Bakgrund: Demenssjukdom är en obotlig sjukdom som sänker den kognitiva förmågan hos personen. På grund av den nedsatta kognitiva förmågan har personer med demenssjukdom svårt att uttrycka sin smärta. Bedömningsinstrument är ett bra hjälpmedel för sjuksköterskan för att tolka och bedöma smärta hos personer med demenssjukdom. Syfte: Syftet är att beskriva hur sjuksköterskan kan identifiera, bedöma, och lindra smärta hos personer med demenssjukdom. Metod: En litteraturöversikt sammanställd från åtta kvalitativa och sju kvantitativa vetenskapliga artiklar. Resultat: För att lindra och tolka smärta hos personen med demenssjukdom observerade sjuksköterskan beteendeförändringar. Att rådfråga anhöriga till personen och att lära känna personen med demenssjukdom var viktiga grundstenar för att tolka och bedöma smärta. Bedömningsinstrument ansågs vara ett bra kompletterande hjälpmedel för sjuksköterskan men används sällan. Slutsats: Kommunikationssvårigheter hos personer med demenssjukdom gör det svårt att tolka och bedöma smärta. Sjuksköterskan observerar, pratar med anhöriga och lär känna personen för att bedöma smärta hos personer med demenssjukdom. Omvårdnadsåtgärder för att lindra smärta är sällsynta och används inte så ofta hos personer med demenssjukdom. / Background: Dementia is an incurable disease that lowers the cognitive ability of the person. Due to the reduced cognitive ability, people with dementia have difficulty expressing their pain. Assessment tools are a resource for the nurse to interpret and assess pain in person with dementia. Aim: The aim is to describe how the nurse can identify, assess and relieve pain in people with dementia. Methods: A literature review compiled from eight qualitative and seven quantitative article. Results: In order to alleviate and interpret pain, nurses used observations on behavioral changes in person with dementia. To consult relatives and getting to know the person with dementia were important foundations for interpreting and assessing pain. Assessment tools were considered to be a good supplementary aid for the nurse but were rarely used. Conclusions: Communication difficulties in people with dementia make it difficult to interpret and assess pain. Nurses observe, speak with relatives and get to know the people with dementia to assess their pain. Nursing measures to alleviate pain are rare and are not often used in people with dementia.

Doctor of Philosophy / Department of Biological & Agricultural Engineering / Kyle R. Mankin / The overall goal of this study was to evaluate and apply the Soil and Water Assessment Tool (SWAT) model for fecal bacteria modeling. Methods were developed to characterize fecal coliform bacteria (FCB) from livestock, human, and wildlife sources to use as input in the model. Model sensitivity to predict FCB concentration was evaluated for the model parameters and input parameters using both SWAT 2000 and 2005 versions. Sensitivity of input parameters generally, ranked as Bacteria concentration ≥ TBACT > Wildlife source loads > Livestock stocking rate ≥ Livestock manure production rate > BACTKDQ for SWAT 2000 whereas it was ranked as BACTKDQ > TBACT > Bacteria concentration > WDLPQ > WDLPS for SWAT 2005. Sensitivity of model and input parameters were found changed from SWAT 2000. The SWAT (2005) model was calibrated and validated for daily flow, sediment, and fecal bacteria concentration using one year of measured data (January to December, 2004). The SWAT model predicted results with poor to very good agreement when compared with measured data with coefficient of determination (R2) and Nash-Sutcliffe Efficiency Index (E) range of 0.10 to 0.89 for daily flows, sediment, total phosphorus, total nitrogen and total FCB concentration. More extensive in-stream data are needed for more comprehensive model assessment. The SWAT model (2005) was evaluated for source-specific FCB modeling using three years (2004-2006) of observed modified deterministic probability of bacteria source tracking (BST) data. The FCB sources were modeled with three combinations (livestock and human, livestock and wildlife, wildlife and human) and each single source to evaluate the source-specific FCB concentrations. The SWAT model determined poor to good agreement for the combined source of FCB (R2, E range from -2.92 to 0.71) but determined generally decreased agreement for each single source of bacteria (R2, E range from -5.03 to 0.39) potentially due to BST uncertainty, spatial variability and source characterization. The SWAT model identified critical sub-watersheds in the watershed where implementing vegetative filter strips (VFS) could be most effective to abate fecal bacteria pollution. The targeting method of VFS application to the watershed sub-basins was found to be more effective in reducing both FCB (60% vs. 42%) and sediment yield (63% vs. 33%) as compared to a random approach. The FCB source characterization methods for modeling developed in this study are general and have the potential to be extended to other watersheds. The results of this study demonstrate that the SWAT model can be used to characterize the distribution of bacteria sources within a bacteria impaired watershed and assist with developing total maximum daily loads (TMDLs) and watershed restoration strategies.

For the past two decades, interest in the performance of local governments has become high in public management. The wave of performance consciousness has thus far diffused from developed countries to developing countries where decreasing public confidence and trust in government has made the implementation of performance management policies a way of improving public perception of government performance. Meanwhile, the implementation of such policies is often based on untested assumptions some of which constitute gaps in the literature. For instance, it is understood that performance management systems enable public organisations that provide services to satisfy citizens’ demand for services. It is also assumed that mechanisms for managing organisational performance recognise and address the interests of multiple stakeholders in an organisational environment and that once performance management systems generate performance information, decision makers are likely to use that information to advance the goals of their organisations. This study explores these assertions by investigating performance management practices of local government authorities in Ghana. It sets out to understand how local governments manage organisational performance and what shapes their performance. It also examines the scope of a performance enhancing policy to determine whether it addresses multiple perspectives of organisational performance and the extent to which local government managers use performance information to improve service delivery. The study adopts a qualitative research approach by using data from interviews, focus group discussions, observations and documents to construct and interpret research findings. This research identified internal and external mechanisms for managing local government performance and found that central-local government relations allows the former to influence the latter’s priorities by imposing on them, the national development policy, in ways that define development planning, performance reporting and local government controls. Following Kaplan and Norton (1992), a Balanced Score Card framework was used to examine the scope of performance indicators used to assess the performance of local governments under the District Development Facility. The findings reveal that performance indicators tend to be skewed towards financial and internal organisational aspects of performance rather than incorporating citizens’ views about local government performance or promoting organisational learning, innovation and accountability. The findings offer insights for re-examining multiple principal-agent relationships at the local government level where the assessment of local government performance excludes the opinions of local residents and affects local governments’ accountability to citizens. Although developing a culture of performance emerged as a key factor for improving local government performance, the findings revealed that the use of performance information by local government managers to make decisions on service delivery depends on the importance of performance information, their commitment to central government’s priorities, reporting requirements of externally funded projects and public service motivation. This study concludes that the utilisation of performance information to improve service delivery is necessary but not sufficient without adopting an all-inclusive, citizen-centred approach woven into the formulation, implementation and evaluation of performance management systems in a developing country context.

Bakgrund: Personcentrerad vård handlar om att sätta personen i fokus, uppmuntra till delaktighet och självbestämmande samt utgå från personens behov. För detta krävs rätt förutsättningar, vårdmiljö och personcentrerade processer. Teamarbete skapar goda möjligheter för vårdpersonal och patienter. En åldrande befolkning innebär utmaningar för äldreomsorgen och behovet av vård- och omsorgsutbildad personal ökar. Syfte: Syftet var att utifrån ett vårdpersonalperspektiv utforska förekomsten av personcentrerad vård på äldreboende. Metod: En kvantitativ tvärsnittsstudie har genomförts. Instrumentet Person-Centered Care Assessment Tool (P-CAT) användes. Data analyserades med analytisk statistik. Resultat: Totalt svarade 46 personer på enkäten. Baserat på P-CAT rapporterades förekomsten av personcentrerad vård vara hög. Deltagare med gymnasium/folkhögskola som högst avslutade utbildning upplevde högre personcentrerad vård än de som gått högskola. Vårdpersonal med vidareutbildning upplevde inte högre personcentrerad vård. Ingen skillnad i upplevd personcentrerad vård påvisades mellan vårdpersonal som arbetade på demensboende och personal som inte arbetade på demensboende. Antal år inom vård och omsorg var inte associerat med grad av personcentrering. Slutsats: Möjlighet till utveckling fanns inom organisation och miljö. Utbildningsinsatser bör följas upp och stödjas. Resultatet kan bidra till underlag för vidare diskussion inom verksamheten

abstract: Background. Street food stands (SFS) are common ways in which people in Mexico access food, having been a part of the environment and culture of Mexican food for generations. However, no studies have used a validated assessment tool to reliably measure food and beverage availability at a variety of SFS. Nor have the availability, density, variety, and distribution of SFS and street foods and beverages been assessed across neighborhood income levels.Objective: This dissertation’s goal was to decrease gaps in knowledge about the role SFS may play in food availability in the Mexican food environment. Methods: Survey design and ethnographic field methods were used to develop, test, and validate the Street Food Stand Assessment Tool (SFSAT). Geographic information system and ground-truthing methods were used to identify a sample of street segments across 20 neighborhoods representing low-, middle- and high-income neighborhoods in Mexico City on which to assess the availability, density, variety, and distribution of SFS and the foods and beverages sold at these food venues using the SFSAT. Results: A sample of 391 SFS were assessed across 791 street segments. Results showed that SFS were found in all neighborhoods. Contrary to the initial hypothesis, most SFS were found in middle-income neighborhoods. While the availability of street foods and beverages was higher in middle-income neighborhoods, the variety was less consistent: fruit/vegetable variety was high in high-income neighborhoods whereas processed snack variety was higher in low-income neighborhoods. SFS were most often distributed near homes, transportation centers, and worksites across the three neighborhood income levels. Conclusion: This study bridged the gap in knowledge about the availability, density, variety, and distribution of SFS and products sold at these sources of food by using an assessment tool that was developed, tested, and validated specifically for SFS. The findings showed that SFS were found across all neighborhoods. Furthermore, results also suggested that SFS can be a source of healthy food items. Additional studies are needed to understand the relationship between SFS availability, food consumption, and health outcomes in the Mexican population. / Dissertation/Thesis / Doctoral Dissertation Anthropology 2020

This thesis focuses on the analysis and evaluation of quality, environmental and safety risks and applying appropriate methodologies. From ČSN EN 31010 Risk management - Risk assessment techniques were selected for work tools - Failure Modes and Effects Analysis (FMEA), Pareto diagram, Bow tie analysis and Causes and effect analysis (Ishikawa diagram). The aim of this thesis is to analyze and assess the quality, environmental and safety risks of selected construction technologies and conditions established an integrated management system to handle simple tools for the management and elimination.

This thesis deals with the analysis and evaluation of quality, environmental and safety risks and the application of appropriate methodologies to concrete construction work. For application are selected key construction technologies, which are classified according to the Classification of building structures and works (TSKP) in Chapter main building production (HSV). From ČSN EN 31010 Risk management – Risk assessment techniques were selected for work tools - Causes and effect analysis, Failure Modes and Effects Analysis (FMEA), Pareto diagram, Bow tie analysis. The aim of this thesis is to analyze and assess the quality, environmental and safety risks of selected construction technologies and conditions established an integrated management system to handle simple tools for the management andelimination.

Magister Public Health - MPH / Despite the effectiveness and scale-up of antiretroviral treatment (ART), HIV-Associated neurocognitive disorders (HAND) still persist. Currently no gold standard tool exists to detect all forms of HAND, including major and minor cognitive impairments. In light of this, a newly developed screening tool was conceptualised, namely the Quick Paediatric Neurocognitive Screening tool (QPNST). The QPNST has been developed to detect HAND in perinatally HIV-infected children aged 5-10 years.

As satellite and climate modelling technology continues to improve and as climatological disasters and issues continue to impact the global community, climate data will increase in size and relevance. With this new influx of information, it is becoming more and more important for scientists to simply and concisely communicate their findings to both decision makers in governments and disaster preparedness organizations and also to the general public. The Soil and Water Assessment Tool (SWAT) is a powerful modelling tool that allows scientists to simulate essentially all of the physical processes involved in the water cycle. The data that SWAT produces can be valuable information as people strive to better plan for and understand various hydrologic events. The work presented in this thesis represents an effort to overcome some of the limitations of the previously developed SWAT visualization software by creating a set of modular web applications that can be duplicated, customized, and run by any organization or individual interested in visualizing and sharing data from SWAT. By eliminating the technical knowledge barriers that are inherent in running and using SWAT models, this work has the potential to increase SWAT’s impact on non-technically trained stakeholders and decision makers in areas where water and climate management is important.

This licentiate thesis examines environmental assessment tools for buildings. This is done by investigating, analysing, comparing and testing how different environmental assessment tools measure the environmental performance of buildings and examining the consequences this may have on architectural design. The study begins by analysing three environmental assessment tools: Leadership in Energy and Environmental Design (LEED), Code for Sustainable Homes (CSH) and EcoEffect. These tools are then tested on a case study building (an eight-storey residential building) to analyse differences regarding assessment results, improvement proposals and potential impacts on architectural design. One of the environmental impacts assessed in the three tools, namely Climate Change caused by gases having Global Warming Potential (GWP), is then analysed in greater detail from a life cycle perspective by measuring CO2-equivalents (CO2-eq). A basic calculation tool (referred to as the ENSLIC tool), based on life cycle assessment methodology, is used to assess a case study building (a four-storey office building in Gävle). The CO2-eq emissions from a building’s material production and energy use are calculated and the impacts of a number of suggested building improvements and changes of energy sources are analysed.  The studies show the complexity of assessment tools and different ways to make comparisons. Both similarities and differences between the tools are apparent, regarding hierarchical structure and also on each hierarchical level, from categories to issues and parameters. It is also shown that the choice of environmental assessment tool may have an influence on the architectural design of buildings. The difficulty with assessing complex buildings is apparent even when only one environmental issue is assessed with the LCA-based ENSLIC tool. Many aspects influence the assessment result. These include energy use, choice of materials and choice of energy sources. The complexity and difficulty in linking buildings to environmental impact create a need for interactive tools measuring environmental performance, which can be useful as decision support in the early design phase. / Denna licentiatavhandling behandlar miljöbedömningsmetoder för byggnader. Arbetet bygger på undersökningar analyser, jämförelser och tester av hur miljöbedömningsmetoder bedömer byggnaders miljöprestanda och undersöker även vilka konsekvenser som detta kan ha på arkitektonisk utformning. Forskningen börjar med att tre miljöbedömningsmetoder, Leadership in Energy and Environmental Design (LEED), Code for Sustainble Homes (CSH) och EcoEffect analyseras och jämförs. Sedan genomförs en fallstudie där de tre metoderna testas på ett bostadshus (ett åttavåningar högt bostadshus i Stockholm). Skillnader gällande miljöbedömningsresultat och miljöbedömningmetodernas förslag på förbättringsåtgärder samt eventuell påverkan på den arkitektoniska utformningen analyseras och diskuteras. En av miljöpåverkanskategorierna som bedöms i de tre metoderna, klimatpåverkan orsakad av gaser med inverkan på den globala uppvärmningen, analyseras sedan mer i detalj utifrån ett livscykelperspektiv genom att mäta byggnaders utsläpp av koldioxidekvivalenter (CO2 ekv). Ett förenklat beräkningsverktyg (som här benämns ENSLIC-verktyget), som är baserat på livscykelmetodik, används för att studera en byggnad (ett fyra våningar högt kontorshus i Gävle). Sedan beräknas utsläppet av CO2 ekv från byggnadens material- och energianvändning. Effekten av ett flertal föreslagna förbättringsåtgärder på byggnaden samt byte av energikällor analyseras också. Studierna visar på miljöbedömningmetodernas komplexitet och presenterar olika sätt att göra jämförelser på. Skillnader och likheter mellan metoderna påvisas gällande hierarkisk struktur och även på varje hierarkisk nivå, från kategorier till enskilda bedömda frågor och parametrar. Dessa skillnader talar för att olika metoder kan påverka den arkitektoniska utformningen av byggnader. Svårigheten i att bedöma komplexa byggnader belyses även när endast en miljöpåverkan bedöms med det livscykelanalys baserade ENSLIC-verktyget. Många saker påverkar resultatet, framförallt energianvändning tillsammans med materialanvändning och val av energikällor. Den komplexa och svåra uppgiften att länka samman byggnader med deras miljöpåverkan öppnar upp för användande av interaktiva verktyg som mäter miljöpåverkan som kan användas som beslutshjälpmedel i tidiga designskeden. / QC 20101123