A substantial amount of behavioural, genetic, and neurophysiological data suggest that Attention Deficit Hyperactivity Disorder (ADHD) is influenced by an underlying abnormality in the midbrain dopamine system. A previous study found that children with ADHD are unusually sensitive to the salience of rewards, mediated in part by the dopamine system (Holroyd, Baker, Kerns & Mueller, 2008). The current study aimed to replicate and expand upon the previous finding using event-related potentials (ERP) recorded from typically developing children and children with ADHD as they navigated a “virtual T-Maze” in two conditions differing on reward saliency. Children also completed a behavioural task designed to measure decision making and sensitivity to reward and punishment. Both groups of children responded to the behavioural task in a way that is indicative of increased sensitivity to reward. Unlike the previous study, the salience of reward as reflected in the ERP did not have an effect on either children with ADHD or typically developing children. However, both groups displayed a larger error-related negativity (ERN) in the condition presented second.

Background: The high levels of sickness absence and disability pensioning experienced during the 1990's and 2000's have become both socially as well as financially burdensome for society. Sickness absence implies a costly loss of production for society and large groups of individuals are risking to become marginalised on the labour market. Sickness absence is both a public health and an economic problem. Thus from both a human approach as well as from an economic perspective it is urgent to increase knowledge about what influences individual behaviour when it comes to sickness absence and return to work. Objectives: The overall aim of the thesis is to elucidate the decisive factors for explaining sickness absence. Three different aspects of sickness absence were considered, i.e. factors leading to sickness absence, factors preventing sickness absence and factors leading back to work ability and work when being sickness absent. This is done using a frame of reference involving broadly defined areas of work, health and social insurance related factors. Material and methods: Study I analyzes the outcome of unemployed sick-listed individuals. A total of 280 individuals from the county of Värmland were followed through register data between the years 2000 to 2001. Linear and logistic regression models were used to analyze the occurrence of short and long term economic incentives. Study II has a longitudinal design and explores determinants of return to work. Sick-listed individuals with a stress-related psychiatric diagnosis from the county of Värmland were analyzed over a period of three years (2000-2003) using logistic regression. The data comprised 911 individuals. Study III is a cross-sectional study using questionnaire data from the county of Värmland from year 2004. A total of 3123 persons either working or being self employed were analyzed on determinants of work presence through logistic regression. Study IV had a cross-sectional design and used questionnaire data from five counties in central Sweden. The data, from 2004, comprised 10536 individuals being employed, i.e. not self-employed, and with self reported physical and mental medical conditions. Logistic regression was mainly used in the analysis and the focus was on risk factors for long term sickness absence. Study V comprises cross-sectional data retrieved at three separate occasions between 1991 and 1994. It includes 8839 individuals from five counties in western Sweden with sickness absence spells over 60 days. The data was analysed through bi-variate probit regression with a focus on effects of vocational rehabilitation on return to work. Results: The results from study I were interpreted as that both short and long term economic incentives matter for the outcome of sickness absence through the interaction of different insurance systems. The principal findings from study II was that age, gender and factors implying less favourable health characteristics and thereby lower work capacity, reduce probabilities of returning to work after long term sickness absence. Considering study III determinants of work presence were found to vary between sexes and whether the determinants were counteracting long or short term sickness absence. Factors interpreted as job control counteracted short term absence. Sense of coherence was found to be an important determinant of work presence for women. In study IV long term sickness absence was found to be related to the level of ill-health. Moreover it was concluded that work environment factors as job strain, job satisfaction, physical work environment were important factors for explaining sickness absence in a population with impaired health. The results from study V indicated that vocational rehabilitation is a potentially effective instrument for improving the individual's work ability and chances of return to work. That no signs of prioritizing selection of rehabilitation participants to those likely to return to work with or without rehabilitation measures, i.e. "managerial creaming", were found was also considered as important results. Conclusions: This thesis shows that we need different models and approaches to improve knowledge about the various aspects of sickness absence as entry into absence, return to work or into disability retirement. It also has the implications that sickness absence behaviour can be influenced. Largely depending on what long term path is chosen for welfare policy at the political level it should be acknowledged that other means, improving working conditions and promoting rehabilitation rather than reducing benefit levels and narrowing the eligibility criteria for the insurance benefits are at hand.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2005. / Härtill 5 uppsatser.

Stressrelaterad psykisk ohälsa ökar mest och står för den längsta varaktigheten bland sjukskrivningarna. Förändringar i sjukförsäkringssystemet och beslut om att minska sjuktalen har gett konsekvenser som ökat antal avslag om sjukpenning. Syftet med studien var att undersöka erfarenheter av avslag om sjukpenning från Försäkringskassan hos personer med stressrelaterad psykisk ohälsa för att beskriva och förstå vad det får för betydelse för deras sjukdomsbild och återhämtning. Studien är kvalitativ och har genomförts genom semistrukturerade intervjuer med fem personer som drabbats av stressrelaterad psykisk ohälsa och fått avslag om sjukpenning från Försäkringskassan. Materialet som samlats genom intervjuerna har analyserats med Ulrich Becks teorin om risksamhället och Randall Collins teori om symboliska interaktionskedjor samt tidigare forskning. Resultatet i studien indikerar att avslag om sjukpenning påverkar sjukdomsbilden och möjligheten till återhämtning negativt för personer som drabbats av stressrelaterad psykisk ohälsa. Respondenterna upplevde att avslaget förlängt sjukdomstiden, genom minskad möjlighet till återhämtning och förvärrad sjukdomsbild. Resultatet visar även på en samlad bild av upplevelsen av avslaget om sjukpenning från Försäkringskassan. Personerna upplever inte att handläggare på Försäkringskassan tror dem och därmed känner de sig kränkta. / Stress-related disorders have increased and accounts for the longest duration of sick leave. Changes in the health insurance system and decisions to reduce the sick-leave have had consequences such as an increased number of rejection of sickness benefits. The aim of this study was to investigate the experience for people having a stress-related disorder and being rejected sickness benefits from the Social Insurance Fund, to describe and understand the importance for their disease image and recovery. The study is qualitative and has been conducted through semistructured interviews with five participants who suffered from stress-related disorders and received a refusal of sickness benefits from the Social Insurance Fund. The material gathered through the interviews has been analyzed with Ulrich Beck’s theory of risk society and Randall Collin’s theory of symbolic interaction-chains and previous research. The result of this study indicates that the refusal of sickness benefits affects the recovery rate negatively for the participants in the study. The participants felt that the refusal extended the disease time, and they experienced reduced opportunities to recover and a worse diseases image. The result also shows a consistent picture of the experience of receiving a refusal of sickness benefits from the Swedish Social Insurance Agency. The participants do not feel that the case officers at the Social Security Fund believe them and thus they feel offended.

Substance abuse is a relapsing chronic illness. In 2014, an estimated 27 million persons reported using illicit drugs in the United States (SAMHSA, 2014). Substance abuse negatively impacts societies, productivity, healthcare costs and families. Families play an important role in relapse prevention and sobriety. With adequate family support, substance abuse positively responds to treatment. Many individuals (about 66 million Americans) play the role as an informal caregiver for a relative with chronic illnesses such as substance abuse but few studies exist on the caregiving experiences. What we know about the family caregiving experience is restricted to data from quantitative studies which do not explain the complexities and competing challenges that exist. Different approaches are thereby needed to deepen our understanding of the family caregiver burden of living with a relative with substance abuse problems. Such studies will enable us to understand the original experience and moment of learning of a relative’s substance abuse problems, decision making and support that follows thereafter. This moment calls for major decision making and encounter with treatment services. The purpose of this study was to explore the lived experience of caregivers of relatives with alcohol and opiate dependence. This study utilized Max van Manen’s (2014) Phenomenology of Practice. Ten participants (N=10) were recruited for this study. Van Manen’s guided existential inquiry was used in the analysis of experiential material collected through interviews. Four main themes emerged from the data: (1) Being in the moment: the extension of the self; (2) The dawn of reality: the being of acceptance; (3) Deciding in the moment: the healthcare experience; (4) Uncertainties and struggle: a lifelong process. These themes described how the participants: experienced, accepted and processed a relative’s substance abuse problem, encountered treatment services and experienced the uncertainties and struggles involved in caring for a relative with substance abuse problems. Two main findings emerged from these themes; the impact of guilt and stigma on seeking care and the need to see addiction as a disease instead of as a moral character failure. This calls for coalitions with stakeholders to decrease stigma, enhance acceptance process and increase access to treatment.

The European Monitoring Centre for Drugs and Drug Addiction reports that drug-related deaths have almost tripled in Sweden between year 2006 and 2015. The aim of this study is to elucidate in which ways drug-related mortality is produced and conceptualized as a problem within policy discourse by critically analyzing The National Board of Health and Welfare’s policy proposal “Nationellt utvecklingsarbete för att motverka narkotikarelaterad dödlighet” (2017). Using Bacchi’s poststructural approach to policy analysis “What’s the problem represented to be?”, two problem representations are identified, namely that drug-related mortality is conceptualized as a problem with drugs and drug use in general as well as a problem due to lack of knowledge and information. This is based on underlying assumptions that all illegal drug use is hazardous and that the solution to the drug problem can be obtained by objective knowledge production thus leaving both the practice of gaining knowledge as well as current Swedish drug laws unproblematized. The effects are, to name a few, that proposed policies mainly targets “all people who use drugs” with a focus on providing “more of the same” which in extension overrides the group of high-risk drug users along with a structural understanding of drug-related mortality.

Magister Psychologiae - MPsych / The appeal of Allport's Contact Hypothesis lies in the simplicity of its core principle, which holds that contact between different groups may serve to reduce prejudices. Contact needs to meet key conditions, i.e. equal power, cooperation towards a common goal and institutional support. Support has been found for the Contact Hypothesis in its original form and for those contacts which fail to meet the specified conditions. This study sought to explore whether contact, in forms different to those traditionally defined by the Contact Hypothesis, i.e. exposure, had any bearing on group prejudice. The prejudice and its underlying negative attitudes of interest, were those informed by HIV and AIDS stigma. HIV and AIDS stigma, defined as a discrediting quality and informed by social processes, is of particular concern as it impedes prevention, treatment and care efforts in South Africa's response to the HIV and AIDS epidemic. The health care context is often an area where Persons Living with HIV (PLHIV) are confronted with HIV and AIDS stigma. The research aims were thus to explore the extent of HIV and AIDS stigma amongst health care workers, the forms of exposure to PLHIV and the relationship between exposure and HIV and AIDS stigma. A quantitative, survey design was employed to accomplish these aims and to test formulated hypotheses, which were based on current literature and the core principle of the Contact Hypothesis. The sample consisted of 202 health care workers in the Cape Town metropole. Data analyses revealed the existence of low to moderate levels of HIV and AIDS stigma and also found that most of the sample had exposure to PLHIV in either its individual forms or overall form. Bivariate correlations revealed negative relationships between forms of exposure, overall exposure and stigma. / South Africa

The existence of HIV related stigma and discrimination in institutions of learning across the world is well-documented in the literature. It is also well known that factors such as knowledge about stigma and discrimination, fear of infection, social judgment, legal and policy environment act as actionable drivers and facilitators of HIV related stigma and discrimination. However, research works focusing on how various actionable drivers and facilitators are related to different forms of HIV related stigma and discrimination at universities in Nigeria are scanty. The purpose of this study was to explore and describe the individual correlates of HIV-related stigma among undergraduate students at a public university in Nigeria. Methods: Quantitative cross-sectional descriptive design was used. Ethical clearance was obtained from the Research Ethics Committee of the University of South Africa. Permission to access the participants was obtained. The study was conducted at Ambrose Alli University which has a population of over 20,000 students. Informed consent was obtained from the participants. Simple random sampling was used to select 404 participants who were handed self-administered questionnaire. Collected data was analysed using All Pearson Chi-square test and Fishers Exact Test (p<0.05). Validity and reliability were also considered. A total of 391 questionnaires (97%) were returned and considered for analysis. Descriptive summary statistics and cross tabulations were used to analyse The results showed that a high proportion of undergraduate students still have stigmatising behaviours toward people living with HIV. These stigmatising behaviours are associated with certain individual characteristics. Recommendation: There is an urgent need for political leaders and heads of universities to implement policies and programmes that will enhance knowledge regarding HIV AND AIDS and thereby reduce stigmatizing attitudes among undergraduate students. / Health Studies / M.P.H.

Imported diseases are infections that have been acquired during a travel or a stay abroad. Such infectious diseases may include cosmopolitan and potential re-introduction illnesses and tropical and re-emerging illnesses. The movement of populations affects the distribution and spread of communicable diseases globally. Today?s mobility and unnatural interaction of different races or otherwise geographically defined populations facilitate the emergence of contagious diseases in humans, animals or, even in plants. Some pathogens can be imported into a new area by travellers or immigrants in the absence of illness signs or symptoms. Many geographical barriers have now been breached by mobility and migration. The theoretical section of this thesis is mainly aimed to provide a description of the most common imported diseases according to their current epidemiological trends. Travel-related risks, risk groups of travellers and migration characteristics are also mentioned. In addition, it deals with domestic and international inbound and outbound tourism and includes a forecast of international tourism development towards 2030. The conclusion of the theoretical section aims to describe epidemiology of imported diseases and to provide an insight into systems of monitoring and surveillance of travel-related infections, such as GeoSentinel Surveillance Network, EuroTravNet, TropNet and the Czech Nationwide Epidat information system. The objective of this diploma thesis of the empirical section is to carry out an analysis of occurrence of imported infectious diseases in the Region of South Bohemia over the last five years. Data and information recorded into Epidat database from 2007 to 2011 shapes the target group. Methods of research are mainly based on descriptive statistics that describe most of collected data quantitatively. Moreover, seven hypotheses were designed that were tested via results using regression analysis, Pearson's chi-squared test and Student's t-test. A total of 190 cases from 46 world-wide destinations were imported between 2007 and 2011. Of those, 166 were imported by residents; 24 cases were brought in by foreigners. The most frequent countries of acquisition were European destinations (49%; n = 92), Asia (33%; n = 63) and Africa (16%; n = 31). Gastro-intestinal (GI) diseases accounted for 68.4% of illnesses, followed by blood-borne and vector-borne infections. GI conditions included campylobacteriosis (n = 38), salmonellosis (n = 33) and shigellosis (n = 30). Amongst blood-borne diseases, hepatitis B accounted for 21 cases (mainly in Vietnamese). Amongst vector-borne illnesses, 6 cases of malaria and 1 case of dengue were identified. Hypothesis H1 (further described only as H2, etcetera) "There is an association between numbers of travellers and occurrence of imported infectious diseases" was rejected. H2 "There is a different incidence rate among countries of acquisition" could not be confirmed because of the lack of the denominator data (numbers of travellers to specific destinations). H3 "The most frequent countries of acquisition are European countries" was confirmed and accepted. H4 "The highest rate of imported infectious diseases is in the České Budějovice District" was confirmed and accepted. H5 "The most frequent imported infections are gastro-intestinal diseases" was confirmed and accepted. H6 "There is a descending tendency of occurrence of imported infectious diseases" was rejected. H7 "There is a higher likelihood of presenting with a vaccination preventable disease in unvaccinated returned travellers" could not be confirmed due to the lack of data.

Les activités humaines produisent des eaux usées dont le traitement génère des boues d’épuration urbaines. Ces boues font l’objet de recherches visant à les transformer en produits à forte valeur ajoutée. Elles pourraient ainsi passer d’un statut de déchet fatal au statut de coproduit attendu à l’issue de l’épuration des eaux. Ce changement de paradigme a des conséquences sur l’évaluation environnementale par Analyse du Cycle de Vie (ACV) des produits « boue-sourcés ». La boue devient un coproduit attendu de la station de traitement des eaux et la charge environnementale liée à leur production doit pouvoir être répartie entre coproduits au moyen d’un facteur d’allocation. Cette thèse propose une construction mathématique de ce facteur d’allocation en combinant des paramètres « procédés » et « produits », intégrant de facto les relations causales entre conduite du procédé et obtention des produits, reflétant la réalité technologique du procédé. La résultante se présente sous la forme d’une matrice dont chaque élément associe, pour chaque donnée d’inventaire, un facteur d’allocation à chacun des coproduits générés. Appliquée à la production de fertilisants phosphatés boue-sourcés, l’ACV réalisée a permis de mettre en lumière la contribution majeure de l’étape de production par rapport aux étapes de traitement et valorisation de la boue. Cette méthodologie de construction d’un facteur d’allocation permet toutefois d’attribuer une charge environnementale à chacun des coproduits d’un système de production indivisible et peut également être utilisée de manière pertinente lors de l’évaluation environnementale des procédés de séparation de nature thermique, chimique ou physique. / Human activities produce wastewater that generates sludge, a waste recycled on agricultural soils or for energy recovery. Extensive research is currently undergone on sludge to develop processes that can convert it into products with high-added value. In this context, sludge could move from a fatal waste status to the status of an expected co-product of wastewater treatment. This paradigm shift has implications for the assessment of environmental impacts of "sludge-based" materials with Life Cycle Assessment. Indeed, sludge becomes an expected co-product from the wastewater treatment plant and the environmental burden of their production must be distributed among co-products by means of an allocation factor. This thesis aims at defining a mathematical construction of this allocation factor by combining process- and product-related parameters, integrating de facto the causal relationships between process operations and products generation and the technological reality of the process. The result is a matrix of which each element associates, for each inventory data, an allocation factor to each of the generated co-products. Applied to the production of sludge-based phosphate fertilizers, LCA highlights the major contribution of the production stage compared to the stages of treatment and recovery of the sludge. Nevertheless, the method developed within this thesis to allocate an environmental load to each co-products of an indivisible production system paves the way for a more coherent environmental assessment of waste-based products. This methodology can also be used effectively in the environmental assessment of thermal, chemical or physical separation processes.