La tesi è strutturata in 3 capitoli e analizza gli investimenti e la regolamentazione nel broadband market". Il primo capitolo analizza la letteratura teorica ed empirica sul rapporto tra gli investimenti e la regolamentazione nel settore delle telecomunicazioni. Il secondo capitolo fornisce un'analisi teorica sullo "stepping-stone theory". La terza parte fornisce un'analisi sull'impatto dei diversi regimi normativi per la costruzione della Next Generation Networks. / This dissertation is composed of three papers and discusses the issue of investment and regulation in broadband market. The first paper reviews the specialized but growing branch of the literature. It surveys the relevant theoretical and empirical literature on the relationship between regulation, at both retail and wholesale level, and investment in telecoms infrastructures. Theoretical analyses state that with respect to retail (incentive) regulation, the firm‘s incentive to invest is related to the level of price cap. As for access regulation, mandatory unbundling can possibly discourage firms‘ incentive to invest, but this is not the case for all circumstances because some studies have displayed an opposite (positive) effect on investment. The influence of regulators‘ limited ability to make credible commitment ex ante is not negligible either. Evidence in empirical findings exhibits a certain disunity. The majority concludes that local loop unbundling based on forward-looking cost methodology discourages both ILECs and CLECs from investing in networks, so that the stepping-stone theory is possibly not supported by the data; other findings support the non-negative effect of access regulation on investment. The second paper provides theoretical analysis on the stepping-stone theory. We dynamically model the competition between a vertically-integrated incumbent firm and a facilities-free new entrant in broadband market, where both firms are entitled with investment options: not only can the incumbent decide how much to spend in upgrading its existing network, but also the entrant can choose whether and when to invest on the construction of its own network. The analysis is conducted under three different kinds of competition: pure services-based, pure facilities-based and mixed competition. We find that the entrant's ability to provide value-added services affects the incumbent's investment choice. Our simulation results support the stepping-stone theory that access regulation provides an impetus for the entrant to invest in their own facilities after entering the market based on leased lines. It is also socially desirable because both the overall welfare and the consumer surplus are maximized in a regulated market under mixed competition. The third paper studies impacts of different regulatory regimes on the construction of Next Generation Networks (NGNs). We model the competition between a vertically-integrated incumbent firm and a facilities-free entrant firm in broadband market, where the incumbent has an investment option to upgrade its current network to the NGN. In order to analyze how policy settings affect the incumbent firm‘s investment choice, three kinds of regulatory regimes are discussed: no regulation, partial regulation (only the traditional network is regulated and the NGN is unregulated) and full regulation (both the traditional network and the NGN are regulated). We find that not only the entrant‘s ability to provide value-added services, but also the substitution factor that indexes the decrease in consumers‘ willingness to pay for the traditional service once the investment occurs, affect the incumbent‘s investment choice. Moreover, the comparison of results under different regimes shows that the incumbent invests the most under partial regulation, which sheds some light on impelling the deployment of Next Generation Networks.

Myoclonus-Dystonia (MD) is an inherited, rare, autosomal dominant movement disorder characterized by quick, involuntary muscle jerking or twitching (myoclonus) and involuntary muscle contractions that cause twisting and pulling movements, resulting in abnormal postures (dystonia). The first MD locus was mapped to 7q21-q31 and called DYT11; this locus corresponds to the SGCE gene. Our group previously identified a second MD locus (DYT15) which maps to a 3.18 Mb region on 18p11. Two patients were chosen to undergo next-generation sequencing, which identified 2,292 shared novel variants within the critical region. Analysis of these variants revealed a 3 bp duplication in a transcript referred to as CD108131, which is believed to be a long non-coding RNA. Characterization of this transcript determined that it is 863 bp in size, it is ubiquitously expressed, with high expression in the cerebellum, and it accounts for ~3% of MD cases.

Recent advances in next generation sequencing have provided unprecedented opportunities for high-throughput genomic research, inexpensively producing millions of genomic sequences in a single run. Analysis of massive volumes of data results in a more accurate picture of the genome complexity and requires adequate bioinformatics support. We explore computational challenges of applying next generation sequencing to particular applications, focusing on the problem of reconstructing viral quasispecies spectrum from pyrosequencing shotgun reads and problem of inferring informative single nucleotide polymorphisms (SNPs), statistically covering genetic variation of a genome region in genome-wide association studies. The genomic diversity of viral quasispecies is a subject of a great interest, particularly for chronic infections, since it can lead to resistance to existing therapies. High-throughput sequencing is a promising approach to characterizing viral diversity, but unfortunately standard assembly software cannot be used to simultaneously assemble and estimate the abundance of multiple closely related (but non-identical) quasispecies sequences. Here, we introduce a new Viral Spectrum Assembler (ViSpA) for inferring quasispecies spectrum and compare it with the state-of-the-art ShoRAH tool on both synthetic and real 454 pyrosequencing shotgun reads from HCV and HIV quasispecies. While ShoRAH has an advanced error correction algorithm, ViSpA is better at quasispecies assembling, producing more accurate reconstruction of a viral population. We also foresee ViSpA application to the analysis of high-throughput sequencing data from bacterial metagenomic samples and ecological samples of eukaryote populations. Due to the large data volume in genome-wide association studies, it is desirable to find a small subset of SNPs (tags) that covers the genetic variation of the entire set. We explore the trade-off between the number of tags used per non-tagged SNP and possible overfitting and propose an efficient 2LR-Tagging heuristic.

No description available.

Abstract Purpose. To identify symptoms/distress among patients with colorectal cancer, from the viewpoint of the next of kin, before and after chemotherapy, and to establish whether there are any barriers to reporting these.   Methods. Individual face-to-face interviews with fourteen next of kin were conducted. Qualitative content analysis was used to analyze the transcripts.  Results. Three areas were identified: symptoms presented, influences on life for the next of kin, and barriers to reporting symptoms/distress. Nine symptoms were raised as most common by the next of kin. All next of kin talked to a large extent about how the patient’s disease and treatment affected them. It affected them psychologically, they had to revaluate their life, and it influenced their social life. Almost all next of kin denied that they experienced any barriers to reporting symptoms/distress though they mentioned the lack of properly communication and lack of time. Conclusions. Although it was not the main purpose of the study, the next of kin raised concerns about the patient’s disease and treatment and how it influenced their life. They mentioned barriers to reporting symptoms, but not to a large extent. The symptoms reported before and during chemotherapy were similar to those found in other studies.

Bakgrund: Palliativ vård som bedrivs i hemmet blir allt vanligare och forskning visar att många vill dö i sitt eget hem. Detta ställer ofta stora krav på närstående till patienter som befinner sig i livets slutskede, då de får inta en vårdande roll. Många närstående upplever den vårdande rollen som positiv, då de får tillbringa den sista tiden tillsammans med patienten. Emellertid upplever många närstående den vårdande rollen som negativ, bland annat för att de kan känna att de har kastats in i rollen som vårdare och därmed förlorat sin frihet. Syfte: Syftet med denna studie är att beskriva hur närstående till patienter i palliativ hemsjukvård upplever sin livssituation. Frågeställningar: Vad för slags stöd är närstående i palliativ hemsjukvård i behov av samt hur kan sjuksköterskan möta dessa behov? Metod: Denna studie är en litteraturstudie där elva kvalitativa artiklar har granskats och utifrån liknelser i studiernas resultat har kategorier utformats, vilka utgjort material till resultatet i denna litteraturstudie. Travelbees omvårdnadsteori, med betoning på den mellanmänskliga relationen, har använts som teoretisk utgångspunkt och kopplats till flera delar i resultatdiskussionen. Resultat: De kategorier som utformades var: Förändringar i vardagen, Tankar och känslor av skuld, Att känna sig sedd och vara delaktig samt Information och kommunikation. Under dessa rubriker beskrivs hur de närstående upplever olika livssituationer.  Diskussion: Resultatet diskuterades utifrån de kategorier som utformats. I diskussionen avhandlades hur sjuksköterskan kan ge stöd till närstående i olika situationer samt vad sjuksköterskan har för ansvar. / Background: Palliative home care is becoming more common and research show that many want to die in their own home. This makes great demands on next of kin of patients at the end of life as they take on a caring role. Many next of kin experiences the caring role as positive as they spend the last time with the patient. However, some of the next of kin experience the caring role as negative because they feel themselves forced into the caring role and therefore lose their freedom. Aim: The aim of this study is to describe how next to kin to patients in palliative home care experience their life situation. Questions: What kind of support is the next of kin in palliative home care in need of and how can the nurse meet their needs? Method: This study is a literature study. Eleven qualitative studies have been reviewed from which categories have been formulated. These categories represent the basis of the results in this study. The theory of the interpersonal relationship by Travelbee is used as theoretical starting-point and is used in several sections in the discussion of the results. Results: The formulated categories are: Changes in everyday life, Thoughts and feelings of guilt, To be seen and to participate and Information and communication. In these categories the experiences of various life situations of next of kin are described. Discussion: The result is discussed from the formulated categories. The responsibility of the nurse and ways of support to next of kin in different life situations are being discussed.

Bakgrund: Palliativ hemsjukvård är en växande vårdform i Sverige som ställer höga krav på involveringen av anhöriga. De anhöriga inom palliativ hemsjukvård befinner sig i en utsatt och omvälvande situation där vårdbördan kan upplevas mycket stor. Stödet från vården har en stor del i hur de anhöriga upplever situationen och ifall den sjuke kan erhålla vård i sitt hem. För att vården ska kunna stödja de anhöriga på ett lämpligt sätt krävs insyn i hur de anhöriga upplever sin situation. Syfte: Att beskriva anhörigas upplevelse av att ha en svårt sjuk närstående som vårdas med palliativ hemsjukvård. Metod: En litteraturstudie baserad på åtta kvalitativa studier publicerade mellan år 2002-2010. Använda databaser är CINAHL, PubMed, Academic Search Premier samt Nursing & Allied Health Source. Även en manuell sökning gjordes. Dataanalysen utfördes enligt metoden beskriven av Friberg som är inspirerad av metaanalys. Resultat: Fem övergripande teman identifierades. Dessa är upplevelsen av en påverkad självbild och identitet, upplevelsen av stöd, upplevelsen av att sätta sig själv i andra hand, upplevelsen av att bli sviken av hemsjukvården samt upplevelsen av att vara tillsammans i dödens närhet. Huvudfyndet som är genomgående i alla teman är de anhörigas påverkade självbild. Diskussion: Resultatet diskuterades utifrån värdighetsbegreppets fyra delar meritvärdighet, den moraliska resningens värdighet, identitetsvärdighet och den universella mänskliga värdigheten. I resultatet blir de anhöriga inte sedda som en egen person, de upplever sig inte ha något val och de tvingas sätta sig själva i andra hand när de vårdar den sjuke. Författarna diskuterar hur detta kan påverka den anhörigas meritvärdighet, identitetsvärdighet och moraliska resningsvärdighet. / Background: In Sweden palliative home care is expanding rapidly and implies high demands on the next of kins’ involvement. Next of kin of relatives enrolled in palliative home care often find themselves in a demanding position and the burden of the care is experienced as heavy to bear. The support from professional caregivers’ can have an influence on how the next of kin experience his or her situation and if the sick relative can receive care at home. It is important for professional caregivers to understand how the next of kin can experience their situation to be able to support them adequately. Aim: To describe lived experiences as narrated by the next of kin of a relative with a severe condition who is cared for by palliative home care. Method: This article is a literature review based on eight qualitative studies published 2002-2010. The studies were found in the databases CINAHL, PubMed, Academic Search Premier and Nursing & Allied Health Source and by a manual search. A data analysis inspired by meta analysis described by Friberg was performed. Result: In the result five main themes were identified; the experience of one’s affected self image and identity, experiences of support, the experience of putting yourself second, the experience of being let down by professional caregivers and the experience of being together close to death. The key finding in the result is the next of kins’ affected self image which can be found in all themes. Discussion: The concept dignity and its four components merit dignity, identity dignity, morale dignity and human dignity led the way in the discussion of the result. In the result the next of kin is not seen as an individual person, they experience that they do not have a choice whether to care or not and they always put themselves second. The writers discuss how these experiences can affect the next of kins’ merit dignity, identity dignity and morale dignity.

Suicid och suicidförsök  sätter närstående i en svår situation.  Lite forskning är bedrivet om vilka behov av stöd närstående har. Det lyfter  behovet  av  att sammanställa  publicerad  forskningen  inom området  för  att  identifiera  på  vilket  sätt  sjuksköterskan  kan underlätta  närståendes  situation.  Syftet  var  att  identifiera behovsområden  där  sjuksköterskan  kan  vara  till  stöd  för närstående  efter  suicid  och  suicidförsök.  Studien  var  en litteraturstudie  där  resultatet  baserades  på  elva  vetenskapliga artiklar  som  genomgick  noggrann  granskning  och  bearbetning. Resultatet  visade  att  suicid  och  suicidförsök  är  fysiskt  och psykiskt påfrestande för närstående och att det finns ett behov av att  tala  om  det  inträffade.  Social  stigmatisering  av  begreppen råder,  vilket  leder  till  att  närstående  är  selektiva  med  vilka  de väljer  att  prata  med  och  i  vilken  utsträckning  de  väljer  att  göra det.  För  närstående  till  suicidförsök  fanns även  ett  uttalat  behov av  avlastning,  då  flertalet  artiklar  indikerade  en  risk  för utbrändhet  och  emotionell  avtrubbning  till  följd  av  en  konstant oro för nya suicidförsök. I studien framkom det att sjuksköterskor behöver  mer  utbildning  inom  suicidområdet för  att  optimera vården av den suicidala och för att förbättra stödet till närstående. Närståendes  behov  av  stöd  är  fortfarande  relativt  outforskat  och mer forskning inom området behövs. / Suicide  and  attempted  suicides  puts  next  of  kin  in  a  difficult position. There  is  little  research  done  in  the  field  related  to  the next of kin needs of support. This clarifies the need of compiling the  research  area  in  order  to  identify  in  what  way  nurses  can support next of kin. The aim of the study was to identify the needs of  support  experienced  by  next  of  kin  to individuals  who attempted  suicide and committed  suicide and how  nurses  could provide  aid  in  these.  The  study  was  a  review  article  based  on eleven  scientific,  peer  reviewed,  research  articles.  The  review pointed  out  that  the  experience  of  dealing  with  suicide  and attempted suicides are both physical and emotionally wearing for the  next  of  kin  and  that  there  exists  a  need  to  talk  about  the experience. However, there exists a stigmatization of both suicide and  attempted  suicides  within  society  which  makes  next  of  kin very selective of whom to confide in and to what extent. Among next  of  kin  to  individuals  who  attempted  suicides  there  existed  a need  to  be  relieved,  due  to a  risk  of  impending  burnout  and emotional  numbness  related  to  the  constant  fear  of  repeated suicide  attempts.  The  study  pointed  out  that  nurses  need  more training  and  education  in  dealing  with  suicide  and  attempted suicides.  More  education  in  the  area  would  optimize  the  care  of the patient as well as improve the support to next of kin. Next of kin  need  of  support  is  still  relatively  unexplored  and  more research of the area is needed.

Background: Alzheimer´s disease is a so-called degenerative dementia in which brain cells gradually degenerate and die. The disease causes memory disorders and the trait of character disappears. Alzheimer´s disease also affects the related parties that may take a great responsibility. Related caregivers are entitled to support from healthcare. Aim: The aim of the study was to describe the experiences of being related when caring for a person suffering from Alzheimer´s disease. Method: The study was based on narratives, which in this case means analysis of autobiographies. Six books were analyzed in accordance with Dahlborg-Lyckhage. Results: Three themes and nine sub-themes were developed. The related experienced several emotions. The feelings are reflected in three themes; anxiety, new life and powerlessness. Fear and anxiety were feelings that were there constantly. The new life led to a role change and aroused feelings of sorrow and loneliness. There were times when the related felt powerless. Anger, irritation, guilt and shame were experiences which they could not control. Conclusion: Alzheimer´s disease affects the entire family. The burden of the related caregiver can lead to illness. It is important that nurses take their responsibility by providing information and support the related so that he or she can better deal with the situation.

Varje år drabbas cirka 1100 personer av någon form av hjärntumör i Sverige. Patienterna drabbas av fysiska, psykiska och kognitiva inskränkningar som förändrar individen. Förändringarna påverkar inte enbart patienterna utan även de närstående. Därför är det viktigt att sjuksköterskan uppmärksammar vilka behov patienter och närstående har samt hur sjuksköterskan kan underlätta för familjerna under sjukdomstiden. Syftet med litteraturstudien var att beskriva hur patienter med diagnosen hjärntumör och deras närstående upplever sjukdomen och dess konsekvenser samt utvärdera vilken funktion sjuksköterskan hade för dem. Utifrån bearbetningen av 19 vetenskapliga artiklar framkom fyra tydliga kategorier. Patientens försämrade förmåga innebar en förändring av roller och relationer inom familjen och en ökad börda på de närstående, som ofta axlade rollen som vårdare. Hur sjukdomen hanterades skiljde sig till viss del mellan patienter och närstående, vilket även resulterade i att behovet av stöd varierade. De närstående kände sig ofta osäkra i rollen som vårdare vilket tyder på att de behöver mer utbildning. Mer utbildning behöver också ges till sjuksköterskan för att kunna tillgodose de behov som patienter och närstående uttryckt. Sjuksköterskan bör uppmärksammas på att närstående är de som känner patienten bäst och genom att se dessa som en resurs underlättas sjuksköterskans arbete och resulterar i att vården blir mer individanpassad. / Each year around 1100 people in Sweden get some form of brain tumor. Patients suffer from physical, mental and cognitive limitations that change the individual. The changes do not only affect the patients but also the next of kin. Therefore it is important that the nurse pay attention to the needs of patients and next of kin and how the nurse can help the families during their illness. The aim of the literature study was to describe how patients with brain tumor and their next of kin experience the illness and its consequences and evaluate the nurses’ function for them. Based on the processing of 19 scientific articles four distinct categories were revealed. The patients’ decreased ability resulted in a change of roles and relationships within the family and an increased burden on the next of kin who often took on the role as caregiver. How the disease was handled differed to some extent between patients’ and next of kin which also resulted in that the need for support varied. The next of kin often felt insecure in the role as caregiver which is suggesting that they need more education. More education also needs to be given to the nurse to be able to meet the needs expressed by patients’ and next of kin. Nurses should pay attention to that the next of kin is the one that knows the patient best and seeing them as a resource makes the nurse’s job easier and result in that healthcare becomes more personalized.