TCC (Transitions of care clinic) is a specialized clinic visit where patients present to their primary clinic after a hospital stay. TCC deploys an interprofessional team to address a gamult of patient concerns. Traditionally, TCC interprofessional team includes a nurse and a doctor. The nurse calls the patient’s house within 2 days to check up on the patient and then they schedule a clinic visit, usually within 7-14 days. However it has been proposed that addition of team members from other disciplines could contribute to better health outcomes for patients seen in TCC. We studied a TCC model with an interprofessional team of not only physicians and nurses but also pharmacists and behavioral therapists for two months. Our aim was to uncover the utility of having a behavioral health team member in TCC visits. This was a prospective study of patients who attended a TCC clinic in a residency setting. An observer collected data on the time the behavioral health provider was in the patient room and the interventions/consultations he/she provided. Data collection is ongoing. We expect to find the following: the percentage of patients within TCC who utilized some form of behavioral therapy in their TCC visits; the percentage of common interventions that were used; average time spent in each visit; average age of patients; and average number of hospitalizations per patient. We expect that these results will demonstrate how behavioral health providers function on interprofessional TCC teams.

Vitamin D insufficiency remains a costly pandemic in veterans. Treatment requires achievement of desired 25-hydroxyvitamin D [25(OH)D] concentrations. The frequency with which 25(OH)D should be measured following treatment remains speculative. A retrospective analysis of veterans with vitamin D insufficiency was conducted. The group was stratified on the basis of initial 25(OH)D and assessed for frequency of follow-up 25(OH)D concentrations. Over 3 years, 278 patients with insufficient 25(OH)D concentrations were identified. Of these, 87 (31%) patients had subsequent levels assessed in the year following initial documentation of vitamin D insufficiency. The likelihood of follow-up testing was unrelated to the initial vitamin D level. In the patients with follow-up 25(OH)D levels, 90% eventually achieved a serum level of 30 ng/mL or greater. Veterans with vitamin D insufficiency have inadequate serial monitoring of 25(OH)D concentrations.

<p>We followed up with about 2,000 smallholder households in Senegal, two years after these households participated in a randomized controlled trial (RCT) aimed at reducing levels of aflatoxins in smallholders’ stored maize. In the initial intervention, treated households were provided with training on proper post-harvest practices, low-cost moisture meters for testing if maize was sufficiently dry to store, plastic tarps for drying maize of the ground, and hermetic (airtight) storage bags to mitigate aflatoxin development in stored maize. Using cross-sectional follow up data on aflatoxins levels and drying and storage practices from 2019 along with baseline demographic data from 2016, we estimate both the longer-term intention-to-treat (ITT) effects and the treatment on the treated (TOT) effects that the four inputs provided on households’ aflatoxins levels in stored maize. The ITT analyses estimate the intervention’s average effect by treatment group, but this may underestimate the true impact for households who complied with recommended post-harvest practices and adopted the recommended technologies. The TOT analyses estimate the local average treatment effects (LATE) of the intervention, that is its impacts on those who were driven by the intervention to follow best practices or use a given technology. Since the decision to follow these practices or adopt a technology was not random, we instrumented the usage decision with the exogenous, random treatment group assignment to get an unbiased estimate. Outside of our main models, we conducted a heterogeneity analysis to test if households with different characteristics benefit differently from the intervention. We interacted each treatment assignment with various household characteristics, including the woman’s level of involvement in the intervention. Additionally, we estimate the cost-effectiveness of providing training and a tarp, according to WHO guidelines for public health interventions. </p>

The study aims to study if it is possible to reduce lead time or resource needs by studying the PD process, Product Development Process linked to the improvement area Unclear requirements from managers on measuring the process. This is done by studying current control, the possibility of using other measuring points and how a measurement system could be established, including Scorecard within Scania R&amp;D, Research and Development. The study is based on the questions What does the product development process look like? What could be measured in the product development process? and How could a measurement system with integrated Scorecard be implemented for better control of the product development process? Theories include the areas of processes, process control, process measurement and process management. Interviews, group interviews, document studies, literature studies and previous research were the basis for studying the problem and opportunities for improvement. All data collection was done remotely as Covid-19 had major impacts. The result of the study shows that R&amp;D does not currently measure the PD process, but measurement is regulated in internal documents. Measurement of lead time, resources and costs was desired by interviewees to measure. Basing the measurement on the current KPI, Key Performance Indicators, and R&amp;D strategic plan 2020 implies established support from the functions that produced the internal documents. The developed measurement system includes the measurement points lead time, cost and resource requirements as well as selected milestones. An introduction of the measurement system would, for Scania R&amp;D, provide an opportunity to control the PD process linked to the measurement points. The measurement system has largely been based on internal documents to increase the relevance of the measurement system and the possibility of an introduction. / Studien syftar till att studera om det går att minska ledtid eller resursbehov genom att studera PD processen, Product Development Process, kopplat till förbättringsområdet Otydliga krav från chefer på mätning av processen. Det utförs genom att studera nuvarande styrning, möjligheten att använda andra mätpunkter samt hur ett mätsystem skulle kunna upprättas inkluderat Scorecard inom Scania R&amp;D, Research and Development. Studien baserar sig på frågeställningarna Hur ser produktframtagningsprocessen ut? Vad skulle kunna mätas i produktframtagningsprocessen? samt Hur skulle ett mätsystem med integrerat Scorecard kunna implementeras för bättre styrning av produktframtagningsprocessen? Teorier berör områdena processer, processtyrning, processmätning och processledning. Intervjuer, gruppintervju, dokumentstudier, litteraturstudier och tidigare forskning låg till grund för att studera problemet och förbättringsmöjligheter. Samtlig datainsamling utfördes på distans då Covid-19 hade stora påverkningar. Studiens resultat visar att R&amp;D i nuläget inte mäter PD processen men mätning finns reglerat i interna dokument. Mätning av ledtid, resurser och kostnader var önskat av intervjupersoner att mäta. Att basera mätningen på nuvarande KPI, Key Performance Indicators, och R&amp;D strategisk plan 2020 innebär ett etablerat stöd hos de funktioner som tagit fram de interna dokumenten. Det framtagna mätsystemet inkluderar mätpunkterna ledtid, kostnad och resursbehov samt utvalda milstolpar. Ett införande av mätsystemet skulle för Scania R&amp;D innebära en möjlighet till att styra PD processen kopplat till mätpunkterna. Mätsystemet har till stor del baserats på interna dokument för att öka mätsystemets relevans samt möjligheten till ett införande.

Syftet med föreliggande studie är att undersöka om och isåfall hur lärare på språkintroduktionsprogrammet i sin undervisning stöttar flerspråkiga elevers interaktion på målspråket genom uppföljningar. Metoden för studien grundar sig i två modeller: Exchange Structure Model av Sinclair &amp; Coulthard (1975) och interaktionell stöttning av Hammond &amp; Gibbons (2005). Data samlades in i form av ljudinspelningar och klassrumsobservationer på språkintroduktionsprogrammet. Resultatet visar att läraren i interaktionen med flerspråkiga elever med begränsade språkliga kunskaper använder sig av stöttande drag genom kopplingar till tidigare erfarenheter, sammanfattningar, metakommentar, approprieringar, omformuleringar, antydande eliciteringar  och framåtriktningar. Undersökningens slutsatser är att uppföljningar kan stötta interaktionen på målspråket och att det kan vara viktigt att läraren för det flerspråkiga klassrummet hittar ett innehåll som är intresseväckade för eleverna.

La majorité des exoplanètes connues à ce jour ont été découvertes par la méthode du transit, qui infère indirectement l’existence de tels objets, si l’alignement le permet, en mesurant la baisse temporaire et répétée de la brillance d’une étoile lors du passage d’une exoplanète devant celle-ci. La recherche de biosignatures, donc de vie, dans l’atmosphère d’une exoplanète est désormais le principal objectif dans ce domaine d’études, et pour maintes raisons, celles de taille de moins d’approximativement deux rayons terrestres autour d’étoiles naines rouges sont particulièrement convoitées. Afin de connaître davantage de tels systèmes dans le voisinage solaire et dans toutes les régions du ciel, le Transiting Exoplanet Survey Satellite (TESS) fut lancé en avril 2018. Le grand échantillonnage de 21'' par pixel des caméras à bord de TESS résulte fréquemment à une contamination des données des étoiles d’intérêt montrant un signal prometteur de transit, par le flux d’autres étoiles à proximité. Lorsque l’une de ces sources contaminantes est une étoile binaire à éclipses, phénomène astrophysique pouvant mimer un transit, la détection constitue très souvent un événement faux positif. Ainsi, de nouvelles observations photométriques et spectroscopiques sont généralement requises pour identifier les véritables exoplanètes. Ce mémoire présente les résultats du suivi photométrique de neuf candidates exoplanètes identifiées par TESS à l’Observatoire du Mont-Mégantic avec la caméra Planètes Extra-Solaires en Transit et Occultations (PESTO). Une routine d’ajustement de courbe de transit développée durant cette maîtrise procure une estimation de certains paramètres physiques (rayons, demi-grand axe et inclinaison) des candidates. Parmi celles-ci, TOI 1452.01 ressort du lot, car cette probable exoplanète d’environ deux rayons terrestres orbite dans la zone habitable de son hôte naine rouge, c’est-à-dire à une distance permettant la présence d’eau liquide à sa surface. / The majority of the exoplanets known to date have been discovered using the transit method, which indirectly infers the existence of such objects by measuring a temporary and repeated drop in the brightness of a star when, for the right alignement, an exoplanet passes in front of it. The search for biosignatures, thus life, in an exoplanet atmosphere is now the main objective in this field of study, and for several reasons, planets with a radius less than approximately two Earth radii around red dwarfs are particularly targeted. With the goal of finding more such systems in the solar neighbourhood and in all regions of the sky, the Transiting Exoplanet Survey Satellite (TESS) was launched in April 2018. The large image sampling of 21'' per pixel of the cameras on board TESS often results in data contamination of stars showing promising transit signal, by the flux of nearby stars. If one of these contaminating sources happens to be an eclipsing binary, an astrophysical phenomenon able to mimic a transit, the detection is most likely a false positive event. Thus, follow-up observations in photometry and in spectroscopy are generally required to identify the genuine exoplanets. This thesis presents the results of a photometric monitoring campaign at the Observatoire du Mont-Mégantic with the Planètes Extra-Solaires en Transit et Occultations (PESTO) camera of nine exoplanet candidates identified by TESS. A transit curve fitting routine developed during this master’s provides an estimation for certain physical parameters (radius, semi-major axis and inclination) of these candidates. Among them, TOI 1452.01 stands out, because this probable exoplanet has an estimated radius close to two Earth radii, in addition to being located within the habitable zone of its red dwarf host, i.e. at a distance allowing the presence of liquid water on its surface.

Bakgrund: Utvecklingen av intensivvården har under de senaste åren lett till att antalet personer som överlever intensivvården har ökat. Över hälften av alla överlevare drabbas av olika komplikationer i efterförloppet som kräver behandling och rehabilitering. Kunskapen om detta är av betydelse för sjuksköterskan för att förstå vikten av personcentrerad vård efter intensivvårdsbehandling. Syfte: Syftet med litteraturstudien var att sammanställa intensivvårdsbehandlade patienters upplevelser av efterförloppet. Metod: En kvalitativ litteraturstudie med induktivt förhållningssätt. Databaserna PubMed, Cinahl och SveMed+ användes för att ta fram material för studien. En kvalitetsgranskning av studierna utfördes med SBU:s granskningsmall för kvalitativa studier. Resultat: Resultatet redovisas utifrån sex kategorier: fysisk, psykisk och kognitiv påverkan, en lång återhämtningsprocess, behov av stöd från närstående, behov av omvårdnad, behov av hanteringsstrategier och förändringar av livet. Konklusion: Studiens resultat skildrar de intensivvårdsbehandlade patienternas olika upplevelser i efterförloppet. Patienterna upplevde att deras behov inte blev tillgodosedda samt att tillgången till och kvaliteten på den uppföljande vården var begränsad. De upplevde även en brist på information om vad tiden efter intensivvårdsbehandlingen skulle innebära. Den uppföljande vården har utvecklats under den senaste tiden, men behöver fortsatt utveckling för att kunna tillgodose behoven hos denna patientgrupp. / Background: The development of intensive care during the latest years have led to increasing numbers of ICU survivors. More than half of all survivors are affected by different complications after intensive care treatment that needs treatment and rehabilitation. This knowledge is of meaning for the nurse to understand the importance of person-centred care after intensive care treatment. Aim: The aim of the study was to compile patients’ experiences of recovery after intensive care treatment. Method: A literature review with a qualitative approach was used. Literature searches were performed in the databases PubMed, Cinahl and SveMed+. The quality of the selected studies was assessed using SBU’s review tamplet for qualitative studies. Results: The results are reported based on six categories: physical, mental, and cognitive impact, a long recovery-process, need for support from family and friends, need for care, need for coping strategies and changes in life. Conclusion: The results of the study describes the patients´ different experiences during the recovery from intensive care treatment. The patients experienced that their needs weren´t fullfilled and that the availability and quality of the follow-up care was limited. They also experienced that there was a lack of information about the recovery. The follow-up care has developed during the recent years, but it needs further development to be able to meet the needs of this group of patients.

No description available.

No description available.

Bakgrund: I början av december 2019 kom de första rapporterna om viruset Severe Acute Respiratory Syndrome Coronavirus 2 som orsakar sjukdomen Coronavirus Disease 2019 (covid-19). Många som genomgått en covid-19-infektion får långvariga besvär. Syfte: Syftet var att undersöka eventuella samband mellan riskfaktorer och kvarvarande symtom efter genomgången covid-19 upp till sex månader efter utskrivning från sjukhus. Metod: Studien är en icke-experimentell prospektiv longitudinell kohortstudie. Kohorten består av 37 patienter som vårdades på ett sjukhus i Västra Götaland för covid-19 under perioden juni 2020 till februari 2021. Potentiella riskfaktorer, biomarkörer och infektionsparametrar under sjukhusvistelsen analyserades tillsammans med patienternas självskattade upplevelse av symtom enligt skalan Post Covid-19 Functional Status (PCFS), vid en, tre och sex månader efter genomgången covid-19. Resultat: Resultatet av analysen visade signifikanta relationer mellan rökning (p=.018), sekundära diagnoser under vårdtiden (p=.003), en ålder &gt;65 år (p=.014) samt att ha en cancerdiagnos (p=.046) och att rapportera kvarvarande symtom som påverkar vardagen. Trötthet och nedsatt ork var de vanligast rapporterade symtomen post-covid, följt av andningsrelaterade besvär. Vid sex månaders uppföljning rapporterar 62% ett eller flera kvarvarande symtom. Slutsats: Då detta är en liten studie kan inga säkra slutsatser dras från analysen. Studien visar dock att det finns anledning till oro angående de långsiktiga konsekvenserna av covid-19. / Background: In early December 2019, reports came about the Severe Acute Respiratory Syndrome Coronavirus 2 causing Coronavirus Disease 2019 (COVID-19). Many who have gone through COVID-19 get long-term symptoms. Aim: The aim was to investigate possible links between risk factors and persisting symptoms after having COVID-19, up to six months after discharge from hospital. Method: The study is a non-experimental prospective longitudinal cohort study. Included were 37 patients who were treated for COVID-19 at a Swedish hospital between June 2020 and February 2021. Potential risk factors, biomarkers and vital signs during the hospital stay were analyzed together with patients' self-assessed experience of symptoms and functionality according to Post COVID-19 Functional Status (PCFS), up to six months after having COVID-19. Results: Significant relationships are shown between smoking (p = .018), secondary diagnoses during the hospital stay (p = .003), age&gt; 65 years (p = .014) and having a cancer diagnosis (p = .046) and to report persistent symptoms that affect daily life. Fatigue was the most commonly reported symptom, followed by respiratory symptoms. At the six-month follow-up, 62% of patients report one or more remaining symptoms. Conclusion: As this was a small scale study, no definite conclusions can be drawn from the analysis. However, the study shows that there is cause for concern regarding the long term consequences of COVID-19. / <p>Program: - (fristående kurs) </p>