Background: Losing an infant is difficult for parents to face. To improve EOL care for dying neonates and their families, NICU nurses need to overcome obstacles and implement supportive behaviors. Understanding the size of obstacles and supportive behaviors will better enable NICU nurses to provide quality EOL care. Objectives: To determine the largest obstacles and supportive behaviors in NICU EOL care. Methods: A descriptive quantitative study of a random national sample of 1058 NICU nurses who were members of NANN (National Association of Neonatal Nurses). The National Survey of NICU Nurses' Perceptions of End-of-Life Care questionnaire was mailed twice yielding 234 usable questionnaires for a response rate of 26%. Results: Three themes emerged in the top rated obstacles: (a) obstacles related to families, (b) obstacles regarding language and communication, and (c) obstacles concerning ethical dilemmas. The lowest rated obstacles were nurses believing that life-saving measures/treatments were prematurely discontinued and unit visiting hours being too liberal. The top eight supportive behaviors included helping families cope with the infant's death and those involving helpful physician behaviors. Lowest rated supportive behaviors were those related to the nurses' own family death experience and behaviors promoting nurse convenience. Conclusions: Obstacles and supportive behaviors for NICU EOL care have been identified. Issues regarding families, communication, and ethical dilemmas need to be addressed. Efforts should be made to more quickly align the plan of care with the projected outcome to limit both infant suffering and nurse distress from inappropriate use of life-extending measures.

This phenomenological study describes the experiences of twelve registered nurses who have nursed a dying or dead patient. These registered nurses come from a variety of backgrounds, not only personally, but also educationally and socially. The study primarily focuses on these registered nurses' most significant experience with death in a professional capacity. Twelve registered nurses were invited to share their stories by means of taped interviews and/or written narrative which attempted to discover the underlying meaning of their experiences. However, in relating their stories, many of the registered nurses wished to describe other death experiences which were of significance for them. The study is grounded in Heideggerian phenomenology and analysis of the transcripts revealed the emerging essences of connectedness, aloneness, questioning and accepting. The study further reveals that these essences align themselves to the four fundamental existentials of spatiality, corporeality, temporality and relationality as described by Merleau-Ponty (1962). Additionally, these essences are related back to the principles of Parse's (1987) theory of Human-Becoming and provide some insights for nursing practice when caring for the dying or the dead patient. Some discussion on how these insights may be related to contemporary nursing practice in Australia is highlighted. Each participant's transcript is followed by a poem which intends to capture the essence of their relationship with the situation(s) they have shared with the author. / Master of Science (Hons) (Social Ecology)

<p>This thesis examines the possibility of designing a fully integrated and switched testing environment for a test laboratory which conducts automated testing. Execution of tests in this environment will make it possible to manage all test objects without requiring any manual intervention resulting in efficient utilization of machine hours and test objects. The thesis explores the concepts and requirements for designing such an environment. It also describes the methods to implement the environment. The result of the thesis work shows that it is possible to design and implement a fully integrated and switched testing environment which can reduce the lead time for delivery by a substantial amount along with a more efficient utilization of machine hours and resources. The exact information related to the instruments, devices under testing and tools are removed by the author according to NDA.</p>

<p>Vikten av att som närstående uppleva stöd och hjälp av distriktssköterskan beskrevs vara mycket positivt både för den närstående och av den sjuke, vilket också krävde nya kunskaper inom området. <strong>Syfte: </strong>Syftet var att belysa närståendes upplevelser vid palliativ vård i hemmet av en familjemedlem. <strong>Metod: </strong>Studien är en litteraturstudie och utförandet har varit att följa de nio stegen enligt Polit och Becks tillvägagångssätt för genomförandet av litteraturstudie. Utifrån nyckelord identifierades sökord som kombinerades vid sökning i databaserna Academic Search Elite, PubMed och CINAHL. Materialet analyserades genom traditionell innehållsanalys.<strong> Resultat: </strong>Resultatet baseras på tolv vetenskapliga artiklar och analysen resulterade i fyra huvudkategorier: välbefinnande, relationen till den döende, en förändrad livssituation samt den palliativa vården. Resultatet visar att närståendes uppfattningar har ett brett spektrum. Social isolering uppfattas då all tid får läggas på hemmets sysslor istället för på socialt umgänge och andra fritidsaktiviteter. Då makt- och hjälplöshet upplevs leder det till att närstående och den döende grälar med varandra. Det uppfattas som betydelsefullt när personalen har tid att ägna sig åt den närstående och den döende. <strong>Slutsats: </strong>Resultatet visar att hur den närstående mår har betydelse, då en familjemedlem vårdas palliativt i hemmet. Resultatet kan användas som en kunskapskälla för distriktssköterskan i dennes kontakt och möten med närstående.<strong></strong></p> / <p>The sense of support and help from the district nurse was described as a positive impact both from the next of kin and the sick person which also demanded new knowledge about the subject area. <strong>Aim: </strong>The aim was to illuminate next of kin´s experiences at palliative care in the home of a family member. <strong>Method: </strong>The study is a literature review and the performing was to follow the nine steps according to Polit and Beck’s procedure to achieve a literature review. On the basis of the keywords, words were identified and combined for search in the databases: Academic Search Elite, PubMed and CINAHL. The material was analysed according to traditional content analysis. <strong>Result: </strong>The result bases on twelve scientific articles and the analysis results in four main categories: wellbeing, the relation to the dying person, a changed life situation and the palliative care. The result shows that the next of kin’s apprehensions have a wide spectrum. Feelings of social isolation perceive when all tasks in the home have to be taken care of instead of social interactions and other leisure activities. The power- and helplessness experiences will lead to quarrelling between next of kin’s and the dying person. It feels important when the staff has time to spend with the next of kin and the dying person. <strong>Conclusion: </strong>The result shows that the next of kin’s feelings of content have a meaning, when a family member receives palliative home care. Hence can the result be used as a source of knowledge when the district nurse encounters next of kin’s.</p>

Vikten av att som närstående uppleva stöd och hjälp av distriktssköterskan beskrevs vara mycket positivt både för den närstående och av den sjuke, vilket också krävde nya kunskaper inom området. Syfte: Syftet var att belysa närståendes upplevelser vid palliativ vård i hemmet av en familjemedlem. Metod: Studien är en litteraturstudie och utförandet har varit att följa de nio stegen enligt Polit och Becks tillvägagångssätt för genomförandet av litteraturstudie. Utifrån nyckelord identifierades sökord som kombinerades vid sökning i databaserna Academic Search Elite, PubMed och CINAHL. Materialet analyserades genom traditionell innehållsanalys. Resultat: Resultatet baseras på tolv vetenskapliga artiklar och analysen resulterade i fyra huvudkategorier: välbefinnande, relationen till den döende, en förändrad livssituation samt den palliativa vården. Resultatet visar att närståendes uppfattningar har ett brett spektrum. Social isolering uppfattas då all tid får läggas på hemmets sysslor istället för på socialt umgänge och andra fritidsaktiviteter. Då makt- och hjälplöshet upplevs leder det till att närstående och den döende grälar med varandra. Det uppfattas som betydelsefullt när personalen har tid att ägna sig åt den närstående och den döende. Slutsats: Resultatet visar att hur den närstående mår har betydelse, då en familjemedlem vårdas palliativt i hemmet. Resultatet kan användas som en kunskapskälla för distriktssköterskan i dennes kontakt och möten med närstående. / The sense of support and help from the district nurse was described as a positive impact both from the next of kin and the sick person which also demanded new knowledge about the subject area. Aim: The aim was to illuminate next of kin´s experiences at palliative care in the home of a family member. Method: The study is a literature review and the performing was to follow the nine steps according to Polit and Beck’s procedure to achieve a literature review. On the basis of the keywords, words were identified and combined for search in the databases: Academic Search Elite, PubMed and CINAHL. The material was analysed according to traditional content analysis. Result: The result bases on twelve scientific articles and the analysis results in four main categories: wellbeing, the relation to the dying person, a changed life situation and the palliative care. The result shows that the next of kin’s apprehensions have a wide spectrum. Feelings of social isolation perceive when all tasks in the home have to be taken care of instead of social interactions and other leisure activities. The power- and helplessness experiences will lead to quarrelling between next of kin’s and the dying person. It feels important when the staff has time to spend with the next of kin and the dying person. Conclusion: The result shows that the next of kin’s feelings of content have a meaning, when a family member receives palliative home care. Hence can the result be used as a source of knowledge when the district nurse encounters next of kin’s.

<p>Current techniques for nucleic acid analysis often involve extensive sample preparation that requires skilled personnel and multiple purification steps. In this dissertation, we introduce an on-chip, isothermal, post-hybridization labeling and signal amplification technique that can directly interrogate unmodified DNA and RNA samples on a microarray format, eliminating the need for microarray sample pre-processing. </p><p>We name this technique Surface Initiated Enzymatic Polymerization (SIEP), where we exploit the ability of a template independent DNA polymerase called Terminal Deoxynucleotidyl Transferase (TdT) to catalyze the formation of long single-stranded DNA (ssDNA) chain from the 3'-end of a short DNA primer, which is tethered on the surface, and TdT's ability to incorporate unnatural reporter nucleotides, such as fluorescent nucleotides. We hypothesize that polymerization of a long ssDNA chain while incorporating multiple fluorescent nucleotides on target DNA or RNA hybridized to probe printed on a surface will provide a simple and powerful, isothermal method for on-chip labeling and signal amplification. </p><p>We developed the SIEP methodology by first characterizing TdT biochemical reaction to polymerize long homopolymer ssDNA (> 1000 bases) starting from the 3'-OH of ten bases oligonucleotides. We found that the preferred monomers (deoxynucleotide, dNTP) are dATP and dTTP, and that the length of the ssDNA extension is determined by the ratio of input monomer (dNTP) to initiator (short oligonucleotides). We also investigated TdT's ability to incorporate fluorescent dNTPs into a ssDNA chain by examining the effect of the molar ratios of fluorescent dNTP to natural dNTP on the initiation efficiency, the degree of fluorophore incorporation, the length and the polydispersity of the polymerized DNA strand. These experiments allowed us to incorporate up to ~50 fluorescent Cy3-labeled dNTPs per kilobase into a ssDNA chain. With the goal of using SIEP as an on-chip labeling method, we also quantified TdT mediated signal amplification on the surface by immobilizing ssDNA oligonucleotide initiators on a glass surface followed by SIEP of DNA. The incorporation of multiple fluorophores into the extended DNA chain by SIEP translated to a up to ~45 fold increase in signal amplification compared to the incorporation of a single fluorophore.</p><p>SIEP was then employed to detect hybridization of DNA (25 bases), short miRNA (21 bases) and long mRNA (1400 bases) by the post-hybridization, on-chip polymerization of fluorescently labeled ssDNA that was grown from the 3'-OH of hybridized target strands. A dose-response curve for detection of DNA hybridization by SIEP was generated, with a ~1 pM limit of detection (LOD) and a 2-log linear dynamic range while the detection of short miRNA and fragmented mRNA targets resulted in ~2 pM and ~10 pM LOD, respectively with a 3-log linear dynamic range.</p><p>We further developed SIEP for colorimetric detection by exploiting the presence of negatively charged phosphate backbone on the surface as target DNA or RNA hybridizes on the immobilized probe. The net negative charge on the surface is further increased by TdT catalyzed polymerization of long ssDNA. We then used positively charged gold nanoparticles as reporters, which can be further amplified through electroless metallization, creating DNA spots that are visible by eye. We observed an increase of 100 fold in LOD due to SIEP amplification.</p><p>Overall, we demonstrated the use of SIEP methodology to label unmodified target DNA and RNA on chip, which can be detected through fluorescence signal or colorimetric signal of metallized DNA spots. This methodology is straightforward and versatile, is compatible with current microarray technology, and can be implemented using commercially available reagents.</p> / Dissertation

Background: Long terminal repeats (LTRs, consisting of U3-R-U5 portions) are important elements of retroviruses and related retrotransposons. They are difficult to analyse due to their variability. The aim was to obtain a more comprehensive view of structure, diversity and phylogeny of LTRs than hitherto possible. Results: Hidden Markov models (HMM) were created for 11 clades of LTRs belonging to Retroviridae (class III retroviruses), animal Metaviridae (Gypsy/Ty3) elements and plant Pseudoviridae (Copia/Ty1) elements, complementing our work with Orthoretrovirus HMMs. The great variation in LTR length of plant Metaviridae and the few divergent animal Pseudoviridae prevented building HMMs from both of these groups. Animal Metaviridae LTRs had the same conserved motifs as retroviral LTRs, confirming that the two groups are closely related. The conserved motifs were the short inverted repeats (SIRs), integrase recognition signals (5' TGTTRNR ... YNYAACA 3'); the polyadenylation signal or AATAAA motif; a GT-rich stretch downstream of the polyadenylation signal; and a less conserved AT-rich stretch corresponding to the core promoter element, the TATA box. Plant Pseudoviridae LTRs differed slightly in having a conserved TATA-box, TATATA, but no conserved polyadenylation signal, plus a much shorter R region. The sensitivity of the HMMs for detection in genomic sequences was around 50% for most models, at a relatively high specificity, suitable for genome screening. The HMMs yielded consensus sequences, which were aligned by creating an HMM model (a 'Superviterbi' alignment). This yielded a phylogenetic tree that was compared with a Pol-based tree. Both LTR and Pol trees supported monophyly of retroviruses. In both, Pseudoviridae was ancestral to all other LTR retrotransposons. However, the LTR trees showed the chromovirus portion of Metaviridae clustering together with Pseudoviridae, dividing Metaviridae into two portions with distinct phylogeny. Conclusion: The HMMs clearly demonstrated a unitary conserved structure of LTRs, supporting that they arose once during evolution. We attempted to follow the evolution of LTRs by tracing their functional foundations, that is, acquisition of RNAse H, a combined promoter/polyadenylation site, integrase, hairpin priming and the primer binding site (PBS). Available information did not support a simple evolutionary chain of events.

No description available.

The first aim of this thesis is to examine relationships between microRNAs targeting gene networks, combining knowledge from microRNA prediction databases into our microRNA Data Integration Portal (mirDIP). Modeling the microRNA:transcript interactome – referred to as the micronome – to build microRNA interaction networks of signalling pathways, we find genes within signalling pathways to be co-targeted by common microRNAs suggesting an unexpected level of transcriptional control. We identify two distinct classes of microRNAs; universe microRNAs, which are involved in many signalling pathways; and intra-pathway microRNAs, which target multiple genes within one signalling pathway. We find universe microRNAs to have more targets, to be more studied and more involved in cancer signalling than their intrapathway counterparts. The second aim was to undertake a more focused view, analyzing the characteristics of microRNAs within the micronome itself beginning with a focus on the under-examined microRNA terminal loop across the micronome to determine if this region of the microRNA structure might contribute to microRNA functioning. We have identified 2 main classes of microRNAs based on loop structure – perfect and occluded, which show biological relevance. We found regulatory motifs within microRNA terminal loops and found a large number of Frequently Occurring Words (FOWs) significantly overrepresented across the micronome. Set analysis of in vitro secreted microRNAs, microRNA expression across a panel of normal tissues, and microRNAs shown to be secreted in lung cancer shows that specific microRNA loop motifs within these groups are significantly overreperesented – suggesting that microRNA terminal loops harbour sequences bearing microRNA processing and localization signals.

Problem: Due to several changes in the market, economy, industry and the environment there was an increasing trend in emerging dry ports/inland terminals throughout Sweden. A dry port is still a young term in the transportation field gaining more popularity and attention. The gap in literature was found that the dynamics of dry port evolution is not yet explored. Thus, the development of the layout, services offered and involved actors of dry ports in Småland, Sweden have to be studied. Purpose:  The purpose for this report seeks to reveal how dry ports have evolved from establishment, in the area around Jönköping, and to discover in what form the dry ports can operate and compete. The study was based on the dynamics of three elements: layout, value added services and networks. Theory:  In the theoretical research the dry port concept is described. Due to the variety of descriptions, authors formed a definition for the thesis to clarify the content. Further, the literature analysis contained the characteristics, classifications and reasons of development as well as involved actors, advantages and disadvantages, location, layout, design and performance measurements. Method: The case study method was chosen to cover the identified gap. This qualitative study with semi-structured interviews conducted face-to-face and by telephone was accomplished with fourteen experts. If the authors faced problems regarding phone interviewees, open questions were prepared and sent to the respondent via email. The data gathering phase was followed by the analysis after which the conclusions were drawn. Conclusion:   The thesis proves that the development of dry ports is affected by a large number of internal and external factors. Terminals need to execute a thorough analysis of the market and the location in which they plan to operate. Therefore, the market has to be analysed continuously in order to keep improving their networks and value added services. Furthermore, the layout has to be adjusted for the changes and measurements have to be performed in order to increase the efficiency.