Bakgrund: I dag upplever många närstående till personer med psykisk ohälsa svårigheter i att bli delaktiga i den professionella vården. Närstående beskriver vårdpersonalen som ointresserade av att möta personer med psykisk ohälsa. Det beskrivs att vårdpersonal har negativt bemötande gentemot personer som söker vård samt till närstående. Syfte: Att beskriva upplevelser hos närstående till personer med psykisk ohälsa i kontakten med den professionella vården. Metod: Litteraturstudie baserad på självbiografier med analysförfarande utifrån en kvalitativ innehållsanalys. Resultat: Upplevelserna från närstående till personer med psykisk ohälsa har beskrivits utifrån följande tema: Vara delaktig men samtidigt åsidosatt - Maktlöshetens ansikte. Temat har identifierats utifrån följande kategorier; Tillit för den professionella vården, När känslor tar överhand och Vårdmiljöns betydelse. Resultatet påvisar vad som gör upplevelsen hos närstående positiv eller negativ. En positiv upplevelse beskrivs ofta av närstående när de upplevt ett gott och trevligt bemötande från vårdpersonal. Negativa upplevelser beskrivs när vårdpersonal uppvisar dålig kunskap i ämnet och en sämre attityd i bemötande gentemot närstående. Vårdmiljön är också betydelsefull. Slutsats: Det finns behov av att implementera och genomföra förbättringsarbeten i professionell vård som möter närstående till personer med psykisk ohälsa. Exempelvis utvecklingsstrategier vid anställning av personal i den psykiatriska vården / Introduction: Next of kin to persons with mental illness often experience it difficult to be involved in the professional health care. Next of kin often describe the health care professionals as disinterested and negative approach towards them and the person who is ill. Aim: To describe experiences from next of kin to persons with mental illness in contact with the professional health care. Method: A study based of autobiographies with analysis method based on a qualitative content analysis. Result: This study results emerged in the main theme; To be involved but also infringed -The face of Powerless. The theme has been identified based on the following categories; Trust for the health care, Emotions taking over and The importance health care environments. The result describes what makes the experience from next of kin positive or negative. Positive experiences were often described when they experienced a good and friendly approach from a health care professional. Negative experiences are described when health care professionals have lacking knowledge and worse attitude towards them. The result also describe that the healthcare environment are important. Conclusion: There are needs to implement and carry out improvements in the professional health care in meeting next of kin of people with mental illness. For example development strategies when health care professionals are recruited in the professional health care.

A current trend in biological science is the increased use of computational tools for both the production and analysis of experimental data. This is especially true in the field of genomics, where advancements in DNA sequencing technology have dramatically decreased the time and cost associated with DNA sequencing resulting in increased pressure on the time required to prepare and analyze data generated during these experiments. As a result, the role of computational science in such biological research is increasing. This thesis seeks to address several major questions with respect to the development and application of single nucleotide polymorphism (SNP) resources in non-model organisms. Traditional SNP discovery using polymerase chain reaction (PCR) amplification and low-throughput DNA sequencing is a time consuming and laborious process, which is often limited by the time required to design intron-spanning PCR primers. While next-generation DNA sequencing (NGS) has largely supplanted low-throughput sequencing for SNP discovery applications, the PCR based SNP discovery method remains in use for cost effective, targeted SNP discovery. This thesis seeks to develop an automated method for intron-spanning PCR design which would remove a significant bottleneck in this process. This work develops algorithms for combining SNP data from multiple individuals, independent of the DNA sequencing platforms, for the purpose of developing SNP genotyping arrays. Additionally, tools for the filtering and selection of SNPs will be developed, providing start to finish support for the development of SNP genotyping arrays in complex polyploids using NGS. The result of this work includes two automated pipelines for the design of intron-spanning PCR primers, one which designs a single primer pair per target and another that designs multiple primer pairs per target. These automated pipelines are shown to reduce the time required to design primers from one hour per primer pair using the semi-automated method to 10 minutes per 100 primer pairs while maintaining a very high efficacy. Efficacy is tested by comparing the number of successful PCR amplifications of the semi- automated method with that of the automated pipelines. Using the Chi-squared test, the semi-automated and automated approaches are determined not to differ in efficacy. Three algorithms for combining SNP output from NGS data from multiple individuals are developed and evaluated for their time and space complexities. These algorithms were found to be computationally efficient, requiring time and space linear to the size of the input. These algorithms are then implemented in the Perl language and their time and memory performance profiled using experimental data. Profiling results are evaluated by applying linear models, which allow for predictions of resource requirements for various input sizes. Additional tools for the filtering of SNPs and selection of SNPs for a SNP array are developed and applied to the creation of two SNP arrays in the polyploid crop Brassica napus. These arrays, when compared to arrays in similar species, show higher numbers of polymorphic markers and better 3-cluster genotype separation, a viable method for determining the efficacy of design in complex genomes.

Bakgrund: Inom den palliativa vården har möjligheten att få vårdas i hemmet ökat genom åren. Idag vet man att närstående utför betydande insatser inom vården och omsorgen och att deras insatser bedöms vara tidsmässigt mycket större än från den offentliga vården. Att vara närstående till någon som är sjuk är en upplevelse som är unik för varje enskild individ. Upplevelsen av isolering, att behöva ignorera sina egna känslor och kämpa för sin egen överlevnad kan uppstå hos de närstående som vårdar en sjuk i hemmet. Syfte: Att belysa närståendes upplevelser av palliativ hemsjukvård. Metod: En litteraturöversikt har gjorts baserad på elva vetenskapliga artiklar som granskats och analyserats. De databaser som använts vid artikelsökningen är Cinahl plus with Full Text, PubMed samt Medline with full text med sökorden Family, Palliative home care, Experiences och Sweden. Efter analysen av texterna i artiklarna framkom fyra teman, vilka var önskan att bli sedd av det palliativa vårdteamet, upplevelsen av maktlöshet, vikten av kommunikation och av att få information samt stöd och stödgruppens betydelse för de närstående. Resultat: Resultatet visar att många närstående känner sig förbisedda då en stor del av det palliativa vårdteamets fokus hamnar på den sjuke. Detta leder även till att de närstående upplever maktlöshet. Det palliativa vårdteamet kan genom god kommunikation och information få de närstående att känna sig uppmärksammande som individer samt att få bli inbjudna till delaktighet i vården av den sjuke. Något som också visat sig vara ovärderligt och bidrog till att skapa mening i det vardagliga livet för de närstående var stödet från omgivningen samt stöd i form av stödgruppsträffar tillsammans med andra närstående i liknande situationer. Diskussion: Diskussionen har baserats på de fyra teman som framkommit i resultatet och sedan relaterats till omvårdnadsteorin, Peaceful end-of-life theory samt konsensusbegreppen människa och vårdande. Betydelsen av kommunikation och information från det palliativa vårdteamet diskuteras, samt vikten av att göra de närstående delaktiga och uppmärksammade i vården av den sjuke. / Background: Within palliative care the opportunity to receive care in the home has increased over the years. Today we know that next of kin’s perform considerable efforts in health and social care and that their efforts, based on time, are considered to be larger than the public services efforts. To be next of kin to someone who is ill is an experience that is unique to each individual. The experience of isolation, having to ignore their own feelings and fight for their own survival may occur in the next of kin who care for an ill person at home. Aim: To highlight next of kin’s experiences of palliative home care. Methods: A literature review has been conducted based on eleven scientific articles, which have been reviewed and analyzed. The databases used in the article search are Cinahl Plus with Full Text, PubMed and MEDLINE with full text using the keywords Family, Palliative home care, Experiences and Sweden. The analysis of the articles revealed four themes which were, a desire to be seen by the palliative care team, the experience of powerlessness, the importance of communication and receiving information and also support and the support group significance for the next of kin’s. Results: The results show that many next of kin’s feel neglected as a large part of the palliative care team's focus is on the sick person. This also leads to the next of kin experiencing powerlessness. The palliative care team can through good communication and information make the next of kin feel noticed as individuals and be invited to participate in the care of the sick person. What also proved invaluable and helped to create meaning in the everyday life of the next of kin was support from the surroundings and support in terms of support group meetings together with other next of kin’s in similar situations. Discussions: The discussion was based on the four themes that emerged from the results and has then been related to the middle-range theory, Peaceful end-of-life and also the central concepts of nursing, person and nursing. The importance of communication and information from the palliative care team are discussed, and also the importance of making next of kin’s participate in the care of the sick person and to be noticed.

Segmented mirrors are to be used in the next generation of the ground-based optical telescopes to increase the size of the primary mirrors. A larger primary mirror enables the collection of more light, which results in higher image resolutions. The main reason behind the choice of segmented mirrors over monolithic mirrors is to reduce manufacturing, transportation, and maintenance costs of the overall system. However, segmented mirrors bring new challenges to the telescope design and control problem. The large number of inputs and outputs make the computations for centralized control schemes intractable. Centralized controllers also result in systems that are vulnerable to a complete system failure due to a malfunction of the controller. Distributed control is a viable alternative that requires the use of a network of simple individual segment controllers that can address two levels of coupling among segments and achieve the same performance objectives. Since segments share a common support structure, there exists a coupling among segments at the dynamics level. Any control action in one segment may excite the natural modes of the support structure and disturb other segments through this common support. In addition, the objective of maintaining a smooth mirror surface requires minimization of the relative displacements among neighbouring segment edges. This creates another level of coupling generally referred to as the objective coupling. This dissertation investigates the distributed H∞ control of the segmented next generation telescope primary mirrors in the presence of wind disturbances. Three distributed H∞ control techniques are proposed and tested on three segmented primary mirror models: the dynamically uncoupled model, the dynamically coupled model and the finite element model of Thirty Meter Telescope (TMT) project. It is shown that the distributed H∞ controllers are able to satisfy the stringent imaging performance requirements. / Graduate / 0548

Lo sviluppo delle tecnologie di sequenziamento ha portato alla nascita di strumenti in grado di produrre gigabasi di dati di sequenziamento in una singola corsa. Queste tecnologie, comunemente indicate come Next Generation Sequencing o NGS, producono grandi e complessi dataset la cui analisi comporta diversi problemi a livello bioinformatico. L'analisi di questo tipo di dati richiede la messa a punto di pipelines computazionali il cui sviluppo richiede un lavoro di scripting necessario per concatenare i softwares già esistenti. Questa tesi tratta l'aspetto metodologico dell'analisi di dati NGS ottenuti con tecnologia Illumina. In particolare in essa sono state sviluppate tre pipelines bioinformatiche applicate ai seguenti casi studio: 1) uno studio di espressione genica mediante RNA-seq in "Olea europaea" finalizzato all’indagine dei meccanismi molecolari alla base dell’acclimatazione al freddo in questa specie; 2) uno studio mediante RNA-seq finalizzato all’identificazione dei polimorfismi di sequenza nel trascrittoma di due razze bovine mirato a produrre un ampio catalogo di marcatori di tipo SNPs; 3) il sequenziamento, l’assemblaggio e l’annotazione del genoma di un ceppo di Lactobacillus plantarum che mostrava potenziali proprietà probiotiche. / The advance in sequencing technologies has led to the birth of sequencing platforms able to produce gigabases of sequencing data in a single run. These technologies commonly referred to as Next Generation Sequencing or NGS produce millions of short sequences called “reads” generating large and complex datasets that pose several challenges for Bioinformatics. The analysis of large omics dataset require the development of bioinformatics pipelines that are the organization of the bioinformatics tools in computational chains in which the output of one analysis is the input of the subsequent analysis. A work of scripting is needed to chain together a group of existing software tools.This thesis deals with the methodological aspect of the data analysis in NGS sequencing performed with the Illumina technology. In this thesis three bioinformatics pipelines were developed.to the following cases of study: 1) a global transcriptome profiling of “Oleaeuropeae” during cold acclimation, aimed to unravel the molecular mechanisms of cold acclimation in this species; 2) a SNPs profiling in the transcriptome of two cattle breeds aimed to produce an extensive catalogue of SNPs; 3) the genome sequencing, the assembly and annotation of the genome of a Lactobacillus plantarum strain showing probiotic properties.

Bakgrund: När en person blir svårt sjuk, är döende och behöver vårdas palliativt berörs inte bara den sjuke, utan även personer i dennes närhet. Det har framkommit att närstående inte alltid uttrycker sina behov i situationen. Närståendes involvering är ett faktum, och deras upplevelser varierar. Närståendes upplevelser knyts i resultatdiskussionen an till begreppet om Känsla av sammanhang.    Syfte: Litteraturöversiktens syfte är att beskriva upplevelser av att vara närstående till en palliativ vårdtagare. Metod: En kvalitativ litteraturöversikt, inkluderande elva studier, har genomförts där dessa studier granskats, bearbetats och analyserats utifrån Fribergs femstegsmodell. Resultat: Det framkom att närstående upplevt förändringar i vardagen sedan deras närstående blivit sjuk. De upplevde åsidosättande av egna behov och intressen. Vårdpersonal fick en betydande roll i situationen, och närstående upplevde trygghet när de var närvarande, men upplevde en otrygghet när kontinuitet och löften inte hölls. Behov av information och stöd visade sig vara viktigt för hanterandet av situationen. Slutsats: Utifrån huvudfynden konstateras att närstående genomgår förändringar genom hela den sjukes palliativa period. Förändringarna upplevs olika, då varje situation är unik, de närstående har individuella behov som behöver tillfredsställas. Uttryckt behov av stöd och information gör att vårdpersonal får en betydande roll i deras liv. / Background: When a person becomes seriously ill, dying and in need of palliative care, not only the sick person get´s affected, even the next of kin´s are concerned. Next of kin´s is not always expressing their needs in such situations. That next of kin´s get´s involved is a fact, and what their experiences are varies. Next of kin’s experiences are in the discussion connected with the theory of Sence of coherence.      Aim: The aim of the literature review is to describe experiences of being next of kin to a person who´s in palliative care. Methods: A qualitative literature review, including eleven studies, have been conducted, and theese studies have been examined, processed and analyzed by the five steps of Friberg. Findings: Findings revealed that next of kin´s experienced changes in everyday life since their relative got ill. They experienced that they had to set aside their own needs and interests. The health care professionals were given a significant role in the situation, and the next of kin´s felt a sense of security when they were present, but experienced insecurity when continuty and promises were not kept. A need for information and support turned out to be important to cope with the situation. Conclusion: Based on the main findings it was stated that next of kin´s undergoes changes throughout the sick persons palliative period. The changes are experienced differently, as each situation is unique, the next of kin´s have individual needs which need to be satisfied. Expressed needs for support and information enables health professionals to have a significant role in their lives.

The idea of using a graphics processing unit (GPU) for more than simply graphic output purposes has been around for quite some time in scientific communities. However, it is only recently that its benefits for a range of bioinformatics and life sciences compute-intensive tasks has been recognized. This thesis investigates the possibility of improving the performance of the overlap determination stage of an Overlap Layout Consensus (OLC)-based assembler by using a GPU-based implementation of the Smith-Waterman algorithm. In this thesis an existing GPU-accelerated sequence alignment algorithm is adapted and expanded to reduce its completion time. A number of improvements and changes are made to the original software. Workload distribution, query profile construction, and thread scheduling techniques implemented by the original program are replaced by custom methods specifically designed to handle medium-length reads. Accordingly, this algorithm is the first highly parallel solution that has been specifically optimized to process medium-length nucleotide reads (DNA/RNA) from modern sequencing machines (i.e. Ion Torrent). Results show that the software reaches up to 82 GCUPS (Giga Cell Updates Per Second) on a single-GPU graphic card running on a commodity desktop hardware. As a result it is the fastest GPU-based implemen- tation of the Smith-Waterman algorithm tailored for processing medium-length nucleotide reads. Despite being designed for performing the Smith-Waterman algorithm on medium-length nucleotide sequences, this program also presents great potential for improving heterogeneous computing with CUDA-enabled GPUs in general and is expected to make contributions to other research problems that require sensitive pairwise alignment to be applied to a large number of reads. Our results show that it is possible to improve the performance of bioinformatics algorithms by taking full advantage of the compute resources of the underlying commodity hardware and further, these results are especially encouraging since GPU performance grows faster than multi-core CPUs.

One of the pressing needs in the field of disease biomarker discovery is new technologies that could allow high performance protein analysis in different types of clinical material, such as blood and solid tissues. This thesis includes four approaches that address important limitations of current technologies, thus enabling highly sensitive, specific and parallel protein measurements. Paper I describes a method for sensitive singleplex protein detection in complex biological samples, namely solid phase proximity ligation assay (SP-PLA). SP-PLA exhibited improved sensitivity compared to conventional sandwich immunoassays. We applied SP-PLA to validate the potential of GDF-15 as a biomarker for cardiovascular disease.   Paper II describes ProteinSeq, a multiplexed immunoassay based on the principle of SP-PLA, for parallel detection of 36 proteins using next-generation sequencing as readout. ProteinSeq exhibited improved sensitivity compared to multiplexed sandwich immunoassays, and the potential to achieve even higher levels of multiplexing while preserving a high sensitivity and specificity. We applied ProteinSeq to analyze 36 proteins, including one internal control, in 5 μl of plasma samples in a cohort of patients with cardiovascular disease and healthy controls. Paper III describes PLA-DTM, a strategy for recording all possible interactions between sets of proteins in clinical samples. Individual proteins and their interactions are first encoded to dual barcoded DNA by PLA, and the barcodes are interrogated by a method named dual tag microarray (DTM). We applied the method for studying interactions among protein members of the NFκB signaling pathway. Paper IV describes a novel probing strategy for analyzing individual biomolecules in solution or in situ. The technique employs a new class of probes for unfolding proximity ligation assays - uPLA probes. The probes are designed so that each probe set is sufficient in forming and replicating circular DNA reporter, without interactions among themselves when incubated with the sample. The uPLA probing strategy provides ease in the design of multiple probe sets in parallelized assays while enhancing the specificity of detection. We used the uPLA probes to detect various targets, including synthetic DNA and cancer-related transcripts in situ.

The aim of this thesis was to modify and evaluate effects, as well as todescribe experiences of a nurse-led multidisciplinary programme of pulmonaryrehabilitation in primary health care for patients with chronicobstructive pulmonary disease (COPD) and their next of kin.Interviews were performed with 12 COPD nurses about their experiencesof patient education (I). Forty-nine patients participated in the interventiongroup and 54 in the control group in a quasi-experimentalstudy which investigated the effects of the programme on functional capacity,quality of life and exacerbation frequency during one year (II).Interviews were performed related to the experiences of 20 patients whohad participated in the six-week programme (III) and the experiences of20 next of kin to the patients that had participated (IV).The results showed that COPD nurses fluctuated between security andinsecurity in patient education and were in need of support, time, structureand collaboration to develop their patient education (I). In Study IIthere were no differences between the groups with regard to functionalcapacity and quality of life, but the number of exacerbations decreased inthe intervention group and increased in the control group (II). The patientsin study III had allowed themselves to live at their own pace followingthe programme but a constant fear was present in spite of the programme(III). Next of kin in Study IV had a life that remained overshadowedby illness but there were positive outcomes of the programme aslong as two years afterwards. The next of kin also had constant fear,however (IV).In conclusion, the six week programme brought about results in changingeveryday life. Nevertheless, all lived in the shadow of fear and uncertaintyin spite of the programme. More research is needed to address therequirements of COPD nurses, patients and next of kin.

Το αντικείμενο της παρούσας διπλωματικής εργασίας είναι η μελέτη της αρχιτεκτονικής των Δικτύων Νέας Γενιάς (Next Generation Networks-NGN) με εστίαση στους μηχανισμούς του Επιπέδου Μετάδοσης και τις Λειτουργίες Τελικού Χρήστη. Συγκεκριμένα, περιγράφεται η αρχιτεκτονική IMS (IP Multimedia Subsystem) με τις αντίστοιχες λειτουργικές συνιστώσες και διεπαφές, ενώ στη συνέχεια παρατίθενται τα βήματα μετάβασης προς δίκτυα και προσβάσεις νέας γενιάς επιλεγμένων μεγάλων τηλεπικοινωνιακών Οργανισμών. Ακολούθως, γίνεται μια συνοπτική αναφορά στις λειτουργίες του επιπέδου μετάδοσης, ελέγχου μεταφοράς και διαχείρισης δικτύου και στη συνέχεια περιγράφεται λεπτομερώς η λειτουργική αρχιτεκτονική των κύριων λειτουργικών οντοτήτων του επιπέδου μετάδοσης (λειτουργίες ελέγχου προσάρτησης δικτύου-NACF, λειτουργίες ελέγχου διαχείρισης φορητότητας-MMCF, λειτουργίες ελέγχου πόρων –RACF, λειτουργίες μετάδοσης κορμού) και τα μοντέλα πληροφόρησης (ένδειξη δέσμευσης, πληροφορία απόκρισης πόρων μετάδοσης κ.α.) των επιμέρους στοιχείων των προαναφερθέντων δομικών οντοτήτων. Σε κάθε δομικό μοντέλο πληροφόρησης υπάρχει αναλυτική παρουσίαση των σημείων αναφοράς και ροών πληροφορίας που εμπλέκονται στη διαχείριση και έλεγχο φορητότητας, προσάρτησης δικτύου, διεργασίας μετάδοσης κορμού και πρόσβασης, αντιστοίχως. Στη συνέχεια, αναλύονται οι λειτουργίες τελικού χρήστη με ειδικότερη αναφορά στις λειτουργίες πύλης δικτύου (CPN) με τα επιμέρους λειτουργικά στοιχεία της, και τα δίκτυα που θα αποτελέσουν τον κορμό πάνω στον οποίο θα στηριχθεί η υλοποίηση της πρόσβασης των δικτύων νέας γενιάς. Πιο συγκεκριμένα, περιγράφονται οι τεχνολογίες πρόσβασης DSL (ADSL, ADSL2 και VDSL2) με τους υποκείμενους περιορισμούς του ρυθμού μετάδοσης (διαφωνία, εξασθένηση), Ethernet (EPON, P2P πάνω από χαλκό και οπτική ίνα), και PON (διασύνδεση P2MP με οπτικό διαμεριστή οπτικής ισχύος, GPON). Τέλος, αναλύονται οι καλωδιακές υποδομές που απαιτούνται για την ανάπτυξη των προσβάσεων νέας γενιάς (εύρος, διάρθρωση, πυκνότητα οπτικών ινών). / The theme of this particular thesis is the study of the Next Generation Networks –NGN architecture focusing on the functionalities of the Transport Stratum and the End User Functions. Specifically, it is described the IMS architecture (IP Multimedia Subsystem) and the related functional components, and then, it is listed the transition steps towards the next generation networks and access of selected Telecommunications Providers. Following, it is briefly outlined the functionalities of transport level, transport control and network management, as well, and subsequently, the functional architecture of the main entities of transport level (network attachment control functions –NACF, Mobility Management and Control Functions- MMCF, Resource and Admission Control Functions- RACF, Transport processing entities) and the information models (event registration reply, resource selection information reply etc) of the aforementioned functional components are being described, in detail. Each structural component is analytically presented with its reference points and information flows that are involved in the management as well as the control of mobility, network admission, transport core and access processing, respectively. Additionally, the end user functions are described, giving weighted reference to the customer premises gateway functions (CGF) and their individual entities, and the networks that will compose the core upon which the implementation of next generation access will be established. That is, different access types are presented such as DSL network (ADSL, ADSL2, VDSL2) with its transfer rate restrictions (i.e. attenuation), Ethernet network (EPON, P2P over copper and optical fiber) and PON (P2MP interconnection using optical power splitter ,GPON). Finally, it is analyzed the cable infrastructure needed for the development of the new generation access (optical fiber rate, structure, density).