Bakgrund: Distriktssköterskors arbete har förändrats över tid. Patienter är idag ofta välinformerade om sin hälsa och medvetna om att de kan påverka sin hälsa. I dagens samhälle är internet en vanlig källa till hälsoinformation, som har blivit allt mer tillgänglig. Det är viktigt att patienten känner delaktighet i sin egen vård.  Vårdgivaren har ett ansvar att leda patienten till tillförlitliga informationskällor. Syfte: Syftet med studien var att belysa distriktssköterskors erfarenheter av att patienter söker hälsoinformation på internet och hur det påverkar deras arbete. Metod: En kvalitativ metod har använts. Åtta intervjuer har genomförts med distriktssköterskor. Resultat: Ur analysen av datamaterialet framträdde tre huvudteman som benämns; Vikten av att veta och förstå, Mötets betydelse för patienter, Distriktssköterskors erfarenhet och ny kunskap. Till dessa teman finns nio olika underteman. Konklusion: Resultatet av denna studie kan bidra till en ökad medvetenhet om att patienter söker hälsoinformation på internet och hur det påverkar distriktssköterskors arbete. Distriktssköterskor får förhålla sig till patienters kunskap som kan se mycket olika ut. Patienters kunskap ställer krav på distriktssköterskorna som får anpassa besöket och vården utifrån denna kunskap samt vägleda patienter rätt. / Background: District nurses work has changed over time. Today patients are more informed of their health and aware of how to influence their health. In today's society, the internet is a regular source for health information, and internet has become increasingly accessible. It is important that patients feel involved in their own care. Health care providers has a responsibility to lead the patient to reliable sources of information. Aim: The aim of this study was to shed light on district nurses' experiences of patients seeking health information on the internet and how it affects their work. Method: A qualitative approach was used. Eight interviews with district nurses were conducted. Results: From the analysis of the data, three main themes emerged which were termed; The importance of knowing and understanding, The meaning of the meeting for patients, District nurses experience and new knowledge. These themes are described by nine different sub-themes. Conclusion: The results of this study may contribute to awareness that patients seek health information on internet and that it may affect district nurses work. District nurses need to relate to patient's knowledge that varies. Patients´ knowledge demands district nurses to adapt the care and the patients visit based on their knowledge and to guide patients’ right.

A case study of the experiences of six African American male teachers in a southern K-12 school district is presented in this study. The purpose of this study was: 1) to hear the voices of African American male teachers in a selected urban school district; 2) to identify the factors that contribute to their job acceptance decisions; 3) to gain an in-depth understanding of why teachers chose teaching as a profession; 4) to determine and understand the nature of the professional lives of these teachers; and finally, 5) to advance our existing knowledge base in attracting African American males to our nation's classrooms. The data collection process consisted of one-on-one, open-ended interview questions with six highly qualified African American male public school teachers in a K-12 school district in the Southern region of the United States. The key themes which emerged through data analysis include: (1) nobility associated with the teaching profession; (2) compassion associated with the teaching profession; (3) stability associated with the teaching profession; (4) family and community influences; (5) life experiences and (6) I was not recruited: I chose this district. Ethic of Care and Critical Race theoretical frameworks were the foundation for the study.

Fjärrvärme är idag den vanligaste formen av fastighetsuppvärmning i Sverige. Förutom värmeanläggningar som byggts just för ändamålet att leverera fjärrvärme har pappers- och massaindustrin blivit en betydande aktör på marknaden i de orter där industrin finns. BillerudKorsnäs massa- och pappersbruk på Gruvön i Grums kommun levererar fjärrvärme till kommunen och till det intilliggande sågverket.   Syftet med projektet är att genom kartläggning av Gruvöns sekundärvärmesystem på barrsulfatlinjen belysa effektiviseringsmöjligheter med en ökad fjärrvärmeleverans som följd.   Målet är att upprätta en simuleringsmodell i programmet Wingems och med hjälp av den se vad dessa effektiviseringsmöjligheter kan leda till i form av ökad fjärrvärmeleverans.   Metoden i arbetet har utgått från att kartlägga energiflöden till två vattencisterner på barrsulfatlinjens sekundärvärmesystem. Driftdata för vattenflöden i sekundärvärmesystemet har inhämtats i form av flödesstorlek och temperatur, vilka har legat till grund för en simuleringsmodell i Wingems.   Sekundärvärmesystemet på barrsulfatlinjen består av en ljumvatten-cistern, en hetvatten-cistern och ett antal värmeväxlare och kondensorer. Ett av de identifierade problemenen med systemet är att temperaturen i ljumvatten-cistern är högre än den borde. Anledningen till detta är ett vattenflöde från en värmeväxlare som kyler svartlut och leds in till cisternen. Vattenflödet håller en temperatur mellan 70-75°C. Huvudkonsumenten till cisternen är en förindunstare som förses med kylvatten. Temperaturen på vattnet bör ligga på 23°C. Vid en lägre temperatur skickas hetvatten från lövsulfatlinjen att värma vattnet till 23°C, på vägen passerar hetvattnet två värmeväxlare som överför energi till fjärrvärmenätet. Med en högre temperatur i cisternen krävs ett mindre flöde att förvärma kylvattnet, vilket leder till en minskad effekt ut på fjärrvärmenätet.   Resultatet visar att genom omledning av kylvattenflödet från svartlutkylaren till hetvatten-cistern på barrsulfatlinjen kan effektöverföringen till fjärrvärmenätet öka med 3,1 MW. En alternativ lösning skulle kunna vara att kyla svartluten med 74°C vatten från hetvatten-cisternen på barrsulfatlinjen. Kylvattnet kan sedan ledas in tillbaka till hetvatten-cisternen, svartlutkylaren skulle då bli en betydande energiproducent till systemet. Simuleringar visar att denna åtgärd skulle kunna ge en potentiell ökad effektöverföring till fjärrvärmenätet med 9 MW. / District heating is the most common form of house heating in Sweden today. Apart from heating plants that has been built to the purpose, the paper and pulp industry has become a significant contributor. BillerudKorsnäs paper and pulp mill at Gruvön in Grums municipality delivers district heating both to the residents in Grums and the nearby sawmill.   However it has been observed that the amount of energy transferred to the district heating network has been reduced after several redevelopments and new installations at the mill. The purpose with this report is through mapping of the mills secondary heating system find efficiency opportunities that will lead to an increased delivery of district heating. The goal is to develop a simulation model with the software Wingems and with the model make simulations to see the amount of increased district heating the efficiency opportunities may lead to.   To achieve this, the method has been to map the energy flow to and from two water tanks in the secondary heating system in the mills softwood line. Input data for streams in the secondary heating system has been gathered, and these have then been used to construct the simulation model.   The part of the secondary heating system that is located at the mills softwood line consists of one lukewarm water tank, one tank that contains hot water and several heat exchangers and condensers. One of the identified problems with the system is that the temperature in the lukewarm water tank is higher than it should be. The main consumer of the water tank is a pre-evaporator that is using water at the temperature of 23°C to condense some of the flash steam it produces. If the temperature of the water in the tank is below 23°C, hot water from the hardwood line is being pumped to heat the water to the pre-evaporator. The hot water passes two heat exchangers that transfer some of the energy to the district heating system. A higher temperature of the water in the lukewarm tank leads therefore to a smaller flow through the heat exchangers that in turn leads to a lower delivery of district heating.   The reason to the higher temperature in the lukewarm tank is a heat exchanger that cools black liquor from the pre-evaporator. The heated water used to cool the black liquor has a temperature between 70°C to 75°C. This water is being led to the lukewarm tank and is the main reason that the temperature in the tank is higher than designed. The results show that a rerouting of the heat exchangers cooling water to the tank containing hot water could lead to a 3,1 MW increased power transfer to the district heating network. Redesigning the heat exchanger to use water from the hot water tank to cool the black liquor and then lead the even hotter water back to the tank could lead to a 9 MW increased power transfer.

The promulgation of the Mental Health Care Act of 2002 in South Africa came with challenges or changes in the nursing of mentally ill people. One of the changes required that mental patients need to be observed and assessed for a period of 72 hours in a general or medical ward before being transferred to a specialist hospital. Sometimes the person remains in the ward for more than the 72 hours. This means that nursing students doing their comprehensive four year diploma (R425) are exposed to nursing people with mental illness in their first, second and third year of training, which is prior to the mental health nursing/psychiatric nursing module undertaken in the last semester of the fourth year. The purpose of this study was to explore student nurses’ narratives on nursing mentally ill people in a medical ward. Narrative inquiry was used as the research methodology. Purposive sampling was used to select 5 participants for this study. The inclusion criteria specified that participants had to be second year students participating in the four year Comprehensive Nursing Diploma Programme (R425) who have nursed, or been in contact with a mentally ill person, for a period of eight weeks. The study was conducted before the participants were exposed to the psychiatric module, which is undertaken in fourth year of the diploma course. Data collection took place through a total of 5 sessions of focus groups which took place in a boardroom. While personal names were excluded, participants were required to fill in certain demographic details. Data analysis was undertaken using narrative data analysis, which looked at narrative strings, which are presenting commonalities and narrative threads which are major emerging themes. The narrative strings or commonalities that were identified were in the area of beliefs, with the dominant beliefs regarding the causes of mental illness being culturally or socially based. Emotions such as fear, sadness and frustration were identified, as well as ignorance which leads to stigmatising attitudes. The narrative threads or emerging themes that were identified were: making sense of experiences; moments of awakenings; breaking free moments; and acceptance of a known person with mental illness. The following themes were identified: moments of awakenings or realisation, where the participants started seeing the mentally ill person in another light; and moments of strengths/unique outcomes, where participants recognised their own strengths in dealing with a mentally ill person. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

KwaZulu-Natal province records the highest number of tuberculosis cases diagnosed in the country, but less than 50% of these were cured in 2008, and fewer in those from rural areas and informal settlements where inadequate health care continues. HIV and AIDS associated tuberculosis frequently require labour-intensive methods of monitoring and combating for any success to be achieved. The socio-economic context wherein these diseases occur further limit their control. The low proportion of tuberculosis patients currently with successful treatment outcomes in Umgungundlovu Health District makes essential an in-depth investigation to establish the factors that are associated with these poor outcomes. This study investigates the factors affecting the current poor treatment outcomes in new patients with tuberculosis in a high disease burden district of KwaZulu-Natal in 2011. Methods A retrospective case-control study was conducted comprising 300 adult cases of tuberculosis who failed to complete 6 months of ambulant therapy and 300 frequency matched controls who completed therapy. A random sample of 15 primary health care clinics was selected from where consecutive cases and controls were selected with probability proportional to the number of tuberculosis patients seen at the clinic. Data was extracted from patient records and interviews. Processed data was analysed to identify risk associations using multivariate logistic regression. Results After adjusting for confounding statistically significant risk factors associated with poor tuberculosis treatment outcomes were unemployment (Odds Ratio (OR) 16.0; 95% CI: 6.7 to 37.8); living in a rural area (OR 14.3; 95% CI: 1.1 to 18), distance from home to clinic (OR 1.4; 95% CI: 1.3 to 1.6), living with HIV (OR 2.3; 95% CI: 1.1 to 4.7) and being very ill (OR -5.0; 95% CI: 2.1 to 11.9). Discussion The principal findings are that non-adherence to TB treatment is significantly associated with a number of non-health systems issues. Determinants of poor TB treatment outcomes in patients receiving six-month ambulatory care are diverse and multifactorial. After adjusting for confounding variables, unemployment, distance from patient home to the clinic, living with HIV and being very ill during TB therapy remained significantly associated with a poor TB treatment outcome. Conclusions Although determinants of poor tuberculosis treatment outcomes in patients receiving six-month ambulatory care are diverse and multifactorial, poor tuberculosis treatment outcomes are significantly associated with identifiable factors independent of the health system. Rigorous intervention strategies should prioritize at least these five major risk factors. Recommendations The TB control programme should go beyond the health systems issues to include inter-sectoral collaboration to address socio-economic and other non-health system barriers to adherence to TB treatment. Further research is recommended in this field. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2012.

The aim of this study was to develop a load prognosis model for Uppsala district heating system to be used as a tool for heat production optimization. The methodwas to build three models for the different customer types; housing, industry andoffices and then scale them for the total system using data from Uppsala districtheating system. The heat load consists of two parts, one that is temperaturedependent and one that is dependent of the social behavior of the customers. Thetemperature part was modelled with an ARX model using an outdoor temperatureprognosis as input signal. The social behavior part was modelled using the mean ofthe social behavior from some days before and additionally by distinguishing betweenweekdays and weekends. The outcome was a model that would produce a prognosisfor the heat load for each customer type. The total model for the whole districtheating system was less accurate, but still usable. All models developed are howeverrelying on the quality of the available weather prognosis. The benefit of a precise loadprognosis is to facilitate production planning and optimization. Accurate predictions ofthe heat demand, especially in the case of peak load, will result in better productionplanning and thus cost efficiency.

South Africa as a developing country experienced high levels of poverty and unemployment. These levels emanate from skills gap and low literacy rate in the townships populated by low income households. To an extent some households lacked access to participate in the economic sector, resulting from fragmented policies and apartheid regime. The lack of participation among the households placed pressure on government. These problems forced the state to provide social protection (grants). Such allowances are expensive especially where there are fewer opportunities for employment activities. The promotion of entrepreneurship and small business remains an important priority of the government of South Africa. The South African government is acknowledged for its commitments to ensure that small businesses progressively contribute to growth and performance of the South African economy. Globally, numerous policy legislative frameworks have been developed to support the SMMEs. This study aimed to discover the support given to the SMMEs by the South African government. In particular, the study is situated within the SMMEs in the SDM. The hypothesis for this study is premised on the fact that SMME`s can contribute immensely to job creation. The outcomes of this argument relies on the provisions based on a conducive environment which can enable the SMME`s to thrive. This statement was validated by means of literature review, interviews and site visits. This study found that the SMMEs are indeed the cornerstone of job creation and for sustainable livelihoods. LED programmes can create more jobs through the SMME sector. Literature worldwide confirms that the SMMEs are vital in creating employment opportunities. This research also confirmed that this is possible only if the environment in which SMMEs operate in is favourable for the SMMEs to prosper. In this regard many policy documents were developed to emphasize the stance of government to develop, grow and capacitate SMMEs in South Africa. It is indeed true that the LED can be used to grow and capacitate SMMEs in South Africa. Despite the progress being made on the development of the SMMEs, few issues need to be taken care off. The municipality indicated that there are no monitoring procedures in place which make it difficult to measure the infectiveness of their interventions and they further pointed out that they are working on the matter. The measurement of these milestones is not properly recorded to inform future generations. It is suggested that more research should be emphasised on the SMME sector, especially being the mandate of the municipality. / Thesis (M. Development and Management (Public Management and Government))--North-West University, Vaal Triangle Campus, 2013

District heating has a long standing tradition in Sweden and today it is the most common way of producing and transporting heat. A District heating system (DH system) is divided into three parts: a production facility, distribution network (DH network) and one more heat stations. The heat produced in the facilities is distributed to the customers via a heat transfer medium, usually water (DH water), in piping networks that make up the DH network. The heat is transferred to the customers via the heat exchanger at which point they can use it as heated tap water or for heating purposes. The DH networks are often constructed in steel as it is cheap and a relatively resistant material. However it has the disadvantages of corrosion and expansions when it is exposed high temperatures which lead to damages in the DH network resulting in loss of the DH water, this is an unavoidable occurrence in any DH network. This results in addition of pollutants by leakages into the DH network or with the water that is used to compensate for the losses. The pollutants cause further corrosion, leading to metal contamination, and more damages on the DH network meaning there is a continuous degradation. Therefore various treatments are used to clean and ascertain an acceptable chemical environment in the DH systems. These treatments are effective but not at a level which is required so many chemicals are used to enhance the treatment of the water. Some of these are known to be toxic to humans and water ecosystems. As leakages are abundant and often end up in the WWTPs of the concerned municipality, which often have troubles with disturbances of the biological treatment, it was decided that an assessment of the toxic effects that DH water pose on activated sludge was to be investigated. This was done by testing water from two DH networks, Växjö and Kalmar, on the same activated sludge obtained from Tegelviken WWTP in Kalmar. A respirometric bioassay approach established by the Organization for Economic Co-operation and Development (OECD), OECD standard 209; OECD Guidelines for the Testing of Chemicals was used with changes made to exposure and measuring time as this decrease the risk of misinterpretation of the results. A dilution series using different concentrations (6.25%, 25% and 100%) of DH water was tested and compered to a blank control samples containing only activated sludge. Assessment of toxicity on total oxidation, oxidation carbon and oxidation of nitrogen was made. To get some idea of what might cause toxic effect samples of the waters was sent to outside laboratories for analyses of metals. The result from the bioassay and metal analysis was used to formulate risk factors associated with a DH water spill and exposure to WWTPs. It was found that both DH waters have a significant inhibition on nitrification in WWTPs. The DH water from Kalmar exhibited similar toxicity dynamics, roughly 20% inhibition, despite large differences in concentration. The DH water from Växjö showed a negative correlation between an increase in concentration of DH water and toxicity, 74% for the lowest concentration and 11% for the highest. The metal analysis concluded that there was no abundance of metal contamination which led to the inference that toxicity is probably caused by the chemicals used for treatment. This poses a great risk for the Baltic Ocean as many WWTPs release their treated water directly into water courses with a short detention time before reaching the sea.

The government of South Africa in the White Paper on Tourism recognises the importance of attracting foreign investment in order to achieve the growth and development objectives of the tourism sector. Foreign investment will increase competition and improve standards as well as create employment and facilitate economic growth. The government should establish a climate of political stability, economic growth and profitability, and provide transparent, stable and consistent policies to attract foreign investment. Crime in South Africa is high and widely believed to restrain investment. The South African White Paper on Tourism has categorically and succinctly stipulated policy guidelines to ensure that tourists are maximally safe and secure. The traditional response to rising crime has been to devote more resources to law enforcement and to introduce tougher penalties in the hope of deterring offenders from committing further crimes. For the purpose of the study, the hypothesis was formulated that the safety and security policy for sustainable development does not necessarily provide a solution to crime and further proactive measures need to be implemented to promote tourism in Sedibeng District Municipality. This study will focus on; strategies for preventing crime in the Sedibeng District Municipality. It is recognised that such policies may need to go beyond the traditional concerns of the criminal justice system (i.e. police, the courts and prisons) if crime prevention is to be addressed in a comprehensive way. Combating crime has been tackled in various ways throughout the world, with some strategies being more successful than others. With the process of formulating a National Crime Prevention Strategy (NCPS) high on South Africa's agenda, the wealth of international experience in crime prevention cannot be ignored. Research, monitoring and objective evaluation of crime policies and programmes, aimed at ensuring that limited financial resources are used most effectively, is a significant contribution which criminologists can make to the policy-making process. / Thesis (M. Development and Management)--North-West University, Vaal Triangle Campus, 2009.

The Sedibeng District Municipality (SDM), according to its Integrated Development Planning Report 2009, is a Category C municipality established in the Gauteng Province. It is the only area of the Gauteng Province that is situated on the banks of Vaal River and Vaal Dam, covering the area formally known as the Vaal Triangle including of Nigel and Heidelberg. It includes the towns of Vereeniging, Vanderbijlpark, Meyerton, and Heidelberg as well as the historic townships of Evaton, Sebokeng, Bophelong, Sharpville, and Ratanda, which have a rich political history and heritage. The SDM covers the entire southern area of Gauteng Province, extending along 120 km axis from East to West. The total geographical area of the municipality is 4630 square kilometers and the numbers of households living are 241223. In order to serve the communities, the municipality needs technologically advanced systems to deliver services efficiently. The study therefore focused on the implementation of e-administration for enhanced service delivery at SDM. The review of Sedibeng District Municipality Integrated Development Plan 2009 regarding service delivery does not indicate any statement recorded regarding e-government as the tool to help speedup service. According to SDM IDP, 2009 the Sedibeng District Municipality has other ICT initiatives such as the implementation of the CCTV in Vanderbijlpark CBD. While Sedibeng District Municipality Website 2009 states that the e-government will be implemented, even the Sedibeng District Municipality‘s website has outdated information. Other pages are still on development viz. visitors, business and residents. There is not much information on the clusters regarding their plans‖. In order to improve the challenge, the study hypothesized that ―lack of effective implementation of e-administration may lead to inefficient service delivery at Sedibeng District Municipality. The findings from the literature review and the empirical research support the central statement. Findings indicate that the SDM is aware regarding the significance of e-administration. The employees at the SDM are therefore receiving training from external service providers to enhance their expertise in the field of e-administration. The SDM needs to be aware and empower community members to understand the utility of e-administration for fast and convenient delivery of services. The SDM needs to invest in human resources to advance the service delivery through appointment of skilled and expert personnel. The adequate implementation of e-administration at the SDM level and the appropriate e-participation by the community members are the foundation blocks of improved and enhanced service delivery. The study recommends that SDM needs to appoint personnel advanced in technology; organize training sessions to enhance technological skills of existing employees on continuous basis; organize public participation forums for community members regarding the significance and utility of e-administration for improved service delivery; organize training sessions for community members to empower them with the technological means of participation; improve its website for the community members to log-in their requests; establish one-stop centres for the community members to utilize the e-administration. This is an imperative step as not all community members have access to computers and internet at home; deploy facilitators to train community members regarding the procedures of e-administration in their local language(s); and to improve on e-infrastructure in the form of establishment of kiosks in rural areas. This will assist geographically scattered community members to approach the municipal officials with ease The study recommends to further explore the concept of e-administration to combat bureaucracy and enhance transparency in the government processes in general and at the grass-roots level in particular. / Thesis (M. Development and Management)--North-West University, Vaal Triangle Campus, 2011