Globally the domestic worker sector is characterised by a sense of “voicelessness”—an esoteric silence fuelled by a dire need to survive. South Africa is heralded as a global ambassador for the rights of these women. Significant sectoral reforms in recent years regulate the transactional element of this employment relationship through stipulated minimum wages and employment standards. The relational element of this engagement, however, remains underexplored. A decade of global scholarship detailing the hardships that characterise this sector has helped to uncover the plight of domestic workers. The study provided the participants with an opportunity to express their experiences and feelings, and the documented findings will hopefully stimulate more scholarly debate on this issue. It is hoped that the study will engender more sensitivity towards the needs of this vulnerable group of workers and promote positive employment relations within the South African labour market. The study describes the lived realities of domestic workers within the South African labour legislative context through five separate but interrelated journal articles. Article 1 provides a detailed “plan of action” that documents the initial considerations and rationale for the study. Guided by existing scholarly discourse, the research questions are highlighted and the proposed research design is presented. Issues related to trustworthiness are debated. This article constitutes the research proposal that was submitted during the initial phase of this research journey. Article 2 presents a transparent account of the methodological considerations that guided the co-construction of meaning within the South African domestic worker sector. Situated within the interpretivist paradigm, with phenomenology as theoretical underpinning, purposive respondent-driven self-sampling resulted in the recruitment of 20 female participants. All of them can be described as domestic workers in terms of Sectoral Determination 7. The pilot study indicated the value of using metaphors while exploring tentative topics. An interview guide facilitated the exploration of key concepts during our engagement. Rich, dense descriptive verbatim accounts of participants’ lived realities confirmed data saturation. In-depth interviews were transcribed and analysed through an inductive process of data reduction. Emanating themes confirmed that the South African domestic workers sector is far from being voiceless if we are only willing to listen. Making these voices heard constitutes a progressive step in future efforts to empower this neglected sector of the labour market. In article 3 a life-cycle approach is used to explore participants’ lived experiences of their work-life cycle. Each individual progresses through these various phases which are contextualised as a transitional process as a result of their unique circumstances and personal trajectory. Findings confirmed the existence of an institutionalised culture of engagement within the sector perpetuated from one generation to the next. Attempts to exit the sector are unsuccessful due in part to their limited formal education and skills repertoire. The article concludes with the notion that domestic workers are trapped within a never-ending cycle of sectoral engagement, and the possibility of exiting the sector remains “but a dream” for many. Article 4 focusses on the reciprocal interpersonal relatedness that often develops due to the prolonged engagement within the individualised sectoral employment context. Characterised by caring and connectedness, this mutually dignified treatment not only signals but also enhances human flourishing. Participants’ accounts of relational reciprocity are indicative of the enactment of cardinal Ubuntu principles within the employment context. The need for actions that surpass the “letter of the law” in order to enhance flourishing within the South African domestic worker sector is advocated. Article 5 explores the role that legislative awareness fulfils in the everyday lives of domestic workers. Findings indicated that empowerment was an unknown construct for all participants. The participants had little or no confidence in engaging their employers on employment issues; this was due in part to their limited legislative awareness. Domestic workers should thus take ownership of their own empowerment efforts. This will sanction their right to assert their expectations of employment standards with confidence and make use of the judicial system to bring about compliant action. The article concluded with the notion that legislative awareness can result in empowered actions though informed employee voices. / PhD (Labour Relations Management), North-West University, Vaal Triangle Campus, 2014

Background: Pelvic floor muscle (PFM) training is recommended as first line conservative management for stress urinary incontinence (SUI). The fundamental issue of how to optimally contract the PFM has not previously been investigated. An effective voluntary PFM contraction is known to positively influence the bladder neck and urethra which are urethrovesical (UV) structures associated with continence. The PFM may be globally or selectively contracted according to cue to instruction. The main research question was to investigate which cue to instruction for a PFM contraction has the potential to optimise position of UVSs following a brief period of practice in continent nulliparous pre-menopausal women (aiming to provide normative data) and parous menopausal women with previously unreported SUI. Hypotheses: Posterior or combined cues for instruction of PFM contraction are more influential in optimising UV position (UVP) during PFMC following brief practice than an anterior cue. Posterior or combined cues are equally influential in altering UVP. Aims: Preliminary aim was to investigate the reliability and suitability of 2-DRTUS and angle of urethral inclination (AUI) for imaging of selective contraction of the PFM and ease of reading images by a non diagnostic imaging researcher. Principal aim was to investigate if there is an optimal cue to instruction for a PFM contraction in two groups of women. Study 1: pre menopausal nulliparous continent women (to provide normative data) and Study 2: post menopausal parous stress incontinent women. Secondary aims were investigation of posture; ability to selectively contract the PFM contraction; and cue preference. Method: Study 1: Twenty women who were able to effectively and selectively contract were taught the following cues: anterior; posterior; anterior and posterior combined. Following 4 weeks of practice, perineal 2-D RTUS images of three PFMC for each cue were captured in supine and standing twice (for repeatability analysis) five minutes apart. Two raters measured AUI. Data analysis was undertaken using a Customized General Linear Model (GLM) ANOVA with Bonferroni correction for interactions between all variables; subject, cue, posture and test. Seventeen data sets were available for analysis. Study 2: Methodology was based on Study 1. Twenty-one women were taught the study cues, followed the practice protocol and underwent data collection in the supine position. Twenty-one sets of data were available for analysis. Results: Reliability: ICC [1,3] for intra rater reliability was 0.957 [CI 95%: 0.946 to 0.967 p=0.000], inter rater reliability [2,1] 0.820 [CI 95%: 0.768 to 0.861] and for repeatability [1,3] 0.781 [CI 95%: 0.690 to 0.849 p=0.000] (continent) and 0.954 [CI 95%:0.931 to 0.971 p=0.000] (incontinent). Principal results Study 1: anterior vs posterior cues (difference) 3.979˚ (CI 95%: [0.503 to 7.455 p=0.021]); anterior vs combined 3.777˚ (CI 95%: [-0.099 to 6.853 p= 0.059]) posterior vs combined cues -0.602˚ (CI 95%: [-2.874- 4.078 p=1.00]). Aggregated data from tests 1 and 2: anterior vs posterior 4.240° (CI 95%: [1.213 to 7.267 p=0.003]); anterior vs posterior 3.756° (95%CI: [0.729 to 6.783 p=0.009]); posterior vs combined-6.48° (95% CI: [-3.511 to 2.542 p=1.000]). Principal results Study 2: anterior vs posterior 3.936˚ (95%CI: [0.863 to 7.008p=0.008]; 4.946˚ anterior vs combined (95%CI: [1.873 to 8.018 p=0.001]); posterior vs combined 1.010° (95%CI: -[2.062 to 4.082 p=1.000]). Aggregated analysis was anterior vs posterior 3.703˚ (95%CI: [1.639 to 5.761 p=0.000]); anterior vs combined 5.089˚ (95%CI: [3.0287 to 7.1503 p=0.000]) and posterior and combined 1.389° (95%CI: [-0.672 to 3.450 p=0.309]). Secondary results: 2-D RTUS and the AUI were found to be suitable for investigating selective PFM contraction. Posture: supine vs standing (difference) 9.496˚ (p=0.000); (posture did not affect absolute AUI). Three continent (13%) and 2 incontinent (7%) subjects were unable to selectively contract the PFM. Cue preference in both studies was posterior or combined. Conclusions: AUI was significantly narrower/optimal when instruction for PFM contraction included a posterior cue, in both continent and stress incontinent women. This is proposed to be due to optimal recruitment of puborectalis. Puborectalis may be more important in urinary continence than widely recognized. This study has provided seminal information with respect to optimal cue to contraction for a PFM contraction and will change practice. Investigation of the potential impact of these findings clinically is required. It is proposed that further understanding will lead to standardisation of PFM instruction, ease of comparability between PFM research studies, and will clarify PFM instructions for the media and lay public.

IT-projekt misslyckas ofta för att de blir sena och dyrare än planerat, och i många fall är det tidsfaktorn som är begränsande för projekten. Det existerar många olika programspråk och behov att dela konstruktioner mellan dessa. Idag använder applikationer inom samma system ofta olika terminologi och behovet av konverteringar uppkommer. Det existerar standardiserade språk som till exempel märkspråket XML men då organisationer väljer att skapa sin egen syntax för att formatera publiceringar kan ett motstånd urskiljas. Uppsatsen kan användas som underlag för vidare forskning inom programspråk. Denna studie fokuserar på att jämföra om val av syntax har någon betydelse för tidsåtgången vid uppmärkning av dokument. Den valda forskningsstrategin är experiment. En pilotstudie utfördes och med resultatet från studien gjordes en hypotesprövning i form av ett t-test. Analysen av resultatet antydde att användandet av valfri syntax implicerade en mindre tidsåtgång vid uppmärkning av dokument än vid användandet av XML. Från analysen konstateras det att ämnet bör undersökas vidare och att studien bör genomföras i större omfattning. / IT projects often fail because they are late and more expensive than planned, and in many cases it is the time factor that is limiting for projects. There exist many different programming languages and the need to share structures between them. Applications within the same system often uses different terminology and the need for conversions occurs. Standardized languages such as XML exist but when organizations choose to create their own syntax for formatting publications instead a resistance can be distinguished. The paper can be used as basis for further research in the area of programming languages. This research focuses on comparing if the choice of syntax affects expenditure of time when marking document. The selected research strategy is experiment. A pilot study has been done and based on the results of the study a hypothesis testing (t-test) was made. The analysis of the results indicated that the use of optional syntax implied that less time was spent at marking document than the use of XML. The conclusion from this was that this area should be further explored and that the study should be done on a larger scale.

Introdução: A população confinada é um segmento exposto a certas situações que aumentam sua vulnerabilidade frente às doenças sexualmente transmissíveis. Infecções pelo HIV, hepatites B e C e sífilis encontram no sistema prisional um ambiente favorável às suas propagações. Estudos em população confinada são cercados de entraves tanto burocráticos como relacionados com a ética e segurança. Assim, assume grande importância um estudo - piloto para, entre outras coisas, identificar pontos prós e contras que possam surgir durante a execução do estudo principal. Objetivo: Desenvolver um estudo piloto para uma pesquisa sobre fatores de risco comportamentais referentes à contaminação pelas infecções pelo HIV, hepatites B e C e sífilis numa população carcerária. Métodos: Estudo epidemiológico transversal. Em julho de 2007, numa amostra de conveniência, 107 reeducandos foram estrevistados usando um questionário padrão e tecnica face-face. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do HCFMUSP. Resultados: Foram realizadas todas as etapas planejadas, a saber: Reuniões na unidade: entre a direção e diversas equipes da unidade prisional; Convite aos participantes: contato com representantes dos reeducandos; Assinatura do TCLE: após formalização do convite à participação do estudo e Aplicação do questionário. Realizadas reuniões sistemáticas para ajuste do questionário. Feita a capacitação de entrevistadores. Elaborado um banco de dados no Microsoft Office para receber os dados por meio de dupla digitação. Foram entrevistados 16,5% da população da unidade. Apresentaram um perfil jovem com média de 31,1 anos de idade. O tempo médio de prisão foi de 18,7 meses. A idade média de início de uso de drogas legais foi de 14,7 e ilegais de 16,6 anos. Após o confinamento, houve redução no consumo de drogas e sem relatado de droga injetável no presídio. 55,1% realizaram tatuagem na prisão. 41,2% relataram ocorrência de DST na vida e 34,0% no ultimo mês, 2,5% referiram serem soropositivos para o HIV. 53,8% mantiveram o numero de relações sexuais após o confinamento e dos 28,6% que faziam uso sistemático de preservativos, 26,3% mantiveram esta freqüência no presídio. Envolvidos com agressões: 78,5% verbais e 65,1% físicas, sendo que 33,6% referiram ameaças de morte. Maconha, álcool e crack foram as drogas envolvidas nestas situações. Discussão: O estudo piloto possibilitou testar o instrumento de pesquisa, sua aplicabilidade e capacidade de identificar fatores de riscos para transmissão das infecções citadas, tanto fora quanto dentro do ambiente prisional. O treinamento dos entrevistadores favoreceu tanto a familiarização com o instrumento, quanto o contato adequado ético e seguro - com os reeducandos. A vivência com esta realidade contribuiu para mapear pontos vulneráveis do planejamento para a execução do estudo principal. Limites do estudo: As análises e a obtenção da sorologia não faziam parte do estudo piloto, postergadas para o estudo principal com amostra adequada. Questionários, quando utilizados como instrumento de coleta, podem apresentar problemas relacionados com as informações obtidas. Muitas delas podem não condizer com a realidade, tanto de forma proposital viés de informação quanto de forma não proposital viés de memória. / Introduction: Confined populations are exposed to circumstances that increase their vulnerability to sexually transmitted infections. HIV, hepatitis B and C, and syphilis, encounter at the prison system an environment favorable to their dissemination. Studies in confined populations are surrounded by bureaucratic, ethical and security barriers. Thus, a pilot study is of great importance -for identify obstacles and opportunities that may arise during the implementation of the main study. Objective: implementation of a pilot study on risk behaviors associated to the dissemination of HIV, hepatitis B and C, and syphilis in an incarcerated population. Methods: Cross Sectional study. In July of 2007, in a convenience sample, 107 prisoners were interviewed, face to face, using a standardized questioner. The study was approved by the Human Subject Committee of the Hospital das Clinicas of the School of Medicine from the University of Sao Paulo. Results: the research protocol was strict followed: institutional meetings of the direction and the different professional teams of the prison system; invitation to participants in close contact with prisoners representatives; signature of the consenting forms after the invitation and before the questionnaire was applied. Meetings were conducted to adjust the questionnaire. Interviewers were trained. A dataset using Microsoft Office was elaborated to allow insertion of the data collected. Subjects represented 16, 5% of the prison population. Participants were young, average of 31, 1 years of age. The length time in prison was 18, 7 months in average. The average of the initiation in the use of legal drugs was 14, 7 and illegal drugs 16, 6 years of age. After the arrestment there was a diminishment of the use of drugs, and no injection of drugs was reported. Tattoo inside of the prison was reported by 55, 1%. STI were reported by 41, 2% in life and by 34% in the last month, and 2, 5% reported to be HIV positive. 53, 8% maintained the same amount of sexual relation that they had outside of the prison. From the 28, 6% that regularly used condoms, 26, 3 regularly used inside of the prison too. Interviewed that were involved in aggression were 78, 5% verbal and 65, 1% physic, and 33, 6% refereed being threatened of dead. Marijuana, Alcohol and crack were the drugs involved in such circumstances. Discussion: The pilot study has tested the instrument of research, its applicability and ability to identify risk factors for transmission of the mentioned infections, both within or outside of the prison. The training of interviewers favored both the familiarity with the instrument, as the appropriate contact secure and ethical - with inmates. The experience with this reality has contributed to map vulnerabilities in the implementation of the main study. Limitations of the study: serology and analysis were not part of the pilot study, therefore postponed for the main study with adequate sample. Questionnaires may present problems with the information obtained. Many of the information may not match the reality; both, information or memory biases could be identified.

Introduction: Chronic orofacial pain (COFP) is distressing and disabling to sufferers and can be costly to patients, health services and society. Frequently, no underlying medical pathology can be found to account for the condition. Despite this, patients are treated according to a biomedical model, often by mechanistic and invasive procedures, which tend to be unsuccessful and not evidence based. Evidence suggests that cognitive behavioural therapy (CBT) based management may produce improved outcomes for patients. However, published studies can tell us little about which intervention components are effective, or recommend an optimum way for these components to be applied. Aim: To develop an evidence based intervention for the management of COFP that is feasible and acceptable to patients and practitioners. Method: The Medical Research Council’s guidelines for developing complex interventions were used as a framework for the research. Evidence from multiple sources was synthesised to produce the draft components of an intervention to manage COFP. An exploratory trial investigated preliminary outcomes, acceptability, feasibility and explored parameters for a full scale randomised control trial. Results: The intervention was acceptable to participants and could be feasibly implemented. No conclusions could be drawn relating to the effectiveness of the intervention. Participants were not affected at baseline for a number of outcomes, which implies that cut off points should be introduced into the inclusion and exclusion criteria of any future studies. Conclusion: The study produced an intervention which is acceptable and feasible to participants, however it is not known if it is effective. A number of recommendations are made for progression to a larger, definitive trial.

Cette thèse est basée sur le constat du manque d’activité physique (AP) chez les adolescents : environ 80% de cette tranche d’âge n’atteint pas les 60min quotidiennes recommandées. Cette situation aux conséquences sanitaires importantes, impacte davantage les jeunes les plus vulnérables comme les adolescents obèses et ceux issus de familles de position sociale et économique défavorisée. Deux études visant à promouvoir l’AP auprès de ces publics ont été menées : des mesures objectives de l’AP avant, pendant et après des interventions ont été réalisées dans deux contextes de prise en charge différents. L’objectif de la première étude était de tester la faisabilité et l’impact d’un programme d’AP à destination d’adolescents issus de milieux défavorisés en impliquant également un de leur parent. 18 parents et 22 adolescents ont participé au programme 1 parent – 1 ado. Il comportait deux fois deux heures d’AP par semaine pendant onze semaines pour chacun des groupes participants. Les niveaux d’AP ainsi que plusieurs paramètres anthropométriques, physiologiques et psychologiques ont été recueillis. Tous les participants ont suivi les onze semaines d’intervention. Les analyses ont montré que le seuil de 60 min d’AP quotidienne était atteint, uniquement pendant la durée du programme pour les adolescents. Celui de 30 min pour les parents l’était à tous les temps de mesures. Des analyses complémentaires ont révélé 1) des effets de la prise en charge sur l’AP modulés par l'âge chez les adolescents et par l'assiduité chez les parents, 2) une diminution de l’amotivation pour les adolescents les plus assidus et 3) une augmentation du bien-être pour les adolescents. Les résultats de cette étude pilote ont mis en évidence la faisabilité et l'efficacité d'un tel programme qui pourrait maintenant être déployé sous la forme d'un essai randomisé incluant un groupe contrôle.L’objectif de la deuxième étude était de tester les effets d’une prise en charge pluridisciplinaire de 10 mois sur l’indice de masse corporelle (IMC) et les niveaux d’AP d’adolescents obèses (21 garçons et 41 filles âgés de 14 ans avec un IMC de 33 kg/m²) dans un centre de Soins de Suite et de Réadaptation (SSR). Le rôle modulateur du climat parental et de la motivation de l’adolescent sur l’efficacité de la prise en charge a été évalué. Les résultats indiquent un effet positif de la prise en charge avec une diminution de l’IMC et une augmentation de l’AP au cours de la cure et quatre mois après. De type curvilinéaire, la perte de poids est forte en début de cure puis se stabilise à la fin. Le climat parental semble jouer un rôle facilitateur lors de cette amélioration, notamment par le père, lorsqu’il est perçu comme étant plus chaleureux, plus impliqué et soutenant davantage l’autonomie. Ces programmes de promotion de l’AP génèrent des résultats prometteurs sur les niveaux d’AP des adolescents. Cependant, l’étude des déterminants du maintien des changements obtenus pendant les interventions doit être poursuivie. / This thesis is based on the observation of the lack of physical activity (PA) in adolescents: approximately 80% of this age group does not reach the recommended daily 60 minutes. This situation and its important health consequences, has a greater impact on the most vulnerable young people, such as obese adolescents and those from socioeconomically disadvantaged families. Two studies aiming at promoting PA to these audiences were conducted: objective measures of PA before, during and after interventions were performed in two different PA program settings.The goal of the first study was to test the feasibility and the impact of a PA program for adolescents from disadvantaged backgrounds. For each adolescent, one of their parents was also involved. Thus, 18 parents and 22 adolescents participated in the “1 parent - 1 adolescent” program. Two hours of PA twice a week during eleven weeks were proposed for each of the participating groups. PA levels and several anthropometric, physiological and psychological parameters were collected. All participants followed the eleven weeks of intervention. The analyzes showed that the daily 60-min AP threshold was reached only during the program for adolescents. The daily 30 min for parents was reached at all measurements times of. Additional analyzes revealed 1) that program efficacy on PA level was modulated by age for adolescents and by attendance rate for parents, 2) a decreased of amotivation for the most assiduous adolescents, and 3) an increase in well-being for adolescents. The results of this pilot study highlighted the feasibility and effectiveness of such a program, which could now be deployed in the form of a randomized trial including a control group.The goal of the second study was to test the effects of 10-month multidisciplinary residential weight reduction program on body mass index (BMI) and PA levels of obese adolescents (21 boys and 41 girls aged 14 years with a BMI of 33 kg / m²). The modulating role of parental climate and motivation of the adolescent on the effectiveness of the care was evaluated. The results indicated a positive effect of the program with a decrease in BMI and an increase in PA during the course of treatment and four months after. With a curvilinear shape, the weight loss was strong at the beginning of the cure and then stabilized at the end. The parental climate seemed to play a facilitating role in this improvement, especially by the father, when he was perceived as being warmer, more involved and more supportive of autonomy. These PA promotion programs generate promising results on adolescent PA levels. However, the study of the determinants of the maintenance of changes during interventions must be continued.

Introdução: A população confinada é um segmento exposto a certas situações que aumentam sua vulnerabilidade frente às doenças sexualmente transmissíveis. Infecções pelo HIV, hepatites B e C e sífilis encontram no sistema prisional um ambiente favorável às suas propagações. Estudos em população confinada são cercados de entraves tanto burocráticos como relacionados com a ética e segurança. Assim, assume grande importância um estudo - piloto para, entre outras coisas, identificar pontos prós e contras que possam surgir durante a execução do estudo principal. Objetivo: Desenvolver um estudo piloto para uma pesquisa sobre fatores de risco comportamentais referentes à contaminação pelas infecções pelo HIV, hepatites B e C e sífilis numa população carcerária. Métodos: Estudo epidemiológico transversal. Em julho de 2007, numa amostra de conveniência, 107 reeducandos foram estrevistados usando um questionário padrão e tecnica face-face. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do HCFMUSP. Resultados: Foram realizadas todas as etapas planejadas, a saber: Reuniões na unidade: entre a direção e diversas equipes da unidade prisional; Convite aos participantes: contato com representantes dos reeducandos; Assinatura do TCLE: após formalização do convite à participação do estudo e Aplicação do questionário. Realizadas reuniões sistemáticas para ajuste do questionário. Feita a capacitação de entrevistadores. Elaborado um banco de dados no Microsoft Office para receber os dados por meio de dupla digitação. Foram entrevistados 16,5% da população da unidade. Apresentaram um perfil jovem com média de 31,1 anos de idade. O tempo médio de prisão foi de 18,7 meses. A idade média de início de uso de drogas legais foi de 14,7 e ilegais de 16,6 anos. Após o confinamento, houve redução no consumo de drogas e sem relatado de droga injetável no presídio. 55,1% realizaram tatuagem na prisão. 41,2% relataram ocorrência de DST na vida e 34,0% no ultimo mês, 2,5% referiram serem soropositivos para o HIV. 53,8% mantiveram o numero de relações sexuais após o confinamento e dos 28,6% que faziam uso sistemático de preservativos, 26,3% mantiveram esta freqüência no presídio. Envolvidos com agressões: 78,5% verbais e 65,1% físicas, sendo que 33,6% referiram ameaças de morte. Maconha, álcool e crack foram as drogas envolvidas nestas situações. Discussão: O estudo piloto possibilitou testar o instrumento de pesquisa, sua aplicabilidade e capacidade de identificar fatores de riscos para transmissão das infecções citadas, tanto fora quanto dentro do ambiente prisional. O treinamento dos entrevistadores favoreceu tanto a familiarização com o instrumento, quanto o contato adequado ético e seguro - com os reeducandos. A vivência com esta realidade contribuiu para mapear pontos vulneráveis do planejamento para a execução do estudo principal. Limites do estudo: As análises e a obtenção da sorologia não faziam parte do estudo piloto, postergadas para o estudo principal com amostra adequada. Questionários, quando utilizados como instrumento de coleta, podem apresentar problemas relacionados com as informações obtidas. Muitas delas podem não condizer com a realidade, tanto de forma proposital viés de informação quanto de forma não proposital viés de memória. / Introduction: Confined populations are exposed to circumstances that increase their vulnerability to sexually transmitted infections. HIV, hepatitis B and C, and syphilis, encounter at the prison system an environment favorable to their dissemination. Studies in confined populations are surrounded by bureaucratic, ethical and security barriers. Thus, a pilot study is of great importance -for identify obstacles and opportunities that may arise during the implementation of the main study. Objective: implementation of a pilot study on risk behaviors associated to the dissemination of HIV, hepatitis B and C, and syphilis in an incarcerated population. Methods: Cross Sectional study. In July of 2007, in a convenience sample, 107 prisoners were interviewed, face to face, using a standardized questioner. The study was approved by the Human Subject Committee of the Hospital das Clinicas of the School of Medicine from the University of Sao Paulo. Results: the research protocol was strict followed: institutional meetings of the direction and the different professional teams of the prison system; invitation to participants in close contact with prisoners representatives; signature of the consenting forms after the invitation and before the questionnaire was applied. Meetings were conducted to adjust the questionnaire. Interviewers were trained. A dataset using Microsoft Office was elaborated to allow insertion of the data collected. Subjects represented 16, 5% of the prison population. Participants were young, average of 31, 1 years of age. The length time in prison was 18, 7 months in average. The average of the initiation in the use of legal drugs was 14, 7 and illegal drugs 16, 6 years of age. After the arrestment there was a diminishment of the use of drugs, and no injection of drugs was reported. Tattoo inside of the prison was reported by 55, 1%. STI were reported by 41, 2% in life and by 34% in the last month, and 2, 5% reported to be HIV positive. 53, 8% maintained the same amount of sexual relation that they had outside of the prison. From the 28, 6% that regularly used condoms, 26, 3 regularly used inside of the prison too. Interviewed that were involved in aggression were 78, 5% verbal and 65, 1% physic, and 33, 6% refereed being threatened of dead. Marijuana, Alcohol and crack were the drugs involved in such circumstances. Discussion: The pilot study has tested the instrument of research, its applicability and ability to identify risk factors for transmission of the mentioned infections, both within or outside of the prison. The training of interviewers favored both the familiarity with the instrument, as the appropriate contact secure and ethical - with inmates. The experience with this reality has contributed to map vulnerabilities in the implementation of the main study. Limitations of the study: serology and analysis were not part of the pilot study, therefore postponed for the main study with adequate sample. Questionnaires may present problems with the information obtained. Many of the information may not match the reality; both, information or memory biases could be identified.

Bakgrunden till denna studie är framdragningen av kustjärnvägen Norrbotniabanan mellan Umeå och Luleå med stationslägen i bland annat Skellefteå och Piteå. Järnvägen är en miljövänlig transportlösning för gods men också för persontransporter, som bidrar till att binda samman hela kustlandet. När nya infrastruktursatsningar ska genomföras föregås de av ingående utredningar. De ska klargöras när, var och hur satsningen ska genomföras och av vem. Finansieringen av projektet är också en viktig fråga, är det privata aktörer eller är det samhället som ska betala. Är det samhället som ska finansiera projektet är det av stor vikt att klargöra om effekterna av åtgärden är samhällsekonomiskt hållbara. Dessa infrastruktursatsningar blir ofta identifierade som riksintressen. Tolkningen av riksintressenas överlägsna ställning vid mark- och vattenanvändningsplanering gör att det infaller ett investeringsvakuum direkt Trafikverket identifierat ett infrastrukturprojekt som är av rikets intresse för kommunikationer. Syftet med denna studie är att utreda de konsekvenser som en framdragning av viktig infrastruktur som Norrbotniabanan har på tätortsutvecklingen under utredningsarbetet av projekten och svara på följande frågeställningar: <ol type="1">  Vad innebär järnvägsutredningar för tätortsutvecklingen före byggstarten av järnvägen? <ul type="disc"><ul type="disc">Vilka är de negativa konsekvenserna för den kommunala tätortsutvecklingen av utredningsarbetet? Vilka är de positiva konsekvenserna för den kommunala tätortsutvecklingen av utredningsarbetet? <ol type="1">Hur kan de negativa konsekvenserna av en järnvägsutredning minimeras? Hur kan de positiva konsekvenserna av en järnvägsutredning tillvartas? För att svara på frågeställningarna har en abduktiv ansats med kvalitativa metoder använts i denna studie. En systematisk litteraturstudie har kompletterats med semistrukturerade intervjuer. För att ytterligare fördjupa förståelsen har en Planstudie genomförts av Piteå kommuns översiktsplan samt påverkade detaljplaner. De viktigaste slutsatserna av denna studie är att utredningskorridoren för Norrbotniabanan har påverkat tätortsutvecklingen i Piteå kommun negativt. Hur stora de negativa konsekvenserna varit är svårt att konkretisera. De negativa konsekvenserna som framkommit av studien är bland annat: Skapar osäkerhet, med allt vad det innebär av uteblivna investeringar i verksamheter men också bostadsbyggande. Förbättringsåtgärder försvåras på befintliga anläggningar. Påverkar fastighetsmarknaden negativt då försäljningar uteblir. Skapar planeringssvårigheter, eftersom alternativa lägen ofta måste väljas. Påverkar tillgången på etableringsbar mark i kommunen. Verksamhetsmarken i kommunen är slut och önskvärda etableringslägen för bostäder i centrum påverkas. En positiv konsekvens av utredningsarbetet för Norrbotniabanan är att det planeras för en regionsammankopplande järnväg. / The background to this study is the development of the Norrbotniabanan coastal railway between Umeå and Luleå with including stations in Skellefteå and Piteå. The railroad is an environmentally friendly solution for goods but also for passenger transport, which helps to tie together the entire coastal region. When new infrastructure initiatives are to be implemented, they are preceded by in-depth investigations. It has to be clarified when and how the investment will be carried out and by whom. Financing the project is also an important issue, is it private actors or is the society going to pay. If the society is financing the project, it is important to clarify whether the impact of the measure is socio-economic. These infrastructure initiatives are often identified as national interests. The interpretation of the supreme position of national interest in land and water use planning makes it an investment vacuum area directly The Swedish Transport Administration (Trafikverket) has identified an infrastructure project that is of the public interest in communications. The purpose of this study is to investigate the impact of a project on important infrastructure like Norrbotniabanan has on urban development during the investigation of the project and answer the following questions. What do railway investigations mean for urban development before the construction of the railway? What are the negative consequences for the municipal urban development of the investigations? What are the positive consequences for the municipal urban development of the investigations? How can the negative impact of a railway investigation be minimized? How can the positive consequences of a railway investigation be improved? To answer the questions an abductive approach whit qualitative method has been used in this study. A systematic literature study has been supplemented with semi structured interviews. To further deepen the understanding, a Plane study has been conducted by Piteå municipality's overview plan and affected detailed plans. The main conclusions of this study are that the investigation corridor for Norrbotniabanan has negatively affected urban development in Piteå municipality. How big the negative consequences have been is difficult to concretize. The negative consequences identified by the study include: • Creates uncertainty, with all that it means of missing investments in businesses but also housing construction. Improvement measures are made difficult at existing facilities. Have effects on the property market in the municipality, due to missing house sales. • Creates planning difficulties, because alternative modes often have to be selected. Have effects on the availability of plannable land in the municipality. The industrial in the municipalities have ended and desirable establishments for housing in the center are affected. A positive consequence of the investigations work for the Norrbotniabanan railway is that it is planned for a regional connecting railway.

Objective Although avoidant/restrictive food intake disorder (ARFID) has been included as a new diagnostic entity of childhood feeding and eating disorders, there is a lack of measures to reliably and validly assess ARFID. In addition, virtually nothing is known about clinical characteristics of ARFID in nonclinical samples. Method The present study presents the development and validation of an ARFID module for the child and parent version of the Eating Disorder Examination (EDE) in a nonclinical sample of N = 39 children between 8 and 13 years with underweight and/or restrictive eating behaviors. For evaluating the ARFID module's reliability, the convergence of diagnoses between two independent raters and between the child and parent module was determined. The module's validity was evaluated based on the full-length child version of the EDE, a 24 h food record, parent-reported psychosocial functioning and self-reported quality of life, and objective anthropometric measures. Results In total, n = 7 children received an ARFID diagnosis. The ARFID module showed high interrater reliability, especially for the parent version, and high convergence between child and parent report. Evidence for the module's convergent, divergent, and discriminant validity was provided. Specifically, children with versus without ARFID reported significantly less macro- and micronutrient intake and were more likely to be underweight. Discussion This pilot study indicates the child and parent version of the EDE ARFID module to be promising for diagnosing ARFID in a structured way but still necessitates a validation in a larger clinical and community-based sample.

I denna studie ett förslag till validering av föräldraskattningsformuläret SCDI-III baserad på en genomförd pilotstudie. Studiens syfte är att undersöka hur väl föräldrars och förskolepedagogers skattning av deltagande barns språkförmåga med skattningsinstrumentet SCDI-III överensstämmer med resultaten av ett test som studieförfattarna utformade. Testmaterialet speglar direkt de frågor som ställs till vårdnadshavarna och förskolepedagoger i SCDI-III.  Tio barn i åldersgruppen 2;5–3;10 år med svenska som starkaste språk, tio vårdnadshavare och tio förskolepedagoger deltog i studien. Studieförfattarna utformade ett eget testmaterial som i så hög grad som möjligt speglar frågeställningarna i föräldraskattsformuläret SCDI-III. Bildbenämning användes för ordförrådsdelen och BUSS-sagan användes för bedömning av meningskomplexitet och meningsbyggnad. Testningen av sju av barnen utfördes i det digitala mötesrummet Zoom och tre barn testades delvis på förskolan. Vårdnadshavarna och förskolepedagogerna fyllde i föräldraskattningsformuläret SCDI-III, varefter resultaten jämfördes.   Resultatet visade generellt på en hög överensstämmelse mellan samtliga bedömargrupper. Det förelåg endast små skillnader mellan grupperna och dessa var förutom två ord (“förstå” och “dum”) inte statistiskt signifikanta.   Slutsatsen var att deltagande vårdnadshavare och förskolepedagoger kunde skatta barnens språkliga förmåga i hög utsträckning. Studiens resultat pekar därmed på att föräldraskattningen SCDI-III kan vara värdefull som kompletterande information gällande barnets språkliga förmåga. Förslag på hur en större valideringsstudie kan genomföras diskuteras. / In the present study, a suggestion is provided of how the parent report instrument, The Swedish Communicative Development Inventories (SCDI-III) can be validated. The suggestion is based on a conducted pilot study. The purpose of the study is to investigate how well parents and preschool teachers assessment of participating children’s language ability with the assessment instrument SCDI-III corresponds with the results of a test designed by the study authors. The test material directly reflects the questions asked to the guardians and preschool teachers in SCDI-III.  Ten children in the age group 2;5-3;10 years old with Swedish as their strongest language, ten guardians and ten preschool teachers participated in the study. The study authors designed a test material which as closely as possible mirrored the content in the questions asked in the parent report SCDI-III. Picture-naming was used for the vocabulary part and the BUS-story test was used for the assessment of sentence complexity and sentence construction. The screening of seven of the children was performed in the digital meeting room Zoom, and three children were partially tested at the preschool. The guardians and preschool teachers filled in the parent report SCDI-III, and the results were compared.   The results generally showed a high degree of agreement between all the assessment groups. There were only small differences between the groups and these, apart from two words ("understand" and "stupid") were not statistically significant.   The conclusion was that participating guardians and preschool teachers could estimate the children’s language ability to a great extent. The results of the study indicate that the parent report SCDI-III, can be valuable as supplementary information regarding the children’s language ability. Suggestions on how a larger validation study may be carried out are discussed.