This non-experimental, descriptive, quantitative survey attempted to evaluate IMCI implementation in the eThekwini district of KwaZulu -Natal. The study focused on IMCI implementation by IMCI trained registered nurses, health facility support and follow-up and supervision. The research population comprised of all IMCI trained registered nurses working in health facilities in the eThekwini district. The convenient sample consisted of 40 research subjects. Data was collected by means of an interview schedule and a checklist, and analysed using Microsoft Excel 2007. Findings of the study revealed that many of the IMCI trained registered nurses were unable to assess, classify and treat the sick child comprehensively and consistently. The recommended follow-up visit at six weeks after completion of IMCI training, and lack of on-going supervision remains an area of concern. Recommendations were that district or clinic supervisors can enhance the skills of IMCI trained registered nurses through recommended follow-up visits and on-going supervision and the provision of updated IMCI chart booklets. / Health Studies / M.A. (Public Health)

With the introduction of universal newborn hearing screening (UNHS) the need for quality early hearing intervention (EHI) services became critical. Screening is but the avenue to EHI services. Without appropriate intervention infants with hearing loss are at risk for language delay which might subsequently adversely influence academic success and vocational choices later on in life. The numerous socio-economic, cultural and healthcare barriers associated with developing countries such as South Africa, do not negate or diminish the need for optimal outcomes for infants with hearing loss through quality EHI services. The principle of quality EHI services, aligned with international standards, is endorsed by the HPCSA (2003: 2). In order to assure quality in EHI, service evaluation is critical. The necessary first step when evaluating service provision is to measure current service delivery. The main aim of this study was to determine whether South African audiologists provide EHI and support services aligned with international professional best practice to infants following the diagnosis of hearing loss. The first part of this study reviews the evidence available in EHI. The guidelines derived from the international evidence were stated as benchmarks against which South African EHI services were measured. These benchmarks were categorised using the so-called six M variation categories. These categories are: Man, machine (equipment), method (systemaric procedures), measurements, material (amplification devices) and Mother Nature. During the empirical research a descriptive design was followed comprising of questionnaire surveys to audiologists in different working sectors rendering EHI services to infants with hearing loss. The questionnaire survey explored the nature and scope of the EHI services offered to infants with hearing loss with regard to all the components (categorised in the six M categories) of the EHI programme of 40 South African audiologists. The results of this study indicate that respondents often do not use evidence-based measurements or methods during EHI services. Results suggest that undergraduate training in areas regarding the selection and fitting of amplification to infants with hearing loss is often inadequate (>20 respondents indicated that they are not trained). Evidence-based measurements are not typically performed when fitting amplification to infants (29 respondents do not perform probe-microphone or elctroacoustic measurements). Many respondents indicated that they do not have the necessary equipment to do these measurements. EHI services often (50% of respondents) do not provide A/R directly, but refer to other team members. From the results there seems to be significant delays in the rendering of EHI services to infants with hearing loss. Financial constraints of the family of the infants, accessibility problems, as well as a lack of infant support from their families often influence the EHI programmes of respondents. The implications of this study were discussed. Recommendations include the development of South African guidelines, aligned with international guidelines but taking into account the challenges posed by the unique South African context. Other recommendations include: Centres of excellence, relevant continuing education programmes and the evaluation of undergraduate training programmes. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / M (Communication Pathology) / unrestricted

Abstract Broadleaved forests are highly valuable biotopes with important recreational value and contain rich occurrences of species of conservation concern. To monitor the development of nature values in a forest ecosystem during an interval of approximately ten years, follow-up inventories were carried out, following the first inventories which took place ten years ago in two nature reserves (Karlsvik and Bohult) dominated by broadleaved trees in the county of Halland, Sweden. Indicator species of lichen and moss were searched for and compared to the first inventories. The results show that both reserves contain more indicator species today than approximately ten years ago, though a change in the species composition was observed. In Bohult fewer indicator lichens were observed, although more observations were made of indicator mosses - making the total number of indicator species higher than in the previous inventory. Potential explanations to the differing results of the two reserves were discussed and assessed to be for varied reasons. The observed increased occurrences of indicator species may be due to increased continuity leading to bigger and older trees which make way for more epiphytes. The observed decreased occurrences of indicator species may be due to human activity such as newly carried out clearcutting in close proximity to the reserve (which could lead to edge effects or other environmental stresses), nitrogen deposition or exploitation. An observed threat for both reserves is the increasing growth of norway spruce (Picea abies) which may outcompete broadleaved species and the potential indicator species they may inhabit. / Sammanfattning Ädellövskogar är mycket värdefulla naturtyper med höga rekreationsvärden och med rika förekomster av naturvårdsarter. För att utvärdera förändringen av skogliga naturvärden inom en tidsperiod av ca tio år utfördes uppföljningsinventeringar av två tidigare inventerade naturreservat som domineras av ädellövskog i Hallands län i Sverige. Signalarter av lavar och mossor eftersöktes och jämfördes med tidigare funna signalarter. Båda reservatens ursprungliga inventeringar utfördes för ca tio år sedan och resultaten visar att de båda reservaten nu har fler signalarter än tidigare, samtidigt som en förändring observerades i artsammansättningen då samtliga signalarter ej återfanns. I Bohult observerades färre signalartslavar, men fler signalartsmossor - vilket resulterade i ett större antal signalarter totalt för området. Potentiella förklaringar till de skilda förändringarna diskuterades och bedömdes bero på varierande orsaker. Det större antalet observerade signalarter skulle kunna förklaras av ökad tid för kontinuitet med fler grova och äldre träd som utgör lämpliga substrat för kolonisering av de eftersökta signalarterna. Det färre antalet observerade signalartslavar i Bohult skulle kunna bero på mänsklig påverkan i form av nyligen utförda kalavverkningar i angränsning till reservatet, vilket kan bidra till kanteffekter eller andra påfrestningar på miljön. Kvävenedfall, dikning av vattendrag eller annan exploatering föreslås också som möjlig orsak. Ett observerat hot för båda reservaten var igenväxningen av gran, vilken skulle kunna konkurrera med ädellövträden och de signalarter de kan husera.

Världen över sker ständiga budgetöverskridanden. Offentliga verksamheter har inte varit något undantag för dessa kostnadsöverskridanden, vilket skapar incitament till att förstå varför de uppstår. I de offentliga projekten drabbas fler än bara de projektansvariga vid budgetöverskridelser. Det är samhället i stort som får betala för arbetet eftersom det är skattefinansierade projekt. Examensarbetet utgör en fallstudie som genomfördes med syftet att skapa förståelse för varför budgetöverskridanden sker i en liten kommun. För att uppnå syftet har både sekundär- och primärdata använts i form av en djupgående dokumentanalys vilken kompletterats av intervjuer. Som fallstudieobjekt har en liten kommun använts för att samla in material. Arbetets dokumentanalys syftar till att sammanställa och jämföra tidigare utförda projekt. Intervjuer med respondenter har kompletterat och förklarat de budgetavvikelser som uppmärksammats från dokumentanalysen. En litteraturstudie av tidigare forskningens resultat möjliggjorde även för jämförelse och ökad förståelse av resultatet. Resultatet av studien är en förklaring till varför budgetöverskridanden förekommer i en liten kommun. De huvudsakliga anledningarna är ändrings-, tilläggs- och avgående arbeten (ÄTA-arbeten) i projekten vilket orsakas av olika faktorer. Dessa olika faktorer kan vara exempelvis felaktiga handlingar eller dåliga markförhållanden. ÄTA-arbeten är väldigt kostnads- och tidsdrivande vilket orsakar budgetöverskridanden. Studien visar också att kostnadsöverskridanden är mer vanligt förekommande än tidsöverskridanden / All over the world budget overruns occur. Public organisations have been no exception for these overruns, which incentivizes creating an understanding to why they occur in the first place. In the public projects there are more people than just the project managers who are affected by these overruns. This is due to the fact that the public projects are financed by tax funds which is paid by the society as a whole. The purpose of this study is to create an understanding of why budget overruns occur where a small municipality has been chosen as the case object to gather data. To achieve this purpose both primary and secondary data has been used to create a document analysis which has been complemented with interviews. The document analysis of the study aims to compile and compare previous projects in the municipality. The interviews are supposed to complement and explain different budget deviations found in the document analysis. Finally, a literature review was carried out in order to enable the comparison of the gathered data and increase the understanding of the findings. The result of the study is an explanation of why budget overruns occur in a small municipality. The primary reasons are change orders in the project plan which is caused by different factors. These different factors are faulty or vaguely formed project plans or even bad conditions of the land. Change orders are very cost and time consuming which causes budget overruns. The study also found that cost overruns are more common than time overruns.

Hypertension (HTN) is the most common chronic disease among jail inmates. Many inmates treated for HTN while incarcerated in the Fairfax County Jail do not continue treatment when they return to their communities. Factors that contribute to discontinuing HTN management once the inmate returns to the community include homelessness, low income, and lack of access to care. The purpose of this quality improvement project was to educate inmates with HTN about community-based outreach services for HTN management and continuity of care while in the community. The outcome measured was the number of inmates who returned to jail reporting use of a community-based clinic for follow-up HTN care after their last release from jail. The project was conducted in 2 phases during a 6-month period. A pre-HTN survey questionnaire measuring HTN history and lifestyle was administered on initial incarceration. A post-HTN survey was completed when the inmates return to the jail during the 6-month period and measured adherence to post jail follow up HTN care. The findings of this quality improvement project indicate that both inmates who returned to jail in Phase 2 of the project followed up their HTN care in the community after release from jail. This project shows promise as a first step in the process of social change in planning discharge for inmates with HTN at the time of incarceration.

The problem with which this investigation is concerned is the design of a model for student follow-up procedures. This model is based on an analysis of the opinions of community junior college experts on the language and characteristics of a student follow-up system. This study has a twofold purpose. The first is to determine a consensus from the responses of experts on public community junior colleges regarding the important definitions, terminology, and characteristics of a student follow-up system. The second is to develop a model that can be implemented for student follow-up investigations.

Projektekonomi och kostnadsstyrning är centrala delar i byggentreprenaders verksamheter. Trots att ett projekt bedöms vara estetiskt tilltalande och innehåller alla kvaliteter som har lovats till beställare, kan utfallet ändå betraktas som olyckligt för entreprenaden om kostnadenblir högre än förväntat. För att identifiera orsaken till varför budgeten har överskridits behöver projekt följas upp. Byggentreprenören NCC har identifierat att deras verksamhet saknar ett bra system för projektuppföljning. Eftersom varje projekt utförs under olika förutsättningar så upplevs det som svårt och resurskrävande att följa upp projekt på ett bra och effektivt sätt.Syftet med denna rapport är att jämföra och analysera projekt som gått sämre för att identifiera samband, samt att utifrån dessa samband finna ett sätt att effektivisera uppföljning och lättare ta lärdom av tidigare projekt och erfarenheter. Rapporten utgår ifrån tre utvalda projekt från byggentreprenören NCC där budgeten har överskridits.Jämförelsen av projekten består av en kvantitativ och en kompletterande kvalitativ del. Den kvantitativa metoden omfattas av en procentuell redovisning av skillnaden mellan aktuell budget och prognos för 10 utvalda kostnadskategorier. Den kvalitativa metoden omfattas av samtal med medarbetare.Projekt 1 innefattade en nybyggnation av tre delar: vård och omsorgsboende, ett gruppboende samt lokaler och kontor för hemvården. Projekt 2 bestod av ett förtätningsprojekt som omfattade nybyggnation av ett flerbostadshus samt fasad- och takrenovering av befintligt hus. Projekt 3 bestod av byggnation av tre punkthus i trä, samt förskola i betong på bottenplan.Flera samband kunde identifierades mellan projekten som möjliga anledningar till det olyckliga ekonomiska utfallet. Coronapandemin, kriget i Ukraina och ogynnsamma avtal identifierades som samband mellan endast Projekt 1 och Projekt 2. De tydligaste sambanden som kunde ses mellan alla tre projekt var relationen mellan kostnadskategorin Löner till yrkesarbetare och fördröjd tidplan, samt brister i projektering och organisation.Resultatet från denna studie diskuteras med en kritisk ton med avseende på metoden där det fanns brister och förbättringsområden. En sådan förbättring omfattade en mer strukturerad metod för samtalen.Slutsatsen är att det finns samband i dessa tre projekt som går att ta lärdom av. / This study's aim is to compare projects where costs have exceeded budget projections in order to identify correlating factors to streamline follow-up auditing and facilitate improvementsfrom project data collection and employee experience. The study is based on three selected projects from construction company NCC where costs exceeded the projected budget.The project comparison consist of a quantitative method and a complementary qualitative method. The quantitative method consists of budget and cost data, presenting the differences between the current budget and the forecasts' costs across 10 selected categories in percentage form. The qualitative method consists of documented conversations with employees relating to these projects' budget categories and the eventual effects on the increased costs.Project 1 examines a new construction project divided into three parts: a nursing home, a group home, and offices for home-care. Project 2 examines of an urban densification project that includes a newly constructed apartment extension attached to an existing building, along with facade and roof renovations of preexisting building. Project 3 examines the construction of three multi-floored, wooden, residential blocks with a concrete preschool on the ground floor.Several factors were identified connecting Project 1 and Project 2 as possible reasons for exceeding budget projections: the Covid 19-pandemic, the strife in Ukraine and the purchasers contracts' unique requirements resulting in unexpected costs. The clearest connections that could be seen in all three projects was the connection between the cost category Wages to skilled workers and delayed schedule as well as deficient project planningand a lack of organization. The results obtained in this study emphasize a methodology for ascertaining areas ofimprovement. A suggested improvement includes a structured approach to employee feedbackinterviews.The conclusion only included the relationships that were common denominators to all three studied projects. The common denominators that were identified covered the connection between the cost by category Wages to skilled workers and delayed schedule, deficient project planning and organization. The organization was interpretated as individual-based and a need for improved experience feedback was identified.

The purpose of the present study was to gain more knowledge about single individuals with specific premarital risk factors for later marital problems (e.g. neuroticism or low emotional readiness, family-of-origin dysfunction, poor communication skills, and hostile conflict resolution style). The sample (N=39) completed the RELATionship Evaluation (RELATE) and were selected for the study based on the presence of one or more risk factors. Participants were contacted via email and asked to complete an online version of the Relationship Follow-up Questionnaire (RFQ) to determine their knowledge or awareness of their risk factor(s) after taking RELATE, their motivation for premarital interventions after taking RELATE, their perceived roadblocks or barriers hindering participation in premarital interventions, and their post-RELATE marriage preparation behaviors including their post-RELATE relationship breakups. The results showed that the RELATE increased an at-risk individual's knowledge or awareness of risk factors, increased their motivation for premarital interventions, and had little to no effect on the break-up of relationships. At-risk individuals reported the major roadblocks or barriers to participation in premarital interventions as being time, money, being uninformed, and the perceived distance/inconvenience of interventions. At-risk individuals' post-RELATE behaviors included discussing the RELATE results with their partner and friends and utilizing books and articles related to marriage. They did not report utilizing individual or couples counseling. Practitioners can use this information to make premarital interventions more appealing to at-risk individuals and encourage the use of the RELATE to increase participation in premarital interventions and help prevent later marital problems.

Currently, the SEP laboratory has developed a system to automatically generate PDF reports summarizing the results of evaluation tests. This system works well in production but has several limitations. In fact, the use of OriginPro software is an obstacle because of the need for a paid license and hence its use is often limited to researchers and therefore not accessible by coaches and athletes. This means that coaches and athletes cannot access the results directly and must always go through the researchers to obtain the PDF report. Moreover, the PDF report is fixed and not dynamic, i.e. once it is generated, it is not possible to interact with it nor to obtain additional information than the ones presented in the report. Thus, this project aims at developing a web interface to visualize the results of the evaluation tests to improve the follow-up of the French elite athletes and coaches, in order to allow them to access in a simpler and faster way the test results but also to offer them new insights and information. Therefore, a prototype of a web interface integrating results dashboards for 22 out of the 28 different evaluation tests, was developed. This prototype was then evaluated on its usability and user experience in order to obtain subjective but also quantitative evaluations. Finally, it was shown that the use of such an interface is of great interest for athletes and coaches. Indeed, it would save them a lot of time compared to the current process of submitting test reports and there would be a real added value with the dynamic aspect of the interface, and this could be integrated into their daily practices in order to individualize the training, capitalize on the data collection, as well as to follow their athletes longitudinally. / För närvarande har SEP-laboratoriet utvecklat ett system för att automatiskt generera PDF-rapporter som sammanfattar resultaten av utvärderingstesterna. Detta system fungerar bra i produktionen men har flera begränsningar. Användningen av OriginPro-programvaran är i själva verket ett hinder eftersom det krävs en betald licens och därför är användningen ofta begränsad till forskare och därför inte tillgänglig för tränare och idrottare. Detta innebär att tränare och idrottare inte kan få tillgång till resultaten direkt utan alltid måste gå via forskarna för att få PDF-rapporten. PDF-rapporten är dessutom fast och inte dynamisk, dvs. när den väl är genererad är det inte möjligt att interagera med den eller att få ytterligare information än den som presenteras i rapporten. Detta projekt syftar därför till att utveckla ett webbgränssnitt för att visualisera resultaten av utvärderingstesterna för att förbättra uppföljningen av franska elitidrottare och tränare, för att ge dem tillgång till testresultaten på ett enklare och snabbare sätt, men också för att ge dem nya insikter och information. Därför utvecklades en prototyp av ett webbgränssnitt som integrerar resultatinstrumentpaneler för 22 av de 28 olika utvärderingstesterna. Prototypen utvärderades sedan med avseende på användbarhet och användarupplevelse för att få subjektiva men också kvantitativa utvärderingar. Slutligen visade det sig att användningen av ett sådant gränssnitt är av stort intresse för idrottare och tränare. Det skulle spara dem mycket tid jämfört med den nuvarande processen med att skicka in testrapporter och det skulle finnas ett verkligt mervärde med den dynamiska aspekten av gränssnittet, och detta skulle kunna integreras i deras dagliga praxis för att individualisera träningen, dra nytta av datainsamlingen och för att följa sina idrottsmän i ett längre perspektiv.

Denna studie har undersökt hur kommuner i Stockholms län följer upp det systematiska kvalitetsarbetet vid de privata skolföretag som kommunen har avtal med för att erbjuda kommunal vuxenutbildning till sina kommuninvånare. Studien önskade att samla in en så heltäckande bild som möjligt gällande vilka arbetssätt som användes i denna uppföljning samt undersöka på vilket sätt uppföljningen kan bidra till ett förbättringsarbete. Datainsamlingsmetoden som valdes var enkäter, dessa skickades till rektorer på kommunerna och till rektorer på privata skolföretag. Enkäten som var riktad mot kommuner skickades ut till 22 rektorer som tillsammans representerade Stockholms läns 26 kommuner. Enkäten som var riktad mot skolor skickades ut till 39 rektorer som representerar de 39 privata skolföretag som har avtal med en eller flera av Stockholms läns kommuner. Svarsfrekvensen för respondenter från kommun blev 46,1% och respondenter från skola blev 28,2%. Den totala svarsfrekvensen landade på 35,3%.  Resultatet visade att de arbetssätt som användes var bland annat: ·         Kontinuerlig kontakt med skolorna under terminen ·         Fysiska besök på skolorna ·         Samla in elevers synpunkter ·         Läsa skolornas årsrapporter ·         Begära in olika typer av dokumentation ·         Begära in handlingsplaner när brister upptäcks ·         Skapande av forum för dialog och erfarenhetsbyte Resultatet visade att sätt där uppföljningen kunde leda till utvecklig var bland annat att: ·         Brister upptäcks ·         Uppföljningen underlättar dialog och vidare samarbete ·         Stöd gällande lag och förordning ·         Goda exempel kunde lyftas Resultat och analys visade dock att det fanns en viss diskrepans mellan svaren hos kommunrepresentanter och skolrepresentanter. Kommunrepresentanterna ansåg i högre utsträckning att uppföljningen var utformad i syfte att utveckla utbildningen tillsammans med skolan, att den dokumentation som begärdes in användes i ett utvecklingsarbete samt att arbetet har ett fokus på både kvalitetssäkring och kvalitetsutveckling medan skolrepresentanterna inte upplevde detsamma i lika stor utsträckning. / This study has examined how municipalities in Stockholm County follow up the systematic quality work at the private school companies with which the municipality has an agreement to offer municipal adult education for its municipal residents.  The data collection method chosen was questionnaires sent to principals in the municipalities and to principals of private school companies. The questionnaire, which was aimed at municipalities, was sent to 22 principals who together represented all the municipalities in Stockholm County. The questionnaire, which was aimed at schools, was sent out to 39 principals representing private school companies that have agreements with one or more municipalities in Stockholm. The response rate for respondents from the municipalities was 46,1% and respondents from school was 28,2%. The total response rate ended up at 35,3%.  The results showed that the methods used by the municipalities included: ·         continuous contact with the schools during the semester  ·         physical visits to the schools ·         collecting student views ·         reading annual reports ·         requesting different types of documentation ·         requesting action plans when deficiencies are discovered ·         creation of forums for dialogue and exchange of experience The results showed ways in which the follow-up could lead to development:  ·         discovering deficiencies ·         the follow-up facilitates dialogue and further cooperation ·         support for current law and regulations ·         good examples could be highlighted.  The results and the analysis showed, however, that there was a certain discrepancy between the answers of municipal representatives and school representatives. The municipal representatives considered to a greater extent that the follow-up was designed with the aim of improving the education together with the school, that the documentation requested was used in a development work and that the follow-up has a focus on both quality assurance and quality improvement while the school representatives did not fully experienced it in the same way. / <p>2022-06-05</p>