Systematic reviews - appraisal and synthesis of all primary research - are increasingly being used to inform policy and practice in health care. Therefore, it is important to understand how the key questions in systematic reviews are identified and prioritised and whether they are relevant to policy makers, practitioners and members of the public. Research priority setting (RPS) is usually defined as any interpersonal activity that leads to the selection of topics and/or choices of key questions to investigate . Diverse approaches to setting research priorities are used in different countries, regions and organisations. There is no consensus in the literature on the most effective processes with which to set these priorities. However, these decisions define the quality and implications of the evidence, and syntheses of it, available to patients, public and policy makers to help them make informed decisions. My initial scoping work, was to design and conduct a survey across an influential international systematic review organisation (Cochrane Collaboration ) on how they set priorities for their reviews. We identified 13 structured approaches to setting priorities. As part of the project, we developed an evaluation framework that demonstrated whether the priority setting processes meet the values and principles of the Cochrane Collaboration. Subsequently, we developed an equity lens for research priority setting exercises to inform the design of research priority setting processes to ensure that they consider the priorities of disadvantaged groups along with advantaged groups. We used the equity lens to do a second evaluation on the priority setting processes in the Cochrane Collaboration. Both evaluation frameworks demonstrated that the Cochrane Collaboration requires better designed priority setting approaches and must be more transparent in reporting those processes. The evaluation of research priority setting exercises in the Cochrane Collaboration, along with the wider literature, demonstrates that research priority setting exercises cannot be evaluated in isolation from organisational cultures, values and context. Therefore, the next step of the project focused on a specific stakeholder group (major research funders) with significant influence on research, including support for systematic reviews. We selected 11 national research agencies in the UK, Netherlands, France, Norway, Denmark, Germany, Australia, Canada, and the USA. We devised and used a checklist based on Chalmers and Glasziou’s “avoidable research waste” framework (and evaluated the processes and policies of these agencies using this checklist). As previous evaluations had demonstrated, this second evaluation found a lack of transparency in the process of setting priorities for research and other related organisational and policy issues. Increased funding is needed for methodological research to evaluate research practices and to monitor how funding research projects is done and reported. My evaluation of funding agencies and the Cochrane Collaboration found a similar lack of transparency and accountability in the context of conflicting values among stakeholders that decreases accountability and scrutiny of researchers and their institutions. However, the projects have led to organisational and policy changes in the two key stakeholder groups (the Cochrane Collaboration and selected funding agencies). Officials of national health research funding agencies have approached me to collaborate with them to address the issues raised by my work on reducing research waste. This led to the establishment of Funders Forum - the Ensuring Value in Research (EViR) Funders’ Collaboration and Development Forum - to enable agencies in various countries to exchange their experience in addressing issues and creating work groups to address them. The Forum is chaired by individuals from three major research funders: NIHR (UK), ZonMW (Netherlands) and Patient-Centered Outcomes Research Institute (PCORI; USA). The Forum organises several meetings to establish common principles, standards and work plans to achieve the common objective around reducing research waste and adding value for research for a national research funder.

Previous studies have shown that football is getting more commercial and together with increased digital possibilities football clubs can bypass traditional media and attract audience via their own media channels. With strategic communication and agenda setting as a theoretic background I wanted to investigate how Swedish top football clubs used their own media channels, what affected the media strategy of the big clubs in Sweden and how sports journalists perceived the football club’s communicative development. I choose AIK as a case and I observed them and sports journalists before, during and after the local derby against Djurgården. Furthermore, I analyzed AIK´s content in their own media channels and media’s coverage of AIK-Djurgården. Finally, I conducted qualitative interviews with representatives from AIK and three sport journalists at three Swedish newspapers. My study revealed that the AIK significantly planned and applied strategic content and messaging across their media channels, consistent with the techniques used by more mature and traditional media organizations. When it comes to access to the club and players there are tendencies and signs of less accessibility, but in general Swedish sport journalists see the Swedish Allsvenskan as open and not as commercial and controlled as the major European football leagues. In the end journalists believe that the material which is produced by AIK and the other big Stockholm clubs (Djurgården and Hammarby) can be seen as a compliment, but also a competitor to the material that media produce.

Bakgrund: Demens är ett samlingsnamn för flera sjukdomar som drabbar hjärnan. Då människan uppnår allt högre ålder beräknas antalet personer med demenssjukdom öka, sjuksköterskor kommer att möta allt fler patienter med demens inom sjukhusvården. Symptomen skiljer sig åt mellan de olika demenssjukdomarna, nya miljöer kan förvärra symptom som förvirring och ångest. Personcentrerad vård är den vårdform som förespråkas för personer med demens och syftar till att öka en persons livskvalité. Syfte: Syftet med studien var att beskriva sjuksköterskors upplevelser av att vårda personer med demens i sjukhusmiljö. Samt att beskriva de inkluderade artiklarnas datainsamlingsmetoder. Metod: Föreliggande studie är en litteraturstudie med deskriptiv design där tolv kvalitativa artiklar analyserats. De inkluderade artiklarnas datainsamlingsmetod sammanställdes. Huvudresultat: Sjuksköterskorna upplevde att anhöriga till personer med demens var en viktig vårdresurs som skulle bejakas. Vidare upplevdes patienternas kommunikationssvårigheter försvåra sjuksköterskans symptomlindring. Slutligen upplevdes kontexten sjukhusmiljö inte vara anpassad för att ge god omvårdnad till personer med demens och tidsbrist hindrade utförandet av god vård. Sammanställningen av artiklarnas datainsamlingsmetod visade att intervjuer och fokusgrupper användes. Slutsats: Det visade sig vara komplext för sjuksköterskor att vårda personer med demens i sjukhusmiljö. Tidsbrist och en icke-demensanpassad miljö gjorde vården mer sjukdomsorienterad och tillät inte sjuksköterskan att vårda utifrån etiska värderingar och ett personcentrerat synsätt. Anhörigas resurser främjade omvårdnaden. Då sjuksköterskor upplevde svårigheter i att kommunicera med personer med demens behövs mer kompetens och utbildning i att vårda personer med demens för att öka sjuksköterskors arbetstillfredsställelse och skapa bättre förutsättningar för personer med demens som befinner sig på sjukhus. / Background: Dementia is an umbrella term for several diseases that affect the brain. The number of people with dementia is estimated to increase as human life expectancy increases, which means that nurses will meet more and more patients with dementia in hospital care. The symptoms differ between the different dementia diseases, new environments can exacerbate symptoms such as confusion and anxiety. Person-centered care is the form of care advocated for people with dementia and aims at enhancing a person's quality of life. Aim: The aim of the study was to describe nurses' experiences of caring for people with dementia in hospital environments. Also, to describe the included articles' data collection methods. Method: The present study is a literature study with descriptive design where twelve qualitative articles have been analyzed. The collected articles' data collection method was compiled. Main results: Nurses experienced that relatives of people with dementia were an important health care resource which should be welcomed. Furthermore, the patient's communication difficulties experienced complicating the times when pain should be treated. Finally, the context of the hospital environment was not adapted to provide good care to people with dementia and lack of time prevented the execution of good care. The compilation of the articles' data collection method showed that interviews and focus groups were used. Conclusion: It turned out to be complicated for nurses to care for people with dementia in a hospital environment. Lack of time and a non-suitable environment for people with dementia made the healthcare more disease-oriented and did not allow nurses to care for ethical values and a person-centered approach. Relatives' resources promoted nursing care. Since nurses experienced difficulties in communicating with people with dementia, more skills and education in caring for people with dementia are needed to increase nurses' job satisfaction and create better conditions for people with dementia in hospitals.

Cette thèse porte sur l’ennui dans cinq romans de Julien Green (Mont-Cinère, Adrienne Mesurat, Minuit, Le Malfaiteur, Le Mauvais Lieu). L’enjeu est d’étudier la représentation de l’ennui dans des romans qui y consacrent tous une place différente. Dans une première partie, l’analyse du décor de l’ennui greenien, que ce soit l’espace extérieur ou l’espace intérieur, a permis de mettre en évidence l’aliénation intérieure des personnages greeniens qui reflète leur incapacité à vivre. L’étude du milieu dans lequel baignent les personnages permet en effet de se faire une idée de l’ampleur de l’ennui. La ville devient alors la toile sur laquelle se projettent leur ennui et leurs maux tandis que la liberté dont ils croient avoir pleine possession n’est qu’une illusion. Symbole de cet emprisonnement, la maison est la métaphore d’une impossibilité d’évasion hors de soi. La maison est un huis clos où se cumulent puis se déchaînent les passions. Les êtres greeniens sont face à une immutabilité qui ne peut que les mettre devant leur impuissance à sortir de cet ennui. Le constat est amer : il n’existe aucune possibilité de distraction, les hommes sont condamnés à s’ennuyer. Dans la deuxième partie, les conséquences de l’ennui sur les personnages ont été mises en évidence. Alors que tous les protagonistes sont prématurément vieillis par cette vie d’ennui, ils tentent désespérément de s’ancrer dans un réel fuyant par des habitudes ridicules et des occupations sans intérêt, à part celui de combler coûte que coûte le néant qui les engloutit. La haine d’autrui apparait et déteint sur leur famille : impossible d’aimer et d’être aimé, il s’agit désormais de se sentir exister en opprimant et réduisant à néant autrui. La troisième partie de la thèse est l’occasion de s’arrêter sur les conséquences avérées de l’ennui. Un déchaînement de violence est la conséquence logique d’un mal qui puise son origine dans la haine. Si les personnages se réfugient un instant dans le monde de la rêverie pour fuir un réel étouffant, cette rêverie les éloigne progressivement du réel et leur fait perdre toute attache à la réalité. C’est en créant leur monde qu’ils se soulagent de leurs maux, de leur inadaptation sociale et de la violence qui couve en eux. Ces folie et violence débouchent directement dans le meurtre comme solution pour se débarrasser d’autrui, cause de l’ennui. Mais le meurtre n’est jamais délibérément voulu et la mort apparaît comme l’unique solution : le personnage se tue parce que – comme Baudelaire écrivait dans sa Correspondance générale – « la fatigue de [s]’endormir et la fatigue de [se] réveiller [lui] sont insupportables » / This thesis aims at studying how boredom is depicked in five novels – Mont-Cinère, Adrienne Mesurat, Minuit, Le Malfaiteur, Le Mauvais Lieu – and how differently Julien Green painted it. In a first part, our analysis of the Greenian boredom from within and without has highlighted his characters’ internal alienation mirroring their inability to live. Indeed, studying the characters’ environment gives some insight into the scope of boredom. The town then becomes the canvass on which their boredom and suffering are displayed whereas the freedom they believe is theirs, is only an illusion. The house – a symbol of this confinement – is the metaphor of some escape beyond the self. The house is a prison cell where passions build up and run high. Greenian beings are involved with some immutability failing to confront them with their inability to ride out this boredom. A sobering conclusion as they cannot enjoy themselves : men are condemned to get bored. In the second part, the consequences of boredom on the characters have been highlighted. While this boring life prematurely makes the characters older, they desperately attempt to ground into an elusive reality through ridiculous habits and pointless activities, except filling the empty nothingness drowning them. Their hating others appears and influences their family : they cannot love or be loved ; from now on they will have to feel they are alive by oppressing and destroying others. The third part points out the proven consequences of boredom. This outburst of violence stems logically from some uneasiness originating in hatred. If the characters retreat for a while into the world of musing to escape from a stifling reality, this musing gradually keeps the real at bay and deprives them of all connections to reality. While creating their world, they relieve their suffering, their social maladjustment and the violence simmering in them. Mania and violence directly lead to murder as the solution to get rid of others, a source of boredom. But murder is never deliberately wanted and death appears as the unique solution : the character kills himself because – as Baudelaire wrote in his Correspondance générale he cannot bear the weariness of sleeping and the weariness of waking up.

OBJECTIVE: To understand dental service utilization by frail older adults residing in a long-term care (LTC) setting in the last two years of their life. To understand the types of dental services utilized by this demographic, the frequency of utilization and determine the characteristics that may be predictors of ‘higher dental service utilization’. METHODS: A retrospective cohort study was conducted by an electronic chart review of all LTC patients at two sites who died between 11/1/2014 - 12/30/2016 and had a dental visit in the two-year period prior to death, resulting in a sample of 369 patients. Based on the number of dental appointments attended prior to death, the patients were categorized into five groups: 0,1-2,3-5,6-9 and10 or more appointments. A multivariate logistic regression model was created to identify the factors associated with higher dental service utilization. RESULT: The study found that 84% of patients who died in the study period, utilized on-site dental services in the last two years of their life. Approximately 66% had 3 or more dental appointments. Diagnostic and preventive procedures were most commonly utilized (utilized by 81% and 73% of patients respectively). Multivariate analysis suggested that dentate patients and patients wearing removable dental prosthesis were about 7 and 12 times more likely respectively to have a higher utilization of dental services (OR=6.5 and OR=11.7). Medicaid beneficiaries were more likely (OR=1.9) to have a higher utilization of dental services than the others. CONCLUSIONS: This study showed that a large percentage of frail older adults utilized dental services even in the last years of their lives when given access to these services. As people are living longer and retaining their teeth longer, there is a rising need and subsequent demand for end-of-life dental services. Certain administrative and policy implementation strategies need to be developed to provide dental services to LTC patients in the last years of their lives.

The wide and enduring educational disparities between European and Asian heritage New Zealanders on the one hand, and indigenous Māori and Pacific Islanders on the other, have been a national education policy priority for some time. Such is the degree of focus on ethnic inequalities that very little attention is devoted to sources of privilege and disadvantage related to socio-economic status (SES) and gender, despite international scholarship showing that both of these profoundly influence experiences of schooling. The current study explores the ways in which SES, ethnicity, and gender influence students’ experiences of learning mathematics in New Zealand schools. Mathematics is a ‘gatekeeper’ subject for a range of highly lucrative career pathways dominated by European and Asian heritage men, making access to mathematical success a social justice issue with powerful material consequences. This thesis describes a mixed methods study of 425 Year Nine (age 13-14) students in three New Zealand state secondary schools, which investigated • the relationships between SES, ethnicity, gender, and success in mathematics, • cultural ideas about what types of people have mathematical ability, and • the effect of ability grouping on attainment disparities. European and Asian students had higher mathematics attainment than Māori and Pacific students. Pacific students reported enjoying mathematics despite their low attainment, whereas Māori students had very negative attitudes towards mathematics. Consistent with international studies, girls had lower confidence than boys in their mathematical abilities, despite having equal attainment. Interview data suggested that these differences in perceptions of mathematics were related to cultural ideas of mathematics as a ‘brain’ activity and therefore a natural fit for socially privileged men. Such ideas were further reinforced by ability grouping, which provided successful students with additional enrichment and withheld from low-attaining students the intellectual challenges that could have facilitated a shift to more successful learning trajectories.

The aim of this thesis was to analyze and discuss how and why the traditional agenda setting process, as it is presented by Kingdon through the concepts of problems, politics and policy, can be seen in a new light of social media (tweets) and the concept of identity, by studying the case of American president Donald Trump and investigate his use of Twitter for agenda setting in the ongoing North Korean nuclear crisis. This thesis used a case study method to study the material of 28 tweets made by Trump about North Korea. The analysis revealed that Kingdon’s traditional agenda setting theory was useful for understanding the material, however an addition of looking at the concept of identity creation which is important within social media and International Relations (IR). The concept of identity helped to understand Trump’s agenda setting in a new light, where identity creation helped to discover an ‘us-and-them’ dynamic.

This paper refers to the unevenness on the quality of life originated by the environmental settings that are calibrated by the different human activities on the natural systems. We emphasize the issue of vulnerability of the poorest societies, looking for explanations that support that condition and the social responsibility of administrators to change those inequalities. / Este artículo se refiere a las desigualdades de calidad de vida que se originan en las ofertas ambientarles y se calibran por las diferentes actuaciones humanas en los sistemas naturales. Se toca el tema de la vulnerabilidad de las sociedades más pobres, buscando explicaciones que mantienen esa condición y la responsabilidad social de los administradores para cambiar estas desigualdades.

Statistics show that the number of mass shootings and involved fatalities have drastically increased over the last five years. The framing of these attacks in the mass media has a substantial impact on the public opinion on the causes of shootings, possible prevention methods and gun control in general. Following study aims to uncover potential ideological influences of political tendencies of liberal and conservative newspapers on the media coverage of the most recent mass shooting in the Marjory Stoneman Douglas High School in Parkland, Florida. A qualitative content analysis with a general structural analysis of 39 articles from the liberal newspaper The New York Times and the conservative newspaper The Washington Times and a more detailed Critical Discourse Analysis of the frames of blame, prevention methods and gun control were conducted. Findings show that The Washington Times´media coverage on blame attributions and prevention methods mainly included frames of mental health. The focus in The New York Times´ coverage is clearly on gun issues and the demand for gun restrictions. The topic gun control is positively framed by The New York Times. The Washington Times, however, framed gun control in connection with conspiracy theories and thus portrayed it in a more negative light. The findings prove an influence of the newspapers´ political tendencies and ideologies on the media coverage of the Florida mass shooting.

Este trabalho estuda uma modalidade de atenção em saúde denominada acompanhamento terapêutico, que é importante ferramenta para o tratamento de sujeitos psicóticos e útil para a Reforma Psiquiátrica. Estuda-se o setting do AT, a fim de estabelecer uma relação possível entre os conceitos psicanalíticos e as singularidades que esta modalidade propõe, problematizando-as através dos seguintes conceitos: dispositivo, acaso/acontecimento e cidade. Busca-se algumas respostas às seguintes questões: Como se estabelece uma relação que propicie o surgimento de um encontro entre acompanhante e acompanhado? No acompanhamento terapêutico como poderíamos pensar um início de tratamento? O que de fato ocorre ou precisa acontecer? O que significa isto do ponto de vista da psicanálise e considerando que estamos trabalhando com sujeitos psicóticos? Qual o espaço de trabalho, ou melhor dizendo, o setting do AT? Que conceitos estão em jogo nesse setting. Podemos nos apoiar nas descobertas freudianas ainda que o setting seja sabidamente diferente? Que problemas isso acarreta desde o ponto de vista técnico? A metodologia é o estudo de caso único. Utiliza-se como fonte os registros de um atendimento, entrevistas e o material escrito produzido pelo próprio sujeito acompanhado. Escolheu-se cenas ilustrativas do caso atendido vinculando-as à teorização apresentada. Entende-se o acompanhamento terapêutico como importante dispositivo clínico e político do processo da Reforma Psiquiátrica. O acompanhante terapêutico é um agente que transita entre os espaços de tratamento (o dentro) e os demais espaços sociais (o fora) com uma visão desinstitucionalizante e com o objetivo de auxiliar os sujeitos a ressignificarem seu lugar social.