The goal of nursing is to promote health and alleviate suffering. Using Appreciative Inquiry, this study explored the possibilities for the nursing profession to reduce the health implications of poverty. Select Saskatchewan registered nurses (RNs) engaged in appreciative interviews that identified positive experiences working with low income clients. The participants were activists challenging the status quo through their practice. Analysis illuminated the best practices of these RNs, constructing a vision for change rooted in their understanding clients realities and communicating those realities through advocacy. By bringing their personal passions to client interactions, and connecting with a broader social justice context, RNs create an opportunity to respond to the effects of income inequities on health.

School counselors have a duty to formulate strategies that aid in the detection and prevention of child sexual abuse (ASCA, 2003). This may be accomplished in a number of ways, such as designing programs, providing training to teachers regarding recognizing and reporting abuse indicators, and collaborating with child protection and other mental health professionals to provide additional aftercare for sexually abused children in the school setting. Much can be learned about trauma symptomology from a clinical sample of sexually abused children. The Trauma Symptom Checklist for Children (TSCC; Briere, 1996) is a 54-item self-report instrument for children and adolescents 8-16 years of age which assesses the frequency of thoughts, feelings, and behaviors related to traumatic events they have experienced. To understand better the trauma symptomology of children and adolescents, the author analyzed an existing data set of TSCC protocols from children who received treatment for sexual abuse from a children’s advocacy center in a metropolitan area near a large city in the southeastern United States. Although a large number of potential participants were lost to follow up (N = 54), T2 analyses revealed significant differences between the groups only on the length of time in therapy. A repeated measures analysis of variance was performed on data from children and adolescents who completed therapy (N = 31) to test whether differences on Depression and Posttraumatic Stress scale scores would exist across the course of therapy. Although no statistically significant findings emerged, implications for clinical practice and research became apparent. Specifically, differences in cutoff T-scores on TSCC scales may be more useful to clinicians for treatment and termination planning purposes than statistically significant differences. In addition, assessing clients at intervals measured by session number, rather than by length of time, may provide more generalizable results for within- and between-participants clinical and research comparisons. These implications may aid clinical and school counselors and researchers to recognize and serve the specific needs of sexually abused children in their respective settings.

ABSTRACT MATERNAL PERCEPTIONS AND RESPONSES TO CHILD SEXUAL ABUSE by Elizabeth U. Willingham Child sexual abuse (CSA) is a complex phenomenon that requires various levels of intervention to address the safety, recovery, and prevention needs of children and families who have experienced victimization. Although there is a large body of literature that has identified and examined many aspects of CSA (Putnam, 2003), less is known about nonoffending caregivers of sexually abused children. The one consistent finding across studies that have investigated CSA, nonoffending caregivers, and traumatic stress in children is the importance the of child-caregiver relationship in facilitating recovery (Elliot & Carnes, 2001; Scheeringa & Zeanah, 2001). CSA is stressful for both the child and the caregiver, and it affects the child-caregiver relationship. Studies are needed to determine the underlying factors and processes that contribute to nonoffending caregivers’ stress and coping responses, supportive and protective reactions, and intervention needs as they relate to supporting their children’s recovery and healing the family unit. This exploratory study examined the phenomenological experiences of mothers whose children had been sexually abused. In-depth exploration and systematic analysis of mothers’ perceptions about their children’s victimization, their reaction, and their distress using constructivist grounded theory methods (Charmaz & Corbin, 2005) provided a better understanding of the mothers’ collective experience and response. This study used theoretical sampling (Miles & Huberman, 1994) for participant selection. The researcher interviewed 14 mothers of children who had been sexually abused and had received services at a child advocacy center. Two key informants were also interviewed to obtain a detailed conceptualization of the theoretical and practical aspects of the programs and services at the child advocacy. The findings from this naturalistic, phenomenological inquiry revealed that the mothers experienced crisis and traumatic distress following their children’s disclosure. The findings also showed that even in the midst of traumatic distress and grief, the mothers did believe and protect their children. In addition, the results of this study highlight how maternal supportive responses are interdependent on numerous factors, especially their capacity to cope with past abuse, current distress, and their level of emotional and financial dependency on their child’s perpetrator.

This is a qualitative study based on interviews with professionals who are cooperating at a children advocacy center, in swedish called “Barnahus”. The center, Barnahus, pulls together law enforcement, criminal justice, child protective service, medical and mental health workers in to one coordinated team. Children suspected to be victims of any kind of violence or sexual abuse shall, at Barnahus, be offered coordinated efforts and support all the way from suspicion to possible intervention.   The aim of the study is to examine how the participants involved relate to collaboration in Barnahus. The study will also present the success factors and barriers to collaboration that identifies by the participating actors, who are mentioned above. The study will provide insight and understanding of how collaboration can be represented in multiprofessional activities in practice.

The goal of nursing is to promote health and alleviate suffering. Using Appreciative Inquiry, this study explored the possibilities for the nursing profession to reduce the health implications of poverty. Select Saskatchewan registered nurses (RNs) engaged in appreciative interviews that identified positive experiences working with low income clients. The participants were activists challenging the status quo through their practice. Analysis illuminated the best practices of these RNs, constructing a vision for change rooted in their understanding clients realities and communicating those realities through advocacy. By bringing their personal passions to client interactions, and connecting with a broader social justice context, RNs create an opportunity to respond to the effects of income inequities on health.

<p>I Jönköpings kommun har stora utvecklings- och ombyggnadsarbeten pågått under ett an-tal år. En av de största förändringarna är en bro som byggdes över Munksjön och stod fär-dig under år 2006. Bron kan ses som en katalysator för flera andra projekt som har löpt pa-rallellt med broprojektet. Uppsatsen fokuserar på processen som förlöpt från det att brons planeringsstadium inleddes 1990 till dess att det slutgiltiga byggnadsbeslutet togs 2004.</p><p>Bron var kontroversiell i bland annat miljöhänseende, men även ekonomiskt och i trafik-hänseende ansågs den vara en tveksam lösning på centrums problem. Första steget i upp-satsarbetet var att samla in information, främst från olika kommunfullmäktigedokument samt underlag som använts när beslut fattats i kommunfullmäktige. För att identifiera in-tressanta problem granskades dessa med hjälp av källkritiskt metod och delades kronolo-giskt in i sex faser, där varje fas representerade ett delbeslut i broprocessen.</p><p>För det fortsatta arbetet behövdes en analysmodell, som inkluderade multipla aktörer, och som kunde användas för en analys av den process som löpt under cirka 15 års tid. Detta ledde först till klassiska implementeringsmodeller, främst Top-down och Bottom-up-modellerna och därefter vidare till Advocacy Coalition Framework (ACF) som utgör en vi-dareutveckling av de båda implementeringsmodellerna. Fördelarna med ACF var många. Den hanterar multipla aktörer, tidspannet lämpar sig väl, och den innehåller ett antal krite-rier vilka ger underlag för intressanta diskussioner. Med analysramen och dokumentstudien som bas kunde problemområde, hypotes, samt beroende och oberoende variabler faststäl-las.</p><p>Valet av analysram föll således på ACF, vilken har använts mycket i USA bland annat för analys av miljöproblem. Ett av de största problemen med analysramen har då varit att mo-tivera varför olika koalitioner uppstått. Detta problem kringgås här genom att peka på de svenska partiernas större homogenitet än deras motsvarigheter i USA, detta beroende på att det där i princip endast finns två partier.</p><p>För att motivera valet av ACF som analysram testades de nio kriterier som denna innefat-tar, och genom att dessa uppfylldes kunde analysramens relevans för forskningsområdet valideras. Med hjälp av analysramen och dess kriterier, samt den källkritiska analysen, upp-ställdes hypotesen: De mest miljömedvetna koalitionerna har fått göra flest eftergifter under broproces-sens gång.</p><p>Innan analysen fortskred redovisas ytterligare två metoder: kvantitativ innehållsanalys och statistisk Chi-två metod. Den kvantitativa innehållsanalysen användes för att utifrån de svenska politiska partiernas höga grad av homogenitet motivera varför olika koalitioner uppstått. Chi-två metoden användes i resultatredovisningen för att ge statistiskt stöd för hypotesen.</p><p>Analysen började med att identifiera de tre koalitioner, som bildats under processen, nämli-gen: Pro-bro, Avvaktande och Anti-bro. De olika aktörerna indelades därefter i den koali-tion de tillhört under varje fas. Vidare fastställdes de tillfällen då en koalition fått göra en eftergift under processen. Totalt har den mest miljömedvetna koalitionen gjort sex eftergif-ter medan den mindre miljömedvetna inte behövt göra någon eftergift.</p><p>Med hjälp av den kvantitativa innehållsanalysen har det varit möjligt att visa hur det bilda-des två koalitioner varav en mer och en mindre miljömedveten. Den mest miljömedvetna koalitionen bestod av: Miljöpartiet, Centerpartiet och Vänsterpartiet medan den mindre miljömedvetna bestod av Folkpartiet, Socialdemokraterna, Kristdemokraterna och Moderaterna.</p><p>Ur koalitionsbildningarna och fördelningen av eftergifter kunde det utläsas att den mest miljömedvetna koalitionen fått göra flest eftergifter, sex mot noll. För att ge statistiskt stöd åt resultatet genomfördes även en Chi-två beräkning, vars utfall var statistiskt signifikant och gav stöd åt hypotesen.</p><p>I den slutliga diskussionen ställs frågan varför kommunen inte följt Agenda 21 och de stat-ligt uppsatta miljömålen. Slutsatsen dras att det är vanligt med konflikter mellan kommuna-la miljö- och tillväxtmål. I detta fall har det blivit en tveksam kompromiss, som varken löst trafikfrågan i Jönköpings centrala delar eller kommit tillrätta med de existerande miljöpro-blemen.</p><p>Uppsatsen avslutas med funderingar om hur ACF kan användas i framtida forskningspro-jekt på liknande områden. I en undersökning med mindre homogena aktörer behöver ana-lysramen kompletteras med bättre metoder för att beskriva hur koalitioner bildas utifrån gemensamma basala värderingar.</p>

Do dying patients have a moral claim to access experimental drugs when all else has failed? This question has been the focus of an active and evolving debate concerning the rights of terminally ill patients, the nature of the drug development process, and the scope of federal regulation, with supporters arguing that seriously ill patients should be able to decide for themselves whether and when to attempt experimental therapies and opponents arguing that the resulting state of affairs would be disastrous for patient safety and for the integrity of the drug development process. This thesis concerns the ethical considerations surrounding the provision of experimental drugs for treatmentoften termed compassionate use or expanded accessand argues that compelling ethical merits on both sides of the debate complicate the formation of satisfactory public policy. Although patient autonomy is often invoked to support liberal access to experimental drugs, the paucity of known information about investigational compounds as well as the unique vulnerability of the terminally ill patient call into question the wisdom of the unfettered exercise of autonomy in this context. Although equitable distribution of experimental drugs is often felt to be a concern, the meaning of equity in this context has not been clearly defined, and in fact several working concepts of equitable access may not be achievable or desirable. Although the financial burden on drug manufacturers is frequently recognized as a barrier to expanded access, the potential for expanded access programs to constitute a marketing strategy should be recognized, and the mixing of profit motives with altruistic ones brought to light. Parsing these and other ethical nuances points to certain ways in which policies governing expanded access can be refined to allow for access while maximizing patient protection and ensuring the generation of scientific knowledge. Physicians, as frequent mediators of requests for experimental drugs, should be knowledgeable of the ethical issues inherent and should help to ensure the judicious use of experimental therapies. Finally, general misconceptions about the benefits of experimental therapy, pervasive in our culture, heighten the contentiousness of this debate. A workable legislative solution should be accompanied by a thoughtful and deliberate effort to educate patients, their advocates, and broader society about the realistic pace of drug development and the limits of modern medicine. This thesis recognizes that individuals who seek expanded access often have valid moral claims to do so, but advocates a cautious attitude toward the dissemination of experimental drugs for treatment and maintains the importance of government and physician participation in adjudicating access.

Sweden lacks a powerful advocate who can represent the passengers in the public transport sector. In conjunction with the liberalization of the public transport market, the bus and rail services that have been opened up for competition and the allocation of responsibility within public transport has been divided into a several amount of actors. The liberalization has been positive for the passengers by a wider supply of transport services and also resulted in new service incentives. Within the commercial rail traffic market there is now a variety of tickets in different price ranges. The railway has also been vertical separated into operating traffic and infrastructure management, which have resulted in uncertain accountability at disruptions, for passengers such as the traffic operators. Since the Swedish Transport Administration Trafikverket nowadays procures the maintenance of the railway, the authority has been criticized losing control over their facility. The new Public Transport Act was introduced in 2010 and provides the local and regional public transport to be procured by the regional public transport authorities. They decide which traffic in the region that should be offered as obligated service that will be subsidised. The state has been reticent in interfering with the regional authorities but has simultaneously in several governmental investigations identified shortcomings in public transport, for example in the systems for ticketing and information. On voluntary bases the industry has been collaborated since a long time for developing such common platforms but the progress has been slow. However the actors introduced a common digital portal for information and ticketing in January 2015. In Denmark and in the United Kingdom there are governmental funded passenger organizations today that comprise operations in quality measurements of public transport and offering support to vulnerable passengers. The organizations are trying to achieve improvements in supply, or demand economic compensation for the passengers in case of traffic disruption. With the Government's recent appropriation direction to Trafikverket, the authority now may support non-profit organizations activities that harmonize with the national transport policy objectives, which mean that financial support could be disbursed to the non-profit passenger organization Resenärsforum, which is the leading passenger organization in Sweden today. An establishment of a new authority, to ensure the passengers' interests would require a more comprehensive governmental investigation. Rather, the state needs to take responsibility by establishing a national traffic service program that could clarify the division of responsibilities among existing authorities. That could also comprise commission for actors, as well public as private, for example in operation passenger information at traffic disruptions.

Over the past few years, incidents of gender-based violence on Canadian university campuses have gained public attention. In 2013 rape chants occurred during frosh week at two universities – UBC and Saint Mary’s. In March 2014 the University of Ottawa’s hockey and coaching staff was suspended after the sexual assault of a woman was reported in Thunder Bay where the team was playing an out-of-town game. Later in 2014, the misogynistic Facebook posts by Dalhousie dentistry students came to the public’s attention. A number of sexual assaults have also taken place on the University of Saskatchewan campus, including high profile cases in 2003 and 2012. The current project takes a step back to explore two research questions. First, how did women’s experiences at the University of Saskatchewan campus shape the institutional discourse and policies and procedures on sexual assault? Second, what were the “ruling relations” that affected the chain of actions leading to the development of sexual assault policies? In order to answer the two research questions, institutional ethnography, augmented by interpretive historical sociology, were utilized. Archival documents from the University of Saskatchewan Archives and Special Collections were gathered and six semi-structured interviews were conducted. Double standards, sexism, limited child care, sexual harassment and sexual assault were just a few issues that female students, faculty, and staff were concerned with at the University of Saskatchewan. There were a number of groups on campus during the time frame under investigation such as the Pente Kai Deka, the Women’s Directorate, and the Help Centre. However, the thesis focuses mainly on the President’s Committee on the Status of Women (PCSW), the President’s Advisory Committee on the Status of Women (PACSW), and the Sexual Harassment Office (SH Office). In 1990 the PACSW was formally created. The main iii goal of the PACSW was to create the Reinventing Our Legacy (ROL) report, which was based on submissions received from all groups on campus. Through the submissions the PACSW derived nine recommendations to address sexual/gender harassment at the University of Saskatchewan. The six interviewees involved with the PACSW described the barriers experienced both within and outside the Committee. As well, the interviewees felt the ROL report did not have the expected impact on the University of Saskatchewan campus. Incidents of sexism, sexual harassment and sexual assault are still occurring at the University of Saskatchewan. Based on information received from the women of the PACSW interviewed for this research, the archival data collected, and other research involvement regarding campus sexual assault, the thesis presents five recommendations for the University of Saskatchewan: a safe space, professional staff, education, policy and procedures, and resources.

This report explores the evolution of advocacy strategies amongst human rights organizations in El Salvador over the past two decades, focusing in particular on domestic activists’ perceived need to use transnational venues for activism in order to achieve positive domestic results. The Salvadoran political transition in 2009 is used to examine how changing political opportunity structures at the domestic level affect human rights organizations’ transnational strategies. Extensive in-country fieldwork in 2011 involved eighteen in-depth interviews with activists, academics, and government officials, four months of participant observation with one of the human rights organizations of interest, and primary document content analysis. The results of this research allow for two human rights networks to be considered: the historical human rights movement seeking justice and reparations for human rights violations committed during the Salvadoran civil war, and the contemporary migrants’ rights movement seeking both protection and reparations for Salvadoran migrants and their families. The findings suggest that despite significant openness at the domestic level, activists perceive transnational strategies as an important complement to domestic strategies that allow them to achieve positive concrete change and protect against future reversals in policy. / text