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I dagens Sverige spenderar människor allt mer tid inomhus. Stadsborna tillbringar den mesta av sin tid inomhus, dvs. ca 90 %. Med detta räknas all den tid personerna vistas i hemmet och arbetet. Att människor spenderar så mycket av sin tid inomhus gör att inomhusklimatet blir en påverkande samt viktig faktor i vardagen (Nationalencyklopedin A). Syftet med studien är att undersöka upplevda problem med inomhusklimatet i två olika studentlägenheter som har tilluftsradiatorer. Med hjälp av frågeställningarna kommer problemen identifieras och slutligen som mål komma fram till olika förslag på lösningar. Metoden för att genomföra studien kommer att ske med hjälp av enkätundersökningar i två olika studentbostads fastigheter och där frågor besvaras gällande hur de boende upplever inomhusklimatet. Dessa svar jämförs sedan med varandra för att konstatera hur de skiljer sig åt och vad skillnaderna kan bero på. Resultatet visar att de boende i Rönnens studentbostäder upplever mest problem. Fastigheten består till största del av mindre lägenheter. Sommarstaden som är den andra fastigheten som har undersökts, domineras av större lägenheter. De boende på Sommarstaden upplever mindre besvär. Detta samband kan bero på lägenheternas storlek eller att tilluftsradiatorerna skiljer sig åt mellan de två fastigheterna. Av resultatet framkommer det att båda fastigheter har brister när det kommer till problem med kall inomhustemperatur. För att förbättra bristerna bör information ges till ny inflyttande hyresgäster angående hur möblering bör gå till med vistelsezon i åtanke. Resultatet har visat att det finns skillnader mellan fastigheternas tilluftsradiatorer. Även då Sommarstadens tilluftsradiator kan anses vara av den bättre modellen så är denna inte tillräckligt bra eftersom en stor del av de boende upplever en för kall inomhustemperatur. / In todays Sweden people spend a lot of time indoors. People living in cities spend about 90% of their time indoors; this includes all the time spent both at home and at work. That amount of time spent indoors means that the indoor climate becomes an important as well as an influential part of everyday life. (NE A). The purpose of this study is to examine the perceived problems with the indoor climate in student apartments that have ventilation radiators. With the help of the queries we identify these problems and ultimately aim to come up with proposals for different solutions. The method for implementing the study will be done with the help of questionnaires in two different student-housing properties, where questions are answered regarding how residents perceive the indoor climate. These responses are then compared with each other to ascertain how they differ and why. The results show that the residents of the Rönnen student housing experience the most problems. This property consists largely of small apartments. Larger apartments dominate Sommarstaden, which is the other surveyed property. The residents of Sommarstaden are experiencing minor inconvenience. These problems may depend on the size of the apartments and/or ventilation radiators that differ between the two properties. Through the results it is apparent that both properties have flaws regarding indoor temperature. In order to improve these flaws information regarding furnishing in an occupied zone should be given to the new occupants. Results show that the ventilation radiators differ between the two properties. Although the ventilation radiators in Sommarstaden could be seen as the better model of the two presented, occupants still feel that the indoor temperature is to cold.

Introduction : La contention médicale est définie comme toute méthode manuelle, physique ou par équipement qui immobilise ou réduit la capacité d’un patient à bouger librement son corps. Avec le développement de la sédation et de l’anesthésie générale, l’utilisation de cette méthode controversée de gestion du comportement a diminué. Objectifs : L’objectif principal de la recherche est de comparer la perception des résidents en dentisterie pédiatrique à l’égard des différentes formes de contention médicale en début et en fin de résidence. L’objectif secondaire est de déterminer les facteurs influençant la perception et l’acceptation des résidents quant à la contention médicale. Méthode : Cette étude est basée sur une approche à méthodes mixtes explicatives séquentielles. Le volet 1 est composé d’une étude transversale par enquête avec questionnaire. Le volet 2 comprend une étude qualitative avec entrevues semi-dirigées. Le questionnaire a été envoyé à 850 résidents membres du AAPD et les résidents inscrits en dernière année de leur programme ont été invités à participer à l’entrevue. Résultats: Un taux de réponse de 11% a été obtenu pour le volet 1. Huit entrevues ont été réalisées. La majorité des résidents utilisent la contention active (85%) et passive (99%). L’éducation est un des facteurs qui influencent la perception des résidents. Une distinction doit être faite entre deux concepts : capable et confortable. L’utilisation de la contention est associée avec la détresse morale pour l’intervenant. Conclusion : Ce projet dresse un aperçu de l’acceptation de la contention dans les programmes de résidences et identifie les facteurs qui influencent la perception des résidents. La contention médicale a encore sa place parmi l’armamentarium des dentistes pédiatriques. Les résidents se sentent capable d’utiliser la contention médicale. Leur niveau de confort augmente lorsque cette technique est utilisée en dernier recours dans un but précis. / Introduction: Protective stabilization (PS) is defined as any manual, physical, or equipment-based method that immobilizes or reduces the patient’s movements in order to safely deliver dental treatment. With the development of sedation and general anesthesia, the use of this behavior management technique has decreased. Additionally, there are polarized opinions on the subject among both parents and healthcare professionals. Few recent studies have been published on PS in pediatric dentistry, and none have focused on the perception of pediatric dentistry residents. Objectives: The main objective of the research is to compare the perception of pediatric dentistry residents towards different forms of PS at the beginning and at the end of their residency. The secondary objective is to determine the factors that influence the residents' perception and acceptance of PS. Method: This study is based on a sequential explanatory mixed-methods approach. Phase 1 consists of a cross-sectional survey with a questionnaire. Phase 2 includes a qualitative study with semi-structured interviews. The questionnaire was sent to 850 resident members of the AAPD. Only residents in their final year of the program were invited to participate in the interview. Results: A response rate of 11% was obtained for the first part. Most residents use active PS (85%) and passive PS (99%). Eight interviews were conducted. Education influenced the residents’ perception. There is a distinction to be made between capable and comfortable. Didactic teaching and clinical exposure made the residents capable of using PS in certain specific scenarios. PS use can be associated with moral distress for the clinician. Conclusion: This project provides an overview of the acceptance of restraint use in residency programs and identifies factors influencing residents' perception. PS still has a place in the armamentarium of pediatric dentists. Residents feel capable to use PS. Their comfort level increases when PS is used as a last resort option and for a specific purpose.

The opportunity to educate obese patients on healthy lifestyle practices and address habits related to chronic disease development is present among many physician office visits, though this opportunity is often overlooked (Flocke, Stange, & Goodwin, 1998). Understanding ways to improve the medical education and enhance the counseling skills of future physicians are of practical and personal relevance to current research. By improving the ways in which physicians counsel obese patients on weight management practices, the healthcare paradigm is poised to create an indelible mark on the wellbeing of our nation. Based on the need to address patient education and counseling, the purpose of this study was to investigate the relationship between physician attitudes and health behaviors on their overall communication and communication skills. The study surveyed 38 second-year medical residents at the New York University Bellevue School of Medicine using the Weight Management Survey developed by NYU researchers. Communication and counseling skills were measured using scores from Objective Structured Clinical Exams (OSCEs) administered on the same day as the Weight Management Counseling survey. Results of the survey and the OSCEs were analyzed to investigate relationships between each survey item of three categories of questions (attitudes toward weight management counseling, attitudes toward obese patients, physician health habits) and each of two sets of OSCE scores (obesity-related communication skills and overall counseling skills). Results of the data analysis suggest significant relationships between physicians' personal health habits–specifically dietary habits–and obesity counseling–related communication skills. Results also suggest a significant relationship between physicians' attitudes toward obesity counseling-related communication skills and overall communication skills. Although an extensive body of evidence corroborates these relationships, future investigations should administer the surveys and methods used in this study in rural as well as other urban locations in order to improve variability among medical residents surveyed and assessed. These results also highlight the need to investigate more information about the learning environment of medical residents and also the working environment of physicians, in a variety of settings, in order to provide more depth to the body of literature suggesting providers' health habits improves patient health outcomes. / Ph. D.

Thesis (MPhil)--University of Stellenbosch, 2000. / ENGLISH ABSTRACT: This is an applied methodological thesis about the attitudes of residents towards a modern high rise public housing complex. A definition and analysis of the theme show that this housing type is characterised by a distinctive design and style known as modernist. Therefore, modern and postmodern theory is used to formulate a general existential hypothesis as to residents attitudes towards this housing type. A cross-sectional survey research design was used to research the thesis. Data was collected by means of questionnaires and analysed in the form of a perceived environmental quality index. It was found that residents show a negative overall attitude towards the housing complex. However, there are also some indications of positive attitudes towards the complex, and significant differences were found between the attitudes of particular groups. The thesis is concluded with the suggestion that this housing type can be regarded as an option for certain groups in the context of South Africa’s current housing situation. / AFRIKAANSE OPSOMMING: Hierdie is `n toegepaste metodologiese tesis oor inwoners se houdings teenoor `n moderne toringblok openbare behuisingskompleks. `n Definisie en analise van die tema wys dat hierdie behuisingstipe, deur `n uitstaande ontwerp en styl wat as modernisties bekend staan, gekenmerk word. Moderne en postmoderne teorie word gebruik om `n algemene eksistensiële hipotese betreffende inwoners se houdings teenoor dié behuisingstipe te formuleer. `n Kruis-seksionele opname navorsingsontwerp is gebruik om die tesis te ondersoek. Data is deur middel van vraelyste ingesamel en in die formaat van `n waargenome- omgewing- kwaliteitsindeks geanaliseer. Dit word bevind dat inwoners in geheel `n negatiewe houding teenoor die kompleks huldig. Tog is daar ook bewyse van positiewe houdings en beduidende verskille tussen die houdings van sekere groepe. Die tesis volstaan met die gevolgtrekking dat hierdie behuisingstipe oorweeg kan word vir sekere groepe in die konteks van die huidige Suid Afrikaanse behuisingsituasie.

In the past five years the energy- and climate advisors representing the municipality of Västerås Sweden have conducted an energy-saving campaign concerning households, which will be completed during fall 2015. The aim of the campaign was to raise awareness of the free energy-guidance provided to inhabitants of Västerås and the necessary actions of households’ energy saving, to reach goal attainment of local and national environmental goals concerning climate change. In preparation of new innovative and effective ways to reach out to the public in the future, this study aims to identify future options by examining good examples through a case study of four different Swedish municipalities strategies and experiences with campaigns and information incentives. First scientific literature was reviewed to build a foundation of findings that the interviews could rest on. Thereafter preliminary investigation and one interview per municipality were conducted to get a deeper understanding of the information activities and approaches towards energy friendly behavior. The result show most monitoring and evaluation were based on statistics of people reached and the experience of the advisors or the inhabitants through surveys. All energy- and climate advisors agree upon the fact that the economical incentives to motivate energy conservation is dominating opposed to environmental incentives. The groups that are the hardest to reach are for instance individuals with low interest, not susceptible or those who do not speak the language. The good examples identified are represented by e.g. projects targeting the majority of households by monthly challenges, motivating climate friendly behavior and sustainable development in Örebro. Information incentives performed in Eskilstuna through meetings with an Arabic speaking energy advisor. As well as the 600m2 energy exhibition in Jönköping localized in connection to a shopping center.

Objectif : L'évaluation de l'acuité visuelle (AV) chez la personne âgée atteinte de troubles cognitifs peut être limitée par le manque de collaboration ou les difficultés de communication du patient. Très peu d'études ont examiné l'AV chez les patients atteints de déficits sévères de la cognition. L’objectif de cette étude était d’évaluer l'AV chez la personne âgée vulnérable ayant des troubles cognitifs à l'aide d'échelles variées afin de vérifier leur capacité à répondre à ces échelles. Méthodes: Trois groupes de 30 sujets chacun ont été recrutés. Le premier groupe était constitué de sujets jeunes (Moy.±ET: 24.9±3.5ans) et le second, de sujets âgés (70.0±4.5ans), ne présentant aucun trouble de la cognition ou de la communication. Le troisième groupe, composé de sujets atteints de démence faible à sévère (85.6±6.9ans), a été recruté au sein des unités de soins de longue durée de l’Institut Universitaire de Gériatrie de Montréal. Le test du Mini-Mental State Examination (MMSE) a été réalisé pour chaque sujet afin de déterminer leur niveau cognitif. L’AV de chaque participant a été mesurée à l’aide de six échelles validées (Snellen, cartes de Teller, ETDRS-lettres,-chiffres,-Patty Pics,-E directionnel) et présentées selon un ordre aléatoire. Des tests non paramétriques ont été utilisés afin de comparer les scores d’AV entre les différentes échelles, après une correction de Bonferroni-Holm pour comparaisons multiples. Résultats: Le score moyen au MMSE chez les sujets atteints de démence était de 9.8±7.5, alors qu’il était de 17.8±3.7 et 5.2±4.6 respectivement, chez les sujets atteints de démence faible à modérée (MMSE supérieur ou égal à 13; n=11) et sévère (MMSE inférieur à 13; n=19). Tous les sujets des groupes 1 et 2 ont répondu à chacune des échelles. Une grande majorité de sujets avec démence ont répondu à toutes les échelles (n=19) alors qu’un seul sujet n’a répondu à aucune échelle d’AV. Au sein du groupe 3, les échelles d’AV fournissant les scores les plus faibles ont été les cartes de Teller (20/65) et les Patty Pics (20/62), quelque soit le niveau cognitif du sujet, alors que les meilleurs scores d’AV ont été obtenus avec les échelles de Snellen (20/35) et les lettres ETDRS (20/36). Une grande proportion de sujets avec démence sévère ont répondu aux cartes de Teller (n=18) mais le score d’AV obtenu était le plus faible (20/73). Au sein des trois groupes, l’échelle de lettres-ETDRS était la seule dont les scores d’AV ne différaient pas de ceux obtenus avec l’échelle de Snellen traditionnelle. Conclusions: L’acuité visuelle peut être mesurée chez la personne âgée atteinte de troubles cognitifs ou de la communication. Nos résultats indiquent que les échelles les plus universelles, utilisant des lettres comme optotypes, peuvent être utilisées avec de bons résultats chez les personnes âgées atteintes de démence sévère. Nos résultats suggèrent de plus que la mesure d’acuité visuelle doit être tentée chez toutes les personnes, peu importe leur niveau cognitif. / Purpose: The evaluation of visual acuity (VA) in cognitively impaired older individuals may be limited by a reduced ability to cooperate or communicate. To date, no study has been performed to guide the clinician as to which VA chart to use in older individuals with moderate to severe dementia. This is important knowing that dementia affects more than 30% of seniors above 85 yrs of age, many of whom will be affected by the most severe stages of the disease. The objective of this research was to assess VA in older institutionalized individuals with moderate to severe dementia, using various acuity charts, and to verify their ability to respond to each of these charts. Methods: Three groups of 30 subjects each were recruited. The first group consisted of young subjects (Avg ± SD: 24.9 ± 3.5 yrs) and the second one, older subjects (70.0 ± 4.5 yrs) with no history of cognitive or communication disorders. The third group (85.6 ± 6.9 yrs) included subjects with mild to severe dementia residing in long-term care units. The Mini Mental-State Examination (MMSE) was performed for each institutionalized subject to verify their cognitive level. The VA of each participant was measured using six validated VA charts (Snellen, Teller cards, ETDRS-letters, -numbers, -Patty Pics, -Tumbling E's) presented in random order. Non parametric tests were used to compare VA scores obtained between the various charts, after Bonferroni-Holm corrections for multiple comparisons Results: The average MMSE scores of subjects with dementia was 9.8 ± 7.5, while it was 17.8 ± 3.7 and 5.2 ± 4.6, for those with mild to moderate (MMSE ≥ 13; n=11) and severe (MMSE < 13; n= 19) dementia. All subjects in groups 1 and 2 responded to each of the charts. A large proportion of subjects with dementia responded to all charts (n= 19) while only one did not respond to any chart. In group 3, VA charts with the lowest scores were the Teller cards (20/65) and Patty Pics (20/62), regardless of the level of dementia, while the best VA scores were obtained with the Snellen (20/35) and ETDRS-letter (20/36) charts. More subjects with severe dementia responded to the Teller cards (n= 18) but the VA obtained was the lowest (20/73). Across all groups, the ETDRS-letter chart was the only one whose scores did not differ from those obtained with the standard Snellen chart. Time to read the letter charts was faster than for the other optotypes. Conclusions: Visual acuity can be measured, and should at least be attempted, in older cognitively impaired individuals having a reduced ability to communicate. Our results indicate that the most universal scales, using letters as optotypes, can be used with good results in people with more severe dementia. Testing requires, however, more time and encouragement in individuals with more severe cognitive deficits in order to obtain and maintain their collaboration.

La pratique de l’hématologie, comme celle de toute profession, implique l’acquisition d’un raisonnement adéquat. Se basant sur une théorie de psychologie cognitive, le test de concordance de script (TCS) a été développé et validé comme un instrument permettant d’évaluer le raisonnement clinique dans diverses spécialités médicales. Le but de cette étude était d’examiner l’utilité et les paramètres psychométriques d’un TCS en hématologie. Nous avons construit un TCS composé de 60 questions que nous avons administré à 15 résidents juniors (R1 à R3 en médecine interne), 46 résidents séniors (R4, R5 et R6 en hématologie) et 17 hématologues à travers le Canada. Après optimisation, le TCS comptait 51 questions. Sa consistance interne mesurée par le coefficient de Cronbach alpha était 0.83. Le test était en mesure de discriminer entre les résidents selon leur niveau de formation. Les questions contenant des images (n=10) semblaient avoir un potentiel discriminatoire plus élevé. Les scores obtenus par les résidents séniors corrélaient modéremment avec ceux obtenus à un test conventionnel d’hématologie composé de questions à choix multiples et à courte réponse (r de Pearson = 0.42; p=0.02). Le TCS a été complété en 36 minutes en moyenne et a été bien reçu par les participants. Le TCS est un instrument d’évaluation utile et valide en hématologie. Il peut être utilisé à des fins formatives en aidant au suivi de la progression des résidents. Il pourrait aussi être combiné à d’autres instruments d’évaluation à des fins sanctionnelles, ou encore, en éducation médicale continue. / The practice of hematology, like any other profession, requires the acquisition of adequate judgment. Based on cognitive psychology theory, the script concordance test (SCT) has been developed and validated as an instrument capable of evaluation clinical judgement in various medical specialties. The goal of this study was to examine the usefulness and the psychometric qualities of the SCT in hematology. We constructed a SCT composed of 60 questions and we administered it to 15 junior residents (R1 to R3 in internal medicine), 46 senior residents (R4, R5 and R6) and 17 hematologists from across Canada. After item optimization, the test comprised 51 questions. Its internal consistency measured by Cronbach alpha was 0.83. The test was able to discriminate between residents according to their year of training. Questions containing an image (n=10) seemed to offer a stronger discriminative potential. Scores obtained by the senior residents correlated moderately with those obtained on a conventional hematology exam made of multiple choice questions and short-answers (Pearson r: 0.42; p=0.02). The SCT was completed in an average of 36 minutes and was well received by participants. The SCT is a useful and valid evaluation instrument in hematology. It may be used during training to monitor resident progression. It may also be combined to other evaluation tools and used for summative purposes or in continuing medical education.

8 ABSTRACT The participants of environmental management are able to contribute to the sustainable development of protected areas through organized cooperation that requires a complex approach. Therefore, identification and classification of attitudes or relationships between stakeholders are highly desirable as well as determining the factors influencing their thinking towards the existence of protected areas. The explanatory variables like age, education, local and ecological knowledge and employment are usually discussed to explain of residents' opinions on protected areas. This work focuses on the residents of National parks Krkonose, Podyji and Ceske Svycarsko and a team of researchers under the leadership of a supervizor was systematically monitored residents' opinions since 1999 in these national parks. Four-block questionnaire field surveys were conducted in 19 villages influenced by national park management and 469 samples were collected. Chi-square test and logistic regression were utilized to analyse the dataset. There are signifiant relationships (p < 0.05) between selected demographic, environmental, social, economic and institutional-political indicators. Positive or negative respondents' opinions on the existence of the national park were significantly influenced by their age (pχ2 = 0.026),...

Syftet med studien är att undersöka boendes egna upplevelser av att bo i Tjärna ängar och undersöka vilka föreställningar de har om hur utomstående ser på bostadsområdet för att se om dessa föreställningar påverkar de boende. Studien är en kvalitativ undersökning där semistrukturerade intervjuer genomförts. Materialet har analyserats utifrån tre olika tolkningsramar, territoriell stigmatisering, etablerade och outsiders samt media. Resultatet som framkom i studien är att bilden av bostadsområdet Tjärna ängar skiljer sig mellan de boende och samhället. De boende upplever området som tryggt medan samhället ser området som oroligt. De boende menar att medias rapportering är en stor faktor till skapandet av bilden i samhället av bostadsområdet. Vidare framkom att området Tjärna ängar är utsatt för en territoriell stigmatisering. / The purpose of this study is to investigate residents own experience of living in Tjärna ängar and examine the notions they have about how outsiders think of Tjärna ängar to see if these notions affect the residents. The study is a qualitative study in which semi-structured interviews were used. The material has been analyzed from three different theoretical perspectives, territorial stigmatization, established and outsiders and the media. The result showed that the image of the area Tjärna ängar differ between the residents and the community. The residents experience the neighborhood as safe while the community sees it as disordered. The residents think that a major factor in the creation of the image that exists in the community is what media reports about the neighborhood. Furthermore the result showed that the neighborhood Tjärna ängar are subject to a territorial stigmatization.