English-medium instruction in Sweden : Perspectives and practices in two upper secondary schools

This thesis presents English-medium instruction (EMI) in the Swedish context, focusing on perspectives and practices in two schools. The research question is as follows: How and why is EMI offered, chosen, and practiced in the Swedish upper secondary school today? The aim is to explore the status of the educational option, the reasons for offering EMI to stakeholders, the stakeholders’ beliefs about and goals of EMI, and the implementation of EMI in the classroom. A survey of all upper secondary schools in Sweden was conducted to ascertain the spread of content teaching through a foreign language. The educational context was studied from an ecological perspective using methods based in linguistic ethnography. Language alternation, academic language, and language hierarchy were all considered. Interviews were analysed for content; and classroom language use was analysed for language choice and function. The concepts of affordance and scaffolding together with translanguaging were key. The de facto policies of the micro contexts of the schools were examined in light of the declared national policy of the macro context of Sweden. The results indicate that the option in Swedish schools has not increased, and also tends to only be EMI—not Content and Language Integrated Learning (CLIL) or instruction through other languages. EMI is offered for prestige, an international profile, marketing potential and personal interest. EMI students are academically motivated and confident, and see the option as “fun”. 100% EMI in the lessons is not the goal or the practice. Translanguaging is abundant, but how language alternation is perceived as an affordance or not differs in the two schools. One focuses on how the languages are used while the other focuses on how much each language is used. In conclusion, the analysis suggests that a development of definitions and practices of EMI in Sweden is needed, especially in relation to language policy and language hierarchy.

‘Being in a womb’ or ‘playing musical chairs’ : the impact of place and space on infant feeding in NICUs

Background: Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents’ experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England. Methods: An ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis. Results: The core category of ‘the room as a conveyance for an attuned feeding’ was underpinned by four categories: the level of ‘ownership’ of space and place; the feeling of ‘at-homeness’; the experience of ‘the door or a shield’ against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; ‘window of opportunity’. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding. Conclusions: If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.

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.