El uso de las metodologías colaborativas en la industria de la construcción es cada vez más frecuente, particularmente BIM que ya tiene varios años de haberse implementado en diversos países, debido a las mejoras generadas en los proyectos. En el Perú el uso de la metodología BIM es una vía transformar la industria de la construcción mediante la implementación progresiva en los proyectos, evidenciada por las iniciativas por parte del estado peruano que busca disminuir los retrasos y sobrecostos que afectan a industria principalmente del sector público. En la actualidad existe una gran brecha de infraestructura en el ámbito educativo que aun no ha sido cubierta, a esto se suma que varios de los proyectos convocados en infraestructura educativa son Saldos de obra, las que son resultado de la resolución de contratos y que en gran mayoría son producto de las deficiencias técnicas en los expedientes técnicos. En vista de ello, en el presente trabajo de investigación se realizó una evaluación interna en la empresa Chung & Tong Ingenieros S.A.C., para obtener las causas principales de las deficiencias en técnicas en los proyectos de infraestructura educativa y plantear indicadores. Los que fueron medidos al aplicar la metodología BIM en el PROYECTO: MEJORAMIENTO Y SUSTITUCION DE LA I.E. SIMON BOLIVAR N°2016 - LIMA - LIMA – COMAS, con el fin de ver el impacto generado, plantear una propuesta de mejora de procesos y la evaluación financiera de la implementación de BIM. / The use of collaborative methodologies in the construction industry is more and more frequent, particularly BIM, which has already been implemented for several years in various countries, due to the improvements generated in the projects. In Peru, the use of the BIM methodology is a way to transform the construction industry through progressive implementation in projects, evidenced by the initiatives by the Peruvian state that seek to reduce delays and cost overruns that affect the industry, mainly in the public sector. Currently there is a large infrastructure gap in the educational field that has still been covered, to this is added that several of the projects called in educational infrastructure are work balances, which are the result of the resolution of contracts and that to a large extent most are the product of technical deficiencies in technical files. In view of this, in the present research work an internal evaluation was carried out in the company Chung & Tong Ingenieros S.A.C., to obtain the main causes of deficiencies in techniques in educational infrastructure projects and to propose indicators. Those that were measured when applying the BIM methodology in the PROJECT: IMPROVEMENT AND SUBSTITUTION OF THE I.E. SIMON BOLIVAR N ° 2016 - LIMA - LIMA - COMAS, in order to see the impact generated, propose a process improvement proposal and the financial evaluation of the BIM implementation. / Trabajo de investigación

SAMMANFATTNING Bakgrund: År 2013 dog 429 barn i Sverige intrauterint, vilket motsvarade tre till fyra dödfödda barn per 1 000 födda. I 10-15 procent av alla fall av barn som föds döda finns ingen känd orsak till barnets död. Syfte: Syftet med föreliggande studie var att undersöka hur kvinnor som förlorat sitt barn intrauterint efter graviditetsvecka 28, skattade sin fysiska och psykiska hälsa tiden innan barnet dog. Syftet var också att undersöka eventuella skillnader avseende skattningen av den fysiska och psykiska hälsan mellan de kvinnor vars barn föddes dött i fullgången tid, jämfört med dem som födde sitt barn före graviditetsvecka 37. Vidare var syftet att beskriva motionsvanor under den sista månaden av graviditeten. Metod: Föreliggande studie baseras på en webbenkät på Spädbarnsfondens hemsida där kvinnor som förlorat sitt barn intrauterint skattade sin fysiska och psykiska hälsa under den sista månaden av graviditeten. Webbenkäten bestod av 87 frågor och besvarades av 798 kvinnor som alla förlorat sitt barn intrauterint. Inklusionskriterierna i föreliggande studie var att det döda barnet skulle vara fött efter 28 fullgångna graviditetsveckor samt efter år 2009. Detta resulterade i att 317 kvinnors svar analyserades. Resultat: Den övervägande majoriteten av kvinnorna hade god fysisk och psykisk hälsa fram till dagen innan deras barn konstaterades dött. För några av kvinnorna försämrades hälsan något under den sista graviditetsmånaden. Resultatet tyder också på att den fysiska och psykiska hälsan var bättre under den sista graviditetsmånaden bland de kvinnor vars barn föddes dött i fullgången tid, jämfört med dem som födde sitt barn före graviditetsvecka 37. Den vanligaste sjukdomen under den sista månaden av graviditeten var högt blodtryck. De flesta kvinnor tränade inte regelbundet under den sista graviditetsmånaden, bland dem som tränade var den vanligaste motionsformen promenader. Fyra av tio kvinnor uppgav att de var utsatta för stress under den sista månaden av graviditeten, den vanligaste orsaken till stress uppgavs vara arbete eller studier. Den näst vanligaste stressfaktorn var oro för den egna hälsan eller barnets hälsa. Slutsats: Majoriteten av kvinnorna hade god fysisk och psykisk hälsa fram till dagen innan deras barn konstaterades dött i livmodern. Kvinnor vars barn föddes dött i fullgången graviditet skattade fysisk och psykisk hälsa något bättre än de som födde sitt barn tidigare under graviditeten. Upplevd stress i slutet av graviditeten orsakades främst av arbete eller studier samt av oro för den egna och det ofödda barnets hälsa.

Objective: To analyze what information skills medical residents have in PDA use, evidence-based medicine (EBM), Loansome Doc use, and off-campus access to databases. Methods: A survey analysis was conducted of 217 medical residents from the 2005/06 East Tennessee State University Quillen College of Medicine class in surgery, family medicine, internal medicine, obstetrics/gynecology, psychiatry, pediatrics, and pathology with a return rate of 48.4%. Quantitative analysis was performed with the SPSS (v. 14.0 for Windows) software program. The results were expressed in percents in graphical or tabular form. The data were analyzed using descriptive statistics (frequencies, mean, median, and mode), and inferential statistics (Mann-Whitney U test and chi-square test.) Results: On a Likert-type scale of 1–7, medical residents rated their PDA skills at a mean of 5.11. By the KruskalWallis Analysis of Variance statistic, there were no signifi - cant differences between residency programs. By use of the Mann-Whitney U Test statistic, it was determined that there was no statistically signifi cant difference between the PDA skills or residents and their attendings. On a Likert-type scale of 1–7, medical residents rated their EBM skills at a mean of 4.82. There was a signifi cant differences between residency programs as determined by the Kruskal-Wallis Analysis of Variance statistic. Residents were infrequent Loansome Doc users, and a disturbing 49.5% did not know how to access medical databases from off-campus. Conclusions: Residents need more training by medical librarians in the clinical information skills of PDA use, EBM, Loansome Doc, and off-campus access.

This research investigates maternal nutritional status through the analysis of young infants (N=27) that are likely pre-weaned from two Roman occupational periods at Put Dragulina. Because young infants are solely dependent on the nutritional status of their mother while in utero and postpartum through the consumption of breast milk, the presence of skeletal pathologies positively associated to nutritional deficiencies on the remains of young infants can be analyzed to reconstruct the nutritional status of the infant’s mother. This study finds that 89% (N=24) of young infants, regardless of occupational period, presented with skeletal pathologies consistent with nutritional deficiencies. These results suggest that the mothers who are absent from the Put Dragulina cemetery would have likely had poor nutritional statuses due to the high frequencies of nutritional stress indicators present on the skeletal remains of their infants.

Autism Spectrum Disorder (ASD) is characterized by a variety of social, sensory, and developmental symptoms. It is estimated that there are 66 cases per 10,000 children in the United States, placing the U.S. in the top ten countries with the highest prevalence of autism. Japan currently has the highest rate at 161 cases per 10,000. There is currently no known cure for this developmental disorder and the diagnostic protocol is not very clear. Those diagnosed are likely to face years of therapy and exposure to different medications to treat the symptoms. However, one risk factor that has received more attention in recent studies is that of Vitamin D and its relationship with ASD. It has been shown that environmental factors can lead to gene expression changes that may affect social behaviors, a core deficit of ASD. Vitamin D deficiencies during development can lead to the upregulation of DNA-repair genes and maternal deficiencies during pregnancy which may inhibit gene repair in the developing fetus. Deficits in Vitamin D have been linked to an increase in the autoimmune response of the body and are thought to lower the immune system’s attack on infections. Quantitative PCR was used to evaluate vitamin D receptor expression in human and mouse homogenate brain tissue punches from the cingulate cortex to determine Vitamin D receptor expression levels. Associations between Vitamin D and ASD may bring us one step closer to determining whether a simple addition of Vitamin D during the prenatal period could help decrease the risk of a developmental disorder such as autism.

In recent years, it has been reported about an increasingly large aging population and that the substance abuse problem has increased for people over the age of 65. Despite this, there are no specific guidelines for older people with addiction problems. Society may face a major challenge where an increasingly large aging population with social problems risks being left without help. This study therefore aims to investigate what kind of help older people with alcohol abuse receive and what advantages and obstacles there are for treatment.  With the aim of getting an overview of the field, a scoping review was used to collect data. Thematic analysis was used to analyze the data, with the hope of seeing a new angle in the articles. The results show that there is a lack of research in ​​older people with substance abuse and also a lack of knowledge to design adequate help. It also appears that professionals believe that their work with elderly people can be compared to working in a gray area, where their responsibilities often become vague. The gray area is largely since the social service's care for the elderly, welfare officers and individual and family care are lacking in their cooperation. Although the results also show that there are some ways of working is better than others, the importance of new research is emphasized to provide the right help. / De senaste åren har det rapporterats om en allt större åldrande befolkning och att missbruksproblem hos personer över 65 år har ökat. Trots detta saknas det specifika riktlinjer för äldre med missbruksproblem. Samhället kan stå inför en stor utmaning där en allt större åldrande befolkning med sociala problem riskerar att bli utan hjälp. Den här studien syftar därför till att undersöka vilken typ av hjälp äldre med alkoholmissbruk får och vilka fördelar respektive hinder det finns för behandling. Med syftet att få en översikt över området används vid datainsamling en scoping review. Vid analys av materialet användes tematisk analys, med förhoppningen att se de insamlade artiklarna ur nya perspektiv. I resultatet framkommer det att det är brist på forskning i området för äldre personer med missbruksproblematik och att det därför saknas kunskap för att utforma adekvat hjälp. Det framkommer även att professionella anser att deras arbete med äldre i alkoholmissbruk kan liknas vid att arbeta i en gråzon där deras ansvar många gånger blir otydligt. Gråzonen beror till stor del på att socialtjänstens äldreomsorg, biståndshandläggare och individ- och familjeomsorg brister i sin samverkan. Trots att resultatet också visar på att det finns arbetssätt som verkar fungera bättre än andra betonas vikten av ny forskning för att säkerställa rätt hjälp.

Background; In today's social debate, much is written and spoken of how poor psychiatric care works, care places are closed and there are difficulties in recruiting nurses / psychiatric nurses. Psychiatric care has problems with its image, and this is based on the media's angle that the people who work there themselves have some kind of psychiatric diagnosis and are ineffective, neurotic and controlling and have no limits to their patients. Media and large parts of society in general have a driving role that contributes to the psychiatric care and psychiatric care patients being stigmatized and the nurse working in psychiatric care is stigmatized through association. This has a negative effect and causes nursing students and registered nurses not to choose psychiatric care. Aim; of the study was to describe how nurses/psychiatric nurses' experiences of working at a psychiatric ward. Method; was a qualitative, descriptive study, based on eight interviews with nurses/psychiatric nurses working in a psychiatric ward. The interviews were analyzed using qualitative content analysis. Results Made up in three categories as "Stigma by association", "Experienced deficiencies" and "Work joy. The nine subcategories were "Stamped", "Stagnation", "Competence and recruitment problems", "Leadership", "Poor working environmen", "Mentor's role", "A rewarding and fun work", "Developing", "Good patient relationship". Conclusion; The informant think they have a educational and fun job but they are sad and frustrated that they are experiencing shortcomings and do not have the correct conditions for doing the best work. Stigma by association is obtained through the work.

Bakgrund: Att genomgå ett missfall kan vara psykiskt tungt och återhämtningen kan vara lång. Var fjärde kvinna går igenom ett missfall som innebär att kroppen själv spontant avbryter en graviditet. Varför ett missfall uppstår är okänt men det finns flertalet riskfaktorer som kan orsaka ett missfall. Kvinnor och deras partner kan uppleva en intensiv sorg efter förlusten. De båda ska få vara delaktiga i missfallupplevelsen och bemötas med empati och respekt. Syfte: Syftet med studien var att beskriva kvinnors erfarenheter i samband med missfall. Metod: En litteraturbaserad studie baserad på tio vetenskapliga kvalitativa artiklar. Resultat: Fyra teman identifierades; ett personligt misslyckande präglat av sorg och besvikelse, behovet av emotionellt stöd, tungt att återgå till vardagen och önskan om att bli förstådd. Konklusion: Det finns vissa brister gällande information, kommunikation och känslomässigt stöd när kvinnor söker vård för missfall. För att kunna bemöta kvinnorna finns det fortfarande behov av kunskap av en god kommunikation och information från vården och förbättra kvinnors erfarenheter i samband med missfall. Ämnet behöver lyftas mer för att normaliseras och förbättra kvinnors erfarenheter vid missfall. / Background: Having a miscarriage can be psychologically difficult and recovery can be long. Every fourth woman goes through a miscarriage, which means that the body itself spontaneously terminates/interrupts a pregnancy. Why a miscarriage occurs is unknown, but there are several risk factors that can affect a miscarriage. Women and their partners experience intense grief after the loss. The woman and her partner must be allowed to participate in the miscarriage experience and be treated with empathy and respect. Aim: To describe women's experiences in connection with miscarriage. Method: A literature-based study with ten qualitative articles. Findings: Four themes were identified; A personal failure characterized by sadness and disappointment, the need for emotional support, heavy to return to everyday life and the desire to be understood. Conclusions: There are certain flaws regarding information, communication and emotional support when women seeking medical care for miscarriage. In order to respond to women, there is still a need for knowledge of good communication and information from medical care and to improve women's experiences of miscarriage. The subject needs to be talked about more in order to normalize and improve women's experiences of miscarriage.

Bakgrund: Smålands Skafferi har genomgått betydande tillväxt på senare år och har anpassat sin verksamhet för att möta den ökade efterfrågan. Företaget arbetssätt har utvecklats organiskt under expansionsperioden. Nya medarbetare har anställts i takt med att arbetsbelastningen har ökat för befintlig personal. Trots fungerande arbetssätt söker företaget nu möjligheter att förbättra effektiviteten, minska kostnader och öka konkurrenskraften. En central del av Smålands Skafferis värdekedja är Order-To-Delivery-processen, som sträcker sig från mottagning av kundorder till avslutad leverans och fakturering. Syfte: Syftet med studien är att identifiera de brister i Smålands Skafferis OTD-process, inklusive bristernas orsaker och konsekvenser samt föreslå förbättringsåtgärder. Metod: Studien är en fallstudie på Smålands Skafferi. Metoden är kvalitativ med en deduktiv ansats och tillämpar kritisk realism som vetenskapligt synsätt.  Semistrukturerade intervjuer och observationer som observatör-som-deltagare användes för datainsamlingen. Analysen utfördes genom mönsterjämförelse med inslag av logiska modeller.  Slutsats: Brister som identifierats i Smålands Skafferis OTD-process är följande: otillgängliga varor, bristande kommunikation, begränsningar med affärssystem, begränsat lagerutrymme, felplock, restnoteringar, utmaningar med färskvaror, ineffektiv ruttplanering samt övervikt på lastbilar. Rekommenderade åtgärder för att eliminera brister i OTD-processen är följande: mätningar (lagerservicenivå), uppdatering i realtid, skanningssystem och sammanställning av vikt för att upptäcka övervikt. / Background: Smålands Skafferi has experienced significant growth in recent years andhas adapted its operations to meet the increased demand. The company's workingmethods have evolved organically during the expansion period. New employees havebeen hired as the workload has increased for existing staff. Despite functional procedures,the company is now seeking opportunities to improve efficiency, reduce costs, andenhance competitiveness. A central part of Smålands Skafferis’s value chain is theOrder-To-Delivery process, which extends from receiving customer orders to completeddelivery and invoicing. Purpose: The purpose of the study is to identify deficiencies in Smålands Skafferi’s OTD-process, including the causes and consequences of these deficiencies, and to propose improvement measures. Method: The study is a case study at Smålands Skafferi. The method is qualitative with a deductive approach, applying critical realism as the scientific perspective. Semi-structured interviews and observations as participant observers were used for data collection. The analysis was conducted through pattern comparison with elements of logical models.  Results: Deficiencies identified in Smålands Skafferi's OTD-process are as follows: unavailable goods, lack of communication, limitations with business systems, limited warehouse space, mispicking, backlogs, challenges with fresh products, inefficient routeplanning and overweight trucks. Recommended measures to eliminate deficiencies in the OTD-process are the following: measurements (warehouse service level), real-time updating, scanning system and compilation of weight to detect excess weight.

The goal of this study is to research the disparities in character positions between clients and server when playing an online game. The data needed was gathered by letting three players play a game made by me against each other, using extrapolation methods like the Kalman Filter on the characters’. During the play-through each client saved all characters positions together with the input made by the players. The clients logged the information every network update, in synch with the server. When the time came, all clients sent their information to the server, where it was collected, analyzed and compared with the information the server had registered. By calculating the difference in position of the server and clients characters, a disparity value could be extracted. This value is what was used to calculate a disparity value between the server characters and all clients’ counterparts. The same value is also what was used to answer the questions on how much impact the different extrapolation methods have on a game, as well as how big of an impact input made have on the delay of the game. An important part of the study was to make sure that the information gathered was collected at the same time on the clients and the server, as well as to be able to enable and disable parts of the methods. Therefore the whole game used in this dissertation was built focused on this study. All extrapolation methods are toggle-able and the information gathered is synched using time.windows.com.