Дисертації з теми "Sharka Disease"

La maladie de la sharka, causée par le Plum pox virus (PPV), est responsable d’importantes pertes économiques chez les Prunus. Toutefois, aucun traitement préventif ou curatif n’est à ce jour disponible et peu de sources de résistance naturelle ont été retrouvées. En France, une approche prophylactique, qui repose essentiellement sur la détection et l’élimination rapide des arbres infectés, a été adoptée afin de réduire la propagation du virus. Néanmoins, certaines contraintes technico-économiques ne permettent pas la détection précoce et efficace du PPV à grande échelle par des méthodes conventionnelles. Le département des Pyrénées Orientales (France) est le plus touché par cette maladie (85% des contaminations). Ces enjeux ont motivé la création du projet Antishark, issu d'une collaboration entre AkiNaO, l'Université de Perpignan Via Domitia, la FDGDON66 et les producteurs locaux. L'objectif du projet consiste à développer une méthode innovante de détection précoce, en ciblant les réponses métaboliques de Prunus persica à un stade précoce de l'infection. Par conséquence, deux études en conditions contrôlées utilisant une approche métabolomique non-ciblée (UHPLC-HRMS) ont été réalisées. Cette approche constitue un outil prometteur pour mettre en évidence les interactions métaboliques entre le PPV et son hôte. Dans une première étude, la réponse métabolique globale à l'infection par le PPV (souches Dideron et Marcus), intégrant les feuilles symptomatiques et asymptomatiques, a permis de discriminer les profils métaboliques provenant de feuilles infectées par le PPV et de feuilles saines. Bien qu’il existe une réponse commune aux deux souches, des différences métaboliques ont également été révélées, mettant en évidence des altérations métaboliques souche-dépendante. De fait, cette observation pourrait amener à terme, la possibilité d’identifier la ou les souches virales responsables d’une infection. De plus, il est possible de discriminer les plants infectés par le PPV (feuilles symptomatiques et asymptomatiques) des plants sains et des plants infectés par un autre virus phytopathogène. Ces observations suggèrent l’existence d’une réponse spécifique potentielle à la maladie de la sharka. L’ensemble de nos résultats corroborent l'hypothèse selon laquelle les arbres asymptomatiques mais infectés par le PPV, pourraient être détectés via les altérations métaboliques provoquées le virus. Par ailleurs, les réponses métaboliques observées sur les feuilles asymptomatiques pourraient être considérées comme des réponses précoces, déclenchées avant l’apparition des symptômes. Dans un deuxième temps, des altérations métaboliques précoces, avant l’apparition des symptômes sharka, ont été confirmées par une étude cinétique et ce, malgré des tests moléculaires négatives (RT-qPCR). Nos résultats indiquent que la détection précoce des plantes infectées par le PPV, en ciblant les réponses métaboliques de Prunus persica, est de facto une stratégie prometteuse. Finalement, des corrélations statistiques entre les deux études ont été retrouvées. Bien que les cultivars présentent des profils métaboliques significativement différents, certaines variables discriminantes sont communes entre les différents cultivars testés (GF-305, nectarine jaune, pêche jaune) et également entre les différents stades d’infection du virus (symptomatique et asymptomatique). Cependant, une co-infection PPV et oïdium observée le long de l’étude cinétique en conditions contrôlées, serait susceptible d’altérer l'impact de l'infection par le PPV. Par conséquent, une nouvelle étude cinétique sans co-infection est en cours pour confirmer ou infirmer ces observations. De plus, l'identification de biomarqueurs liés à la maladie, également en cours, permettrait de mieux comprendre les interactions métaboliques entre la pêche et le PPV. Enfin, d'autres expérimentations en conditions naturelles sont en cours afin d'évaluer la robustesse de nos potentiels biomarqueurs
Sharka disease, caused by Plum pox virus (PPV), is responsible for significant economic losses in Prunus. However, no preventive or curative treatments are currently available and only a few sources of natural resistance have been found. In France, a prophylactic approach has been adopted in an attempt to limit the spread of the PPV, which is essentially based on the rapid detection and removal of infected trees. However, certain technical and economic limitations do not allow the early andeffective detection of PPV on a large scale by conventional methods. The department of Pyrénées Orientales (France) is the most affected by this disease (85% of infections). These issues motivated the creation of the Antishark project, which is the result of a collaboration between AkiNaO, the University of Perpignan Via Domitia, FDGDON66 and local producers. The objective of the project was to develop an innovative method of early detection, targeting the metabolic responses of Prunuspersica at an early stage of the infection. Consequently, two studies under monitored conditions using an untargeted metabolomics approach (UHPLC-HRMS) were carried out. This approach is a promising tool to reveal the metabolic interactions between PPV and its host. In a first study, the global metabolic response to PPV-infection (Dideron and Marcus strains), including symptomatic and asymptomatic leaves, allowed the discrimination of metabolic profiles from PPV-infected and healthy leaves. Although there was a common response between the two strains, metabolic differences were also revealed, notably highlighting strain-specific metabolic alterations. In fact, this novel result could eventually lead to the possibility of identifying the viral strain(s) responsible for the infection. Furthermore, it was possible to discriminate PPV-infected plants (symptomatic and asymptomatic leaves) from healthy plants and from plants infected by another plant pathogenic virus. These observations suggest the existence of a potential specific response to the sharka disease. Based on all these findings, the hypothesis that asymptomatic PPVinfected trees could be detected through virus-induced metabolic alterations is supported.Furthermore, the metabolic responses collected from asymptomatic leaves could be considered as early responses to PPV-infection, i.e., before the appearance of symptoms. In a second step, early metabolic alterations, before the appearance of sharka symptoms, were confirmed by a kinetic study, despite negative molecular tests (RT-qPCR). Our results indicate that early detection of PPVinfected plants by targeting metabolic responses in Prunus persica was a promising strategy. Finally,statistical correlations between the two studies were found. Although the cultivars showed significantly different metabolic profiles, some discriminant features were common between the different cultivars tested (GF-305, yellow nectarine, yellow peach) and also between the different stages of the virus infection (symptomatic and asymptomatic). Nevertheless, a co-infection of PPV and powdery mildew observed during the kinetic experiment under monitored conditions could alter the impact of PPV-infection. Consequently, a new kinetic study without co-infection, is ongoing to confirm or refute these first observations. In addition, the identification of biomarkers related to the sharka disease, also in progress, would provide a betterunderstanding of the metabolic interactions between peach and PPV. Finally, other experiments under natural conditions are underway to evaluate the robustness of our potential biomarkers

Background Non-adherence to evidence based secondary prevention medicines (SPM) by coronary heart disease (CHD) patients limits their expected benefits and may result in a lack of improvement or significant deterioration in health. This study explored self-reported non-adherence to SPM, barriers to adherence, and the perception that patients in West Yorkshire have about their medicines in order to inform practice and improve adherence. Methods In this cross-sectional study a specially designed postal survey (The Heart Medicines Survey) assessed medicines-taking behaviour using the Morisky Medicines Adherence 8 items Scale (MMAS-8), a modified version of the Single Question Scale (SQ), the Adherence Estimator (AE), Beliefs about Medicines Questionnaire(BMQ) and additional questions to explore practical barriers to adherence. Patients were also asked to make any additional comments about their medicines-taking experience. A purposive sample of 696 patients with long established CHD and who were on SPM for at least 3 months was surveyed. Ethical approval was granted by the local ethics committee. Results 503 (72%) patients participated in the survey. 52%, 34% and 11% of patients were prescribed at least four, three and two SPMs respectively. The level of non-adherence to collective SPM was 44%. The AE predicted that 39% of those had an element of intentional non-adherence. The contribution of aspirin, statins, clopidogrel, beta blockers, angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARBs) to overall non-adherence as identified by the SQ scale was 62%, 67%, 7%, 30%, 22% and 5%, respectively. A logistic regression model for overall non-adherence revealed that older age and female gender were associated with less non-adherence (OR = 0.96, 95% CI: 0.94, 0.98; OR = 0.56, 95% CI: 0.34, 0.93; respectively). Specific concern about SPM, having issues with repeat prescriptions and aspirin were associated with more non-adherence (OR = 1.12, 95% CI: 1.07, 1.18; OR = 2.48, 95% CI: 1.26, 4.90, OR = 2.22, 95% CI: 1.18, 4.17). Other variables were associated with intentional and non-intentional non-adherence. 221 (44%) patients elaborated on their medicines-taking behaviour by providing additional comments about the need for patient tailored information and better structured medicines reviews. Conclusions The Medicines Heart Survey was successful in revealing the prevalence of self-reported non-adherence and barriers to adherence in our population. Healthcare professionals should examine specific modifiable barriers to adherence in their population before developing interventions to improve adherence. Conducting frequent structured medicines-reviews, which explore and address patients' concerns about their medicines and healthcare services, and enable them to make suggestions, will better inform practice and may improve adherence.

Financial incentives offered by payers to health care providers and patients have been identified as a key mechanism to lower costs while improving quality of care. How to effectively design incentive programs that can align the varying objectives of health care stakeholders, as well as predict programs' performance and stakeholders' decision response is an unresolved research challenge. The objective of this study is to establish a novel approach based on multiscale decision theory (MSDT) that can effectively model and efficiently analyze such incentive programs, and the complex health care system in general. The MSDT model captures the interdependencies of stakeholders, their decision processes, uncertainties, and how incentives impact decisions and outcomes at the payer, hospital, physician, and patient level. In the first part of this thesis, we study the decision processes of agents pertaining to the investment and utilization of imaging technologies. We analyze the payer-hospital-physician relationships and later extend the model to include radiologist and patient as major stakeholders in the second part of this thesis. We focus on a specific incentive program, the Medicare Shared Savings Program (MSSP) for Accountable Care Organizations (ACOs). The multi-level interactions between agents are mathematically formulated as a sequential non-cooperative game. We derive the equilibrium solutions using the subgame perfect Nash equilibrium (SPNE) concept and the backward induction principle, and determine the conditions under which the MSSP incentive leads to the desired outcomes of cost reduction and quality of care improvements. In the third part of this thesis, we study the multi-level decision making in chronic disease management. We model and analyze patients' and physicians' decision processes as a general-sum stochastic game with perfect information and switching control structure. We incorporate the Health Belief Model (HBM) as the theoretical foundation to capture the behavioral aspect of agents. We analyze how incentives and interdependencies affect patients' engagement in health-promoting activities and physicians' delivery of primary care services. We show that a re-alignment of incentives can improve the effectiveness of chronic disease management.
Ph. D.

This research evaluated the effectiveness of a decision support intervention to guide older people who have advanced stages of kidney disease in making treatment choices about dialysis or conservative treatment. A pragmatic randomised controlled trial was conducted to determine if the intervention lowered decision conflict and decision regret. The research found that the decision support intervention increased participants’ knowledge of risk, benefits and symptoms of dialysis. There were no observable differences between groups for decision conflict or decision regret. The research raises issues about fully informed patient choice in end of life care and lays the foundation for ongoing research.

Modern medical practice and science involve complex phenotypic definitions. Understanding patterns of association across this range of phenotypes requires co-analysis of high-dimensional association studies in order to characterise shared and distinct elements. In this thesis I address several problems in this area, with a general linking aim of making more efficient use of available data. The main application of these methods is in the analysis of genome-wide association studies (GWAS) and similar studies. Firstly, I developed methodology for a Bayesian conditional false discovery rate (cFDR) for levering GWAS results using summary statistics from a related disease. I extended an existing method to enable a shared control design, increasing power and applicability, and developed an approximate bound on false-discovery rate (FDR) for the procedure. Using the new method I identified several new variant-disease associations. I then developed a second application of shared control design in the context of study replication, enabling improvement in power at the cost of changing the spectrum of sensitivity to systematic errors in study cohorts. This has application in studies on rare diseases or in between-case analyses. I then developed a method for partially characterising heterogeneity within a disease by modelling the bivariate distribution of case-control and within-case effect sizes. Using an adaptation of a likelihood-ratio test, this allows an assessment to be made of whether disease heterogeneity corresponds to differences in disease pathology. I applied this method to a range of simulated and real datasets, enabling insight into the cause of heterogeneity in autoantibody positivity in type 1 diabetes (T1D). Finally, I investigated the relation of subtypes of juvenile idiopathic arthritis (JIA) to adult diseases, using modified genetic risk scores and linear discriminants in a penalised regression framework. The contribution of this thesis is in a range of methodological developments in the analysis of high-dimensional association study comparison. Methods such as these will have wide application in the analysis of GWAS and similar areas, particularly in the development of stratified medicine.

Background: Management of atrial fibrillation (AF) is complex and requires active patient engagement in shared decision making to achieve better clinical outcomes, greater medication adherence, and increased treatment satisfaction. Efficacy in patient-physician interactions is a critical component of patient engagement, but factors associated with efficacy in older AF patients have not been well-characterized. Methods: We performed a cross-sectional analysis of baseline data from the ongoing Systematic Assessment of Geriatric Elements in Atrial Fibrillation (SAGE-AF) study, a cohort study of older adults (age ≥ 65) with non-valvular AF and CHA2DS2-VASc score ≥ 2. Participants were classified according to their Perceived Efficacy in Patient-Physician Interactions (PEPPI-5) score (lower: 0-44; higher: 45-50). Logistic regression analysis was used to identify sociodemographic, clinical (AF type, AF treatment, medical comorbidities), and geriatric (cognitive impairment, sensory impairment, frailty, independent functioning) factors associated with lower reported efficacy. Results: Participants (n = 1209; 49% female) had a mean age of 75. A majority (66%) reported higher efficacy in their interactions with physicians. Lower efficacy was associated with persistent AF (adjusted odds ratio [aOR] = 1.52; 95% confidence interval [CI] = 1.13-2.04) and with symptoms of depression (aOR = 1.67; CI = 1.20-2.33) or anxiety (aOR = 1.40; CI = 1.01-1.94). Decreased odds of lower efficacy were observed in participants with chronic kidney disease (aOR = 0.68; CI = 0.50-0.92) and those classified as pre-frail compared to those classified as not frail (aOR = 0.71; CI = 0.53-0.95). Conclusion: Older patients with persistent AF or symptoms of depression or anxiety have decreased efficacy in patient-physician interactions. These individuals merit greater attention from physicians when engaged in shared decision making.

La loi du 04 mars 2002 relative aux droits des malades et à la qualité et à la qualité du système de santé et la loi HPST (Hôpital, Patients, Santé et Territoires) de 2009 qui accorde un cadre légal à l’éducation thérapeutique ont promu l’autonomie du patient en favorisant sa participation aux décisions médicales. L’autogestion de la maladie chronique voulue par les pouvoirs publics en fournissant ces outils juridiques pour améliorer la qualité de soins, a suscité notre intérêt pour programme d’éducation thérapeutique destiné à des patients insuffisants rénaux en pré-dialyse. L’un des objectifs est de favoriser la liberté des patients à choisir une méthode de dialyse. Dans notre travail de thèse, nous avons voulu montrer comment les déterminants sociaux des décisions médicales et ceux liés aux choix d’une méthode de dialyse sont construits. Si en France, les patients semblent davantage se tourner vers une prise en charge à l’hôpital, dans certains pays, c’est le pluralisme médical qui est de mise. L’exercice de l’auto-analyse a montré le poids de l’économique, de la culture, de la famille dans les choix de santé.Par ailleurs, la place de l’éducation thérapeutique dans le processus décisionnel n’est pas figée : l’éducation thérapeutique peut être complémentaire à la pratique médicale, être un outil d’aide à la décision pour certains patients insuffisants rénaux ou être utilisée par les médecins pour favoriser l’observance décisionnelle des patients. Nous avons montré que les patients et les médecins se basent sur plusieurs facteurs qui peuvent influencer la nature de la délibération.Cette étude a montré que le choix est réseauté et que les décisions sont construites car elles sont basées sur des interactions et des stratégies médicales. Ces déterminants permettent également de comprendre comment la confiance est construite dans le processus décisionnel. Tantôt distribuée, tantôt déplacée, la confiance est explicative du type d’information que le patient priorise. Le choix réseauté du patient amène finalement à la relativisation du modèle de décision médicale partagée qui semble de plus en plus avoir un caractère normatif dans la relation entre professionnels de santé et patients
The law of March 04th, 2002 on the rights of patients and the quality of the health system and the law HPST (Hôpital, Patients, Santé et Territoires) of 2009 that grants legal framework for patients’ education, have promoted the patient’s autonomy by encouraging his participation in medical decisions. Self-management of chronic illness as favoured by public authorities in providing the legal tools to improve the quality of care has aroused our interest in patient education programs for patients with renal failure in pre-dialysis. One of the objectives of this program is to allow patients free choice when deciding on the method of dialysis.Our thesis aims to underline how the social determinants at work in medical decisions and those involved in the choice of a dialysis method are constructed.In France, patients seem to favor hospital patient care, but in some countries, medical pluralism is more frequent. The exercise of self-analysis has revealed the significant part played by economy, culture and family in health choices.Moreover, the part played by patient education in the decision-making process is neither fixed nor pre-determined: patient education can complement medical practice, can be a decision support tool for some kidney patients or be used by doctors to promote patient decision-making compliance.We have shown that patients and physicians rely on several factors that may influence the nature of the discussion.This study reveals that the choice is networked and that the decisions that are made are the outcome of several interactions and medical strategies. These determinants also help to understand how trust develops and leads to decision-making.Sometimes distributed, sometimes shifted, trust accounts for the type of information prioritized by the patient. The networked choice of the patient finally puts the shared decision-making model into perspective as it increasingly seems to have a normative character in the relationship between health professionals and patients

Contexte : les Plans Cancer 2 et 3 soulignent l'importance de la décision médicale partagée. Cependant, la littérature sur la reconstruction mammaire (RM) suite à un cancer du sein montre la place essentielle du médecin dans la prise de décision. Les proches apparaissent également comme peu pris en compte par les médecins dans le choix des traitements et en particulier le partenaire intime qui est le proche généralement le plus présent aux côtés de la patiente. À l'heure actuelle, aucune recherche n'a étudié les interactions conjugales dans le processus de décision d'une RM. Pourtant, plusieurs études ont montré l'interdépendance des deux membres du couple face à une maladie chronique et le rôle essentiel du partenaire dans l'ajustement des patientes au cancer du sein. Objectif : cette recherche a pour objectif principal d'étudier les interactions conjugales dans le processus de décision d'une RM suite au diagnostic d'un cancer du sein. Méthode : deux études ainsi qu'une revue systématique de la littérature ont été réalisées afin de répondre à cet objectif. Ces deux études étaient mixtes, comprenaient une partie quantitative (auto-questionnaires) et une partie qualitative (entretiens avec les femmes et leur partenaire). La première étude était rétrospective, en interrogeant des couples plusieurs années après le diagnostic du cancer. La seconde était prospective, en interrogeant des couples juste après le diagnostic du cancer. Les données quantitatives ont fait l'objet d'analyses non-paramétriques. Les données qualitatives ont fait l'objet d'une analyse de contenu thématique, d'une analyse lexicale (pour l'étude rétrospective) et d'une analyse phénoménologique interprétative (pour l'étude prospective). Résultats : les résultats de l'étude rétrospective montrent que l'ajustement émotionnel des femmes est le même quel que soit leur décision (RM immédiate, RM différée ou sans RM). Cependant, les femmes qui n'ont pas eu de RM recommanderaient moins leur décision comparées aux femmes qui ont eu une RM. Par ailleurs, les couples rapportent que la prise de décision de la RM est vécue et prise au sein du couple. Le partenaire y apparaît comme un soutien à la décision. La question de la temporalité apparaît différemment dans le discours des couples selon la décision. Les résultats de la revue systématique soulignent les différents rôles que les proches peuvent avoir dans la prise de décision d'un traitement pour une maladie chronique, notamment de manière directe (e.g., le partenaire communique ses préférences au patient) et indirecte (e.g., le choix du patient est guidé par sa perception de ses responsabilités familiales). Les résultats de l'étude prospective montrent qu'avant la mastectomie, les partenaires de femmes qui ne vont pas avoir de RMI expriment plus d'émotions négatives et un besoin d'information plus important que les partenaires de femmes qui vont avoir une RMI. De plus, les femmes et leurs partenaires pensent à la RM au moment de la mastectomie. Ces pensées leur permettent de se projeter dans le futur, où la RM est associée à une bonne santé. Penser à la RM pourrait alors permettre aux couples de s'ajuster face à la mastectomie et au diagnostic de cancer du sein. Conclusion : la prise de décision de la RM apparaît comme vécue au sein du couple, avec des spécificités en fonction de la décision prise (RM immédiate, RM différée ou pas de RM). Au niveau clinique, ce travail permet d'identifier les besoins des couples et de proposer des pistes d'interventions et d'outils à développer afin d'accompagner les femmes et leur partenaire. Au niveau de la recherche, il conviendrait d'investiguer plus largement comment la décision de la RM est prise entre la femme, son partenaire et les différents professionnels de santé impliqués dans la prise en charge médicale
Context: cancer Plans 2 and 3 emphasize the importance of a shared decision-making. However, the literature on breast reconstruction (BR) following breast cancer shows the physician essential place in this decision-making. Close others are also little included by physicians in this treatment choice and more specifically intimate partners. The latter is usually the most present near the women. To date, no research has studied couple interactions in the decision-making process of a BR. Yet, several studies have pointed out the interdependence of both members of a couple to face a chronic illness and partners' key role in women's adjustment facing breast cancer. Objective: the main objective of this research is to study couple interactions in the decision-making process of a BR following breast cancer diagnosis. Method: two studies as well as a systematic literature review were realized to meet this objective. These two studies were mixed, including a quantitative part (self-reported questionnaires) and a qualitative part (interviews with women and their partners). The first study was retrospective, interviewing couples several years after breast cancer diagnosis. The second study was prospective, interviewing couples just after breast cancer diagnosis. Quantitative data were subjected to non-parametric analysis. Qualitative data were subjected to a thematic content analysis, a lexical analysis and an interpretative phenomenological analysis. Results: the results of the retrospective study show that women's emotional adjustment is the same regardless their decision (immediate BR, delayed BR or no BR). However, women without BR would less recommend their decision compared to women with BR. In addition, couples report that BR decision was lived and taken within the couple. Partners were described as supportive in the decision-making process. The question of temporality emerged differently in couple's discourse according to the decision. The results of the systematic literature review highlight the different roles family members can have in treatment decision-making of a chronic illness, including direct (e.g., the partner says his/her preferences to the patient) and indirect influence (e.g., patient's choice is guided by his/her perception of his/her family responsibilities). The results of the prospective study shows that before the mastectomy, partners of women not having an immediate BR express more negative emotions and a greater need for information compared to partners of women having an immediate BR. Furthermore, women and their partners think to the BR at the time of the mastectomy. These thoughts allow couples to project themselves in the future, where BR is associated to a good health. Thinking to BR could allow couples to cope with the mastectomy and breast cancer diagnosis. Conclusion: BR decision-making appears as experienced within the couple, with specificities considering the decision (immediate BR, delayed BR or no BR). At the clinical level, this work allows to identify couples needs and to propose interventions and tools to develop in order to accompany women and their partners. At the research level, it should be distinguished more broadly how BR decision is made between the women, her partner and the health professionals involved in the medical care

The main objective of this mini–dissertation is to investigate the basic form and content of moral education as it manifests itself in the mamtiseni and nkciyo female initiation rituals of the Mount Frere region of the Eastern Cape Province of the Republic of South Africa. The main theoretical position taken is the reemergent African Renaissance coupled with African indigenous knowledge systems, first revived by (former) President Thabo Mbeki. Accordingly the main purpose of this study is to address the transmission of moral aspects of female Bhaca initiation inherent in behavioural/cultural educational enculturation. The main findings of the mini–dissertation constitute the following: 1. Mamtiseni and nkciyo rituals play a major role in the enculturation of young Bhaca girls. 2. The song texts carry strong messages of how to go about achieving a healthy and surviving society. There are further opportunities for research in the following aspects: 1. Nkciyo initiation schools are very exclusive, involving many secret codes. The fact that I am a male put me at a disadvantage. 2. There are many more points of difference between the two rituals than meets the eye.
Thesis (M.Mus.)--North-West University, Potchefstroom Campus, 2011.

Dr. Eleine Mad är Madeleine Jacobsssons talesperson för dom vetenskapliga och paranormala upptäckter som uppstår i hennes världar. Hon beskriver innehåll, teknik och estetik utifrån ett kategoriseringssytem där konsten delas upp som olika typer av komponenter och därefter avkodas dessa allteftersom. För att förstå intuitionens inblandning i arbetsprocessen omförvandlas den till tre separata roller av en Sökare, Samlare och Myntare. Med rollerna försöker jag beskriva på vilka sätt som intuitionen är till gagn eller av förödelse för det konstnärliga arbetet. Sagan om M handlar om en grodlik karaktär, Delop, som lämnar sin hemplanet för att uppsöka andra världar. I sitt sökande hittar Delop ett folkslag vars syn och levnadssätt skiljer sig från hennes erfarenheter av “verkligheten” såsom hon lärt sig att överleva i den.
Dr. Eleine Mad is Madeleine Jacobsson's spokesperson for the scientific and paranormal discoveries that arise in her worlds. She describes content, tecniques and aesthetics based on a categorization system where art is divided into different types of components and then decoded as they go. To understand the intuition's involvement in the work process, it is transformed into three separate roles by a Seeker, Collector and a Myntare(In swedish language the one who is a "myntare" -is verbally declaring a concept or term). With these roles I try to describe in what ways intuition is beneficial or devastating to the artistic work. The story of M is about a frog-like character, Delop, who leaves the home planet to seek out other worlds. In her search, Delop finds a world whose views and lifestyles differ from her experiences of "reality" as she learned to survive in it.

Recorded sound and image material of the presentation is available for private use.

The aim of the study was to offer solutions for the enhancement of Indonesia’s HIV and AIDS policy and to suggest future possibilities. In the process, the gendered nature of the epidemic was explored. In light of the relatively lower rates of employment among Indonesian women, this study also sought to gain insights into the possible reasons for many women appearing to be attached to domesticity. In the first phase of the study, interviews with stakeholders in HIV and AIDS prevention were conducted, followed by a Delphi exercise involving 23 HIV and AIDS experts. In the second phase, 28 women from various ethnicities were interviewed, including those in polygamous and contract marriages. The overall results were interpreted through the lens of complexity theory. Fewer than half of the proposed objectives were approved by the experts in the Delphi round. These were interventions mainly aimed at the risk groups while most objectives relating to education about HIV and AIDS and safer sex for the general public failed to obtain consensus. Reasons for the lack of consensus were differences in perceptions associated with human rights, moral reasoning, the unfeasibility of certain statements and personal conviction about the control of the epidemic. Emphasis on men’s and women’s innate characteristics; men’s role as breadwinner; women’s primary role as wife, mother and educator of their children; and unplanned pregnancies emerged as major themes from the qualitative phase. While the adat and Islam revival movements may have endorsed the ideals of the New Order state ideology, Javanese rituals regarded as violating Islam teachings were abandoned. Ignorance about safer sex and HIV and AIDS was also established. Interpretation of the results through the lens of complexity theory revealed that the national HIV and AIDS policy needs to encompass interventions for the general population, which would include comprehensive sex education in schools and media campaigns focusing on women. It was found that women’s vulnerability to HIV and their penchant for domesticity appear to be associated with their perceived primary role as wife and mother, as promoted by the adat-based New Order state ideology.
Sociology
D. Litt. et Phil. (Sociology)