Transition : en betydelsefull fas i den långtidssjuka ungas vård

The aim of this caring science thesis is to deepen the understanding for the long-term ill adolescents care. In particular it aims to reach a better understanding of transition in health care, with a focus on how young people perceive health care. The goal is to build a model, a consistent theoretical framework that makes it possible to listen to the adolescent´s own voice, providing a better understanding of what good care consists in from their point of view. This Master's thesis consists of a literature overview on the concept of transition and a themed interview with young patients regarding transition of health care. The overall issue is 1. What is good care during the transition according to the adolescents themselves? 2. How does transition affect the young people's health and lives? The theoretical perspective of this thesis lies in the caring science tradition that has been developed at the Åbo Akademi University department of caring science with the caritative nursing theory as a basis. The epistemological and ontological assumptions are based on the caritative nursing theory, which in itself is ethical. Understanding of the concept of transition is based on A. Meleis transitions theory. The methodological approach is hermeneutical. The theme interview has been analyzed by using S. Kvales method. The material consists of a thematic interview with 10 long-term ill adolescents, about their views of the care received. This thesis research even in how NOBABs standards appears in the litterature as well as how they are implemented from the point of view of young people. The findings of this thesis shows that good care for the adolescent is a true presence with the young and an understanding of the direction in which the young move toward during the transition of care. Good care for an adolescent consists in being recognized as a person who is seen, known, appreciated and understood. Good care for the young involves recognizing her strength and joy of life including the contrast she experiences between health and suffering. To recognize their personal strength and courage supports the adolescents during the process of transitions of care Good care for the young involves responsibility for the individual person and humility in approaching her, giving attention to her view of life and aspirations. Openness and humility in the approach lays the foundation for a trusting relation during the transition of care. A unified theoretical framework is needed to promote the long-term ill adolescents care during transition of care. When the young and her individual needs is the centerpiece of healthcare creates this the basis for empowering care that supports the young in her quest for health. This master thesis adds a given model to the long-term ill adolescents` healthcare.

Samvaro, språkanvändning och attityder : svenskspråkiga elevers syn på att gå i en samlokaliserad skola

Syftet med denna avhandling är att beskriva svenskspråkiga elevers uppfattningar om och erfarenheter av att gå i en samlokaliserad skola med finskspråkiga elever. Utgående från syftet har tre forskningsfrågor utformats:1. Har de svenskspråkiga elevernas kontakt med de finskspråkiga eleverna förändrats, och i så fall på vilket sätt? 2. Har de svenskspråkiga elevernas användning av det finska språket förändrats, och i så fall på vilket sätt? 3. Har de svenskspråkiga elevernas attityder gentemot de finskspråkiga eleverna förändrats, och i så fall på vilket sätt? Som datainsamlingsmetod används kvalitativa par- och gruppintervjuer. Respondenterna är 11 elever i en samlokaliserad skola och de intervjuas för första gången våren 2010 när de går i årskurs 2. Samma respondenter intervjuas på nytt i december 2012 när de går i årskurs 5. Resultaten redovisas i avhandlingen med hjälp av narrativa berättelser enskilt för varje par och grupp. I slutet av resultatredovisningen jämförs även de förändringar som skett inom varje par och grupp sinsemellan för att läsaren ska få en helhetsbild av förändringarna. Undersökningen visar att det inte skett någon förändring i de svenskspråkiga elevernas kontakt med de finskspråkiga eleverna, men att en vilja till en ökad kontakt har vuxit fram under åren i den samlokaliserade skolan. Det har inte heller skett någon markant förändring i de svenskspråkiga elevernas användning av det finska språket. Även de svenskspråkiga elevernas attityder gentemot de finskspråkiga eleverna har hållits stabila för en del elever, samtidigt som attitydutvecklingen för en del flickor varit positiv. Med hjälp av avhandlingens resultat kan elevernas uppfattningar och erfarenheter tas i beaktande när samlokaliserade skolor planerar sin vardag och funderar på samarbete över språkgränsen. Avhandlingens resultat och elevernas åsikter kan även tas i beaktande när beslut om samlokaliserade skolor görs inför framtiden.

Sphingosine-1-phosphate-evoked invasion of follicular thyroid cancer cells : evidence for the involvement of HIF-Iα, MMP2 and MMP9

Sphingolipids are widely expressed molecules, which traditionally were considered to have majorly structural properties. Nowadays, however, they are implicated in a wide range of different biological processes. The bioactive lipid sphingosine 1-phosphate (S1P) has emerged during the past decade as one of the most studied molecules due to its proliferative and pro-migratory abilities both during normal physiology and in the pathology of a subset of different diseases. Migration and invasion of cancer cells require changes in cell behavior and modulation of the tissue microenvironment. Tumor aggressiveness is markedly enhanced by hypoxia, in which hypoxia inducible transcription factors 1-2α (HIF-1-2α) are activated to promote metabolism, proliferation and migration. Invasion requires degradation of the extracellular matrix (ECM) achieved by several degrading and remodeling enzymes. Matrix metalloproteinases (MMPs) are broadly expressed and well accepted as proteolytic enzymes with essential roles both in normal physiology and in pathology. Previously, S1P was shown to strongly evoke migration of follicular ML-1 thyroid cancer cells. The objective of this study was to further investigate and understand the mechanisms behind this regulation. In the first project it was demonstrated that S1P enhances the expression and activity of HIF-1α. S1P enhanced the expression of HIF-1α by increasing its synthesis and stability. The S1P-increased HIF-1α was mediated via S1P3, Gi/0, PI3K, PKCβI, ERK1/2, mTOR and translation factors p70S6K and eIF4E. Finally, it was shown that HIF-1α mediated S1P-induced migration. The ECM is constituted of a complex and coordinated assembly of many types of proteins. In order to be able to invade, cells need to break down the ECM, therefore several key players in this event were investigated in the second project. S1P increased the secretion and activity of MMP2 and MMP9 via S1P-receptor 1 and 3 and that these MMPs participated in the S1P-facilitated invasion of ML-1 cells. In this interplay, calpains and Rac1 were involved, both of which are crucial players in migration and invasion. The prognosis for some types of thyroid cancer is relatively good. However, there are forms of thyroid cancers, for which there are no treatments or the current available treatments are inefficient. Thus, new medical interventions are urgently needed. In the third project the significance of the S1P-receptor modulating drug FTY720, which is currently used for the treatment of multiple sclerosis (MS), was studied. The effect of FTY720 was tested on several thyroid cancer cell lines, and it inhibited the proliferation and invasion of all cancer cell lines tested. In ML-1 cells, FTY720 attenuated invasion by blocking signaling intermediates important for migration and invasion of the cells. Moreover, FTY720 inhibited the proliferation of ML-1 cells by increasing the expression of p21 and p27, hence, inducing cell arrest in G1 phase of the cell cycle. Thus, it can be suggested that FTY720 could be used in the treatment of thyroid cancer.

” För tillfället så har jag inga elever med behov av differentiering” : differentiering i gymnastikundervisningen inom den grundläggande utbildningens årskurser 7–9

Differentiering i gymnastikundervisning är ett relativt outforskat område. I den nya läroplanen som tas i bruk höstterminen 2016 har begreppet differentiering fått en allt större betydelse. Enligt läroplanen innebär differentiering att läraren erbjuder elever exempelvis olika arbetssätt, tempo och grupper för att eleverna ska utvecklas enligt sina individuella förutsättningar. Speciellt inför byte av läroplan är det intressant att undersöka hur gymnastikundervisningen ser ut inom den grundläggande utbildningens årskurser 7–9. Syftet med avhandlingen är att undersöka hur gymnastiklärare planerar, genomför och utvärderar gymnastikundervisningen med avseende på differentiering i årskurserna 7–9 i finlandssvenska skolor. Utöver detta undersöks lärarnas kännedom om läroplanen samt andra faktorer som kan påverka differentieringen. Dessutom undersöks hur olika gymnastikgrenar enligt gymnastiklärarna inverkar på möjligheten till differentiering. Utgående från syftet har fyra forskningsfrågor formulerats: 1. Hur differentierar gymnastiklärarna gymnastikundervisningen? 2. Hur är gymnastiklärarnas kännedom om de nationella läroplanernas bestämmelser om en differentierad undervisning? 3. Hur är sambandet mellan skol- och läraranknutna faktorer och differentieringen i gymnastikundervisningen? 4. Hur ser gymnastiklärarna på sina möjligheter till differentiering i olika grenar? För att besvara frågeställningarna valdes en kvantitativ forskningsmetod i form av en webbenkät. Webbenkäten skickades ut åt 108 gymnastiklärare och 14 rektorer. På webbenkäten svarade 49 respondenter vars svar analyserades statistiskt. Majoriteten av gymnastiklärarna känner rätt bra eller i någon mån till differentiering. Av gymnastiklärarna anser 4 att alla elever i deras undervisning är i behov av differentiering. Gymnastiklärarna differentierar främst utvärderingen i gymnastikundervisningen. Själva genomförandet av undervisningen tenderar att differentieras minst. Skol- och läraranknutna faktorer påverkar inte differentieringen i gymnastikundervisningen. De grenar som gymnastiklärarna ansåg vara mest möjliga att differentiera var redskapsgymnastik, friidrott och bollspel.

Grammatikdidaktik: Svensk grammatik och språklig medvetenhet i några läromedel för grundskolans första årskurser

Mitt övergripande forskningsintresse är grammatikdidaktik, medan det explicita syftet med denna licentiatavhandling är att erhålla ny kunskap om grammatikdidaktik så som den synliggörs i nutida läromedel för grundskolans första årskurser. Den empiriska undersökningen är gjord i tre nutida läromedelspaket avsedda för undervisning i skolämnet modersmål och litteratur i årskurs ett och två, läromedlen som undersöks är de finlandssvenska serierna Läseboken och Litteraturboken samt den sverigesvenska serien Kom och läs! Bland resultaten kan nämnas att det finns ett brett spektrum av nivåer av extern grammatik i alla de undersökta läromedelspaketen. Den fonologiska och syntaktiska medvetenheten, vilka bägge är viktiga för läs- och skrivutvecklingen i de diskuterade årskurserna, satsas på i alla tre läromedelspaket. Det jag dock också märkt i läromedlen som kan påverka läs- och skrivutvecklingen är att andelen belägg för grafonomi är större i årskurs två än i årskurs ett. Härigenom får eleverna på detta sätt småningom växa in i en skriftkultur. Det finns betydligt fler muntliga uppgifter i lärarhandledningarna till serierna Litteraturboken och Kom och läs! än i Läseboken. Det exakta ”hur” står inte alltid utskrivet i lärarhandledningarna, men de flesta gånger verkar tanken vara att det rör sig om diskussioner eller andra muntliga genrer. I många fall känns de muntliga uppgifterna mer funktionella än skriftliga uppgifter som inte verkar vara helt genomtänkta. Att mitt material innehåller fler funktionella uppgifter i lärarhandledningar och fler formalistiska eller delvis funktionella uppgifter i arbetsböcker överensstämmer med att lärarhandledningar kan vara en bättre väg för att öka elevernas kunskapssökande och minska förmedlingspedagogiken.

Handledning i slöjdundervisning med kompetensutveckling som mål

Det övergripande syftet med studien är att undersöka hur handledning i slöjdundervisningen kunde bidra till utveckling av kompetenser. Studien fokuserar på de mål för mångsidig kompetens som ställs i grunderna för läroplanen för den grundläggande utbildningen 2014. Som en aspekt av detta undersöks också hur handledning kommer till uttryck i slöjdundervisningen idag. Utgående från detta ställdes följande forskningsfrågor: 1. Hur ser handledning i slöjdundervisning ut? 2. Hur kan kompetensområden behandlas i handledningssituationer i slöjd? I studien har observation som undersökningsmetod använts. I observationen filmades slöjdlektionerna för att sen kunna genomföra en noggrann analys av dessa. Vid observationstillfället följde filmkameran läraren för att fånga upp den kommunikation och interaktion som pågick under handledningssituationerna. Observationerna bestod av två lektioner där 64 handledningssituationer kunde urskiljas. Antalet lärare som deltog var två medan det totala antalet elever var 20, 11 i textilslöjd och 9 i teknisk slöjd. Materialet som användes i studien uppgick till 154 minuter videomaterial. Materialet analyserades utifrån fem olika aspekter. Den första aspekten var i vilken grad lärare eller elev tar initiativ till en handledningssituation samt hur initiativet togs. Den andra aspekten var handledningens karaktär. Analysen av handledningens karaktär utgick från två perspektiv på handledning, föreskrivande och icke-föreskrivande handledning. Den tredje aspekten som analyserades var i vilken mån läroplanens mål för mångsidig kompetens blev synliga i handledningssituationerna. Den fjärde aspekten var elevernas position i slöjdprocessen. Den femte och sista aspekten som analyserades var hur lärarens kommentarer för över ansvaret på eleven eller ifall lärarens kommentar innebär att läraren tar ansvaret för att ett produktionshinder övervinns eller ett problem löses. För att kunna besvara forskningsfråga två har analysen också innefattat en jämförelse mellan föreskrivande och icke-föreskrivande handledning. I jämförelsen undersöktes hur respektive handledningsform bidrog till en viss ansvarsförskjutning samt i vilken grad kompetensområden synliggjordes. Resultatet från studien visar att handledningen i slöjdundervisningen har en stark föreskrivande karaktär. Vidare framkom att lärare i hög grad initierar handledningssituationer. De kompetensområden som synliggjordes i handledningssituationerna har oftast en anknytning till praktiska färdigheter eller planeringsfärdigheter. Resultatet indikerar att lärarens möjligheter att behandla specifika kompetensområden är beroende av undervisningens utformning samt var i slöjdprocessen elevernas arbeten är. Studiens resultat visar på en diskrepans mellan befintliga modeller kring handledning i slöjdundervisning och det som synliggjorts i denna studie. I avhandlingens resultatdiskussion presenteras därför en modell för handledning i slöjdundervisning

Litteracitet i fem högstadieungdomars en-till-en-datorpraktiker

The study focuses on five lower secondary school pupils’ daily use of their one-toone computers, the overall aim being to investigate literacy in this form of computing. Theoretically, the study is rooted in the New Literacy tradition with an ecological perspective, in combination with socio-semiotic theory in a multimodal perspective. New Literacy in the ecological perspective focuses on literacy practices and place/space and on the links between them. Literacy is viewed as socially based, in specific situations and in recurring social practices. Socio-semiotic theory embodying the multimodal perspective is used for the text analysis. The methodology is known as socio-semiotic ethnography. The ethnographic methods encompass just over two years of fieldwork with participating observations of the five participants’ computing activities at home, at school and elsewhere. The participants, one boy and two girls from the Blue (Anemone) School and two girls from the White (Anemone) School, were chosen to reflect a broad spectrum in terms of sociocultural and socioeconomic background. The study shows the existence of a both broad and deep variation in the way digital literacy features in the participants’ one-to-one computing. These variations are associated with experience in relation to the home, the living environment, place, personal qualities and school. The more varied computer usage of the Blue School participants is connected with the interests they developed in their homes and living environments and in the computing practices undertaken in school. Their more varied usage of the computer is reflected in their broader digital literacy repertoires and their greater number and variety of digital literacy abilities. The Blue School participants’ text production is more multifaceted, covers a wider range of subjects and displays a broader palette of semiotic resources. It also combines more text types and the texts are generally longer than those of the White School participants. The Blue School girls have developed a text culture that is close to that of the school. In their case, there is clear linkage between school-initiated and self-initiated computing activities, while other participants do not have the same opportunities to link and integrate self-initiated computing activities into the school context. It also becomes clear that the Blue School girls can relate and adapt their texts to different communicative practices and recipients. In addition, the study shows that the Blue School girls have some degree of scope in their school practice as a result of incorporating into it certain communicative practices that they have developed in nonschool contexts. Quite contrary to the hopes expressed that one-to-one computing would reduce digital inequality, it has increased between these participants. Whether the same or similar results apply in a larger perspective, on a more structural level, is a question that this study cannot answer. It can only draw attention to the need to investigate the matter. The study shows in a variety of ways that the White School participants do not have the same opportunity to develop their digital literacy as the Blue School participants. In an equivalence perspective, schools have a compensational task to perform. It is abundantly clear from the study that investing in one-to-one projects is not enough to combat digital inequality and achieve the digitisation goals established for school education. Alongside their investments in technology, schools need to develop a didactic that legitimises and compensates for the different circumstances of different pupils. The compensational role of schools in this connection is important not only for the present participants but also for the community at large, in that it can help to secure a cohesive, open and democratic society.

Exploring the personal and professional lives of teachers in the search for authenticity /

"We teach who we are" (Palmer, 1998, p. 2). This simple, yet profound, statement was the catalyst that began my thesis journey. Using a combination of self-study and participant narratives, Palmer's idea was explored as search for authenticity. The self-study component of this narrative was enhanced by the stories of two other teachers, both women. I chose to use narrative methodology to uncover and discover the relationship between the personal and professional lives of being a teacher. Do teachers express themselves daily in their classrooms? Do any lessons from the classroom translate into teachers' personal lives? The themes of reflection, authenticity, truth, and professional development thread themselves throughout this narrative study. In order to be true to myself as a teacher/researcher, arts-based interpretations accompany my own and each participant's profile. Our conversations about our pasts, our growth as teachers and journeys as individuals were captured in poetry and photographic mosaics. Through rich and detailed stories we explored who we are as teachers and how we became this way. The symbiotic relationship between our personal and professional lives was illustrated by tales of bravery, self-discovery, and reflection. The revelations uncovered illustrate the powerful role our past plays in shaping the present and potentially the friture. It may seem indulgent to spend time exploring who we are as teachers in a time that is increasingly focused on improving student test scores. Yet, the truth remains that, "Knowing myself is as crucial to good teaching as knowing my students and my subject" (Palmer, 1998, p. 2).

Personal soundtracks on public transit : personal listening devices and socio-spatial negotiations of students' bus journeys

One way of exploring the power of sound in the experience and constitution of space is through the phenomenon of personal listening devices (PLDs) in public environments. In this thesis, I draw from in-depth interviews with eleven Brock University students in S1. Catharines, Ontario, to show how PLDs (such as MP3 players like the iPod) are used to create personalized soundscapes and mediate their public transit journeys. I discuss how my interview participants experience the space-time of public transit, and show how PLDs are used to mediate these experiences in acoustic and non-acoustic ways. PLD use demonstrates that acoustic and environmental experiences are co-constitutive, which highlights a kinaesthetic quality of the transit-space. My empirical findings show that PLDs transform space, particularly by overlapping public and private appropriations of the bus. I use these empirical findings to discuss the PLD phenomenon in the theoretical context of spatiality, and more specifically, acoustic space. J develop the ontological notion of acoustic space, stating that space shares many of the properties of sound, and argue that sound is a rich epistemological tool for understanding and explaining our everyday experiences.

Ties From My Father: Personal Narrative as a Tool for Engaging Teenagers and Social Service Practitioners

The purpose of this project is to provide social service practitioners with tools and perspectives to engage young people in a process of developing and connecting with their own personal narratives, and storytelling with others. This project extensively reviews the literature to explore Why Story, What Is Story, Future Directions of Story, and Challenges of Story. Anchoring this exploration is Freire’s (1970/2000) intentional uncovering and decoding. Taking a phenomenological approach, I draw additionally on Brookfield’s (1995) critical reflection; Delgado (1989) and McLaren (1998) for subversive narrative; and Robin (2008) and Sadik (2008) for digital storytelling. The recommendations provided within this project include a practical model built upon Baxter Magolda and King’s (2004) process towards self-authorship for engaging an exercise of storytelling that is accessible to practitioners and young people alike. A personal narrative that aims to help connect lived experience with the theoretical content underscores this project. I call for social service practitioners to engage their own personal narratives in an inclusive and purposeful storytelling method that enhances their ability to help the young people they serve develop and share their stories.

Using Poetry, Story, and Reflection to Understand Professional Self After Personal Loss

This research investigated professional identity transformation after personal loss. Through autoethnographic methods, I explore how my personal experience of my sister’s breast cancer and death affected my identity as a diabetes educator in the health culture. I discover a transformation of a professional who focuses on evidence-based medicine to a professional who values connection, therapeutic alliance, and mindfulness with patients and self in the diabetes education encounter. Using a holistic perspective on transformational learning, I integrate the poem “Wild Geese” to a collection of written narratives to connect my personal loss experience to my professional life. By unpacking the generated stories and using poetry, I conduct a process of critical and self-reflection to discover how my identity as a health professional has transformed and what makes meaning in my role as a diabetes educator in the health culture. I consider concepts of a conscious self, social relations and language and discover themes of knowledge exchange, food, and empathy as forms of language expression. These language expressions are not present in my professional life as I focus on rational, logical facts of evidence-based medicine and standardized education methods. Through this reflexive process, I hope to understand how my professional practice has changed, where I place an importance on connection, therapeutic alliance, and mindfulness. I move away from always “doing” in my professional life to focus on my state of “being” in my professional world. Rather than knowledge acquisition as the only factor in professional development, this study contributes to an understanding of additional qualities health professionals may consider that focus on the patient education encounter.

Autonomy and Relatedness in Mainland Chinese Adolescents: Social or Personal? Accommodation or Distinctiveness?

Three studies comprised the current research program, in which the major goals were to propose and validate empirically the proposed two-level (universal and culture-specific) model of both autonomy and relatedness, as well as to develop reliable and valid measures for these two constructs. In Study 1, 143 mainland Chinese adolescents were asked open-ended questions about their understanding of autonomy and relatedness in three social contexts (peer, family, school). Chinese youth’s responses captured universal and culturally distinctive forms of autonomy (personal vs. social) and relatedness (accommodation vs. distinctiveness), according to a priori criteria based on the theoretical frameworks. Also, scenarios designed to reflect culture-specific forms of autonomy and relatedness suggested their relevance to Chinese adolescents. With a second sample of 201 mainland Chinese youth, in Study 2, the obtained autonomy and relatedness descriptors were formulated into scale items. Those items were subject to refinement analyses to examine their psychometric properties and centrality to Chinese youth. The findings of Study 1 scenarios were replicated in Study 2. The primary goal of Study 3 was to test empirically the proposed two-level (universal and culture-specific) models of both autonomy and relatedness, using the measures derived from Studies 1 and 2. A third sample of 465 mainland Chinese youth completed a questionnaire booklet consisting of autonomy and relatedness scales and scenarios and achievement motivation orientations measures. A series of confirmatory factor analysis (CFA) autonomy and relatedness measurement models (first-order and second-order), as well as structural models linking culture-specific forms of autonomy and relatedness and achievement motivation orientations, were conducted. The first-order measurement models based on scale and scenario scores consistently confirmed the distinction between personal autonomy and social autonomy, and that of accommodation and distinctiveness. Although the construct validity of the two culture-specific forms of autonomy gained additional support from the structural models, the associations between the two culture-specific forms of relatedness and achievement motivation orientations were relatively weak. In general, the two-level models of autonomy and relatedness were supported in two ways: conceptual analysis of scale items and second-order measurement models. In addition, across the three studies, I explored potential contextual and sex differences in Chinese youth’s endorsement of the diverse forms of autonomy and relatedness. Overall, no substantial contextual variability or sex differences were found. The current research makes an important theoretical contribution to the field of developmental psychology in general, and autonomy and relatedness in particular, by proposing and testing empirically both universal and culture-specific parts of autonomy and relatedness. The current findings have implications for the measurement of autonomy and relatedness across social contexts, as well as for socialization and education practice.

A study of my personal approach to composition

La version intégrale de ce[te] mémoire [thèse] est disponible uniquement pour consultation individuelle à la Bibliothèque de musique de l’Université de Montréal (www.bib.umontreal.ca/MU).