Våldets onda cirklar : En explorativ undersökning av mäns barndomsupplevelser, maskuliniteter, känslor, våld samt terapeutiska interventioner mot våld

Avhandlingens överordnade syfte är att utforska möjligheterna för ett integrerat forskningsperspektiv på mäns våld samt exemplifiera hur sådan forskning kan bedrivas. Det konkreta syftet är att öka kunskapen om hur våldsamma mäns barndomsupplevelser, socialisation, maskulinitetskonstruktion och emotioner kan relateras till deras våld mot andra män, mot sig själva och mot kvinnor samt till hur terapeutiska interventioner mot våld kan analyseras och utvecklas i korrespondens med denna kunskap. Med vetenskapsteoretiska utgångspunkter hämtade från den kritiska realismen och ekologiska metoder relaterar studien forskning från olika skolbildningar till varandra; - psykologisk: om barndomserfarenheter och socialisation, socialpsykologisk: om emotioner och interaktion samt sociologisk: om social klass, könsmaktsstrukturer och hegemonisk maskulinitet. Detta genomförs för att kunna få tillgång till kunskap om hur olika faktorer samverkar vid mäns våld. I studie I och II studerades möjligheterna att undersöka de sociala banden mellan terapeut/terapi och klient inom terapeutiska behandlingar mot våld. I studie I operationaliserades indikatorer på emotionerna stolthet och skam och i studie II testades dessa på terapeuter inom en KBT-orienterad terapi. I studie IIIundersöktes män i olika maskulinitetspositioner, där urvalet för den ena gruppen hämtades ur populationen män dömda till terapi för våld och missbruk och den andra ur populationen män som organiserat arbetade för jämlikhet och mot våld mot kvinnor. I studien jämfördes de båda gruppernas förhållningssätt till faktorer som i tidigare forskning relaterats till våld och våld mot kvinnor. I studie IVundersöktes våldsdömda mäns karriärer fram till deras nuvarande position som våldsbejakande kriminella i avsikt att öka kunskapen om det samspel mellan faktorer som i olika situationer leder fram till deras våld mot andra män, sig själva och kvinnor. Samtliga empiriska studier använde kvalitativa metoder för datainsamling och analys. I studie IV användes individuella intervjuer och biografisk analys, I studie II ochIII användes gruppintervjuer samt deduktiv innehållsanalys. I studie I, den teoretiska reviewartikeln, utgjorde sociologisk, socialpsykologisk och psykologisk teoribildning empiri. Avhandlingen visar att det finns fler fördelar är nackdelar med ett nivåövergripande perspektiv. Nivåintegrerande studier försvåras av att de kräver en komplex metodologi för att kunna hantera samverkan mellan faktorer bakom våld på olika nivåer men ger å andra sidan en mer holistisk förståelse av fenomenet i fråga. Resultaten visar att integrerande perspektiv kan minska risken för ekologiska felslut och ökar förståelsen av komplex samverkan mellan faktorer bakom mäns våld, något som kan komma att bidra till kunskapsutvecklingen inom våldsterapiområdet. Den teoretiska reviewartikeln (studie I) exemplifierade hur teoretiskt och metodologiskt driven forskning om sociala band kan göras pragmatiskt tillämpbar av terapeuter inom våldbehandlingar. Den tillämpade studien av en KBT-terapi (studie II) gav exempel på hur operationaliserade indikatorer på stolthet och skam kan användas praktiskt för att bestämma kvalitén på det sociala bandet mellan terapeut och klient. Den studerade KBT-terapin innehöll som förväntat både skam- och stolthetskapande moment vilket utgör värdefulla utgångspunkter för vidare forskning. Jämförelsen mellan män i idealtypiskt motsatta maskulinitetspositioner (studie III) visade att både gruppen av män som arbetar mot våld mot kvinnor och männen dömda till behandling mot våld, bär på ambivalenta attityder gentemot våld och våld mot kvinnor. Jämförelsen visade vidare att gruppernas maskulinitetskonstruktioner och attityder till våld korresponderar med grupperingarnas olika tillgång till ekonomiska, sociala och kulturella resurser. Den biografiskt fokuserade kvalitativa studien av män i våldsbehandling (studie IV) undersökte explorativt hur karriären fram till våldskriminell kan se ut och hur barndomsupplevelser, socialisation, maskulinitet och emotioner hos enskilda våldsverkande män kan tänkas ha samverkat med varandra när våld äger rum. Resultaten visade att de män som vittnar om utsatthet för allvarligt våld i barndomen är mer skambenägna och vid kränkningar från andra tenderar att omedvetet och utan föregående känslor av skam direkt reagera med aggressioner och våld mot båda könen. Övriga män var visserligen skambenägna men beskrev en mer kontrollerad våldsreaktion. Två män som blivit brutalt fysiskt mobbade i grundskolan, berättade om ett mer kontrollerat våld. En preliminär hypotes är att männen kan ha lärt sig att kognitivt, för att undslippa fortsatt mobbing, ta kontrollen över processen där skamkänslor ersätts med aggressioner. Föräldrarnas personliga problem tillsammans med deras bristande sociala kontroll och omsorg antogs ha ett samband med flera av männens skolproblem, deras umgänge med avvikande ungdomar, deras senare svårigheter med att kunna försörja sig med konventionella medel samt deras våldskarriärer.

Developing a Communication link between Agents and cross Platform IDE

The main objective of this thesis work is to develop communication link between Runrev Revolution (IDE) and JADE (Multi-Agent System) through Socket programming using TCP/IP layer. These two independent platforms are connected using socket programming technique. Socket programming is considered to be newly emerging technology among these two platforms, the work done in this thesis work is considered to be a prototype.A Graphical simulation model is developed by salixphere (Company in Hedemora) to simulate logistic problems using Runrev Revolution (IDE). The simulation software/program is called “BIOSIM”. The logistic problems are complex, and conventional optimization techniques are unlikely very successful. “BIOSIM” can demonstrate the graphical representation of logistic problems depending upon the problem domains. As this simulation model is developed in revolution programming language (Transcript) which is dynamically typed and English-like language, it is quite slow compared to other high level programming languages. The object of this thesis work is to add intelligent behaviour in graphical objects and develop communication link between Runrev revolution (IDE) and JADE (Multi-Agent System) using TCP/IP layers.The test shows the intelligent behaviour in the graphical objects and successful communication between Runrev Revolution (IDE) and JADE (Multi-Agent System).

Communication in Smoking Cessation and Self-management : a study at Nurse-led COPD-clinics in Primary Health Care

ABSTRACTThe general aim of this thesis was to investigate behavioral change communication at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary health care, focusing on communication in self-management and smoking cessation for patients with COPD.Designs: Observational, prospective observational and experimental designs were used.Methods: To explore and describe the structure and content of self-management education and smoking cessation communication, consultations between patients (n=30) and nurses (n=7) were videotaped and analyzed with three instruments: Consulting Map (CM), the Motivational Interviewing Treatment Integrity (MITI) scale and the Client Language Assessment in Motivational Interviewing (CLAMI). To examine the effects of structured self-management education, patients with COPD (n=52) were randomized in an intervention and a control group. Patients’ quality of life (QoL), knowledge about COPD and smoking cessation were examined with a questionnaire on knowledge about COPD and smoking habits and with St. George’s Respiratory Questionnaire, addressing QoL. Results: The findings from the videotaped consultations showed that communication about the reasons for consultation mainly concerned medical and physical problems and (to a certain extent) patients´ perceptions. Two consultations ended with shared understanding, but none of the patients received an individual treatment-plan. In the smoking cessation communication the nurses did only to a small extent evoke patients’ reasons for change, fostered collaboration and supported patients’ autonomy. The nurses provided a lot of information (42%), asked closed (21%) rather than open questions (3%), made simpler (14%) rather than complex (2%) reflections and used MI non-adherent (16%) rather than MI-adherent (5%) behavior. Most of the patients’ utterances in the communication were neutral either toward or away from smoking cessation (59%), utterances about reason (desire, ability and need) were 40%, taking steps 1% and commitment to stop smoking 0%. The number of patients who stopped smoking, and patients’ knowledge about the disease and their QoL, was increased by structured self-management education and smoking cessation in collaboration between the patient, nurse and physician and, when necessary, a physiotherapist, a dietician, an occupational therapist and/or a medical social worker.Conclusion The communication at nurse-led COPD clinics rarely involved the patients in shared understanding and responsibility and concerned patients’ fears, worries and problems only to a limited extent. The results also showed that nurses had difficulties in attaining proficiency in behavioral change communication. Structured self-management education showed positive effects on patients’ perceived QoL, on the number of patients who quit smoking and on patients’ knowledge about COPD.

Design and assessment of a large commercial Photovoltaic System in Barbados

One of the main aims of this thesis is to design an optimized commercial Photovoltaic (PV) system in Barbados from several variables such as racking type, module type and inverter type based on practicality, technical performance as well as financial returns to the client. Detailed simulations are done in PVSYST and financial models are used to compare different systems and their viability. Once the preeminent system is determined from a financial and performance perspective a detailed design is done using PVSYST and AutoCAD to design the most optimal PV system for the customer. In doing so, suitable engineering drawings are generated which are detailed enough for construction of the system. Detailed cost with quotes from relevant manufacturers, suppliers and estimators become instrumental in determining Balance of System Costs in addition to total project cost. The final simulated system is suggested with a PV capacity of 425kW and an inverter output of 300kW resulting in an array oversizing of 1.42. The PV system has a weighted Performance Ratio of 77 %, a specific yield of 1467 kWh/kWp and a projected annual production of 624 MWh/yr. This system is estimated to offset approximately 28 % of Carlton’s electrical load annually. Over the course of 20 years the PV system is projected to produce electricity at a cost of $0.201USD/kWh which is significantly lower than the $0.35 USD/kWh paid to the utility at the time of writing this thesis. Due to the high cost of electricity on the island, an attractive Feed-In-Tariff is not necessary to warrant the installation of a commercial System which over a lifetime which produces electricity at less than 60% of the cost to the user purchasing electricity from the utility. A simple payback period of 5.4 years, a return on investment of 17 % without incentives, in addition to an estimated diversion of 6840 barrels of oil or 2168 tonnes of CO2 further provides compelling justification for the installation of a commercial Photovoltaic System not only on Carlton A-1 Supermarket, but also island wide as well as regionally where most electricity supplies are from imported fossil fuels.

Maternal health care professionals perspective on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam

Background. High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.