Formal caregivers' perceptions of quality of care for older people : associating factors

Background: Despite the growing number of studies concerning quality of care for older people, there is a lack of studies depicting factors associated with good quality of care from the formal caregivers' perspective. The aim was to describe formal caregivers' perceptions of quality of care for older people in the community and explore factors associated with these perceptions. In total, 70 nursing assistants, 163 enrolled nurses and 198 registered nurses from 14 communities in central Sweden participated in the study. They filled out the following questionnaires: a modified version of Quality from the Patient's Perspective, Creative Climate Questionnaire, Stress of Conscience Questionnaire, items regarding education and competence, Health Index and Sense of coherence questionnaire. The overall response rate was 57 % (n = 431). Results: In the perceived reality of quality of care respondents assessed the highest mean value in the dimension medical-technical competence and physical technical conditions and lower values in the dimensions; identity-oriented approach, socio-cultural atmosphere and in the context specific dimension. The caregivers estimated their competence and health rather high, had lower average values in sense of coherence and organizational climate and low values in stress of conscience. Conculsions: The PR of quality of care were estimated higher among NA/ENs compared to RNs. Occupation, organizational climate and stress of conscience were factors associated with quality of care that explained 42 % of the variance. Competence, general health and sense of coherence were not significantly associated to quality of care. The mentioned factors explaining quality of care might be intertwined and showed that formal caregivers' working conditions are of great importance for quality of care.

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.

The world of the Sumerian mother goddess : an interpretation of her myths

The present study is an interpretation of the two myths copied in the Old Babylonian period in which the Sumerian mother goddess is one of the main actors. The first myth is commonly called “Enki and Ninḫursaĝa”, and the second “Enki and Ninmaḫ”. The theoretical point of departure is that myths have society as their referents, i.e. they are “talking about” society, and that this is done in an ideological way. This study aims at investigating on the one hand which contexts in the Mesopotamian society each section of the myths refers to, and on the other hand which ideological aspects that the myths express in terms of power relations. The myths are contextualized in relation to their historical and social setting. If the myth for example deals with working men, male work in the area during the relevant period is discussed. The same method of contextualization is used regarding marriage, geographical points of reference and so on. Also constellations of mythical ideas are contextualized, through comparison with similar constellations in other Mesopotamian myths. Besides the method of contextualization, the power relations in the myths are investigated. According to this latter method, the categories at issue, their ranking, as well as their changed ranking, are noted. The topics of the myths are issues important for the kingship and the country, such as irrigation, trade, health and healing, birth, collective work, artisanry and rivalry. All these aspects are used in order to express what the power relations between the goddess Ninḫursaĝa/Ninmaḫ and the god Enki look like. The relations are negotiated and recalibrated, which leads to the goddess getting a lowered status. Part of the negotiations and recalibrations is gender behavior, which is related to historical developments in society. The present work points to the function of these myths as tools of recalibrating not only deities, but also men and women in society.

'Moving On' and Transitional Bridges : Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden

During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.

Barn och unga med en nära anhörig som avlidit : Barn och ungas erfarenheter av att delta i stödgrupp

I denna kvalitativa studie har enkäter insamlats från barn och unga som deltagit i stödgruppsverksamhet för barn och unga med en avliden nära anhörig i Dalarnas län. Syftet med studien har varit att beskriva deltagarnas erfarenheter av stödgrupperna. Genom kvalitativ innehållsanalys har tre kategorier identifierats; bearbetning, gemenskap och strukturens betydelse. Studien visar främst på betydelsen av att få träffa andra barn och unga i liknande situation samt indikerar till att deltagarnas KASAM (känsla av sammanhang) förhöjts genom deltagandet i stödgruppen.

‘Moving on’ : Violence, wellbeing and questions about violence in antenatal care encounters. A qualitative study with Somali-born refugees in Sweden

Background Somali-born women constitute one of the largest groups of childbearing refugee women in Sweden after more than two decades of political violence in Somalia. In Sweden, these women encounter antenatal care that includes routine questions about violence being asked. The aim of the study was to explore how Somali-born women understand and relate to violence and wellbeing during their migration transition and their views on being approached with questions about violence in Swedish antenatal care. Method Qualitative interviews (22) with Somali-born women (17) living in Sweden were conducted and analysed using thematic analysis. Findings A balancing actbetween keeping private life private and the new welfare system was identified, where the midwife's questions about violence were met with hesitance. The midwife was, however, considered a resource for access to support services in the new society. A focus on pragmatic strategies to move on in life, rather than dwelling on potential experiences of violence and related traumas, was prominent. Social networks, spiritual faith and motherhood were crucial for regaining coherence in the aftermath of war. Dialogue and mutual adjustments were identified as strategies used to overcome power tensions in intimate relationships undergoing transition. Conclusions If confidentiality and links between violence and health are explained and clarified during the care encounter, screening for violence can be more beneficial in relation to Somali-born women. The focus on “moving on” and rationality indicates strength and access to alternative resources, but needs to be balanced against risks for hidden needs in care encounters. A care environment with continuity of care and trustful relationships enhances possibilities for the midwife to balance these dual perspectives and identify potential needs. Collaborations between Somali communities, maternity care and social service providers can contribute with support to families in transition and bridge gaps to formal social and care services.

Methods and background characteristics of the TOHNN study : a population-based study of oral health conditions in northern Norway

OBJECTIVES: The aim of the Tromstannen - Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. STUDY DESIGN: Cross-sectional population-based study including a questionnaire and clinical dental examination. METHODS: A randomly selected sample of 2,909 individuals (20-79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20-34, 35-49, 50-64 and 65-79) and ethnicity (Norwegian, Sámi, other European and other world). RESULTS: From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20-34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. CONCLUSION: The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.

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.

Theoretical and experimental optical holography

The intent of this paper is to present an analysis of optical holography. Both the physical theory behind holography and the experimental techniques used in making holograms will be presented. To accomplish this goal, the paper is divided into two independent sections: the theoretical section followed by the experimental section. Each section is intended to be a complete unit. The Theoretical Section is an exposure to the theory behind holography. This consists of a review of the concepts of interference and diffraction. followed by a brief review of partial coherence. The remaining part of the Theoretical Section is devoted to the mathematical analysis of optical holography. The Experimental Section begins with an introduction to the equipment and facilities currently available for optical holography at Colby College. Holographic procedures is dominated by the description of transmission holography (v.s. reflection. or white-light. holography). After these general holographic procedures a few variations on the basic transmission hologram are presented. The experimental section will end with an introduction to holographic interferometry, a major application of holographic techniques.

O estilo gerencial do executivo público catarinense

The purpose of this study was make an utterance of the managerial style of the public executive from Santa Catarina and compare it with public executives from Minas Gerais and United States, considering their capacity in giving and receiving feedback and their opening or auto-expositions in the interrelations with subordinates. It began with a review of the literature about functions and managerial style from several contributions that exist in the theory of the organizations. The theoric countersignement used in this essay was stablished in “Johari’s Window”, of Luft, that brought the possibility of the analysis of the interpersonal relations, considering the feedback variants and opening. The research is descriptive and still comparative, being applied to public executives from Santa Catarina, between the occupants of the first and the second hierarchic rungs. The instrument used was the questionnaire “Personel Relations Surwey”, of John Hall and Martha Williams, the same was applied at the researches that had been made in Minas Gerais and in United States. It was evident, by the statistic analysis in coherence with the theoric model, several conclusions, among them we detach: a) The unexistence of a standart managerial style between public executives from Santa Catarina; b) Executives from this state use more feedback than executives from Minas Gerais and the same as north-americans; c) The executives from Santa Catarina have more opening (overture) than mineiros and north-americans; d) Some personel variants interfere in the managerial style of the public executive from Santa Catarina.

Um oposicionista na política baiana dos anos 1990: a trajetória de Paulo Jackson Vilasboas

Paulo Jackson Vilasboas nasceu em Caetité, no sertão da Bahia, em 8 de junho de 1952 e morreu em 19 de maio de 2000, no município de Morro do Chapéu, também no sertão. Formado em Engenharia pela Escola Politécnica da Universidade Federal da Bahia - UFBA, na década de 1980 destacou-se como um dos principais sindicalistas baianos, tendo sido presidente do Sindicato dos Trabalhadores em Água e Esgoto - SINDAE. Entretanto, foi durante a década de 1990, quando as forças políticas ligadas ao atual senador Antônio Carlos Magalhães dominavam a política no estado, que Paulo Jackson se destacou como um dos principais opositores ao grupo dominante. No período de 1993 a 2000, atuou como deputado estadual na Assembléia Legislativa da Bahia, tornando-se conhecido por ter feito oposição ao Carlismo, mas também por uma trajetória marcada pela coerência política e pela defesa de causas importantes como água e saneamento para toda a população.

Sobre a formação e o acesso a acervos de arte contemporânea: o caso do Ateliê Carlos Vergara

A institucionalização de acervos particulares de artistas não é um fenômeno recente, mas esse processo se acelerou nos últimos 30 anos. As transformações sociais decorrentes do estabelecimento de uma ordem econômica globalizada criaram novas regras no universo das organizações culturais. Este trabalho é o resultado de uma pesquisa sobre instituições responsáveis por gerir acervos de artistas contemporâneos realizada com o objetivo de encontrar diretrizes para a constituição de uma iniciativa da mesma ordem: o Ateliê Carlos Vergara. O tema foi examinado com base em entrevistas com cinco artistas plásticos brasileiros e em um levantamento sobre a trajetória de Carlos Vergara e de seu ateliê. Algumas questões relacionadas à organização e à preservação dos acervos, à sustentabilidade das instituições, ao papel dos herdeiros em sua gestão, assim como ao alinhamento dessas iniciativas aos princípios dos artistas, são discutidas neste texto.

O ECR na relação fornecedor x atacadista

Este relatório intitulado “Pesquisa sobre o ECR na Relação Fornecedor X Atacadista no Brasil”, foi desenvolvido pelo Professor Manoel de Andrade e Silva Reis, para o Núcleo de Pesquisas e Projetos (NPP) da Fundação Getúlio Vargas de São Paulo. Inicialmente apresenta alguns conceitos importantes para o entendimento do texto e faz considerações gerais sobre o ECR no Brasil e seu histórico. A principal parte do trabalho é a pesquisa realizada com 10 FORNECEDORES e 20 ATACADISTAS, sendo que 60% dos FORNECEDORES e 40% dos ATACADISTAS responderam aos questionários. As principais conclusões da pesquisa são: 1) Existem sérios obstáculos a transpor para a implantação abrangente do ECR na relação FORNECEDOR X ATACADISTA no Brasil, como: a) O setor ATACADISTA tem um forte preconceito com relação ao ECR, pelo receio de perda de mercado com a implantação de uma nova forma de fazer negócio. Isso evita que seus membros aprofundem o conhecimento das suas estratégias e ferramentas; b) Empresas ATACADISTAS tendem a ser muito fechadas, dificilmente abrindo suas informações para fornecedores, um dos requisitos básicos para a implantação bem sucedida do ECR. Têm também grande rivalidade com seus pares ATACADISTAS. c) O setor ATACADISTA desconfia das verdadeiras intenções dos FORNECEDORES. Há ATACADISTAS que chegaram a implantar uma ferramenta do ECR para teste e desistiram, por sentirem que os FORNECEDORES fogem aos acordos estabelecidos, visando, em especial, preencher as cotas de venda. 2) Na opinião das empresas ATACADISTAS, a sobrevivência setor depende de fatores como: a) Necessidade de uma radical mudança cultural das empresas, de forma a adotar os conceitos de compra e venda necessários no ECR; b) Necessidade de especialização em canais escolhidos e nos produtos característicos dos mesmos, visando tornar-se especialista na sua comercialização; c) Gestão mais adequada dos níveis de estoque; d) Maior agilidade no acesso ao pequeno varejo. 3) Fatores que podem aumentar a atratividade do setor ATACADISTA para os FORNECEDORES: a) Redução do número de transações; b) Redução dos custos pelos elevados volumes; c) Prestação de serviços ao pequeno varejo (devoluções, trocas, promoções, treinamento e incentivos); d) Pulverização das vendas.

A dinâmica da organização interna da mesa diretoria e comissões da assembléia do estado do Rio de Janeiro

A globalização do capitalismo joga indivíduo em um mundo de controvérsias, quase de crise existencial, já que oscila entre sonho de satisfazer todos os seus desejos realidade de não poder realizá-los. globalização que interessa são as ressacas emocionais do indivíduo, que distancia da razão, do equilíbrio entre poder querer torna um compulsivo do consumo. processo de massificação homogeneização cultural, que não apenas gera vícios consumistas nos indivíduos, como também os impede de participarem politicamente. Politicamente, uma primeira fase da globalização caracterizada pela égide das monarquias absolutistas que concentram enorme poder mobilizam os recursos econômicos, militares burocráticos, para manterem expandirem seus impérios coloniais. Os principais desafios que enfrentam advinham das rivalidades entre elas, seja pelas disputas dinástico-territoriais ou pela posse de novas colônias no além do mar. Politicamente globalização recente caracteriza-se pela crescente adoção de regimes em procura de uma democracia mais ampla participativa participação política, portanto, exigência básica para que indivíduo supere as barreiras impostas pela globalização consiga desenvolver ações de cidadania dentro da própria sociedade global. Nesse sentido, necessário encurtar distanciamento entre as formas institucionais existentes, sejam jurídicas ou políticas, real possibilidade de reconhecer nas leis, nas instituições, as suas próprias leis seu próprio poder.

Busca pelo homem social nas organizações: indícios, constatações, possibilidades

This study approaches the question of organizations in search for competitiveness when globalization, knowledge and technological advances in the First World is a challenge in developing countries. The case study research focus on Bahia Sul ¿ a large organization which belongs to the important sector of paper and cellulose, especially in terms of exports. This study analyses an organization in that underpriviledged situation of a third world country in which the majority of organizational strategies are heavily thrown on people who are simultaneously reduced to instruments for economic results and who are highly demanded in terms of productivity and creativity. Due to that reality, references chosen present two key contrasting concepts. Mass man, going back to Taylor¿s blue collars as well as to Marcel¿s knowledgeable but empty words man, whose abilities do not feet his needs, in contrast with rogerian expectations of person as a mutable and continuously enriched human being and with habermasian position looking for political and decision making participation in work an social situations. Results show a strong presence of mass man, despite his technological knowledge, and scarce indications of the social man and which appears in mere aspirations out of labor situations. Conclusions emphasize a need for coherence between organizational practices in search for competitiveness and expectations on persons¿ performance because they stimulate exchanges in terms of working places for obedience and some material comfort which is aggravated by the fact that any possibility of personal fulfillment is interpreted as only possible in out of work situations. Competitiveness in such a context is not to be expected.