The democratisation of science - shifting science governance, work opportunities and ideologies away from the exclusive domains of elite minorities and into the hands of the people - is an important aim of science communication. If communication products such as television series can influence people�s relationships with science in terms of their career choices, belief systems and feelings of ownership over science, then it is important for science communicators to understand what television series are saying about science. In this thesis I examine representations of science in the long-running science fiction television series, 'Doctor Who'. In particular I analyse the social, cultural, political and economic aspects of this representation to assess its consistency with four goals for the democratisation of science: goals that I name franchise (lay empowerment in science governance), equality (equal access to opportunities in science workplaces and careers), progress (democratic choice about the role of technology in our lives and our societies) and enlightenment (democratic freedom to choose our beliefs and worldviews about the universe). Analysing the more than 200 'Doctor Who' serials broadcast between 1963 and 2008, I first give an overview of broad trends in the way the program has dealt with science themes and characters across four decades (1960s, 1970s, 1980s and 2000s), finding significant changes over that period. I then analyse in greater theoretical depth three ways that debates about the democratisation of science manifest within 'Doctor Who'. I show that the program varies in the degree to which it is consistent with the goals for the democratisation of science. First, I investigate plotlines that depict struggles for science governance within societies and that show people trying to achieve democratic outcomes by renegotiating their relationship to science. Within that discussion I show that the literary construct of �the hero� can obstruct democratic outcomes in the struggles for science governance that disenfranchised characters face. In this regard, I link �the hero� to the social construct of �the expert� in real world science, which has also been critiqued as obstructive to democratisation ends. Second, I investigate real-world public dissent to ideologies of science as they are expressed allegorically in the program. Such expressions manifest through themes that counterpose one ideological position on science (such as liberal humanism) to another ideological position (such as technorationalism) in the form of a battle between archetypal characters who embody these principles. Responding to the work of scholars who have elaborated this point, I show that such expressions of dissent to science can be twisted and undermined to serve scientistic ideals through the clever manipulation of the literary imagery that is generally associated with antiscience protest. Third and finally, I investigate the role-modelling function of scientist and non-scientist characters in 'Doctor Who': do they role-model empowered or disempowered positions for audiences within the institution of science? In concert with the literature I show that some structural elements of fiction - including the presence of a fallible scientist hero or an ensemble cast - can contribute positively to the capacity of characters to fulfil a positive role-modelling function that encourages equality in the science workplace and open access to science for all.

Proefschrift Universiteit Maastricht. / Met lit. opg. - Met samenvatting in het Engels.

Vårdrelaterade infektioner är ett globalt problem, patienter i utvecklingsländer är speciellt utsatta på grund av att många sjukhus har begränsade resurser. Därför kom idén upp att göra en studie som belyser hur sjuksköterskor hanterar handhygien med avseende att förebygga vårdrelaterade infektioner på Bulongwa Lutheran Hospital i Tanzania. Data samlades in genom en observationsstudie som varade i fyra dagar. Anteckningar från observationen skrevs ner i löpande text och analyserades genom en detaljerad innehållsanalys. I analysen växte ett antal kategorier fram, vilka resulterade i fyra övergripande teman: tvättmöjligheter, handtvätt, handskanvändning och övriga hygienaspekter. Resultatet av studien visade att sjukhusmiljön medförde vissa svårigheter för sjuksköterskorna att förhålla sig till god handhygien. Då handtvätt utfördes gjordes det med varierad noggrannhet och inträffade framförallt efter städmoment. Skyddshandskar användes vid städning och i vissa fall vid hantering av kroppsvätskor. Sjukhuset var försett med information i form av affischer för hur handhygien bör genomföras och sjuksköterskorna hyste kunskap i när tillfällen för handtvätt var aktuellt och på vilket sätt det skulle utföras. Slutsatsen som kan dras av denna studie är att bristfällig tillgänglighet av resurser troligtvis medförde en försämrad följsamhet till rekommenderade riktlinjer på Bulongwa Lutheran Hospital. / Healthcare associated infections are a global issue, patients in developing countries are especially vulnerable because of many hospitals' limited resources. The purpose of this study was to highlight how nurses manage hand hygiene for preventing healthcare associated infections at Bulongwa Lutheran Hospital in Tanzania. Data were collected during a four days observational study. Notes from the observation were written in linear form and analyzed using a detailed content analysis. The analysis brought a number of categories, which in the end resulted in four themes: places for hand washing, hand washing, glove usage and other health aspects. The results showed that the hospital environment caused a few problems for the nurses to respond to good hand hygiene. When hand washing was performed, it was made with varying accuracy and occurred most frequently after cleaning. Gloves were used during cleaning and in some cases when handling body fluids. The hospital was provided with information in the form of posters showing how hand hygiene should be performed and the nurses had knowledge of the occasions when hand washing was disclosed and the manner in which it should be performed. The conclusion to be drawn from this study is the lack of availability of resources likely led to deterioration in adherence to recommended guidelines at Bulongwa Lutheran Hospital.

<p>Förlossningsvårdens processer har vanligen utvärderats med jämförelsetal samt statistik över bakgrundsfaktorer och interventioner. Utvärderingarna har använts som argument för att likna vården vid normal förlossning med den som krävs vid komplicerade förhållanden. WHO (1996) rekommenderade och kategoriserade vård vid normal förlossning. Ett instrument fanns utvecklat som använts i ett kvalitetsutvecklingsarbete för att kartlägga förlossningsvård i förhållande till WHO: s rekommendationer. Studiens syfte var att kartlägga barnmorskors dokumenterade vård enligt WHO: s rekommendationer om vård vid normal förlossning tre år efter föregående kartläggning. Studien var prospektiv och genomfördes på en medelstor svensk förlossningsavdelning. Det ovan beskrivna instrumentet användes för att granska barnmorskors dokumentation av medicinska och omvårdnadsmässiga ställningstaganden i 200 förlossningsjournaler. Resultatet består av data som beskrivs med deskriptiv statistik.</p><p>Resultatet visade att barnmorskorna använde vårdinsatser inom samtliga av WHO: s kategorier och att WHO: s rekommendationer följdes delvis. Barnmorskorna gjorde riskbedömning av kvinnorna vid ankomsten till förlossningen men anpassade sedan bara delvis vården utifrån denna riskbedömning. Medicinska interventioner exempelvis CTG, farmakologisk smärtlindring och oxytocinstimulering var ofta dokumenterade trots att de flesta kvinnorna bedömts som lågrisk vid ankomst. Basal övervakning av kvinnans fysiska välbefinnande exempelvis puls, blodtryck och temp dokumenterades sporadiskt och omvårdnadsmässiga variabler som exempelvis stöd var bara dokumenterat i enstaka journaler. Jämfört med de tidigare mätningarna och i förhållande till WHO: s rekommendationer har ett antal variabler fortsatt att utvecklas i positiv riktning och några har återgått efter att ha förändrats under kvalitetsutvecklingsarbetet. Några variabler har försämrats efter att kvalitetsutvecklingsarbetet avslutades.</p> / <p>Childbirth and the delivery process have traditionally been evaluated using descriptive statistics to describe background factors and interventions. These evaluations have been used as an argument to liken care in normal birth with the care necessary for women with complications related to pregnancy and childbirth. WHO (1996) classified the practices common in the conduct of normal childbirth in to four categories. An audit instrument intended to measure midwifery care in relation to these four categories was found. The instrument had been used within a quality improvement program.</p><p>The aim of the study was to describe documented intrapartal care in relation to WHO recommendations for care in normal birth, three years subsequent to the last auditing. The design was prospective and descriptive and the study was conducted in a middle sized Swed-ish maternity unit. The instrument was used to study midwifes´ documented care in 200 delivery records.</p><p>The results of the study showed that the midwives uses care and interventions from WHO´s four categories and that the recommendations from WHO were only partly adhered to. Midwives conducted risk assessments of the women on admission to the mater-nity unit, but they did not adjust the care to the result of the risk assessments. Medical interventions such as electronic fetal monitoring, use of pharmacological pain relief and oxytocin augmentation were frequently documented in spite of the fact that 82 % of the women were considered lowrisk. Physiological items such as pulse, blood-pressure and temperature were sparingly documented and caring variables for example support were scantily documented. Comparisons with previos audits and the relation to WHO´s recom-mendations shows that some variables developed positively, some changed during the quality improvement program and has now reverted to the state previous from the program. Some of the variables deteriorated.</p>

Förlossningsvårdens processer har vanligen utvärderats med jämförelsetal samt statistik över bakgrundsfaktorer och interventioner. Utvärderingarna har använts som argument för att likna vården vid normal förlossning med den som krävs vid komplicerade förhållanden. WHO (1996) rekommenderade och kategoriserade vård vid normal förlossning. Ett instrument fanns utvecklat som använts i ett kvalitetsutvecklingsarbete för att kartlägga förlossningsvård i förhållande till WHO: s rekommendationer. Studiens syfte var att kartlägga barnmorskors dokumenterade vård enligt WHO: s rekommendationer om vård vid normal förlossning tre år efter föregående kartläggning. Studien var prospektiv och genomfördes på en medelstor svensk förlossningsavdelning. Det ovan beskrivna instrumentet användes för att granska barnmorskors dokumentation av medicinska och omvårdnadsmässiga ställningstaganden i 200 förlossningsjournaler. Resultatet består av data som beskrivs med deskriptiv statistik. Resultatet visade att barnmorskorna använde vårdinsatser inom samtliga av WHO: s kategorier och att WHO: s rekommendationer följdes delvis. Barnmorskorna gjorde riskbedömning av kvinnorna vid ankomsten till förlossningen men anpassade sedan bara delvis vården utifrån denna riskbedömning. Medicinska interventioner exempelvis CTG, farmakologisk smärtlindring och oxytocinstimulering var ofta dokumenterade trots att de flesta kvinnorna bedömts som lågrisk vid ankomst. Basal övervakning av kvinnans fysiska välbefinnande exempelvis puls, blodtryck och temp dokumenterades sporadiskt och omvårdnadsmässiga variabler som exempelvis stöd var bara dokumenterat i enstaka journaler. Jämfört med de tidigare mätningarna och i förhållande till WHO: s rekommendationer har ett antal variabler fortsatt att utvecklas i positiv riktning och några har återgått efter att ha förändrats under kvalitetsutvecklingsarbetet. Några variabler har försämrats efter att kvalitetsutvecklingsarbetet avslutades. / Childbirth and the delivery process have traditionally been evaluated using descriptive statistics to describe background factors and interventions. These evaluations have been used as an argument to liken care in normal birth with the care necessary for women with complications related to pregnancy and childbirth. WHO (1996) classified the practices common in the conduct of normal childbirth in to four categories. An audit instrument intended to measure midwifery care in relation to these four categories was found. The instrument had been used within a quality improvement program. The aim of the study was to describe documented intrapartal care in relation to WHO recommendations for care in normal birth, three years subsequent to the last auditing. The design was prospective and descriptive and the study was conducted in a middle sized Swed-ish maternity unit. The instrument was used to study midwifes´ documented care in 200 delivery records. The results of the study showed that the midwives uses care and interventions from WHO´s four categories and that the recommendations from WHO were only partly adhered to. Midwives conducted risk assessments of the women on admission to the mater-nity unit, but they did not adjust the care to the result of the risk assessments. Medical interventions such as electronic fetal monitoring, use of pharmacological pain relief and oxytocin augmentation were frequently documented in spite of the fact that 82 % of the women were considered lowrisk. Physiological items such as pulse, blood-pressure and temperature were sparingly documented and caring variables for example support were scantily documented. Comparisons with previos audits and the relation to WHO´s recom-mendations shows that some variables developed positively, some changed during the quality improvement program and has now reverted to the state previous from the program. Some of the variables deteriorated.

Bakgrund Antalet kirurgiska ingrepp förväntas öka, och därmed ökar även den totala risken för komplikationer. Världshälsoorganisationen, World Health Organization, WHO, har tagit fram en Checklista att använda i samband med kirurgiska ingrepp för att minska komplikationer och öka patientsäkerheten. Syftet med föreliggande studie är att undersöka operationssjuksköterskors erfarenheter av Checklistan. Metod En pilotstudie genomfördes och fem operationssjuksköterskor intervjuades. Intervjuerna transkriberades ordagrant och en manifest kvalitativ innehållsanalys gjordes med induktiv ansats. Resultatet visar att det fanns hinder vid användning av Checklistan, det fanns en ovana vid de nya rutiner som Checklistan innebär, arbetslagets attityder påverkar användningen och att vissa i operationsteamet visade oförståelse för Checklistans syfte. Osäkerhet rådde bland operationssjuksköterskorna för när Checklistans olika faser skulle utföras samt vem som ska initiera Checklistan. Användning av Checklistan medförde trygghet för så väl patient som personal, liksom en ökad handlingsberedskap för operationssjuksköterskan. Presentation av personalen på operationssalen ansågs vara positiv för ny personal, och negativ då detta tar tid och innebär upprepning. Slutsats WHO:s Checklista är ett bra verktyg för att öka kommunikationen och därmed öka patientsäkerheten. Det fanns ett behov av att anpassa Checklistan till den egna kliniken. / Background The number of surgical procedures is expected to increase, and thus also the total number of complications might increase. World Health Organization, WHO, has developed a Checklist for use in connection with surgical procedures to minimize the risk of errors and to enhance patient safety. The aim of this study was to investigate the theatre nurses' experiences of this Checklist. Method A pilot study was performed and five theatre nurses were interviewed. The interviews were transcribed verbatim, and a qualitative manifest content analysis was conducted with an inductive approach. The result shows that there were obstacles in the use of the Checklist, the staff was unaccustomed to the new procedures the Checklist had led to, the surgical team’s attitudes affected the use of the Checklist, and some in the surgical team showed lack of understanding of the purpose of the Checklist. Uncertainty prevailed among theatre nurses when to perform the different phases of the Checklist, and who should be initiating the Checklist. The use of the Checklist led to increased safety for the patients as well as for the staff, and also led to an increased preparedness for theatre nurses. The presentation of the staff in the theatre room was considered to be positive for new staff, and negative since this took time and involved repetition. Conclusion The WHO's Checklist is a useful tool to increase communication and thereby increase patient safety. There was a need to adapt the Checklist to the own clinics.

Rates of obesity in children are rising at an alarming rate, particularly among girls and ethnic minorities. Engaging in regular physical activity can help reduce this risk. Little is known about factors associated with physical activity (PA) in preadolescent populations, an age when intervention is ideal. Guided by Social Cognitive Theory, this study used a repeated-measures design to examine PA and its correlates, including PA self-efficacy, outcome expectations, and social influences (from parents and peers). Among participants (N = 57) in Girls on the Run, an innovative PA intervention for elementary school girls. Participants (M age = 9.4) predominately include girls from ethnic groups at highest risk for obesity, with 74% African American and 18% Hispanic. Multiple regressions indicated that, at baseline, girls with higher self-efficacy were significantly more likely to report greater intentions to be physically active (ß =.40, p ps p > .05). Overall, findings suggest the importance of targeting physical activity self-efficacy and fostering high levels of peer and parental support for physical activity to help girls meet recommended guidelines. Implications for future interventions are discussed.

Background: Speech rate plays an essential role in overall speech intelligibility in fluent speakers and is an important variable affecting fluency in people who stutter (PWS). There are no normative speech rate data for South African English (SAE). In PWS, attempts to manipulate speech rate for improved fluency have mostly focused on articulation rate. Revisiting the role of pauses in speech rate and the manipulation of both frequency and duration of pauses was deemed necessary to investigate a potentially valuable alternative strategy to assist PWS in rate reduction and possible improved fluency. Aims: The aims of this study were to investigate the speech rate and pause use for first language (L1) and second language (L2) SAE fluent speakers and PWS in both monologue and reading tasks. In addition, this study investigated if the manipulation of pause use could increase fluency in L1 and L2 PWS given six sessions of pause instruction in SAE. Methods: 80 fluent speakers (40 L1 SAE and 40 L1 isiZulu) and 14 PWS (7 L1 SAE and 7 L1 isiZulu) were asked to engage in a 2-minute monologue and a reading task in order to calculate the mean speech rate, frequency of pauses and average pause duration for each group. Following baseline measures, the 14 PWS were randomly assigned to either immediate or delayed intervention consisting of 6 sessions addressing manipulation of pauses. A crossover treatment design allowed for repeated measures of speech rate and pause use across three data collection periods. Results: Results revealed L1 and L2 SAE fluent speakers differed significantly in speech rate and frequency of pauses in reading and in pause length in the monologue. L1 and L2 PWS differed in frequency of pauses in reading. L1 fluent speakers and PWS differed in speech rate and both measures of pause use in reading. L2 fluent speakers and PWS differed in frequency of pauses in the monologue. Results from the crossover intervention for the PWS revealed a significant decrease in percentage syllables stuttered (% SS) for the delayed treatment group and a clinically significant decrease in % SS for both groups, in conjunction with a reduced speech rate that could be linked to increased frequency and/or average duration of pauses. Conclusions: This study presented speech rate and pause use norms for both fluent speakers and PWS, L1 and L2 SAE speakers that may provide useful guidelines for speech language pathologists in South Africa. Additionally, the intervention results for PWS presented efficacy data for six sessions of pause manipulation with measurable findings for improved fluency.

Os tumores odontogênicos compõem um grupo de lesões incomuns, porém interessantes, que se forma a partir dos tecidos que dão origem aos dentes. Esses tumores vêm sendo estudados há décadas por patologistas e cirurgiões que buscam entender seus mecanismos de formação e desenvolvimento, assim como desenvolver técnicas adequadas de tratamento. Inúmeras foram as tentativas realizadas até hoje para classificar esses tumores odontogênicos, sendo a última a nova Classificação de Tumores Odontogênicos da Organização Mundial da Saúde, publicada em 2005. Assim sendo, este trabalho teve por objetivo determinar a prevalência dos tumores odontogênicos diagnosticados nos Serviços de Anatomia Patológica das Faculdades de Odontologia de Bauru (USP) e de Araçatuba (UNESP) no Brasil, e das Faculdades de Odontologia da UNAM, da UAM-X e do Laboratório privado Peribact no México, compará-las e definir um perfil da ocorrência desses tumores nessas instituições e países seguindo essa nova classificação. Todos os casos diagnosticados como tumores e cistos odontogênicos passíveis de reanálise diagnóstica foram selecionados dos arquivos dessas instituições. Os dados demográficos e os aspectos clínicos de cada lesão foram obtidos a partir dos laudos e das fichas de requisição de exame anatomopatológico e as lâminas examinadas por um avaliador. Os resultados demonstraram que a inclusão do queratocisto no grupo de tumores provocou uma alteração significante na prevalência dessas lesões. O tumor odontogênico queratocístico foi a lesão mais prevalente, seguida pelo odontoma, ameloblastoma e mixoma no Brasil e no México. Quanto aos dados demográficos e localização, nossos achados corroboram com aqueles descritos na maior parte dos trabalhos realizados em todo o mundo, com diferenças pontuais em países como a China. Entretanto, a falta de maiores conhecimentos biomoleculares e genéticos dificulta a compreensão dessas diferenças. / Odontogenic tumors constitute a group of uncommon and particularly interesting lesions, arising from the odontogenic tissues. These tumors have been studied for decades by pathologists and surgeons seeking understand the mechanisms of formation and development, and trying to develop appropriate techniques of treatment. Many were the attempts made so far to classify these odontogenic tumors, the most recent being the new classification of odontogenic tumor of the World Health Organization, published in 2005. Therefore, this study aimed to determine the prevalence of odontogenic tumors diagnosed in five centers of diagnostic pathology: Laboratory of Oral Pathology, Faculty of Dentistry of Bauru USP; Laboratory of Oral Pathology, Faculty of Dentistry of Araçatuba UNESP, in Brazil; and Department of Oral Pathology, Faculty of Dentistry UNAM; Laboratory of Oral Pathology, Faculty of Dentistry of UAM-Xochimilco and Peribact Laboratory, a private laboratory of oral pathology, in Mexico; compare them and develop a profile of the occurrence of these tumors in these institutions and countries, following this new classification. All cases diagnosed as odontogenic cysts and tumors were selected for diagnostic review. The demographic and clinical features were obtained from the records when available. The cases were re-evaluated, and the diagnosis in each case was confirmed or modified when necessary. The results showed that the inclusion of keratocyst in the group of tumors caused a significant change in the prevalence of these lesions. The keratocyst odontogenic tumor was the most prevalent lesion, followed by odontoma, ameloblastoma and myxoma in Brazil and Mexico. Our findings corroborate with those reported arround the world, with occasional differences in countries, such as China. However, the lack of molecular and genetic knowledge precludes a better comprehension of these differences.

Os tumores odontogênicos compõem um grupo de lesões incomuns, porém interessantes, que se forma a partir dos tecidos que dão origem aos dentes. Esses tumores vêm sendo estudados há décadas por patologistas e cirurgiões que buscam entender seus mecanismos de formação e desenvolvimento, assim como desenvolver técnicas adequadas de tratamento. Inúmeras foram as tentativas realizadas até hoje para classificar esses tumores odontogênicos, sendo a última a nova Classificação de Tumores Odontogênicos da Organização Mundial da Saúde, publicada em 2005. Assim sendo, este trabalho teve por objetivo determinar a prevalência dos tumores odontogênicos diagnosticados nos Serviços de Anatomia Patológica das Faculdades de Odontologia de Bauru (USP) e de Araçatuba (UNESP) no Brasil, e das Faculdades de Odontologia da UNAM, da UAM-X e do Laboratório privado Peribact no México, compará-las e definir um perfil da ocorrência desses tumores nessas instituições e países seguindo essa nova classificação. Todos os casos diagnosticados como tumores e cistos odontogênicos passíveis de reanálise diagnóstica foram selecionados dos arquivos dessas instituições. Os dados demográficos e os aspectos clínicos de cada lesão foram obtidos a partir dos laudos e das fichas de requisição de exame anatomopatológico e as lâminas examinadas por um avaliador. Os resultados demonstraram que a inclusão do queratocisto no grupo de tumores provocou uma alteração significante na prevalência dessas lesões. O tumor odontogênico queratocístico foi a lesão mais prevalente, seguida pelo odontoma, ameloblastoma e mixoma no Brasil e no México. Quanto aos dados demográficos e localização, nossos achados corroboram com aqueles descritos na maior parte dos trabalhos realizados em todo o mundo, com diferenças pontuais em países como a China. Entretanto, a falta de maiores conhecimentos biomoleculares e genéticos dificulta a compreensão dessas diferenças. / Odontogenic tumors constitute a group of uncommon and particularly interesting lesions, arising from the odontogenic tissues. These tumors have been studied for decades by pathologists and surgeons seeking understand the mechanisms of formation and development, and trying to develop appropriate techniques of treatment. Many were the attempts made so far to classify these odontogenic tumors, the most recent being the new classification of odontogenic tumor of the World Health Organization, published in 2005. Therefore, this study aimed to determine the prevalence of odontogenic tumors diagnosed in five centers of diagnostic pathology: Laboratory of Oral Pathology, Faculty of Dentistry of Bauru USP; Laboratory of Oral Pathology, Faculty of Dentistry of Araçatuba UNESP, in Brazil; and Department of Oral Pathology, Faculty of Dentistry UNAM; Laboratory of Oral Pathology, Faculty of Dentistry of UAM-Xochimilco and Peribact Laboratory, a private laboratory of oral pathology, in Mexico; compare them and develop a profile of the occurrence of these tumors in these institutions and countries, following this new classification. All cases diagnosed as odontogenic cysts and tumors were selected for diagnostic review. The demographic and clinical features were obtained from the records when available. The cases were re-evaluated, and the diagnosis in each case was confirmed or modified when necessary. The results showed that the inclusion of keratocyst in the group of tumors caused a significant change in the prevalence of these lesions. The keratocyst odontogenic tumor was the most prevalent lesion, followed by odontoma, ameloblastoma and myxoma in Brazil and Mexico. Our findings corroborate with those reported arround the world, with occasional differences in countries, such as China. However, the lack of molecular and genetic knowledge precludes a better comprehension of these differences.