Bakgrund: Diabetes Mellitus är mer vanligt förekommande hos individer med intellektuell funktionsnedsättning jämfört med övriga befolkningen. Intellektuell funktionsnedsättning är en kognitiv nedsättning som innebär svårigheter att ta in och bearbeta information samt tillämpa och bygga kunskap. Egenvård är ett begrepp som används för att beskriva de insatser som den enskilde individen vidtar för att lindra eller bota sjukdom och främja hälsa.  Syfte: Att beskriva vad som upplevs påverka egenvården hos individer med intellektuell funktionsnedsättning och diabetes. Metod: Litteraturöversikt, med induktiv ansats, baserad på kvalitativa artiklar via datainsamling gjord i CIINAHL och PsychINFO. Metoden snowballing har även använts för datainsamlingen. Resultatet sammanställdes genom en integrerad analys. Resultat: Svårigheter att ta till sig och använda sig av information upplevs inverka negativt på förmågan till egenvård vid diabetes hos individer med intellektuell funktionsnedsättning och diabetes. Kunskapen hos vårdteamet och stödet från omgivningen upplevs även påverka egenvården. Slutsats: Möjligheten bör finnas inom ramen för sjuksköterskeprogrammet att synliggöra omvårdnad vid intellektuell funktionsnedsättning. Inom vården bör man vidta åtgärder utifrån behovet av mer undervisning om diabetes som är särskilt anpassad för individer som är intellektuellt funktionsnedsatta. Det skulle även vara värdefullt att framtida forskning belyser dessa individers möjlighet till egenvård. / Background: Diabetes mellitus is more common amongst individuals with an intellectual disability compared to the rest of the population. Intellectual disability is a cognitive impairment which results in difficulties with processing information and applying and building knowledge. Self-management is a term used to describe the activities that the individual perform in order to cure disease and promote health. Objective: To describe experiences of what affects self-management amongst individuals with an intellectual disability and diabetes. Method: Literature review, with an inductive approach, with a review of relevant qualitative articles found in CINAHL and PsychINFO. The snowballing method is also used for collecting data. The result is compiled using an integrated analysis.   Result: Difficulties with reciving and using information is experienced to impede the ability to self-manage diabetes amongst individuals with intellectual disability and diabetes. The understanding of diabetes and intellectual disability amongst health care professionals and contextual support is also experienced to affect self-management. Conclusion: Within the context of the nursing program it would be useful with more dedicated education about intellectual disability. More research about these individuals’ ability to self-manage would be useful as well. Within the health care system actions should be taken to meet the need for information that is suited for individuals with intellectual disability.

Bakgrund: Att leva med en kronisk sjukdom som diabetes typ 1 kräver daglig kontroll av sin livsföring. Som ung vuxen inträffar många förändringar i livet och det kan vara en utmaning att samtidigt vara drabbad av en kronisk sjukdom och lära sig att leva med denna och de känslor som sjukdomen framkallar. Syfte: Syftet med denna litteraturöversikt är att beskriva unga vuxnas upplevelser av att leva med diabetes typ 1. Metod: Litteraturöversikt med 13 kvalitativa artiklar av olika design. Systematisk sökning av studier i databaserna Pubmed, Cinahl och PsycINFO. Resultat: I de granskade studierna framkom att leva med diabetes och samtidigt växa upp och bli vuxen upplevdes många gånger svårt. Rädsla för att vara annorlunda jämfört med andra jämnåriga, känslor av att tappa kontrollen samt rädslor inför framtid och för komplikationer var vanligt. Den unga vuxna kände sig ofta begränsad och hade svårt att integrera rutiner kring egenvården i det dagliga livet. Familj och vänner hade ofta en viktig roll för den unga vuxna men det fanns även en känsla av kluvenhet gentemot anhörigas delaktighet och sitt eget ansvar för sin sjukdom och hälsa. I kontakten med hälso- och sjukvården upplevdes en del brister och missnöje. Slutsats: Många unga vuxna upplever negativa känslor kring sin sjukdom och har svårigheter att få vardagslivet att fungera. Genom att få kännedom om hur unga vuxna med diabetes upplever sin sjukdom och livssituation kan sjuksköterskans stödjande roll utvecklas. / Background: Living with a chronic disease like type 1 diabetes requires a daily control of the lifestyle. As a young adult, several changes in life occurs. During this time of life, it might be a challenge to also have a chronic disease and learn to live with the disease and the feelings who may emerge from it. Aim: The aim of this study is to describe the experiences of young adults living with type 1 diabetes. Method: A literature review based of 13 qualitative studies with different designs. A systematic search in the databases Pubmed, Cinahl and PsycINFO was conducted. Result: The reviewed studies showed that living with diabetes while growing up and becoming an adult, many times felt difficult. Fear of being different from other peers, feelings of losing control and fears for the future and for complications was common. The young adult often felt limited and had difficulties with integrating routines for self-management in daily life. Family and friends often had an important role for the young adult. However, the young adults could feel ambivalent in family and friend’s participation in self-management and their own responsibility for their health and illness. In contact with the health services, young adult experienced some shortages and discontent. Conclusion: Many young adults experience negative feelings about their illness and have difficulties in everyday life. By gaining knowledge about how young adults with diabetes experience their disease and life situation the supporting role from the nurse can develop.

Bakgrund: Typ 2-diabetes är en kronisk sjukdom som står för 90 procent av alla diabetesfall i världen och beräknas öka de kommande åren, på grund av bland annat ohälsosamma levnadsvanor såsom kost och fysisk aktivitet. Egenvård innebär att patienten tar ansvar och för att hantera det behövs kunskap och stöd från vårdpersonalen. Syfte: att beskriva upplevelser av egenvården vid typ 2-diabetes, med fokus på livsstilsförändringar. Metod: En allmän litteraturöversikt baserad på tolv kvalitativa vetenskapliga artiklar genomfördes. Resultat: Det har framkommit olika upplevelser av egenvården och dessa har kategoriserats i teman med subteman: 1) Känsla av kontroll: Olika uppfattningar av betydelsen av typ 2-diabetes, 2) Upplevelser av livsstilsförändringar: Kostomläggning och Fysisk aktivitet och 3) Upplevelser av omvårdnadsåtgärder: Rådgivning, Motiverande samtal, MI och Gruppbaserad patientutbildning. Slutsats: Att ändra på sin livsstil kan upplevas som krävande och omställningen behöver stödjas och anpassas utefter patientens behov. Klinisk betydelse: Patientens upplevelser av egenvård med behov, krav och brister kan fungera som ett kunskapsverktyg för vårdpersonalen vid omvårdnaden av typ 2-diabetes. / Background: Type 2-Diabetes is a chronic disease that accounts for 90 percent of all diabetes cases in the world and is expected to increase in the upcoming years, due to unhealthy habits such as diet and physical activity. Self-management means that the patient takes responsibility and in order to manage it knowledge is needed and support from caregivers. Objective: To describe the experiences of self-management in Type 2-Diabetes, focusing on lifestyle changes. Method: A literature review based on twelve qualitative scientific articles were conducted. Results: It has turned out that there have been different experiences of self-management and these have been categorized into themes with subthemes: 1) Sense of control: Different views of the importance of Type 2-Diabetes, 2) Experiences of lifestyle changes: Change of diet and Physical activity and 3) Experiences of nursing interventions: Counseling, Motivational interviewing, MI and Group-based patient education. Conclusion: To change the lifestyle may be perceived as demanding and conversion needs to be adjusted to the patient's needs. Clinical significance: Patient’s experiences of self-management with needs, demands and deficiencies can serve as a knowledge tool for the care staff in the care of Type 2-Diabetes.

Thesis (MBA)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: The changing environment has had an influence on managerial skills and competencies. The question is what will be expected from the millennium manager? Thus what competencies would be needed to cope in the now faster changing era and how must training interventions be adapted to ensure optimum development opportunities? Although management is found at all levels and in all functions of an organisation, each level and each role requires different personal skills for the performance of the management task. However conceptual skills which involves the manager's thinking and planning abilities and interpersonal skills which refer to the ability to work with people, are mutually inclusive to all managerial positions. From literature it is clear that there are many methodologies available for management development such as corporate universities, outsourcing to local accredited colleges and universities for specialised programs such as a formal MBA, mentoring programs, leadership development programs, self-directed learning and career development. Critical evaluation of these interventions however indicate that conceptual skills are addressed but that the social and emotional dimensions are lacking. The focus of development interventions must shift to a more holistic, integrated approach of employee well-being. Another question to be asked is do educators take cognisance of the fact that personality and or psychological types are learning in different ways under different circumstances. In literature there seems to be very little evidence that programs are adapted to cater for these differences. From the literature sufficient information regarding learning theories, andragogy, learning styles and management development models is available. The challenge however is to incorporate and integrate the available information effectively to address the needs of a psychological, culturally diverse population. The trend in management development is moving towards incorporation of emotional intelligence as one of the components of development programmes. The emotional competence framework focus on personal competence which determines how we manage ourselves, and on social competence which determines how we handle relationships. In order to be able to effectively manage ourselves we have to focus on self-awareness, self-regulation and motivation. Therefore the need exists for a selfmanagement intervention in management development programmes. Very little information is available in existing literature on self-management programmes. The outcome of this literature survey is a suggested framework for a self-management module. The framework suggests three phases namely phase 1: Self-discovery which entails the gathering of information regarding personality and learning styles, brain dominance and the emotional intelligence (EO) map. Phase 2: Self-transforming which starts with the analysis of the self-discovery interventions, followed up by a guided process of self-transforming which entails personal goal setting and action plans. Phase 3: Self-mastery which is an active working towards the goals in all spheres of one's life, and celebrating "victories" to reinforce newly acquired skills or competencies. A follow-up on this study would be to develop a detailed module, integrating all the principles, theories and models to ensure a management development intervention that succeeds in providing "self-managing managers"! / AFRIKAANSE OPSOMMING: Die veranderende omgewing en tye het 'n invloed gehad op bestuursvernuf en bekwaamheid. Die vraag is dus: Wat sal verwag word van die "Millennium Bestuurder"? Dit wil sê, watter bekwaamhede sal nodig wees om aan te pas by dié vinniger veranderende era en hoe moet beroepsopleiding aangepas word vir optimum ontwikkelingsgeleenthede. Alhoewel bestuur gevind word op alle vlakke en in alle funksies van 'n organisasie, vereis elke vlak en elke rol verskillende persoonlike kundighede vir die uitvoer van die bestuurstaak. Konsepsuele kundigheid, wat na die bestuurder se denkvermoë, beplanningsvernuf en interpersoonlike vaardighede verwys, is wedersyds ingeslote by alle bestuursvlakke. Vanuit die literatuur is dit duidelik dat daar baie metodes van studie beskikbaar is vir bestuursontwikkeling soos korporatiewe universiteite, plaaslike ge-akkrediteerde kolleges en universiteite vir gespesialiseerde programme soos 'n formele MBA, mentorskapprogramme, leierskapontwikkelingsprogramme, self-gedrewe leeraktiwiteite en beroepsontwikkeling. Kritiese evaluasie van die intervensies wys daarop dat konsepsuele kundighede wel geadresseer word, maar dat die sosiale en emosionele dimensies ontbreek. Die fokus van ontwikkelingsintervensies moet skuif na 'n meer holistiese geïntegreede benadering in terme van werknemersgesondheid. Ons kan die vraag afvra of opvoeders wel kennis neem van die feit dat persoonlikheids- en sielkundige tipes verskillend leer onder verskillende omstandighede. In die literatuur blyk daar min bewyse te wees van programme wat aangepas is om vir dié verskille voorsiening te maak. In die literatuur is daar wel genoegsame inligting oor leerteorieë, andragogie, leerstyle en bestuursontwikkelingsmodelle. Die uitdaging is dus om die beskikbare inligting te inkorporeer, integreer en die behoeftes van 'n sielkundig, kulturele diverse populasie effektief te adresseer. Die neiging in bestuursontwikkeling is die inkorporering van emosionele intelligensie as een van die komponente van ontwikkelingsprogramme. Die emosionelevaardigheidsraamwerk fokus op persoonlike vaardigheid, wat bepaal hoe individue hulself bestuur, en op sosiale vaardigheid, wat bepaal hoe individue verhoudings hanteer. Dus die behoefte bestaan vir 'n self-bestuurs intervensie in bestuursontwikkelingsprogramme. Baie min informasie in Suid-Afrikaanse navorsing is beskikbaar in bestaande literatuur op self-bestuursprogramme. Die uitkoms van dié literatuurstudie is 'n voorgestelde raamwerk vir 'n self-bestuurs module. Die raamwerk stel drie fases voor naamlik, Fase 1: Self-ontdekking wat insluit die invordering van informasie aangaande persoonlikheids-en-Ieerstyle, brein dominansie en die emosionele intelligensie kartering. Fase 2: Self-transformasie wat begin by die analise van die self-ontdekkings intervensies, gevolg deur 'n gereguleerde proses van selftransformasie wat omvat persoonlike doelstellings en aksie planne. Fase 3: Selfbemeestering wat 'n aktiewe strewe is na die bereiking van doelstellings in alle sfere van 'n individu se lewe en die viering van "oorwinnings" om nuutgevonde vaardigede en kundighede te versterk. 'n Opvolg op dié studie sou wees om 'n gedetailleerde module saam te stel wat al die beginsels, teorieë en modelle integreer om sodoende 'n bestuursontwikkelings intervensie te verseker met "self-besturende bestuurders" as uitkoms!

Autonomic computing aims at making computing systems self-managing by using autonomic managers in order to reduce obstacles caused by management complexity. This thesis presents results of research on self-management for large-scale distributed systems. This research was motivated by the increasing complexity of computing systems and their management. In the first part, we present our platform, called Niche, for programming self-managing component-based distributed applications. In our work on Niche, we have faced and addressed the following four challenges in achieving self-management in a dynamic environment characterized by volatile resources and high churn: resource discovery, robust and efficient sensing and actuation, management bottleneck, and scale. We present results of our research on addressing the above challenges. Niche implements the autonomic computing architecture, proposed by IBM, in a fully decentralized way. Niche supports a network-transparent view of the system architecture simplifying the design of distributed self-management. Niche provides a concise and expressive API for self-management. The implementation of the platform relies on the scalability and robustness of structured overlay networks. We proceed by presenting a methodology for designing the management part of a distributed self-managing application. We define design steps that include partitioning of management functions and orchestration of multiple autonomic managers. In the second part, we discuss robustness of management and data consistency, which are necessary in a distributed system. Dealing with the effect of churn on management increases the complexity of the management logic and thus makes its development time consuming and error prone. We propose the abstraction of Robust Management Elements, which are able to heal themselves under continuous churn. Our approach is based on replicating a management element using finite state machine replication with a reconfigurable replica set. Our algorithm automates the reconfiguration (migration) of the replica set in order to tolerate continuous churn. For data consistency, we propose a majority-based distributed key-value store supporting multiple consistency levels that is based on a peer-to-peer network. The store enables the tradeoff between high availability and data consistency. Using majority allows avoiding potential drawbacks of a master-based consistency control, namely, a single-point of failure and a potential performance bottleneck. In the third part, we investigate self-management for Cloud-based storage systems with the focus on elasticity control using elements of control theory and machine learning. We have conducted research on a number of different designs of an elasticity controller, including a State-Space feedback controller and a controller that combines feedback and feedforward control. We describe our experience in designing an elasticity controller for a Cloud-based key-value store using state-space model that enables to trade-off performance for cost. We describe the steps in designing an elasticity controller. We continue by presenting the design and evaluation of ElastMan, an elasticity controller for Cloud-based elastic key-value stores that combines feedforward and feedback control. / <p>QC 20120831</p>

The overall aim of this thesis is to enquire into and problematize the governance of career guidance and how individuals’ career management is constructed within EU policy. The empirical material consists of European policy documents produced during 2000-2015. The two central research questions explore (1) how European career guidance is made governable, and (2) how individuals’ career management is constructed and governed. The Foucauldian governmentality perspective and the analytic method of problematization is utilized. The analysis focuses on the compositions of normative forms of reason, discursive practices and techniques by which governing is exercised and knowledge is produced. The thesis is based on four articles, three of which concern career guidance and career management. The fourth article concerns education of citizenship. The analysis shows that the formation of a policy space for comparison of national systems of career guidance is significant for making European career guidance amenable to governance. It is mobilized by governing practices for involvement of institutional actors and the construction of standards of performance. This form of governance becomes effective on the condition that institutional actors use and produce knowledge and practices about what works in career guidance, and this implies self-control and constant monitoring. It is a complex process of producing self-regulation of career guidance adjustable to change and innovation in which both standardization and modulation are inbuilt. Moreover, this is dependent on the interplay of governance and self-government. Knowledge and practices shape career management as an individual competence, which each individual is assumed to achieve. The use of guidance techniques supporting this design and self-regulating practices contributes to responsibilizing individuals to achieve this competence. Knowledge of individuals’ management of their careers includes civic competence. This led me to extend my use of the theoretical framework to investigate how knowledge of civic competence is constructed in European policy documents concerning teacher education from 2000 to 2012. My analysis shows that presumptions of teaching civic competence support the production of the active and learning subject.

The purpose of this study was to determine the effectiveness of the Preparation for Adult Living skills training program by measuring the learning gains and learning outcomes of students participating in the training. The quasi-experimental posttest control group design was used. A treatment sample of twelve students received the Preparation for Adult Living training. A nontreatment sample was selected by matching the characteristics of educational and reading level and the gender of twelve students with no previous independent living skills training with those of the treatment sample. Students in the treatment sample were tested for learning gains using the Preparation for Adult Living Test. Both the treatment and nontreatment sample were tested using the post-training Preparation for Adult Living Scale to determine the level of their learning outcomes. The Preparation for Adult Living Test results were analyzed using the t-test for correlated samples of pretests and posttests. The t-test for independent samples was used to analyze the Preparation for Adult Living Scale results to determine the students' learning outcomes. A Pearson r correlation coefficient was calculated for Preparation for Adult Living Scale scores to determine if a relationship existed between employment and the life coping skills of the treatment sample. The findings indicated that no learning gains were made during the training, but that the training had an impact on the students' post-training life-coping skills. A strong relationship was found between the specific life-coping and employment skills of the treatment sample. Investigation of the reliability and validity of the Preparation for Adult Living Test and Scale instruments was recommended.

Background: Peer-to-peer (P2P) support programs have the potential to assist ESRD patients in managing their disease and improve outcomes. Yet, there is little research examining P2P programs’ impact on psychosocial outcomes and disease management behaviors. Methods: A 4-month P2P mentoring intervention was designed and piloted in a facility serving 249 in-center hemodialysis patients in Lynchburg, Virginia. Preceded by a social marketing effort, which included a program naming contest and participant recruitment, the intervention included: (1) mentor training, (2) pairing of mentees and mentors, (3) kick-off social mixers, (4) ongoing meetings between mentees and mentors, (5) mentor training booster, and (6) a final celebration. A single arm quasi-experimental study with repeated measurements at three time points was used with data collection over four months. The hypotheses that the intervention would result in improvements for both mentees and mentors (i.e., self-efficacy, knowledge, perceived social support, dialysis social support (i.e., support from peers within the dialysis setting), and self-management behaviors) were tested using repeated measures ANOVA or the Friedman’s test for nonparametric data. Results: Mentees experienced increases in self-efficacy, F(2,22)=8.15, p<.01; knowledge, F(2,44)=6.62, p<.01; perceived social support, F(2,22)=7.30, p<.01; and dialysis social support, F(2,44)=4.79, p=.01. Mentors experienced increases in knowledge, F(2,22)=11.88, p<.01; dialysis social support, F(2,42)=3.19, p=.05; and dialysis self-management, χ2(2) = 7.65, p =.02. Conclusion: A P2P mentoring program for in-center hemodialysis patients can be beneficial for both mentees and mentors. Future research should focus on larger groups of patients using more rigorous research designs.

Title of the Master 's Thesis: ,,7 habits - action research in the primary school" Summary: The topic of my diploma thesis is ,,7 habits - action research in the primary school". The text is divided into two parts. In the first part I have defined the basic terminology used in the work and then I have focused on the classification of 7 habits. I have concentrated on the description of 7 habits of Happy kids and critically discuss about the implications of learning them in the primary school. In the practical part I have template to connect the information about 7 habits of Happy kids and programme The Leader in Me with their didactic usage in the lessons with a group. Key words: habits, self - management, leadership, action research, The Leader in Me

Bakgrund: Då en patient drabbas av långvarig sjukdom som Diabetes typ 2 uppstår ett behov av kunskap för att hantera sin sjukdom. Tidigare forskning visar att gruppundervisning till patienter med diabetes typ 2 sänker HbA1c vilket i sin tur minskar risken för komplikationer. Problemet är att alla inte erbjuds grupputbildning och ett annat problem är att en betydande andel tackar nej till erbjuden utbildning. Syfte: Syftet var att beskriva uppfattningar om gruppundervisning hos patienter med diabetes typ 2 som valt att avstå erbjuden gruppundervisning. Metod: Nio semistruktuerade intervjuer analyserades med en fenomenografisk metod. Intervjuerna analyserades genom sju steg för att få fram uppfattningar om hur patienter med diabetes typ 2 som valt att avstå erbjuden gruppundervisning resonerar. Resultat: Analysen resulterade i två kvalitativt skilda beskrivningskategorier sett ur ett patientperspektiv: en möjlighet att dela erfarenheter med andra i samma situation men med risk att ”blotta” sig själv och sin sjukdom i en grupp med okända samt att formen för lärande och kunskap inte är anpassat till patientens specifika behov och prioriteras inte då sjukdomen inte uppfattas som allvarlig. Konklusion: En möjlig förståelse av resultatet är att gruppundervisning inte passar alla utan en variation av former för undervisning krävs så att patienter kan få den undervisning som de själva uppfattar som kunskapsgivande, i passande tid och form. / Background: When a patient suffers from long-term illness such as type 2 diabetes, there is a need for knowledge to deal with their illness. Earlier research shows that group education for patients with type 2 diabetes is of significance for, among other things, HbA1c, which in turn reduces the risk of complications. However, the main problem with group education is that not all patients are offered to participate and that a significant percentage of those that are invited to group education sessions decline the offer. Aim: The purpose was to describe perceptions of newly diagnosed patients with type 2 diabetes to refrain from offering group instruction. Method: Nine semi-structured interviews have been analysed by using a phenomenographic approach. The interviews were analysed through seven steps to unveil the perceptions of group education in people with type 2 diabetes which chose to renounce the offered group education. Results: The analysis resulted in two different categories of descriptions seen from a patient perspective: an opportunity to share experiences with others in the same situation but with the risk of “exposing” themselves and their illness in a group with unknown and the form of learning and knowledge is not adapted to the person´s specific needs and is not prioritized when the disease is not perceived as serious. Conclusion: A possible understanding of the result is that group education does not suit everyone but a verity of form of education are required so that the patients can get the education that themselves perceive as giving knowledge, in appropriate time and form.