Bakgrund: Att hantera dödsfall är en central uppgift i yrket som legitimerad sjuksköterska. Sjuksköterskor kommer i sitt yrke möta både förväntade och oväntade dödsfall och det krävs att sjuksköterskor utvecklar yrkeskompetens för att kunna hantera de emotionella upplevelserna i samband med dödsfall. Sjuksköterskeutbildningen bör förbereda sjuksköterskor inför att möta döende och avlidna personer och vilka uppgifter sjuksköterskor har kring dödsfall, dock uttrycks en brist i utbildningen.Syfte: Syftet med denna litteraturöversikt var att beskriva sjuksköterskors upplevelser i samband med dödsfall inom slutenvården.Metod: Litteraturöversikten är baserad på 16 vetenskapliga artiklar, både kvalitativa och kvantitativa, som är publicerade mellan 2010 och 2020 och hämtade från databaserna CINAHL, PsycINFO och PubMed.Resultat: Resultatet visar att sjuksköterskor påverkas av dödsfall både personligt och yrkesmässigt, det beskrivs även att stöd efter dessa upplevelser är viktigt för att hantera upplevda känslor. Vidare visar resultatet att sjuksköterskor inte alltid är förberedda på vilket ansvar de har vid dödsfall i förhållande till anhöriga. Skillnader framkommer i upplevelser av förväntade och oväntade dödfall, där sjuksköterskor upplever oväntade dödsfall som svårare att hantera.Slutsats: Sjuksköterskor påverkas både personligt och yrkesmässigt och de flesta sjuksköterskor känner någon form av sorg när en patient avlider. Anhörigas reaktioner kan påverka hur sjuksköterskan upplever dödsfallet. Att få stöd är en viktig del i att hantera dessa situationer. Upplevelser av dödsfall beskrivs även som utvecklande för sjuksköterskor. / Background: Dealing with death is a central task in the profession as a registered nurse. In their profession, nurses will face both expected and unexpected deaths, and it is required that nurses develop professional competence in order to be able to handle the emotional experiences in connections with deaths. The nursing education should prepare nurses to meet dying and deceased people and what information nurses have about deaths, however, a shortcoming is expressed in the education.Aim: The aim of this literature overview was to describe nurses' experiences in connection with deaths in inpatient care.Method: The literature review is based on 16 scientific articles both qualitative and quantitative that were published between 2010 and 2020 and retrieved from the databases CINAHL, PsycINFO and PubMed.Results: The results show that nurses are affected by deaths both personally and professionally, it is also described that support after these experiences is important for dealing with perceived emotions. Furthermore, the results show that nurses are not always prepared for the responsibility they have in the event of death in relation to relatives. Differences emerge in experiences of expected and unexpected deaths, where nurses experience unexpected deaths as more difficult to deal with.Conclusion: Nurses are affected both personally and professionally and most nurses feel some form of grief when a patient die. Relatives' reactions can affect how the nurse experiences the death. Getting support is an important part of dealing with these situations. Experiences of death are also described as developing for nurses.

The Swedish school system underwent a rapid liberalization process in the late 1900s. One of the major changes was the implementation of free school choice. The reform intended to ake pupils and parents able to actively choose which school to attend. However, since the introduction, free school choice has been a topic of much debate and criticism. In articular, there is a dispute whether the reform has caused an increase in school segregation or not. This study examines the veracity of these claims. This is done in the form of a literary overview where the results of previous research are analyzed. A selection of literature has been conducted according to specific criteria, which has resulted in one doctoral dissertation and six academic journal articles. The source-material has been reviewed and analyzed using an analysis chart. The results of the studies have then been compared to find similarities and dividing lines. The segregation variables examined are ethnicity and socio-economics. The latter has been broken down into the sub-variables of economic background and educational background. In addition, the study also examines whether or not residential segregation can be excluded as a source of error. The analysis concludes that ethnic school segregation has increased in Sweden as a result of the school choice reform. The same applies to the variable educational background. However, there are some differences in the results regarding economic background. Dividing lines can be found concerning if segregation of this variable has increased or remained static. Relative consensus that housing segregation can be excluded as a source of error seems to prevail among researchers. However, one of the articles presents a more critical approach regarding the exclusion. There is also some disagreement about the degree to which the residential segregation and free school choice affect school segregation. / Den svenska skolan genomgick under det sena 1900-talet en skyndsam liberaliseringsprocess. En av de större förändringarna som skedde var införandet av det fria skolvalet. Reformen innebär att elever och vårdnadshavare kan göra aktiva val om på vilken skola undervisningen ska ske. Det fria skolvalet har dock sedan införandet varit mycket omdiskuterat och kritiserat. Särskilt råder en debatt om huruvida reformen har orsakat en ökad segregation i Sveriges skolor. I denna uppsats studeras påståendets sanningshalt. Detta sker i form av en litteraturöversikt där tidigare forskning på området behandlas. Ett urval av litteratur har skett efter särskilda kriterier, vilket har resulterat i en doktorsavhandling och sex akademiska tidskriftsartiklar. Dessa har sedan granskats och analyserats med hjälp av ett analysschema. Studiernas resultat har jämförts för att finna likheter och skiljelinjer. De segregationsvariabler som har studerats är etnicitet och socioekonomi. Den sistnämnda har brutits ner till ekonomisk bakgrund och utbildningsbakgrund. Utöver detta har det i studien även undersökts utifall boendesegregationen kan uteslutas som felkälla eller ej. Om inte detta görs kan denna förvränga datamaterialet för skolvalets effekter. Analysen visar att den etniska skolsegregationen har ökat i Sverige, till följd av skolvalsreformen. Detsamma gäller variabeln utbildningsbakgrund. I resultaten gällande ekonomisk bakgrund råder dock vissa olikheter. Skiljelinjer går att finna om segregationen efter denna variabel har ökat eller förhållit sig statisk. Relativ enhällighet tycks råda bland forskarna att boendesegregationen kan uteslutas som felkälla. I en av artiklarna presenteras dock ett mer kritiskt förhållningssätt till detta. Viss oenighet råder också kring vilken grad boendesituationen och skolvalet påverkar skolsegregationen.

Bakgrund: Genomgång av aktuellt kunskapsläge visar att patienter har andliga behov och att de flesta uppskattar att diskutera detta med sjuksköterskor. Sjuksköterskor har vetskapen om betydelsen av andlighet i omvårdnaden och visar förståelse i praktiska kunskaper, ändå blir patienters andliga behov inte bemötta. Syfte: Syftet med denna studie var att belysa patienters andliga behov ur patienters eget perspektiv. Metod: Det är en litteraturöversikt grundad på tio vetenskapliga originalartiklar publicerade mellan 1997 och 2011. Resultat: Fem teman identifierades: Kärlek till de närmaste, Närhet till det gudomliga, Acceptans av ödet, Människovärde och Strävan efter sanningen. Slutsats: Patienters andliga behov är att bejaka livet, en motsägelsefull inspiration, insikt om meningen med lidandet, att finna skönhet i det fula och en ny förståelse om sig själv. / Background: The recent studies shows that patients had spiritual needs and that the majority of them appreciate to discuss them with nurses. Nurses realize the importance of spirituality in patient care and show understanding in practical knowledge, however remain patients’ spiritual needs unsatisfied. Aim: The aim of this study was to illuminate patients’ spiritual needs from their own perspective. Method: This is a literature overview based on ten research articles published between 1997 and 2011. Findings: Five themes: Love to one’s family, Closeness to the divine, Acceptance of one’s destiny, Human dignity and Pursuit for the truth were identified. Conclusion: Patients’ spiritual needs are to affirm the life, conflicting inspiration, insight in the meaning of suffering, to discover the beauty in the ugliness and new understanding about oneself.

Les systèmes informatiques envahissent de plus en plus notre quotidien, en allant de la plus simple application de lecture des fichiers audio, à la plus critique comme les voitures et les avions. Dans les systèmes critiques, la validation par vérification formelle s'impose. Cette thèse s'inscrit dans ce cadre et tend à doter le langage UML, langage de modélisation standard de facto, d'une sémantique formelle pour des finalités de vérification. En premier lieu, nous avons analysé et révisé le fondement théorique des principales approches de formalisation et de vérification issues de la littérature et se focalisant sur le langage UML, ses profils et les concepts des réseaux de Petri (RdPs). En deuxième lieu, nous avons proposé une nouvelle approche hiérarchique de formalisation des diagrammes globaux d'interactions (IOD). En se basant sur ce point, nous avons développé des formalismes temporels et temporisés des diagrammes de Timing UML2 (TD), appliqués par des exemples d'illustration. Ensuite, nous avons conçu une approche de vérification sur les approches développées, s'intéressant aux Systèmes Temps Réel (STRs), utilisant l'extension temporelle du langage des contraintes objets OCL/Temps Réel (OCL TR), le profil UML MARTE et la logique temporelle temporisée (TCTL), exploitée d'une technique de vérification automatique après la transformation du modèle (Model Checking). Enfin, nous avons appliqué les formalismes proposés sur une étude de cas, afin de garantir leurs efficacités logique et temporelle. / The computer systems have increasingly invaded our daily lives from the simplest application as audio files reading to the most critical one as cars and airplanes. For critical systems, the validation by the formal verification is required. This Thesis concerns this area of research and aims to ensure the betterment of UML language, which is the de facto standard, with formal semantics for verification finality. For the first part, we have analyzed and revised the theoretical foundations the existing formal verification methods used UML, their profiles and the basic concepts of the Petri nets (PNs). For the second part, we have created a novel hierarchical approach to formalize the Interaction Overview Diagrams (IOD). Based on this idea, we have developed temporal formalisms based on the UML2 Timing Diagrams (TD), applied by illustration examples. Then, we have proposed a Formal Verification approach based on last formalisms which are interested in Real Time Systems (RTS) and employ the temporal extension of the Object Constraints language (OCL/Real Time) (OCL TR), the UML MARTE profile and the timed computation Tree logic (TCTL), given by the Model Checking technique after the model's transformation. Finally, we have applied all the proposed formalisms through a case study, in order to ensure its logical and temporal efficiency.

Locoweed poisoning, caused by ingestion of certain species of Astragalous and Oxytropis, has had serious economic impacts through a loss of productivity in livestock. This study has attempted to evaluate losses suffered by livestockmen grazing their cattle on areas infested with locoweed species. The results indicate a serious economic impact on these individuals. Personal interviews were carried out with five cattle ranchers faced with typical locoweed problems. These beef cattle operations were located in Utah, Wyoming, and New Mexico. All of these producers described similar problems and losses due to locoweed poisoning. Information obtained from these interviews was used to estimate a 1978 dollar loss for three ranches, running in common, and located near Park Valley, Utah. This study found the problem areas to be: (1) reduced weaning weights of calves; (2) increased requirements in the number of replacement heifers; (3) an increase in death loss; (4) reproductive problems (abortions and infertility); and (5) increased costs associated with labor and management problems. The summation of economic losses in each of these problem areas reflected a total estimated loss of $30,689.02 in 1978. To determine if locoweed poisoning had long-range effects on weight gains, a sample of 20 calves were put on a 138-day feeding experiment. Of these 20 calves, 12 had grazed a locoweed-infested area, while the remaining 8 had no access to the plant. Overall average gain of both groups was found to be nearly identical. This indicates that animals will recover with proper but, sometimes, costly management. Profitability of spraying locoweed-infested ranges with 2,4-dichlorophenoxy acetic acid (2,4-D) was determined through information supplied by the Wyoming rancher. An internal rate of return of 39.4 percent was found by using this method of locoweed control in this particular instance. Ranchers interviewed in this study estimated their losses due to locoweed poisoning to be from 30 to 40 percent reduction in profit. Although profit margins were not determined, the estimated loss of $30,689.02 found in this study would be close to their determination. With the rampant increase in operating costs which have occurred in the past decade, producers could not long endure losses of this magnitude. However, it was determined that with proper plant control and management these losses could be substantially reduced.

The purpose of this essay was to use a content analysis to investigate how the image of Charles XII's person and political actions has been presented over time in overviews of Sweden's history. The essay also aims to investigate what needs and interests lie behind the use of Charles XII with the help of Klas-Göran Karlsson's use of history typology. The investigated period was defined against the background of Sweden's democratic development during the years 1824–1948. To structure the survey, three periods were generated: early democratization, parliamentarism and universal and equal suffrage. The material consists of eight overview works on Sweden's history; the focus of the investigation has been the chapter that concerns the lifetime of Charles XII.  The analysis of the material shows that there is a predominantly positive portrayal of Charles XII's person over the entire period with occasional exceptions. The survey also shows that Charles XII's deed tends to a greater extent to be portrayed negatively compared to his person. The use of Charles XII has varied during the examined period, but it appears that Charles XII is actualized as a symbolic figure in times when Russia projects its power towards Europe and Sweden. Charles XII is highlighted as ahead of his time by having realized the threat Russia would pose to Europe and Sweden. Such use occurs mainly in works published after the Crimean War and reappears in works published after World War I and World War II. The investigation shows that the representation of Charles XII is strongly dependent on the time in which its author lives and which needs and interests are served by a particular representation.

INTRODUÇÃO: Diversos ensaios clínicos randomizados (ECR) foram realizados nos últimos anos sobre a eficácia dos agentes biológicos no tratamento da artrite reumatóide (AR). Porém, as revisões sistemáticas sobre o tema ainda geram dúvidas sobre a real eficácia relacionada à capacidade funcional e qualidade de vida. MÉTODOS: O presente estudo sintetizou as evidências geradas pelas revisões sistemáticas que compararam o tratamento realizado com a utilização dos agentes biológicos e o tratamento convencional com a utilização das drogas anti-reumáticas modificadoras da doença de síntese química (DARMDq), considerando a capacidade funcional e qualidade de vida dos pacientes com AR, além de avaliar a qualidade metodológica das revisões sistemáticas recuperadas. Utilizamos as bases de dados PubMed (Medline), EMBASE e Cochrane para realizar o levantamento de revisões sistemáticas com ou sem meta-análises de ECR. Dois pesquisadores de maneira independente realizaram a seleção das revisões sistemáticas, avaliaram a qualidade metodológica utilizando a ferramenta AMSTAR e classificaram a qualidade das evidências pelo GRADE. RESULTADOS: Esta overview incluiu 10 revisões sistemáticas e meta-análises de ECR que avaliaram a capacidade funcional mensurada pelo HAQ e a qualidade de vida mensurada pelo SF-36 (PCF e PCM) em pacientes com AR que utilizaram a terapia com os agentes biológicos comparada a terapia convencional com a utilização das DARMDq. A maioria da revisões sistemáticas apresentaram alta qualidade metodológica avaliada pela ferramenta AMSTAR e a qualidade da evidência variou entre baixa a alta qualidade pelo GRADE. A melhora da capacidade funcional e qualidade de vida observada no período inicial do tratamento (24 semanas) com a terapia biológica, foi de pequena relevância clínica. Esta diferença entre os tratamentos não foi observada no longo prazo (52 semanas), principalmente com os agentes biológicos na forma de monoterapia. CONCLUSÃO: Evidências que variam entre baixa a alta qualidade mostraram que os agentes biológicos apresentaram melhora de baixa relevância clínica na capacidade funcional e qualidade de vida no período inicial do tratamento em comparação à terapia convencional com as DARMDq. Entretanto, não há diferenças entre a utilização da terapia biológica e da terapia convencional a longo prazo / INTRODUCTION: Several randomized clinical trials (RCTs) have been conducted in recent years on the efficacy of biological agents in the treatment of rheumatoid arthritis (RA). However, systematic reviews on this topic still raise doubts about the real efficacy related to functional capacity and quality of life. METHODS: This study synthesized the evidence generated by systematic reviews comparing the treatment with biological agents and the conventional treatment with disease-modifying antirheumatic drugs (DMARD), considering the functional capacity and quality of life of patients with RA, also evaluating the methodological quality of the systematic reviews retrieved. PubMed (Medline), EMBASE and Cochrane databases were searched for systematic reviews with or without RCT meta-analyzes. Two researchers independently carried out the selection of systematic reviews, assessed the methodological quality using the AMSTAR tool and classified the quality of the evidence by GRADE. RESULTS: This overview included 10 systematic reviews and meta-analyzes of RCTs that assessed functional capacity measured by HAQ and quality of life measured by SF-36 (PCS and MCS) in RA patients who used therapy with biological agents compared to conventional therapy with DMARDq. Most of the systematic reviews presented high methodological quality evaluated by the AMSTAR tool and the quality of the evidence ranged from low to high quality by GRADE. The improvement in functional capacity and quality of life observed in the initial period of treatment (24 weeks) with biological therapy presented low clinical relevance. This difference between the treatments was not observed in the long term (52 weeks), mainly with the biological agents in the form of monotherapy. CONCLUSION: Evidence that varied between low to high quality demonstrated that biological agents presented improvement with low clinical relevance of the functional capacity and quality of life during the initial period of treatment compared to conventional therapy with DMARDq. However, there are no differences in the long term between the use of biological therapy and conventional therapy

INTRODUÇÃO: Diversos ensaios clínicos randomizados (ECR) foram realizados nos últimos anos sobre a eficácia dos agentes biológicos no tratamento da artrite reumatóide (AR). Porém, as revisões sistemáticas sobre o tema ainda geram dúvidas sobre a real eficácia relacionada à capacidade funcional e qualidade de vida. MÉTODOS: O presente estudo sintetizou as evidências geradas pelas revisões sistemáticas que compararam o tratamento realizado com a utilização dos agentes biológicos e o tratamento convencional com a utilização das drogas anti-reumáticas modificadoras da doença de síntese química (DARMDq), considerando a capacidade funcional e qualidade de vida dos pacientes com AR, além de avaliar a qualidade metodológica das revisões sistemáticas recuperadas. Utilizamos as bases de dados PubMed (Medline), EMBASE e Cochrane para realizar o levantamento de revisões sistemáticas com ou sem meta-análises de ECR. Dois pesquisadores de maneira independente realizaram a seleção das revisões sistemáticas, avaliaram a qualidade metodológica utilizando a ferramenta AMSTAR e classificaram a qualidade das evidências pelo GRADE. RESULTADOS: Esta overview incluiu 10 revisões sistemáticas e meta-análises de ECR que avaliaram a capacidade funcional mensurada pelo HAQ e a qualidade de vida mensurada pelo SF-36 (PCF e PCM) em pacientes com AR que utilizaram a terapia com os agentes biológicos comparada a terapia convencional com a utilização das DARMDq. A maioria da revisões sistemáticas apresentaram alta qualidade metodológica avaliada pela ferramenta AMSTAR e a qualidade da evidência variou entre baixa a alta qualidade pelo GRADE. A melhora da capacidade funcional e qualidade de vida observada no período inicial do tratamento (24 semanas) com a terapia biológica, foi de pequena relevância clínica. Esta diferença entre os tratamentos não foi observada no longo prazo (52 semanas), principalmente com os agentes biológicos na forma de monoterapia. CONCLUSÃO: Evidências que variam entre baixa a alta qualidade mostraram que os agentes biológicos apresentaram melhora de baixa relevância clínica na capacidade funcional e qualidade de vida no período inicial do tratamento em comparação à terapia convencional com as DARMDq. Entretanto, não há diferenças entre a utilização da terapia biológica e da terapia convencional a longo prazo / INTRODUCTION: Several randomized clinical trials (RCTs) have been conducted in recent years on the efficacy of biological agents in the treatment of rheumatoid arthritis (RA). However, systematic reviews on this topic still raise doubts about the real efficacy related to functional capacity and quality of life. METHODS: This study synthesized the evidence generated by systematic reviews comparing the treatment with biological agents and the conventional treatment with disease-modifying antirheumatic drugs (DMARD), considering the functional capacity and quality of life of patients with RA, also evaluating the methodological quality of the systematic reviews retrieved. PubMed (Medline), EMBASE and Cochrane databases were searched for systematic reviews with or without RCT meta-analyzes. Two researchers independently carried out the selection of systematic reviews, assessed the methodological quality using the AMSTAR tool and classified the quality of the evidence by GRADE. RESULTS: This overview included 10 systematic reviews and meta-analyzes of RCTs that assessed functional capacity measured by HAQ and quality of life measured by SF-36 (PCS and MCS) in RA patients who used therapy with biological agents compared to conventional therapy with DMARDq. Most of the systematic reviews presented high methodological quality evaluated by the AMSTAR tool and the quality of the evidence ranged from low to high quality by GRADE. The improvement in functional capacity and quality of life observed in the initial period of treatment (24 weeks) with biological therapy presented low clinical relevance. This difference between the treatments was not observed in the long term (52 weeks), mainly with the biological agents in the form of monotherapy. CONCLUSION: Evidence that varied between low to high quality demonstrated that biological agents presented improvement with low clinical relevance of the functional capacity and quality of life during the initial period of treatment compared to conventional therapy with DMARDq. However, there are no differences in the long term between the use of biological therapy and conventional therapy

The idea of a free network is a myth of the past. Networking costs are expected to remain a burden to future IT budgets, no doubt raising questions regarding the payment of such services. Users do not normally pay to use local area networks, as companies tend to own their LANs. However, when wide area or international networks are considered, the situation is different. It is argued that in these cases the invoicing and payment system should be integral to the network's communication protocol. This implies changes to the networking protocol (to handle invoicing) as well as a new look at customary ideas of representing currency (to handle payment). In this dissertation, an invoicing and payment scheme that uses electronic cash and is implemented as part of the basic ATM protocols is discussed. The main advantages of this scheme can be summarized as a low administrative overhead and user privacy. / Computer Science / M. Sc. (Computer Science)

Notre travail de recherche porte sur l'analyse de l'action du professeur et ses interactions avec les élèves dans le domaine spécifique de l'étude du numérique en Cours Préparatoires. L'objectif de notre thèse est d'analyser l'action du professeur et ses pratiques didactiques en classes, et formatives dans une Cellule d'Animation Pédagogique. La première partie comporte une présentation du contexte socio économique et éducatif du Niger. Nous nous interrogeons ensuite sur les pratiques professorales permettant ou non aux élèves de prendre de réelles responsabilités par rapport aux savoirs, et sur la pertinence du travail de conception collective de séances. Dans la deuxième partie, nous exposons nos outils théoriques, les travaux antérieurs en lien avec nos objets de recherche, et la problématique générale de notre travail. La troisième partie est consacrée à la démarche méthodologique qui fonde notre étude sur l'analyse des manuels, des vidéos de classe et les observations in situ. La quatrième partie examine les ressources mathématiques utilisées à l'écoleprimaire au Niger, en interrogeant l'influence de ces ressources sur les pratiques habituelles des professeurs enquêtés. Les cinquième et sixième parties analysent les séances empiriques en termes de topogénèse, et de recours aux systèmes sémiotiques pour étudier le savoir en jeu dans les situations didactiques. Dans la septième partie, nous proposons un dispositif innovant de formation continue sur la conception collective de leçons dans une CAPED. En conclusion, dans une huitième partie nous présentons d'abord une synthèse de nos résultats, et nous exposons ensuite les perspectives que ce travail de recherche offre en termes de propositions en vue de l'élaboration d'ingénieries didactiques qui pourraient permettre la mise en place d'un travail coopératif entre professeurs et chercheurs