Bakgrund: Då vårdtiderna är kortare ställs det krav på samordnad vård- och omsorgplanering (svpl) för att patient och närstående ska känna sig trygga och säkra vid utskrivning. En god planering där alla upplever sig vara delaktiga minskar patient och närståendes oro.  Syfte: Syftet med denna studie var att beskriva hur patient och närstående upplever sin delaktighet vid svpl. Metod: Studien är en litteraturöversikt som är baserad på både kvalitativa och kvantitativa artiklar. Resultat: Tre huvudtema framkom Dialog som främjar delaktighet, Förmedla hälsoproblem och delta i sin planering av fortsatt vård och Att uppleva delaktighet vid överlämnande till annan vårdgivare. Resultatet visade att kommunikation hade stor betydelse för att uppleva delaktighet, ett område där det finns utvecklingspotential och som ligger i linje med personcentrerad vård. Genom att använda andra arbetsmetoder än vad som görs idag gavs möjligheten till ökad delaktighet. Slutsats: Upplevelsen av delaktighet är starkt kopplat till att patienten upplevde sig informerad samt att hen uppfattades som expert på sitt eget tillstånd. Patient och närstående kände sig informerade och upplevde sig ha kunskap när det var ett gott samspel mellan patient och vårdpersonal. / Background: When the waiting periods in health care are shortened, there is need for a coordinated healthcare plan to make the patient and family feel safe and secure at discharge. A good plan where all concerned feel involved decreases the patient and families anxieties. Aim: The aim of this study was to describe how the patient and related experience their participation in a coordinated healthcare plan. Method: The study is a literary survey based on both qualitative and quantitative articles. Results:  Three main theme emerged, Dialogue that promotes participation, Convey health problems and participate in their planning of continuing care and Experiencing involvement in transfer to another health care provider. The result show that communication where very important to feel participation, an area where there is potential for development and is in line with person-centered care. By choosing different work methods than are used today the possibility for increased participation is given. Conclusion: The experience of participation are strongly connected with the patients feelings of being informed and that he or she is perceived as an expert of his or her own condition. The patient and family felt informed and knowledgeable when there was a good interaction between them and the health personnel.

Bakgrund: Palliativ vård bygger på ett förhållningsätt som innebär att öka livskvalitén för både patienten och dess närstående. Palliativ vård handlar om god symtom kontroll och lindring. Den palliativa vården i hemmet lägger stort ansvar på de närstående, inte bara när det kommer till kontrollera symtomen men att organisera vården för patienten 24 timmar/dygnet. Sjuksköterskan måste se patienten och närståendes livssituation för att ge bra stöd i hemmet. Syfte: Syftet med denna studie var att belysa närståendes erfarenheter av att vårda den sjuke palliativt i hemmet. Metod: Som metod valdes en litteraturbaserad studie. Datamaterialet bestod av nio kvalitativa vetenskapliga artiklar. Resultat: Tre kategorier identifierades såsom: Ny roll, behov av hjälp från kunniga och behålla det egna livet med sex underkategorier. Närståendes erfarenheter, att ha ett stort ansvar är svårt och krävande men även meningsfullt. Brist på stöd från sjukvården påverkar närståendes förmåga att vårda den sjuke. Slutsats: När närstående vårdar den sjuke i hemmet är tiden både tung och meningsfull. Det beror på vilket stöd och information de får från sjuksköterskorna samt om de själva får möjligheten att distansera sig till vårdandet för att behålla det egna livet.

No description available.

BACKGROUND:Next-generation DNA sequencing (NGS) technologies have made huge impacts in many fields of biological research, but especially in evolutionary biology. One area where NGS has shown potential is for high-throughput sequencing of complete mtDNA genomes (of humans and other animals). Despite the increasing use of NGS technologies and a better appreciation of their importance in answering biological questions, there remain significant obstacles to the successful implementation of NGS-based projects, especially for new users.RESULTS:Here we present an 'A to Z' protocol for obtaining complete human mitochondrial (mtDNA) genomes - from DNA extraction to consensus sequence. Although designed for use on humans, this protocol could also be used to sequence small, organellar genomes from other species, and also nuclear loci. This protocol includes DNA extraction, PCR amplification, fragmentation of PCR products, barcoding of fragments, sequencing using the 454 GS FLX platform, and a complete bioinformatics pipeline (primer removal, reference-based mapping, output of coverage plots and SNP calling).CONCLUSIONS:All steps in this protocol are designed to be straightforward to implement, especially for researchers who are undertaking next-generation sequencing for the first time. The molecular steps are scalable to large numbers (hundreds) of individuals and all steps post-DNA extraction can be carried out in 96-well plate format. Also, the protocol has been assembled so that individual 'modules' can be swapped out to suit available resources.

This thesis focuses on algorithms solving the on-line Bin-Covering problem, when the items are generated from a known, stationary distribution. We introduce the Prospect Algorithm. The main idea behind the Prospect Algorithm is to use information on the item distribution to estimate how easy it will be to fill a bin with small overfill as a function of the empty space left in it. This estimate is then used to determine where to place the items, so that all active bins either stay easily fillable, or are finished with small overfill. We test the performance of the algorithm by simulation, and discuss how it can be modified to cope with additional constraints and extended to solve the Bin-Packing problem as well. The Prospect Algorithm is then adapted to achieve perfect packing, yielding a new version, the Prospect+ Algorithm, that is a slight but consistent improvement. Next, a Markov Decision Process formulation is used to obtain an optimal Bin-Covering algorithm to compare with the Prospect Algorithm. Even though the optimal algorithm can only be applied to limited (small) cases, it gives useful insights that lead to another modification of the Prospect Algorithm. We also discuss two relaxations of the on-line constraint, and describe how algorithms that are based on solving the Subset-Sum problem are used to tackle these relaxed problems. Finally, several practical issues encountered when using the Prospect Algorithm in the real-world are analyzed, a computationally efficient way of doing the background calculations needed for the Prospect Algorithm is described, and the three versions of the Prospect Algorithm developed in this thesis are compared.

Purpose: To test whether a psycho-educational program affects mental wellbeing in persons treated for colorectal cancer and their next-of-kin. Design: A prospective, longitudinal, randomized controlled trial. Setting: Surgical clinic at a university hospital in Sweden. Sample: 105 colorectal cancer patients and 71 next-of-kin were allocated to a psycho­educational program or to standard care. Methods: Mental wellbeing was evaluated with the Mood Adjective Check List and The Hospital Anxiety and Depression Scale at baseline and at 1, 6, and 12 months. The program consisted of seven meetings, including lecture and time for reflection with other patients/next­of-kin. Main Research Variable: Overall mood, activity, calmness, pleasantness, anxiety, and depression. Findings: The psycho-educational program increased overall mood, calmness, and pleasantness among patients after one month but had no effect on activity, anxiety, or depression. The program had no effect on the overall mood, activity, calmness, pleasantness, anxiety, or depression among next-of-kin. Conclusion: The psycho-educational program had a short-term effect on overall patient mood, calmness, and pleasantness but not on next-of-kin. Implications for Nursing: A psycho-educational program including lecture and time for reflection can be used with a colorectal cancer patient population to improve some aspects of their mental wellbeing.

This thesis is a comparative study of two Next-Generation Firewalls (NGFWs) with the aim to conclude which one is the most suitable for a small enterprise network. The network in question is Company A’s Office A1. Office A is in the process of upgrading their internal network and with the upgrade a new NGFW will be implemented. The two NGFW platforms that have been researched per Company A’s request are Juniper Networks’ SRX-series firewalls and Palo Alto Networks’ (PAN) PA-series, with focus on the SRX1500 and PA-3020 for a fair comparison. To be able to evaluate different platforms and appliances, the concept of NGFW and what it constitutes has been researched and presented. Both of the NGFW platforms have been tested and compared in terms of ease-of-use and cost analysis. The testing focused on the respective web-interfaces and shows no significant differences between the two NGFWs at a first glance in terms of functionality. However, PAN’s web-interface does objectively feel more up-to-date and provides application visibility natively, which Juniper offers as a separate service as part of the centralised management platform, which is excessive for Office A’s network. The research and collection of data has been conducted based on Office A’s needs and requirements. Third-party research has been collected from NSS Labs and Gartner and serves as a basis for the evaluation. The future network of Office A introduces new services and the general usage will mainly consist of office oriented application based traffic. The evaluation of the research of the two NGFWs and the collection of data, in the context of Office A’s network, shows that the PA-3020 would be favoured. The key points are as follows: PAN’s NGFWs are built specifically for application awareness whereas Juniper are new in the NGFW market and has recently started to add the more advanced application awareness features. PAN offers a one-box solution suited for smaller networks such as Office A whereas a Juniper implementation would require additional hardware (VM’s) to obtain similar features. PAN offers more features in terms of user identification which is a key factor in enabling a true context aware security environment seamlessly integrated and invisible to the users. No major difference in cost if a similar set of features are to be implemented, based on non-rebated list prices (additional hardware not included). 1 Note: Due to confidentiality, the name and details of the company has been anonymised throughout the report.

Bakgrund: Sjuksköterskor behöver möta närstående till personer som vårdas palliativt. Sjuksköterskan kan skapa meningsfulla relationer med närstående och använda denne som en resurs för patienten. Närståendestöd är en av hörnstenarna inom den palliativa vården. Sociala relationer är en av de 6 S:n som används vid personcentrerad palliativ vård, då närstående kan tillföra fler dimensioner till patientens livsberättelse. Syfte: Syftet med denna litteraturstudie var att beskriva sjuksköterskans erfarenheter av att möta närstående till patienter inom palliativ vård. Metod: Metoden var en litteraturöversikt där tolv vetenskapliga artiklar inkluderades. Artiklarna hämtades från databaserna CINAHL Complete och Pubmed och analyserades med hjälp av Fribergs analysmetod. Resultat: Två teman identifierades: yttre och inre förutsättningar för sjuksköterskan. Yttre förutsättningar för sjuksköterskan delades in subteman såsom tidens betydelse, vårdmiljöns inverkan och när närstående har en annan åsikt. I inre förutsättningar för sjuksköterskan framkom sjuksköterskans förmåga att involvera närstående, sjuksköterskans förmåga att utveckla sin kompetens i mötet med närstående, kommunikationens betydelse och förutsättningar att skapa teamarbete. Diskussion: Med de 6 S:n som teoretisk utgångspunkt har litteraturöversiktens resultat diskuterats utifrån bakgrund och annan relevant litteratur. Närstående behövs i vården kring patienten men det är inte alltid som närståendes vilja är densamma som patientens eller vårdgivarens. För att sjuksköterskan ska kunna använda närstående som en resurs krävs tydlig kommunikation och stöd från sjuksköterskan i arbetet mot ett gemensamt mål för palliativ vård. / Background: Nurses need to face next of kin to people who receive palliative care. The nurse can create meaningful relationships with the next of kin and can use them as a resource for the patient. Support for the next of kin is a cornerstone in palliative care. Social relations are one of the 6 S:s used for person-centered palliative care when next of kin can add more dimensions to the patient's life story. Aim: The purpose of this study was to describe nurses' experiences in meeting next of kin to patients in palliative care. Method: The method was a literature review where twelve scientific articles were included. Articles were taken from the databases CINAHL Complete and Pubmed and analyzed using analysis of Friberg. Results: Two themes were identified: external and internal conditions for the nurse. External conditions for the nurse divided into subthemes such as time significance, the care environment impact and when the next of kin has a different opinion. The internal conditions for the nurse came up as the nurse's ability to involve next of kin, nurses' ability to develop their skills in the meeting with next of kin, the importance of communication and the ability to create teamwork. Discussion: With the 6 S:s as a theoretical basis, this literature review has been discussed from the basis of the background and other relevant literature. Next of kin are needed in the health care around the patient but it is not a guarantee that the next of kin`s wishes is the same as the wishes of the patients or the caregivers. For the nurse to use next of kin as a resource it requires clear communication and support from the nurse in the work towards a common goal of palliative care.

Understanding the genetic basis of adaptive evolution, and how natural selection has shaped patterns of polymorphism and divergence within and between species are enduring goals of evolutionary genetics. In this thesis, I used whole genome re-sequencing data to characterize the genomic signatures of natural selection along different evolutionary timescales in three Populus species: Populus tremula, P. tremuloides and P. trichocarpa. First, our study shows multiple lines of evidence suggesting that natural selection, due to both positive and purifying selection, has widely shaped patterns of nucleotide polymorphism at linked neutral sites in all three species. Differences in effective population sizes and rates of recombination largely explain the disparate magnitudes and signatures of linked selection that we observe among species. Second, we characterize the evolution of genomic divergence patterns between two recently diverged aspen species: P. tremula and P. tremuloides. Our findings indicate that the two species diverged ~2.2-3.1 million years ago, coinciding with the severing of the Bering land bridge and the onset of dramatic climatic oscillations during the Pleistocene. We further explore different mechanisms that may explain the heterogeneity of genomic divergence, and find that variation in linked selection and recombination likely plays a key role in generating the heterogeneous genomic landscape of differentiation between the two aspen species. Third, we link whole-genome polymorphic data with local environmental variables and phenotypic variation in an adaptive trait to investigate the genomic basis of local adaptation in P. tremula along a latitudinal gradient across Sweden. We find that a majority of single nucleotide polymorphisms (SNPs) (&gt;90%) identified as being involved in local adaptation are tightly clustered in a single genomic region on chromosome 10. The signatures of selection at this region are more consistent with soft rather than hard selective sweeps, where multiple adaptive haplotypes derived from standing genetic variation sweep through the populations simultaneously, and where different haplotypes rise to high frequency in different latitudinal regions. In summary, this thesis uses phylogenetic comparative approaches to elucidate how various evolutionary forces have shaped genome-wide patterns of sequence evolution in Populus. / <p>The research in this thesis was supported by the Swedish research council (to Pär K. Ingvarsson) and the JC Kempe Memorial Scholarship Foundation (to Jing Wang). The PhD study of Jing Wang in Sweden was funded by the State Scholarship from China Scholarship council.</p>

Next Generation Networks (NGNs) aim to provide a unified network infrastructure to offer multimedia data and telecommunication services through IP convergence. NGNs utilize multiple broadband, QoS-enabled transport technologies, creating a converged packet-switched network infrastructure, where service-related functions are separated from the transport functions. This requires significant changes in the way how networks are managed to handle the complexity and heterogeneity of NGNs. This thesis proposes a Service Oriented Architecture (SOA) based management framework that integrates heterogeneous management systems in a loose coupling manner. The key benefit of the proposed management architecture is the reduction of the complexity through service and data integration. A network management middleware layer that merges low level management functionality with higher level management operations to resolve the problem of heterogeneity was proposed. A prototype was implemented using Web Services and a testbed was developed using trouble ticket systems as the management application to demonstrate the functionality of the proposed framework. Test results show the correcting functioning of the system. It also concludes that the proposed framework fulfils the principles behind the SOA philosophy.