Högskolan i Skövde

Background: Regular physical activity has a positive effect on both physical and mental health, including better sleep and improved concentration. Even though physical activity has many health benefits, children and young people become less active, while time being still increases. This literature review looks at the role of the school nurse in promoting physical activity in their daily lives. 

Aim: The aim is to describe school nurses health-promoting work in relation to physical activity. 

Method: The study was conducted as a qualitative systematic literature review with inductive thematic analysis. Where ten peer-reviewed articles were included in the analysis. 

Findings: The results show that school nurses’ health-promoting work related to physical activity is individualized and relationship-based, where motivation and trust are central to facilitating change. The work is influenced by individual and organizational factors, with limited resources acting as a barrier, while collaboration and support serve as facilitators. Health dialogues emerge as an important tool. 

Conclusion: The school nurse’s work in promoting physical activity is person-centered and based on trusting relationships as well as the student’s individual circumstances. The ability to support sustainable lifestyle habits is influenced both by the student’s life situation and by organizational factors such as time, resources, and collaboration.

Background: Type 1 diabetes is a chronic disease that often develops during childhood and requires lifelong treatment and daily self-management. When a child is diagnosed, the disease affects not only the child but also the everyday life of the whole family. Parents take on a central role in the child’s treatment and need to manage both practical demands and emotional challenges. Aim: The aim of this study was to describe parents’ experiences of living with a child with type 1 diabetes. Method: The study was conducted as a general literature review according to Friberg. A total of ten scientific articles were included, nine qualitative and one quantitative. Results: The results identified five themes describing parents’ experiences of living with a child with type 1 diabetes: worry and fear related to the child’s illness, constant responsibility, the need for knowledge, the importance of support, and the balance between control and the child’s independence. Parents experienced emotional burden, daily responsibility and a need for clear, repeated and individually adapted information. Support from healthcare services, family and school was important for creating security in everyday life. Conclusion: Parents of children with type 1 diabetes need continuous, individually adapted and family-centred support. Nurses have an important role in strengthening parents’ knowledge, sense of security and ability to manage everyday life, as well as supporting the child’s participation in self-management. 

In mammals, circadian rhythms are managed by a central clock in the hypothalamus and peripheral oscillators found in various tissues, including the skin. Light and temperature are significant factors that influence the skin. This study examined whether temperature cycles can synchronise rhythms in epidermal cells, such as keratinocytes and melanocytes. Both cell types underwent two cycles of a 12-h temperature-entrainment protocol at 34 °C, followed by 12 h at 37 °C. Cells were released at constant temperatures on the third day, and sampling was performed every 4 h. The expression of core clock genes, such as BMAL1, PER2, and auxiliary clock genes DBP and NR1D1, was assessed using qPCR. Circadian analyses were performed using the cosine-based R function CircaSingle from the CircaCompare package. Both cell lines exhibited synchronisation after the temperature cycle, with BMAL1 and PER2 showing opposite temporal patterns. Human keratinocyte cells displayed significant rhythmicity for all genes analysed, indicating a strong clock output. In human melanocytes, all tested genes, except NR1D1, were rhythmic. These results show that both cell lines responded to temperature cycles, providing a robust strategy to synchronise epidermal skin cells in culture. The results provide a foundation for future experiments using more complex models, such as reconstructed skin epidermis. 

Induced pluripotent stem cells (iPSCs) offer powerful platforms for disease modelling, though maintaining genomic stability across varying culture conditions remains challenging. This study aimed to generate and characterize a new human iPSC line from peripheral blood mononuclear cells (PBMCs) of an adenylosuccinate lyase mutation carrier; and to evaluate how different extracellular matrix coatings, Matrigel, Geltrex, and BioLaminin 521, influence the genomic stability of pre-established schizophrenia-derived iPSC lines. PBMCs were reprogrammed using non-integrating Sendai virus vectors, yielding fully characterized, virus-free pluripotent clones with a normal 46, XY karyotype at an average efficiency of 0.126%. In the matrix study, high-resolution quantitative polymerase chain reaction (qPCR)-based genetic screening revealed variations in chromosomal abnormality profiles among different substrates. Across conditions, the most commonly observed recurrent submicroscopic copy number variations involved chromosome 12p (chr12p), chr17q, chr20q, and chrXp. BioLaminin 521 showed the highest overall variability, Matrigel displayed intermediate instability with a chr10p deletion, and Geltrex maintained the greatest genomic stability. However, because these alterations became more pronounced at higher passages, these outcomes are heavily influenced by prolonged passaging alongside potential matrix effects. In conclusion, while a trend suggests that matrix composition influences colony architecture, prolonged culture duration appears to drive selective replication pressures. These preliminary findings highlight the need for further validation and the importance of combining cytogenetics with molecular screening for monitoring genomic integrity.

Background: Vaccination is one of the largest disease prevention efforts in the world. Despite good vaccination coverage in Sweden, there are differences in trust and compliance with vaccines between different groups in society. To create trust around future vaccination decisions, the school nurse needs to establish a good relationship with guardians through an empathetic approach and active listening in the conversation. 

Aim: To describe school nurses' experience of meeting guardians in Sweden who oppose vaccination. 

Method: A qualitative interview study with an inductive approach. Eleven semistructured interviews were conducted with schoolnurses and analyzed through qualitative content analysis. 

Findings: The study resulted in three main categories and eight subcategories; Barriers to vaccination - Ignorance and misinformation among guardians/Vaccination resistance related to background, culture or religion/Disagreeing guardians; Strategies for vaccine resistance - Approaches/The school nurse's approach/Finding a balance; Confidence in facing vaccine resistance - Peer support/Experience, education and guidelines. 

Conclusion: The study shows that the school nurses experienced that vaccine resistance comes from misinformation as well as cultural and religious values. An empathetic non-judgmental approach was experienced as the most successful strategy when a guardian chooses to refuse a vaccine. The school nurses found security through peer support such as professional meetings, supervision and collaboration with school doctors. There is a desire for national guidelines for how school nurses should handle vaccine resistance.

The roguelite genre has grown significantly in recent years, with meta-progression becoming one of the most central design features of many popular titles. However, little research exists on how different meta-progression designs affect the player experience. This study has investigated how two widely different meta-progression designs shape player motivation, perceived fairness and sense of mastery. It used Hades 2 as an example of heavy meta-progression and The Binding of Isaac as an example of minimal meta-progression. A comparative game analysis of ten hours of recorded gameplay per game was conducted together with a Reddit forum analysis of roughly 15-20 threads per game. The findings show that heavy meta-progression sustains motivation more immediately but can conceal the player’s mastery, while minimal meta-progression produces a stronger sense of personal achievement, however, getting there is longer and more demanding. Additionally the lack of meta-progression can directly amplify the experience of unfairness in specific encounters.

Museums as places of informal learning are increasingly adopting playful interactives and serious games as educational tools. Due to the complex nature of learning and the objectives of museums, definitive methods of designing serious games for museum use is difficult. This study identifies the themes of autonomy, social interaction and physical space as key themes that encapsulate the common requirements of museum serious games and proposes a framework for the design of museum serious games based on a review of previous research and interviews with museum professionals. Evaluation of the interviews result in the identification of design approaches to serious game development that better support learning in a museum environment.

Machine Learning (ML) model diagnostics provide valuable information about model behaviour and performance but are often difficult to understand for non-expert users that have no experience in data science or ML. The information is often presented in a numerical format or in graphs that are difficult to understand for the end user that needs to make decisions based on the insights derived from the diagnostics. This thesis investigates the use of Large Language Models (LLMs) to transform model diagnostic information into human-centered insights. The main focus of the thesis is how different input configurations and data representations influence the LLM-generated explanation quality, which was explored through multiple comparative experiments. To evaluate the experiment outcomes an evaluation approach combining automatic evaluation and human evaluation is used. The automatic evaluation is based on the G-EVAL framework from Y. Liu et al. (2023) and the human evaluation is performed with weighted scoring. The last part of the thesis involves a user study which assesses whether LLM-generated explanations improve users’ perceived understanding, trust and helpfulness compared to a conventional dashboard. 

The results show that the data representation and structure of the prompt has a significant impact on the explanation quality. Numerical and textual representations with time-series data presented in windows outperformed visual data representation and continuous numerical time series data representation. The user study revealed that participants found LLM-generated explanations easier to understand and helpful than a dashboard alone. However, users preferred a combined solution where the LLMgenerated explanations provide the initial interpretation and dashboards can be used to investigate further. The thesis contains practical recommendations for the representation of diagnostic information to maximize the quality of generated explanations.  

The internet has been subjected to undue information influences since its inception but video games and even to an extent game-adjacent platforms have started to be subjected to undue information influences too. The Swedish Psychological Defence Agency has documented the ways Sweden could be subjected to undue information influences although they have not documented if it has already occurred, and they only focused on foreign threats and not domestic threats. This research tries to document if undue information influences has already occurred to Swedish players on game-adjacent platforms with a focus on both domestic and foreign threats. This research found out that Swedish players are not subjected to information influences on a daily basis although there are occasions where they are, and when they do see information influences it is usually connected to foreign countries or organisations, Swedish political parties and anti-wokeness like Gamergate and Nazism.

Police incidents and the public safety are remaining as essential concerns that are societal, especially within urban environments where there are patterns of incidents that vary through location and time. In conjunction with the availability of data within the public sector together with progresses within artificial intelligence (AI), new opportunities have been created for conducting analysis of patterns of police incidents that are spatio-temporal. The aim of the thesis was investigating the extent to which models of machine learning and deep learning approaches can predict the counts of police incidents through diverse locations and time periods within Sweden. Additionally, the thesis explored which factors that were temporal and spatial that were contributing the most to the predictions of the models with explainable artificial intelligence (XAI). Historical data of police incidents was retrieved out of the public API that was provided by the Swedish Police Authority (Polismyndigheten). Decision tree, random forest, XGBoost, long short-term memory (LSTM) and convolutional neural network (CNN) were the models that were implemented and also evaluated by utilizing metrics for regression including R2-score, MAE and RMSE.

An explainability analysis was applied with the aim of improving the models’ interpretability. The results indicated that the approaches of traditional machine learning achieved a stronger performance of predictions compared to the approaches of deep learning. XGBoost achieved the overall strongest performance, followed by random forest being close, while LSTM and CNN achieved a performance that was weaker for the available data. The analysis of explainability showed that both of the variables that were temporal and spatial had an influence on the predictions where the factors that were geographical contributed the strongest. The findings in the thesis suggest that techniques of machine learning, especially models that are tree based are able to provide insights that are valuable to patterns of police incidents that are spatio-temporal. Furthermore, the thesis illustrated how XAI have the possibility of improving the transparency and also the understanding of the models in contexts of the public sector.

The increased use of AI-driven technologies in cognitive cities has introduced new challenges related to cybersecurity. While previous research has primarily focused on traditional cybersecurity threats, less attention has been given to emerging challenges related to adaptive AI systems and human involvement, particularly concept drift and human-centric vulnerabilities. The aim of this study was therefore to explore how these threats are defined, conceptualized and addressed within existing smart and cognitive city research. To address this, a scoping review was conducted to examine existing literature related to these emerging challenges. The findings showed that concept drift is primarily described as changes in data distribution over time that reduce model performance and require continuous adaptation strategies. The findings also described cybersecurity concerns with concept drift, particularly in relation to intrusion detection, anomaly detection, and malware classification systems. Human-centric vulnerabilities are mainly discussed through multiple themes such as participation, bias, trust, transparency, governance and human behavior. The review identified potential connections between these threats, suggesting that human-generated data may influence the data that AI systems rely on. The study concludes that existing research remains fragmented between technical and socio-technical perspectives, highlighting the need for more integrated approaches to support the development of adaptive, trustworthy and resilient cognitive city systems.

Modern vehicles run on software. Braking, steering, driver assistance, and even door locking all depend on code, and a new passenger car may carry more than 100 million lines of it. When that code needs fixing, manufacturers increasingly distribute patches wirelessly through over-the-air (OTA) updates rather than physical recalls. However, the same wireless channel that delivers a security fix can also be exploited, and the OTA chain presents a long attack surface: backend servers, cellular links, in-vehicle gateways, and individual control units each offer a point of entry. Man-in-the-middle interception, replay of outdated firmware, rollback to vulnerable versions, and firmware tam-pering have all been documented, and a 2024 formal analysis of the Uptane framework, widely regarded as the most trusted OTA security standard, surfaced six previously undetected flaws. Regulators have responded with legally binding requirements. UNECE R155 and R156, ISO 24089, ISO/SAE 21434, and China's GB 44495/44496 now govern how vehicle software must be secured and updated across most major markets. What has been missing is a methodologically transparent synthesis of the academic research that could inform compliance efforts. Existing OTA surveys rely on narrative methods without documented search protocols, and PRISMA-compliant automotive reviews have not targeted OTA specifically. This thesis addresses that gap. Six databases were searched for peer-reviewed work published between 2018 and March 2026; 1,299 unique records were screened; and after quality assessment and a post-hoc narrowing to the post-regulation period (2021 to 2026), fifty studies were retained for in-depth analysis. The review produces a threat-countermeasure map and a regulatory coverage matrix, both of which surface a pattern that prior surveys were not positioned to detect: research has concentrated heavily on se-curing the delivery of updates, while operational requirements such as update failure handling, post-update verifi-cation, and continuous monitoring are each addressed by no more than three studies.

Background: Vaccinations are among the most effective measures for preventing serious diseases. Despite this, the coverage of HPV vaccination is lower than other vaccines in the Swedish childhood vaccination programme. Guardians who are hesitant or choose not to vaccinate their child may affect both individual and public health. School nurses play a central part in providing guardians with evidence-based information and answering questions about HPV vaccination. Although parental hesitancy towards HPV vaccination has been described in previous research, there is limited synthesized knowledge regarding school nurses’ experiences of interacting with these guardians and the barriers that may arise in this interaction. Such knowledge is important for understanding and developing school nurses’ work in their interactions with guardians.

Aim: To describe school nurses’ experiences of encountering guardians who are hesitant about or decline HPV vaccination for their child, and to describe the barriers to HPV vaccination that schoolnurses perceive in their interactions with guardians.

Method: A systematic literature review with a qualitative approach was conducted. A total of 15 studies were included and analyzed using thematic analysis.

Findings: Three themes were identified: different expressions of vaccine hesitancy in interactions with guardians, balancing the responsibility to provide information with respect for guardians’ decisions, and barriers in interactions with guardians regarding HPV vaccination. The findings showed that vaccine hesitancy could be expressed through concerns about side effects, limited knowledge, and perceptions related to the child’s age as well as the association between HPV vaccination and sexuality. School nurses described striving to provide evidence-based information while respecting guardians’ right to make decisions. Dialogue was highlighted as central in encounters with hesitant guardians. Furthermore, various barriers, such as time constraints, language barriers, and challenges in the consent process, were found to affect opportunities for dialogue and follow-up.

Conclusion: The findings suggest that interactions with hesitant guardians are complex and influenced by several interrelated factors. School nurses need to balance providing information with respecting guardians’ decisions, with dialogue constituting a central component of these interactions. Guardians’ beliefs and knowledge, as well as barriers such as time constraints, language barriers, and challenges in the consent process, may affect opportunities for dialogue.

Self-supervised learning (SSL) has shown promise for extracting useful representations from unlabelled tabular data, but recent work has found that SSL embeddings do not improve unsupervised anomaly detection. This thesis investigates whether these limitations can be overcome by pairing SSL representations with semi-supervised detector heads, a direction identified as future work by Mai et al. (2024). Using SCARF as the SSL method, embeddings from a frozen, contrastively pre-trained encoder are passed to four downstream models: Isolation Forest and One-Class SVM in the unsupervised setting, and self-training with XGBoost and logistic regression at label budgets of 1%, 5%, 10%, and 20%. Raw and PCA-transformed features serve as baselines. Experiments are conducted on three tabular benchmark datasets from ADBench (Cardiotocography, Shuttle, SpamBase), across five random seeds. The results show that SCARF embeddings consistently underperform raw and PCA features across all datasets, detectors, and supervision levels. Semi-supervision improves detection for all feature conditions, but the improvement is proportionally similar across conditions, and the performance gap between SCARF and baselines does not close as more labels are introduced. These findings extend the negative results of Mai et al. into the semi-supervised regime, suggesting that the contrastive pre-training objective of SCARF, applied without supervised fine-tuning, does not produce representations sufficiently aligned with the anomaly detection task to benefit from semi-supervised detector heads.

Manufacturing organisations are increasingly becoming a more important topic of discussion in terms of cybersecurity due to the growing numbers of directed attacks towards the sector and updated regulatory requirements. Although previous research has shown that game-based training is one of the more effective methods for behavioural change, its suitability in time-constrained organisations such as in the manufacturing sector is an underexplored subject. This study investigates the use of analogue serious games for cybersecurity awareness training in large Swedish food manufacturing organisations, with a particular focus on organisational factors influencing its implementation. 

A mixed-methods design was used to gain a broad and deep understanding of existing barriers and potentials for game-based implementation in this sector. In practice, the qualitative data collection consisted of 12 semi-structured interviews. Additionally, a quantitative data collection was performed, using the organisational culture assessment instrument (OCAI) and 14 additional opinion-based questions with the use of a likert scale. The combination of these methods enabled this study to identify cultural and operational barriers for implementing game-based training for a large Swedish food manufacturer. 

The findings showed several barriers for feasibility and acceptance for example time-constraints, fears of being judged and attitude towards change, amongst others. 

Predicting continuous output signals from heterogeneous observational data –where input sources differ not only in content but in their fundamental temporal structure– poses a significant challenge in applied data science. This study investigates the extent to which preprocessing and structural representation decisions determine the predictability of such signals, and which input variables and temporal representations retain the most predictive information. The experimental work was conducted in collaboration with Alleima, a Swedish metallurgical company, using real production data from the induction heating stage that precedes hot steel extrusion – a setting that naturally combines static process parameters with time-varying sensor measurements. 

The proposed pipeline encompasses signal segmentation of the output profile, three input aggregation strategies of increasing domain dependency, and dimensionality reduction of the target signal prior to modeling. A total of 3.004 billet heating observations were used across three aggregation strategies –one of which was further combined with dimensionality reduction of the target signal– yielding four experimental configurations thatwere systematically compared. The best-performing configuration achieved an RMSE of 10.55^◦C and an R² of 0.74. ASHAP-based feature importance analysis consistently identified a small set of dominant predictors across experimental configurations, with the most informative temporal representations differing from those initially anticipated by domain experts – a finding that highlights the value of data-driven feature evaluation in heterogeneous input settings. 

The results demonstrate that preprocessing design is the primary driver of predictive performance in this class of problem, and that domain-informed aggregation strategies yield measurable improvements over purely statistical alternatives. The methodology and findings generalize beyond the specific industrial context studied here, with implications for any supervised regression setting involving heterogeneous data sources of differing temporal structure. 

Multi-factor authentication (MFA) has become a method for users looking to protect their online accounts. While MFA is secure, the process of recovering MFA-enabled accounts remains highly vulnerable, with no standard implementations across online platforms and often compromising either security or user convenience. This thesis aims to address this issue by designing, developing and evaluating evidence-based design guidelines aimed at aiding platform owners to balance security and usability for their MFA recovery mechanisms. By utilising a Design Science Research approach, the thesis analysed data from a multi-vocal literature review of both academic and grey literature sources using thematic analysis. An initial artefact was developed, demonstrated and evaluated by experts via semi-structured interviews. The finalised guidelines provide an evaluation matrix and rules structured around low-, medium-, and high-value platform contexts. Key results include a decision matrix, rules applicable to certain contexts and general rules that apply everywhere. Ultimately, this thesis provides platform owners with guidelines that, when followed, balance MFA account recovery security and usability, preventing potential account compromises and account lockouts.

The approach of using visual effects (VFX) as navigation has been adopted in several recent video game titles. This research aims to examine what the industry has generated and how it potentially affects the player experience. This study took inspiration from Moura and Bartram’s research on wayfinding tools (2014) and Krukowski et al.’s guidance with global illumination effect (2025) following the three main categories of VFX that have been previously outlined by Yang et al. (2009). By examining how specifically environmental VFX can be used in open-world environments, this study presents two types of VFX navigation - Dynamic and Static. The adopted method for this study was qualitative in nature, including playtesting a prototype and a semi-structured interview after. Thematic analysis was selected for treating the raw data. This paper is aiming to be useful for developers as the results contain potential points of consideration when choosing this tool as for navigating.

This qualitative study explores the impact of diegetic and traditional non-diegetic Heads-Up Display (HUD) designs on player experiences. HUDs serve a dual purpose in video games: they communicate essential gameplay mechanics while contributing to the game’s aesthetic and narrative identity of the game world. There is often a trade-off between immersion and usability. While traditional non-diegetic HUDs excel in delivering clear, immediate information, they can detract from immersion by drawing attention away from the game world. This study aims to unpack these trade-offs and explore how HUD designs can affect the players' playing experience.

Previous research has lacked research testing the same game with both a traditional non-diegetic and a diegetic HUD; therefore, in this study, a game prototype was made and was tested on participants. A semi-structured interview, questionnaires with Likert scales, and a thematic analysis were conducted, focusing on the players' playing experiences and immersion with the two different HUDs.

Cognitive aging is associated with substantial variability in working memory performance, yet the molecular and neural mechanisms underlying this variability remain incompletely understood. The present study examined whether translocator protein (TSPO) was associated with large-scale functional connectivity and working memory in healthy older adults. Thirty-nine adults aged 50–81 years underwent positron emission tomography with [¹¹C]PBR28 to assess TSPO binding, resting-state functional MRI to measure functional connectivity and behavioural assessment of working memory. The primary functional connectivity measure was coupling between the Action Mode Network (AMN) and Frontoparietal Network (FPN), two systems implicated in externally directed behaviour and executive control. Analyses were conducted using the CONN toolbox in MATLAB. Age was associated with AMN–FPN connectivity and with functional connectivity of both AMN and FPN; however, these effects did not survive correction after controlling for gray matter volume. TSPO binding was associated with functional network organisation in a network-specific manner. FPN TSPO was associated with AMN–FPN between-network connectivity, whereas AMN TSPO was associated with AMN functional connectivity; both associations remained significant after controlling for gray matter volume. Working memory was initially associated with AMN–FPN, AMN, and FPN connectivity; however, only the association with FPN connectivity remained significant after gray matter adjustment. These findings suggest that cognitive aging is associated with overlapping contributions from neuroimmune variation, structural integrity, and functional network organisation. In particular, TSPO-related variation may be relevant to functional network organisation beyond gray matter differences, whereas FPN connectivity may robustly relate to working memory in later adulthood.

Background: During adolescence, identity development takes place as young people explore different roles. During this period, they may be exposed to violence, alcohol and drug use, as well as sexual risk behaviours. These experiences may have long-term consequences, including mental health problems, continued risk behaviours and exposure to violence. The school nurse plays an important role in identifying young people at risk.

Aim: To describe adolescents’ sexual risk behaviours and experiences of violence, alcohol and drug use.

Method: A quantitative cross-sectional study with a descriptive approach was conducted. Data were collected using the SEXIT 3.0 questionnaire. The participants consisted of 108 first-year upper secondary school students. The data were processed using SPSS version 29 and analysed descriptively.

Findings: The results showed that adolescents who used alcohol or drugs more often reported other risk behaviours than those who did not. Increased risks were also observed among adolescents who identified as homosexual, bisexual or another sexual orientation, as well as among those who reported an early sexual debut. These risks included greater sexual risk-taking and increased exposure to violence.

Conclusion: The findings indicate that risk behaviours tend to co-occur among adolescents. A holistic perspective and early interventions within school health services are important for identifying and preventing ill health at an early stage.

Background: Social media is a significant part of adolescents’ lives and can affect self-esteem through unrealistic ideals and social comparison. Self-esteem is defined as an individual’s experience of their own value and resilience can be described as a psychological ability to cope with adversity. In their health-promoting work, school nurses can help strengthen adolescents’ resilience and self-esteem.

Aim: To describe school nurses' strategies for strengthening adolescents’ self-esteem and resilience in relation to social media and ideals.

Method: Qualitative survey study with an inductive approach. The sample was selected through a combination of purposive sampling, convenience sampling and snowball sampling. 39 school nurses were included in the study. The survey responses were analyzed using meaning analysis in accordance with Dahlberg (2014).

Findings: The analysis resulted in six themes: Recognizing and addressing the influence of social media; Keeping up with an algorithm-driven lifeworld; Building close and trusting relationships with students; Supporting important adult relationships; It is not only about screen time and Resilience through self-awareness and critical thinking.

Conclusion: By recognizing and addressing the influence of social media and strengthening adolescents’ self-awareness and critical thinking, school nurses can support adolescents’ in managing the ideals and comparisons that characterize an algorithm-driven lifeworld. Relational strategies and strategies focusing on lifestyle habits also constitute important protective factors. The study indicates that strategies to strengthen self-esteem and resilience are integrated into a larger context, highlighting the importance of a holistic view and a lifeworld-oriented approach.

Efficient and specific delivery of mRNA to target tissues is critical for maximising therapeutic benefits while minimising off-target effects and systemic toxicity. Systemic administration of mRNA using lipid nanoparticles (LNPs) or extracellular vesicles (EVs) typically leads to predominant accumulation in the liver. We hypothesised that cardiac-specific EVs could promote enhanced relative cardiac enrichment of delivered mRNA compared with non-cardiac EVs or LNPs. In mice, intravenous administration of cardiac progenitor cell-derived EVs (CPC-EVs) achieved the greatest relative cardiac selectivity of modified mRNA encoding vascular endothelial growth factor A (VEGF-A) to the heart, with reduced liver accumulation relative to non-cardiac EVs and LNPs. Cytokine profiling across seven organs revealed that LNP delivery triggered a widespread pro-inflammatory response, whereas CPC-EVs elicited only a localised and limited cytokine activation, suggesting a more favourable safety profile. Furthermore, direct intramyocardial injection of CPC-EVs not only led to efficient mRNA uptake by cardiac tissue and robust VEGF-A protein expression, but also minimal transcriptomic perturbation in the cardiac tissue, as confirmed by RNA-seq. In contrast, LNPs and non-cardiac EVs induced widespread perturbation in the transcriptome of cardiac tissue. Functionally, VEGF-A mRNA delivery via CPC-EVs markedly increased CD31 and α-SMA expression and vessel formation in ex vivo aortic ring assays, confirming enhanced angiogenic potential. Together, these findings support CPC-EVs as a promising platform for achieving enhanced cardiac delivery of mRNA, with reduced liver accumulation, limited off-target transcriptomic perturbation, a more selective cytokine response, and enhanced angiogenic activity in ex vivo assays.

Large Language Models (LLMs) demonstrate strong reasoning and language capabilities but remain limited in their ability to maintain operational state across multi-turn interactions. This limitation is particularly problematic in enterprise environments, where conversational systems must track evolving information over time. This thesis investigates whether a persistent vectorbacked memory architecture can improve state tracking in agentic AI systems and evaluates its effectiveness across both proprietary cloud-hosted models and locally deployed Small Language Models (SLMs). A controlled quantitative experiment was conducted using a synthetic enterprise logistics dataset comprising 500 multi-turn conversational sessions. The evaluation framework compared memory-augmented agents against stateless baselines under conditions with and without access to conversational history. Performance was assessed across storage efficacy, retrieval accuracy, temporal robustness, orchestration behaviour, and operational latency. Ten language models, including the GPT-5 family, Llama, Qwen, Gemma, Hermes, and Mistral, were evaluated within a common agentic architecture supported by a Qdrant vector database. The results demonstrate that persistent memory substantially improves the ability of conversational agents to maintain and recover operational state when compared with stateless configurations. However, the study also reveals that successful memory storage does not guarantee successful memory utilization. While storage performance remained consistently high across most models, retrieval and reasoning over retrieved information emerged as the primary bottlenecks. Furthermore, the findings show that semantic interference caused by conflicting information has a greater impact on performance than conversational distance alone. The results also indicate that model architecture and tool orchestration capabilities influence overall memory performance more strongly than model scale in isolation. The study contributes a reproducible evaluation framework for memory-augmented agents and provides empirical evidence regarding the strengths and limitations of persistent vector memory in enterprise-oriented conversational systems. The findings offer practical guidance for organisations considering the deployment of memory-enabled AI agents in environments where reliable state tracking, data sovereignty, and operational efficiency are critical. 

Material logistic solutions evolve together with the introduction of new technology to further advance performance and efficiency gains. The development of Autonomous Mobile Robots (AMR) has established the ability of having flexible self-navigating vehicles, which in comparison to their predecessor doesn’t require a fixed guidance installed within the environment. AMRs as a solution provides flexibility in material logistics and can adapt its own path to reach its intended destination, even if unanticipated obstacles emerge in its planned trajectory. They are however bound to the terrestrial plane and may only move along open floor spaces, forcing layouts to plan and include enough space for logistical operations. A technology which is implemented in increasingly more industries is Unmanned Aerial Vehicles (UAV), or drones, which utilizes similar flexible navigational techniques as AMRs but without the terrestrial restriction. UAVs allow for planning efficient deliveries in three dimensions of movement but introduces new types of challenges related to navigation, safety and reliability. To explore the applicability for material logistics in assembly environments, previously implemented techniques for navigation, localization and obstacle avoidance of UAVs in indoors environments are identified and discussed. Several different technologies are presented as guidelines together with their advantages and challenges in relation to being a solution for logistical operations. A gap in knowledge surrounding the utilization of computer vision for obstacle avoidance is identified from the reviewed literature and is assessed within the study through experiments. The result from the experiments is added to the guidelines of technologies and show the potential of computer vision in safety-related systems. Conclusions drawn from the study shows that the critical aspects of navigation and obstacle avoidance can be solved using several methods but with different types of benefits. While some methods provide more accurate localization of the UAV, others enable for smooth adaptation of dynamic obstacles or rapid manoeuvres. A key overall aspect is the technique’s latency, affecting the reaction time of the UAV while in flight.

In the current industrial context, collaborative robotics, computer vision and digital twins are becoming increasingly important for developing flexible and safer manufacturing systems. This is especially relevant in battery-cell kitting, where components must be identified, sorted and assembled with the correct colour, position and polarity. This thesis aims to develop a vision-guided robotic kitting system using a UR10e collaborative robot, AI-based computer vision and a RoboDK digital twin. A workstation was designed where the robot can analyse battery kits, sort cells, handle lids and bridge pieces, and coordinate the process between the physical and the digital twin in RoboDK. To validate the system, two vision methods were implemented and compared: an ROI and colour-based approach, and an Artificial Intelligence vision model approach. The results showed that the first method was useful as an initial prototype but presented limitations in colour-dependent detections. The YOLOv8 method provided more reliable results and allowed a more flexible implementation of the kitting process. Finally, the results, limitations and sustainability impact of the system are discussed, showing the potential of combining collaborative robots, computer vision and digital twins for automated battery-cell kitting.

Background: When a child is cared for within healthcare, the entire family is affected, and parental presence is important for the child’s sense of security and recovery. Family-centered care therefore emphasizes the importance of parental involvement. Despite this, previous research shows that there are difficulties in implementing this approach in practice, and knowledge of how nurses experience and manage this is limited. Therefore, there is a need to compile and highlight nurses’ experiences of family-centered care.

Aim: To investigate nurses’ experiences of family-centered care within pediatric care.

Method: A general literature review based on ten scientific articles with both qualitative and quantitative designs.

Results: Nurses generally have a positive attitude towards family-centered care and view parents as a crucial resource for the child’s well-being. Despite this, there is a significant “implementation gap” between theory and practice due to organizational barriers such as staff shortages, time constraints, and high workload. Collaboration between nurses and families is often characterized by informal roles, and parents’ contributions risk being overlooked due to insufficient documentation.

Background: Type 1 diabetes (T1D) is a chronic autoimmune disease that requires lifelong insulin treatment as well as daily self-care. For adolescents, the disease involves continuous demands such as blood glucose monitoring, insulin administration and adjustments of diet and physical activity. Self-care can affect both psychological and physical well-being and requires support from healthcare professionals and the surrounding environment in order for adolescents to manage their disease in the best way possible.

Aim: To describe adolescents’ experiences of self-care in connection with type 1-diabetes.

Method: The study was conducted as a qualitative literature review based on ten scientific articles. The articles were reviewed and analysed according to Friberg’s five step model for integrated analysis.

Findings: Adolescents with type 1-diabetes experience self-care as a constantly present part of everyday life characterized by worry, responsibility, and the need for continuous adaptation. Increased responsibility for insulin, diet and physical activity is experienced as challenging, while the desire to fit in socially affects how self-care is managed. Limited spontaneity and difficulties maintaining routines emerge as recurring obstacles. Support from family members and healthcare professionals is perceived as important for safety and the management of self-care.

Conclusion: Self-care in type 1-diabetes affects adolescents’ everyday lives emotionally, socially and practically. The results highlight the need for person-centered and individualized support to strengthen adolescents' sense of security and self-care ability.

Digitalization has transformed the conditions of working life and shapes how work is organized, experienced and carried out in practice. This is particularly evident within HR-context, where digital tools are integrated into everyday work and reshape job demands, work processes and professional roles. The aim of this study is to examine how digitalization influences HR employees’ psychosocial work environment and professional role within a municipal organization, with a fokus on the balance between job demands and resources in relation to a sustainable working life. The study draws on the Job Demands-Resources model, Organizational Role Theory and Sense of Coherence as its theoretical framework. Using a qualitative and interpretive approach, semi-structed interviews were analyzed through reflexive thematic analysis. The findings show that digitalization is not primarily about the introduction of new digital tools, but about changing working conditions that reorganize the content, pace and boundaries of work. This is reflected in increased and often diffuse job demands, as well as a more fluid professional role in which responsibilities and expectations are continuously renogotiated. At the same time, collective and relational resources emerge as crucial for creating comprehensibility and managebility. The study thus highlights how the consequences of digitalization are shaped through the interplay between organizational structures, social practices, and individuals’ meaning-making, which is central to understanding a sustainable working life, and provides insights that can support organizations in developing more sustainable and clearly defined ways of working in digitalized contexts.

Background: Sexual and reproductive health and rights (SRHR) constitute a key public health area with significant importance for children’s and adolescents’ health and well-being. Schools are an important setting for health promotion, where school nurses play a central role in providing education and support regarding sexual and reproductive health. However, research shows that SRHR education is not always implemented, and knowledge about school nurses’ experiences of providing such education is limited.

Aim: The aim was to explore school nurses’ experiences of teaching sexual and reproductive health.

Method: A qualitative systematic literature review with an inductive approach was conducted. A total of 17 scientific articles were included and analyzed using the methodology described by Polit and Beck (2021).

Findings: Three themes were identified: organizational and societal conditions, pedagogical and relational aspects, and professional competence and inclusion. Teaching was influenced by resources, collaboration, and competence, and was often dependent on individual initiatives.

Conclusion: School nurses’ teaching is shaped by organizational, collaborative, and individual factors. To ensure equitable and sustainable education, their role needs to be clarified and integrated into school practice, supported by organizational structures, competence development, and interprofessional collaboration.

This study investigates how real-time visualisations and KPI structures can be developed to support the rapid identification of trends and deviations in production and quality data at the operational level within the manufacturing industry. The study is based on the premise that modern production environments generate large amounts of data, but that it is still unclear how this information should be structured, visualised and used to function as actionable decision support in daily operations.

The study was conducted as a qualitative case study in an industrial production environment. Data was collected through five semi-structured interviews with respondents who work with, use or are affected by dashboards, KPI structures and digitalisation in production. The collected material was analysed using reflexive thematic analysis according to Braun and Clarke, where recurring patterns were identified and organised into themes.

The findings show that real-time visualisations and KPI structures are already used to create an overview of production and support follow-up of flows, deliveries and deviations. However, the use of dashboards is still largely reactive. They are primarily used to detect problems after they have already occurred, rather than to identify trends early enough to support proactive action. The study also shows that KPIs are often connected to organisational goals, but are not always sufficiently actionable at the operational level.

The conclusion is that the development of real-time visualisations and KPI structures should not only focus on making data available. It should also focus on making trends over time more visible, supporting rapid interpretation of deviations, and adapting visualisations to users' work practices and information needs. To enable more proactive data-driven decision-making, both technical and organisational aspects need to be developed together.

I Sverige blir allt fler personer diagnostiserade med autismspektrumtillstånd samtidigt som det råder rekryteringsproblem och kompetensbrist inom svensk sjukvård. Personer med autismspektrumtillstånd har utmaningar vid beslutsfattande där värdebaserade och metakognitiva beslut framkommer; val där de fattar beslut baserade på sina egna subjektiva åsikter kring flera alternativ. En miljö där dessa alternativ finns gott om är matbutiker, vilket är ett område där personer med autismspektrumtillstånd får hjälp med antingen sitt boendestöd eller personlig assistent. Detta medför att personer med AST inte kan handla allt som behövs när de vill, då det inte är möjligt att få den hjälp som krävs vid tider som kräver spontanitet och självständighet.

Syftet med uppsatsen är att besvara följande frågeställning: “Hur kan ett digitalt hjälpmedel underlätta beslutsfattande vid matinköp för vuxna med autismspektrumtillstånd?".

Forskningsarbetet grundade sig i en kvalitativ ansats där intressenter intervjuades för att samla in data kring deras behov och krav på det digitala hjälpmedlet. Dessa intervjuer var semistrukturerade för att öppna möjligheter för eventuella följdfrågor eller omformuleringar. Detta öppnade möjligheten för forskarna, och den närvarande kontaktpersonen, att lägga till eller formulera om frågorna under tiden intervjuerna utfördes. Därefter genomfördes tematisk analys på intervjuerna, vilket var till grund för kravdokument för det utvecklade digitala hjälpmedlet. Därefter utvecklades ett digitalt hjälpmedel utifrån kravdokumentet, vilket sedan presenterades för respondenterna för ytterligare feedback.

Resultatet visar att ett digitalt hjälpmedel som utför komplexa val i matbutiker kan hjälpa personer med autismspektrumtillstånd i vardagen när mänskligt stöd inte är tillgängligt. Detta kräver att det digitala hjälpmedlet utvecklas med tre huvudområden i åtanke, mänskligt stöd och digital självständighet, reducering av kognitiv belastning, och tillgänglighetsdesign.

Background: Postpartum depression is a depression that women can experience in the period after childbirth. Approximately 12–13 percent of Western-born women can develop the disease compared to immigrant groups who have a higher value of approximately 20 percent.

Purpose: to shed light on women's experiences of postpartumdepression

Method: A qualitative literature study with an inductive approach based on twelve scientific articles about women's experiences of postpartum depression.

Results: The results of the study identified three main themes: Experiences of psychosocial changes in postpartum depression, Experiences of inadequacy in the maternal role & Lack of support from healthcare professionals and the environment. Women with postpartum depression describe feelings of failure, guilt and altered self-image. The role of mother is associated with feelings of inadequacy and difficulties in creating attachment to the child. Postpartum depression affects the relationship with the partner, which contributes to the feeling of loneliness and conflicts. Insufficient communication and support from healthcare makes it difficult to detect postpartum depression. The women also describe the importance of coping strategies and how they contributed to recovery.

Conclusion: The purpose of this study was to shed light on women's experiences of postpartum depression. The results showed experiences of inadequacy in motherhood, lack of support and changed life situation in the period after childbirth, which affected both the woman and the family. This study highlights the importance of early identification of postpartum depression, increased knowledge and person-centered support.

Background: Pressure ulcers are a common healthcare- associated injury inpatient care and may cause patient suffering, prolonged hospital stays and increased healthcare cost. Nurses play a central role in preventive care through risk assessment, planning and implementation of evidence-based intervention

Aim: To illuminate nurses’ experiences of preventing pressure ulcers in inpatient care.

Method: A general literature review with a qualitative approach based on ten scientific original articles.

Results: The findings show that nurses’ pressure ulcer prevention practices are influeced by organizational factors, knowledge and teamwork. High workload, time constraints and lack of resources were identified as major barriers to implementing preventive intervention, clear routines and effective communication within the healthcare team created better conditions for a systematic preventive approach.

Conclusion: Pressure ulcer prevention in inpatient care is a complex area of nursing in which organizational support, clinical competence, continuous competence development and clear information transfer, which may contribute to reduced care-related injuries and improved patient safety.

Workplace incivility can affect safety, well-being and the social work environment, while bystander intervention is shaped by the social situation. The aim was to compare working adults’ willingness to show civil courage as bystanders in digital and physical work environments and to examine how audience size and diffusion of responsibility related to this willingness. The study was based on social impact theory and diffusion of responsibility. A quantitative web-based vignette study was conducted using a within-subjects design in which work environment and audience size were systematically varied. The analytical sample consisted of 103 working adults. The results showed higher civil courage in physical than in digital work environments and with a small rather than a large audience. No significant interaction between work environment and audience size was found. Diffusion of responsibility was higher with a large audience and in the digital work environment, and higher diffusion of responsibility was consistently associated with lower civil courage. The study shows that civil courage in response to workplace incivility should be understood as a situational social psychological response. Practically, the results point to the importance of clear responsibility structures and courses of action in digital and physical work environments.

Assistant nurses´ work in elderly care is characterized by high demands, limited resources, and emotional strain. The high workload combined with irregular working hours and significant responsibility for care recipients, affects the conditions for recovery and work-life balance. The aim of this study is to explore how different factors interact and shape how female assistant nurses in elderly care experience work-life balance. The study is based on a qualitative approach, using semi-structured interviews analyzed from a social psychological perspective.

The results show that leadership plays a central role in shaping work-life balance, where lack of support, unclear communication, and varying managerial presence effect both the work environment and individuals’ scope for action. Furthermore, work-related factors such as high workload, staffing shortages, and irregular working hours significantly limit opportunities for recovery and balance. Social norms related to the professional role, collegial expectations, and gendered expectations further contribute to increased strain and influence how work-life balance is experienced and managed.

Overall, the study shows that work-life balance is shaped through an interplay between organizational and social factors, where responsibility tends to be shifted onto the individual, despite the conditions being largely structurally determined. The findings indicate a need for organizational measures, such as improved staffing, clearer leadership, and increased support within work teams. This can create better conditions for assistant nurses´ recovery and a sustainable work environment.

Work-Integrated Learning (WIL) in higher education is recognised for linking academic knowledge with professional practice, yet traditional long-term placements are resource-intensive and challenging to coordinate. This study explores the feasibility of a short-term, course-based WIL process within engineering education. A six-week WIL process was developed and integrated into a third-year course in a bachelor’s programme in manufacturing engineering. Five students were placed individually or in pairs at three manufacturing companies from different sectors and of different sizes, attending one to two days per week. A common assignment was provided for all students, with flexibility for company-specific adaptation. Semi-structured interviews with students and company supervisors constituted the evaluation. The data analysis identified consistent benefits; students reported enhanced ability to connect theory and practice and increased professional understanding, while supervisors noted organisational learning benefits through students’ fresh perspectives and critical reflection. However, challenges included limited preparation, communication gaps, and difficulties adapting a generic assignment to diverse industrial contexts. Suggested improvements included more structured preparation, clearer communication of expectations, customised assignments, and consideration of shorter, full-time placements. The findings demonstrate that short-term, course-based WIL can complement traditional placements by offering meaningful learning opportunities and strengthening university-industry collaboration. Although, the results also suggest that effective implementation requires structural adjustments to support preparation, communication, and contextual alignment. Future research should refine the process by testing scalability with larger student groups, additional companies, and international participants, as well as further investigating critical success factors for short-term WIL.

Background: In chronic diseases such as COPD (chronic obstructive pulmonary disease), the treatment can affect the patients positively and negatively, through unconsciously caused suffering from the healthcare staff. COPD patients meet healthcare staff continuously during treatments and examinations. Where the treatment becomes an important cornerstone of the healthcare encounter. Healthcare staff, such as nurses, need to be open, responsive, respectful and educational. Aim: To highlight how COPD patients experience the encounter with healthcare. Method: A qualitative literature review, focusing on the patient perspective. A qualitative approach was chosen to highlight the experiences and perceptions of COPD patients. A total of eleven scientific articles were included. Findings: The results include five themes: Safety in the care meeting, the significant role of communication, the importance of closeness to the care staff, the feeling of guilt and shame and the importance of planning in the care meeting. COPD patients state that safety, good communication, closeness and planning in the care meeting are important aspects in the meeting with the care staff. Where COPD patients should be given space to express their feelings and experiences, guilt and shame. Conclusion: The conclusions that the results show are that COPD patients want to feel safe in the care meeting. This is to promote communication and the COPD patients' experience of closeness to the care staff. By giving patients space to open up about feelings or experiences, closeness and safety can be ensured. Planning the care meeting or contacts with the care can help increase patient participation and person-centered care.

This study aims to explore how high school girls experience body ideals on social media and how these relate to their self-image and psychological well-being. Social media are a central part of young people’s everyday lives, where idealized body images are constantly present. The study is based on a social psychological perspective, drawing on theories of social comparison, social identity, and symbolic interactionism. A qualitative method was applied, and data were collected through ten semi-structured interviews with girls aged 16-19, which were analyzed using thematic analysis. The findings show that body ideals constitute a recurring and normative part of the participants’ everyday lives, where slim and fit bodies appear as dominant ideals. Exposure and social validation in the form of “likes” and comments contribute to social comparison, body pressure, and feelings of inadequacy, despite an awareness that the content is often unrealistic. At the same time, some participants describe strategies to reduce negative influence, such as critical reflection and controlling their social media content. The findings also indicate that the impact varies between individuals, highlighting the complexity of how body ideals are experienced and managed. These processes can be understood through social comparison, the pursuit of social acceptance, and how social feedback shapes self-image.

Background: Stroke is a common and serious condition caused by a blood clot or cerebral hemorrhage, often leading to physical, cognitive and communicative impairments. Rehabilitation is central to recovery and requires collaboration between patients, relativesand healthcare professionals.

Aim: Describe adult patients’ experiences of life aftersuffering a stroke.

Method: Qualitative literature based on ten scientific studies from apatient perspective.

Findings: Three themes with nine subthemes were identified. The results showed that stroke survivors experience a sense of loss, reduced independence, and limitations both socially and in daily life. This is due to impaired physical and cognitive abilities. Hidden disabilities, such as fatigue and concentration difficulties, were particularly prominent and were often misunderstood by others. Simultaneously, there is a strong drive to regain identity and autonomy. While deficiencies in caregivers, information and coordination hinder recovery, individualized support and continuity in rehabilitation have proven essential for regaining quality of life.

Conclusion: Life after stroke involves a significant adaptation process that accents identity, participation and quality of life. Lack of coordination within healthcare can aggravate recovery, while relatives have an important but demanding role. Therefore a person-centred and long term care is essential for a safe and successful recovery.

Transitioning from linear to circular production is vital for manufacturing companies aiming to reduce environmental impact. Simultaneously, they face rapid technological change, fluctuating demands, and frequent product introductions. Addressing these challenges requires rethinking how production systems are designed and operated, not only to improve resource efficiency but also to extend system lifespan through relevance and resilience. Reconfigurability offers a promising approach, enabling systems to adapt continuously to evolving needs. However, literature lacks guidance on managing production systems that remain resource-efficient and long-lived, i.e., circular production systems. This study explores how circularity and reconfigurability can be operationalized across the lifecycle of production systems based on examples from six companies. It presents a spectrum of approaches, including technical solutions, support structures, and collaboration models. Technical solutions show how systems can be reused and reconfigured to maximize efficiency. Collaboration models emphasize revising design practices to foster partnerships between suppliers and manufacturers. Support structures offer insights into leveraging data to relocate and reuse components, avoiding premature decommissioning. Efficient reselling practices at end-of-life are also discussed. Overall, the paper bridges theory and practice, offering actionable strategies for industry and research.

Reconfigurable Manufacturing Systems (RMS) offer a compelling solution to anticipating uncertainty in volatile markets. Despite their potential value, their adoption is often constrained by industrial investment models that narrowly focus on short-term business cases, overlooking lifecycle considerations and the economic value of flexibility. This oversight can be traced to inadequate systematic risk management of flexibility dimensions and insufficient planning for extended equipment use in production system design. This paper explores how companies can better anticipate market uncertainty in their economic investment models, a prerequisite for valuing reconfigurability effectively. This study identifies critical barriers to adopting RMS through a literature review and interviews with representatives from four manufacturing companies. Findings reveal a gap in including and quantifying the economic and sustainability advantages, particularly regarding lifecycle and flexibility considerations caused by volume, product, and product mix uncertainties. Instead, current investment models include short-term cost metrics, leaving long-term adaptability undervalued.

Background: Dementia is a growing societal challenge that affects both the person diagnosed and their relatives. Dementia is described as an umbrella term for several degenerative neurological conditions that lead to deterioration of cognitive functions. Memory impairment, as well as changes in personality and language, are significant symptoms. As cognitive functions gradually decline, dependence on relatives increases, which may result in considerable emotional, social and practical consequences for them.

Aim: The aim was to investigate how relatives of people with dementia experience the support they receive from healthcare services.

Method: The method consisted of an integrative review of qualitative research inspired by meta-synthesis.

Findings: The results show that relatives of people with dementia often experience the support from healthcare and social care services as insufficient, unclear, and difficult to navigate. At the same time, support that is individualized, continuous, and characterized by participation, confirmation, and respectful treatment creates a sense of security. The findings also demonstrate that the design and delivery of support have a significant impact on relatives' everyday lives and well-being.

Conclusion: The study shows that relatives’ experiences of support in dementia care are greatly influenced by how the support is designed initiated and followed up.

Introduction: E-health services and digital platforms have become an important part of modern healthcare, including pharmacy practice. For pharmacists, such tools may support information seeking, medication counseling, and patient communication.

Aim: The aim was to examine how pharmacists use e-health services and digital platforms in patient encounters during medication counseling, and which facilitators and barriers influence their use or non-use.

Methods: This study was conducted as a quantitative survey among pharmacists and prescriptionists with patient-oriented work tasks. Data were collected online through EvaSys, and 44 of 50 submitted responses were included in the analysis. The material was analyzed using descriptive statistics and Spearman’s rank correlation. The study was based on the Unified Theory of Acceptance and Use of Technology, which was used as the theoretical framework to examine factors that may influence pharmacists’ use of digital tools.

Results: The results showed that digital tools were used frequently in pharmacists’ work, mainly for medication-related information checking, identifying drug interactions, and supporting medication counseling. Fass, Janusmed/Janusinfo, and internal digital knowledge or counseling support systems were the most used tools. The main barriers were lack of time and lack of technical support. The analysis also showed positive associations between support and resources and perceived ease of use, as well as between perceived usefulness and behavioral intention.

Conclusion: Digital tools play a clear role in pharmacists’ work and may support medication-related information checking and medication counseling. At the same time, the results indicate that organizational and technical conditions may be important for enabling more active use of digital tools in patient communication.

Background: Palliative care is offered to terminally ill patients with the goal of alleviating suffering and providing improved quality of life at the end of life. The patient receives palliative care at several different institutions such as hospital, home, and special accommodation adapted for palliation such as hospice. The nursing profession involves being patient-oriented and has a great responsibility for the care of the palliative patient. Ethical challenges lead to feelings of guilt and moral stress in the nurse. The nurse uses the four bioethical principles as decision support: the principle of autonomy, beneficence, non- maleficence, and justice.

Aim: To highlight the ethical challenges nurses face in palliative care.

Method: The study was conducted as a literature review and collected and analyzed information from previous research related to ethics and palliative care. The articles used for the study were both qualitative and quantitative.

Findings: The result were divided into five themes; to respond to the patient's values and culture, to respond to the patient's relatives, to care for the person who can no longer take care of himself, interpersonal and work environment factors and medical challenges.

Conclusion: In summary, it is concluded that nurses face several different types of different ethical challenges.

Background: Smoking tobacco has decreased among youth in Sweden, meanwhile usage of snus and vapes has increased. Nicotine can lead to addiction, psychiatric issues and damage to the heart and liver, especially in bodies that are still developing. Health promotion emphasised preventive measures, in which a nurse, through health counselling and patient-centred care, played a role. Knowledge of nurses’ attitudes was important to strengthen prevention.

Aim: This study aimed to analyse nurses’ attitudes and perspectives on tobacco and nicotine usage in youth.

Method: This study was a web-based cross-sectional study with a self-constructed questionnaire and non-probability sampling. Data was collected through digital distribution and analysed with both quantitative methods (SPSS) and qualitative content analysis. Ethical principles were followed, and the authors' pre-understanding was analysed to lessen the impact on the result.

Findings: A survey consisting of 90 nurses showed that few had education on nicotine, still, a majority saw nicotine usage in youth as a serious health issue. Knowledge about nicotine was low, nurses’ confidence in conversations was acceptable meanwhile education increased knowledge. Challenges seen were normalisation, low motivation and time constraints.

Conclusion: The nurses’ knowledge and own nicotine usage affect youth support. More education and structural changes should be implemented for effective prevention.

This thesis aims to answer the following research question: How has the traits of the archetypical witch been redefined from traditional depictions to contemporary video game characters? With a basis in Saussure's semiotics, an analysis of the video game characters Bayonetta from Bayonetta (2009), Auntie Ethel from Baldur's Gate 3 (2023) and Melinoë from Hades II (2025) has been carried out. A close reading of historical literature, playscripts and academic texts has been conducted with the intent of identifying traditional witch-traits. This background contributed to the production of a critical framework of traditional traits, and in turn the analysis of contemporary traits within the chosen characters.

This thesis examines the player motivation behind emergent route-seeking in immersive simulation games, focusing on how players use and interpret systemic tools, mechanics, and possibilities to create alternative routes. While previous research explains emergent gameplay through rule interaction and systemic design, less is known about why players actively or incidentally seek and construct these routes. To investigate this, the study used a mixed-method online survey with 140 participants, combining 26 Likert-scale items with three open-ended critical incident questions. The quantitative findings showed a shared motivational core around systemic interaction, discovery, creative/self-directed play, and boundary-testing. At the same time, the qualitative findings indicated that similar emergent gameplay actions could be motivated by different reasons, including mastery, entertainment, curiosity, immersion, survival pressure, habit, and player-owned experience. The study contributes by showing emergent route-seeking is best understood as a shared attraction to systemic freedom that becomes personally meaningful through player-specific motivational pathways.

Background: There are many factors that influence students' psychological health. School-related stress has increased in Sweden, and this increase can mainly be seen in the grade 7-9, and it is linked to an increased number of psychosomatic complaints. School-related stress is seen as a consequence of an imbalance where the students' own resources are inadequate to meet the demands. The schools are responsible to promote health and learning. The student's health service is a central element of promoting the students' health and the school nurse has an important role in the work to support the students' health and well-beeing.

Aim: The aim of this study was to examine the school nurses' experiences of school-related stress among students in grades 7-9 in Sweden.

Method: A quantitative cross-sectional study. Data was collected through web-based questionnaire. A total of 43 school nurses, working with students in grades 7-9 from different parts of Sweden participated. The result was presented using descriptive statistics.

Findings: School nurses engage with students that experience school-related stress often, and nearly half of the participants report that school-related stress has increased. The main causes of school-related stress, among the students, according to the school nurses were inadequate health-related habits, aspiration for high and sufficient grades, school-related environmental factors, and the student's self-perception. School nurses frequently address school-related stress among students, both during health dialogues and spontaneous contact.

Conclusion: The study shows that school-related stress among the students is something that school nurses meet regularly. School nurses have an important role in preventive work to identify and work with these students. The study has a wide range of geographical coverage and a varying degree of experience among the participants. Despite a limited sample size this study can bring insight to school nurses experience of school-related stress among students in grade 7-9. The study contributes to further research and development to prevent and manage school-related stress.

Background: Childhood cancer is a serious, life-altering disease that affects both the child and the entire family, requiring prolonged treatment and comprehensive nursing care. Nurses provide physical and emotional care while supporting families, but pediatric oncology also involves a significant emotional burden, particularly when facing children’s suffering and developing long-term relationships with patients and families.

Aim: The aim was to describe nurses’ experiences of working in pediatric oncology.

Method: The study was conducted as an integrative review of qualitative research, a based on ten scientific articles. The articles were identified, quality appraised, then analyzed using Friberg’s five step model.

Findings: Nurses in pediatric oncology care experience nursing care as both relationally meaningful and emotionally demanding. Through creating security and providing familycentered care, nurses strive to reduce suffering and support the child's wellbeing. At the same time, the work is characterized by emotional strain, organizational limitations, and ethical dilemmas, placing huge demands on nurses’ professional competence and ability to manage complex situations.

Conclusion: Nursing work within pediatric oncology is both emotionally demanding and meaningful. To provide safe and person-centered care, organizational support, education, and resources are needed to strengthen nurses’ ability to provide high-quality care and support both the child and the family.