Who Should do What to Whom? : Occupational Groups´Views on Special Needs

The overall aim of this thesis is to increase our knowledge of different occupational groups´ views on work with children in need of special support. This is explored in four separate studies. The first study investigates the views of occupational groups in preschools and schools in one municipality. A questionnaire was handed out to all personnel (N=1297) in the municipality in 2008 (72.5 % response rate). The second study explores the views of educational leaders (N=45) in the same municipality. Questionnaire # 2 was distributed in 2009. All the educational leaders responded to the questionnaire. The third study describes the views of different occupational groups concerning special educational needs coordinators´ (SENCOs) role and work. This was highlighted by comparing responses from questionnaire #1 and # 2. Responses concerning SENCOs´ work were also added using a third questionnaire. This questionnaire was handed out in 2006 to chief education officers (N=290) in all municipalities in Sweden. The response rate was 90.3%. Finally, the fourth study presents five head teachers´ descriptions of their work with special needs issues. Study four was a follow-up study of questionnaire # 2. These head teachers were selected because of their inclusive values and because they seemed to be effective according to certain criteria. They were interviewed in January 2012. The results reveal a number of interesting findings. For example, there are both similar and different views among the occupational groups concerning work with children in need of special support. A majority of the respondents in all groups state that children´s individual deficiencies is one common reason why children need special support in preschools/schools. Differences between the occupational groups become especially visible regarding their views of SENCOs‟ work. Critical pragmatism (Cherryholmes, 1988) is applied as a theoretical point of departure. Skrtic´s (1991) critical reading and analysis of special education relative to general education is specifically used to interpret and discuss the outcome of the studies. Additionally, Abbott´s (1988) reasoning concerning the “division of expert labor” is used to discuss the occupational groups´ replies concerning “who should do what to whom”. The findings in the studies are contextualized and theoretically interpreted in the separate articles. However in the first part of this thesis (in Swedish: Kappa), the theoretical interpretations of the empirical outcome are discussed in more detail and the results are further contextualized and synthesised. Inclusion and premises for inclusive education are also discussed in more depth in the first part of the present thesis.

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.

What aspects of rehabilitation provision contribute to self-reported met needs for rehabilitation one year after stroke - amount, place, operator or timing?

BACKGROUND AND OBJECTIVE: To a large extent, people who have suffered a stroke report unmet needs for rehabilitation. The purpose of this study was to explore aspects of rehabilitation provision that potentially contribute to self-reported met needs for rehabilitation 12 months after stroke with consideration also to severity of stroke. METHODS: The participants (n = 173) received care at the stroke units at the Karolinska University Hospital, Sweden. Using a questionnaire, the dependent variable, self-reported met needs for rehabilitation, was collected at 12 months after stroke. The independent variables were four aspects of rehabilitation provision based on data retrieved from registers and structured according to four aspects: amount of rehabilitation, service level (day care rehabilitation, primary care rehabilitation and home-based rehabilitation), operator level (physiotherapist, occupational therapist, speech therapist) and time after stroke onset. Multivariate logistic regression analyses regarding the aspects of rehabilitation were performed for the participants who were divided into three groups based on stroke severity at onset. RESULTS: Participants with moderate/severe stroke who had seen a physiotherapist at least once during each of the 1st, 2nd and 3rd-4th quarters of the first year (OR 8.36, CI 1.40-49.88 P = 0.020) were more likely to report met rehabilitation needs. CONCLUSION: For people with moderate/severe stroke, continuity in rehabilitation (preferably physiotherapy) during the first year after stroke seems to be associated with self-reported met needs for rehabilitation.

Why Critical Whiteness Studies needs to think about warfare

Sociologisk Forsknings digitala arkiv

Shared decision-making in mental health care : a user perspective on decisional needs in community-based services

BACKGROUND: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice. OBJECTIVE: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden. METHODS: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.'s model of SDM. RESULTS: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

Parenthood in transition : Somali-born parents' experiences of and needs for parenting support programmes

BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

Unfulfilled rehabilitation needs and dissatisfaction with care 12 months after a stroke : an explorative observational study

BACKGROUND: People who have suffered a stroke commonly report unfulfilled need for rehabilitation. Using a model of patient satisfaction, we examined characteristics in individuals that at 3 months after stroke predicted, or at 12 months were associated with unmet need for rehabilitation or dissatisfaction with health care services at 12 months after stroke. METHODS: The participants (n = 175) received care at the stroke units at the Karolinska University Hospital, Sweden. The dependent variables "unfulfilled needs for rehabilitation" and "dissatisfaction with care" were collected using a questionnaire. Stroke severity, domains of the Stroke Impact Scale (SIS), the Sense of Coherence scale (SOC) and socio demographic factors were used as independent variables in four logistic regression analyses. RESULTS: Unfulfilled needs for rehabilitation at 12 months were predicted by strength (SIS) (odds ratio (OR) 7.05) at three months, and associated with hand function (SIS) (OR 4.38) and poor self-rated recovery (SIS) (OR 2.46) at 12 months. Dissatisfaction with care was predicted by SOC (OR 4.18) and participation (SIS) (OR 3.78), and associated with SOC (OR 3.63) and strength (SIS) (OR 3.08). CONCLUSIONS: Thirty-three percent of the participants reported unmet needs for rehabilitation and fourteen percent were dissatisfied with the care received. In order to attend to rehabilitation needs when they arise, rehabilitation services may need to be more flexible in terms of when rehabilitation is provided. Long term services with scheduled re-assessments and with more emphasis on understanding the experiences of both the patients and their social networks might better be able to provide services that attend to patients' needs and aid peoples' reorientation; this would apply particularly to those with poor coping capacity.

O Processo de agencificação no Brasil: divergência ou mimetismo?

O presente trabalho tem como objetivo analisar o processo de difusão das agências reguladoras independentes no Brasil, ou agencificação, com o intuito de verificar se este processo foi convergente ou divergente, de acordo com duas perspectivas teóricas concorrentes que buscam compreender os processos de difusão. Para isso, foram verificados os mecanismos de difusão – natureza política, verticais e horizontais – e identificadas variáveis contextuais relevantes – como a aparente confusão feita entre flexibilidade de gestão e regulação, o federalismo regulatório, a presença de atores setoriais fortemente articulados, e a importância das moedas de troca no presidencialismo multipartidário brasileiro – que atuaram no processo brasileiro de agencificação. As peculiaridades do caso brasileiro, como a criação de uma agência independente para o cinema e as mudanças ocorridas em âmbito estadual, indicam tratar-se de uma “difusão sem convergência” ou “convergência divergente”, uma vez que, embora o Brasil tenha experimentado uma “explosão” de agências reguladoras, estas foram modeladas de acordo com as necessidades locais e especificidades do contexto nacional.

Influência do lodo de ETE na massa para fabricação de cerâmica vermelha

The WTP produce many kinds of residue on your treatment stages, but the sludge is the more problematic from the final disposition point view. The actual rate of residue production deriving from technological evolution and the crescent population needs prevents the subtle equilibrium generation between consumption and recycling/reuse, creating problems of pollution resulting from inappropriate management of residues. Thus, is necessary achieve a new equilibrium between the grow from raw materials and energy and the residue generation. This equilibrium should be achieved by technical and economic feasibility of environmental supported models through recycling and reuse. The red ceramic industry stand out in residue absorption question as raw material due their clay mass heterogeneity, constituted by clay minerals and non-clay minerals with wide mineralogical variation, allowing residue inclusion which act like plastic or non-plastic materials, contributing to retain heavy metals contained in residues in the vitreous mass formed during the burning of the ceramic bodies. This work propose the study of the influence of incorporation of 25 wt.% sludge from wastewater treatment plant, according preliminary results, in the mass to produce ceramic bodies. The raw materials was characterized through chemical composition analyses by XRF, mineralogical analyses by XRD, thermal analyses by TG and DTA, Atterberg limits and thermodilatometry. Subsequently was composed the mass with 75 wt.% of clay and 25 wt.% of dried wastewater sludge from UFRN WWTP. Samples with 6,0 x 2,0 x 0,5 cm was produced with unidirectional compacting under pressure of 20MPa and burned in temperatures between 950 and 1,200ºC. After fired, the ceramic bodies have been submitted to physical and mechanical analyses through the measure of firing shrinkage, water absorption, density, apparent porosity and flexural strength; crystallographic analyses through XRD and microstructure analyses by SEM. The technological properties obtained was satisfactory to production of roof tiles with 25 wt.% at 1,200 ºC, but the production of others products at lower temperatures was not feasible

Identidade e participação da comunidade rural nos processos de desenvolvimento local:desafios e competências do regulado de Nhambita-Moçambique

This thesis is defined as a reflection on the mechanisms of expression and insertion of the homo situs in the participatory governance in Mozambique. For a better understanding of this social fact, it was settled a periodization which covered the decline of colonialism at the time of the independence, which was proclaimed in June 1975, the civil war that lasted over 16 years and the period of the democratic State, further established. Therefore, we sought to understand the mechanisms and failures of the participation of the homo situs in local development projects that absorbed the needs and problems of these peasants, not mobilizing the skills and social competences of these communities. It would be essential for the homo situs a genuine democratic practice involving a political culture based on the social construction of the territories of the traditional man which was characterized by being procedural and historical, finding in participation its higher base. In this context, it would be desirable that the community development in Mozambique could contemplate and respect the choices of the homo situs. For this purpose, it would be fundamental the consistency between theory and practice, which builds and rebuilds, continually the competence of the peasants, facilitating the possibility of realization of their primordial aspirations. In the research, it became apparent that there is not a continuous process of participation of the rural communities, which appear as participants, only at the time of the implementation of the activities. Therefore, even having the participation of the communities expected by the law, with predictable moments of discussion and necessary conditions for that, the State failed to establish an ongoing process of democratic dialogue with traditional populations, as well as it failed to organize, properly, accurate informational bases to help solve the problems of rural areas. These facts have led to obstacles to the process of conquest of the human and civil rights of the traditional communities

O desenvolvimento sustentável na ordem constitucional e sua promoção através do planejamento urbano

The man, being subject and object of their changes, has passed by many process to find a better life way. Since your existence, he finds to live in groups for make easy your life and make concrete yours desires. All by history, when the individual´s rights was establishment, collectives and lonely way, contribute for evaluate the relationship between individuals and they own, and them and state, which has a duty to those, positive or negative, depending on the case. The circle of fundamentals rights has been sustainable development and the concept of growth economy associated to the environment protection. This association reflect a apparent conflict between values very distinct, but the constitutional interpretation can be reunite both of them and make it live in harmony; values of environmental order and economical order can be exist together, as long as the state contribute to this. On the city, where the most of relationships happening, the urban plan appear how a effective way of sustainable development, finding the harmony between the growth economy and environment protection. To effective the socials functions of the city (inhabit, circulate, work and entertainment) and the citizen´s life quality, the city is the scenery that show how the urban plan, across established previously legal instruments, like the governmental public politics, to effective the right to development, right of third generation. The director plan how effective tool for local needs - obligation defined by Citizen Statute that contribute for the program linked defined by the urban plan. The state´s intervention on the private sector of citizen, and the restriction on their rights are be justified by the collective´s rights and their quality of life. So, in front the urban scenery has been the plan to make social functions of city, the healthy way of life, which is the sustainable development

Effects of different sampling intervals on apparent protein and energy digestibility of common feed ingredients by juvenile oscar fish (Astronotus ocellatus)

O presente estudo avaliou a digestibilidade aparente da proteína e da energia de ingredientes (farelo de soja, farinha de peixe, farelo de trigo e milho) por juvenis de apaiari (Astronotus ocellatus) usando dois diferentes intervalos de coleta (30 min. e 12h). Os 160 juvenis de apaiari utilizados (22,37 ± 3,06 g de peso corporal) foram divididos em quatro tanques rede plásticos e cilíndricos, cada um colocado em um tanque de alimentação de 1.000 L. O experimento foi inteiramente casualizado em esquema fatorial 2 x 4 (2 intervalos de coleta de fezes e 4 ingredientes foram) com quatro repetições. Os testes estatísticos não detectaram efeito da interação entre o intervalo de coleta e tipo de ingrediente nos coeficientes de digestibilidade. O intervalo de coleta não afetou a digestibilidade da proteína e da energia. As características físicas das fezes dos juvenis de apaiari aparentemente as tornam menos sensíveis à perda de nutrientes por lixiviação, permitindo intervalos de coleta maiores. A digestibilidade da proteína dos ingredientes avaliados foi semelhante, mostrando que a digestibilidade aparente de ingredientes animais e vegetais por juvenis de apaiari é eficiente. Os coeficientes de digestibilidade da energia foram maiores para a farinha de peixe e o farelo de soja comparado a farelo de trigo e milho. Ingredientes ricos em carboidratos (farelo de trigo e milho) apresentaram os piores coeficientes de digestibilidade da energia e, portanto, não são usados eficientemente pelos juvenis de apaiari.