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.

Självet, rollerna och pågående koordinationer av mänskliga handlingar : Om att försöka se ’samhället’ som något annat än fängelse eller marionetteater

The self, roles and the ongoing coordination of human action. Trying to see ‘society’ as neither prison nor puppet theatre In the article it is argued that structural North-American role-sociology may be integrated with theories emphasizing ‘society’ as ongoing processes (f. ex. Giddens’ theory of structuration). This is possible if the concept of role is defined as a recurrence oriented to the action of others standing out as a regularity in a societal process. But this definition makes it necessary to in a fundamental way understand what kind of social being the role-actor is. This is done with the help of Hans Joas’ theory of creativity and Merleau-Pontys concept of ‘flesh’ arguing that Meads concept of the ‘I’ maybe understood as an embodied self-asserting I, which at least in reflexive modernity has the creative power to split Meads ‘me’ into a self-voiced subject-me and an other voiced object-me. The embodied I communicating with the subject-me may be viewed as that role-actor which is something else than the role played. But this kind of role-actor is making for new troubles because it is hard to understand how this kind of self is creating self-coherence by using Meads concept of ‘the generalized other’. This trouble is handled by using Alain Touraines concept of the ‘subject’ and arguing that the generalized other is dissolving in de-modernized modernity. In split modernity self-coherence may instead be created by what in the article is called the generalized subject. This concept means a kind of communicative future based evaluation, which has its base in the ‘subject’ opposing the split powers of both the instrumentality of markets and of life-worlds trying to create ‘fundamentalistic’ self-identities. This kind of self is communicative because it also must respect the other as ‘subject’. It exists only in the battle against the forces of the market or a community. It never constructs an ideal city or a higher type of individual. It creates and protects a clearing that is constantly being invaded, to use the words of the old Frenchman himself. Asa kind of test-case it is by the way in the article shown how Becks concept of individualization may be understood in a deeply social and role-sociological way.

I andras hem : Om minnesarbete som förnyelse av familjesociologi

In the home of others: exploring new sites and methods when investigating the doings of gender, class and ethnicity What role does the experience of being in and observing other people’s home play informing one’s gender and class identities and family aspirations? And how can it be explored? Through the traditions of socialization theory the everyday/-night experiences of family life are objectified into an institution (the family) with abstracted relations (mother-father-child) and functions (”primary socialization”). This is a view directly related to ruling relations through which the family is institutionalized, by rules and regulations, and made accountable as such. Hereby the question of experiences of other sites (and localities!) and other relations when forming one’s gender and family aspirations are not raised. In this article it is argued that when using an alternative approach (the method of inquiry proposed by Dorothy E. Smith) and alternative methods (memory work) the door to other homes is opened. Using experience stories a picture is drawn where new sites and relations are made visible as crucial contexts where gender and family life is explored and learned. By illuminating the ”work knowledge” of family life another way of mapping is presented, a way that extends and transforms the traditions within family research.

Student Thesis Level: Master’s Thesis in Business Administration Corporate Social Responsibility (CSR) networking : A case study on why members join CSR network and why are they sharing their knowledge

Purpose – This research focuses on finding the reasons, why members from different sectors join a cross-sector/multi-stakeholder CSR network and what motivates them to share (or not to share) their knowledge of CSR and their best practices. Design/methodology/approach – Semi-structured interviews were conducted with members of the largest cross-sector CSR network in Sweden. The sample base of 15 people was chosen to be able to represent a wider variety of members from each participating sectors. As well as the CEO of the intermediary organization was interviewed. The interviews were conducted via email and telephone. Findings – The findings include several reasons linked to the business case of CSR such as stakeholder pressure, competitive advantage, legitimacy and reputation as well as new reasons like the importance of CSR, and the access of further knowledge in the field. Further reasons are in line with members wanting to join a network, such as access to contact or having personal contacts. As to why members are sharing their CSR knowledge, the findings indicate to inspire others, to show CSR commitment, to be visible, it leads to business opportunity and the access of others knowledge, and because it was requested. Reasons for not sharing their knowledge would be the lack of opportunity, lack of time and the lack of experience to do so. Originality/value – The research contributes to existing studies, which focused on Corporate Social Responsibility and cross-sector networking as well as to inter-organizational knowledge sharing in the field of CSR.

Informal sanctions and conditional cooperation: : A natural experiment on voluntary contributions to a public good.

In a natural experiment, this paper studies the impact of an informal sanctioning mechanism on individuals’ voluntary contribution to a public good. Cross-country skiers’ actual cash contributions in two ski resorts, one with and one without an informal sanctioning system, are used. I find the contributing share to be higher in the informal sanctioning system (79 percent) than in the non-sanctioning system (36 percent). Previous studies in one-shot public good situations have found an increasing conditional contribution (CC) function, i.e. the relationship between expected average contributions of other group members and the individual’s own contribution. In contrast, the present results suggest that the CC-function in the non-sanctioning system is non-increasing at high perceived levels of others’ contribution. This relationship deserves further testing in lab.

Utveckling av metod för att bedöma behovet av ogräsbekämpning i spår

A system for weed management on railway embankments that is both adapted to the environment and efficient in terms of resources requires knowledge and understanding about the growing conditions of vegetation so that methods to control its growth can be adapted accordingly. Automated records could complement present-day manual inspections and over time come to replace these. One challenge is to devise a method that will result in a reasonable breakdown of gathered information that can be managed rationally by affected parties and, at the same time, serve as a basis for decisions with sufficient precision. The project examined two automated methods that may be useful for the Swedish Transport Administration in the future: 1) A machine vision method, which makes use of camera sensors as a way of sensing the environment in the visible and near infrared spectrum; and 2) An N-Sensor method, which transmits light within an area that is reflected by the chlorophyll in the plants. The amount of chlorophyll provides a value that can be correlated with the biomass. The choice of technique depends on how the information is to be used. If the purpose is to form a general picture of the growth of vegetation on railway embankments as a way to plan for maintenance measures, then the N-Sensor technique may be the right choice. If the plan is to form a general picture as well as monitor and survey current and exact vegetation status on the surface over time as a way to fight specific vegetation with the correct means, then the machine vision method is the better of the two. Both techniques involve registering data using GPS positioning. In the future, it will be possible to store this information in databases that are directly accessible to stakeholders online during or in conjunction with measures to deal with the vegetation. The two techniques were compared with manual (visual) estimations as to the levels of vegetation growth. The observers (raters) visual estimation of weed coverage (%) differed statistically from person to person. In terms of estimating the frequency (number) of woody plants (trees and bushes) in the test areas, the observers were generally in agreement. The same person is often consistent in his or her estimation: it is the comparison with the estimations of others that can lead to misleading results. The system for using the information about vegetation growth requires development. The threshold for the amount of weeds that can be tolerated in different track types is an important component in such a system. The classification system must be capable of dealing with the demands placed on it so as to ensure the quality of the track and other pre-conditions such as traffic levels, conditions pertaining to track location, and the characteristics of the vegetation. The project recommends that the Swedish Transport Administration: Discusses how threshold values for the growth of vegetation on railway embankments can be determined Carries out registration of the growth of vegetation over longer and a larger number of railway sections using one or more of the methods studied in the project Introduces a system that effectively matches the information about vegetation to its position Includes information about the growth of vegetation in the records that are currently maintained of the track’s technical quality, and link the data material to other maintenance-related databases Establishes a number of representative surfaces in which weed inventories (by measuring) are regularly conducted, as a means of developing an overview of the long-term development that can serve as a basis for more precise prognoses in terms of vegetation growth Ensures that necessary opportunities for education are put in place