Résumé confidentiel / Confidential abstract

I samband med operation exponeras patientens kropp för att kunna genomföra ett ingrepp och det är operationssjuksköterskans uppgift att bevara patientens kroppsliga integritet. Det finns dock inga tydliga riktlinjer för detta och kan vara en svår utmaning för operationssjuksköterskor. Syftet med studien var att beskriva operationssjuksköterskors erfarenheter av hur de bevarar patientens kroppsliga integritet. Kvalitativ ansats med intervjuer som datainsamlingsmetod valdes för att beskriva operationssjuksköterskors erfarenheter inom området. Urvalet bestod av nio operationssjuksköterskor fördelade på fyra sjukhus inom tre län. Datamaterialet analyserades enligt en kvalitativ innehållsanalys och resulterade i sju subkategorier under en och samma kategori. Operationssjuksköterskorna beskrev begreppet integritet som en människas personliga sfär och att varje enskild patients integritet bevaras genom individanpassad vård. Skydda patientens kroppsliga integritet kan göras genom att skyla kroppen och undvika obehöriga blickar, men samtidigt finns faktorer som försvårar bevarandet av patientens kroppsliga integritet. En kombination av professionalism och empati menar operationssjuksköterskorna leder dem till att bevara patientens kroppsliga integritet där patientrelationen är viktig men av olika skäl kan utebli. Slutsatsen av resultatet är att patientrelationen är viktig för att kunna inhämta den information operationssjuksköterskan behöver för att kunna bevara patientens kroppsliga integritet. / During a surgery the patient’s body is exposed in order to carry out the surgery and it is the operating room nurse’s main task to care for and to protect the patient’s bodily integrity. However, at this time there are no clear guidelines on how to treat this subject and it can be a difficult challenge for the nurses. The purpose of this study was to describe the operating room nurses experiences of how they best protect the patient's bodily integrity. A qualitative approach with interviews and data collection methods was chosen to describe the operating room nurses' experiences in the field. The sample consisted of nine surgical nurses, spread across four hospitals in three counties. The data was analyzed according to a qualitative content analysis and resulted into seven sub-categories under the same category. Operating room nurses described the concept of integrity as a human's personal space, and that each patient’s integrity is maintained through individualized care. Protecting the patient’s bodily integrity can be done by covering the body and preventing unauthorized eyes but there are factors that can for different reasons make this difficult. The operating room nurses think that a combination of professionalism and empathy leads them to maintain the patient's bodily integrity where patient relationship is important, but for various reasons may be compromised. The conclusions from the result is that the patient relationship is important in order to obtain the information that the operating room nurse needs to be able to protect the patient's bodily integrity.

Résumé confidentiel / Confidential abstract

The field has developed many evidence-based treatments (EBTs); the integrity of EBTs being delivered, however, has been studied less than rigorously. Because many treatment manuals are developed to be delivered session-by-session, one way to assess treatment adherence, specifically, is across the course of the case: do therapists deliver treatment components in the order prescribed? The goals of this study were to characterize how therapists deviate from prescribed order and how adherence to order relates to child characteristics. Therapy process data were collected from a subsample of children (N = 33, aged 7-15) that received cognitive behavioral therapy (CBT) to address primary symptoms of anxiety. Adherence to CBT was measured by the CBT Adherence Scale for Youth Anxiety (Southam-Gerow & McLeod, 2011). Four methods to assess order were developed. Analyses include descriptive and correlative statistics that characterize the delivery of CBT and the relation between adherence to order and pretreatment characteristics.

The goal of the current study was to develop and test a rigorous measure of therapist adherence to a cognitive-behavioral, manual-based treatment for childhood and adolescent depression. This project employed data from the recently completed UCLAYouth Anxiety and Depression Treatment study. This study aimed to advance the literature by devoting the full focus of the project to the development of a manual-based measure that would demonstrate interrater reliability across multiple raters. This study reported on the psychometric development of the PASCET Manual Adherence Scale (PMAS) (e.g. scoring strategy, item development, reliability), a unique measure of therapist adherence that represents the content of the treatment manual for the "Primary and Secondary Control Enhancement Training" program (PASCET; Weisz et al., 1999). In sum, the P-MAS showed strong interrater reliability for most items of the scale. The items with poorer ICCs may have been influenced by instrumentation problems, small sample size, and range restriction. Some session content showed evidence that more meetings may be required to sufficiently cover the material, particularly for those that involve heavy in-vivo content, require the use of technology, or involve cognitive interventions which may be challenging for children and young teenagers. The results indicated that therapists adhered to slightly more than half of the prescribed manual content overall. The variability in adherence appeared greater for session-specific content than for standard session items, reflecting the variability within that content and the myriad of factors which may have influenced adherence to diverse material. Adherence for session-specific content demonstrated a slightly downward trend over time, with a significant drop off between the first and second phases of treatment and a leveling off between second and third phases. For all but two relevant sessions, therapist adherence to didactic content was significantly higher than adherence to in-vivo content, highlighting the challenges of engaging depressed youth in active learning. As this active involvement is theorized to be an essential component in addressing depressive symptoms, the challenges in implementation of this content may represent the most significant barrier to therapist adherence with this manual.

Twenty five first through third order streams in the Coastal Plain of Virginia were sampled for benthic macroinvertebrates and fishes to determine whether a predictable relationship between areas of Unfragmented Natural Land Cover (UNLC) and biotic integrity could be established. I hypothesized that as the area of UNLC increased in a watershed at either the whole catchment or riparian scale, biotic indices measuring stream water and habitat quality would increase. Biotic integrity was measured through the scores from the Coastal Plain Macroinvertebrate Index (CPMI) for benthic macroinvertebrates and the VCU Index of Biotic Integrity (IBI) for fishes. Using GIS, the percentage of UNLC at the catchment and riparian scale was calculated for each stream's watershed. Physicochemical parameters, habitat metrics and other environmental data were also analyzed to determine if relationships existed between those parameters and biotic integrity. Unfragmented Natural Land Cover ranged from 7% to 82% at the catchment scale and 10%to 96% in the riparian area. There were no significant correlations between the biological assessment scores for either the benthic macroinvertebrate or the fish communities and UNLC at either scale. Analyses of physicochemical parameters and habitat metrics did show some significant correlations between those variables and biotic metrics. Dissolved oxygen (DO) and pH were positively correlated with the CPMI and DO was positively correlated with the IBI scores. Several habitat metrics were significantly correlated with the CPMI, including pool variability, which was positively correlated with the CPMI, and bank stability, sediment deposition, and channel flow status, which were negatively correlated with the CPMI. The results of this study indicated that streams with unconstrained channels score significantly lower on the CPMI and have significantly lower DO concentrations than streams with constrained channels despite some streams with unconstrained channels having high percentages of UNLC in the watershed. Although there were other biotic and abiotic factors that may have introduced variability into the study, such as severe weather, beaver activity, and changing land use, it is likely that the CPMI was not an appropriate bioassessment tool for swampy Coastal Plain streams. It is therefore imperative from assessment and management perspectives for state agencies and researchers to develop appropriate bioassessment indices for Coastal Plain streams that have limiting water quality influenced by natural processes.

The aim of this dissertation is to describe and analyse individual stages of a civil process for the protection of personal integrity. The civil process is a unique stream, within which there is a protection of personal rights offered to individuals. Immaterial damage caused by unauthorized interference in such important personal right such as rights of personal integrity without doubt are, is often correctly replaced only by the judicial decision. For this reason, it requires knowledge of both the substantive civil law, which underlines the protection of the rights of personal integrity, as well as civil procedure law, in which the substantive law is being implemented. The content of this dissertation is the analysis of the various parts of the judicial process from filing an action for protection of personal integrity to the court's decision, enforcement and execution in matters of protection of personal integrity. The dissertation illustrates the complex picture into the issues of civil proceedings in the matters of protection of personal integrity and quotes directly from court decisions in each of the stages of the proceedings. Given the general arrangements for the protection of personal integrity the report of judgment and decisions is one of the main sources of knowledge during the civil...

This thesis deals with personal integrity and its testing for the job tender. The main objective is to determine the test-retest reliability of the integrity test, which is currently being developed and studied at the National Institute of Mental Health in Klecany. Another aim of the work is to compare the Czech version of the integrity test, a whole set of psychological tests designed to investigate the integrity intended for recruiting new employees, and the findings of foreign tests, which are used primarily in the United States. The use of integrity tests is a common practice abroad in the selection process of new employees, for example in lower administration or positions working with money. Work has both theoretical and practical character. The theoretical part summarizes the findings about integrity from authors throughout history, present information about foreign integrity test (types, weaknesses, ethical issues of testing, the proposed rules for the implementation of integrity tests for job tenders for organization, etc.). Finally, it discusses psychometrics and required characteristics for quality tests. The practical part is based on a test-retest study that was conducted on a sample of 51 respondents in the time interval of 4 to 5 months. Respondents were repeatedly presented with a...

Trusted Computing capability has become ubiquitous these days, and it is being widely deployed into consumer devices as well as enterprise platforms. As the number of threats is increasing at an exponential rate, it is becoming a daunting task to secure the systems against them. In this context, the software integrity measurement at runtime with the support of trusted platforms can be a better security strategy. Trusted Computing devices like TPM secure the evidence of a breach or an attack. These devices remain tamper proof if the hardware platform is physically secured. This type of trusted security is crucial for forensic analysis in the aftermath of a breach. The advantages of trusted platforms can be further leveraged if they can be used wisely. RADIUM (Race-free on-demand Integrity Measurement Architecture) is one such architecture, which is built on the strength of TPM. RADIUM provides an asynchronous root of trust to overcome the TOC condition of DRTM. Even though the underlying architecture is trusted, attacks can still compromise applications during runtime by exploiting their vulnerabilities. I propose an application-level integrity measurement solution that fits into RADIUM, to expand the trusted computing capability to the application layer. This is based on the concept of program invariants that can be used to learn the correct behavior of an application. I used Daikon, a tool to obtain dynamic likely invariants, and developed a method of observing these properties at runtime to verify the integrity. The integrity measurement component was implemented as a Python module on top of Volatility, a virtual machine introspection tool. My approach is a first step towards integrity attestation, using hypervisor-based introspection on RADIUM and a proof of concept of application-level measurement capability.

Embedded software today is pervasive: they can be found everywhere, from coffee makers and medical devices, to cars and aircraft. Embedded software today is also open and connected to the Internet, exposing them to external attacks that can cause its Control-Flow Integrity (CFI) to be violated. Control-Flow Integrity is an important safety property of software, which ensures that the behavior of the software is not inadvertently changed. The violation of CFI in software can cause unintended behaviors, and can even lead to catastrophic incidents in safety-critical systems. This dissertation develops a two-part approach for CFI: (i) prescribing source-code safetychecks, that prevent the root-causes of CFI, that programmers can insert themselves, and (ii) formally proving CFI for the machine-code of programs with source-code safety-checks. First, our prescribed safety-checks, when applied, prevent the root-causes of CFI, thereby enabling software to recover from CFI violations in a customizable way. In addition, our prescribed safety-checks are visible to programmers, empowering them to ensure that the behavior of their software is not inadvertently changed by the prescribed safety-checks. However, programmer-inserted safety-checks may be incomplete. Thus, current techniques for proving CFI, which assume that safety-checks are complete, may not work. Second, this dissertation develops a logic approach that automates formal proofs of CFI for the machine-code of software containing both source-code CFI safety-checks and system calls. We extend an existing trustworthy Hoare logic with new proof rules, proof tactics, and a novel proof-search algorithm, which exploit the principle of local reasoning for safety properties to automatically generate CFI proofs for the machine-code of programs compiled with our prescribed source-code safety-checks. To the best of our knowledge, our approach to CFI is the first to combine programmer-visible source-code enforcement mechanisms for CFI–enabling programmers to customize them and observe that their software is not inadvertently changed–with machine-code proofs of CFI that can be automated, and that does not require a trusted or verified compiler to ensure its proven properties hold in machine-code. We evaluate our CFI approach on realistic embedded software. We evaluate our approach on the MiBench and WCET benchmarks, implementations of common file utilities, and programs interfacing with hardware inputs and outputs on the Raspberry Pi single-board-computer. The variety of our target programs, and our ability to support useful features such as file and hardware inputs and outputs, demonstrate the wide applicability of our approach.