Abstract Malignancy Associated Changes are subtle alterations in the morphology and nuclear texture of cells in the vicinity of a malignant lesion. The phenomenon was first described in 1959, and has been the subject of considerable research in the four intervening decades, due to its potential utility to cancer screening programs. In this thesis the history of research into malignancy associated changes is reviewed, and the major findings of previous workers summarized. Original work aimed at improving the accuracy of classification of Pap smear slides is described in detail. A novel algorithm, which incorporates a genetic algorithm for feature selection and training of a neural network, is described. The algorithm was tested upon a large artificial dataset consisting of points from nested spheres in multiple dimensions. It was able to select the most discriminatory features and classify data with 99% accuracy on 80% of runs for two dimensional data, and on 90% of runs for three-dimensional data. The algorithm was also tested on two real data sets from the UCI Machine Learning Repository, the “sonar” data and the “ionosphere” data. On both of these datasets the algorithm produced a classifier using a subset of features which performed as well as previously reported classifiers using the full feature set. This algorithm was then tested on a large dataset of cell images, and its performance compared with that of the standard stepwise linear discriminant analysis approach. Both of these approaches produced similar results, which are comparable to those of previous workers in this field. Interestingly, runs of the genetic algorithm with different random number seeds tended to select different feature subsets, which produced approximately equivalent performance. This finding indicates that amongst the features used, which were selected from those previously identified in the literature as useful for MACs detection, many subsets exist which are equally discriminatory.

Η πρόληψη του καρκίνου του τραχήλου της μήτρας (ΚΤΜ) αποτελεί κυρίαρχη συνιστώσα της φροντίδας υγείας των γυναικών. Απαραίτητη προϋπόθεση για την πρόληψη του συγκεκριμένου καρκίνου είναι η εκτίμηση αναγκών υγείας του γυναικείου πληθυσμού, ιδιαίτερα στην Ελλάδα. Ο ΚΤΜ είναι κακοήθη νεοπλάσματα του τραχήλου της μήτρας ή του τραχήλου της περιοχής. Το τεστ Παπανικολάου μπορεί να εντοπίσει ενδεχομένως προκαρκινικές αλλαγές. Η θεραπεία των υψηλού βαθμού αλλαγών μπορεί να εμποδίσει την ανάπτυξη του καρκίνου. Στις ανεπτυγμένες χώρες, η διαδεδομένη χρήση των προγραμμάτων προσυμπτωματικού ελέγχου του τραχήλου της μήτρας έχει μειώσει την επίπτωση της διεισδυτικής του τραχήλου της μήτρας κατά 50% ή και περισσότερο. Μετά από μελέτες που διήρκησαν μία 20ετία αποδείχθηκε ότι υπάρχει αιτιολογική σχέση μεταξύ ΚΤΜ και του Ιού Ανθρωπίνων Θηλωμάτων. Ο Ιός των Ανθρωπίνων Θηλωμάτων είναι μέλος οικογένειας ιών που είναι ικανή να μολύνει. Τα εμβόλια κατά του HPV (Gardasil και Cervarix) εμποδίζoυν τη μόλυνση από τους HPV τύπους (16 και 18) που προκαλούν το 70% του ΚΤΜ και μπορούν να οδηγήσουν και σε περαιτέρω μειώσεις. Το εμβόλιο Gardasil ( Merck & Co ) είναι ένα εμβόλιο που έχει αποδειχθεί ότι αποτρέπει ορισμένους τύπους του ιού του HPV, ειδικότερα τους τύπους 16, 18, 6, και 11. Οι HPV τύποι 16 και 18 υπολογίζεται ότι προκαλούν το 70% του ΚΤΜ και είναι υπεύθυνες και για τον καρκίνο πρωκτού , του αιδοίου , του κόλπου και του πέους. Οι τύποι 6 και 11, υπολογίζεται ότι προκαλούν το 90% των περιπτώσεων των γεννητικών κονδυλωμάτων . Το Gardasil προλαμβάνει λοιμώξεις του ιού HPV, αλλά δεν αντιμετωπίζει υπάρχουσα λοίμωξη. Ως εκ τούτου, για να είναι αποτελεσματικός ο εμβολιασμός, πρέπει να δοθεί πριν από τη λοίμωξη. Το Cervarix (GlaxoSmithKline) είναι ένα εμβόλιο κατά ορισμένων μορφών καρκίνου που προκαλεί ο HPV. Το Cervarix έχει σχεδιαστεί για την πρόληψη της λοίμωξης από τους HPV τύπους 16 και 18, που προκαλούν περίπου το 70% του ΚΤΜ. Αυτοί οι τύποι επίσης μπορεί να προκαλέσουν και κάποια άλλα είδη καρκίνων, όπως των γεννητικών οργάνων και ορισμένων στοματοφαρυγγικών καρκίνων. Επιπλέον, κάποια διασταυρούμενη αντίδραση προστασίας από στελέχη του ιού 45 και 31 έχει αποδειχθεί σε κλινικές δοκιμές με τη χρήση του Cervarix. Σκοπός της παρούσας εργασίας είναι η εκτίμηση αναγκών υγείας για την πρόληψη του ΚΤΜ στο γυναικείο πληθυσμό που διαμένει στην Πάτρα και στον Πύργο. Επιμέρους στόχοι είναι η καταγραφή της συμμετοχής των γυναικών στον εμβολιασμό κατά του ΚΤΜ και η διερεύνηση παραγόντων που επηρεάζουν τη συμμετοχή τους. Ο σχεδιασμός ολοκληρωμένου προγράμματος πρόληψης με τον εμβολιασμό κατά του ΚΤΜ είναι εφικτός και βασίζεται στην εχέμυθη σχέση ασθενούς και γιατρού. / The prevention of cervical cancer constitutes a main component of women’s health care. A necessary precondition for this prevention is the health needs assessment of the female population, especially in Greece. Cervical cancer is malignant neoplasm of the cervix uteri or cervical area. Pap smear screening can identify potentially precancerous changes. Treatment of high grade changes can prevent the development of cancer. In developed countries, the widespread use of cervical screening programs has reduced the incidence of invasive cervical cancer by 50% or more. Human papillomavirus (HPV) infection is a necessary factor in the development of almost all cases of cervical cancer. After 20 years studies, the relationship between cervical cancer and human papillomavirus (HPV) was proved. A HPV is a member of the papillomavirus family of viruses that is capable of infecting humans. HPV vaccines (Cervarix and Gardasil), which prevent infection with the HPV types (16 and 18) that cause 70% of cervical cancer, may lead to further decreases. Gardasil (Merck & Co.) is a vaccine proven to prevent certain types of human papillomavirus (HPV), specifically HPV types 16, 18, 6, and 11. HPV types 16 and 18 cause an estimated 70% of cervical cancers and are responsible for many anal, vulvar, vaginal, and penile cancer cases. HPV types 6 and 11 cause an estimated 90% of genital warts cases. Gardasil prevents HPV infections, but does not treat existing infection. Therefore, to be effective it must be given before HPV infection occurs. Cervarix is manufactured by GlaxoSmithKline. It is a vaccine against certain types of cancer-causing human papillomavirus (HPV). Cervarix is designed to prevent infection from HPV types 16 and 18 that cause about 70% of cervical cancer cases. These types also cause some other genital cancers and some oropharyngeal cancers. Additionally, some cross-reactive protection against virus strains 45 and 31 were shown in clinical trials. The purpose of this study is to assess health needs for cervical cancer prevention concerning the female population living in Patras and Pyrgos. Partial purposes are: to record women’s participation in HPV vaccines and look into the factors that affect this participation. The planning of a preventive project concerning HPV vaccines is feasible and is based on a perfect relationship and trust between patient and doctor.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-11-22T19:37:02Z No. of bitstreams: 1 KarlaGeaneDeOliveira_TESE.pdf: 3227760 bytes, checksum: 056ba0932fd2f9f765081b698f1bcb0f (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-11-22T22:36:02Z (GMT) No. of bitstreams: 1 KarlaGeaneDeOliveira_TESE.pdf: 3227760 bytes, checksum: 056ba0932fd2f9f765081b698f1bcb0f (MD5) / Made available in DSpace on 2017-11-22T22:36:02Z (GMT). No. of bitstreams: 1 KarlaGeaneDeOliveira_TESE.pdf: 3227760 bytes, checksum: 056ba0932fd2f9f765081b698f1bcb0f (MD5) Previous issue date: 2017-08-11 / A figura feminina ? um dos participantes essenciais nos textos do jornal O PORVIR (1926-1929). Esta tese apresenta um estudo das representa??es textual-discursivas dessa figura. O trabalho parte do princ?pio de que as representa??es textual-discursivas s?o atividades de textualiza??o operacionalizadas nos e pelos textos e interpretadas semanticamente. O quadro geral que orienta a pesquisa ? o da An?lise Textual dos Discursos, uma abordagem te?rica e descritiva do campo da Lingu?stica Textual proposta por Adam (2011), focalizando o conceito de representa??o discursiva. O presente estudo traz a no??o de representa??o textual-discursiva a partir da interlocu??o entre os trabalhos de Adam (1999, 2008, 2011) e os de Grize (1996, 1997). O estudo parte da hip?tese geral de que todo texto (re)constr?i representa??es textual-discursivas, pelo menos em tr?s inst?ncias, quais sejam: do enunciador, do coenunciador e dos temas tratados, e que n?o se trata de rela??es diretas e simples. Al?m disso, ? o interpretante quem reconstr?i essas representa??es textual-discursivas, a partir dos enunciados, por conseguinte, das esquematiza??es, textualizados por interm?dio de estrat?gias lingu?sticas diferentes, em fun??o de um projeto de dizer do enunciador na constru??o de sentidos do texto, incluindo as modifica??es progressivas de um referente que n?o apenas retomam mas tamb?m instauram (re)categoriza??es desse objeto de discurso na continuidade textual. O objetivo ? examinar as representa??es textual-discursivas da figura feminina em textos do jornal O PORVIR (1926-1929). A metodologia consiste em uma pesquisa documental, de m?todos mistos, com uma estrat?gia de investiga??o concomitante (CRESWELL, 2010). Os dados s?o uma colet?nea de 10 textos selecionados nesse peri?dico. Para a an?lise dessas representa??es textual-discursivas, este estudo utiliza opera??es de textualiza??o espec?ficas: referencia??o, modifica??o da referencia??o, predica??o, modifica??o da predica??o e conex?o. Os resultados apontam diferentes representa??es textual-discursivas da figura feminina, entre elas, como m?e, no ambiente da vida familiar. Essa representa??o textual-discursiva mais abrangente evidencia duas perspectivas distintas na continuidade textual, quais sejam: a m?e rom?ntica, idealizada, mais pr?xima dos pap?is protot?picos da figura da m?e j? instaurados socialmente; e a agente social, respons?vel pela forma??o da fam?lia e pela prepara??o dos sujeitos para constituir a sociedade. A figura feminina, como mulher em uma perspectiva ampla, aparece em sua forma rom?ntica, idealizada e tamb?m inserida no ?mbito religioso. A representa??o textual-discursiva da figura feminina, de outro modo, tem por base o seu contexto geogr?fico e a perspectiva negativa dessa figura, a partir da qual recebe qualifica??o com atributos depreciativos. Ademais, h?, ainda, representa??es textual-discursivas da figura feminina relacionadas ? faixa et?ria, ao comportamento feminino e aos processos de tornar-se eleitora, conquistando o direito ao voto. Esses processos conjecturam representa??es textual-discursivas da figura feminina quanto ? sua emancipa??o e cidadania, vivendo a transi??o para a vida p?blica. Trata-se de representa??es textual-discursivas (re)constru?das consoante cadeias referenciais complexas, instauradas segundo estrat?gias lingu?sticas diferentes. Os processos de (re)constru??o dessas representa??es textual-discursivas surgem na continuidade textual e dizem respeito aos recursos de constru??o de sentidos do texto. Al?m disso, as estrat?gias lingu?sticas de introdu??o e de retomada do referente afetam a complexidade das representa??es textual-discursivas operacionalizadas. As recategoriza??es (re)constroem representa??es textual-discursivas da figura feminina mais complexas, as quais caracterizam/qualificam de forma peculiar o objeto de discurso. Esse comportamento lingu?stico n?o ocorre com frequ?ncia com os casos de designa??o imediata ou tardia desse objeto nos dados analisados, uma vez que, (re)constroem representa??es textual-discursivas da figura feminina que a perspectivam de forma mais generalizada. As retomadas do objeto de discurso no texto t?m origem em v?rios tipos de processos de referencia??o, quais sejam: an?foras resumidoras, an?foras associativas, an?foras pronominais e an?foras especificadoras. As an?foras pronominais t?m grande recorr?ncia, corroborando a manuten??o de representa??es textual-discursivas da figura feminina no processamento da unidade texto. Concernente ?s predica??es, a figura feminina preenche pap?is sem?nticos de agente, paciente e experienciador. As conex?es operam representa??es textual-discursivas dessa figura a partir do estabelecimento de diferentes rela??es sem?nticas entre as unidades textuais. / The female figure is one of the most essential participants in the texts of the newspaper O Porvir (1926-1929). This thesis presents a study of the textual-discoursive representations of that figure, considering that they are textualization activities operationalized in the texts and by the texts, whilst being semantically interpreted. The Textual Discourse Analysis is the general framework that serves as guideline for this research, a theoretical and descriptive approach to text linguistics proposed by Adam (2011) that focuses on the concept of discoursive representations. The current study concerns the notion of textual-discoursive representation according to the dialogue between the works of Adam (1999, 2008, 2011) and Grize (1996, 1997). This study is grounded on the general hypothesis that every text (re)constructs textual-discoursive representations in at least three levels, consisting of the enunciator, the co-enunciator and of concerned topics, as well as on the fact that these do not establish simple and straightforward relationships. Moreover, it is the interpreter who reconstructs these textual-discoursive representations, according to utterances and, subsequently, its schematizations, where they are textualized having different linguistic strategies as mediator and while being subject to the project of utterance of the enunciator in the construction of the meanings of the text, which includes progressive modifications regarding a referent that does not only refer to (re)categorizations of a given discourse object, but that also implement them in the textual continuity. This research aims to examine the textual-discoursive representations of the female figure in the texts of the newspaper O PORVIR (1926-1929). The methodology consists of documental techniques of mixed methods, following a concurrent research strategy (CRESWELL, 2010). The data are a collection of 10 selected texts from the above-mentioned newspaper. In order to pursue an analysis of these textual-discoursive representations, the current study utilizes specific textualization operations: referral, modification of the referral, predication, modification of the predication, and connection. The results indicate that there are several textual-discoursive representations of the female figure, among which that of the mother in a domestic context. That wider textual-discoursive representation brings to evidence two distinct perspectives in textual continuity, i. e., the romantic mother, idealized and closer to the prototypical roles of the motherly figure established in the society; and the social agent, responsible for the welfare of the family and for preparing the individuals for social life. The female figure, the woman in a broader perspective, appears in her romantic form, idealized and also integrated to a religious landscape. She is represented, otherwise, by being based on her geographical context and on a negative perspective, according to which she is qualified with depreciative attributes. Besides, there are, still, textual-discoursive representations of the female figure related to her age group, to the female behavior and to the women?s suffrage processes, where they come to win the right to vote. Such processes conceive textual-discoursive representations regarding the female figure in relation to her emancipation and civil rights, witnessing the transition towards public life. It concerns textual-discoursive representations (re)constructed in consonance to complex referential chains, implemented according to diverse linguistic strategies. The (re)construction processes of these textual-discoursive representations arise from the textual continuity and refer to resources of construction of meaning within the text. Moreover, the linguistic strategies for the introduction and resumption of the referent in the texts affect the complexity in the operationalized textual-discoursive representations. The re-categorizations re(construct) the textual-discoursive representations of the more complex feminine figures, characterizing/qualifying the object of the discourse in a peculiar manner. Such a linguistic behavior does not occur frequently in the cases of immediate or late designation of that object in the analyzed data, since they re(construct) textual-discoursive representations of the female figure in a broader perspective. The resumption of the object of discourse in the text has its source in several types of referral processes, i. e., resumptive, associative, pronominal and specialized anaphora. Pronominal anaphora occurs in high frequency, confirming the maintenance of textual-discoursive representations of the female figure in the processing of the text-unit. Regarding the predications, the female figure takes on the semantic roles of the agent, the subject and the experiencer. The connections operate textual-discoursive representations of that figure according to the establishment of different semantic relationships among textual units.

O objetivo geral dessa pesquisa é demonstrar como uma Associação de Mulheres em uma entidade religiosa pode proporcionar um local favorável para a realização de educação em saúde com a finalidade de proporcionar conhecimento em um ambiente seguro vinculando a ação individual e coletiva de busca de vivências que melhore a saúde das mulheres e combatendo uma doença que no Brasil é a terceira causa de morte feminina em território nacional segundo o Ministério da Saúde. As associações de mulheres em entidades religiosas possuem estatutos próprios que estabelecem as diretrizes a serem seguidas pelas as mulheres. Através de um conhecimento prévio do estatuto das Associações de Mulheres em entidades religiosas, do Programa Atenção Integral a Saúde da Mulher (PAISM), conhecimento das Leis do Sistema Único de Saúde (SUS) e do programa de prevenção do câncer de colo uterino, os profissionais da saúde responsáveis por promover promoção, prevenção e reabilitação poderão ter um local propicio onde as mulheres de forma individual e coletiva se sintam seguras para obter conhecimento, estabelecer metas e realizar ações de promoção e prevenção para o Câncer de Colo Uterino e a superação das barreiras enfrentadas pelas mulheres na realização do exame citopatológico. A hipótese do trabalho é que os profissionais de saúde que trabalham com educação permanente em saúde podem e devem utilizar o ambiente religioso para realizar promoção, prevenção e reabilitação de todas as politicas de saúde preconizadas pelo Programa Atenção Integral a Saúde da Mulher. Trata-se de uma pesquisa qualitativa baseada no estudo fenomenológico-hermenêutico direcionado ao método de analise de estudos teóricos, documentos e textos. O fenômeno foi descrito pelo método descritivo através da escolha do tema, levantamento bibliográfico, formatação do problema, formulação das hipóteses, ficha de leitura do material e fichamento, delimitação da pesquisa, coleta de dados, discussão e conclusão. A pesquisa foi delineada através da analise do estatuto da Sociedade de Socorro que é uma associação de mulheres de A Igreja de Jesus Cristo dos Santos dos últimos Dias conjuntamente com uma analise das politicas do SUS do PAISM e do programa de promoção e prevenção do câncer de colo uterino vigente em território brasileiro. Uma associação de mulheres em uma entidade religiosa possui um extraordinário trabalho, estabelecendo como propósito dessa organização de mulheres preparadas para as bênçãos da vida eterna, ajudando-as a aumentar sua fé e retidão pessoal, fortalecer a família e o lar, e auxiliar os necessitados. A educação em saúde nesses locais fortalecerá os princípios do SUS e a melhoria na condição de saúde das mulheres como proposito primordial. O cumprimento desse propósito se dará por meio de aulas proporcionadas pelos profissionais de saúdes e reforçada nas aulas do evangelho aos domingos e de outras reuniões, do trabalho de professoras visitantes, do serviço de bem-estar e do serviço de solidariedade. Sendo assim, venho advogar pela inclusão ou manutenção da educação permanente em saúde nas associações de mulheres nas mais diversas religiões. / The overall goal of this research is to demonstrate how an Association of Women in a religious entity may provide a favorable location for conducting health education with the purpose of providing knowledge in a safe environment while linking individual action and collective research experience that improves women's health and fighting a disease in Brazil that is the third leading cause of death of women in the country according to the Ministry of Health. Women's associations in religious bodies have their own statutes that establish the guidelines to be followed by the women. Through a prior knowledge of the status in Womens Associations in religious entities, the Comprehensive Care Program for Women's Health (CCPWH), knowledge of the Laws of the Unified Health System (UHS) and the program for prevention of cervical cancer, the professionals responsible for promoting health promotion, prevention and rehabilitation may have a conducive place where women individually and collectively feel safe to obtain knowledge, set goals, and achieve promotion and prevention for cervical cancer and overcome barriers faced by women in the Pap smear testing. The hypothesis of the study is that health professionals who work with continuing health education can and must use this environment to perform religious promotion, prevention and rehabilitation of all health policies advocated by the CCPWH. This is a qualitative research study based on hermeneutic-phenomenological directed method for analysis of theoretical studies, documents and texts. The phenomenon was described by the descriptive method for choosing the topic, bibliography, formatting the problem, formulating hypotheses, form reading and cataloging the material, delimitation of the research, data collection, discussion and conclusion. This research was designed through analyzing the status of the Relief Society, the association for women of The Church of Jesus Christ of Latter-day Saints, in conjunction with an analysis of the policies of the UHS with the CCPWH a program for promotion and cervical cancer prevention currently in force in Brazil. An association of women in a religious entity has an extraordinary work; establishing the purpose of this organization of women prepared for the blessings of eternal life by helping them to increase their faith and personal righteousness, strengthen families and homes, and help the needy. Health education in these locations will strengthen the principles of the UHS and improve the health status of women as a primary purpose. The fulfillment of this purpose will be through classes offered by health professionals and enhanced gospel classes on Sundays and other meetings, also through visiting teaching, welfare service, and compassionate service to the poor and needy. Therefore, come advocate for inclusion or maintenance of continuing health education in women's associations in various religions.

Aim: The aim of this thesis was to investigate experiences of receiving notification of an abnormal Pap smear result and its impact on women’s health-related quality of life as well as to investigate women’s awareness of human papillomavirus.   Methods: In total, 176 women and 20 healthcare professionals participated. Data were collected through individual interviews (I, II) and a questionnaire (IV) including the instrument Functional Assessment of Chronic Illness Therapy – Cervical Dysplasia (FACIT-CD) and Hospital Anxiety and Depression Scale (HADS). For the translation and cross-cultural adaptation of the FACIT-CD, and for evaluation of its linguistic validity and reliability, cognitive debriefing interviews and a questionnaire consisting of the Swedish instrument FACIT-CD was used. Data were analysed by content analysis (I, II) and by using statistical analysis (III, IV), while one part (III) was analysed according to FACIT translation methodology.     Results: Women receiving notification of an abnormal Pap smear result have good overall HRQoL; they become anxious but not depressed. Reasons for anxiety were mainly that women misinterpreted the result as cancer, which could lead to lower attendance for further investigation, treatment and follow-up. To cope with the anxiety, women sought emotional support and information. They primarily used the Internet for information but also turned to healthcare professionals for information needs. Moreover, women had low awareness of HPV, its sexually transmitted nature, and its relationship to abnormal Pap smear results and cervical cancer. An awareness of HPV as a sexually transmitted infection did not lead to higher level of anxiety or more depression symptoms or worse HRQoL, compared to not being aware. Finally, the Swedish FACIT-CD is equivalent to the English version and linguistically valid and exhibited good internal consistency reliability.   Conclusion: Women have low awareness of HPV and abnormal Pap smear results, whereupon they misinterpret their test result as cancer. It is of importance that women understand their test result, in order to minimise anxiety as well as to maintain high attendance for investigation, treatment and follow-up of abnormalities.

Bakgrund: Hälso- och sjukvårdens personal har till uppgift att arbeta sjukdoms-förebyggande, genom att ge information och råd till patienter med otillräcklig fysisk aktivitet. Förskrivningen av FaR är fortfarande låg trots att det i dag är många som är stillasittande. Fysisk aktivitet på recept, FaR har under flera år funnits som arbetsverktyg och är en bra metod för att öka den fysiska aktiviteten. Syfte: Syftet är att kartlägga distriktssköterskornas och sjuksköterskornas arbete med och inställningar till fysisk aktivitet på recept, FaR. Metod: Enkätstudie på vårdcentraler i Västmanlands län. Analysen utförs med en ansats av mixad metod där numeriska data bearbetas via kvantitativ design och textdata med en kvalitativ ansats Resultat: Det framkom i resultatet att de flesta distriktsköterskorna och sjuksköterskorna hade en positiv inställning till FaR, dock saknades tid, kunskap och resurser för att förskriva FaR. Hälften av distriktssköterskorna och sjuksköterskorna har förskrivit FaR under det senaste året och 98% rekommenderade fysisk aktivet utan att förskriva FaR. Slutsats: Hälso- och sjukvården i Sverige måste fortsätta implementeringsarbetet med att förespråka och möjliggöra förskrivning av FaR genom att se över organisationen angående resurser, rutiner och riktlinjer för hur arbetet med FaR ska gå framåt. Fokus behöver sättas på utbildning, både i grundutbildningen och fortbildning. / Background: The healthcare personnel have the task of working with disease prevention by providing information and advice to patients with insufficient physical activity. The prescription of FaR is still low, although today there are many who are sedentary. Physical activity on prescription, FaR has been used as a tool for many years and is a good method for increasing physical activity. Aim: The aim is to map nurses work with and attitude towards physical activity on prescription, PaP. Method: Surveillance study at health centers in Västmanland County. The analysis is performed using a mixed-mode approach where numerical data is processed through quantitative design and text data with a qualitative approach Results: In the result it was found that most district nurses and nurses had a positive attitude towards FaR, but there was insufficient, knowledge and resources to prescribe FaR. Half of district nurses and nurses have prescribed FaR over the past year and 98% recommended physical activity without prescribing FaR. Conclusion: Healthcare in Sweden must continue its implementation efforts to advocate and enable prescription of FaR by reviewing the organization regarding resources, routines and guidelines for how the work on FaR will go forward. Focus must be placed on education, both in undergraduate and continuing education.

Abstrakt Introduktion: Fysisk aktivitet har positiva effekter på hälsan och bidrar även till primär och sekundär prevention av flera olika sjukdomar. Fysisk aktivitet på recept (FaR) är en individanpassad metod som innebär förskrivning av fysisk aktivitet i hälsofrämjande syfte. Uppsatsens syfte är att kartlägga och beskriva eventuella skillnader i FaR-förskrivningar och uppföljningar mellan kön, yrkesgrupper och områden inom primärvården Region Västerbotten. Metod: Datainsamlingen kommer från primärvården i Region Västerbotten och består av strukturerade sökord i journalanteckningar angivna av vårdpersonal mellan 2014–2020. Statistiska tester som användes var Chi-2 test för könsskillnader mellan journalförda sökord och Mann-Whitney-U-test för skillnader mellan större och mindre kommuner. Signifikansnivå för samtliga tester var α<0,05. Resultat: Under perioden 2014-2019 så skrevs 33 871 journalförda sökord för Otillräckligt fysiskt aktiva och 13 380 journalförda sökord för FaR. Kvinnor förskrivs fler FaR än män (p<0,001), män uppnår oftare rekommendationerna för fysisk aktivitet efter FaR-förskrivning (p<0,001) och män deltar på fler uppföljningsbesök 2019 (p<0,01). Fysioterapeuter förskriver flest FaR (73,1%). Det var ingen signifikant skillnad i antal FaR-förskrivningar mellan mindre och större kommuner i Västerbotten utifrån antal listade patienter per hälsocentral (p>0,05). Konklusion: Denna uppsats visar att det finns skillnader i FaR-förskrivningar mellan kön och professioner inom primärvården i Västerbotten och att det finns utvecklingspotential för att FaR ska bli en effektivare metod att använda i primärvården för en förbättrad folkhälsa i Västerbotten. Nyckelord: FaR, hälsa, sjukvård, prevention, folkhälsa / Abstract Introduction: Physical activity has positive health benefits and works as a primary and secondary prevention toward different types of diseases. Physical activity on prescription (PAP) is an individualized method that is used to prescribe physical activity for health promotion purposes. This essay will investigate and describe potential differences in PAPprescriptions between genders, professions and health centers in primary care in Region Västerbotten in Sweden. Method: The data was collected between 2014-2020 and contains structured keywords in journal notes given by health care professionals in primary care in Region Västerbotten. The statistical tests used in this essay were Chi-2 test for gender differences between keywords in journal notes and Mann-Whitney-U-test to look at differences between larger and smaller municipalities. The significance level was α<0,05. Results: During the period 2014-2019 33 781 keywords in journal notes were written for Insufficient physically active and 13 380 keywords in journal notes were written for PAP. Women are prescribed PAP more often (p<0,001), men reach the guidelines for physical activity more often after a PAP prescription (p<0,001) and participate more on follow ups 2019 (p<0,01). Most of the PAP:s in primary health care 2019 are prescribed by physiotherapists (73,1%). There are no statistical differences in the amount of PAP prescriptions between smaller and larger municipalities in Västerbotten related to registered patients per health center (p>0,05). Conclusion: This essay concludes that there are differences in PAP-prescription between genders and professions in primary care in Västerbotten and that PAP has the development potential to become a more efficient method in primary care for an improved public health in Västerbotten. Key words: PAP, health, health care, prevention, public health

Title: The force toning in women's softball Objectives: The aim of this study was to demonstrate post-activation potentiation (PAP) following the muscle toning during the strenght training. The toning effect on upper limb explosive force was analyzed following application of two different degrees of resistence. Methods: In this study, we applied randomized selection for the subject to minimize the effect of possible ambiguities such as gender, training status, and player maturity. A homo- -geneous group of well-trained women with the most developed technical response was accepted. (Czech national team, Women's softball). We used the contrast method, where the data were analyzed to determine the effect of different resistance degrees and a fixed rest interval for the strength-dynamic exercise. It is a sticking out of medicine ball in sitting position, which was performed by women of the highest player level. The measurement was processed by using the direct method of dynamic efforts. We compared the explosive force with a medicine ball sticking forward in relation to the distance of the sticking medicine ball by the tested person. Results: The measurement has shown that the PAP generated by toning protocol has a sig- -nificant impact on enhancing the response in explosive drills. The exercise for...

In the thesis "Electoral Authoritarianism in Comparative Perspective of Southeast Asia", while analyzing for cases of regime survival and fall, author develops the argument that certain subtypes of authoritarian regimes are better build to cope with change than others. Since the four cases are under new institutionalism generally classified as electoral authoritarianism, the text depicts some of the methodological problems related to this particular research perspective. Building on the systems approach and new institutionalism, the thesis analyzes the relation between institutional character of regime elite and its ability to cope with changes in the environment, i.e. adaptability. Author shows that at the time of crisis, personalistic regimes tend to react almost solely with repression a restrictions, whereas regimes with ruling parties exhibit a substantial degree of personal and policy flexibility, which positively informs their chances for survival. The conclusion also demonstrates the methodological weaknesses of regime typology based on the quality of electoral process. It diverts the attention from other features of regimes which significantly inform logic and inner dynamics of authoritarianism. As a result, under the banner of electoral authoritarianism, there are regimes which differ from each...

Assuring production forms a crucial part of mining business profitability. Factors related to various mine operations, activities and business processes can threaten required/planned mine production. To address problems and ensure production level in mining, it is necessary to implement a mine production assurance program (MPA). Since such a guideline does not exist for mining as a process industry, this study started by reviewing four such techniques used in similar industries. These methods include: total productive maintenance, six sigma, a method prescribed by European foundation of quality management, and production assurance program (PAP) used in the oil and gas industry.These methods and techniques were reviewed according to their objectives and applications. Their implementation and achieved success was determined through a literature review and field participation/study. Comparing the tools, techniques and focus with mining productivity and production factors, it was observed that applicability of these methods for mining is limited due to a lack of tools for specific analysis or a lack of consideration of the requirements of mining. However, given certain similarities in objective and methods, PAP from the oil and gas industry may provide some guidance for MPA.As a basis of MPA, an index is required to create a clear relationship between different situations which can occur in mining operation and production loss. A literature review on mining productivity improvement methods shows availability, utilisation and production performance of equipment are the key factors in determining overall production. A single index applicable for chain operation in mining is needed. Overall equipment effectiveness (OEE) which includes these three elements has some limitations for application in mining. A Mine Production index (MPi) is thus proposed. This index involves all three parameters for equipment productivity mentioned above. It also consists of weights for each parameter. The weights in this study are determined through expert opinions/judgements using fuzzy analytical hierarchy process (FAHP). Equipment with low MPi can be labelled as bottlenecks. Weights associated with MPi calculation for bottleneck equipment can point out critical factors in equipment operation. Once bottleneck equipment and relevant critical factors are known, further analysis can be carried out to determine the exact cause of production loss.By using MPi for machine operations, it is possible to rank machines in terms of production effectiveness. When the study applied MPi to chain operations in a mining case study, a crusher was determined as bottleneck equipment. Further root cause analysis and uncertainty detection for bottleneck equipment is also possible, and this forms the basis for MPA. / CAMM - Lean mining