Purpose To investigate the efficacy of adjunctive selective laser trabeculoplasty (SLT) in reducing 24-h intraocular pressure (IOP) fluctuations and nocturnal IOP peaks. Methods In this prospective interventional case series, 157 medically treated eyes of 157 patients with primary open-angle glaucoma (POAG) who were assigned SLT to further reduce IOP were consecutively included. Each patient had a complete glaucoma work-up and 24-h IOP monitoring (6 measurements, including one in the supine position) taken before and on average 6 months after SLT. The main outcome measures were the reduction of 24-h IOP fluctuations and nocturnal peak IOP. Secondary outcome measures were success rates, factors influencing the reduction of high 24-h IOP fluctuations and nocturnal peak IOP, complications, and severe adverse events. Results Medicated mean 24-h IOP (mmHg) was statistically significantly reduced from 15.1 ± 2.6 to 13.8 ± 2.4 (P < 0.001) and IOP fluctuations from 6.5 ± 2.7 to 5.4 ± 2.6 (P < 0.001) 6 months after SLT. Ninety-four eyes (59.9%) initially had high IOP fluctuations (more than 5 mmHg). These were reduced from 8.1 ± 2.3 to 5.6 ± 2.7 at 6 months (P < 0.001). Fifty-two eyes (55.3%) had fluctuations below 5 mmHg post-SLT which was defined as success. Fifty-one patients (32.5%) had nocturnal IOP peaks. In these cases, nocturnal IOP was reduced by 19.2% from 20.1 ± 3.4 to 16.2 ± 3.3 mmHg at 6 months (P = 0.001). Conclusions The current study demonstrates that adjunctive SLT not only reduces mean 24-h IOP in treated POAG patients, but also has an additional benefit in reducing IOP fluctuations and nocturnal peak IOP.

Purpose: Clinically evaluate a modified applanating surface Goldmann tonometer prism designed to substantially negate errors due to patient variability in biomechanics. Methods: A modified Goldmann prism with a correcting applanation tonometry surface (CATS) was mathematically optimized to minimize the intraocular pressure (IOP) measurement error due to patient variability in corneal thickness, stiffness, curvature, and tear film adhesion force. A comparative clinical study of 109 eyes measured IOP with CATS and Goldmann prisms. The IOP measurement differences between the CATS and Goldmann prisms were correlated to corneal thickness, hysteresis, and curvature. Results: The CATS tonometer prism in correcting for Goldmann central corneal thickness (CCT) error demonstrated a reduction to <+/- 2 mmHg in 97% of a standard CCT population. This compares to only 54% with CCT error <+/- 2 mmHg using the Goldmann prism. Equal reductions of similar to 50% in errors due to corneal rigidity and curvature were also demonstrated. Conclusion: The results validate the CATS prism's improved accuracy and expected reduced sensitivity to Goldmann errors without IOP bias as predicted by mathematical modeling. The CATS replacement for the Goldmann prism does not change Goldmann measurement technique or interpretation.

Rapporten syftar till att beskriva och problematisera kvalitet i idéburen, social välfärd. Ansatsen är att utmana antagandet att idéburen verksamhet drivs av goda intentioner och därför levererar omsorgstjänster av god kvalitet. Resultatet visar att idéburna organisationer erbjuds en särställning i välfärden tack vare sina särdrag. Genom Idéburna Offentliga Partnerskap (IOP) kan de undgå ordinarie kvalitetskrav, samtidigt som det saknas empiriska belägg för att särdragen leder till kvalitet. Idéburen omsorg är av god kvalitet enligt människors uppfattningar, men inte alltid enligt dess faktiska kvalitetsarbete. Rapporten är en teoretisk dokumentstudie och behandlar tidigare forskning, politiska skrivelser och partnerskapsdokument från IOP i en kommun. Resultatet har analyserats med stöd av Webers idealtyper. Författaren utgår från en kritisk rationalistisk grund och rapporten har två inriktningar. Dels är den en förberedande undersökning om kvalitet i idéburen välfärd, och dels är den en vetenskapsteoretisk reflektion och modellutveckling av Webers idealtyper. Rapporten kan därför läsas utifrån ett intresse för idéburen välfärdsverksamhet men även utifrån ett intresse för vetenskapsteori och metodologi.

Sociala problem beskrivs ofta som komplexa och för att möta utmaningar i samhället betonas vikten av samverkan mellan olika aktörer. Förändringar i det svenska välfärdssystemet har möjliggjort olika typer av samarbeten mellan den offentliga sektorn och civilsamhället. Idéburet offentligt partnerskap (IOP) är en överenskommelse om samarbete mellan civilsamhällets organisationer och den offentliga sektorn, i syfte att uppnå ett allmännyttigt samhälleligt mål. Eftersom formen är relativt ny och samverkan lyfts fram som viktig för socialt arbete, har syftet med denna studie varit att undersöka hur ideella organisationer och förvaltningar i Uppsala kommun upplever att samverkansformen IOP fungerar. Teoretiskt vägleds studien av teorier om samverkan samt byråkratisering. Studien antar en hermeneutisk utgångspunkt och baseras på sju kvalitativa semistrukturerade intervjuer med representanter från den offentliga och idéburna sektorn samt kompletteras med en dokumentstudie. Studiens resultat visar att aktörerna väljer att teckna IOP-överenskommelser då IOP bidrar till att uppnå gemensamma mål genom att parterna tillför viktiga resurser till varandra. Dessutom blir relationen mer jämställd och bidrar till ökad dialog samt långsiktig finansiering för organisationerna. Resultatet visar även att det generellt är svårt att mäta effekter av IOP och att IOP medför både utmaningar och nya möjligheter. Utmaningar som finns med samverkansformen är att arbetet är administrativt tungt, tar mycket tid, att det inte finns några tydliga riktlinjer och att det finns en risk för att det blir personbundet. Å andra sidan medför IOP även nya möjligheter såsom bättre insyn hos varandra, en bättre kontakt och att parterna kompletterar varandra för att kunna hjälpa Uppsalas medborgare och uppnå samhällseffekter.

Purpose To evaluate the effectiveness and safety of Selective Laser Trabeculoplasty (SLT) with the SLT mode of the VISULAS ® green laser in patients with primary open-angle glaucoma (POAG). Methods This prospective, interventional multicenter clinical investigation included patients with POAG who either needed a treatment escalation because the individual intraocular pressure (IOP) target was not met or treatment initiation and had an IOP ≥ 17 mmHg at baseline in the study eye. The study was conducted in five research centers across Germany. Approximately 100 laser applications were delivered to 360° of the trabecular meshwork. Glaucoma medications were not modified during the 3-month follow-up to allow evaluation of the sole effect of VISULAS ® green with SLT. Efficacy outcomes were postoperatively absolute and relative IOP changes at 1 and 3 months. Safety outcomes analyzed the rate of intra- and postoperative adverse events. Results Thirty-four eyes of 34 POAG patients were included. The overall mean number of preoperative glaucoma medications was 2.2 ± 1.4 in 29 treated eyes, 5 eyes were treatment naïve. Mean baseline IOP (mmHg) was 21.0 ± 2.69 and was reduced by − 3.53 ± 3.34 [95% CI − 4.61; − 2.45] and − 3.59 ± 3.41 [95% CI − 4.64; − 2.53] at the 1- and 3-month follow-up, respectively (p < 0.0001), with 48.5% of cases achieving a ≥ 20% IOP reduction at 3 months [95% CI = 30.8%; 66.5%]. The mean relative IOP reduction was − 16.4% and − 16.3% at 1 and 3 months, respectively (p < 0.0001). Potentially device- or procedure-related adverse events were mild to moderate and included 3 postoperative IOP-spikes and 6 reports regarding eye pain and discomfort. All were resolved without sequelae. Conclusions SLT performed with the VISULAS ® green laser achieved clinically significant additional IOP reductions in medically treated as well as in treatment naïve eyes with POAG and there were no relevant safety issues. The results are comparable to other reported SLT studies.

Ocean optical studies have been conducted extensively in open ocean waters but less so in coastal waters where the influence of human population is increasing dramatically. The waters of the Strait of Georgia, British Columbia, Canada, are very important to the rearing of young salmon and herring, and to the fishing industry of British Columbia overall. The oceanography and plankton communities of the Strait have been researched extensively, however the forces behind the frequent occurrence of phytoplankton blooms in these waters still causes debate among researchers. In order to shed some light onto this topic and increase our knowledge of the characteristics of the waters of the Strait of Georgia, optical and bio-physical data were measured in the euphotic waters of the Strait in late spring and early summer of 2006. Hyperspectral optical data were measured for the first time in these waters using in situ optical profilers to collect inherent optical properties and radiometric quantities that were later used to derive apparent optical properties. The inherent optical properties included absorption coefficient, spectral beam attenuation coefficient, chromophoric dissolved organic matter absorption coefficient, particulate absorption coefficient, and particulate scattering coefficient. In situ irradiances and radiances were used to derive various diffuse attenuation coefficients. Water masses in the euphotic zone of the Strait of Georgia were then classified into three optical water masses according to their inherent optical properties using a clustering algorithm. OM1 waters were characterized by high and spectrally-invariant particulate scattering due to inorganic particles carried by the Fraser River plume. Absorption and scattering showed some spectral dependence in OM2 waters, with particles and chromophoric dissolved organic matter contributing equally to light absorption. The deepest waters, OM3, were the least influenced by the Fraser River, and the contribution of chromophoric dissolved organic matter to absorption was greater than in OM1 and OM2. A radiative transfer model, Hydrolight, was used to model some of the optical properties that were not collected in situ and then used to assess the magnitude of light available to phytoplankton in the Strait. Based on the minimum light requirements for photosynthesis of two of the main phytoplankton species in the Strait, the analysis presented here showed that there was enough light available for photosynthesis in the photosynthetically-available radiation range for the two phytoplankton species in all three optical water masses.

Background: Compare Goldmann applanation tonometer (GAT) prism and correcting applanation tonometry surface (CATS) prism to intracameral intraocular pressure (IOP), in vivo and in vitro. Methods: Pressure transducer intracameral IOP was measured on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically to 10, 20, and 40 mmHg. Simultaneously, IOP was measured using a Perkins tonometer with a standard GAT prism and a CATS prism at each of the intracameral pressures. Statistical comparison was made between true intracameral pressures and the two prism measurements. Differences between the two prism measurements were correlated to central corneal thickness (CCT) and corneal resistance factor (CRF). Human cadaver eyes were used to assess measurement repeatability. Results: The CATS tonometer prism measured closer to true intracameral IOP than the GAT prism by 1.7+/-2.7 mmHg across all pressures and corneal properties. The difference in CATS and GAT measurements was greater in thin CCT corneas (2.7+/-1.9 mmHg) and low resistance (CRF) corneas (2.8+/-2.1 mmHg). The difference in prisms was negligible at high CCT and CRF values. No difference was seen in measurement repeatability between the two prisms. Conclusion: A CATS prism in Goldmann tonometer armatures significantly improve the accuracy of IOP measurement compared to true intracameral pressure across a physiologic range of IOP values. The CATS prism is significantly more accurate compared to the GAT prism in thin and less rigid corneas. The in vivo intracameral study validates mathematical models and clinical findings in IOP measurement between the GAT and CATS prisms.

Education White Paper No.6 (2001) – Special Education: Special Needs Education. Building an Inclusive Education and Training System creates the expectation that more South African schools will need to follow an inclusive approach to address, effectively, the varying educational needs of all learners. A number of South African private schools implemented inclusive programs before the publication of this white paper. This research focuses on the perceptions of four South African private school principals with regards to the implementation of these programs and the consequential development of their schools. This qualitative research generated data about the selected private schools through a semi-structured interview, a document analysis, and a literature review. The processed data displayed the principals’ perceptions about the South African private schools’ nature; location; the expertise of the various stakeholders; the schools’ criteria and considerations for administering an inclusive program; the effects of the inclusive programs on the schools’ development; the influence of an inclusive approach on the development of staff, infrastructure and administration within these schools; and the nature of the systemic changes within these private schools. The literature review confirms that inclusive education is a diffuse term and that the American IDEA legislation, as the most progressive policy in this regard, ensures comprehensive inclusive mainstream schools for all learners, irrespective of their educational needs, in the least restrictive environment in their respective communities. The interview data was transcribed, labelled according to specific markers and thematically interpreted in five groups. The data analysis showed that the location of the private school, the expertise of the stakeholders at the school and the motivation for the program’s existence all play a definitive role in the extent; nature; marketing; assessment; policy formulation; accreditation; infrastructural developments; cost; policies; procedures; decision making; leadership style; in service training and staff allocation linked to the inclusive program. There are still misconceptions and questions about inclusive education within and outside the private school milieu. The growing cost and increased workload linked to this approach impede its widespread development and make other schools hesitant to implement it in the same manner as the private schools used in this research sample. AFRIKAANS : Onderwys Witskrif Nr.6 (2001) –Spesiale Onderwys: Die vestiging van ’n inklusiewe Onderwys en Opleidingstelsel se verwagting is dat meer Suid-Afrikaanse skole ’n inklusiewe benadering sal volg om al die onderwysbehoeftes van alle Suid-Afrikaanse leerders effektief aan te spreek. ’n Aantal Suid- Afrikaanse privaatskole het voor hierdie publikasiedatum verskillende inklusiewe programme geïmplementeer. Dié navorsing werp lig op die sienings van vier Suid-Afrikaanse privaatskool-hoofde aangaande die implementering van dié programme én die skoolontwikkeling wat daaruit voortvloei. Die kwalitatiewe het data oor die geselekteerde privaatskole deur ’n semi-gestruktureerde onderhoud, ’n dokument-analise en literatuurstudie ingesamel en verwerk. Die data het die skoolhoofde se persepsies aangaande die Suid-Afrikaanse inklusiewe privaatskole se aard; ligging; die kundigheid van hulle belanghebbendes; die skole se kriteria en oorwegings om die inklusiewe program te bedryf; die effekte van die inklusiewe program op skool- ontwikkelings; die invloed van die inklusiewe benadering op die personeel-, infrastruktuur- en administratiewe ontwikkelings in dié skole; én die aard van die sistemiese veranderings in die privaatskole opgelewer. Die literatuurstudie het bevestig dat inklusiewe onderwys ‘n diffuse term is en dat die Amerikaanse IDEA-wetgewing, as die progressiefste beleid in hierdie verband, verseker dat ‘n volwaardige inklusiewe hoofstroomskool alle leerders, ongeag hulle onderwysbehoefte, in die minsbeperkte leeromgewing in hulle gemeenskap akkommodeer. Die onderhouddata is getranskribeer, volgens merkers geëtiketteer en tematies geïnterpreteer in vyf groeperings. Die data-analise toon dat die ligging van die privaatskool, die kundigheid van belanghebbendes by die skool en die motivering vir die program ‘n besliste rol speel in die omvang; aard; bemarking; assessering; beleidformulering; akkreditering; infrastruktuurontwikkelings; koste; beleide; prosedures; besluite; leierskapstyl; indiensopleiding en personeeltoewysing van die inklusiewe praktyke. Daar is steeds wanopvattings oor inklusiewe onderwys binne en buite die privaatskoolbedryf, en die verhoogde werkslas en groeiende koste hieraan verbonde rem die wydverspreide ontwikkeling en maak nuwe skole huiwerig om dieselfde stap te neem as die gevestigde skole. Copyright / Dissertation (MEd)--University of Pretoria, 2010. / Education Management and Policy Studies / unrestricted

Background: Goldmann applanation tonometry (GAT) error relative to intracameral intraocular pressure (IOP) has not been examined comparatively in both human cadaver eyes and in live human eyes. Futhermore, correlations to biomechanical corneal properties and positional changes have not been examined directly to intracameral IOP and GAT IOP. Methods: Intracameral IOP was measured via pressure transducer on fifty-eight (58) eyes undergoing cataract surgery and the IOP was modulated manometrically on each patient alternately to 10, 20, and 40 mmHg. IOP was measured using a Perkins tonometer in the supine position on 58 eyes and upright on a subset of 8 eyes. Twenty one (21) fresh human cadaver globes were Intracamerally IOP adjusted and measured via pressure transducer. Intracameral IOP ranged between 5 and 60 mmHg. IOP was measured in the upright position with a Goldmann Applanation Tonometer (GAT) and supine position with a Perkins tonometer. Central corneal thickness (CCT) was also measured. Results: The Goldmann-type tonometer error measured on live human eyes was 5.2 +/- 1.6 mmHg lower than intracameral IOP in the upright position and 7.9 +/- 2.3 mmHg lower in the supine position (p <.05). CCT also indicated a sloped correlation to error (correlation coeff. = 0.18). Cadaver eye IOP measurements were 3.1+/-2. 5 mmHg lower than intracameral IOP in the upright position and 5.4+/- 3.1 mmHg in the supine position (p <.05). Conclusion: Goldmann IOP measures significantly lower than true intracameral IOP by approximately 3 mmHg in vitro and 5 mmHg in vivo. The Goldmann IOP error is increased an additional 2.8 mmHg lower in the supine position. CCT appears to significantly affect the error by up to 4 mmHg over the sample size.

I denna uppsats undersöks hur statens föreställningar om civilsamhällets roller i välfärden avspeglas i en offentlig utredning om idéburet offentliga partnerskap (IOP). Detta är särskilt intressant givet hur den tidigare civilsamhällesforskningen pekar på att staten alltmer värderar organisationer i det civila samhället likt aktörer på en marknad samtidigt som välfärdssystemen utvecklats på ett sätt som ignorerar organisationernas särart. IOP togs fram som ett försök att avhjälpa problematiken med en felriggad välfärdsmarknad och inramningen i Idéburen välfärd (SOU 2019:56) ger insyn i hur denna problematik förhandlas om i förslag för organisationernas ökade deltagande i välfärdsproduktionen. I en kritiskt granskande ansats kombineras Carol Bacchis policymetod What’s the Problem Represented to be (WPR) med en analytisk modell av statens föreställningar om civilsamhället. Angreppsättet låter undersöka statliga förhållningssätt till civilsamhällets inflytande i välfärdsproduktionen. Studien visar att civilsamhällets organisationer anses ha en avsaknad på inflytande i allt från behovsanalys till de premisser som välfärdstjänster utförs på. Den idéburna partens särart antas komma till rätta i IOP och spelar in i önskan om att främja deltagande på mer ömsesidiga grunder. För detta framstår dock vikten av att vara på rätt sida juridiken som avgörande. I den tvetydiga bedömningen av lagrummet för IOP identifieras en diskrepans mellan utredningens föreställningar och lösningsförslag. Det resulterar i ett förhållningssätt som värdesätter idéburnas särart men undgår att föreslå regleringar som förändrar möjligheten till inflytande i eller genom IOP.