Thesis (Ph. D.)--UCLA, 2008. / Vita. Includes bibliographical references (leaves 387-400).

M.Cur. / Few South African studies have been done with regard to private midwives and their clients. The practices of these midwives are overloaded, indicating a growing need for their services. An exploratory, contextual and descriptive study was undertaken to investigate some of the issues relating to the practice of the private midwife. This was done from the perspective ofthe women attending these practices. The aims of this study were to explore and describe how women experience the care they receive from their private midwives in Gauteng during antenatal visits, labour and postnatal contacts; to explore and describe the reasons for clients of private midwives in Gauteng to choose an independent midwife as birth attendant and to explore how these clients get to hear about their midwives. Eight women, attending a total of two different midwifery practices, were interviewed. The main categories that emerged from analysing the women's experience of private midwifery care were that the midwives were caring, family orientated, informative, knowledgeable, guiding and unintrusive. Time was both respected and given by the midwives. The midwives saw childbirth as a normal and natural process. The midwives empowered the women and left them in control oftheir childbirth. A mutual, intimate relationship was formed between the women and their midwives, which was based on trust and continuity of care. The women felt they were treated as unique individuals. One woman related some negative aspects ofthe care she received. A variety of reasons were given for choosing a private midwife as birth attendant. Some had specific wishes for their birth, such as a homebirth and knew that private midwives would grant them Other reasons included cost effectiveness, control over childbirth, one on one care, shorter waiting periods, longer consulting times and wanting an experienced birth attendant. Previous negative experience with staff at government hospitals and private gynaecologists; and hearing about positive experiences with private midwives also contributed to women opting for independent midwives. The women got to hear about their private midwives through their general practitioner, obstetrician, antenatal class instructor, friends, family members or health professional that delivered a previous baby. These research findings were supported by existing literature and recommendations were made to midwifery practice, education and research.

BACKGROUND: Periodontitis is prevalent among adults 30 years and older and its prevalence increases with age. By 2040, there is an expected 50% increase in adults over the age of 65 years old in the US population. Therefore, it is essential to maintain good oral health and prevent tooth loss, pain, discomfort, and poor nutrition from improper chewing of food. Adults directly influence their periodontitis risk factors through at home oral care practices and smoking habits. Thus, the importance of home oral care practices and better choices in smoking habits may prevent the progression of periodontitis. The purpose of this study is to assess the association of at home oral care practices and smoking to periodontitis. The findings may be useful in future oral health education to emphasize the importance of oral hygiene care at home and smoking cessation. It may help dentists identify patients that will benefit from oral care instructions and smoking cessation and possibly aid in the development of prevention programs to combat the high prevalence of periodontitis in the foreseen growing population of the elders over the age of 65 in the U.S. OBJECTIVES: To assess the association of at home oral care practices to periodontitis and compare smokers and nonsmokers with respect to their oral care practices. We expect that people who regularly brush their teeth, floss, and use mouthwash twice or more per day, and who are nonsmokers will have less periodontitis. METHODS: Three categories of brushing: two to six times/week, once a day, or two or more/day in the past week were used. Additionally, three categories of flossing and rinsing: never, once to six times/week, or one or more times/day in the past week were also used. Odds ratio was calculated controlling for age, bone loss, gender, socioeconomic status, and smoking. Additionally, odds ratio was calculated for the oral care practices comparing smokers versus non-smokers. RESULTS: A total of 141 adults participated in the survey, 18% never flossed, 23% never rinsed, 6% brushed less than daily, and 35% had periodontitis. After controlling for variables, the lack of flossing was associated to periodontitis (odds ratio=1,88, 95% 1.00, p<0.0492) while rinsing and brushing were not associated with periodontitis. There were five times higher odds of periodontitis for a participant who never flossed compared to counterparts (95% CI 2.10-13.56). A dose response was not observed. After calculating for the odds ratio of the association of oral care practices to periodontitis among smokers versus non-smokers, the lack of flossing was positively associated with periodontitis such that smokers who never flossed had twice the higher odds of periodontitis compared to counterparts (odds ratio=4.20, CI 1.30-13.50, p<0.012). Participants who were smokers, with bone loss, and from low socioeconomic status had higher odds of having periodontitis. DISCUSSION: The lack of flossing was associated with higher prevalence of periodontitis. Smokers and especially daily smokers were more likely to engage in poor oral hygiene behaviors. Participants with bone loss, low socioeconomic status, and smokers were also associated with higher prevalence of periodontitis. Flossing at least once a week had a protective association to periodontitis. However, this was a cross-sectional study so a causal relation between the oral care practices and periodontitis cannot be established.

Indiana University-Purdue University Indianapolis (IUPUI) / Intellectual disability (ID) is considered a high-incidence disability affecting approximately 1.2 million adults in America (Brault, 2012). Diagnosed before the age of 18, ID is characterized by poor intellectual functioning, difficulty with adaptive behaviors, and problems with activities of daily living. Adaptive behaviors include practical, social and conceptual skills. Individuals with ID may lack the ability to personally care for themselves, self-direct and display naïve decision-making capabilities. Activities of daily living, such as maintaining one’s health, are influenced by poor adaptive behaviors. Between the years of 1997 and 2008, the prevalence of developmental disabilities, including ID, has increased 2.2% and while there is research dedicated to determining the risk factors causing ID, there is a continued need to research adaptive behavior management (Boyle et al., 2011). Current research in adaptive behavior focuses on determining best practices in order to help adults with ID thrive in schools, the workplace, home, and in the community. Adaptive behaviors related to healthcare, self-direction, and personal care still continue to be an area of adversity for the population and research on prevalence of healthcare-related problems are growing (Ervin & Merrick, 2014). Health concerns increase with the severity of the ID as well as age (Moss et al., 1993; Schrojenstein et al., 1997). Over 40% of adults with ID will develop four or more chronic diseases with an increase in age (Hsieh, Rimmer, & Heller, 2012). In the typical population, there is a plethora of evidence demonstrating that regular physical activity (PA) reduces the risk for chronic diseases, specifically all-cause mortality, colon and breast cancer, hypertension, cardiovascular disease, obesity, and depression (American College of Sports Medicine, 2013). However, the number of adults with ID participating in regular PA is considerably lower than the typical population. This lack of participation increases individual risk for secondary health conditions. With diminished capabilities in adaptive behaviors, there are significant issues that affect this population’s ability for self-care and independence in health-related care. Additionally, there are limited opportunities for individuals to take steps to improve his or her ability for self-care. Improving the availability of quality instruction for PA and adherence may increase overall PA and reduce incidence and prevalence of chronic disease in adults with ID.

AbstractThe purpose of this essay is to extend our knowledge about Educational Science and internationalization in higher education. At the beginning of our studies we were informed that the International Student Council offered the possibility to write an essay about Internationalization on home ground at Malmö University. We found the subject very interesting and started to discuss how we could plan the essay. The point with our work was to investigate and clarify how Internationalization at Home (IaH) is implemented at some of the programmes at Malmö University. We have collected information about how selected groups of students at Malmö University understand internationalization in their education. We have selected student groups from professional programmes primarily aiming for the Swedish job market. We have made the following conclusions from our survey:Most of the students:- are informed about internationalization at Malmö University- think international competence is important for the career-don’t choose to study abroad even if they take it into consideration- don’t know the concept of IaH- wish the information about internationalization should be easier to obtainWe looked after and selected literature about IaH and some theoretical literature about social processes. We wanted to provide a better knowledge for the work of the International Office at Malmö University. Finally, we presented the results in an international conference. The results of the essay were that most of students at Malmö University agreed that internationalization of higher education is very important and wanted by students. The students understand that IaH is a great concept in the reforming process of education.

No description available.

M.Cur. / There is little information about the outcomes and safety of home births, although more and more women are starting to lean towards natural and active births. A home birth provides a more relaxed environment with familiar attendants and less medical intervention. No separation exists between mother and baby as well as other family members. Freedom of movement is promoted and the woman can eat and drink as she pleases. Unnecessary routine preparation for labour doesn't exist and privacy is respected. The purpose of this research was to explore and describe the outcomes of home births in Pretoria, attended by private midwifes, and to provide guidelines in relation with home births.

Det finns ett uttalat behov av nya innovativa vårdmodeller inom hälso- och sjukvården. Svensk vård står inför signifikanta utmaningar och karaktäriseras av brist på sjukvårdsplatser, eskalerande kostnader och minskat patientförtroende. Hospital at Home (HaH) erbjuder möjligheter till förbättrad tillgänglighet, kostnadseffektivitet och patienttillit inom vården, men dess implementering begränsas av bristande förståelse för rådande finansiella förutsättningar, otillräckliga regelverk och inadekvata ersättningsmodeller. Denna studie syftar till att fördjupa förståelsen för de finansiella förutsättningar som påverkar implementeringen av innovativa vårdmodeller, såsom HaH, i komplexa decentraliserade sjukvårdssystem. Genom att utveckla ett teoretiskt ramverk som utforskar hur befintliga ersättningsstrukturer påverkar införandet av innovativa vårdformer, syftar denna studie till att bidra till förbättrat strategiskt beslutsfattande för en framgångsrik implementering och effektiv integrering av HaH i den svenska vården. Studien har tillämpat en utforskande abduktiv ansats, vilken realiserats genom en mixad metod som kombinerar enkäter och fallstudier. Datainsamlingen genomfördes via enkäter distribuerade till Sveriges 21 regioner samt genom semi-strukturerade intervjuer med representanter från tre svenska HaH-initiativ. Studien konstaterar att förberedelse och implementering av vårdinnovationer i decentraliserade system påverkas av flertalet både yttre och inre faktorer. Regelverk och direktiv, avtal samt extern budgetering och resursfördelning utgör grunden för hur vårdtjänster struktureras och finansieras. Dessa externa ramar är fundamentala i skapandet av en miljö som främjar vårdinnovation. Lokala variationer, vårdaktörer, verksamhetsformer och ersättningsmodeller spelar sedan en direkt roll i hur olika vårdmodeller utformas, finansieras och levereras i praktiken. Slutligen understryker studien behovet av en nationell definition av HaH och dess verksamhetsform, revidering av begränsande regelverk samt inkorporering av rörliga ersättningskomponenter till HaH-vårdutförare för att underlätta en storskalig implementering av HaH i Sverige. / There is a pressing need for innovative care delivery models within healthcare. Swedish healthcare faces formidable challenges including a shortage of hospital beds, escalating costs, and diminishing patient trust. Hospital at Home (HaH) presents an opportunity to enhance accessibility, cost-effectiveness, and patient trust within the healthcare system. However, its widespread adoption is impeded by a lack of understanding of current financial preconditions, insufficient regulations, and inadequate reimbursement models. This study seeks to enhance the understanding of financial preconditions influencing the implementation of innovative care models, such as HaH, within decentralized healthcare systems. Through the development of a theoretical framework that examines how current compensation structures impact the adoption of innovative care models, this study aims to inform strategic decision-making for the successful implementation and effective integration of HaH into Swedish healthcare. This thesis employs an exploratory abductive approach, utilizing a mixed-methods strategy that combines surveys and case studies. Data was collected through surveys distributed across all 21 Swedish regions, complemented by semi-structured interviews with representatives from three Swedish HaH initiatives. The study finds that the preparation and implementation of healthcare innovations in decentralized systems are significantly shaped by a range of external and internal factors. Regulatory frameworks, contractual agreements, and mechanisms for budgeting and resource distribution form the basis for how healthcare services are structured and financed. These external factors are fundamental in creating an environment that promotes healthcare innovation. Moreover, local variations, healthcare providers, operational forms, and reimbursement models directly influence how different care models are designed, financed, and delivered in practice. Finally, the study highlights the critical need for a national definition of HaH, the revision of restrictive regulations, and the integration of variable reimbursement components to facilitate widespread adoption of HaH across Sweden.

In this essay I analyze the meaning of the concepts home and at home and the feeling of coming home. What is a home and what different interpretations are there regarding the concepts of home and being at home? What kinds of feelings are aroused by coming home? The world we live in offers great opportunities to travel, which in itself creates a perspective on the meanings of the concepts. The world we live in also forces people to move from their homes, families and countries due to various reasons, which creates various problems and a certain urgency concerning the concepts. I describe basic terms concerning the concepts, both regarding concrete definitions and more abstract notions, and then compare them with my own reflections.          Based on my writing project Coming home I discuss these questions in various ways. I also describe the considerations I have made regarding these issues and the impact they have made in the text collection. I present my own description of home as a result of and defined by the emotions this term creates and where the moods are decisive.          The intention with Coming home is to offer different perspectives on and reflections upon the various feelings of coming home expressed by my own voice in the literary texts under study.

The goal of this study was to understand black women’s perspectives on stay-at-home mothering and examine the ways in which Mocha Moms, Inc. provides support. Twelve African American mothers from three chapters of Mocha Moms, Inc. were interviewed and data were analyzed and coded for themes. Findings indicate that participants did not aspire to stay home with their children. Additionally, participants reject stereotypical ideas of at-home mothering. They also see themselves as the primary educators of their children. Finally, they do not feel respected in the black community or in society.