Aim:  The overall aim of this thesis was to explore the development of a video-supported interactive learning model for movement awareness among nursing students. Methods:  Study I was a cross-sectional survey regarding prevalence and impact of musculoskeletal symptoms (MSS) among nursing students. In the remaining three studies a learning model was developed and explored; II - the inter-personal interaction (qualitative content analysis), III - the students’ experiences of using the learning model (phenomenological hermeneutics), IV - the students’ learning processes (hermeneutic approach). Results: 143 of the 224 respondents in study I reported MSS during the previous 12 months and of those 91 reported impact on physical daily life activities. The odds ratio for reporting MSS study year 3 was 4.7 (95% CI: 2.1 – 10.7). Study II shows that the students’ movement awareness and self-analysis developed when encountering their own movement through video feedback. Studies III and IV show that the facilitator’s reflective and responsive approach appears to be essential in creating interaction and a permitting learning atmosphere. The students became emotionally and cognitively challenged and personally engaged, were motivated to change by discovering details in their movements and gained a greater understanding of the relationship between their own movements and current or risk for future MSS. They also experienced emotional, cognitive and bodily confusion, which was interpreted as a necessary step in the changing process. Conclusion: MSS among nursing students appears to be a problem and education regarding ergonomic movements and principles is suggested to be emphasized in the nursing curriculum. The video-supported learning model enabled encountering and discovering one’s own body and movement in different ways, which facilitated reflection and motivation for change, which was supported by the facilitator’s reflective approach. The learning model, which could contribute to multifactorial ergonomic interventions, could also support movement awareness and learning in practical learning situations within education and rehabilitation. Further research needs to study the model in different contexts and in relation to MSS prevention.

Stellar companions can influence the formation and evolution of planetary systems, but there are currently few observational constraints on the properties of planet-hosting binary star systems. We search for stellar companions around 77 transiting hot Jupiter systems to explore the statistical properties of this population of companions as compared to field stars of similar spectral type. After correcting for survey incompleteness, we find that 47% +/- 7% of hot Jupiter systems have stellar companions with semimajor axes between 50 and 2000 au. This is 2.9 times larger than the field star companion fraction in this separation range, with a significance of 4.4 sigma. In the 1-50 au range, only 3.9(-2.0)(+4.5)% of hot Jupiters host stellar companions, compared to the field star value of 16.4% +/- 0.7%, which is a 2.7 sigma difference. We find that the distribution of mass ratios for stellar companions to hot Jupiter systems peaks at small values and therefore differs from that of field star binaries which tend to be uniformly distributed across all mass ratios. We conclude that either wide separation stellar binaries are more favorable sites for gas giant planet formation at all separations, or that the presence of stellar companions preferentially causes the inward migration of gas giant planets that formed farther out in the disk via dynamical processes such as Kozai-Lidov oscillations. We determine that less than 20% of hot Jupiters have stellar companions capable of inducing Kozai-Lidov oscillations assuming initial semimajor axes between 1 and 5 au, implying that the enhanced companion occurrence is likely correlated with environments where gas giants can form efficiently.

This thesis explores the use of observational microdata in cost-effectiveness analysis. The application of econometric methods adjusting for selection bias is first reviewed and critically appraised in the economic evaluation literature using a structured template. Limitations of identified studies include lack of good quality evidence regarding the performance of different analytical approaches; inadequate assessment of the sensitivity of their results to violations of fundamental assumptions or variations to crucial estimator parameters; failure to combine the cost and effectiveness outcomes in a summary measure; and no consideration of stochastic uncertainty for the purpose of evaluating cost-effectiveness. Data from the Birthplace national cohort study are used in an attempt to address these limitations in the context of an empirical comparison of estimators relying on regression, matching, as well as the propensity score. It is argued that although these methods cannot address the potential impact of unobservable confounding, a novel approach to bias-corrected matching, combining entropy balancing with seemingly unrelated regression, still has the potential to offer important advantages in terms of analytical robustness. The net economic benefit is proposed as a straightforward way to exploit the strengths of rigorous econometric methodology in the development of reliable and informative cost-effectiveness analyses.

The retinoic acid induced 1 (RAI1) gene maps within the Smith-Magenis syndrome (SMS) region on chromosome 17p11.2. Interstitial deletion of 17p11.2 including RAI1 or mutation of RAI1 results in SMS, while duplication of 17p11.2, including RAI1, results in the dup(17)(p11.2) syndrome. Smith-Magenis syndrome is a complex disorder characterized by a constellation of ~30 features that includes mental retardation, sleep disturbance, craniofacial defects, neurological and behavioral anomalies, and variable systemic features. Dup(17)(p11.2) syndrome is characterized by mental retardation, craniofacial defects, developmental delay, failure to thrive, and hyperactivity. We hypothesized that RAI1 is a dosage-sensitive gene with specific roles in SMS and dup(17)(p11.2) syndrome. To understand the clinical consequences of haploinsufficiency of RAI1 in humans, 60 SMS patients were evaluated by fluorescent in situ hybridization and/or sequencing of RAI1 to identify 17p11.2 deletions or intragenic mutations. Phenotypic comparison between patients with deletions and those with RAI1 mutations show that 21 of 30 SMS features are the result of haploinsufficiency of RAI1. Other features such as cardiac and renal anomalies, speech and motor delay, chronic respiratory and ear infections, hypotonia, short stature, and ear and eye anomalies are associated with 17p11.2 deletions rather than RAI1 mutations (P <0.05). Mouse models were evaluated using both qualitative and quantitative methodologies for phenotypic consequences due to altered Rai1 dosage. To this extent, BAC transgenic mice overexpressing Rai1 1.5-fold (hemizygous) or 2-fold (homozygous) and Rai1-targeted heterozygous (Rai1+/-) mice with 0.5-fold dosage were utilized. Compared to wild type littermates, Rai1 overexpressing mice have growth retardation, increased locomotor activity, gait abnormalities, and abnormal anxiety-related behavior, while Rai1+/- mice are obese and hypoactive. Analyses of homozygous BAC transgenic mice revealed a dosage-dependent exacerbation of the phenotype. Both the Rai1-overexpressors and Rai1-haploinsufficient mice showed neurological deficits. To identify target genes altered due to haploinsufficiency of RAI1, RNA-interference-based knockdown (~50%) of RAI1 was achieved in HEK293T cell lines. Genome-wide gene expression profiling showed that ~60 genes were upregulated and ~200 genes were downregulated due to RAI1 haploinsufficiency. Real-time qPCR not only confirmed the gene expression profile in HEK293 cells but also in lymphoblastoid cell lines obtained from SMS patients with 17p11.2 deletion. Further, our analysis has identified several RAI1 downstream genes, implicated in circadian activity, growth regulation, lipid biosynthesis, and neuronal regulation, which are potential candidate genes for non-deletion/non-RAI1-mutation cases of SMS and SMS-like phenotypes. These results show that Rai1 dosage has major consequences on molecular processes involved in growth, development, circadian rhythm, and neurological and behavioral functions, thus providing evidence for several dosage-thresholds for phenotypic manifestations causing dup(17p11.2) syndrome or Smith-Magenis syndrome in humans.

In order to continue to improve the effectiveness of psychotherapy, researchers must identify key change processes. Unfortunately, there are disparate views in the field about the relative importance and potency of specific techniques versus relationship factors. Few measures have been developed to examine the relative contribution of these factors, particularly for child-focused treatment. The Common-Factor Therapist Competence Scale for Youth Psychotherapy (COMP-CF) was developed to address this deficit. For this study, 142 video-taped sessions of child CBT for anxiety were observed and rated by independent coders using the COMP-CF. The measure demonstrated good reliability and internal consistency. Significant between-therapist and between-session differences were noted that warrant further exploration. The COMP-CF also demonstrated initial validity when compared to other observer-rater measures of therapeutic processes such as alliance, CBT-specific competence, and adherence. Recommendations for further development and refinement are discussed. Used in conjunction with adherence measures, the competence measure developed here may help improve our understanding of the therapeutic process.

This thesis' focus is on the use of Alfred North Whitehead's concept of Actual Entities as a computational tool for computer science and the introduction of a novel usage of Actual Entities as learning agents. Actual Entities are vector based agents that interact within their environment through a process called prehension. It is the combined effect of multiple Actual Entities working within a Colony of Prehending Entities that produces emergent, intelligent behavior. It is not always the case that prehension functions for desired behavior are known beforehand and frequently the functions are too complex to construct by hand. Through the use of Artificial Neural Networks and a technique called Observational Intelligence, Actual Entities can extract the characteristic behavior of observable phenomena. This behavior is then converted into a functional form and generalized to provide a knowledge base for how an observed object interacts with its surroundings.

Context. Radial velocity and transit methods are effective for the study of short orbital period exoplanets but they hardly probe objects at large separations for which direct imaging can be used. Aims. We carried out the international deep planet survey of 292 young nearby stars to search for giant exoplanets and determine their frequency. Methods. We developed a pipeline for a uniform processing of all the data that we have recorded with NIRC2/Keck II, NIRI/Gemini North, NICI/Gemini South, and NACO/VLT for 14 yr. The pipeline first applies cosmetic corrections and then reduces the speckle intensity to enhance the contrast in the images. Results. The main result of the international deep planet survey is the discovery of the HR8799 exoplanets. We also detected 59 visual multiple systems including 16 new binary stars and 2 new triple stellar systems, as well as 2279 point-like sources. We used Monte Carlo simulations and the Bayesian theorem to determine that 1.05(-0.70)(+2.80)% of stars harbor at least one giant planet between 0.5 and 14 MJ and between 20 and 300AU. This result is obtained assuming uniform distributions of planet masses and semi-major axes. If we consider power law distributions as measured for close-in planets instead, the derived frequency is 2.30(-1.55)(+5.95)%, recalling the strong impact of assumptions on Monte Carlo output distributions. We also find no evidence that the derived frequency depends on the mass of the hosting star, whereas it does for close-in planets. Conclusions. The international deep planet survey provides a database of confirmed background sources that may be useful for other exoplanet direct imaging surveys. It also puts new constraints on the number of stars with at least one giant planet reducing by a factor of two the frequencies derived by almost all previous works.

Constructing sustainable structures in rock that satisfy all predefined technical specifications requires rational and effective construction methods. When the geotechnical behaviour is hard to predict, the Euro­pean design code, Eurocode 7, suggests application of the observational method to verify that the performance is acceptable. The basic principle of the method is to accept predefined changes in the design during con­struction to comply with the actual ground conditions, if the current de­sign is found unsuitable. Even though this in theory should ensure an effective design solution, formal application of the observational method is rare. Investigating the applicability of the observational method in rock en­gineering, the aim of this thesis is to identify, highlight, and solve the aspects of the method that limit its wider application. Furthermore, the thesis aims to improve the conceptual understanding of how design deci­sions should be made when large uncertainties are present. The main research contribution is a probabilistic framework for the observational method. The suggested methodology allows comparison of the merits of the observational method with that of conventional design. Among other things, the thesis also discusses (1) the apparent contradiction between the preference for advanced probabilistic calculation methods and sound, qualitative engineering judgement, (2) how the establishment of limit states and alarm limits must be carefully considered to ensure structural safety, and (3) the applicability of the Eurocode defini­tion of the observational method and the implications of deviations from its principles. / För att kunna konstruera en anläggning i berg, som uppfyller satta tek­niska krav, krävs det en rationell och effektiv konstruktionsmetod. När konstruktionens beteende är svårt att förutsäga, erbjuder den europeiska standarden Eurokod 7 den så kallade observationsmetoden. Denna metod tillåter i förväg förberedda förändringar i designen under konstruktions­tiden, om observationer av konstruktionens beteende indikerar att så behövs. På så vis anpassas konstruktionen till de faktiska förhållandena i marken. Trots att detta tillvägagångssätt i teorin ger en rationell design, används metoden sällan i enlighet med Eurokod 7. Denna doktorsavhandling undersöker tillämpbarheten av observa-tionsmetoden när man bygger i och på berg. Målet är att belysa de aspekter som begränsar dess användning och i dessa fall föreslå förbätt­ringar som ökar tillämpbarheten. I ett vidare perspektiv syftar avhand­lingen även till att förbättra den konceptuella förståelsen för hur beslut bör fattas i designprocessen när det finns stora osäkerheter. Avhandlingen visar hur observationsmetoden kan användas i ett san­nolikhetsbaserat ramverk. Metodiken ger användaren möjlighet att jäm­föra för- och nackdelarna med observationsmetoden och konventionell dimensionering. Avhandlingen diskuterar bland annat även (1) den skenbara motsatsen mellan användandet av sannolikhetsbaserade beräkningsmetoder för att lösa komplexa dimensioneringsfrågor och kvalitativa ingenjörsmässiga bedömningar, (2) hur larmgränser och brottgränstillstånd bör definieras för att ge tillräcklig säkerhetsmarginal, samt (3) hur Eurokod 7:s strikta definition av observationsmetoden påverkar dess användbarhet. / <p>QC 20160926</p>

Tidigare forskning kring hygienrutiner har visat att följsamheten hos vårdpersonal är bristande samt att bristande följsamhet leder till ökad förekomst av vårdrelaterade infektioner (VRI). Syftet var att undersöka följsamheten kring basala hygienrutiner hos sjuksköterskor och undersköterskor samt jämföra hur följsamheten skiljer sig personalkategorierna emellan samt före och efter patientkontakt, på en medicinsk akutvårdsavdelning i södra Sverige under åren 2013–2018. Studien hade empirisk utformning. Data samlades in genom observationer och analyserades med stöd av Statistical Package for the Social Sciences (SPSS). Det som observerades var följsamhet till korrekt användning av handdesinfektion, handskar, platsförkläde/skyddsrock och rätt klädsel. Totalt gjordes 564 observationer mellan åren 2013–2018. Resultatet visar att det finns rum för förbättring i följsamhet. Överlag visar undersköterskor på en högre grad av följsamhet genom alla observerade år. Märkbar skillnad sågs mellan följsamhet till handdesinfektion före och efter patientkontakt, där följsamheten i sistnämnda var bristande. Vidare interventioner behövs för att förbättra följsamheten till basala hygienrutiner, minska risken för vårdrelaterade infektioner och höja patientsäkerheten. / Title: Compliance of nurses and assistant nurses to guidelines regarding basic hygiene routines in a medical intensive care unit: A quantitative long-term study. Previous research has shown that compliance to hygiene routines among healthcare professionals is inadequate and that inadequate compliance is linked to increased prevalence of healthcare-associated infections (HCAI). The aim of this study was to examine the compliance of nurses and assistant nurses to guidelines regarding basic hygiene routines and to make an occupational comparison before and after patient contact, in a medical intensive care unit in southern Sweden over a period of six years. The study had an empirical approach. Data was collected through observations and was analyzed using Statistical Package for the Social Sciences (SPSS). Observed aspects included compliance to correct usage of hand rub, plastic gloves, aprons as well as proper clothing. A total of 564 observations were made during the years 2013–2018. The result shows that there is room for improvements to compliance, with assistant nurses overall showing a higher rate of compliance throughout all observed years. Noticeable differences in compliance were found between hand rub usage before and after patient contact, with a lack of compliance in the latter. Further interventions are needed in order to improve compliance rates to guidelines regarding hygiene to prevent HCAI and increase patient safety.

I dagens svenska gymnasieskola ska matematikundervisningen enligt läroplanen ge eleverna möjlighet att relatera matematiken till andra ämnen, då elever får en mer positiv bild av matematik när de inser att den finns överallt i deras vardagliga liv. Samtidigt är frågor som varför ska vi lära oss det här? och när kommer jag använda det här? vanligt förekommande under matematikundervisning, och elever har svårt att se meningen med matematikundervisningen. Syftet med denna studie är följaktligen att undersöka matematikens användning i ämnena fysik och kemi i gymnasieskolan. Mer specifikt; hur matematiska begrepp och metoder används och förklaras i fysik- och kemiundervisning. För att undersöka detta deltog fyra gymnasielärare (två i fysik och två i kemi) i en observationsstudie för att i en klassrumsmiljö identifiera och analysera om och hur matematiken används i de båda ämnena. Efter analys och kategorisering med hjälp av ett etablerat ramverk visade resultaten att samtliga deltagande lärare, i olika utsträckning, tillämpade interdisciplinär matematik i sin undervisning. Studien visade även att tillämpning av interdisciplinär matematik gav övervägande positiva resultat i fysik- såväl som kemiundervisningen. / In today's Swedish upper secondary school, the teaching of mathematics should, according to the curriculum, provide the students with the opportunity to relate mathematics to other subjects, since students get a more positive view of mathematics when they realize that it exists everywhere in their everyday life. Meanwhile, questions such as why should we learn this? and when will I use this? are frequently used during mathematics teaching, and students find it difficult to see the meaning in learning mathematics. Therefore, the purpose of this study is to investigate the use of mathematics in physics and chemistry in upper secondary school. More specifically; how mathematical concepts and methods are used as well as explained in physics and chemistry teaching. To investigate this, four upper secondary school teachers (two in physics and two in chemistry) participated in an observational study to identify and analyze if and how mathematics is used in the two subjects. After analysis and categorization with the help of an established framework, the results showed that all participating teachers, to varying degrees, applied interdisciplinary mathematics in their teaching. Moreover, the study showed that applying interdisciplinary mathematics yielded overwhelmingly positive results in physics and chemistry education.