La présente étude vérifie l’existence de relations significatives entre la consommation maternelle pré et postnatale de psychotropes (nicotine, alcool et drogues) et deux dimensions importantes du tempérament de l’enfant âgé entre 0 et 3 ans (Gartstein et Rothbart, 2003), soit la détresse face aux limitations (DL; prédisposition à l’irritabilité, à la frustration et à la colère) et la détresse face à la nouveauté (DN; crainte, peur, inhibition). De plus, elle examine les contributions relatives de la consommation maternelle de psychotropes pré et postnatale au tempérament de l’enfant ainsi que l’effet modérateur potentiel du sexe de l’enfant dans ces relations. L’échantillon comprenait 90 dyades mère-enfant issues d’un projet plus vaste s’intéressant au développement d’enfants nés de jeunes mères considérées à risque sur le plan psychosocial. La consommation maternelle a été évaluée à l’aide de questionnaires à trois reprises, soit à environ cinq mois de grossesse et à environ trois et huit mois suite à l’accouchement. Pour le tempérament, lors des visites à trois et huit mois de vie, la mère a également complété un questionnaire élaboré par Gartstein et Rothbart (2003) qui permet d’évaluer 14 dimensions du tempérament dont celles de détresse face aux limitations et de détresse face à la nouveauté. Diverses analyses statistiques (descriptives, corrélations, tests de comparaison de moyennes et régressions multiples) ont été effectuées afin d’atteindre les objectifs à l’étude. Les résultats ne montrent aucune relation significative entre la consommation pré et postnatale d’alcool et de nicotine et les deux dimensions du tempérament de l’enfant. Cependant, l’exposition in utero à la marijuana durant les premiers mois de grossesse et après l’accouchement est associée positivement à la dimension de crainte (DN) chez l’enfant de trois mois (mais pas à la dimension de colère, DL). De plus, les résultats suggèrent parfois un poids plus important de la présence de consommation prénatale dans l’explication de la DN comparativement à la présence de consommation postnatale et parfois, le contraire. La fréquence de consommation de drogues suggèrent toutefois que la fréquence de consommation prénatale a plus d'importance dans l'explication de la DN chez l'enfant que la fréquence de consommation postnatale. En ce qui concerne la modération par le sexe de l’enfant, les résultats montrent qu’il n’existe pas d’effet modérateur du sexe de l’enfant dans la relation étudiée. Pris dans leur ensemble, les résultats font ressortir la complexité existant dans la relation entre la consommation maternelle et le tempérament du nourrisson. Tant au niveau de la recherche que de la pratique, la présente étude suggère également l’importance d’utiliser des mesures et des interventions différenciées selon le psychotrope utilisé par les mères et le moment de la consommation (pré et/ou postnatal).

Bakgrund: I Sverige är den vanligaste dödsorsaken kranskärlssjukdom, vilket kan innebära hjärtinfarkt. Riskfaktorer för hjärtinfarkt är låg fysisk aktivitet, höga blodfetter, rökning, låg inkomst och låg utbildning. En hjärtinfarkt uppstår vanligtvis på grund av att ett åderförfettningsplack har brustit och bildat en blodpropp.  Syfte: Syftet med denna litteraturstudie är att undersöka kvinnor och mäns erfarenheter efter en hjärtinfarkt. Metod: Nio kvalitativa vetenskapliga studier analyserades enligt Fribergs modell för litteraturöversikt. Resultat: Resultatet sammanställdes i de tre kategorierna Begränsningar i vardagen, Stöd respektive brist på stöd från omgivningen, Förändrad syn på livet.  Konklusion: De personer som drabbats av en hjärtinfarkt lider ofta av hälsoproblem som fatigue i efterförloppet. Livsstilsförändringar kan vara svåra att genomföra och framförallt att bibehålla. Hälso- och sjukvårdspersonal bör vara väl insatta i vad livet efter en hjärtinfarkt innebär och ge gott stöd till de som drabbats. Livsstilsförändringar bör genomföras några få i taget istället för alla på samma gång för att det ska bli hållbart på lång sikt. / Background: The most common cause of death in Sweden is coronary heart disease, which can imply myocardial infarction. Risk factors for myocardial infarction are low physical activity, high blood lipids, smoking, low income and poor levels of education. A myocardial infarction occurs when a fatty, calcified plaque has ruptured and formed a trombosis. Aim: The aim of this literature study is to examine women and men’s experiences after a myocardial infarction. Method: Nine qualitative scientific studies were analyzed according to Friberg’s model for literature review. Results: The results were complied into three categories named Restrictions in daily life, Support or lack of support from the community, Altered life vision. Conclusion: The people who have suffered a myocardial infarction often sustain health problems such as fatigue in the aftermath. Lifestyle changes may be difficult to adopt and above all to maintain. Healthcare professionals should be well informed of what life after a myocardial infarction can implicate and give good support to those affected. Lifestyle changes should be carried out a few at a time rather than all at once to make them sustainable in the long term.

This report details a design process that generates new forms from mundane materials and tools. By utilizing a structure of limitations to establish artificial constraints, making becomes a sort of game where the designer must negotiate the rules and objects in order to achieve a solution. The best results come from setting up explicit limitations about the type of manipulation permitted, establishing design objectives, specifying the material or tool to be explored. Throughout the process of designing a structure of limitations affords the designer a critical distance from the assumed uses of common materials and familiar tools resulting in new forms, and often unexpected results. Self-assigned parameters help the designer gain control over rules and constraints established by clients. / text

<p> </p><p> </p><p> </p><p> </p><p> </p><p><strong>Abstract</strong></p><p><strong>Problem: </strong>The desire for development in less privileged countries like Uganda has created the need for the privileged countries like Sweden to embark on external knowledge transfer through different projects, as one of the objectives to achieve development. However, some factors tend to limit the success of this external knowledge transfer process.<strong> </strong></p><p><strong>Purpose: </strong>The purpose of this research is to find out the factors that lead to the barriers and limitations of knowledge transfer in development projects. Since there are differences in objectives between nonprofit and profit making projects, the research is also aimed at highlighting the extent to which the affecting factors hinder the achievement of objectives and goals. <strong> </strong></p><p><strong>Method: </strong>Qualitative methods were used in this research. Telephone interviews were conducted after sending questionnaires to four respondents from different organizations that were actively involved in the projects. In order to have balanced results, two respondents each from Uganda and Sweden were interviewed. Trustworthiness and ethical issues were put into consideration while conducting the interviews, in a bid to create a desirable atmosphere for conducting the study.<strong> </strong></p><p><strong>Result: </strong>External knowledge transfer is affected by factors like culture, individual factors, and knowledge management factors. Apart from the mentioned factors, research found that instead of organizational factors that would affect profit making projects to a greater extent, factors like the political will, ownership and local needs are the ones that affect development projects.</p><p><strong>Conclusion: </strong>The factors that affect the external knowledge transfer process are to a greater extent human, and are controllable. In development projects, the recipient country should identify the needs that would initiate the external knowledge transfer process. Most of the affecting factors would be controlled through building of relationships and strong ties, local ownership, and political considerations. All this put into consideration, external knowledge transfer between developed and developing countries stand a high chance to succeed.</p><p> </p><p> </p><p> </p><p> </p>

Bakgrund: I dagens samhälle är det många individer som lider av hjärtsvikt och det är många patienter med hjärtsvikt som behöver vård. Patienter med hjärtsvikt upplever både fysiska och psykiska påfrestningar som påverkar deras välbefinnande.  För patienter med hjärtsvikt är egenvård viktig del för att möjliggöra att vardagen fungerar. Syfte: Att beskriva upplevelser av egenvård hos patienter med hjärtsvikt. Metod: litteraturöversikt med induktiv ansats. Databaserna CINHALL och MEDLINE användes och tretton kvalitativa artiklar inkluderades i litteraturöversikt. Resultat: Litteraturöversiktens resultat beskriver patienters upplevelse av egenvård. Bland annat framkommer att motivation är viktigt för att utöva egenvård. Patienter uppskattade stödet de fick från familj, vänner och vårdpersonal i samband med egenvård. Utifrån resultatet framkommer egenvårds- och insiktsbrist hos patienter med hjärtsvikt, vilket leder till dålig följsamhet till egenvård. Resultatet presenteras i följande tre huvudrubriker: motivation, stöd, kunskap. Slutsats: Patienter med hjärtsvikt har hinder och begränsningar i samband med egenvård. Patienterna har också bristande insikt kring hjärtsvikt och egenvård vilket medför nedsatt välbefinnande. Patienter med hjärtsvikt och bristande egenvård är i stort behov av stöd, vägledning och kunskap i syftet att öka patientens makt och självbestämmande över situationen. Sjuksköterskor bör utifrån litteraturöversiktens resultat ha kunskap om värdet att förstå patientens upplevelse av egenvård i samband med hjärtsvikt för att kunna anpassa vården tillsammans med patienter och utefter individens behov. / Background: In today's society, there are many people who suffer from heart failure and many people with heart failure who need care. Patients with heart failure experience both physical and mental stresses that also affect the quality of life. For patients with heart failure, self-care is an important part for enabling a functioning life. Aim: To describe experiences of self-care in people with heart failure. Method: Literature overview with inductive approach. Thirteen qualitative articles were included and downloaded through the CINHALL and MEDLINE databases. Result: The essay result describes patients' self-care experience and shows that motivation is a driving force in self-care practice. Patients appreciated the support they received from family, friends and care personnel in connection with self-care. Based on the results, self-awareness and lack of knowledge results in poor compliance with self-care. The results are presented in the following three main headings: motivation, knowledge and support. Conclusion: The essay showed that patients with heart failure have barriers and constraints associated with self-care. Another problem in patients was lack of knowledge about heart failure and self-care which results in reduced quality of life. Patients with heart failure and lack of self-care are in great need of support, guidance and knowledge in order to increase patient's power and self-determination over the situation. Nurses should understand the patient's perception of self-care in heart failure in order to be able to adapt care together with the patient and to the needs of the individual person.

Background: Diabetes type 2 is a increasing disease and societal problem. To be able to sustain a healthy life despite the disease, major lifestyle changes including dietary changes and physical activity is required. Aim: The aim of this literature review was to describe the experiences of persons living with diabetes mellitus type 2. Method: An inductive approach were used, qualitative articles were analysed by Fribergs Analysis model. Result: Three main themes was discovered; “Psychological effect of diabetes”, “Practical influence on the everyday life with diabetes” and “Social and existential influences of diabetes”. There were six sub-themes found. Conclusion: There were worries about the disease and complications. Motivation was an important factor for necessary self-care. Limitations in daily life was often related to diet and social engagements. High demands of managing lifestyle changes felt arduous. Nurses have an important role in encourage to self-management and should contribute to further individualization in diabetes care.The support was often found inadequate. / Bakgrund: Diabetes mellitus typ 2 är en växande folksjukdom och samhällsproblem. För att bibehålla ett hälsosamt liv trots sjukdomen behöver personerna ofta genomgå livsstilsförändringar i form av ändrade kost- och motionsvanor. Syfte: Syftet med denna litteraturöversikt var att beskriva personers upplevelser av att leva med diabetes mellitus typ 2. Metod: En induktiv ansats användes, kvalitativa artiklar granskades och analyserades genom Fribergs analysmodell. Resultat: Här återfanns 3 huvudteman; “ Psykisk påverkan vid diabetes”, “Praktisk påverkan i vardagen med diabetes” samt “Social och existentiell påverkan vid diabetes”. Det urskildes också sex stycken subteman. Slutsats: Det fanns en ständig oro över sjukdomen och eventuella komplikationer. Motivation och stöd var viktigt för nödvändig egenvård. Begränsningar i det dagliga livet var ofta relaterat till kost och sociala tillställningar. Krav på livsstilsförändringar upplevdes som svåra. Sjuksköterskan har en viktig roll för att uppmuntra till personernas egenvård och borde verka för att ytterligare individanpassa diabetesvården.

Background: Dysfunctional breathing (DB) is a respiratory disorder involving an upper chest breathing pattern and respiratory symptoms that cannot be attributed to a medical diagnosis. Aim: The overall aim of this thesis was to describe patients with DB and investigate clinical outcomes after physiotherapy treatment. Methods: Study I was descriptive and comparative, that included 25 patients with DB and 25 age- and sex-matched patients with asthma. Health-related quality of life (HRQoL), anxiety, depression, sense of coherence, influence on daily life due to breathing problems, respiratory symptoms, emergency room visits and asthma medication were investigated. Study II, a 5-year follow-up study based on the same sample as study I (22 patients with DB, 23 patients with asthma), studied treatment outcomes after information and breathing retraining. Study III was descriptive and correlational (20 healthy subjects), investigating whether the Respiratory Movement Measuring Instrument (RMMI) can discriminate between different breathing patterns in varying body positions. Study III also studied correlations between respiratory movements and breathing volumes (12 healthy subjects). Study IV was a single-subject AB design with follow-ups. Self-registered patient-specific respiratory symptoms and respiratory-related activity limitations and breathing pattern (measured with the RMMI) were evaluated after an intervention consisting of information and breathing retraining in five patients with DB. Results: Patients with DB had lower HRQoL (SF-36): vitality (mean 47 vs. 62), social functioning (70 vs. 94) and role emotional (64 vs. 94) (p&lt;0.05) than patients with asthma. The DB group had a higher prevalence of anxiety (56% vs. 24%) and experienced more breathing problems than the asthma group. Patients with DB had made several emergency room visits and had been treated with asthma medication. At the 5-year follow-up, patients with DB showed improved HRQoL (SF-36): physical function 77 to 87 (p=0.04), decreased breathing problems and emergency room visits, and they were not treated with asthma medication. The RMMI can differentiate between different breathing patterns in different body positions. Strong correlations between respiratory movements and breathing volumes were observed (rs 0.86-1.00). The results in study IV indicate that patients with DB benefit from information and breathing retraining regarding decreased respiratory symptoms and activity limitations and improved breathing pattern.

Every law in the Czech legal system regulates social relations. This adjustment serves to protect and determine values in society. Important role in this process hold the basic legal principles. Private law is no exception. Probably the most important principle of private law is the principle of autonomy of will. Its expression in the law of business oblagations is the principle of contractual freedom, which is the main theme of this work. The principle of freedom to contract is quite crucial for the functioning of the modern principle of contract law, which regulates relations arising in a market economy. The aim of this work is to describe the principle of freedom to contract and its manifestation in the legal standards, which governs business obligations. Finally, this work discusses restrictions of freedom to contract, since it is clear that this can not be applied without some correctives. Keywords: contractual freedom restrictions of contractual freedom commercial contractual relations

Delaktighet är en viktig aspekt i förbättringsarbetet. Delaktighet höjer kvaliteten och skapar förankring hos medarbetarna och är ett hjälpmedel att erhålla ett framgångsrikt kvalitetsarbete. Verksamheterna behöver dock förutsättningar för att skapa delaktighet. I framgångsrika organisationer karaktäriseras framgången av delaktighet skapandet och motivation hos medarbetarna. Syftet med studien var att beskriva hur produktionsledare kan skapa möjlighet till delaktighet i förbättringsarbetet. Metoden som användes var kvalitativ induktiv ansats ur ett livsvärldsperspektiv. Djupintervjuer utfördes med åtta produktionsledare och kvalitativ innehållsanalys användes för att granska texterna med syfte att finna meningsenheter och kategorier. Fiskbensdiagram utfördes som ett komplement till intervjuerna. Resultatet och analysen visade på två kategorier, förutsättningar och begränsningar i skapandet av delaktighet i förbättringsarbetet. Resultatet visade i sin tur på att det finns svårigheter att tolka begreppet delaktighet och än svårare att konkretisera de verktyg som används. Det finns ett värde av ytterligare forskning kring delaktighet skapandet i framtiden. / Participation is an important aspect when it comes to continuous improvements. Participation increases quality and creates support among employees and is a tool for achieving successful quality work. Companies need prerequisites for creating participation, and in successful companies this success is characterized by the creation of participation and motivation among employees. The aim of the study was to describe how production supervisors create opportunities for participation in improvement processes. The method used was a qualitative inductive approach from a life-world perspective. In-depth interviews were conducted with eight production supervisors and qualitative content analysis was used to examine texts to find sentence entetities and categories. Fishbone diagrams were created as a complement to the interviews. The results and the analysis indicated two categories, prerequisites and limitations to create participation in improvement work. This showed that there are difficulties when it comes to interpreting the term participation and even more difficult to specify the tools inuse. In the future it is of great importance to ensure that the research around the creation of participation is in focus.

La notion de qualité de vie s'est largement développée dans le domaine de l'évaluation de la santé générale des populations, mais aussi dans l'évaluation des prises en charge thérapeutiques et médicales, tout particulièrement dans le champ de la neurologie, comme la sclérose en plaques. Il est consensuellement admis qu'en pratique la mesure de la qualité de vie repose sur le recours à des questionnaires standardisés. La mise à disposition d'outils adaptés, valides et sensibles, s'est avérée nécessaire. Mais la prise en compte de ce critère se heurte à certaines difficultés, conduisant à une sous-utilisation de ces outils. Deux questions peuvent être isolées : quels sont les freins relatifs à l'utilisation de la mesure de qualité de vie dans la sclérose en plaques et quel est l'apport de de la mesure de la qualité de vie pour le clinicien pour la prise en charge des patients.L'objectif général de ce travail cherche à déterminer la nature des difficultés inhérentes à l'utilisation de la mesure de la qualité de vie elle-même, et l'intérêt de l'utilisation de cette mesure notamment dans la pratique clinique courante.Les travaux scientifiques s'articulent autour de : 1. La maîtrise de la mesure de la qualité de vie en produisant des données complémentaires sur la validité et la fiabilité de la mesure de qualité de vie (le MusiQoL) ; 2. Des usages et limites de la mesure de la qualité de vie au sein de populations présentant des troubles cognitifs; 3. L'intérêt dans la pratique clinique de la mesure de la qualité de vie exploré au travers de l'identification des déterminants de la qualité de vie et de l'étude de son rôle prédictif sur l'évolution de l'état de santé. / AbstractThe quality of life (QoL) measurements are being considered increasingly important with regard to evaluating disease progression, treatment and the management of care provided to patients with multiple sclerosis (MS). QoL is commonly assessed using self-reported questionnaires and it is important to have robust, valid, reliable, and universally applied measures. Despite the acknowledged need to consider QoL issues, QoL assessment remains under-utilized in MS clinical practice. The general objective of this manuscript is to explore the difficulties for clinicians to be convinced by the clinical relevance and accuracy of the QoL assessment implementation in clinical practice. The present scientific works are based on: 1. Confirmation of validity, reliability, and sensibility to change of the MS-specific QoL instrument designated in this work (MusiQoL); 2. Exploration of the meaning of QoL assessment among MS patients with cognitive impairment; 3. Promotion both the used and usefulness of measuring QoL in MS clinical practice by improvement of knowledge about QoL determinants and potential predictive role of QoL on disability