Magister Administrationis - MAdmin / This study assesses the social consequences of water management devices in poor households in Samora Machel, a poor urban area characterised by high levels of unemployment and poverty. South Africa is currently faced with an increase in the roll out of water management technologies, mainly in poor areas, allegedly to manage water demand and help poor households manage their water consumption and prevent wastage. The water management device (WMD) limits access to the free basic water (FBW) allocation and automatically cuts it off when the allocation is finished. In 2009/2010 the City of Cape Town started rolling out the devices in Samora Machel, which previously used the conventional water meter that supplied the area with unlimited water access. WMDs limit water access to 350 litres of FBW per day. People living in Samora Machel claim that 350 litres is not enough and they are experiencing problems of frequent water cuts even before the allocated litres are used up. There have also been water leaks ever since the installation of the devices. Section 27(1)(b) of the Constitution of the Republic of South Africa, Act 108 of 1996, entrenches the right of access to sufficient water. The WMDs are criticised for infringing the right of access to sufficient water supply to poor households by leaking, cutting off water supply frequently and by limiting access to FBW supply. Moreover, critics argue that the WMDs are not water-demand management mechanisms; they are cost-recovery mechanisms that are introduced under the neo-liberal policies introduced by the post-apartheid government in 1994. This criticism is based on the fact that the WMDs are implemented in poor areas only, where water is needed more for basic survival, rather than in high-income areas, where water is mostly used for luxury purposes.

Introduction: In the nurses’ profession, interacting with relatives is a part in her/his daily work. Previous research has shown that nurses can experience relatives as a valuable asset in providing information, but it has also shown that there can be an ambiguity among nurses about relatives’ participation. In Viet Nam, the nurses’ experiences about relatives' participation has not yet been explored. Aim: The aim with this study was to explore registered nurses’ experiences of the relative´s participation in the care of patients at a hospital in Viet Nam. Method: A qualitative design was conducted. Data were collected through semi-structured interviews with nine registered nurses. Content analysis was used to analyze the data. Result: The analysis of the nurses’ experiences resulted in three categories; Relatives' role in care, Relatives’ knowledge and Relatives’ presence at the workplace. Conclusion: This study presented registered nurses' experiences on the importance of relatives being a part of the care regarding providing information and relieving workload. This study also showed that the participation of the relatives can bring risks for the work environment and patients.

Osteoporos, även benämnt som benskörhet är en metabol skelettsjukdom vilken karakteriseras av nedgång i bentäthet samt en förändrad mikroarkitektur i skelettet vilket ger en ökad risk för frakturer. Hela 120 000 osteoporosrelaterade frakturer diagnostiserades 2017, vilka belastade den svenska sjukvården med 20 miljarder kronor. Den årliga förekomsten av osteoporosrelaterade frakturer förväntas öka med en ökad äldre population och en förändrad livsstil, vilket i sin tur kommer leda till ökade sjukvårdskostnader. Idag finns flera godkända läkemedel mot osteoporos och i första hand rekommenderas de antiresorptiva läkemedlet alendronat och därefter denosumab. Följsamheten till alendronat är dock väldigt låg och beror främst på de biverkningar som medföljer behandlingen. Patienter som inte svarar på behandling med antiresorptiva läkemedel kan övergå till anabola läkemedel, där teriparatid varit det enda tillgängliga läkemedlet. Under 2019 godkändes ytterligare ett anabolt läkemedel, romosozumab som en monoklonal antikropp riktad mot sklerostin. Romosozumabs anabola effekt utgörs genom att det selektivt binder till sklerostin vilket omöjliggör dess naturliga inhibering av den kanoniska Wingless-int -signaleringsvägen, vilket resulterar i en ökad benbildning genom en ökad osteoblastdifferentiering samt osteoprotegerin -medierad supersession av osteoklaster. Syftet med litteraturstudien var att undersöka läkemedelet romosozumab vid behandling av osteoporos hos postmenopausala kvinnor. Är romosozumab effektivt som initial behandling, som initialbehandling följt av antiresorptiv behandling och vid insättning efter terpi med antiresorptiva läkemedel? För att besvara denna frågeställningen undersöktes två olika variabler: Läkemedlets påverkan på bentäthet och frakturrisk och läkemedlets effektivitet jämfört med andra behandlingsalternativ. Litteraturstudien baserades på en analys av fem kliniska studier där data gällande förändring av bentäthet (BMD) och incidens av ny fraktur presenterades. Resultatet visade att initial behandling med romozozumab under 12 månader gav en statistiskt signifikant ökning av BMD om 11.3-13.7% samtidigt som frakturrisken visades var lägre jämfört med placebo, teriparatid, denosumab och alendronat. Ökningen av BMD och den minskade frakturrisken bibehölls efter 12 månaders underhållsbehandling med antiresorptiva läkemedel. Däremot kunde inga slutsatser dras kring hur länge romosozumabs effekt kan bibehållas vid underhållsbehandling med antiresorptiva och inte heller vilken effekt romosozumab har hos patienter som sedan tidigare administrerats antiresorptiva läkemedel. / Osteoporosis, also referred as bone fragility is a metabolic bone disease characterized by a decrease in bone density as well as a altered bone microarchitecture, which increase the risk of fractures. As many as 120,000 osteoporosis-related fractures were diagnosed in 2017, and an economic burden on the Swedish healthcare system was 20 billion SEK. With an aging population and a change lifestyle, the annual incidence of osteoporosis- related fractures are expected to increase, which in turn will lead to increased healthcare costs. During the first years of life bone modeling occurs, a process of bone formation. After completed modeling the bone will continually undergo a resorption and modeling, a process referred to as remodeling. The remodeling is estimated to occour at 1-2 million different locations in the bone simultaneously. The cells involved in this process are osteoclasts that resorbs bones, osteoblasts that build up bones and osteocytes that can stimulate the bone-forming ability of osteoblasts and osteoclasts for resorption when rebuilding old bone. During the continuous process of remodeling the bone resorption and formation are equal, in diseases such as osteoporosis the bone resorption is greater than bone formation. Today there are several approved drugs for osteoporosis and the most widely used are the antiresorptive drugs bisphosphonates followed by denosumab. Though the adherence to bisphosphonates are very low and mainly due to the side effects that come with the treatment. Patients who do not respond to antiresorptive therapy may switch to anabolic drugs, where teriparatide was previously the only drug available. In 2019, another anabolic drug, named romosozumab was approved, a humanized monoclonal antibody specifically targeted against the protein sclerostin. Romosozumab blocks sclerostin from binding to low-density lipoprotein receptor-related protein 5 or 6 (LRP5/6) on osteoblasts which allows activation of the intracellular wingless-int signaling pathway that actives transkiption of target genes. The primarily target genes for the activation of LRP5/6 are genes involved in osteoblast differentiation but also genes for osteoprotegerin which inhibit osteoclasts differentiation through binding to receptor activator of nuclear factor kappa-Β ligand (RANKL). The purpose of this literature study was to investigate the drug romosozumab as treatment of osteoporosis in postmenopausal women: Is romosozumab effective as initial treatment, as initialtreatment followed by resorptive therapy and upon post-therapy with antiresorptive drugs? Romosozumab is a relatively new drug on the market, therefore there is a limited number of published clinical trials and conclusions drawn regarding if the long-term effect of romosozumab can be maintained in antiresorptive maintenance therapy, nor about the effect of the drug in patients previously administrated antiresorptive therapy. To answer the purpose of the literature study, two different variables were examined: the drugs impact on bone mineral density (BMD) and fracture risk, and the drug’s effectiveness compared to other treatment options. Five clinical trials were selected for analysis based on the purpose of the literature study from the two medical reference databases: PubMed and ClinicalTrials.gov. The data from the analyzed studies showed that by using romosozumab as initial treatment for 12 months resulted in a statistically significant increase in BMD of 11.3–13.7% at the same time as the risk of a new fracture was lowered compared to placebo, teriparatide, denosumab and alendronat. The increase in BMD and the reduced fracture risk were maintained during the 12-month follow-up treatment with antiresorptive drugs.

The purpose of this paper is to analyse the link between human rights and, HIV and AIDS. It also assesses whether persons who experience inequality, prejudice, marginalisation and limitations in their social, economic and cultural rights are at a greater risk of HIV exposure. The study aims to assess whether persons living with cognitive disabilities have been a marginalised in the international and regional responses to HIV and AIDS, because cognitive disabilities impact on the basic social skills of an individual such as reading, writing, interacting with people and affect the ability of an individual to learn new things and infer information from social cues and body language. The author will therefore review specific international human rights instruments, African human rights instruments and some national policies and legislation in order to examine this, and based on the findings will provide recommendations accordingly. / Dissertation (LLM)--University of Pretoria, 2012. / gm2014 / Centre for Human Rights / unrestricted

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This essay aims to illustrate how teachers from two different schools work to convey values in their professional roles, according to the basic values found in the Swedish curriculum Lgr11. This has been done through qualitative interviews with these schools’ teachers, individual at one school and in a group at the other. The results show that these teachers share roughly the same view on basic values, but that the methods employed by the teachers of either school differ. They also show that these two schools’ management prioritize this work differently. Conclusions that can be drawn from the results are that schools where this type of work is prioritized and where teachers work from the same point of view have greater success in conveying basic values.

Bibliography: leaves 199-204. / This thesis is concerned with developing a method for determining the Quality of Life of a group or community in quantitative terms. The method devised is aimed at providing decision-makers with a useful tool when allocating public funds. The method involves setting critical values for indicators and then applying a mathematical formula, in order to standardise information gathered from several different sources. A value for the indicator of a particular group or community is thus calculated. This procedure made it possible to compare data from these different sources. Arising out of this the values for individual indicators were aggregated to produce indices evaluating the Quality of Life, which are in a form that may be readily used by decision-makers. Surveys were run in Elsies River, a coloured suburb of Cape Town, and in Basuto QwaQwa, a homeland in the Orange Free State, using two questionnaires. The results were computed and the method developed here used to compare and aggregate the data. Other sources of data included opinions from experts and objective data concerning the two survey areas which were also standardised and aggregated. The results show that the method is pragmatic and could be useful to decision-makers. The standardisation provided the means for arriving at the indices which show how different aspects of the Quality of Life may be assessed. The results, however, are not absolute and could change through a process of negotiation: in fact this is an essential qualification.

According to a report from the Medical Products Agency in 2011, the Swedish drug waste from inpatient care was approximately 100 tons and from the public 1500 tons. At Stockholms Sjukhem, the weight of the annual drug waste is currently one to two tons. The aim of this cross-sectional study was to gain quantitative and qualitative data of drug waste produced at ten medical wards at Stockholms Sjukhem Bromma and Stockholms Sjukhem Kungsholmen through investigation of the content of drug waste bins for one week. There were 141 identified drugs in the disposal bins. However, a slightly larger number of drugs also found were not possible to identify and are therefore, not reported in our tables. Nurses are responsible for drug waste and  therefore, a suitable group to interview. According to the nurses, expiration dates  and prescription changes are among the most common reasons why drugs are  discarded. The main cause of drug waste of the drugs identified was passed expiration dates. However, most of the waste consisted of empty packaging materials, while drug waste accounted for a very small proportion. In conclusion, an increased effort in education and improved routines in source sorting and drug handling would contribute to reduce the drug waste at Stockholms Sjukhem.

Neurogenesis is an important and vastly under-explored area in reptiles. While the ability to generate new brain cells in the adult mammalian brain is limited, reptiles are able to regenerate large populations of neuronal cells. Pythons exhibit a characteristic specific dynamic action (SDA) response after food intake with an increase in metabolic rate that facilitates processing the meal. Associated with this change in SDA, pythons (Python spp.) also exhibit impressive plasticity in their digestive and cardiovascular physiology due to the sheer magnitude of the increase in organ growth that occurs after a meal to speed digestion, absorption, and assimilation of nutrients. While this systemic growth in response following food consumption is well documented, whether the python brain exhibits associated changes in cell proliferation following food consumption and digestion is currently unexplored. For this study, juvenile male ball pythons (Python regius) were used to test the hypothesis that postprandial neurogenesis is associated with food consumption. We used the thymidine analog 5-bromo-12’-deoxyuridine (BrdU) to quantify and compare cell proliferation in the brain of fasted snakes and at two time points: two days and six days after a meal, which span time periods of during and after SDA response, respectively. Quantification of BrdU-labeled cells in the ventricular regions relealed that – consistent with other reptile species – the retrobulbar and olfactory regions had the highest numbers of proliferating cells in the python brain, regardless of sampling time. Throughout the telencephalon, cell proliferation was significantly greater in the six-day post-feeding group, with no difference between the two-day post-feeding group and controls. Most other postprandial systemic plasticity occurs within a day or two after a meal and decreases thereafter; however, the brain displays a more delayed response, with a surge of cell proliferation after most of the digestion and absorption is complete. Our results support our hypothesis that food consumption does affect cell proliferation in the python brain, and indicates that the degree of increased proliferation is dependent on the time since feeding.

This diploma thesis describes the design and creation of an application used to track Project Manager allocation in the company IBM Global Services Delivery Center Czech Republic. The first chapter contains theoretical information needed to understand the content of the thesis, while the second chapter focuses on analyzing the current status of this area. The third chapter then explores the options on how to solve the identified problem, and the best alternative is then chosen and created.