The aim of the study was to investigate the perceived factors influencing the possibilities of engaging more children and youth in organized physical activity during their leisure time within the current IOP project. The studys method used semi-structured interviews for data collection. Conventional content analysis was used for data analysis. The results indicate that resources, organizationalstructure and activites, and the interest of children and youth have the greatest impact on their level of engagement in physical activity. Girls, children from different ethnic backgrounds, and those lacking adult role models were considered more challenging to reach. The informants unanimously emphasized the importance of increased collaboration. The conclusion drawn is that access to economic resources, visible organizations, and children and youth's own interest are crucial in promoting their physical activity. The lack of these factors was found to be a hindrance. Challenges were identified in reaching girls, children from different ethnic backgrounds, and those lacking adult role models. The informants emphasized the significance of increased collaboration for promoting physical activity among children and youth.

Voluntary Sector Organisation Public Partnerships (IOPs) are a new form of collaboration for voluntary and public organisations, which aim to give financial support ta a welfare service provided by the voluntary actor. The aim of this study is to examine the importance of voluntary organisations in the modern welfare state. The importance they have as welfare producers. In this study i have chosen to look at how Karlstad municipality works with IOP cooperation. My theoretical starting point of this study have been the concept of social capital and how IOP collaboration works from a trust perspective. I have used both document study and interviews to answer my purpose. I have interviewed both officials in Karlstad municipality and representatives of the voluntary organisations that have IOP cooperation with the municipality in Karlstad. The conclusion I have found here is that Karlstad municipality and the three voluntary organisations I met, have a good collaboration with a high level of trust between them. But there is also some dissatisfaction that it is the municipality that benefits most from the cooperation. Another conclusion is that IOP collaboration has a great impact on the individuals who get help through the voluntary organisations. The study shows that many of these individuals would be completely helpeless unless the voluntary organisations improve their work.

This thesis addresses the reliability of Goldmann-type applanation tonometers (GAT). It deals with the investigation of the relation between predicted intraocular pressure, IOPG and true pressure, IOPT. The problem of the accuracy of GAT readings has acquired special importance over the last two decades as new types of surgical procedures to correct vision disorders are being explored and gain universal acceptance. The overall aim of the present study is to assess the effects of individual variations in the corneal central thickness (CCT), material properties of the involved tissues and paracentral applanation on the accuracy of IOPG. Two finite element models have been constructed: a two-dimensional axisymmetric model of the cornea and a three-dimensional model of the whole corneoscleral envelope. Various material descriptions were adopted for the cornea in 2D, whereas the 3D model accounted for collagen microstructure and represented a hyperelastic ber reinforced material. Nonlinear analyses were carried out using the commercial general-purpose finite element software ABAQUS. An extensive literature survey and consultations with ophthalmologists and clinicians were the platform for establishing relevant modelling procedures. The results reveal a clear association between all considered parameters and measured IOPG. The effect of assumed CCT is highly dependent on the corneal material properties. Material model alone has a profound effect on predicted IOPG. Variations in tonometer tip application produce clinically signi cant errors to IOPG measurements. Potential effects of corneal stiffness and paracentral applanation on GAT readings are larger than the impact of CCT. The behaviour of the models is broadly in agreement with published observations. The proposed procedures can be a useful tools for suggesting the magnitudes of corrections for corneal biomechanics and possible human errors. The present modelling exercise has an ability to reproduce the behaviour of human cornea and trace it under IOP and GAT, providing potentially useful information on the distribution of stresses and strains. Some recommendations can be drawn in pursuit of the clinical imperatives of ophthalmologists. / QC 20100729

The discovery of the ocular hypotensive effect of topically applied prostaglandins (PGs) has raised a number of questions about the mechanisms of action involved. The aim of the present thesis was to answer some of these questions. PGs reduce the intraocular pressure (IOP) by increasing uveoscleral flow through the ciliary muscle, but the exact mechanism is not known. Morphological changes may be involved. PGs are also involved in the inflammatory response. In the first study the aim was to investigate the effect of latanoprost, a prostaglandin F2 a-analogue, on the blood-aqueous barrier and the IOP restoration after long-term treatment. 26 glaucoma patients were treated with latanoprost (50 pg/ml) once daily for 6-12 months. Aqueous protein concentration was followed with a laser flare meter in 16 patients throughout this period. No change was observed. IOP increased slowly after withdrawal of treatment. It was concluded that latanoprost has no clinically significant effect on the permeability of the blood-aqueous barrier and that the IOP will return to pretreatment levels within a few weeks, indicating that any changes in the ciliary muscle morphology are reversible. In 20 healthy volunteers it was attempted to prevent the ocular hypotensive effect of latanoprost by inhibiting uveoscleral flow by a pronounced ciliary muscle contraction. For this purpose a high dose of the cholinergic agonist, physostigmine (1 drop 8 mg/ml alternate hours) was used. However, the effects on IOP of the two drugs were mainly additive most likely due to a short-lasting effect of physostigmine on the ciliary muscle. The progressive IOP reduction by physostigmine in the second study raised the question as to whether the drug reduces aqueous flow apart from enhancing outflow. On the contrary, in the third study repeated administrations of physostigmine, in 20 normal subjects, increased aqueous flow, measured with fluorophotometry, by about 25%. From studies of patients it is known that latanoprost twice daily has less ocular hypotensive effect than once daily. This was the subject of the two remaining studies. The possibility that latanoprost causes a short-lasting increase in aqueous flow was examined in 18 healthy volunteers. Application of a second drop in the morning would blunt some of the early IOP lowering effect of latanoprost. Once or twice daily applications had similar effect on aqueous flow, a tendency to an increase without any difference between the dose regimens. The next study confirmed the difference in effect on IOP between once and twice daily applications in 40 normal subjects. The difference remained even when one of the two applications was omitted after two weeks’ treatment. The results indicate that applying latanoprost twice daily induces a modest receptor desensitisation. / <p>Diss. Umeå : Umeå universitet, 1997, härtill 5 uppsatser.</p> / digitalisering@umu

Purpose: The aim of the study was to quantify the isolated tear film adhesion error in a Goldmann applanation tonometer (GAT) prism and in a correcting applanation tonometry surface (CATS) prism. Methods: The separation force of a tonometer prism adhered by a tear film to a simulated cornea was measured to quantify an isolated tear film adhesion force. Acrylic hemispheres (7.8 mm radius) used as corneas were lathed over the apical 3.06 mm diameter to simulate full applanation contact with the prism surface for both GAT and CATS prisms. Tear film separation measurements were completed with both an artificial tear and fluorescein solutions as a fluid bridge. The applanation mire thicknesses were measured and correlated with the tear film separation measurements. Human cadaver eyes were used to validate simulated cornea tear film separation measurement differences between the GAT and CATS prisms. Results: The CATS prism tear film adhesion error (2.74 +/- 0.21 mmHg) was significantly less than the GAT prism (4.57 +/- 0.18 mmHg, p<0.001). Tear film adhesion error was independent of applanation mire thickness (R-2=0.09, p=0.04). Fluorescein produces more tear film error than artificial tears (+0.51 +/- 0.04 mmHg; p<0.001). Cadaver eye validation indicated the CATS prism's tear film adhesion error (1.40 +/- 0.51 mmHg) was significantly less than that of the GAT prism (3.30 +/- 0.38 mmHg; p=0.002). Conclusion: Measured GAT tear film adhesion error is more than previously predicted. A CATS prism significantly reduced tear film adhesion error by similar to 41%. Fluorescein solution increases the tear film adhesion compared to artificial tears, while mire thickness has a negligible effect.

Animal models of ocular hypertension are important for glaucoma research but come with experimental costs. Available methods of intraocular pressure (IOP) elevation are not always successful, the amplitude and time course of IOP changes are unpredictable and irreversible, and IOP measurement by tonometry is laborious. This dissertation focuses on the development and implementation of two novel systems for monitoring and controlling IOP without these limitations. The first device consists of a cannula implanted in the anterior chamber of the eye, a pressure sensor that continually measures IOP, and a bidirectional pump driven by control circuitry that can infuse or withdraw fluid to hold IOP at user-desired levels. A portable version was developed for tethered use on rats. The system was fully characterized and deemed ready for cage- or bench-side applications. The results lay the foundation for an implantable version that would give glaucoma researchers unparalleled knowledge and control of IOP in rats and potentially larger animals. Moreover, a novel mathematical technique was developed to efficiently analyze IOP records obtained using the pressure controlling device. The algorithm successfully yields the value of several parameters that influence ocular physiology and are commonly linked to glaucoma development. This unique methodology uses information regarding the amount of volume necessary to maintain IOP at different levels to quantify the outflow facility of perfused eyes. The use of this technology largely simplifies the investigator’s experimental set-up and cuts procedural times in half. The second device is an implantable pressure sensor for continuously monitoring IOP. The miniature system is equipped with pressure and temperature transducers, on-board amplifiers and a powerful microcontroller that ensure data quality. The sensor is able to obtain measurements with twice the accuracy and precision of any other IOP sensor used to date, avoid electronic drifts commonly seen in commercial sensing devices, and can potentially be used in a variety of animal models. The sensor was characterized and tested in alert rats for weeks on end. Data obtained with this device showed the presence of previously reported circadian rhythms, with IOP significantly increasing during nocturnal cycles. This technology provides researchers with an unprecedented tool to analyze IOP dynamics over time. The characterization of the amplitude, period and phase of the IOP profiles of normal and glaucomatous eyes may help establish a definitive correlation between ocular hypertension and glaucoma progression. While implantable systems provide investigators with essential physiological data, their implementation can be difficult. Challenges such as reduced operational lifetimes and limited data acquisition capabilities are commonly faced by most bio-devices. These limitations are frequently linked to small battery capacities, however the implementation of bigger batteries is not usually viable due to size requirements. Energy harvesting technologies have surfaced in recent years in an attempt to replace battery applications; however, most technologies provide low power densities and cannot deliver continuous telemetric operation. An innovative wireless powering system was developed to overcome these limitations. The technology uses radio frequency (RF) energy transfer to continuously harvest high energy levels. Taking advantage of the controlled environment under which most research animals are housed, RF transmitters are placed around the cage to form strong, omnidirectional electric fields. An especial antenna was designed to be worn by the animal and collect large energy levels, irrespective of animal movements and positioning. The system was tested on the implantable IOP sensor for weeks, providing robust performances and allowing the sensor to collect data continuously with high precision. The device consistently generated power densities much greater than those required by the sensor. The surplus of energy could be used to operate multiple sensors simultaneously, greatly increasing the investigator’s leverage. The technology is easily adaptable to other bio-sensors and has the potential to revolutionize the biomedical field.

Drawing from the notion of governance through collaboration, this study aims to understand how the term partnership is used in the academic literature and whether the concerned partners are aware of its characteristics. Furthermore, the study intends to compare the opportunities with the difficulties of this specific collaboration in order to examine its success rate. Considerable discussions on the topic of IOP as a way of collaboration, has influenced politics in Sweden in recent years. The emphasis has been on how the public sector can best utilize the expert knowledge of the idea-driven organizations. This makes it relevant to discuss how these idea-driven organizations can be developed and how they can establish their existence in the public sector. To study how these can be developed, Mörth &amp; Sahlin's and Guy Peter's distinctions of what characterizes partnership has been applied. This is to know whether or not this partnership has a theoretical foundation, which the results of the conducted interviews confirmed that it had. Another factor that can help the development of idea-driven organizations is to know what opportunities and difficulties they may face. Conclusions showed that the major difficulties that could risk this collaboration were: differences in purposes, time limitations and the balance between authority to act independently and the account for responsibility. The first two had been successfully eliminated through the design of the IOP model and only the last one remained a risk. However, despite this remaining difficulty, there are several possibilities that could argue for the success of the partnership. These opportunities were: The positive influence of the outside world, the legitimacy gained through the approval from principal levels and the trust between the concerned parties. Through the conducted interviews, it can be concluded that the collaborators are well acquainted with the implications of partnership as they are depicted in the academic literature. Furthermore, by comparing the difficulties and opportunities of this collaboration, we can detect that many of the potential difficulties have been eliminated through the design of the collaboration model IOP. In addition, the presented opportunities constitute a substantial basis for success.

Syfte: Syftet med studien var att ta reda på om non contact tonometern Topcon TRK-2P med justerat IOP kan kompensera för den extra tjockleken som fås av en kontaktlins på ögat. Kan maskinen fortfarande ge ett överensstämmande resultat jämfört med IOP utan en kontaktlins på ögat? Metod: 30 personer deltog och medelvärdet på åldern var 24,1 ± 6,9 år. Studien började med en undersökning av ögats hälsa. Därefter mättes högra ögats IOP via en reboundtonometer (iCare ic100), sedan den centrala korneala tjockleken med hjälp av Sirius. Efter detta mättes IOP samt pachymetri igen men nu via non contact tonometern (Topcon TRK-2P). Dessa mätningar upprepades sedan för fyra olika styrkor på kontaktlinser. Linsen var en sfärisk Comflicon A korttidslins med styrkorna Sf -6,00 D, Sf -3,00 D, Sf +3,00 D och Sf +6,00 D. Resultat: De justerade IOP-värdena erhållna av Topcon TRK-2P gav statistiskt signifikanta lägre IOP-värden för alla kontaktlinser jämfört med IOP-värdet utan kontaktlinser (P&lt;0,01). De ojusterade IOP-värdena erhållna av Topcon TRK-2P gav lägre IOP-värden för Sf -3,00 D och Sf -6,00 D och högre IOP-värden för Sf +3,00 D och Sf +6,00 D jämfört med IOP-värdet utan kontaktlins (P&lt;0,01). Justerade IOP-värden erhållna av iCare satt i Ehlers formel i Sirius gav relativt överensstämmande resultat för Sf -6,00 D och Sf +6,00 D, men visade statistiskt signifikanta lägre IOP-värden för Sf -3,00 D och Sf +3,00 jämfört med IOP-värdet utan kontaktlinser (P&lt;0,01). Medan ojusterade IOP-värden erhållna av iCare gav överensstämmande resultat för alla kontaktlinser förutom för Sf +6,00 D (P&lt;0,01), där ett statistiskt signifikant högre IOP-värde sågs jämfört med IOP-värdet utan kontaktlinser. Slutsats: Topcon TRK-2P ger inte överensstämmande resultat för det justerade IOP-värdet med kontaktlinser på ögat, och bör därför inte användas vid tryckmätning över kontaktlinser.

Idea-born – public partnership (IPP) is a state-initiated form of cooperation that are supposed to make it easier for civil society to cooperate with the public sector to solve complex social problems. The study explores how municipalities organize collaboration through IPP and examine opportunities and obstacles with the form of collaboration. Theoretically, the study is guided by concepts from Emerson et al' (2012) model of collaborative governance. The study adopts a qualitative research strategy, and the material was collected from semi-structured interviews with people who work in both the public and idea-based sectors. The results of the study show that the interaction through IPP is complex. There is no predetermined template – IPP becomes what the parties make it. Since there is no uniform definition, there is also no given organization. The parties establish the organization deemed necessary to achieve the purpose of the collaboration. IPP can be preceded by time- and resource consuming processes or be a fast track to collaboration. Likewise, the IPP organization differs in terms of incentives for collaboration, number of participating parties, duration, steering groups, meeting frequency, meeting constellations and personnel administration. The study also shows that the respondents experience following opportunities with IOP; the actors complement each other; share and maximize resources and that the municipality can employ coordinators who are responsible for the IPP work. The obstacles appear to be inadequate procedural and institutional arrangements; lack of knowledge; insufficient dialogue and that trust is damaged by the voice function of civil society.

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