Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

Language and interaction in online asynchronous communication in university level English courses

Interaction involves people communicating and reacting to each other. This process is key to the study of discourse, but it is not easy to study systematically how interaction takes place in a specific communicative event, or how it is typically performed over a series of repeated communicative events. However, with a written record of the interaction, it becomes possible to study the process in some detail. This thesis investigates interaction through asynchronous written discussion forums in a computer-mediated learning environment. In particular, this study investigates pragmatic aspects of the communicative event which the asynchronous online discussions comprise. The first case study examines response patterns to messages by looking at the content of initial messages and responses, in order to determine the extent to which characteristics of the messages themselves or other situational factors affect the interaction. The second study examines in what ways participants use a range of discourse devices, including formulaic politeness, humour and supportive feedback as community building strategies in the interaction. The third study investigates the role of the subject line of messages in the interaction, for example by examining how participants choose different types of subject lines for different types of messages. The fourth study examines to what extent features serving a deictic function are drawn on in the interaction and then compares the findings to both oral conversation and formal academic discourse. The overall findings show a complex communicative situation shaped by the medium itself, type of activity, the academic discipline and topic of discussion and by the social and cultural aspects of tertiary education in an online learning environment. In addition, the findings may also provide evidence of learning.  

Language Dominance in Early and Late Bilinguals

The proposed presentation is a progress report from a project which is aimed at establishing some phonetic correlates of language dominance in various kinds of bilingual situations. The current object of study is Swedish students starting in classes which prepare for the International Baccalaureate (IB) programme. The IB classes in Sweden are taught in English, except for classes in Swedish and foreign languages. This means that after they enter the programme the students are exposed to and speak a good deal more English than previously.The assumption made by many students that they will, on the one hand not “damage” their Swedish, and on the other will dramatically improve their English simply by attending an English-medium school will be tested. The linguistic background of the students studied and their reasons for choosing the IB programme will be established. Their English and Swedish proficiency will be tested according to various parameters (native-like syntax, perceived foreign accent, the timing of vowels and consonants in VC sequences, vocabulary mobilisation) on arrival at the school, and again after one and three years at the school. The initial recordings are now underway.In a preliminary study involving just three young people who were bilingual in Swedish and English, the timing of the pronunciation of (C)VC syllables in Swedish and English was studied. The results of this investigation indicate that it may be possible to establish language dominance in bilingual speakers using timing data. It was found that the three subjects differed systematically in their pronunciation of the target words. One subject (15 years old), who was apparently native-like in both languages, had the V-C timing of both Swedish and English words of a native speaker of English. His brother (17 years old), who had a noticeable Swedish accent in English, pronounced both Swedish and English words in this respect like a native speaker of Swedish. The boys’ sister (9 years old) apparently had native-like timing in both languages.

The functions of Japanese Sound Symbolic Words in Different Types of Texts and Their Translation

Though sound symbolic words (onomatopoeia and mimetic words, or giongo and gitaigo in Japanese) exist in other languages, it would not be so easy to compare them to those in Japanese. This is because unlike in Japanese, in many other languages (here we see English and Spanish) sound symbolic words do not have distinctive forms that separate them immediately from the rest of categories of words. In Japanese, a sound symbolic word has a radical (that is based on the elaborated Japanese sound symbolic system), and often a suffix that shows subtle nuance. Together they give the word a distinctive form that differentiates it from other categories of words, though its grammatical functions could vary, especially in the case of mimetic words (gitaigo). Without such an obvious feature, in other languages, it would not be always easy to separate sound symbolic words from the rest. These expressions are extremely common and used in almost all types of text in Japanese, but their elaborated sound symbolic system and possibly their various grammatical functions are making giongo and gitaigo one of the most difficult challenges for the foreign students and translators. Studying the translation of these expressions into other languages might give some indication related to the comparison of Japanese sound symbolic words and those in other languages. Though sound symbolic words are present in many types of texts in Japanese, their functions in traditional forms of text (letters only) and manga (Japanese comics)are different and they should be treated separately. For example, in traditional types of text such as novels, the vast majority of the sound symbolic words used are mimetic words (gitaigo) and most of them are used as adverbs, whereas in manga, the majority of the sound symbolic words used (excluding those appear within the speech bubbles) are onomatopoeias (giongo) and often used on their own (i.e. not as a part of a sentence). Naturally, the techniques used to translate these expressions in the above two types of documents differ greatly. The presentation will focus on i) grammatical functions of Japanese sound symbolic words in traditional types of texts (novels/poems) and in manga works, and ii) whether their features and functions are maintained (i.e. whether they are translated as sound symbolic words) when translated into other languages (English and Spanish). The latter point should be related to a comparison of sound symbolic words in Japanese and other languages, which will be also discussed.