Medicines non-use in primary care

This study expands the current knowledge base on the nature, causes and fate of unused medicines in primary care. Three methodologies were used and participants for each element were sampled from the population of Eastern Birmingham PCT. A detailed assessment was made of medicines returned to pharmacies and GP surgeries for destruction and a postal questionnaire covering medicines use and disposal was used to patients randomly selected from the electoral roll. The content of this questionnaire was informed by qualitative data from a group interview on the subject. By use of these three methods it was possible to triangulate the data, providing a comprehensive assessment of unused medicines. Unused medicines were found to be ubiquitous in primary care and cardiovascular, diabetic and respiratory medicines are unused in substantial quantities, accounting for a considerable proportion of the total financial value of all unused medicines. Additionally, analgesic and psychoactive medicines were highlighted as being unused in sufficient quantities for concern. Anti-infective medicines also appear to be present and unused in a substantial proportion of patients’ homes. Changes to prescribed therapy and non-compliance were identified as important factors leading to the generation of unused medicines. However, a wide array of other elements influence the quantities and types of medicines that are unused including the concordancy of GP consultations and medication reviews and patient factors such as age, sex or ethnicity. Medicines were appropriately discarded by 1 in 3 patients through return to a medical or pharmaceutical establishment. Inappropriate disposal was by placing in household refuse or through grey and black water with the possibility of hoarding or diversion also being identified. No correlations wre found between the weight of unused medicines and any clinical or financial factor. The study has highlighted unused medicines to be an issue of some concern and one that requires further study.

Black middle school students' perceptions of success and their influence on academic performance

The purpose of the study was to investigate the perceptions of success held by Black middle school students in a Miami-Dade County (FL) public school and how these perceptions influence academic performance. The study sought to determine if differences exist among African-American, Haitian-American, and Haitian immigrant subgroups of the Black student population. ^ The study combined qualitative and quantitative methodology in data collection and analysis. The qualitative data consisted of three focus group interviews. Using a semi-structured protocol, questions focused on the student's perceptions of the characteristics of successful people, definitions of success, behaviors associated with achieving success, and peer, family and school support. The quantitative data comprised the responses of 352 Black middle school students to the Inventory of Student Motivation (ISM) developed to measure mastery, performance and social goal orientations. Response similarities and differences were examined using a series of two-way ANOVAs on the success scales by gender and culture. A three-way repeated measures ANOVA was conducted on mastery, performance and social general goal scales by culture and gender. ^ The results of the ISM revealed no statistically significant differences among African-American, Haitian-American, and Haitian students in their mastery, performance or social goal orientations. All three cultural groups scored significantly high on the mastery goal scale. There was a significant effect for gender on the mastery general scale with the females being more concerned with mastery than the males. Qualitative focus group interview results included varying definitions of success. African-American and Haitian-American students defined success in materialistic terms. Haitian students defined success in scholastic achievement terms. All students indicated hard work, persistence and goal setting through completion as important to achieving success. Negative influences included peer pressure, teacher and societal expectations, and classroom environment. Parental reaction to low academic performance varied by culture. ^

Perceptions of underprepared community college students regarding their educational achievement

The purpose of this study was to understand the perceptions of underprepared college students who had participated in learning communities and who persisted to complete developmental classes and earned at least 30 college-level credit hours to graduate and the perceptions of their peers who had dropped out of college. The theories posed by Tinto, Astin, and Freire formed the framework for this case study. The 22 participants were graduates or transfer students now attending a public university, currently-enrolled sophomores, and students no longer enrolled at the time of the study. Semi-structured individual interviews and a group interview provided narrative data which were transcribed, coded, and analyzed to gain insights into the experiences and perspectives of the participants. The group interview provided a form of member checking to increase accuracy in interpreting themes. A peer reviewer provided feedback on the researcher’s data analysis procedures. The analysis yielded four themes and 14 sub-themes which captured the essence of the participants’ experiences. The pre-college characteristics/traits theme described the students’ internal values and attributes acquired prior to college. The external college support/community influence theme described the encouragement to attend college the students received from family, friends, and high school teachers. The social involvement theme described the students’ participation in campus activities and their interactions with other members of the campus. The academic integration theme described students’ use of campus resources and their contacts with the faculty. The persisters reported strong family and peer support, a sense of responsibility, appreciation for dedicated and caring faculty, and a belief that an education can be a liberatory means to achieve their goals. The non-persisters did not report having the same sense of purpose, goal orientation, determination, obligation to meet family expectations, peer support, campus involvement, positive faculty experiences, and time management skills. The researcher offers an emerging model for understanding factors associated with persistence and three recommendations for enhancing the academic experience of underprepared college students: (a) include a critical pedagogy perspective in coursework where possible, (b) integrate co-curricular activities with the academic disciplines, and (c) increase student-faculty interaction.

Language learning strategy use by colombian adult English language learners: A phenomenological study

The purpose of this phenomenological study was to describe how Colombian adult English language learners (ELL) select and use language learning strategies (LLS). This study used Oxford’s (1990a) taxonomy for LLS as its theoretical framework. Semi-structured interviews and a focus group interview, were conducted, transcribed, and analyzed for 12 Colombian adult ELL. A communicative activity known as strip story (Gibson, 1975) was used to elicit participants’ use of LLS. This activity preceded the focus group session. Additionally, participants’ reflective journals were collected and analyzed. Data were analyzed using inductive, deductive, and comparative analyses. Four themes emerged from the inductive analysis of the data: (a) learning conditions, (b) problem-solving resources, (c) information processing, and (d) target language practice. Oxford’s classification of LLS was used as a guide in deductively analyzing data concerning the participants’ experiences. The deductive analysis revealed that participants do not use certain strategies included in Oxford’s taxonomy at the third level. For example, semantic mapping, or physical response or sensation was not reported by participants. The findings from the inductive and deductive analyses were then compared to look for patterns and answers to the research questions. The comparative analysis revealed that participants used additional LLS that are not included in Oxford’s taxonomy. Some examples of these strategies are: using sound transcription in native language and help from children. The study was conducted at the MDC InterAmerican campus in South Florida, one of the largest Hispanic-influenced communities in the U.S. Based on the findings from this study, the researcher proposed a framework to study LLS that includes both external (i.e., learning context, community) and internal (i.e., culture, prior education) factors that influence the selection and use of LLS. The findings from this study imply that given the importance of the both external and internal factors in learners’ use of LLS, these factors should be considered for inclusion in any study of language learner strategies use by adult learners. Implications for teaching and learning as well as recommendations for further research are provided.

Ensino colaborativo e educação física: contribuições à inclusão escolar

In Brazil, special education public is a challenge to all teachers, especially to Physical Education ones. Among others, it encompasses students with disabilities, students with intellectual giftedness, and students with pervasive developmental disorder. Besides posing challenges, the inclusion process causes worry and generates debates on problems that impede the full partaking of such pupils in schooling practices related to physical education. This thesis presents a research that focused on these matters by means of co-working involving the researcher and the Physical Education teacher in regular classrooms following co-teaching perspective. The starting point of the research is the following question: what contributions co-working involving Physical Education teacher and researcher may provide to people with disabilities and to Physical Education teacher in regular schools attended by students who are the special education’s target? The research aimed at discussing and analyzing the development of such co-working activity involving the researcher and Physical Education teacher. It followed co-teaching perspective and was put into practice in a public school in Uberlândia, state of Minas Gerais. Participant qualitative approach, which recognizes relations between social sciences and intervention in social reality, was the methodological choice to develop the research in three phases: 1) making the research; 2) intervening in social reality; 3) assessing/diagnosing it. Strategies to gather data included semi structured interview, questionnaire, participant observation, and group interview. Data come, above all, from oral accounts as well as from the work by the group of participants of the research, which means, researcher, Physical Education teacher who works at regular schools and three teachers who deal with AEE (Atendimento Educacional Especial), a special educational teaching program. The concept of inclusion is discussed accordingly to authors such as Miranda (2001), Mantoan (2001), Duarte and Santos (2003), Mittler (2003), Rodrigues (2006), and Bueno (2008). The conception of co-working is developed in the light of studies by Capellini (2004) and Mendes (2009), among others. Results point out not only initial conditions of anguish, doubts and hardships, but also a will to debate difficulties Physical Education teachers face in their daily pedagogical activities at school. Likewise, results showed that teachers who took part in the research are interested in continuing their training in connection with co-teaching as strategy to teach physical education at inclusive schools.

Perceptions of Underprepared Community College Students regarding their Educational Achievement

The purpose of this study was to understand the perceptions of underprepared college students who had participated in learning communities and who persisted to complete developmental classes and earned at least 30 college-level credit hours to graduate and the perceptions of their peers who had dropped out of college. The theories posed by Tinto, Astin, and Freire formed the framework for this case study. The 22 participants were graduates or transfer students now attending a public university, currently-enrolled sophomores, and students no longer enrolled at the time of the study. Semi-structured individual interviews and a group interview provided narrative data which were transcribed, coded, and analyzed to gain insights into the experiences and perspectives of the participants. The group interview provided a form of member checking to increase accuracy in interpreting themes. A peer reviewer provided feedback on the researcher’s data analysis procedures. The analysis yielded four themes and 14 sub-themes which captured the essence of the participants’ experiences. The pre-college characteristics/traits theme described the students’ internal values and attributes acquired prior to college. The external college support/community influence theme described the encouragement to attend college the students received from family, friends, and high school teachers. The social involvement theme described the students’ participation in campus activities and their interactions with other members of the campus. The academic integration theme described students’ use of campus resources and their contacts with the faculty. The persisters reported strong family and peer support, a sense of responsibility, appreciation for dedicated and caring faculty, and a belief that an education can be a liberatory means to achieve their goals. The non-persisters did not report having the same sense of purpose, goal orientation, determination, obligation to meet family expectations, peer support, campus involvement, positive faculty experiences, and time management skills. The researcher offers an emerging model for understanding factors associated with persistence and three recommendations for enhancing the academic experience of underprepared college students: (a) include a critical pedagogy perspective in coursework where possible, (b) integrate co-curricular activities with the academic disciplines, and (c) increase student-faculty interaction.

Étude exploratoire des transitions de milieux de vie en communauté des personnes présentant une déficience intellectuelle

Cette étude exploratoire dresse un portrait des transitions de milieux de vie (MDV) dans des Centres de réadaptation en déficience intellectuelle et en troubles envahissants du développement (CRDITED) de la grande région de Montréal. Elle permet d’identifier 1) les pratiques de transition de MDV des intervenants pivots en CRDITED, 2) les critères de succès de la transition de MDV et les moyens de les évaluer selon les personnes présentant une déficience intellectuelle et les intervenants pivots et 3) l’écart entre les pratiques souhaitées et les pratiques actuelles à partir du point de vue des deux types de participants. Des personnes présentant une déficience intellectuelle (N = 9) et des intervenants pivots (N = 19) se sont exprimés sur leurs expériences de transition de MDV en participant à des entretiens de groupe. Une analyse qualitative de contenu a permis d’identifier une typologie des expériences de transition de MDV du point de vue des intervenants pivots. Un seul type de transition de MDV parmi les cinq identifiés, le type préparée, offre des conditions favorisant la réalisation de la transition dans des conditions satisfaisantes pour les intervenants pivots. Les autres types de transitions (types dernière minute, explosive, clé en main et salle d’attente) offrent peu d’occasions pour la personne présentant une déficience intellectuelle de s’impliquer dans le processus de transition. Les propos des intervenants pivots permettent d’identifier les caractéristiques d’une transition de MDV qu’ils jugent idéale (type comme si c’était moi). Les types de transitions sont comparés entre eux sur deux axes, soit sur l’axe représentant un continuum d’implication de la personne présentant une déficience intellectuelle dans sa propre transition et sur l’axe identifiant les grandes étapes de réalisation de la transition. Les résultats permettent de déceler un écart important entre les transitions actuellement effectuées et les politiques, intentions et engagements de l’offre de service auprès de cette clientèle, notamment au regard de l’implication de la personne présentant une déficience intellectuelle dans les décisions relatives à sa transition de MDV. L’étude permet aussi d’identifier trois dimensions importantes de l’évaluation du succès de la transition selon les perspectives des personnes présentant une déficience intellectuelle et des intervenants pivots. Les dimensions identifiées sont : bien-être psychologique et comportement, santé physique et collaboration. Les propos des intervenants pivots permettent de constater qu’il existe parfois un paradoxe entre leurs perceptions du succès de la transition de MDV et celles des personnes présentant une déficience intellectuelle. L’interprétation des résultats a permis d’élaborer des recommandations afin de favoriser de meilleures pratiques de transition.

Rapports différenciés aux médias entre trois générations de femmes réfugiées au Québec

Cette thèse présente l’analyse des propos de trois générations de femmes réfugiées au Québec sur les manières dont ces femmes s’exposent, s’identifient et s’approprient le discours des médias pour ensuite en discuter entre elles. L’analyse permet de cerner certaines de leurs pratiques d’insertion et d’adaptation à un nouveau milieu de vie. L’immigration favorise de plus en plus l’éclosion des « cultures de la mixité », lesquelles représentent un enjeu incontournable en matière d’intégration. Quant aux médias, ils sont une source incontournable d’accès à l’information et à la culture. Le développement des techniques de transmission telles les réseaux câblés, le satellite de diffusion directe, Internet et le numérique permet au consommateur de médias, quel que soit son origine, de s’approprier de façon personnelle les produits culturels qui en retour déterminent la participation à la vie active dans la société hôte. Cette nouvelle intégration culturelle se transmet-elle aisément au sein des générations d’immigrantes? Cette thèse découle aussi d’un projet plus vaste sur les transmissions intergénérationnelles des savoirs, des pratiques et de l’entraide entre trois générations de femmes réfugiées au Québec (Vatz Laroussi, Guilbert & al. CRSH, 2009-2012). Étudier les transmissions de savoirs au sein des familles immigrantes, c’est reconnaitre avec les auteurs contemporains l’importance de la transmission et de la circulation des histoires personnelles s’inscrivant dans une histoire familiale et sociale de l’époque a méthodologie adoptée s’appuie sur les entretiens semi-directifs, le commentaire réflexif ainsi que l’analyse de contenu. La démarche méthodologique a été empruntée au projet principal. Les entretiens réalisés auprès des familles de réfugiés établis dans plusieurs régions du Québec (Sherbrooke, Joliette, Québec et Montréal) ont été réalisés par une équipe pluridisciplinaire, multiculturelle et féminine. L’originalité de cette recherche se trouve entre autres dans la collecte d’information qui s’est faite auprès de trios générationnels (grand-mère, mère et fille). Chaque membre du trio a été rencontré de façon individuelle et par la suite, le trio s’est formé pour une dernière entrevue de groupe. Ainsi, une analyse thématique des discours des répondants a été réalisée. Cette analyse a permis de mettre en perspective divers éléments proéminents relatifs à la relation entre les médias et chaque membre du trio générationnel. Il a été constaté que les médias sont appréhendés différemment par chaque membre du trio, que des médias comme la télévision et l’Internet sont les plus prisés par les jeunes et ils servent à la fois de fenêtre sur le pays d’accueil, d’ouverture sur le monde et d’expression de soi-même face aux frustrations vécues au Québec. En dernier lieu, une analyse de la question de la transmission intergénérationnelle au prisme des médias entre les trois générations de femme réfugiée a été faite. On constate que dans les trios, la transmission n’est pas unidirectionnelle. Elle va dans tous les sens. Sortant des sentiers battus elle devient un espace de création.

Tecnologia social para autogestão : um estudo em empreendedorismo econômico solidário da cadeia produtiva da cajucultura no Rio Grande do Norte

The theme of this dissertation is social technology for self-management: a study in economic enterprise supportive of Rio Grande do Norte. The research aimed to obtain evidence that the reapplication of technology management, basic economic-financial and pricing, as production costs, has the potential to contribute to the self-management of APABV. The social technology and self-management are theoretical frameworks used and where workers are central figures in both the generation and replication of technologies that are compatible with their realities, as in the conduct and management approach adopted by them in their venture, they are makers decisions. To achieve the proposed objective was accomplished participatory research, which was used in addition to document analysis, participatory methodologies such as the construction of the DRP, group interview, experience in the production environment and family of entrepreneurs APABV. This research allowed the management technologies such as spreadsheets controls basic economic and financial costs, when socialized and understood by workers has the potential informational and become part of their daily decision-making process of the project, making up social technology

Children of Matter: Luxury Value Perceptions of Millennials in Higher Education in Europe

In recent years, the luxury market has entered a period of very modest growth, which has been dubbed the ‘new normal’, where varying tourist flows, currency fluctuations, and shifted consumer tastes dictate the terms. The modern luxury consumer is a fickle mistress. Especially millennials – people born in the 1980s and 1990s – are the embodiment of this new form of demanding luxury consumer with particular tastes and values. Modern consumers, and specifically millennials, want experiences and free time, and are interested in a brand’s societal position and environmental impact. The purpose of this thesis is to investigate what the luxury value perceptions of millennials in higher education are in Europe, seeing as many of the most prominent luxury goods companies in the world originate from Europe. Perceived luxury value is herein examined from the individual’s perspective. As values and value perceptions are complex constructs, using qualitative research methods is justifiable. The data for thesis has been gathered by means of a group interview. The interview participants all study hospitality management in a private college, and each represent a different nationality. Cultural theories and research on luxury and luxury values provide the scientific foundation for this thesis, and a multidimensional luxury value model is used as a theoretical tool in sorting and analyzing the data. The results show that millennials in Europe value much more than simply modern and hard luxury. Functional, financial, individual, and social aspects are all present in perceived luxury value, but some more in a negative sense than others. Conspicuous, status-seeking consumption is mostly frowned upon, as is the consumption of luxury goods for the sake of satisfying social requisites and peer pressure. Most of the positive value perceptions are attributed to the functional dimension, as luxury products are seen to come with a promise of high quality and reliability, which justifies any price premiums. Ecological and ethical aspects of luxury are already a contemporary trend, but perceived even more as an important characteristic of luxury in the future. Most importantly, having time is fundamental. Depending on who is asked, luxury can mean anything, just as much as it can mean nothing.

Customer needs in innovation and R&D strategy development

Tutkimuksen kohteena oleva yritys avasi innovaatiokeskuksen 2015 vuoden loppupuolella. Tutkimuksen tavoite on tutkia keinoja löytää asiakastarpeita innovaatiokeskuksessa sekä selvittää, kuinka asiakastarpeet sisällytetään innovaatio- ja tuotekehitysstrategiaan. Kattava prosessi asiakastarvekartoituksesta esitellään ja prosessi säädetään yritykselle sopivaksi asiakkaille tehdyn kyselyn tulosten mukaan. Lisäksi yrityksen tuotepäälliköille järjestettiin haastattelu, jotta heidän näkemyksiään asiakastarvekartoituksen kehittämisestä ja tarpeiden lisäämisestä strategiaan päästiin myös hyödyntämään. Asiakastarpeiden kartoittamiseen soveltuvaksi menetelmäksi löydettiin ryhmätyömalliin perustuva menetelmä, jossa tarpeita kerätään innovaatiokeskuksessa. Lisäksi tietokoneita hyödyntävä GDSS-kokous auttaa välttämään useita yleisiä kokousten ongelmia. Tutkimuksen mukaan asiakastarpeiden suuret kehityslinjat ja kaikista tärkeimmät tarpeet voidaan lisätä strategiaan hyödyntämällä innovaatiokenttiä, skenaarioita ja roadmappeja sekä asiakastarvetaulukkoja.

Étude exploratoire des transitions de milieux de vie en communauté des personnes présentant une déficience intellectuelle

Cette étude exploratoire dresse un portrait des transitions de milieux de vie (MDV) dans des Centres de réadaptation en déficience intellectuelle et en troubles envahissants du développement (CRDITED) de la grande région de Montréal. Elle permet d’identifier 1) les pratiques de transition de MDV des intervenants pivots en CRDITED, 2) les critères de succès de la transition de MDV et les moyens de les évaluer selon les personnes présentant une déficience intellectuelle et les intervenants pivots et 3) l’écart entre les pratiques souhaitées et les pratiques actuelles à partir du point de vue des deux types de participants. Des personnes présentant une déficience intellectuelle (N = 9) et des intervenants pivots (N = 19) se sont exprimés sur leurs expériences de transition de MDV en participant à des entretiens de groupe. Une analyse qualitative de contenu a permis d’identifier une typologie des expériences de transition de MDV du point de vue des intervenants pivots. Un seul type de transition de MDV parmi les cinq identifiés, le type préparée, offre des conditions favorisant la réalisation de la transition dans des conditions satisfaisantes pour les intervenants pivots. Les autres types de transitions (types dernière minute, explosive, clé en main et salle d’attente) offrent peu d’occasions pour la personne présentant une déficience intellectuelle de s’impliquer dans le processus de transition. Les propos des intervenants pivots permettent d’identifier les caractéristiques d’une transition de MDV qu’ils jugent idéale (type comme si c’était moi). Les types de transitions sont comparés entre eux sur deux axes, soit sur l’axe représentant un continuum d’implication de la personne présentant une déficience intellectuelle dans sa propre transition et sur l’axe identifiant les grandes étapes de réalisation de la transition. Les résultats permettent de déceler un écart important entre les transitions actuellement effectuées et les politiques, intentions et engagements de l’offre de service auprès de cette clientèle, notamment au regard de l’implication de la personne présentant une déficience intellectuelle dans les décisions relatives à sa transition de MDV. L’étude permet aussi d’identifier trois dimensions importantes de l’évaluation du succès de la transition selon les perspectives des personnes présentant une déficience intellectuelle et des intervenants pivots. Les dimensions identifiées sont : bien-être psychologique et comportement, santé physique et collaboration. Les propos des intervenants pivots permettent de constater qu’il existe parfois un paradoxe entre leurs perceptions du succès de la transition de MDV et celles des personnes présentant une déficience intellectuelle. L’interprétation des résultats a permis d’élaborer des recommandations afin de favoriser de meilleures pratiques de transition.

(inter)FACE: A Study of Black Families Advocating for their Children’s Education

Black students are consistently overrepresented in categories of academic underachievement. Parent engagement has long been touted as an effective strategy for improving the educational outcomes of Black children. However, most parent engagement research reflects deficit based perspectives frame Black parents as problems that must be fixed or mitigated before they can positively contribute to their children’s education. Consequently, parent engagement research and frameworks ignore the perspectives of Black parents and the assets they use to participate effectively in parent engagement. In this case study, I draw on individual and focus group interview data, documents, and observations, to examine how fifteen Black families, collectively known as FACE: 1) define and participate in parental engagement, 2) experience barriers to and opportunities for engagement, and 3) experience benefits of engagement for their children and their own personal development. Guided by Black Feminist and Critical Race Theories, I show how Black families in this study used a myriad of engagement strategies to improve their children’s educational experiences which were invisible to schools and how they used school-sanctioned engagement activities to meet their own objectives. Ultimately, I argue that school-centered parent engagement frameworks and models are ineffective for empowering Black families and accounting for the essential ways that these families contribute to the well-being of their children. Based on my findings, I discuss implications for theory, practice and policy, and research, and make recommendations for a more family-centered approach to parent engagement.

Tecnologia social para autogestão : um estudo em empreendedorismo econômico solidário da cadeia produtiva da cajucultura no Rio Grande do Norte

The theme of this dissertation is social technology for self-management: a study in economic enterprise supportive of Rio Grande do Norte. The research aimed to obtain evidence that the reapplication of technology management, basic economic-financial and pricing, as production costs, has the potential to contribute to the self-management of APABV. The social technology and self-management are theoretical frameworks used and where workers are central figures in both the generation and replication of technologies that are compatible with their realities, as in the conduct and management approach adopted by them in their venture, they are makers decisions. To achieve the proposed objective was accomplished participatory research, which was used in addition to document analysis, participatory methodologies such as the construction of the DRP, group interview, experience in the production environment and family of entrepreneurs APABV. This research allowed the management technologies such as spreadsheets controls basic economic and financial costs, when socialized and understood by workers has the potential informational and become part of their daily decision-making process of the project, making up social technology

Rättfärdigade prioriteringar - en kvalitativ analys av hur personal i äldreomsorgen hanterar motstridiga verksamhetslogiker

Tidigare forskning visar att äldreomsorgspersonal kämpar med två typer av logiker: en ekonomisk logik och en omsorgslogik. Även om båda logikerna behövs för att skapa god omsorg så utmanar de varandra. Dessa utmaningar kommer till uttryck i omsorgspraktiken där personalen ställs in för val och måste göra prioriteringar. Denna avhandling syftar till att förstå hur äldreomsorgspersonal beskriver att de arbetar för att finna balans mellan logikerna och hur de rättfärdigar sina prioriteringar i omsorgen om de äldre personerna. Frågeställningen för avhandlingen är att ta reda på hur personal och enhetschef vid ett kommunalt äldreboende förstår och hanterar interaktionen mellan de två logiker som styr omsorgsarbetet för att främja de äldre personernas välbefinnande. Syftet innehåller tre delsyften: 1) att analysera personalens erfarenheter av och meningsskapande kring de äldre personernas välbefinnande och deras reflektioner kring det omsorgsarbete de utför, 2) att belysa och problematiserade logiker som styr omsorgsarbetet samt 3) att analysera hur personalen rättfärdigar sina prioriteringar i rådande kontext och hur deras förklarbarhet påverkar deras professionella identiteter. Målet är att bidra med socialvetenskaplig kunskap om de överväganden personal gör när de ställs inför att göra prioriteringar i äldreomsorgens praktik. Material samlades in genom 12 individuella intervjuer med personal vid ett kommunalt äldreboende, en intervju med personalens enhetschef och en uppföljande gruppintervju med tre personer ur personalgruppen. Materialet analyserades med tre analysmetoder: fenomenologisk analys, reflexiv analys och positioneringsanalys. Resultatet visar att personalen definierar de äldre personernas välbefinnande som ett behov av att känna sig existentiellt berörd. Denna känsla av existentiell beröring delas in i tre delar: känsla av valfrihet, känsla av njutning och känsla av närhet till någon eller något. Arbetet för att uppnå detta välbefinnande beskrivs innebära ett balanserande av tre tvetydigheter: att vilja värna om de äldre personernas valfrihet och samtidigt hantera institutionella begränsningar, de äldre personernas behov av aktivering å ena sidan och att de inte behöver aktiveras å andra sidan samt att förstå de äldre personernas behov av rutiner samtidigt som det är svårt att veta vilka behov de har. Tvetydigheterna kontextualiserades och de två logikerna som styr omsorgsarbetet analyserades. Analysen visar att enhetschefen skapar en hybrid av den ekonomiska logiken och omsorgslogiken; ekonomi är omsorg och vice versa. Denna hybrid möter motstånd från personalen som skiljer på de båda logikerna genom att tala om ”vård och det där andra”. Personalen upplever att den ekonomiska logiken begränsar deras möjligheter att utföra omsorg i linje med omsorgslogiken. Motsättningar mellan de båda logikerna leder till prioriteringar som rättfärdigas av personalen i syfte att behålla de professionella identiteterna. Den teoretiska analysen bygger på teorier om institutionella logiker, förklarbarhet ochprofessionell identitet. Analyserna visar vikten av att väcka dialog mellan enhetschefer och personal där de diskuterar innebörder av olika värdeord som används på politisk nivå. Sådana diskussioner skulle kunna bidra till mindre motstånd och en högre överensstämmelse mellan verksamhetsmål och praktik. Avhandlingen visar även vikten av att förstå logiker som vertikala istället för horisontellt uppdelade. Alltså, att styrande verksamhetslogiker existerar uppifrån och ned i verksamheter (från politisk nivå till chefsnivå och till praktisk nivå) och att de inte kan delas in i exempelvis en professionslogik och en styrningslogik. Den senare synen kan bidra till potentiella missförstånd eftersom det gör att konflikter kan tolkas existera mellan personal och chef, medan de egentligen existerar mellan olika motstridiga värderingssystem. Slutsatsen är att de båda logikerna behövs för att stödja äldre personers välbefinnande. Ibland är logikerna samspelta och ibland är de i konflikt med varandra. När logikerna ställs mot varandra är det av vikt att komma ihåg att den ekonomiska logiken är lika förhandlingsbar som omsorgslogiken. De två logikerna existerar i samspel och om deras motstridigheter inte belyses finns risk att omsorgspraktiken inte stödjer de äldre personernas välbefinnande.