How single is ‘single’ : some pragmatic reflections on single versus multifaceted interventions to facilitate implementation

An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science.

Soft computing in biometrics : a pragmatic appraisal

The ever increasing spurt in digital crimes such as image manipulation, image tampering, signature forgery, image forgery, illegal transaction, etc. have hard pressed the demand to combat these forms of criminal activities. In this direction, biometrics - the computer-based validation of a persons' identity is becoming more and more essential particularly for high security systems. The essence of biometrics is the measurement of person’s physiological or behavioral characteristics, it enables authentication of a person’s identity. Biometric-based authentication is also becoming increasingly important in computer-based applications because the amount of sensitive data stored in such systems is growing. The new demands of biometric systems are robustness, high recognition rates, capability to handle imprecision, uncertainties of non-statistical kind and magnanimous flexibility. It is exactly here that, the role of soft computing techniques comes to play. The main aim of this write-up is to present a pragmatic view on applications of soft computing techniques in biometrics and to analyze its impact. It is found that soft computing has already made inroads in terms of individual methods or in combination. Applications of varieties of neural networks top the list followed by fuzzy logic and evolutionary algorithms. In a nutshell, the soft computing paradigms are used for biometric tasks such as feature extraction, dimensionality reduction, pattern identification, pattern mapping and the like.

Euphemism: Sweet Talking or Deception?

The aim of this paper is to shed light on euphemism in two different senses: sweet talking and deception. I shall treat euphemism from two different perspectives: the usual use of euphemism, sweet talking, in which it is used to maintain one's face and the orthophemistic sense, deception, where 'torture' is referred to as "enhanced interrogation techniques". I shall analyze examples, taken from religious, cultural, political backgrounds, on each case. Moreover, I shall talk about taboo since it is usually associated with euphemism. I shall talk about the referential (semantic) and expletive (pragmatic) aspects of swearing expressions. In this essay, I shall show that euphemism can be used in two different senses: sweet talking and deception.

Contemporary Approaches to Translation in the Classroom : A study of students' Attitudes and Strategies

The purpose of this study is to explore the strategies and attitudes of students towards translation in the context of language learning. The informants come from two different classes at an Upper Secondary vocational program. The study was born from the backdrop of discussions among some English teachers representing different theories on translation and language learning, meeting students endeavoring in language learning beyond the confinement of the classroom and personal experiences of translation in language learning. The curriculum and course plan for English at the vocational program emphasize two things of particular interest to our study; integration of the program outcomes and vocational language into the English course - so called meshed learning – and student awareness of their own learning processes. A background is presented of different contrasting methods in translation and language learning that is relevant to our discussion. However, focus is given to contemporary research on reforms within the Comparative Theory, as expressed in Translation in Language and Teaching (TILT), Contrastive Analysis and “The Third Space”. The results of the students’ reflections are presented as attempts to translate two different texts; one lyric and one technical vocational text. The results show a pragmatic attitude among the students toward tools like dictionaries or Google Translate, but also a critical awareness about their use and limits. They appear to prefer the use of first language to the target language when discussing the correct translation as they sought accuracy over meaning. Translation for them was a natural and problem-solving event worth a rightful place in language teaching.

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.  

Pregnant Adolescents in Vietnam : Social context and health care needs

Background: The number of childbearing adolescents in Vietnam is relatively low but they are more prone to experience adverse outcome than adult women. Reports of increasing rates of abortion and prevalence of STIs including HIV among youth indicate a need to improve services and counselling for these groups. Midwives are key persons in the promotion of young people’s sexual and reproductive health in Vietnam. Aim: The overall aim of this thesis is to describe the prevalence and outcome of adolescent pregnancies in Vietnam (I), to explore the social context and health care seeking behavior of pregnant adolescents (II), as well as to explore the perspectives of health care providers and midwifery students regarding adolescent sexuality and reproductive health service needs (III, IV). Methods: The studies were conducted from 2002 to 2005, combining qualitative and quantitative research methods. A population based prospective survey was used to estimate rates and outcomes of adolescent pregnancies (I). Pregnant and newly delivered adolescents’ experiences of childbearing and their encounters with health care providers were studied using qualitative interviews (II). Health care providers’ perspective on adolescent sexual and reproductive health (ASRH) and views on how to improve the quality of abortion care was explored in focus group discussions (FGD). The values and attitudes of midwifery students about ASRH were investigated using questionnaires and interviews (IV). Descriptive statistics was used to analyse quantitative data (I, IV) and content analysis were applied for qualitative data (II, III, and IV). Findings: Adolescent birth rate was similar to previously reported in Vietnam but lower when compared to other Asian countries. The incidence of stillborn among adolescents was higher than for women in higher reproductive ages. The proportion of preterm deliveries was 20 % of all births, higher than previous findings from Vietnam. About 2 % of the deliveries were home deliveries, more common among women with low education, belonging to ethnic minority and/or living in mountainous areas (I). Ambivalence facing motherhood, pride and happiness but also worries and lack of self-confidence emerged as themes from the interviews; and experience of ‘being in the hands of others’ in a positive, caring sense but also in a sense of subordination in relation to husband, family and health care providers (II). Health care providers at abortion clinics and midwifery students generally disapproved of pre-marital sex, but had a pragmatic view on the need for contraceptive services and counselling to reduce the burden of unwanted pregnancies and abortions for young women. Providers and midwifery students expressed a need for training on ASRH issues (III, IV). Conclusion: Cultural norms and gender inequity make pregnant adolescent women in Vietnam vulnerable to sexual and reproductive health risks. Health care providers experience ethical dilemmas while counselling unmarried adolescents who come for abortion and this has a negative impact on the quality of care. Integrated ASRH in education and training programmes for health care providers, including midwives, as well as continued in-service training on these issues are suggested to improve reproductive health care services in Vietnam.

Konsten att välja rätt spårvagn : en studie av segregation, skolval och unga människors studieplaner

The art of choosing the right tram – A study of urban segregation, choice of school and young people’s life plans When discussing barriers to integration and young people’s choice of school, research often focuses on language skills, cultural capital, supportive environments and other more obvious, distinct and material aspects that have an impact on educational achievement. In the present study, we have instead chosen to look at how young immigrants construct their inner career landscapes and life-plans, and how this relates to their perception of ethnicity, neighbourhood and identity. The sample used here consists of altogether twenty individuals. The interviews were used to explore certain designated dimensions and processes. All interviews were conducted in the school environment, in classrooms and other locations. The students attended two different inner-city schools. A narrative-sociological approach is used in the analysis. The young people’s perceptions and narratives are analysed in relation to concepts such as: territorial stigmatization, identity, self-perception and modifications of life plans. The findings show that the feelings of otherness which originates in housing conditions, experiences of exclusion and the everyday life of many immigrants, are transposed into the school area and transformed into strategies and life plans.

Role of Culture in the Acquisition of CSL – From the Perspective of Intercultural Communication Competence

In the past few decades, the demands for coping with the rapid development of information communication technology, internationalization and globalization worldwide have shifted the focus of Chinese as a second language (CSL) towards intercultural communication competence in which the role of culture in the acquisition of CSL and in the pragmatic use of the language is emphasized and promoted. However, most of the present research in this academic area still remains only on a theoretical level.   In order to explore the possibilities and limitations of integrating Chinese culture and implementing intercultural communication theory into CSL education, an action research has been conducted since the beginning of 2013 to review an actual course for beginners. This paper will present the findings of the research: 1) By applying the theoretical framework of intercultural communicative competence, the findings indicated that the existing CSL course provided limited information explaining the cultural elements that are reflected in the Chinese language. 2) The findings also suggested that the cultural skills acquired in the students’ first language do influence their acquisition of CSL. This is demonstrated in the students’ written tasks such as introducing themselves and presenting other people, etc. The findings can be examples and resources for further research in this academic field.     

Den skickligt inkompetente chefen

The skilled incompetent manager Based on a critical interpretation of a leadership seminar we illustrate how the performance of the managers involved skilled incompetence. It expresses itself through a non-critical attitude, easily-made solutions and pseudo-communication, which together fuel a kind of knowledge flexibility. This uncritical, somewhat shallow and pragmatic attitude towards knowledge (e.g. management concepts), ought not to be understood as just dysfunctional, but also as a more or less unaware but adjusted competence, that in some situations works as a social lubricant in bureaucratic organizations.

'Moving On' and Transitional Bridges : Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden

During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.

Enhancing Intercultural Communication in Teaching Chinese as a Foreign Language : An Action Research Study

Enhancing Intercultural Communication in Teaching Chinese as a Foreign Language – An Action Research Study Over the past few decades, the rapid development of information communication technology, internationalization and globalization worldwide have required a shift in the focus of Chinese as a foreign language (CFL) towards competence in intercultural communication in which the role of culture in the acquisition of CFL and in the pragmatic use of the language is emphasized and promoted. However, most of the current research in this academic area remains only on a theoretical level. Practical examples, particularly with regard to distance learning/teaching of the Chinese language, are very limited. This motivated the implementation of an action research study which aimed at exploring the possibilities and limitations of integrating Chinese culture and applying intercultural communication theory into a contemporary distance CFL course for beginners. By observing and comparing the performance of subjects in the control and experimental groups, this action research study focuses on exploring three basic areas. Firstly, it discloses the cultural elements which underlie effective daily communication. Secondly, it investigates how students acquire cultural knowledge and develop their ability to competently communicate in the target course. And thirdly, it evaluates how the modified course syllabus could enhance students’ intercultural communicative competence. The findings of the research aim to serve as both a resource and reference for educators and researchers who are interested in carrying out reforms and research in this academic domain.

‘Moving on’ : Violence, wellbeing and questions about violence in antenatal care encounters. A qualitative study with Somali-born refugees in Sweden

Background Somali-born women constitute one of the largest groups of childbearing refugee women in Sweden after more than two decades of political violence in Somalia. In Sweden, these women encounter antenatal care that includes routine questions about violence being asked. The aim of the study was to explore how Somali-born women understand and relate to violence and wellbeing during their migration transition and their views on being approached with questions about violence in Swedish antenatal care. Method Qualitative interviews (22) with Somali-born women (17) living in Sweden were conducted and analysed using thematic analysis. Findings A balancing actbetween keeping private life private and the new welfare system was identified, where the midwife's questions about violence were met with hesitance. The midwife was, however, considered a resource for access to support services in the new society. A focus on pragmatic strategies to move on in life, rather than dwelling on potential experiences of violence and related traumas, was prominent. Social networks, spiritual faith and motherhood were crucial for regaining coherence in the aftermath of war. Dialogue and mutual adjustments were identified as strategies used to overcome power tensions in intimate relationships undergoing transition. Conclusions If confidentiality and links between violence and health are explained and clarified during the care encounter, screening for violence can be more beneficial in relation to Somali-born women. The focus on “moving on” and rationality indicates strength and access to alternative resources, but needs to be balanced against risks for hidden needs in care encounters. A care environment with continuity of care and trustful relationships enhances possibilities for the midwife to balance these dual perspectives and identify potential needs. Collaborations between Somali communities, maternity care and social service providers can contribute with support to families in transition and bridge gaps to formal social and care services.

Barriers and facilitators in the provision of post-abortion care at district level in central Uganda : a qualitative study focusing on task sharing between physicians and midwives

Background: Abortion is restricted in Uganda, and poor access to contraceptive methods result in unwanted pregnancies. This leaves women no other choice than unsafe abortion, thus placing a great burden on the Ugandan health system and making unsafe abortion one of the major contributors to maternal mortality and morbidity in Uganda. The existing sexual and reproductive health policy in Uganda supports the sharing of tasks in post-abortion care. This task sharing is taking place as a pragmatic response to the increased workload. This study aims to explore physicians' and midwives' perception of post-abortion care with regard to professional competences, methods, contraceptive counselling and task shifting/sharing in post-abortion care. Methods: In-depth interviews (n = 27) with health care providers of post-abortion care were conducted in seven health facilities in the Central Region of Uganda. The data were organized using thematic analysis with an inductive approach. Results: Post-abortion care was perceived as necessary, albeit controversial and sometimes difficult to provide. Together with poor conditions post-abortion care provoked frustration especially among midwives. Task sharing was generally taking place and midwives were identified as the main providers, although they would rarely have the proper training in post-abortion care. Additionally, midwives were sometimes forced to provide services outside their defined task area, due to the absence of doctors. Different uterine evacuation skills were recognized although few providers knew of misoprostol as a method for post-abortion care. An overall need for further training in post-abortion care was identified. Conclusions: Task sharing is taking place, but providers lack the relevant skills for the provision of quality care. For post-abortion care to improve, task sharing needs to be scaled up and in-service training for both doctors and midwives needs to be provided. Post-abortion care should further be included in the educational curricula of nurses and midwives. Scaled-up task sharing in post-abortion care, along with misoprostol use for uterine evacuation would provide a systematic approach to improving the quality of care and accessibility of services, with the aim of reducing abortion-related mortality and morbidity in Uganda.

Healthcare providers balancing norms and practice : challenges and opportunities in providing contraceptive counselling to young people in Uganda - a qualitative study

BACKGROUND: Pregnancies among young women force girls to compromise education, resulting in low educational attainment with subsequent poverty and vulnerability. A pronounced focus is needed on contraceptive use, pregnancy, and unsafe abortion among young women. OBJECTIVE: This study aims to explore healthcare providers' (HCPs) perceptions and practices regarding contraceptive counselling to young people. DESIGN: We conducted 27 in-depth interviews with doctors and midwives working in seven health facilities in central Uganda. Interviews were open-ended and allowed the participant to speak freely on certain topics. We used a topic guide to cover areas topics of interest focusing on post-abortion care (PAC) but also covering contraceptive counselling. Transcripts were transcribed verbatim and data were analysed using thematic analysis. RESULTS: The main theme, HCPs' ambivalence to providing contraceptive counselling to sexually active young people is based on two sub-themes describing the challenges of contraceptive counselling: A) HCPs echo the societal norms regarding sexual practice among young people, while at the same time our findings B) highlights the opportunities resulting from providers pragmatic approach to contraceptive counselling to young women. Providers expressed a self-identified lack of skill, limited resources, and inadequate support from the health system to successfully provide appropriate services to young people. They felt frustrated with the consultations, especially when meeting young women seeking PAC. CONCLUSIONS: Despite existing policies for young people's sexual and reproductive health in Uganda, HCPs are not sufficiently equipped to provide adequate contraceptive counselling to young people. Instead, HCPs are left in between the negative influence of social norms and their pragmatic approach to address the needs of young people, especially those seeking PAC. We argue that a clear policy supported by a clear strategy with practical guidelines should be implemented alongside in-service training including value clarification and attitude transformation to equip providers to be able to better cater to young people seeking sexual and reproductive health advice.