BACKGROUND:Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country.METHODS:This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure).RESULTS:We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers.Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)).CONCLUSION:Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB stigma and raise awareness about the benefits of early diagnosis and prompt treatment are needed. Policies that remove patients' financial barriers in access to TB care, and integration of the informal care sector into TB control in urban and rural settings are central factors in TB control.

Background Asthma and chronic obstructive pulmonary disease (COPD) are common obstructive airway diseases with a substantial burden in terms of morbidity, mortality and costs. Smoking is the single most important risk factor for COPD, and is associated with incident asthma. It is important to know if the prevalence of asthma and COPD is increasing or decreasing in the population in order to effectively allocate health care resources. The definitions of these diseases have varied over time which makes it difficult to measure changes in prevalence. The preferred method is to estimate the prevalence with the same procedures and definitions based on cross-sectional population samples with identical age distributions in the same geographical area at different time points. Measurements of lung function (spirometry) are required to diagnose COPD, and spirometry is used to evaluate disease severity and progress of both asthma and COPD, where observed values are compared to reference values. The most commonly used reference values in Sweden are published during the mid 1980s, and there are few evaluations of how appropriate they are today based on Swedish population samples. The aim of the thesis was to estimate trends in the prevalence of asthma and COPD in relation to smoking habits, and to evaluate and estimate reference values for spirometry. Methods The project was based on population-based samples of adults from the Obstructive Lung Disease in Northern Sweden (OLIN) studies. Postal questionnaires were sent to large cohorts, recruited in 1992 (n=4851, 20-69 years), 1996 (n=7420, 20-74 years) and 2006 (n=6165, 20-69 years), respectively. The questionnaire included questions on respiratory symptoms and diseases, their comorbidities and several possible risk factors including smoking habits. Structured interviews and spirometry were performed in random samples of the responders to the 1992 and 2006 surveys, of which n=660 (in 1994) and n=623 (in 2009) were within identical age-spans (23-72 years). The trend in asthma prevalence was estimated by comparing the postal questionnaire surveys in 1996 and 2006, and the trend in COPD prevalence was estimated by comparing the samples participating in dynamic spirometry in 1994 and 2009, respectively. The prevalence of COPD was estimated based on two different definitions of COPD. Commonly used reference values for spirometry were evaluated based on randomly sampled healthy non-smokers defined in clinical examinations of participants in the 2006 postal questionnaire (n=501). The main focus of the evaluation was the global lung function initiative (GLI) reference values published in 2012, for which Z-scores and percent of predicted values were analysed. New sex-specific reference values for spirometry were estimated by linear regression, with age and height as predictors. These new OLIN reference values were also evaluated on a sample of healthy non-smokers identified in the population-based West Sweden Asthma Study. Results Although the prevalence of smoking decreased from 27.4% to 19.1%, p<0.001, between 1996 and 2006, the prevalence of physician-diagnosed asthma increased from 9.4% to 11.6%, p<0.001. The prevalence of symptoms common in asthma such as recurrent wheeze did not change significantly between the surveys or tended to decrease, while bronchitis symptoms such as cough and sputum production decreased significantly. The evaluation of the GLI reference values showed that the predicted values were significantly lower compared to the observed values in Norrbotten, which makes the percent of predicted too high. This was especially true for FVC percent predicted with a mean of 106%. In general, the deviations were more pronounced among women. New OLIN reference values valid for the Norrbotten sample were modelled and showed a high external validity when applied on the sample from western Sweden. The prevalence of moderate to severe COPD decreased substantially over the 15-year period between 1994 and 2009, regardless of definition. Conclusions In parallel with substantially decreased smoking habits in the population between 1996 and 2006, the prevalence of several airway symptoms decreased while the prevalence of physician-diagnosed asthma increased. These results suggest increased diagnostic activity for asthma, but may also suggest that the asthma prevalence has continued to increase. In contrast to asthma, the prevalence of COPD tended to decrease and moderate to severe COPD decreased substantially. The continuous decrease in smoking in Sweden during several decades prior to the study period is most likely contributing to these results. The evaluation of reference values showed that the GLI reference values were lower than the observed spirometric values in the population, especially for women, why the new up-to date reference values may be of importance for disease evaluation in epidemiology and in the health care as well.

Current treatment practice guidelines in a number of countries mandate the assessment of violence risk in all patients diagnosed with schizophrenia. Although more than 100 different instruments have been developed to facilitate the assessment of violence risk, few have been specifically validated for use in those with schizophrenia. Recent work instead suggests that these instruments are typically associated with lower predictive validity in samples with schizophrenia when compared to that achieved in diagnostically heterogeneous samples, leading to concerns that these instruments omit risk factors that may be specific to the prediction of violence risk in this population. The present thesis therefore aimed to investigate the predictive validity of a number of risk factors for violence in those with schizophrenia. Firstly, to identify key risk factors for violence, a meta-analysis was undertaken, finding that although a number of criminal history risk factors are strongly associated with violence risk, nonetheless a number of risk factors rarely assessed by existing violence risk assessment instruments were significantly associated with violence in those with schizophrenia; most notably a history of attempted suicide. Results of this review also suggested that although the criminal history domain is most strongly associated with violence risk, nonetheless, there is considerable variability in the magnitude of association for the individual risk factors. Study two therefore aimed to investigate this variability and found that a history of violence was most strongly associated with subsequent violence. Study three aimed to identify whether suicidal behaviour, which has rarely been considered risk factors for violence in previous work, incrementally contributes to the prediction of violence. A simple risk model composed of young age, comorbid substance use disorder, previous violence, and a history of suicidal threats, explained as much predictive validity, as measured by the area under the receiver operating characteristic curve, as established risk assessment instruments such as the HCR–20, LSI–R, PCL–R, and VRAG. Current risk assessment approaches may therefore need revision in light of these findings.

This thesis investigates the influence of firms’ internal and external environmental factors upon their adoption of HRIS behaviour (i.e., the variation between adopters and non-adopters) and the level of implementation of HRIS applications and its effectiveness. An integrated conceptual framework was developed for the factors that determine the organisation’s adoption and the level of practice of HRIS applications. This framework integrates ideas and elements from the Diffusion of innovation Theory (DOI) and technology organization environment (TOE) model, the Unified Theory of Acceptance and Use of Technology (UTAUT) and the IT studies in the area of HRM. Data were collected through structured-directed interviews with 236 respondents. The survey units were the shareholding companies in Jordan, and the key single respondents approach was employed. The findings of the study support that internal and external environmental factors are related not only to adoption of HRIS behaviour (i.e., the difference between adopters and non-adopters), but also to the level of implementing of HRIS applications. In comparison to each environmental dimension acting alone, the integration approach of the two internal and external dimensions gives better explanation not only of the prediction of the level of implementing of HRIS applications, but also of the prediction of adoption behaviour. Therefore, a better understanding of adoption of HRIS behaviour and the level of implementing of HRIS applications requires that firms’ environmental factors be viewed as whole (i.e., the interaction of the internal and external dimension) rather than being isolated fragments (i.e., only a single dimension). The current research contributes to the existing body of knowledge by enhancing current understanding of the organisational adoption of HRIS, which is an under-researched area in Jordan as a developing country. By employing analytical tools based on Rogers’s Innovation Diffusion Theory , UTAUT, TOE , and the findings of empirical studies of IT adoption, evidence confirms that the adoption of HRIS in the business organisations depends largely on interaction of internal and external environmental factors and the findings support the need for an integrated view of the adoption phenomenon. In that respect, this study also attempts to make an important theoretical contribution towards articulating differences in the determinants of adoption and the level of implementations of HRIS applications and its effectiveness.

Background: A trend of constructing new stadiums has emerged in Sweden during the 2000s. Since the turn of the century more than 50 stadiums has been constructed and currently further stadiums are being developed. Several cities invest in a new stadium, with the purpose of creating value for the society and for marketing the city. The investment creates benefits, but the effects are usually hard to measure. However, the annual economical result of a stadium that has been in operation during a time period is clear, which has led to extensive discussions about the economic losses that usually occurs. Problem: The problem of constructing new stadiums is the investment cost, which is expensive and often financed by the taxpayers. The construction cost is high, but another problem is the operating cost that often exceeds the economic calculations. Critics argue that the investments of stadiums are a waste of the taxpayers’ money that could have been used for other public service, for example health care, education and elderly care. Question formulation: The purpose of this master thesis is to analyze the economic profitability for six stadiums in Sweden, for finding common success factors and factors that affects the stadiums economy negative. The intention is to analyze why some stadiums has performed better economical results than others. Method: To investigate the profitability of stadiums a literature study has been performed to describe previous research regarding market conditions, budgeting and overrun costs, ownership and financing options and the stadium’s profitability. Subsequently, a case study has been carried out, including Friends Arena, Gamla Ullevi, Sparbanken Skåne Arena, Saab Arena, Sparbanken Lidköping Arena and Göransson Arena. These stadiums have been selected based on geographical aspects, as they are located in larger cities, medium cities and small cities. Result and conclusion: According to this analysis Saab Arena and Sparbanken Lidköping Arena have reached the most profitable results. The paper concludes three success factors; a stadium should be constructed in an area with low competition regarding events. A project requires careful planning with unbiased and realistic assumptions of the economic calculations. The result gets better with funding from private companies and with sponsors for name rights. Finally, this study indicates that good economical results can be achieved, however it requires responsible decision makers who has great knowledge in the area of constructing stadiums. / Bakgrund: Under 2000-talet har en trend uppstått i Sverige angående arenainvesteringar. Sedan sekelskiftet har fler än 50 arenor konstruerats och för närvarande pågår ytterligare arenaprojekt som både är i planerings- och konstruktionsfasen. Många städer beslutar att investera i en ny arena för att skapa mervärde för samhället och för att marknadsföra staden. Arenor skapar därmed flera fördelar, men effekterna är vanligtvis svåra att mäta. De årliga ekonomiska resultaten för arenor som har varit i drift under en tidsperiod är däremot tydliga, vilket har lett till kritik och omfattande debatter om arenornas ekonomiska förluster. Problematik: Problemet med att upprätta nya arenor är att det är dyra investeringar som många gånger finansieras med skattemedel. Det är inte bara konstruktionskostnaden som anses hög, utan även driftkostnaderna brukar överstiga de ekonomiska kalkylerna. Kritiker menar att arenainvesteringar är ett slöseri med skattmedel som istället kan användas inom annan offentlig verksamhet såsom vård, skola och äldreomsorg. Frågeställning: Syftet med denna masteruppsats är att analysera den ekonomiska lönsamheten för sex utvalda arenor i Sverige, för att finna gemensamma framgångsfaktorer samt faktorer som påverkar arenornas ekonomi negativt. Avsikten är att analysera varför en del arenor når bättre ekonomiska resultat än andra. Metod: För att undersöka arenors lönsamhet har en litteraturstudie genomförts för att beskriva tidigare forskning inom områdena marknadsförutsättningar, budgetering och överskridande kostnader, ägande och finansieringsalternativ samt arenans lönsamhet. Därefter har en fallstudie genomförts som inkluderar Friends Arena, Gamla Ullevi, Sparbanken Skåne Arena, Saab Arena, Sparbanken Lidköping Arena och Göransson Arena. Dessa arenor valdes på grund av geografiska aspekter då de är belägna i storstäder, mellanstora städer och mindre städer. Resultat och slutsats: Enligt denna analys har Saab Arena och Sparbanken Lidköping Arena nått de mest lönsamma resultaten. Slutsatsen med denna studie är tre framgångsfaktorer; En arena ska konstrueras i ett område med låg konkurrens om evenemang. Det krävs en noggrann planering med opartiska och realistiska ekonomiska kalkyler. Bättre ekonomiskt resultat nås genom finansiering från privata bolag och sponsorer för namnrättigheter. Slutligen visar denna studie på att goda ekonomiska resultat kan uppnås, men det kräver ansvarsfulla beslutsfattare med stor kunskap inom området.

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The purpose of this study was to investigate whether student achievement and absences are influenced by the home and social factors such as parental education, family make-up, ethnicity, home ownership, retention, free lunch, sex, and grade. The following hypotheses were tested: 1. There was no statistically significant relationship at .05 level between student achievement and each of: grouping, grade, sex, mother's education, father's education, family make-up, ethnicity, free lunch, rehousing, home ownership. 2. There was no statistically significant relationship at the .05 level between student absenteeism and each of: achievement grouping, grade, sex, mother's education, father's education, family make-up, ethnicity, free lunch, rehousing, home ownership. The population consisted of four classes (2, 4th and 2 5th grades) and 40 students randomly drawn from these classes. Twenty males and twenty females were represented, ten whites and thirty minorities out of a population of 75% minorities and 25% white. The instrument used was a schedule constructed to obtain information from school files on each variable as defined. The main results were observed in the correlation matrix where: Achievement was significantly related to grouping, mother's education, father's education, family make-up, free lunch, rehoused, retention, home ownership, hence the null hypotheses for these variables were rejected. Sex and ethnicity were not significantly related to achievement and hence the hull hypotheses for these variables were accepted. Absenteeism were significantly related to achievement, grouping, sex, mother's education, father's education, family make-up, ethnicity, free lunch, rehousing/retention, and home ownership. The null hypotheses were therefore, rejected for these variables. However, the null hypotheses were accepted for absenteeism and grade level, and ethnicity. In a factor analysis of the data achievement and absenteeism were placed in Factor 1 with father's education and mother's education, grouping, free lunch, family make-up, home ownership, and rehousing indicating that all these variables belong to the same family. Hence a change in one result is a change in the others.

This study explores what motivates engineers in their early-mid career to change careers. It first establishes the definition of a career change from the perspective of those who have changed careers, and then examines what drives, influences and facilitates a career change, as well as how a career change is enacted physically and emotionally. This has been looked at through the contemporary lens of the ‘intelligent career framework’. This research adopted a qualitative, abductive approach following an initial inductive small-scale exploratory study. The fieldwork consisted of a pilot and main study using semi-structured interviews. For the main study, 22 interviews were conducted within one organisation in order to elicit the subjective experiences of engineers who had undertaken a career change. The findings show how the driving factors relate predominantly to knowing-why and knowing-where. The influencing and facilitating factors vary by individual, and relate to knowing-what, knowing-how knowing-when and knowing-whom. Six clusters of interacting factors were observed with knowing-why, knowing-how and knowing-when at the core. Whilst the process of career change was complex and long, differing pathways through which individuals changed careers were evident, as well as emotions that needed to be managed. This study contributes to knowledge in the area of contemporary career theory by exploring career change through a new lens: the intelligent career framework. It demonstrates how individuals use their ‘career capital’ to effect a career change and the ways in which the six knowings interact to bring about a career change. It extends the understanding of the process of career change and discovers some of the organisational factors that influence or facilitate individuals making a career change. All of these contributions address identifiable gaps in the literature.

This study focuses on connection between socioeconomic factors and the didactic choices in the English language teaching in lower primary school. The aim of the study is to examine if and how these choices differ between a charity-based school and a non-charity based (private) school in a slum area in Kenya, based on the reflections of teachers. Furthermore the aim is to investigate the motives or reasons behind the didactic choices, as expressed by the teachers during the interviews, and how these are possible to relate to the economic and social situation of the schools and the children. The research questions for the study was what the similarities and the differences are in how the lower primary teachers in an informal school compared with a private school in a rural area in Kenya reflect on their didactic approach in the subject English. The second question is how their reflections and didactic choices can be understood in relation to the economic and social conditions that characterize each school. The method used was a qualitative multi case study where the data collection was made by direct observations of four lessons and semi-structured interviews with four teachers, two in each school. The theoretical perspective used was Maslow’s motivation theory about the hierarchy of basic needs (1970, 1987) and the frame factor theory through Löwing (2004) and Knutas (2008). The main findings were that despite the two schools different economical resources and the childrens’ different socioeconomic backgrounds the overall didactic approach was very similar which partly can be explained with social and cultural norms that affect the way of teaching. Another finding was that the biggest obstacle for the language learning was small amount of pre-knowledge which was connected to poor or no use of English at home, and a lack of basic need. These factors were according to the teachers mostly found among the poor or in some way vulnerable children