Health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia : a systematic literature review of qualitative and quantitative data.

BACKGROUND: Unsafe abortions are a serious public health problem and a major human rights issue. In low-income countries, where restrictive abortion laws are common, safe abortion care is not always available to women in need. Health care providers have an important role in the provision of abortion services. However, the shortage of health care providers in low-income countries is critical and exacerbated by the unwillingness of some health care providers to provide abortion services. The aim of this study was to identify, summarise and synthesise available research addressing health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. METHODS: A systematic literature search of three databases was conducted in November 2014, as well as a manual search of reference lists. The selection criteria included quantitative and qualitative research studies written in English, regardless of the year of publication, exploring health care providers' perceptions of and attitudes towards induced abortions in sub-Saharan Africa and Southeast Asia. The quality of all articles that met the inclusion criteria was assessed. The studies were critically appraised, and thematic analysis was used to synthesise the data. RESULTS: Thirty-six studies, published during 1977 and 2014, including data from 15 different countries, met the inclusion criteria. Nine key themes were identified as influencing the health care providers' attitudes towards induced abortions: 1) human rights, 2) gender, 3) religion, 4) access, 5) unpreparedness, 6) quality of life, 7) ambivalence 8) quality of care and 9) stigma and victimisation. CONCLUSIONS: Health care providers in sub-Saharan Africa and Southeast Asia have moral-, social- and gender-based reservations about induced abortion. These reservations influence attitudes towards induced abortions and subsequently affect the relationship between the health care provider and the pregnant woman who wishes to have an abortion. A values clarification exercise among abortion care providers is needed.

Teaching grammar: A study of the common English grammar errors and grammar teaching methods that can be relevant for Swedish upper secondary schools

Grammar has always been an important part of language learning. Based on various theories, such as the universal grammar theory (Chomsky, 1959) and, the input theory (Krashen, 1970), the explicit and implicit teaching methods have been developed. Research shows that both methods may have some benefits and disadvantages. The attitude towards English grammar teaching methods in schools has also changed and nowadays grammar teaching methods and learning strategies, as a part of language mastery, are one of the discussion topics among linguists. This study focuses on teacher and learner experiences and beliefs about teaching English grammar and difficulties learners may face. The aim of the study is to conduct a literature review and to find out what scientific knowledge exists concerning the previously named topics. Along with this, the relevant steering documents are investigated focusing on grammar teaching at Swedish upper secondary schools. The universal grammar theory of Chomsky as well as Krashen’s input hypotheses provide the theoretical background for the current study. The study has been conducted applying qualitative and quantitative methods. The systematic search in four databases LIBRIS, ERIK, LLBA and Google Scholar were used for collecting relevant publications. The result shows that scientists’ publications name different grammar areas that are perceived as problematic for learners all over the world. The most common explanation of these difficulties is the influence of learner L1. Research presents teachers’ and learners’ beliefs to the benefits of grammar teaching methods. An effective combination of teaching methods needs to be done to fit learners’ expectations and individual needs. Together, they will contribute to the achieving of higher language proficiency levels and, therefore, they can be successfully applied at Swedish upper secondary schools.

Gender Equality a case study of Sweden : Gender Equality Gender Equity and policies of combating inequality at workplace to make the society equal.

The paper analyses Gender Equality, Gender Equity and policies of combating inequality at workplace to make the society equal as a case study of Sweden. The aim of paper is see the gender equality, gender equity, discrimination against women at workplace and to describe the policies combating inequality in the welfare state of Sweden. This work highlights the gender equality in terms of institutionalizing gender equality, gender equity, gender and pay gap, parental leave, gender and the pension system and sexual behavior directed towards women and policies combating inequality to bring equality in society. For my research I used the secondary data the fact sheets, scientific literature, statistics from eurostate of Sweden and case studies about Swedish society and the theoretical explanation to explain the phenomena. To achieve my aim I used the combination of both qualitative and quantitative methods of research. I showed the empirical evidences of these phenomena from the Swedish society and theoretical analysis about equality and equity of gender in different wakes of life. I found an interesting conclusion that there are good policies and legislation to combat inequality to bring society but there are no policies to change the perception of society about male and female role.

Learning Grammar : A study of upper secondary level students’ attitudes and beliefs concerning the learning of grammar

The communicative approach to language learning is widely taught in Western education, and yet its predecessor, the grammar-translation method, is still commonly employed in other parts of the world. In Sweden, the increasing popularity of the communicative approach is often justified by the high level of students’ communicative skills (Öhman, 2013). At the same time, students’ written texts and speech contain many grammatical errors (Öhman, 2013). Consequently, being aware of their tendency to produce grammatical errors, some students express beliefs regarding both the explicit and implicit learning of grammar (Sawir, 2005; Boroujeni, 2012). The objective of this thesis is to gain more knowledge regarding students’ beliefs concerning the learning of English grammar at the upper secondary level, in Sweden. With this purpose a survey was conducted in two schools in Sweden, where 49 upper-secondary English students participated. Qualitative and quantitative methods were applied to process the collected data. Despite some difference in the participants’ ages, there were many similarities in their attitudes towards the teaching and learning of grammar. The results show that the participants in both schools believe that only by applying both, explicit and implicit methods, can they obtain a high level of language proficiency. The results of this study can help teachers in planning different activities that enhance the students’ knowledge of grammar.

The quality of the physical environment and its association with activities and well-being among older people in residential care facilities

The physical environment can influence older people’s health and well-being, and is often mentioned as being an important factor for person-centred care. Due to high levels of frail health, many older people spend a majority of their time within care facilities and depend on the physical environment for support in their daily life. However, the quality of the physical environment is rarely evaluated, and knowledge is sparse in terms of how well the environment meets the needs of older people. This is partly due to the lack of valid and reliable instruments that could provide important information on environmental quality. Aim: The aim of this thesis was to study the quality of the physical environment in Swedish care facilities for older people, and how it relates to residents’ activities and well-being. Methods: The thesis comprises four papers where both qualitative and quantitative methods were used. Study I involved the translation and adaptation of the Sheffield Care Environment Assessment Matrix (SCEAM) into a Swedish version (S-SCEAM). Several methods were used including forward and backward translation, test of validity via expert consultation and reliability tests. In Study II, S-SCEAM was used to assess the quality of the environment, and descriptive data were collected from 20 purposively sampled residential care facilities (RCFs). Study III was a comparative case study conducted at two RCFs using observations, interviews and S-SCEAM to examine how the physical environment relates to older people’s activities and interactions. In study IV, multilevel modeling was used to determine the association between the quality of the physical environment and the psychological and social well-being of older people living in RCFs. The data in the thesis were analysed using qualitative content analysis, and descriptive, bivariate and multilevel statistics. Results: A specific result was the production of the Swedish version of SCEAM. The instrument contains 210 items structured into eight domains reflecting the needs of older people. When using S-SCEAM, the results showed a substantial variation in the quality of the physical environment between and within RCFs. In general, private apartments and dining areas had high quality, whereas overall building layout and outdoor areas had lower quality. Also, older people’s safety was supported in the majority of facilities, whereas cognitive support and privacy had lower quality. Further, the results showed that environmental quality in terms of cognitive support was associated with residents’ social well-being. Specific environmental features, such as building design and space size, were also noted, through observation, as influencing residents’ activities, and several barriers were found that seemed to restrict residents’ full use of the environment. Conclusions: This thesis contributes to the growing evidence-based design field. The S-SCEAM can be used in future research on the association between the environment and people’s health and well-being. The instrument could also serve as a guide in the planning and design process of new RCFs.

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.

Assessing feasibility and acceptability of study procedures : getting ready for implementation of national stroke guidelines in out-patient health care

BACKGROUND: Even though Swedish national guidelines for stroke care (SNGSC) have been accessible for nearly a decade access to stroke rehabilitation in out-patient health care vary considerably. In order to aid future interventions studies for implementation of SNGSC, this study assessed the feasibility and acceptability of study procedures including analysis of the context in out-patient health care settings. METHODS: The feasibility and acceptability of recruitment, observations and interviews with managers, staff and patients were assessed, as well as the feasibility of surveying health care records. RESULTS: To identify patients from the the hospitals was feasible but not from out-patient care where a need to relieve clinical staff of the recruitment process was identified. Assessing adherence to guidelines and standardized evaluations of patient outcomes through health care records was found to be feasible and suitable assessment tools to evaluate patient outcome were identified. Interviews were found to be a feasible and acceptable tool to survey the context of the health care setting. CONCLUSION: In this feasibility study a variety of qualitative and quantitative data collection procedures and measures were tested. The results indicate what can be used as a set of feasible and acceptable data collection procedures and suitable measures for studying implementation of stroke guidelines in an out-patient health care context.

Financial time series analysis : Chaos and neurodynamics approach

This work aims at combining the Chaos theory postulates and Artificial Neural Networks classification and predictive capability, in the field of financial time series prediction. Chaos theory, provides valuable qualitative and quantitative tools to decide on the predictability of a chaotic system. Quantitative measurements based on Chaos theory, are used, to decide a-priori whether a time series, or a portion of a time series is predictable, while Chaos theory based qualitative tools are used to provide further observations and analysis on the predictability, in cases where measurements provide negative answers. Phase space reconstruction is achieved by time delay embedding resulting in multiple embedded vectors. The cognitive approach suggested, is inspired by the capability of some chartists to predict the direction of an index by looking at the price time series. Thus, in this work, the calculation of the embedding dimension and the separation, in Takens‘ embedding theorem for phase space reconstruction, is not limited to False Nearest Neighbor, Differential Entropy or other specific method, rather, this work is interested in all embedding dimensions and separations that are regarded as different ways of looking at a time series by different chartists, based on their expectations. Prior to the prediction, the embedded vectors of the phase space are classified with Fuzzy-ART, then, for each class a back propagation Neural Network is trained to predict the last element of each vector, whereas all previous elements of a vector are used as features.

À la recherche des facteurs de réussite au lycée : Apprentissage de langues en ligne au lycée - une étude

The aim of this academic essay is to research into Distance teaching in language education at a comprehensive upper high school in a region in Sweden. Qualitative and quantitative studies are combined by using evaluation and interview methods with students who have completed their studies and with those who have decided to terminate them 2012/2013. The goals are to identify success factors and elements in devising and compiling on-line language courses thus eliminating failure by students unable / choosing not to complete courses. Present Distance teaching is mostly applicable for the already motivated students and research shows that measures can be taken to increase the percentage of successful and satisfied students.

Russian Arctic Ports : Problems with the development and management of tourist flows

The potential changes to the territory of the Russian Arctic open up unique possibilities for the development of tourism. More favourable transport opportunities along the Northern Sea Route (NSR) create opportunities for tourism development based on the utilisation of the extensive areas of sea shores and river basins. A major challenge for the Russian Arctic sea and river ports is their strong cargo transport orientation originated by natural resource extraction industries. A careful assessment of the prospects of current and future tourism development is presented here based on the development of regions located along the shores of the Arctic ocean (including Murmansk and Arkhangelsk oblast, Nenets Autonomous okrug (AO), Yamal-Nenets AO, Taymyr AO, Republic of Sakha, Chykotsky AO). An evaluation of the present development of tourism in maritime cities suggests that a considerable qualitative and quantitative increase of tourism activities organised by domestic tourism firms is made virtually impossible. There are several factors contributing to this. The previously established Soviet system of state support for the investments into the port facilities as well as the sea fleet were not effectively replaced by creation of new structures. The necessary investments for reconstruction could be contributed by the federal government but the priorities are not set towards the increased passenger transportation. Having in mind, increased environmental pressures in this highly sensitive area it is especially vital to establish a well-functioning monitoring and rescue system in the situation of ever increasing risks which come not only from the increased transports along the NSR, but also from the exploitation of the offshore oil and gas reserves in the Arctic seas. The capacity and knowledge established in Nordic countries (Norway, Finland) concerning cruise tourism should not be underestimated and the already functioning cooperation in Barents Region should expand towards this particular segment of the tourism industry. The current stage of economic development in Russia makes it clear that tourism development is not able to compete with the well-needed increase in the cargo transportation, which means that Russia’s fleet is going to be utilised by other industries. However, opening up this area to both local and international visitors could contribute to the economic prosperity of these remote areas and if carefully managed could sustain already existing maritime cities along the shores of the Arctic Ocean.

Module property verification : A method to plan and perform quality verifications in modular architectures

Modular product architectures have generated numerous benefits for companies in terms of cost, lead-time and quality. The defined interfaces and the module’s properties decrease the effort to develop new product variants, and provide an opportunity to perform parallel tasks in design, manufacturing and assembly. The background of this thesis is that companies perform verifications (tests, inspections and controls) of products late, when most of the parts have been assembled. This extends the lead-time to delivery and ruins benefits from a modular product architecture; specifically when the verifications are extensive and the frequency of detected defects is high. Due to the number of product variants obtained from the modular product architecture, verifications must handle a wide range of equipment, instructions and goal values to ensure that high quality products can be delivered. As a result, the total benefits from a modular product architecture are difficult to achieve. This thesis describes a method for planning and performing verifications within a modular product architecture. The method supports companies by utilizing the defined modules for verifications already at module level, so called MPV (Module Property Verification). With MPV, defects are detected at an earlier point, compared to verification of a complete product, and the number of verifications is decreased. The MPV method is built up of three phases. In Phase A, candidate modules are evaluated on the basis of costs and lead-time of the verifications and the repair of defects. An MPV-index is obtained which quantifies the module and indicates if the module should be verified at product level or by MPV. In Phase B, the interface interaction between the modules is evaluated, as well as the distribution of properties among the modules. The purpose is to evaluate the extent to which supplementary verifications at product level is needed. Phase C supports a selection of the final verification strategy. The cost and lead-time for the supplementary verifications are considered together with the results from Phase A and B. The MPV method is based on a set of qualitative and quantitative measures and tools which provide an overview and support the achievement of cost and time efficient company specific verifications. A practical application in industry shows how the MPV method can be used, and the subsequent benefits

Informations- och kommunikationsteknologi som stöd för patienter med astma och kronisk obstruktiv lungsjukdom avseende egenvård. En litteraturstudie.

Bakgrund: Astma och KOL är två vanlig kroniska sjukdomar som är kopplade till stort sjukdomslidande och lägre livskvalité. Många personer som idag lever med sjukdomarna lever isolerat från andra. Idag har vi en ständig utveckling av sociala nätverk som öppnar en ny möjlighet för egenvård. Egenvård kan göra att patienter får en bättre vardag samt att det lättare kan få ett socialt umgänge. Syfte: Syftet är sammanställa befintlig litteratur och där undersöka hur informations- och kommunikationsteknologi underlättar egenvården för patienter med astma och KOL. Metod: Litteraturstudie där artiklarna söktes i databaser för omvårdnadsvetenskap så som Web Of Science, pubmed och Cinahl. Litteraturstudien baseras på 16 vetenskapliga artiklar som både är kvalitativa och kvantitativa. Artiklarna som valdes är inte äldre än 10 år gamla, skrivna på engelska och publicerade i en vetenskaplig tidning. Resultat: Resultatet som artiklarna påvisade är grundade på IKT i form av datorer, mobiltelefoner, surfplattor och web-baserad program. Artiklarna visar att egenvården kan förbättras genom ökad livskvalité, bättre kommunikation och bättre sjukdomsinsikt när man använder IKT. Slutsats: IKT är en viktig roll i våran hälso- och sjukvård idag. Det finns dock liten forskning på hur egenvården kring astma och KOL påverkas av IKT. Den forskning som finns pekar åt är att den förbättrar för patienter. Det behövs även mer forskning kring IKT som en resurs för egenvård kring ett omvårdnadsperspektiv.