en vårdplan framtagen för palliativ vård vars syfte är att överföra det bästa av hospicevården till den övriga sjukvården. LCP ger vägledning för vårdpersonal i vården av patienter i livets slutskede för att säkerställa god vård för patient och närstående. Syfte: Syftet var att beskriva hur sjuksköterskan upplever användandet av vårdplanen Liverpool Care Pathway (LCP) i livet slutskede. Metod: Metoden som användes var litteraturstudie. Sökningar gjordes i CINAHL och PubMed där elva vetenskapliga artiklar, som svarade på studiens syfte, framkom och granskades i sin helhet. Resultat: Resultatet visade att LCP förbättrade kommunikationen, ökade kunskap och självförtroende, ökade delaktigheten för närstående i vården, förbättrade arbetsmiljön och ökade patientsäkerheten. Dock sågs en risk med att använda LCP som en standardiserad vårdplan vilket kunde medföra att patient och närstående kunde känna sig negligerade. Slutsats: Sjuksköterskans upplevelse av användandet av LCP har i litteraturstudien beskrivits positiv både för sjuksköterskan och annan vårdpersonal. Användandet av LCP har även resulterat i förbättrad vård för patient och närstående.

Abstract Background: There is a need of good palliative care of the growing elderly population. Liverpool Care Pathway (LCP) is a care program that was developed for palliative care in other facilities than hospice departments. There is lack of evidence on the effect of the LCP, therefore it has been phased out in many countries. Objective: To investigate the advantages and disadvantages of Liverpool Care Pathway, factors affecting the implementation and if the LCP can be used in the care of dying elderly non-cancer patients. Methods: A literature review containing 15 scientific original articles. Articles were searched in PubMed. All of the articles were of high or medium quality. Results: Several studies showed that communication improved. Treatment of symptoms and pain increased in frequency. Examinations and blood sampling decreased. Psychosocial support for patient and family improved. Management of medication was safer with the LCP. Shortcomings regarding documentation were discussed. The quality of implementation had influence on how the LCP would be carried out. Factors affecting implementation was time, money, personal views, leadership and support. Conclusion: The results of the literature review shows improvements on the communication, medication management, symptom management and psychosocial support to patients and families. The documentation process requires further improvement. For LCP to work optimally implementation it requires careful implementation with clear leadership and proper training. There are parts of the LCP that could be used in the care of dying elderly non-cancer patients, but more research is needed in this area. Keywords: LCP, Palliative Care, Elderly Care, Implementation, / Sammanfattning Bakgrund: Det finns ett behov av god palliativ vård hos den växande äldre befolkningen. Liverpool Care Pathway (LCP) är ett vårdprogram som togs fram för palliativ vård även utanför hospiceavdelningar. Evidens saknades för effekten av LCP, därför har den fasats ut i många länder. Syfte: Att undersöka fördelar och nackdelar med Liverpool Care Pathway, faktorer som påverkar implementeringen och om LCP kan användas vid vården av döende äldre utan cancerdiagnos. Metod: En litteraturöversikt innehållande 15 vetenskapliga originalartiklar. Artiklarna söktes i databasen PubMed. Samtliga artiklar bedömdes vara av medel eller hög kvalitet. Resultat: Flera studier påvisade att kommunikationen förbättrades. Symtom och smärtbehandling ökade i frekvens. Undersökningar och provtagningar minskade. Psykosocialt stöd till patienten och anhöriga förbättrades. Läkemedelshanteringen blev säkrare med LCP. Brister gällande dokumentation diskuterades. Kvaliteten på implementeringen hade stor inflytande på hur LCP skulle komma att utföras. Faktorer som påverkade implementeringen var tid, pengar, personliga åsikter, ledarskap och stöd. Slustats: Resultatet från litteraturöversikten visar att det finns fördelar för kommunikationen, läkemedelshanteringen, symtomhanteringen och psykosocialt stöd till patienter och anhöriga. Dokumentationen behöver förbättras. För att LCP ska fungera optimalt krävs en noggrann implementering med tydligt ledarskap och ordentlig utbildning. Det finns delar i LCP som skulle kunna användas i vården av döende äldre utan cancerdiagnos men mer forskning krävs inom området. Nyckelord: LCP, Palliativ vård, Äldreomsorg, Implementering

We simulate the behavior of a steel ball bearing as it impacts a rigid foundation by solving a discretized version of the dynamic equations of linearized elasticity for a homogeneous, isotropic material. Space is discretized using the finite element method and time is discretized using the implicit trapezoidal method. Impact with a fixed foundation is incorporated into the model using a complementarity condition. This ensures that we have normal forces acting on the bearing only when and where the bearing is in contact with the foundation. After discretization in space, this condition becomes a linear complementarity problem which is solved using an iterative method for solving LCPs that is similar to the Gauss-Seidel method for solving linear systems. The LCP is solved at each time step to determine the normal forces due to contact. By assuming cylindrical symmetry, we are able to simulate the impact of a three-dimensional ball using only two spatial coordinates and two-dimensional finite elements. This decreases the computational cost of a highly refined three-dimensional simulation dramatically. Using this model, we investigate the deformations that occur during and after contact. We hypothesized that dropping a steel ball from even a small height causes plastic deformation. We tested this hypothesis using our model by computing the state of stress inside the ball at various times during the simulation. By comparing the computed maximum shear stress to the yield strength of the material, we can determine if the threshold for plastic deformation is reached. We found that with an impact speed of 2 m/s the stresses induced in the ball are large enough to cause plastic deformation. Because plastic deformation requires energy and is irreversible, it is an important consideration when investigating how high the ball will bounce after contact. To quantify the energy loss due to plastic deformation, we propose a theoretical model capable of describing plastic deformation.

This research presents an analysis of low cost fabrication techniques for embedded thin film resistors suitable for large volume needs. High frequency applications are targeted from 2 to 40GHz. Two approaches are taken. The first utilizes commercially available foils to produce resistors using only thermocompression bonding and wet chemical etching. The second method utilizes electroless plating with a modified plasma treatment to promote adhesion to organic materials. This process uses only chemical baths to form the thin films. Several RF and millimeter wave applications using these processes have been explored including terminations and attenuators. Accurate simulations of resistor performance were obtained using impedance boundaries in conjunction with the finite element method. Resistors created using the foil transfer process are measured to be accurate within 5% of these simulated values. Electroless values are currently accurate to around 40%, with research underway expected to improve this to around 10%.

Wireless systems with emerging applications are leaning towards small size, light-weight and low cost. Another trend for these wireless devices is that new applications and functionalities are being added without increasing the size of the device. To accomplish this, individual components must be miniaturized and the system should be designed to maximize the integration of the individual components. The high level of 3D integration feasible in system on package design (SoP) concept can fulfill the latter requirement. Bandpass filters are important components on all wireless systems to reject the unwanted signals and reduce interference. Being mostly implemented with passive and distributed components, bandpass filters take considerable space in a wireless system. Moreover, with emerging bands and multiple applications encompassed in a single device, many bandpass filters are required. The miniaturization related to bandpass filters can be approached by three main ways: (1) at the component level through the miniaturization of individual bandpass filters, (2) at the system level through the use of tunable filters to reduce the overall number of filters, and (3) at the system level through the high level of integration in a 3D SoP platform. In this work we have focused on all three aspects of miniaturization of band pass filters mentioned above. In the first part of this work, a low frequency (1.5 GHz global positioning system (GPS) band) filter implemented through 3D lumped components in two leading SoP technologies, namely low temperature co-fired ceramic (LTCC) and the liquid crystal polymers (LCP) is demonstrated. The miniaturized filter is based on a second order topology, which has been modified to improve the selectivity and out-of-band rejection without increasing the size. Moreover, for the case of LCP, the filter is realized in an ultra-thin stack up comprising four metallization layers with an overall thickness of only 100 _m. Due to its ultra-thin structure, the LCP filter is ten times smaller size as compared to the filters reported in published work. The filter is exible and, therefore, suitable for conformal applications. In the second part of this work, relatively higher frequency (Ku band) distributed bandpass filter is presented which can be tuned through an applied magnetic field. This has been realized in a relatively new LTCC tape with magnetic properties, known as ferrite LTCC. Traditionally, magnetically tunable filters require large external electromagnets or coils, which are non-integrable to typical planar circuit boards and are also inefficient. To demonstrate high level of integration, completely embedded windings realized in multiple layers of LTCC have been used instead of the external coils. As a result, the presented bandpass filter is several orders of magnitude smaller that the reported ones. Aside from reducing the size, the embedded windings based design is more efficient than the external coils because it can avoid the demagnetization effect (fields lost at air-ferrite interface) and thus require much smaller bias fields for tunability. Though the embedded windings bring in a number of advantages as mentioned above, the currents passing through these windings generate considerable heat which can inuence the performance of the microwave structure (bandpass filters in our case). This has never been studied before fro Ferrite LTCC based designs with embedded windings. In this work, the effect of the heat generated by these windings has been investigated. It has been found that this self-heating effect inuences the tunability of the filters considerably so it must be estimated at the design stage. Therefore, a strategy to simulate this effect has been developed. The resultant simulations agree well with the measurements verifying the simulation strategy. The designs presented in this work demonstrate the feasibility of realizing highly integrated, miniaturized and tunable filters in SoP platform which are very suitable for modern and futuristic small form factor and slim wireless devices.

Thermotropic liquid crystalline polymers (TLCPs) possess a number of physical and mechanical properties such as: excellent chemical resistance, low permeability, low coefficient of thermal expansion, high tensile strength and modulus, and good impact resistance, which make them desirable for use in the storage of cryogenic fluids. Rotational molding was selected as the processing method for these containers because it is convenient for manufacturing large storage vessels from thermoplastics. Unfortunately, there are no reports of successful TLCP rotational molding in the technical literature. The only related work reported involved the static coalescence of two TLCP powders, where three key results were reported that were expected to present problems that preclude the rotational molding process. The first result was that conventional grinding methods produced powders that were composed of high aspect ratio particles. Secondly, coalescence was observed to be either slow or incomplete and speculated that the observed difficulties with coalescence may be due to large values of the shear viscosity at low deformation rates. Finally, complete densification was not observed for the high aspect ratio particles. However, the nature of these problems were not evaluated to determine if they did, in fact, create processing difficulties for rotational molding or if it was possible to develop solutions to the problems to achieve successful rotational molding. This work is concerned with developing a resin selection method to identify viable TLCP candidates and establish processing conditions for successful rotational molding. This was accomplished by individually investigating each of the phenomenological steps of rotational molding to determine the requirements for acceptable performance in, or successful completion of, each step. The fundamental steps were: the characteristics and behavior of the powder in solids flow, the coalescence behavior of isolated particles, and the coalescence behavior of the bulk powder. The conditions identified in each step were then evaluated in a single-axis, laboratory scale, rotational molding unit. Finally, the rotationally molded product was evaluated by measuring several physical and mechanical properties to establish the effectiveness of the selection method. In addition to the development and verification of the proposed TLCP selection method, several significant results that pertain to the storage of cryogenic fluids were identified as the result of this work. The first, and argueably the most significant, was that the selection method led to the successful extension of the rotational molding process to include TLCPs. Also, the established mechanical properties were found to be similar to rotationally molded flexible chain polymers. The biaxial rotationally molded container was capable of performing to the specified requirements for cryogenic storage: withstand pressures up to 34 psi at both cryogenic and room temperatures, retain nitrogen as a gas and as a cryogenic liquid, the mechanical preform retaining nitrogen, as both a gas and as a cryogenic liquid, and resist the development of micro-cracks during thermal cycling to cryogenic conditions. / Ph. D.

abstract: ABSTRACT X-Ray crystallography and NMR are two major ways of achieving atomic resolution of structure determination for macro biomolecules such as proteins. Recently, new developments of hard X-ray pulsed free electron laser XFEL opened up new possibilities to break the dilemma of radiation dose and spatial resolution in diffraction imaging by outrunning radiation damage with ultra high brightness femtosecond X-ray pulses, which is so short in time that the pulse terminates before atomic motion starts. A variety of experimental techniques for structure determination of macro biomolecules is now available including imaging of protein nanocrystals, single particles such as viruses, pump-probe experiments for time-resolved nanocrystallography, and snapshot wide- angle x-ray scattering (WAXS) from molecules in solution. However, due to the nature of the "diffract-then-destroy" process, each protein crystal would be destroyed once probed. Hence a new sample delivery system is required to replenish the target crystal at a high rate. In this dissertation, the sample delivery systems for the application of XFELs to biomolecular imaging will be discussed and the severe challenges related to the delivering of macroscopic protein crystal in a stable controllable way with minimum waste of sample and maximum hit rate will be tackled with several different development of injector designs and approaches. New developments of the sample delivery system such as liquid mixing jet also opens up new experimental methods which gives opportunities to study of the chemical dynamics in biomolecules in a molecular structural level. The design and characterization of the system will be discussed along with future possible developments and applications. Finally, LCP injector will be discussed which is critical for the success in various applications. / Dissertation/Thesis / Doctoral Dissertation Physics 2014

In the field of orthopaedics and traumatology, a whole series of problems appear related to fracture fixation by means of various types of plates. Appropriate application of the plate is the difficult task that a doctor needs to deal with in the operating room. Regarding mechanics, the number of screws and their spacing have a major impact on the healing process. If there are too many screws or lack of them, the fracture does not heal properly. This can lead to implant failure. This work deals with stress-strain analysis of screws and bone tissue with a fracture fixed by LCP. It deals with the influence of different geometrical configurations of the screws on the stress, deformation and strain of the system. For this purpose, the computational modelling was used by means of the finite element method. Two computational models have been created, on which different screw arrangement was analysed. The first computational model represents diaphysis of the femur that is at the beginning of the healing process. For the four load models and eleven geometric configurations and number of the screws, a total of 44 computations were performed. The second computational model represents the distal part of the femur. Femoral geometry model was created based on CT (computed tomography) examination, geometric model of the plate was created by 3D scanning. Deformations and stresses were compared in the three geometric configurations of the screws during the healing process.

This thesis concerns with change detection problematics in digital images captured under indoor conditions with an ordinary integrated camera in two consecutive moments. All challenges that accompany this problem will be discussed, starting with preprocessing and arriving to evaluation of the results. Currently used methods from this field are described and compared with each other such as differencing and LCP (Local Correlation Peak). A novel method, based on LTP descriptors, effectively solving this problem is proposed in this work. The proposed method is then tested on real data. The results of this tests are discussed subsequently. Besides the change detection method a method for parallax error minimization is proposed here.

This study examines how systems development operations manage the Software Development Life Cycle (SDLC) in a Low-Code Platform (LCP) and how these descriptions relate to today's SDLC standards. To investigate this, a case study for a specific LCP has been made. Semi-structured interviews have been carried out with the aim of investigating theSDLC managed in the investigated LCP. An analysis model based on ISO/IEC/IEEE12207:2017 has been used for a deductive thematic analysis. The analysis shows a great breadth regarding how system development operations can integrate an LCP into their IT infrastructure and work with it. The choice of strategy will control how the system development operation works with the SDLC for IT artifacts that are developed in theplatform. In order for the organization to be able to enjoy the benefits of the LCP, business processes need to be possible to model in the platform. Complex and extensive business rulesaffect the possibilities to model business logic through low-code in the platform. Addressing this through traditional code can increase the complexity of certain elements of the SDLC and the need for expertise, which can significantly increase resource requirements and the time required for the system development process. / Denna studie undersöker hur systemutvecklings-verksamheter hanterar SoftwareDevelopment Life Cycle (SDLC) i en Low-Code Platform (LCP) och hur dessa beskrivningarrelaterar till dagens standarder för SDLC. För att undersöka detta har en fallstudie för enspecifik LCP genomförts. Semistrukturerade intervjuer har utförts i syfte att undersöka hurolika projekt hanterat SDLC i den undersökta LCP:en. En analysmodell baserad påISO/IEC/IEEE 12207:2017 har använts för en deduktiv tematisk analys. Analysen visar på enstor bredd gällande hur systemutvecklings-verksamheter kan integrera en LCP i sinIT-infrastruktur och arbeta med denna. Valet av strategi kommer styra hursystemutvecklings-verksamheten arbetar med SDLC för IT-artefakter som utvecklas iplattformen. För att organisationen ska kunna åtnjuta fördelarna med LCP:en behöveraffärsprocesser vara möjliga att modellera i plattformen. Komplexa och omfattandeaffärsregler påverkar möjligheterna att modellera affärslogik genom low-code i plattformen.Att åtgärda detta genom traditionell kod kan öka komplexiteten i vissa moment i SDLC ochpåverka behovet av kompetens vilket avsevärt kan öka resurskrav och tidsåtgången försystemutvecklingsprocessen.