Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a novel pathogen that emerged in December of 2019 and has since infected people of all ages around the world. Children with acute SARS-CoV-2 infection are largely spared of the severe disease seen in adults. However, a life-threatening, post-viral inflammatory condition known as Multisystem Inflammatory Syndrome – Children (MIS-C) develops in a small fraction of children four to six weeks after either past SARS-CoV-2 infection or exposure and is characterized by high fevers, significant gastrointestinal symptoms and severe cardiac complications. Little is known about the lasting immune profiles of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in children, let alone the long-term effects of the disease in this population. This study presents clinical features and serologic immune profiles of forty-nine pediatric patients (ages 12.4 ± 6.7 years) enrolled in the Massachusetts General Hospital Pediatric COVID-19 Biorepository with previous diagnoses of SARS-CoV-2 infection or the COVID-19-related MIS-C. Thirty-two children ages 0-22 years completed a questionnaire which captured lingering clinical symptoms of COVID-19 and MIS-C at the follow-up timepoint. This questionnaire study revealed significant on-going symptoms in both cohorts, including respiratory, gastrointestinal, neurologic and cardiovascular symptoms. To characterize lasting immune responses following the acute presentation, serum antibodies to S, RBD and N proteins of SARS-CoV-2 were quantified at the follow-up timepoint in forty-nine pediatric patients with past COVID-19 or MIS-C at a mean follow-up timepoint of 6.56 ± 1.75 months. Serologic signatures against SARS-CoV-2 in COVID-19 and severe MIS-C patients were compared at acute illness and at follow-up timepoints. Anti-SARS-CoV-2 antibodies remained elevated over time showing adequate seroconversion. Interestingly, anti-SARS-CoV-2 IgA remained elevated in the vast majority of individuals at follow-up, suggesting continued antigen exposure and mucosal inflammation. This research elucidates whether children maintain antibody levels to SARS-CoV-2 over time and speaks to the differences in antibody recovery to baseline in COVID-19 and MIS-C patients. It also highlights the lingering symptoms in both the COVID-19 and MIS-C cohorts, and suggests the need for significant long-term follow-up in children months, or even years after resolution of acute illness or disease. In total, this study addresses the substantial gap in understanding of the recovery of the adaptive immune system after SARS-CoV-2 infection in children. / 2023-11-09T00:00:00Z

HIV and AIDS pandemic have been declining in South Africa. HIV and AIDS affect individuals, families, organizations and the communities at large. While the roll out of the antiretroviral treatment (ART) has brought much excitement and hope to both patients and the health practitioners, it has also brought challenges (Maskew, Macphail, Menez & Rubel, 2007:853). In order for ART to be effective patients need to adhere to antiretroviral treatment, thus adherence is a critical component of ART. Patients who discontinue treatment are at high risk of illness and death because of AIDS related diseases or developing drug resistant virus. With a better understanding of the reasons for defaulting antiretroviral treatment interventions can be designed to improve adherence to antiretroviral treatment. Thus the purpose of this study was to explore the reasons why HIV and AIDS infected patients default antiretroviral treatment because adherence to ART is of utmost important. Within the context of qualitative and applied research the researcher utilized the collective case study design. Semi structured interviewing was used as data collection method to elicit qualitative information on the reasons why patients default ART. The main research question that was put forward to all participants was: What are your reasons for defaulting ART? The participants in this study were patients who have default their ART during 2012. By using systematic sampling fourteen participants from Thekganang ARV Clinic in Seshego District Hospital, Limpopo province, were selected to form a sample for this study. Some conclusions based on the findings were that: The participants were knowledgeable about the basic facts of HIV and AIDS and they had a good understanding about the importance of adherence even though they defaulted their antiretroviral treatment. The use of ART may also be challenging to individuals. The findings of this study were that not all participants in the study experienced challenges with taking ART. Those who experienced challenges included fear of disclosing HIV status, fear of stigmatization and physical challenges due to ill health. Regarding the reasons for defaulting ART, participants’ reasons for defaulting antiretroviral treatment were similar although some of the reasons applied to only one participant. Participants’ reasons for treatment default were classified into socio-economic factors, patient related, psychological related and medication related factors. Socio- economic factors included shortage of food in the household and lack of money for transport to attend clinic appointments. Patient related factors included substance abuse, lost appointment cards, participants were too busy with personal issues and relocation to another area of residence. Psychological factors that contributed to non-adherence to treatment were depression and denial. Medical related factor voiced was that participant was too confused about the drug regimen. Most participants were satisfied with the services in Thekganang ARV clinic although some participants raised concerns about staff attitudes and long queue. The findings will assist the hospital management and the clinic staff to make informed decisions about the management of defaulters in the clinic. The study was concluded with the relevant recommendations to the ART facilities. The recommendations included implementation of the multi-disciplinary centred approach, establishing patient education programmes and on-going support services to patients who fail to adhere to treatment. Future research studies should determine the prevalence of drug resistant HIV patients in the ART facilities and the development of a systematic method of capturing ‘‘lost to follow up’’ patients who pass away within hospitals. / Dissertation (MA)--University of Pretoria, 2014. / lk2014 / Social Work and Criminology / MA / Unrestricted

Background: Cervical cancer among Black women is a major individual and public health concern. Despite advancements in medical technology and policy, disparities in cervical cancer diagnosis and mortality still exist between White and Black women, with Black women having higher rates of diagnosis (10.0 vs 7.1 per 100,000) and mortality (4.1 vs 2.0 per 100,000). Previous studies have focused heavily on barriers to obtaining cervical cancer screening among Black women and efforts to improve screening rates. Despite speculation by researchers that gaps in receipt of quality follow-up care may contribute to disparities, its role in disparate mortality rates between Black and White women has yet to be formally studied. Purpose: The goals of the present research were to (1) assess differences in Pap screening rates and (2) rates of adherence to recommended follow-up care after abnormal Pap results between Black and White women, (3) evaluate how specific factors of the Health Belief Model (HBM) influence the decision-making process for obtaining Pap screening and (4) receiving recommended follow-up Pap care, and (5) evaluate the role of ethnic centrality as a factor in health decision-making. Results: Results indicated that HBM facets functioned similarly in predicting engagement in Pap screening and follow-up care, although there were differences in the influence of different facets by race. Ethnic centrality showed little applicable influence on adherence to follow-up care among Black women. An exploratory analysis revealed that doctor recommendation was the most influential factor predicting follow-up care use for both racial groups. Conclusion: The present study offers support for increased education and training on provider recommendation of appropriate follow-up care, as well as effective provider communication of results and services using messaging that appeals to the values and concerns of patients.

Master of Public Health - MPH / Background: HIV/AIDS remains a major public health issue that is affecting all population groups and communities in Zambia. Among the most affected groups are key populations (KPs) such as female sex workers. KPs are considered at high risk of contracting HIV but have limited access to HIV services and retention in care due to internalized stigma, discrimination, criminalization, and negative attitudes towards HIV treatment. Under the USAID Open Doors project in Zambia, KPs access comprehensive HIV prevention, care and treatment services. The test and treat strategy is implemented by the project in support of the UNAIDS 90-90-90 targets by 2020 to diagnose 90% of people living with HIV, put 90% of them on treatment, and for 90% of them to have suppressed viral load. Aim: This study aimed to determine retention in care among female sex workers (FSWs) in the first six months after ART initiation using the HIV care cascade. Methodology: A retrospective cohort study was conducted of all new HIV positive female sex workers (FSWs) initiated on ART between October 2018 and June 2019 (9 months period) based on the electronic records. Data were extracted from SmartCare, an electronic health record system used by the ART clinic. Microsoft Excel and Epi-Info 7 software were used for data entry and analysis. Kaplan–Meier survival analysis was conducted to examine differences in retention rates. Results: A total of 205 FSWs were initiated on ART, out of which 180 were active on ART (36 youths and 144 adults) and 25 were lost to follow-up (four youths and 21 adults) during the 9 months study period. Of the 180 FSWs active on ART, 36 were FSWs aged 18 – 24 years (youths) representing 90% retained in care while 144 were FSWs aged 25 – 42 years (adults) with 87% being retained on ART treatment. Retention in ART care was not significantly different in the survival curves between the age groups of FSW youths and FSW adults during the study period (p-value = 0.637). Retention in ART care was not statistically significant for education (p-value = 0.481), marital status (p-value = 0.545), and occupation (p-value = 0.169). Conclusion: Retention in ART care among FSWs was 88%. However, there were no significant differences by age group identified in this study. While this study shows 88% retention rate among FSWs, it will be used as a baseline in meeting the UNAIDS 90-90-90 goals.

Bakgrund: Bröstcancer är den näst vanligaste cancerformen som kan drabba kvinnor. Utvecklingen av behandlingsmetoder har ökat chansen att överleva och bota bröstcancer under åren. Bröstcancer kan påverka kvinnan både psykiskt och fysiskt. Följderna kan bli psykiskt påfrestande där livskvalitén påverkas negativt. Behandlingar kan leda till ingrepp som ändrar kvinnors utseende och påverkar den levda kroppen. Syfte: Att belysa kvinnors upplevelser efter friskförklaring från bröstcancer  Metod: Studien utfördes med en kvalitativ litteraturöversikt. Resultat: Kvinnor upplevde brister i vården och behövde mer stöd efter sin friskförklaring då effekterna av behandling varade många år efter. Känslor som ångest, övergivenhet och rädsla formade deras vardag. Det påverkade kvinnors självkänsla negativt när de fick leva med en ny kropp efter mastektomin. Konklusion: Kvinnorna upplevde skiftande känslor efter friskförklaring som behöver bemötas av sjuksköterskan för att öka kvinnors välbefinnande. / Background: Breast cancer is the second most common cancer that affects women. The development of treatment methods has increased the chance of surviving and curing breast cancer over the years. Breast cancer can affect the woman both mentally and physically. The repercussion can be mentally stressful where the quality of life can be adversely affected. Treatments like masectomy can lead to physicall alterations and affect the living body. Purpose: To illiustrate womens experiences of breastcancer survivorship. Method: The study was conducted with a qualitative literature review. Result: Women feel a lack of support after survivorship in a declining health care invoirment, because the lasting effects of treatment throughout the years. Emotions such as anxiety, abandonment and fear was a part of their everyday lives. It negativly affected women's self-esteem when they had to live with a new body after the mastectomy. Conclusion: Women continuosily experience interchanging emotions following their survivorship that need to be addressed by nurses in order to increase mental well-being.

Continuum manipulators which are robot limbs inspired by trunks, snakes, and tentacles, represent a promising field in robotic manipulation research. They are well known for their compliance, as they can conform to the shape of objects they interact with. Furthermore, they also benefit from improved dexterity and reduced weight compared to traditional rigid manipulators. The current state of the art continuum robots typically consists of a bulky pneumatic or tendon-driven actuation system at the base, hindering their scalability. Additionally, they tend to sag due to their own weight and are weak in the torsional direction, limiting their performance under external load. This work presents an origami-inspired cable-driven continuum manipulator module that offers low-cost, light-weight, and is inherently safe for human-robot interaction. This dissertation includes contributions in the design of the modular and torsionally strong continuum robot, the motion planning and control of the system, and finally the embedded sensing to close the loop providing robust feedback.

Idag är det bostadsbrist i Stockholm samtidigt som staden växer i rekordtakt. Detta har medfört att det är svårt att hitta en bostad och priserna är höga. För att motverka bostadsbristen har Skanska tillsammans med Ikea tagit fram konceptet BoKlok där de vill bygga bostäder för alla. För att möjligheten ska finnas för alla att köpa en av deras bostäder behöver de vara billiga, vilket uppnås genom en effektiv produktionsprocess som i hög grad efterliknar den traditionella industriprocessen. Husproduktionen är idag effektiv men effektiviteten i markarbetena kan förbättras. Uppgiften att utforma ett uppföljningssystem för förbrukade resurser och mängder har tagits fram för att ta ett steg i riktning mot den industriella processen med standardiserade rutiner och arbetsmoment. Syftet med examensarbetet är att skapa ett uppföljningssystem för markarbeten inom BoKlok-konceptet. Genom framtagandet av ett ifyllnadsblad, en databank och en metod för sammanställning och presentation ska följande tre delmål uppfyllas: - Ökad inblick i projekten - Anpassning mot en industriell process - Användarvänligt system Resultaten visar att uppföljningssystemet bidrar till en ökad inblick genom att uppföljning sker veckovis, vilket delvis kan ersätta den traditionella magkänslan för hur ett projekt fortskrider. Från resultaten framkom även att kontinuerlig utvärdering av arbetet är ett sätt att anpassa sig till en industriell process och det ligger i linje med det standardiserade tänkandet. För att uppnå ett användarvänligt uppföljningssystem har många yrkeskategorier inom distrikt Mark Stockholm Syd gemensamt bidragit med synpunkter på utformningen. Sammanfattningsvis visar examensarbetets resultat att uppföljningssystemet för markarbeten kan användas inom Skanskas och Ikeas gemensamma BoKlok-koncept inom distrikt Mark Stockholm Syd. / Today there is a housing shortage in Stockholm and while the town is growing in a record pace the prices of permanent residences keeps raising. Skanska have together with Ikea created a common solution to prevent the escalating problem, called BoKlok. The concept of BoKlok is to build houses that everybody can live in and also afford to purchase. In order to keep the prices down the houses must be built in an efficient way like the producing industry in general. BoKlok has embraced the industrialized process in building houses but the earthworks still have a long way to go. The task for this graduate thesis is to create a system that follows up used resources and amounts in the earthworks. The target is to try and find a way towards an industrial process with standard routines and work methods. The purpose is to create for the earthworks a functioning follow-up method within the BoKlok-concept. By creating a form, a database and a comparison-method of collected values could the three milestones of the graduate thesis be accomplished. The three milestones are: - Increased insight in the projects - Adjustment towards an industrialized process - User-friendly configuration The result shows that the follow-up system contributes to increased insight if it is done on a weekly basis. The follow-up system results in numeric facts that can replace the previously “feeling” of the projects turnout. One conclusion is that if the earthworks are evaluated constantly, a flow of potential improvement appears which is what an industrialized process is all about. To create a user-friendly configuration of the follow-up system the people that work with earthworks in the company have contributed with opinions that has improved the system. To summon up the results of this graduate thesis the follow-up system can be used within the earthworks of the concept BoKlok. In each case it can be used by the district “Mark Stockholm Syd”.

RQ1: What diversity management practices facilitate gender representation in the workplace? RQ2: Which challenges arise when implementing gender quotas into the work environment?  Purpose: The impact of this research is twofold: it will address a knowledge gap in the academic literature on gender challenges, gender quota application and follow-up in business, as well as contribute to research on practice-based diversity and quotaring. Additionally, this study will have an impact on how issues like this are handled in practice.  Method: Five semi-structured interviews with managers in various positions in a multinational organization, as well as three focus group discussions, were conducted as part of this qualitative study to allow interactions between theories and empirical findings. In addition to the interviews, the theoretical framework allowed for a thematic analysis. Conclusion: The empirical data gathered for this study has provided sufficient evidence to conclude that a firm's acceptance of diversity and diversity management policies and practices, such as gender quotas, is highly valued by stakeholders, but often difficult to admit. When it comes to incorporating efforts like inclusion and diversity into a firm’s plans, diversity has proven to be quite beneficial, however using gender quotas as part of diversity management techniques is frowned upon. We can also conclude that women still face significant challenges solely based on gender in the business world, such as salary differences, pregnancy, attitudes and males’ perceptions, to name a few. Thus, gender equality still has a long way to go.

Calculations are an important part of planning around a construction project. From concept to completion of the project calculation is a tool to try to predict the actual cost. During the production stage in particular, deviations occur which makes the actual cost different from the calculations.This thesis is done in collaboration with JM Residential Stockholm. The study includes a cost follow-up in which a comparison was made between the calculated production cost and actual cost for the five projects. The aim of the study was to observe the most common reasons that a project deviates from the calculated production cost and then summing these causes in a number of categories. The survey covers a limited number of accounts for each project. Information on deviations has been retrieved from cross-checking with calculations, and from interviews with those responsible for each project. The work also explains how the process of calculation is done, from early planning through to production.

52 7.2 Souhrn v anglickém jazyce Malignant melanoma is the most lethal skin cancer whose incidence has been worldwide increasing. The prognosis of the disease is dependent on many factors - the effected locality, age, form of the tumor and the growth stage at which it was surgically removed. There has been no reliable adjuvant treatment available so far; although cytokins have been recently administered to high-risk patients. The accent is therefore put mainly on the timely detection and the relevant extent of surgical intervention whose degree depends on the stage of the disease. The result of the above mentioned facts is the necessity of an early diagnosis of new cases and permanent follow-up of the patients in whom melanoma has been already confirmed. The patients in the follow-up care are regularly checked, for the rest of their lives, at by the so called melanoma commissions, usually at dermatological clinics. The permanent contact with fact of the possible presence of the disease (information about the diagnosis, repeated follow-ups, waiting for the results of the examination) is stressful for these patients, although they become, to a certain extent, gradually adapted to stress. A good adaptation is however dependent also on the extent of social support, depression, the severity of the disease and...