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Perifer vaskulär insufficiens innebär arteriell och/eller venös cirkulationssvikt i nedre extremiteter, vilket kan förorsaka bensår. Vaskulär insufficiens i benen är ett ökande hälsoproblem som ofta är ett mycket smärtsamt tillstånd och kan ha stora konsekvenser för den drabbade i dennes dagliga liv. Litteraturöversikt valdes som metod för att besvara syftet; att beskriva forskning om patienters upplevelser av hur perifer vaskulär insufficiens i de nedre extremiteterna påverkar det dagliga livet. Detta utifrån Carnevalis omvårdnadsteori om dagligt liv funktionellt hälsotillstånd. Stora inskränkningar i dagligt liv på grund av sjukdomen identifierades i litteraturen. Smärtan spelade en central roll i flertalet begränsningar respondenterna mötte. Den sänkte deras mobilitet, vilket medförde social isolering och begränsningar i vardagliga aktiviteter och förändrad självbild. Smärtan orsakade även sömnrubbningar och förändrade sinnesstämningar. Flera respondenter upplevde rädslor, de med arteriell insufficiens för amputation och för tidig död, och de med venös insufficiens för situationer som kunde medföra nya sår. Ett annat återkommande fynd var brist på kunskap, smärtlindring och brister i relationen med vårdpersonal. / Peripheral vascular insufficiency entails arterial and / or venous circulatory failure in the lower extremities, which can cause ulcers. Vascular insufficiency in the legs is an increasing health problem which often is a very painful condition and can have a major impact on the patient's daily life. Literature review was chosen as a method to answer the study aim; to describe research on patients' experiences of peripheral vascular insufficiency in the lower limbs and how it affects everyday life. This according to Carnevali’s theory on daily life functional health status. Major limitations in daily life because of the disease were identified in the literature. The pain was a central part of the restrictions all respondents met. It lowered mobility, leading to social isolation, limitations in activities in daily life and change in self-image. The pain also caused sleep disorders and altered moods. Several respondents experienced fears, those with arterial insufficiency of amputation and premature death, and those with venous insufficiency of situations that could cause new ulcers. Another frequent finding was a lack of knowledge, pain relief and trustful relationships with health professionals.

The purpose of this study was to compare high-resistance cycle training (HRCT) with resistance training (RT), and their effects on Wingate anaerobic test watt max (Wmax) and watt average (Wave), strength (improvement in 1 repetition max [RM]), and time-trial performance. Twenty-five healthy college-age untrained male subjects were randomly assigned to the HRCT (n=10), RT (n=10), or control (n=5) group. All subjects completed pre and posttesting for the leg press (LP), 30 s Wingate anaerobic test, and 15-min time-trial. Subjects also completed familiarization tests prior to pretesting in the Wingate anaerobic test and 15-min time-trial. HRCT and RT subjects trained 2x/wk for 8 weeks with at least 48 hrs between training sessions. During each training session HRCT completed 4 x 30 sec efforts increasing resistance when >65 rotations per minute (rpm) could be maintained for the full training session. RT completed 3 x 10 repetitions of leg press with weight increasing 5 -10 lbs when all repetitions were completed during a training session. ANOVA with Tukey post-hoc was used to determine if differences existed between the groups. Within group change was analyzed using paired T-test. Effect size was computed to determine meaningfulness of differences. HRCT and RT groups both showed statistical significance (p < 0.05) pre to posttesting in LP, Wingate anaerobic test Wmax and Wave, and 15-min time-trial. Control group also showed statistical significance (p < 0.05) pre to posttesting in LP and 15-min time-trial. Significant between group differences were noted between HRCT and control in Wingate anaerobic test Wmax (p=0.03) and Wave (p = 0.007) and 15-min time-trial (p = 0.003). There was a significant difference between RT and control on the 15-min time-trial (p = 0.008). When comparing HRCT and RT no statistical difference was seen in LP, Wingate anaerobic test Wmax and Wave, and 15-min time-trial. High-resistance cycle training and RT resulted in similar strength gains. However, HRCT showed greater improvements in cycling specific activities: 30 s Wingate anaerobic test Wmax and Wave, and 15-min time-trial. Results suggested that HRCT may increase performance on bike related assessments when compared to RT.

Electronic identification is used by an individual to prove who he or she is by electronic means and is normally used for logging in to various services. In Sweden there are a number of different solutions that are developed and provided by different parties. In order to promote and coordinate electronic identification for public services, the Swedish E-identification Board was founded in 2011. The Board has developed a technical framework for integration between the Relying Party and the Identity Provider based on the Security Assertion Markup Language V2.0 (SAML) standard. SAML is a quite old standard that has some limitations complicating an electronic identification solution based on it. A newer competing standard is OpenID Connect, which could be a possible candidate as an alternative to SAML. The objective of this thesis is to determine to what extent it is possible to ensure confidentiality, integrity, and accountability in an electronic identification based on OpenID Connect. To achieve this, a number of requirements for electronic identifications were identified and a design proposal based on OpenID Connect was developed together with a proof-of-concept implementation. The design proposal was evaluated against the requirements, with the final result that an electronic identification based on OpenID Connect could meet the requirements. / E-legitimation används av en individ för visa vem han eller hon är på elektronisk väg och används vanligtvis för att logga in på olika tjänster. I Sverige finns ett antal olika lösningar som utvecklas och tillhandahålls av olika parter. För att främja och samordna elektronisk identifiering för offentliga tjänster grundades E-legitimationsnämnden 2011. Nämnden har tagit fram ett tekniskt ramverk för integrationen mellan Förlitande Part och Legitimeringstjänst baserad på Security Assertion Markup Language V2.0 (SAML) standarden. SAML är en relativt gammal standard med vissa begränsningar som komplicerar en e-legitimationslösning baserad på den. En nyare konkurrerande standard är OpenID Connect, vilket kan vara en möjlig kandidat som ett alternativ till SAML. Syftet med detta examensarbete är att undersöka i vilken utsträckning det är möjligt att säkerställa sekretess, integritet och ansvarsskyldighet för en e-legitimation baserad på OpenID Connect. För att uppnå detta, identifierades ett antal krav för e-legitimationer och ett designförslag baserat på OpenID Connect utvecklades tillsammans med en proof-of-concept implementation. Designförslaget utvärderades mot kraven, med det slutliga resultatet att en e-legitimation baserad på OpenID Connect kan uppfylla kraven.

Syftet med denna litteraturstudie är att jämföra larvterapi och konventionella metoder vid behandling av svårläkta sår utifrån följande perspektiv: upprensning av sår, duration av sårläkning och patienternas upplevelse. Polit & Becks (2006) modell användes vid arbete med denna litteraturstudie. Sökning av relevant litteratur gjordes i tre databas: PubMed, CINAHL och The Cochrane Library. Relevanta artiklar granskades med hjälp av granskningsprotokollerna modifierade av författarna efter Willman (2006). Nio olika studier har undersökts i denna litteraturstudie. Studierna utreder dels larvterapins effektivitet i upprensning av sår samt larvernas läkningsförmåga och dels hur patienterna upplever larvterapi. Detta sattes i relation till konventionella behandlingsmetoder. Resultaten är positiva i larvterapins favör. Larvterapi är ett effektivt sätt att rensa upp nekrotisk och inflammerad vävnad i svårläkta sår. Såren rensas och läker fortare med få biverkningar jämfört med konventionella behandlingar. Dessutom bildas granulationsvävnad snabbare, vilket är en förutsättning för sårets läkning. Korrekt information och involvering av patienten skapar en positiv attityd i denna behandlingsform. Ett stort behov finns för detta i sårläkningens område pga ökade restriktioner av antibiotikaanvändning och ett önskat minskat lidande hos patienter med svårläkta sår. Det finns stora möjligheter för larvterapin om den fortsätter att utforskas. / The aim of this literature study is to compare larva therapy and conventional methods in treatment of ulcers on the basis of the following perspective: debridement of ulcers, duration of wound healing and patients´ experience. Polit & Becks (2006) model was used when working with this literature study. Search of relevant literature was done in three databases: PubMed, CINAHL and The Cochrane Library. Relevant articles were checked with the help of checklists modified of authors after Willman (2006). Nine different studies have been examined. The studies partly investigate the larva therapy’s effectiveness in debridement of ulcers and maggots´ capability in healing and partly how patients experience the larva therapy. This was set in relation to conventional treatment methods. The results are positive in larva therapy’s favour. Ulcers are debrided and healed quicker with few secondary effects compared to conventional treatments. Larva therapy is an effective way to debride necrotic and inflamed tissue in ulcers. Moreover new granulation tissue forms faster which is a condition for wound healing. Correct information and patients´ participation creates a positive attitude for this treatment. There is a big need for this in wound healing because of increased restrictions of use of antibiotics and desired decreased suffering for patients with ulcers. There are many possibilities with larva therapy if it continues to be researched.

Honungens terapeutiska egenskaper utgör en grund för dess användning vid behandling av svårläkta sår vilket kan vara ett alternativ till andra konventionella metoder. Syftet med föreliggande studie var att undersöka vetenskaplig litteratur för att belysa vilka effekter användning av honung kan ha i samband med svårläkta sår samt patienters tillfredställelse med behandlingen. En systematisk modell med sju steg användes som metod för denna studie. Litteratursökningen genomfördes i databaserna PubMed, CINAHL, Medline och Cochrane Library. Relevanta artiklar granskades med hjälp av protokoll modifierad av författarna. Resultatet av 8 inkluderade studier (9 artiklar) visar att behandling med honung möjligtvis är likvärdig konventionell behandling vid svårläkta bensår. Mer forskning av hög kvalitet behövs för att säkert fastställa effektiviteten avseende behandling med honung.Nyckelord: honung, komplementär medicinsk behandling, litteraturstudie, svårläkta bensår, sårläkning. / Therapeutic properties of honey forms a basis for its use in the treatment of recalcitrant wounds which can be an alternative to other conventional methods. The purpose of this study was to examine the scientific literature to illustrate which effects the use of honey may be associated with regarding ulcers and patients' experience of treatment. A systematic model with seven stages was used as a method for this study. The literature search was conducted in PubMed, CINAHL, Medline and the Cochrane Library. Relevant articles were reviewed according to protocol modified by the authors. The results of the eight included studies (nine articles) show that honey is probably equal treatment to other conventional treatments for healing of recalcitrant leg wounds. More high quality research is needed to evaluate the effectiveness of honey treatment. Keywords: honey, complementary medical treatment, literature review, recalcitrant leg ulcers, wound healing.

Syftet med denna systematiska litteraturstudie var att undersöka hur patienter upplever sitt venösa bensår och dess omvårdnadsåtgärder. Litteraturstudien grundades på metod av Forsberg & Wengström (2003). Tio vetenskapliga kvalitativa artiklar inkluderades i litteraturstudien. Resultatet visade på att patienters upplevelser av venösa bensår hade en negativ inverkan på livet. Hos patienterna fanns en ständig oro och rädsla för eventuella komplikationer, yttre våld mot såret samt känslor av hopplöshet gällande sårläkningen. Mer forskning krävs för att få en tydligare förståelse för dessa patienter och deras upplevelser av deras bensår samt upplevelser kring omvårdnadsbehandlingen vid venösa bensår. / The aim of this systematic literature review was to examine how patients perceived their risk of venous leg ulcers and its care measures. The literature study was based on a method of Forsberg & Wengström (2003). Ten scientific articles included in the literature study. The results showed that patients' perceptions of venous leg ulcers have a negative impact on their lives. Among the patients was a constant worry and fear of possible complications, external violence against the bone or the wound and feelings of hopelessness regarding the wound healing. More research is needed to reach a clearer understanding of these patients experience of their ulcers and the experiences of its care measures.

Bakgrund: I sitt dagliga arbete är det många yrkesutövare som ställs inför svåra utmaningar och höga förväntningar. Att kunna bearbeta och reflektera kring dessa utmaningar ger en ökad kompetens och förbättrad självkänsla. I dagens arbetsmiljö, präglad av tidsbrist och hög arbetsbelastning, kan svåra situationer lätt uppstå. Genom en strukturerad handledning tillsammans i grupp möjliggörs reflektioner och bearbetning av etiskt svåra situationer. Syfte: Studiens syfte var att undersöka om det finns ett behov och/eller intresse hos leg. sjuksköterskor för schemalagd omvårdnadshandledning, på ett mindre sjukhus i södra Sverige. Resultat: Studien visar att övervägande delen av antalet deltagare är positiva till att delta på omvårdnadshandledning. Majoriteten respondenter ansåg att behovet av omvårdnadshandledning fanns på arbetsplatsen och huvudparten av dessa var också överens om att schemalagd tid borde avsättas. / Background: Many professionals are faced with difficult challenges and high expectations in their daily work. To process and reflect on these challenges provide increased skill and also improved self-esteem. In today’s work environment, characterized by lack of time and heavy workload, difficult situations can easily arise. Through structured mentoring, in groups, reflection and processing of ethically difficult situations are made possible. Objective: The aim of this study is to investigate whether there is a need and/or interest in reg. nurses for scheduled clinical supervision. The study was conducted in a small hospital in southern Sweden. Results: The study shows that the vast majority of the participants are interested in participating in clinical supervision. The majority of the respondents felt that there is a need for nursing supervision in their workplace. Most of them also were of the idea that scheduled time should be devoted to supervision.

Epithelial morphogenesis is contingent upon cell shape changes. Cell shape changes are the driving force for the metamorphosis of the adult Drosophila leg from the leg imaginal disc precursor. Genetic analysis has identified several Drosophila genes involved in regulating cell shape changes during leg disc morphogenesis. These include members of the RhoA signaling pathway and the product of the Stubble-stubbloid (Sb-sbd) locus, a transmembrane serine protease. Mutations in the Sb-sbd gene interact genetically with the members of the RhoA signaling pathway, however the nature of the relationship between Sb-sbd serine protease activity and RhoA signaling is not understood. To identify additional components of the RhoA signaling pathway that may help us to understand the role of the Sb-sbd protease in RhoA signaling the Drosophila genome was systematically scanned for genes that interact with Sb-sbd and RhoA mutations using deletions/deficiencies of specified regions of each chromosome. A total of 201 deficiencies uncovering approximately 84.9-91% of the euchromatic genome and spanning the X, second, and third chromosoms were tested. Of the 201 deficiencies tested, five putative interacting genetic regions and one gene within these deficiencies were identified. The candidate gene Eip78C encodes a nuclear steroid hormone receptor previously identified as having an important role in metamorphosis.

This dissertation is a collection of several models to understand airline and passenger dynamics in the National Airspace System (NAS). Agent-based modeling is one of the most widely used modeling simulation-analysis approaches to understanding the dynamic behavior of complex systems. The usefulness of agent-based modeling has been demonstrated by simulating the complex interactions between airlines, travelers, and airports of a small-scale transportation system. Three airlines, one low cost and two network airlines are simulated to examine how each airline behaves over time to maximize their profit margins for a given passenger demand and operation cost structure. Passenger mode choice and itinerary choice sub modules are embedded in the framework to characterize traveler agent's response to the evolved airline schedule. An airport delay model was implemented to estimate the average delay at each airport. The estimated delay fed into the mode choice and itinerary choice models to update the travel time related variables. International passenger demand is a very important component of the air transportation system in the United States. The proportion of international enplanements relative to total enplanements increased from 8% in 1990 to 11% in 2008. Nine linear regression models are developed to forecast the enplanements from the United States to each of nine international regions. The international enplanements from the CONUS to each world region are modeled as a function of GDP and GDP per capita of both the United States and the specific region. A dummy variable is also used to account for the effects of September 11, 2001. The total number of international enplanements is forecast to increase from 74.7 million in 2008 to 184.4 million in 2028. The average annual growth rate is expected to be 4.7%. The European Union – United States Open Skies Agreement, which became effective March 30, 2008. Mathematical models are developed to forecast the effect of EU-US Open Skies Agreement on commercial airline passenger traffic over the North Atlantic Ocean. Nine econometric models were developed to forecast passenger traffic between the United States and nine selected European countries between 2008 through 2020. 68 new nonstop flights between the United States airports and the European airports are predicted by the model in 2020 using the airport pair passenger demand forecast. London, Heathrow is demonstrated as an example for rerouting the excess air travel passengers from one airport to other airports when the airport operational capacity is exceeded. The proportion of international enplanements relative to total enplanements within CONUS increased from 8% in 1990 to 11% in 2008. 51% of the sampled international and U.S. territories passengers served by U.S. carriers had at least one domestic coupon in 2007. The number of DOI passengers through airport-pairs in each of the historical years (1990-2007) is estimated based on the adjusted 100% international itineraries including pure international itineraries plus the non-CONUS itineraries. The total number of DOI enplanements is estimated to grow from 37.3 million in 1990 to 79.4 million in 2007. 193 CONUS airports are estimated to have at least 10,000 DOI enplanements in 2007. The number of DOI enplanements is forecast to grow from 79.4 million in 2007 to 206.2 million in 2030 with average growth rate of 4.2% per year. In recent years, there has been an increasing use of secondary airports both in Europe and the U.S. Regional airports have long been considered as a possible source of relief to reduce airport congestion at the hub airport and to efficiently accommodate future air travel demand. The conditions under which the secondary airports develop in a metropolitan area are examined. Fifteen multi-airport systems including 19 Operational Evolution Plan airports and 25 active secondary airports are identified in the National Airspace System. Diverse trends of traffic distribution among airports in the same metropolitan area are observed. We observed that the number of markets served at the secondary airports is less than that at the primary airport in the same metropolitan area. Most of the secondary airports are currently dominated by the low-cost carriers. The share of seats supplied by the low-cost carriers at the secondary airports has increased during the period 1990-2008. Full service carriers concentrate their service mainly on the primary airport in all the multi-airport systems analyzed. The average seat capacity per aircraft at the secondary airports is higher than that of primary airports in most of the multi-airport systems. The secondary airports mainly serve the domestic O&D passengers. / Ph. D.