Background. The research on management in Swedish home care has been conductedmainly from sociological perspectives where structural conditions have been of interest (see for example Hagerman et al., 2013; Andersson, 2014; Österlind, 2013). The conditions impacting on management are described as differing ideals where the main ideals are the care perspective and the cost perspective (see for example Andersson, 2014; Österlind, 2013). The conflict between ideals create tensions between ideology and practice and different expectations (Antonsson, 2013) and may also create problems, dilemmas and paradoxes (Österlind, 2013). The rules impacting on the home care activities are bureaucratic rules stemming from the state and municipality. However, Trydegård (2000) argues that at the same time there is room for autonomy and path-dependence in the home care units. Purpose and research approach. There seems to be a lack of studies on management control in home care, and more especially no study combining a discourse, structures and theories on management control. The purpose of this thesis is to explore management control in home care in the relation between structures and managers’ interpretative repertoires in a social-constructionist perspective. The purpose is also to create a prototype model for further research. The ontological positioning and theoretical framework are building on Giddens’ structuration theory (1979, 1984) in which structures are seen as both the medium and outcome of social interaction and rules are important. The units of analysis are the managers’ accounts on management control in semi-structured interviews. The accounts are analysed in a so called case cluster analysis (McClintock et al., 1979) in the software program NVivo. The codes are building on Ouchi’s theory of management control (1979) as ‘input control’, ‘behaviour control’, ‘output control’ and ‘clan control’, and also building on Giddens’ structuration theory (1978, 1984) defined as 8 characteristics of rules, ‘normative sanctions’, ‘signification of meaning’, ‘authoritative’ or ‘allocative resources’. Findings. The findings reveal that home care is highly bureaucratic in input and output control by the use of formal rules stemming from municipality or state. In behaviour control home care has a medium-low degree of bureaucracy if exercised through ‘signification of meaning’ and medium-high when exercised through ‘authoritative resources’. In clan control home care has a low degree of bureaucracy and can either be positive or negative depending on how informal leaders in the unit impact on cooperation between care personnel and if there is trust and a good communication between manager and care personnel. Two main patterns of structuration appear: creation of structures for an efficient process flow of home care to increase efficiency, and co-creation of new rules for behaviour to increase cooperation. Managers focus on different situations of management control depending on conditions in the home care unit and own interpretations. Two interpretative repertoires are identified; the discourse on hard matters is created in relation to matters that are more rigid in structure, such as legislation and municipal goals and that are difficult to interpret differently, whereas soft matters are created in discourse around dilemmas and human or relational aspects of control.

Η διατήρηση της μικροβιολογικής ποιότητας του υδάτινου περιβάλλοντος είναι υψίστης σημασίας δεδομένων των κινδύνων που ενέχονται για τη δημόσια υγεία. Η αξιολόγηση της μικροβιολογικής ποιότητας των υδάτων πραγματοποιείται με την ανίχνευση της κοπρανώδους μόλυνσης και με τον έλεγχο της παρουσίας και συγκέντρωσης συγκεκριμένων μικροοργανισμών – δεικτών, όπως είναι η Escherichia coli. Ωστόσο, η απλή ανίχνευση κοπρανώδους μόλυνσης δεν επαρκεί για την υπόδειξη τρόπων εξυγίανσης και αντιμετώπισης του εκάστοτε προβλήματος. Οι δύο κύριες ομάδες στις οποίες διακρίνεται η κοπρανώδης μόλυνση είναι η ανθρώπινη και η ζωική, οι οποίες υποδηλώνουν πιθανή παρουσία διαφορετικών κάθε φορά παθογόνων μικροοργανισμών για τον άνθρωπο. Έτσι, προκειμένου να οριοθετηθεί ο κίνδυνος για τη δημόσια υγεία και να καθοριστούν μέτρα αντιμετώπισης της μόλυνσης ενδείκνυται ο προσδιορισμός της ανθρώπινης ή ζωικής προέλευσης της κοπρανώδους μόλυνσης. Στην παρούσα μελέτη αναπτύχθηκαν, εφαρμόστηκαν και αξιολογήθηκαν οι μέθοδοι: α)Έλεγχος πολλαπλής ανθεκτικότητας σε αντιβιοτικά (Multiple Antibiotic Resistance – MAR – φαινοτυπική μέθοδος) και β) PCR με τυχαία ενισχυμένα τμήματα πολυμορφικού DNA - Random Amplified Polymorphic DNA-PCR (RAPD-PCR – γονοτυπική μέθοδος), ως τεχνικές προσδιορισμού και διάκρισης προέλευσης μικροοργανισμών. Κατά το πρώτο στάδιο καθορίστηκαν οι παράμετροι των μεθόδων για το διαχωρισμό στελεχών E. coli γνωστής προέλευσης (60 στελέχη απομονωμένα από ζωικά κόπρανα και 68 στελέχη από ανθρώπινα). Για το διαχωρισμό και κατηγοριοποίηση των στελεχών εφαρμόστηκαν η Ιεραρχική Ανάλυση Κατά Συστάδες και η Διαχωριστική Ανάλυση. Με τη MAR ανάλυση τα στελέχη E. coli εμφάνισαν διαφορετικούς συνδυασμούς ανθεκτικότητας και διαχωρίστηκαν βάσει της προέλευσής τους με μέσο ποσοστό σωστής ταξινόμησης (ARCC) 99,2%. Με την RAPD-PCR χρησιμοποιήθηκαν δύο εκκινητές ξεχωριστά (1254 & 1290) και τα 128 στελέχη E. coli γνωστής προέλευσης διαχωρίστηκαν σε ανθρώπινης και ζωικής πηγής με ARCC 98,4% και με τους δύο εκκινητές. Η διακριτική ικανότητα της RAPD-PCR με τους δύο εκκινητές ήταν D1254=0,97 & D1290=0,90. Επιπλέον, η αξιολόγηση της επαναληψιμότητας της RAPD-PCR και με τους δύο εκκινητές έδωσε ικανοποιητικά αποτελέσματα με την εμφάνιση ίδιων ηλεκτροφορητικών εικόνων για τα ίδια βακτηριακά στελέχη. Στη συνέχεια οι επιλεγμένες τεχνικές εφαρμόστηκαν για την ταξινόμηση και κατηγοριοποίηση στελεχών E. coli άγνωστης προέλευσης εκτιμώντας την ανθρώπινη ή ζωική πηγή τους βάσει του μοντέλου διαχωρισμού των E. coli γνωστής προέλευσης. Οι E. coli άγνωστης προέλευσης (234 στελέχη) απομονώθηκαν από δείγματα πόσιμου νερού δικτύου από 11 περιοχές και δείγματα μη επεξεργασμένων λυμάτων από τις εισόδους τεσσάρων σταθμών βιολογικού καθαρισμού (ΚΕΡΕΦΥΤ – Νομός Αττικής, ΨΥΤΤΑΛΕΙΑ – Νομός Αττικής, ΡΙΟ – Νομός Αχαΐας και ΠΑΤΡΑ - Νομός Αχαΐας). Τα 234 στελέχη με τη MAR ανάλυση ταξινομήθηκαν ως ανθρώπινα και ζωικά σε ποσοστά 46,6% και 53,4% αντίστοιχα. Τα αποτελέσματα ταξινόμησης ήταν διαφορετικά με τη μέθοδο RAPD-PCR. Με τον εκκινητή 1254 τα άγνωστα στελέχη προσδιορίστηκαν ως ανθρώπινα κατά το 64,9% και ως ζωικά κατά το 35,1%. Αντίστοιχα, με τον εκκινητή 1290 τα ποσοστά ήταν 60,3% ανθρώπινα και 39,7% ζωικά. Τα στελέχη του πόσιμου νερού που προέρχονταν από τους σταθμούς δειγματοληψίας που ήταν αστικά κέντρα χαρακτηρίστηκαν εξ ολοκλήρου ως ανθρώπινης προέλευσης. Αντίθετα, στις περιοχές δειγματοληψίας με ανεπτυγμένη κτηνοτροφία βρέθηκαν και στελέχη ζωικής προέλευσης, γεγονός που υποδηλώνει την είσοδο στο δίκτυο κοπρανώδους υλικού προερχόμενου από ζώα των συγκεκριμένων περιοχών, τα οποία ενδεχομένως να έχουν άμεση πρόσβαση στις πηγές και γεωτρήσεις. Όσον αφορά στο χαρακτηρισμό των E. coli που καταλήγουν στους αναφερόμενους βιολογικούς καθαρισμούς, η πλειοψηφία ανίχνευσης ανθρωπίνων στελεχών δηλώνει την πιθανή παρουσία στα ακατέργαστα λύματα πολλών ανθρωπίνων εντερικών παθογόνων σημαντικών για τη δημόσια υγεία. Δεδομένου ότι τα τελευταία χρόνια οι ερευνητές έχουν αποδυθεί σε μια προσπάθεια επαναχρησιμοποίησης επεξεργασμένων λυμάτων επισημαίνεται η ανάγκη επεξεργασίας τους σε διάφορα στάδια για τη διασφάλιση της δημόσιας υγείας. Παρατηρήθηκε συμφωνία αποτελεσμάτων με τη χρήση των δύο εκκινητών καθώς η διαφορά στα ποσοστά δεν ήταν στατιστικά σημαντική (P>0,05). Συγκρίνοντας τα αποτελέσματα που ελήφθησαν με τις δύο μεθόδους, τη φαινοτυπική (MAR ανάλυση) και τη γονοτυπική (RAPD-PCR), υπήρξε στατιστικά σημαντική διαφορά (P<0,05), με συνέπεια να τίθεται θέμα επιλογής της πιο ενδεδειγμένης μεθόδου τυποποίησης και διάκρισης περιβαλλοντικών μικροοργανισμών. H παρούσα μελέτη αναδεικνύει την RAPD-PCR ως μια γονοτυπική μέθοδο με ικανοποιητική διακριτική ικανότητα, ευαισθησία, επαναληψιμότητα υπό αυστηρά καθορισμένες συνθήκες και χαμηλού κόστους. Η ευκολία εφαρμογής για την τυποποίηση μεγάλου αριθμού βακτηριακών στελεχών, χωρίς την απαίτηση γνώσης της νουκλεοτιδικής αλληλουχίας του γενετικού υλικού την καθιστούν ιδιαίτερα προσιτή σε εργαστήρια μοριακής μικροβιολογίας, ως τεχνική διάκρισης προέλευσης της κοπρανώδους μόλυνσης στο υδάτινο περιβάλλον. / Maintenance of the microbiological quality and safety of water systems is imperative, as their faecal contamination may exact high risks to human health as well as result in significant economic losses. The microbiological quality of water systems is evaluated by detecting their faecal pollution and especially specific faecal indicators such as Escherichia coli. Simple detection of faecal pollution is not sufficient in order to apply appropriate management plans to remedy the problem and to prevent any further contamination. Human faecal material is generally perceived as constituting a grater human health risk than animal faecal material, considering that it is more likely to contain human-specific enteric pathogens. Thus, it would be desirable to determine the source of the faecal material, especially for the assessment of risk for public health and for the development of monitoring plans. In the present study the development and assessment of Multiple Antibiotic Resistance Analysis (MAR – phenotypic method) and Randomly Amplified Polymorphic DNA-PCR Analysis (RAPD-PCR – genotypic method) were established as microbial source tracking methods. Firstly, parameters of the two selected methods were determined for the discrimination of E. coli isolates of known source (60 isolates from animal faecal material & 68 isolates from human faecal material). Hierarchical Cluster Analysis and Discriminant Analysis were applied for the classification of the isolates. With MAR analysis E. coli isolates developed different resistance profiles and were discriminated according to their source with an average rate of correct classification (ARCC) of 85.2%. With RAPD-PCR analysis two different 10-nt primers of arbitrary sequence were used (1254 & 1290) and the 128 E. coli isolates of known origin were classified as human and animal with the following ARCC: ARCC1254= 87.5% & ARCC1290= 81.3%. The discriminatory power of RAPD-PCR with the two selected primers was D1254=0.97 & D1290=0.90. Furthermore, the assessment of reproducibility of RAPD-PCR analysis provided satisfactory results with both primers, as RAPD profiles were identical for the same bacterial isolates. The assessment of specificity of the method resulted in the discrimination among RAPD profiles of E. coli isolates and other reference bacteria. The selected methods were applied for the classification and the source tracking of E. coli isolates, derived from tap water and raw sewage samples. In total 234 E. coli strains were isolated from tap water from 11 areas and raw sewage samples from four treatment plants (KEREFYT – prefecture of Attiki, PSITALIA - prefecture of Attiki, RIO - prefecture of Achaia and PATRA - prefecture of Achaia). With MAR analysis the 234 isolates were classified as human and animal in percentages of 46.6% & 53.4%, respectively. Classification results were different with RAPD-PCR analysis. With primer 1254 the classification was: 64.9% of human origin and 35.1% of animal origin and with primer 1290 the classification was: 60.3% of human origin and 39.7% of animal origin. Isolates derived from tap water of urban areas were classified in total as of human origin. On the contrary, in areas with many farm breeders many isolates were classified as of animal origin, indicating presence of faecal material in the water systems derived animal activities. As far as E. coli isolates from raw sewage samples are concerned, the majority of them were classified as of human source, indicating the possible presence of other human enteric pathogens as well. Taking into account the fact that there has been an effort in order to reuse treated sewage, it seems necessary a multi-stage process to renovate wastewater before it re-enters a body of water. There was an agreement of results of classification obtained form the use of the two different primers as the percentages did vary statistically (P>0.05). Comparing results obtained from the two selected methods, the difference was statistically significant (P<0.05), raising a question of the appropriate method for the typing and discrimination of environmental microorganisms. The present study demonstrates RAPD analysis as a simple, cost effective genotypic method with satisfactory discriminatory power, sensitivity and reproducibility. It can be applied for the analysis of a large number of bacterial isolates without the prior knowledge of nucleotide sequence of DNA to be necessary. Finally, it may fulfil environmental for the determination of origin of faecal pollution protecting water resources and public health.

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Statistikoje ir jos taikyme vienas dažniausiai sprendžiamų uždavinių yra daugiamačių tankių vertinimas.Tankių vertinimas skirstomas į parametrinį ir neparametrinį vertinimą. Parametriniame vertinime daroma prielaida, kad tankio funkcija f, apibūdinanti duomenis yi, kai i kinta nuo 1 iki n, priklauso tam tikrai gan siaurai funkcijų šeimai f(•;θ), kuri priklauso nuo nedidelio kiekio parametrų θ=(θ1, θ2, …, θk). Tankis, apskaičiuojamas pagal parametrinį vertinimą, gaunamas iš pradžių apskaičiavus parametro θ įvertį θ0 ir f0=f(•;θ). Toks traktavimas statistiniu požiūriu yra labai efektyvus, tačiau jeigu nei vienas šeimos f(•;θ) narys nėra artimas funkcijai f, rezultatai gali būti gauti labai netikslūs. Neparametriniam tankio vertinimui jokios parametrinės prielaidos apie f nėra reikalingos, tačiau vietoj to daromos kitos prielaidos, pavyzdžiui, apie funkcijos f tolydumą arba, kad f yra integruojama. Tankio funkcijos forma yra nustatoma iš turimų duomenų.Turint dideles imtis, tankis f gali būti apskaičiuotas pakankamai tiksliai. Šiuolaikinėje duomenų analizėje naudojama daugybė neparametrinių metodų, skirtų daugiamačių atsitiktinių dydžių pasiskirstymo tankio statistiniam vertinimui. Ypač plačiai paplitę branduoliniai įvertiniai, populiarūs ir splaininiai bei pusiau parametriniai algoritmai. Taikant daugumą populiarių neparametrinio įvertinimo procedūrų praktikoje susiduriama su jų parametrų optimalaus parinkimo problema. Branduolinių įvertinių konstrukcijos svarbiausiu... [toliau žr. visą tekstą] / Most algorithms work properly if the probability densities of the multivariate vectors are known. Unfortunately, in reality these densities are usually not available, and parametric or non-parametric estimation of the densities becomes critically needed. In parametric estimation one assumes that the density f underlying the data yi where i varies from 1 to n, belongs to some rather restricted family of functions f(•;θ) indexed by a small number of parameters θ=(θ1, θ2, …, θk). An example is the family of multivariate normal densities which is parameterized by the mean vector and the covariance matrix. A density estimate in the parametric approach is obtained by computing from the data an estimate θ0 of θ and setting f0=f(•;θ). Such an approach is statistically and computationally very efficient but can lead poor results if none of the family members f(•;θ) is close to f. In nonparametric density estimation no parametric assumptions about f are made and one assumes instead that f, for example, has some smoothness properties (e.g. two continuous derivatives) or that it is square integrable. The shape of the density estimate is determined by the data and, in principle, given enough data, arbitrary densities f can be estimated accurately. Most popular methods are the kernel estimator based on local smoothing of the data. Quite popular are histospline, semiparametric and projection pursuit algorithms. While constructing various probability density estimation methods the most... [to full text]

Cette thèse poursuit deux objectifs principaux. Le premier consiste à développer un modèle de la compatibilité conjugale fondé sur les notions d’attachement (évitement de la proximité et anxiété d’abandon) et de personnalité (névrotisme). Le deuxième objectif est d’examiner la validité prévisionnelle de ce modèle de compatibilité chez des couples en psychothérapie conjugale. Dans un premier temps, la présente thèse fait brièvement état de la situation des couples au Québec et des répercussions de la détresse conjugale. Par la suite, la recension de la documentation traite du concept de compatibilité entre conjoints en tant qu’alternative à la conceptualisation des dynamiques de couples. Cette analyse théorique montre ensuite la pertinence d’enrichir les modèles de compatibilité en y introduisant les notions d’attachement et de névrotisme. L’examen de ce modèle est suivi par une description des enjeux méthodologiques et statistiques à prendre en compte pour déterminer les fondements scientifiques des hypothèses sur la compatibilité conjugale. L’analyse de la validité prévisionnelle du modèle de compatibilité proposé compose le cœur de cette thèse. Pour ce faire, des couples effectuant une thérapie conjugale ont complété une série de questionnaires en début de suivi, dont l’Échelle d’ajustement dyadique (Spanier, 1976), le Questionnaire sur les expériences d’attachement amoureux (Brennan, Clark, & Shaver, 1998) et le NEO-FFI (Costa & McCrae, 1992). Les données des 365 couples de l’échantillon sont d’abord analysées en appliquant une méthode fondée sur les modèles d’interdépendance acteur-partenaire (APIM) (Kashy & Snyder, 1995). Les résultats démontrent que la présence d’évitement de la proximité est négativement liée à la satisfaction des conjoints eux-mêmes et à celle de leur partenaire. La méthode APIM révèle aussi que plus l’écart entre les conjoints sur l’évitement et le névrotisme est grand, plus les partenaires rapportent être insatisfaits de leur relation. Les résultats sont ensuite examinés à l’aide d’une technique statistique, l’analyse des regroupements naturels ou des clusters, susceptible de mieux examiner la notion de compatibilité. Cette analyse montre la présence de sept regroupements naturels de conjoints selon leurs scores d’attachement et de névrotisme. De plus, lorsque ces clusters sont croisés en fonction de la détresse conjugale, trois grands sous-types de couples qui engendrent des profils de détresse conjugale distincts émergent des analyses. Ces clusters présentent enfin des différences qualitatives quant à la nature des mandats thérapeutiques confiés aux thérapeutes. Les implications des résultats sont discutées en regard de la validation du modèle de compatibilité fondé sur les notions d’attachement et de névrotisme. Certaines données de la présente thèse suggèrent que ce ne sont pas les caractéristiques de l’un ou de l’autre des conjoints prises isolément, mais plutôt la combinaison des caractéristiques des conjoints qui explique le mieux la nature et la gravité de la détresse conjugale vécue. Plusieurs défis conceptuels, théoriques et méthodologiques sont discutés et des pistes de recherches futures sont proposées afin de consolider les assises scientifiques du modèle de compatibilité. / The first goal of this thesis is to propose a new model of compatibility. Partner’s compatibility is conceptualized from two attachment dimensions (avoidance and anxiety) as well as personality trait (neurotism). The second goal was to test this model on a sample of couples seeking marital therapy. A critical literature review on the role of compatibility in the understanding of couples’ dynamics is completed, underlining the relevance of improving this concept’s definition by taking attachment and neurotism into account. Methodological and statistical issues to consider are also discussed. To evaluate the predictive validity of the model, 365 couples completed the Dyadic adjustment scale (Spanier, 1976), the NEO-FFI (Costa & McCrae, 1992) and the Experiences in close relationships questionnaire (Brennan, Clark, & Shaver, 1998) at intake. The association between personality, attachment and marital satisfaction is first examined with the Actor-Partner Interdependence Model (Kashy & Snyder, 1995). Results show that attachment avoidance is negatively associated with marital satisfaction for spouses themselves as well as for their partners. Analysis of similarities and differences is then performed, revealing that differences between partners on the combination of avoidance and neurotism are correlated with marital insatisfaction. To examine the patterns of natural groupings between partners in the sample, clusters analyses were conducted. Seven different types of couples exhibiting significant differences in their marital satisfaction were found. Three main groups of couples were identified within these types, the first one regrouping mostly satisfied couples, a second one including very dissatisfied partners and a last one presenting a difference between the man’s and the women’s satisfaction. These results could be considered as provinding preliminary confirmation of our compatibility model based on attachment and neurotism, but these propositions must be validated. Some elements of the present findings suggest that it is the combination of attachment anxiety, avoidance and neurotism between partners that is linked to severity of marital distress. However, many challenges, conceptual, theoretical, as well as methodological, are then discussed and future scientific contributions are proposed in order to consolidate the conceptual base of compatibility.

研究目的：失眠影響國人身心健康甚多，藥物取向治療為當代最廣泛的失眠治療方式。研究顯示許多失眠患者，可藉由短期服用助眠藥物改善失眠，避免個體失眠慢性化，且於停藥後未有任何藥物副作用困擾。然而，臨床上仍觀察到不少個案，對助眠藥物產生依賴，需長期服用助眠藥物，此舉不僅造成醫療資源之浪費，其安全性與有效性仍受爭議。而心理因素在藥物依賴扮演重要的角色，同樣是長期服用助眠藥物，不同的助眠藥物使用者卻可能存有相異的用藥心態，因此助眠藥物使用者的用藥行為以及用藥相關心態，可能會組合成不同的用藥型態，而探討助眠藥物之不同使用型態與其心理機轉，有助於進一步瞭解助眠藥物使用現象。故本研究旨在用量化方法探討助眠藥物使用型態之差異，試圖將不同的助眠藥物使用型態進行分群，並提出可能影響助眠藥物使用型態的相關因子。 研究方法與結果：本研究招募了272名曾經或目前正在服用助眠藥物的使用者填寫研究問卷，透過對兩個外顯用藥行為變項（用藥總時間、用藥頻率）與六個用藥相關心理變項（對助眠藥物的渴求程度、對助眠藥物的正、負向態度、主觀規範、以及促進、抑制之知覺控制）的集群分析，我們將助眠藥物使用型態分為「慣性使用」、「矛盾依賴」、「控制使用」以及「輔助使用」四種型態。在外顯用藥行為方面，「慣性使用」集群與「矛盾依賴」集群皆展現較長的用藥時間與高頻率的使用，「控制使用」群集與「輔助使用」群集則展現較短的用藥時間與低頻率的使用。然而，四組群集皆展現其獨特的心理特徵。「慣性使用」群集對助眠藥物的渴求程度最強，正向態度比負向態度高，主觀認為重要他人支持自己服用助眠藥物，傾向持續服用助眠藥物；「矛盾依賴」群集呈現對助眠藥物正向與負向態度皆高的矛盾狀態，且主觀認為自己無法控制藥物之使用；「控制使用」群集雖也對助眠藥物出現正向、負向態度皆高的表現，但其可對藥物使用進行控制；「輔助使用」群集的個案對於助眠藥物的負向態度高於正向態度，藥物渴求程度低，且傾向避免使用助眠藥物。多項式邏輯斯回歸的分析結果則進一步顯示年齡較大、失功能睡眠信念問卷分數較高的個案，較容易落入「慣性使用」組；被診斷過情緒疾患、失眠時間較長、睡前激發程度問卷分數較高的個案，較容易落入「矛盾依賴」組；受教育年限較高的個案，較傾向落入「控制使用」組；最後，年紀較輕、失功能睡眠信念問卷分數較低的個案，則容易落入「輔助使用」組。 結論：本研究結果顯示相似的用藥行為仍有相異的用藥相關心理狀態，且部分心理相關變項可能會影響助眠藥物之使用型態，故推測用藥心理與助眠藥物使用者的特質扮演影響用藥型態的重要因素。此結果可提供臨床工作者，初步了解助眠藥物使用之心理機轉，亦能將其運用於協助不同類型的安眠藥物使用者擬訂減藥處遇。 / Purpose：Insomnia has great impact on people's health in Taiwan. Pharmacological approaches are the most commonly used treatment for insomnia. Although short-term hypnotic use could improve sleep, however some patients use hypnotics for a prolonged period of time and have difficulty to discontinue using them. This would lead to great cost of the individuals and societies. Psychological factors have been found to play an essential role in the long-term use of other substances. Clinical observation also showed that there were individual differences in the psychological aspects of medication use in spite of similar medication use behaviors. Therefore, it is possible to use hypnotic-related behaviors and psychological factors to categorize hypnotic users in order to further the understanding the mechanism underlying chronic hypnotic use. The purpose of this research is to identify hypnotic use patterns by exploratory quantitative method and the characteristics associated with different hypnotic usage patterns. Methods and Results: 272 previous or current hypnotic users were recruited to complete a package of questionnaires. Through cluster analysis with two explicit medication behavior variables (total duration of hypnotic use, frequency of hypnotic use) and six hypnotic-related psychological variables (craving for hypnotic, positive and negative attitudes towards hypnotic, subjective norm, facilitating and inhibiting perceived behavioral control), four hypnotic usage patterns were identified, which were “habitual use”, “paradoxical dependence”, “controlling use”, and “supplementary use”. In terms of explicit medication behaviors, “habitual use” and “paradoxical dependence” clusters both show longer time and higher frequency of hypnotic use. On the other hand, “controlling use” and “supplementary use” clusters showed similar medication use behaviors with shorter duration and lower frequency of hypnotic use. In addition, the four clusters exhibited different psychological profiles. Users in “habitual use” cluster have strongest craving for hypnotic, higher positive than negative attitude toward hypnotic use, and believe that significant others support their medication behavior. Users in “paradoxical dependence” cluster showed paradoxical attitude toward hypnotics, and reported less control over their hypnotic use. Users in “controlling use” cluster also had paradoxical attitude toward hypnotic, but their craving level of hypnotic was lower than users in “paradoxical dependence” cluster. In addition, users in “controlling use” cluster feel they can control their hypnotic use. Users in “supplementary use” cluster had lowest craving level, higher negative attitude toward hypnotic, and tend to avoid taking hypnotic when possible. Multiple logistic regression further showed that (1) people with older age or higher score on the Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS) tend to classified into “habitual use” cluster; (2) people with mental disorder diagnosis, long history of insomnia, or higher score in Pre-Sleep Arousal Scale (PSAS) tend to be classified into the "paradoxical dependence " cluster; (3) patient with more years of education more likely fall into “controlling use” cluster, finally, (4) the hypnotic users who are younger or lower score in DBAS are easier classified into the “supplementary use ” cluster. Conclusions：The results of the current study indicates that similar medication behavior could have different hypnotic-related psychological status. Therefore, psychological factors are needed to be assessed in order to understand the process of long-term hypnotic use. The results provides a further understanding of the psychological mechanisms of hypnotic use, and also help clinician in related-field to develop insomnia treatment plan or hypnotic discontinuation program based on insomniacs’ characteristics and their psychological variable toward hypnotic use.

This thesis investigates long-term cognitive outcome in two cohorts of adolescents and young adults exposed to stressors during the perinatal period: one group born preterm (&lt;37 weeks of gestation and birth weight &lt;1,500 g); one group exposed to two or more courses of antenatal corticosteroids (ACS), to stimulate lung maturation in the face of threatening preterm birth. In fetal life the brain undergoes dramatic growth, and a disruption to the early establishment of functional neural networks may interrupt development in ways that are difficult to predict. Executive function refers to a set of cognitive processes that are important for purposeful regulation of thought, emotion, and behavior, and even a subtle depreciation may influence overall functioning. Study I investigated the stability of executive function development after preterm birth. Executive functions were differentiated into working memory and cognitive flexibility. Both components were highly stable from preschool age to late adolescence. In Study II, we identified subgroups within the group of children born preterm with respect to cognitive profiles at 5½ and 18 years, and identified longitudinal streams. Outcome after preterm birth was diverse, and insufficiently predicted by perinatal and family factors. Individuals performing at low levels at 5½ years were unlikely to improve over time, while a group of individuals performing at or above norm at 5½ years had improved their performance relative to term-born peers by age 18. Studies I and II pointed to the need for developmental monitoring of those at risk, prior to formal schooling. Study III investigated long-term cognitive outcome after repeat ACS treatment. The study did not provide support for the concern that repeat ACS exposure will have an adverse impact on cognitive function later in life. In sum, exposure to perinatal stressors resulted in great variation in outcome. However, for many, their rough beginnings had not left a lasting mark. / <p>At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 1: Submitted.</p>

Die kumulative Promotion befasst sich mit der Lebensform „Living apart together“ (LAT), worunter Paare verstanden werden, die nach Maßgabe ihre Selbstwahrnehmung in getrennten Haushalten leben. Die Arbeit besteht aus insgesamt vier Beiträgen, die in peer-review-Journals erschienen sind sowie einer zusammenfassenden Synopse. Ein erster Schwerpunkt des Promotionsprojektes besteht darin, die Binnendifferenzierung der partnerschaftlichen Lebensform LAT zu untersuchen. Dazu werden mit Daten des Beziehungs- und Familienpanels (Befragte zwischen 15 und 39 Jahre) verschiedene Typen von LAT-Partnerschaften mithilfe von Clusteranalysen identifiziert. Hierbei erweist sich eine heuristische Einteilung in drei Idealtypen – die LAT als Vorstufe stärker verfestigter Lebensformen, LAT als berufsbedingte Notlösung und LAT als Beziehungsideal – als weitgehend empirisch tragfähig. Gleichzeitig werden neue Typen wie z.B. die „ökonomisch deprivierte LAT“ identifiziert, bei der eine ökonomisch prekäre Lage und eine starke Betroffenheit von Arbeitslosigkeit die weitere Institutionalisierung der Partnerschaft zu hemmen scheinen. Das zweite Ziel der Arbeit besteht darin, die Entwicklung der LAT-Partnerschaften im Längsschnitt, d.h. die Übergänge in den gemeinsamen Haushalt einerseits und in eine Trennung andererseits, zu untersuchen. Hier zeigen sich zum Teil deutlich Unterschiede zwischen den zuvor identifizierten Clustern. Eine niedrige Übergangsrate in die Kohabitation sowie ein hohes Trennungsrisiko können z.B. für jugendliche LAT-Partnerschaften, aber auch für den ökonomisch deprivierten Typ, beobachtet werden. Die Kohabitationsneigung bei berufsbedingten Fernbeziehungen ist dagegen höher und das Trennungsrisiko geringer als theoretisch erwartet. Schließlich wird als dritter Schwerpunkt des Projektes der Frage nachgegangen, welche Rolle Eigenschaften der Herkunftsfamilie im Institutionalisierungsprozess spielen. Es zeigt sich, dass Jugendliche die für sie typische LAT-Partnerschaft insbesondere dann früh verlassen und einen Haushalt mit ihrem Partner gründen, wenn es sich nicht um Kernfamilien, sondern um alleinerziehende Eltern oder Stiefeltern handelt. Im Promotionsprojekt wird der Frage nachgegangen, auf welche Mechanismen diese Zusammenhänge hauptsächlich zurückführbar ist, wobei verschiedene theoretische Ansätze – ökonomische Deprivation, Transmissionseffekte, soziale Kontrolle, Stress – vergleichend gegenübergestellt werden.

Nuo 1995 metų bankai pradėjo teikti savo klientams tiesiogines prieigas prie savo sąskaitų per internetą iš bet kurio pasaulio taško. Lietuvoje šios paslaugos vartotojų skaičius auga kiekvienais metais. Tačiau didėjant internetinės bankininkystės klientų skaičiui, daugėja ir su paslaugos vartojimu susijusių problemų. Viena didžiausių – vartotojų kompetencijos trūkumas naudojantis paslauga. Vieni nemoka atlikti paprasčiausių operacijų, o labiau patyrę vartotojai dažniausiai nebūna susipažinę su visomis internetinės bankininkystės galimybėmis. Darbe aprašomas bankininkystės žinyno modelis, sukurtas naudojant techninio rašymo principus ir pritaikytas atskiriems vartotojų segmentams. Modelio tinkamumas įvertintas atliekant eksperimentinį tyrimą, kuris susidarė iš virtualaus komandinio darbo projekto bei anketinės apklausos. / Since 1995 banks offer their clients direct access to bank accounts through internet from everywhere in the world. In Lithuania number of internet banking users is growing every year. During 9 months of year 2006, number of users has increased 24 %. More and more traditional banking features are implemented into internet banking and that makes internet banking complex. While the number of users keeps increasing, we have to face more problems too. In 2003 SEB Bankas carried out a research that indicated that one third of people do not use internet banking because they are not ignorant of this service. Beginners usually do not know how to perform basic features while advanced users are not familiar with the entire internet banking opportunities. The goal of this paper is to create an internet banking manual’s model that combines the principles of technical writing and will be adopted for separated user segments. Dual experimental research has been carried out to evaluate the created model.

<p><font face="TimesNewRomanPSMT"> <p align="left">Groundwater in arid and semi-arid areas like the Karoo region of South Africa is an important source of domestic, agricultural and industrial source of fresh water. As a scarce resource, it requires extensive quality control and protection through innovative methods and efficient strategies. The town of Beaufort West and its vicinity use groundwater as a major source of municipal and private water supply. Forty nine groundwater samples were collected from spatially referenced boreholes located in and around the town of Beaufort West and were analyzed for <font face="TimesNewRomanPSMT">EC, pH, <font face="TimesNewRomanPSMT">TDS,<font face="TimesNewRomanPSMT">TH, SAR, TA, Ca</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">2+</font></font><font face="TimesNewRomanPSMT">, Mg</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">2+</font></font><font face="TimesNewRomanPSMT">, Na</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">+</font></font><font face="TimesNewRomanPSMT">, K</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">+</font></font><font face="TimesNewRomanPSMT">, HCO</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">3-</font></font><font size="3" face="TimesNewRomanPSMT">, Cl</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">-</font></font><font size="3" face="TimesNewRomanPSMT">, NO</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">3- </font></font><font size="3" face="TimesNewRomanPSMT">and SO</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">42- </font></font><font face="TimesNewRomanPSMT"><font size="3">according to&nbsp / <font face="TimesNewRomanPSMT">SANS 241 standards and tested for ionic balance. The groundwater of the study area was characterized using WHO and South African drinking water quality standards as well as TDS and Salinity hazard classifications. These comparisons and classifications characterized the groundwater of the study area as hard to very hard, with low to medium salinity hazard. These results are in accordance with the dominance of the ions Ca</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">2+</font></font><font face="TimesNewRomanPSMT">, Na</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">+</font></font><font face="TimesNewRomanPSMT">, HCO</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">3 - </font></font><font face="TimesNewRomanPSMT">and Cl</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">- </font></font><font face="TimesNewRomanPSMT">in the groundwater samples. Linear relationships between the hydrochemical variables were analysed through correlation and multiple regression analysis to relate the groundwater quality to the underlying hydrogeochemical processes. These linear relationships explained the contribution of the measured variables towards the salinity, hardness and anthropogenic contamination of the groundwater. The groundwater of the study area was also assessed using conventional trilinear diagrams and scatter plots to interpret the water quality and determine the major ion chemistry. The conventional methods highlighted the sources of the hydrochemical variables through analysis and interpretation of rock-water interaction and evaporations processes. To supplement <font face="TimesNewRomanPSMT">these conventional methods and reveal hidden hydrogeochemical phenomenon, multivariate statistical analyses were employed. Factor analysis reduced the hydrochemical variables into three factors (Hardness, Alkalinity and Landuse) that characterize the groundwater quality in relation to the source of its hydrochemistry. Furthermore, combination of Cluster (CA) and Discriminant analyses (DA) were used to classify the groundwater in to different hydrochemical facies and determine the dominant hydrochemical variables that characterize these facies. The classification results were also compared with the trilinear diagrammatic interpretations to highlight the advantages of these multivariate statistical methods. The CA and DA classifications resulted in to six different hydrochemical facies that are characterized by NO</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">3 -</font></font><font face="TimesNewRomanPSMT">, Na</font><font size="1" face="TimesNewRomanPSMT"><font size="1" face="TimesNewRomanPSMT">+ </font></font><font face="TimesNewRomanPSMT">and pH. These three hydrochemical variables explain 93.9% of the differences between the water types and highlight the influence of natural hydrogeochemical and anthropogenic processes on the groundwater quality. All the univariate, bivariate, multivariate statistical and conventional hydrogeochemical analyses results were analyzed spatially using ArcGIS 10.0. The spatial analysis employed the Inverse Distance Weighted (IDW) interpolation method to predict spatial distribution of unmeasured areas and reclassification of the interpolation results for classification purposes. The results of the different analyses methods employed in the thesis illustrate that the groundwater in the study area is generally hard but permissible in the absence of better alternative water source and useful for irrigation.</font></font></font></font></font></font></p> </font></p>