In this study 21 trans-identified youth in Toronto and Ottawa, Ontario, Canada were interviewed about their experiences related to transition. Using the materialist research strategy of Institutional Ethnography, I explore the organization of trans-specific health care services in Ontario. I describe challenges participants had in relation to accessing care and describe key differences in how care is currently delivered in Ontario. The ways in which various politico-legal and medical forms of organization shape the provision of trans care in Ontario are explored in detail. This work provides an empirically grounded addition to the growing literature that seeks to make sense of trans marginalization and exclusion.

Long-term care for the elderly people is a widely discussed topic in recent years not only among health professionals but also by the general public. And it will not change in the future. According to the Czech Statistical Office (2012) in 2050, the population aged over 65 will double and the population older than 85 years even quintuple. This work deals with long-term care for the elderly from the perspective of nursing, for the current demographic trends affect it significantly. Long-term hospitalization of the elderly in medical facilities is linked to many complications, not only physiological, but also psychological, social and spiritual. The aim of the thesis entitled "Long-term care for the elderly in nursing perspective" was to find out what the nurses in long-term care for seniors consider as the greatest problems, if they would welcome a change in competences in long-term care for the elderly, and to obtain an opinion about the long-term institutional care and long-term home care. Individual opinions of nurses from different departments were compared; what kind of solution to the current problems of long-term care for the elderly the nurses propose themselves. Objective 1: Find out what the sisters find as the most crucial problem in long-term care for seniors. Objective 2: Determine whether nurses feel the necessity for change in nursing competences in the management of long-term ill elderly. Goal 3: Find out what is the opinion of nurses about long-term institutional care for the elderly compared to long-term community care at home. The main research question based on the research problem and the research objectives was defined as follows: What is the prospect of long-term care for the elderly in terms of nursing? I decided for an exploratory approach. I was looking for another connection to general research question and examined them in depth. I decomposed this relatively broad topic covered by the research questions into several specific questions: 1. Will it be necessary to make additional changes in financing long-term care, due to a growing demographic age of the population increases? 2. Could nurses in long-term care for the elderly take over certain powers previously belonging to doctors? 3. Will the importance of providing nursing care long-term ill seniors at home increase? 4 Should be a long-term care for the elderly moved out of hospitals to specialized facilities? 5. Will it be necessary to increase the number of health care facilities with the focus on long-term care because of the growing number of senior citizens? 6. In connection with the increasing number of hospitalized elderly, will medical facilities have enough of gadgets? For the research was chosen a qualitative interview method. Nurses from various departments were interviewed and the outcomes were processed using the content analysis. Sisters? perspective on a long-term nursing care for elderly is: closer connection of health and social services, to increase quality of care, to strengthen the autonomy of elderly, dignified care for the elderly, increased use of home care and informing the general public about it, streamlining communication with seniors and their families, safer environment and to increase the motivation of nurses to provide the highest quality of nursing care.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-04-14T19:23:00Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Sayonara_CD.pdf: 3440704 bytes, checksum: cc86a2b97e39029b3a7f7a0494f3bc9b (MD5) / Made available in DSpace on 2016-04-14T19:23:00Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Sayonara_CD.pdf: 3440704 bytes, checksum: cc86a2b97e39029b3a7f7a0494f3bc9b (MD5) Previous issue date: 2014-07-29 / Propesq/UFPE, Capes,Reuni/UFPE / O cuidado da criança envolve diferentes pessoas, concepções e práticas em contextos culturais específicos. Partindo da psicoetologia, uma perspectiva interacionista que possui um olhar biopsicossocial do ser humano – considerando que seu comportamento, assim como sua estrutura orgânica e corporal, é produto e instrumento de seu processo de evolução – o cuidado da criança pode ser compreendido a partir do cuidado parental. Este é concebido como um conjunto de ações e comportamentos selecionados ao longo da história evolutiva da espécie, de modo a garantir a sobrevivência da prole, ajustando-o a transformações socioculturais que caracterizam o modo de vida dos seres humanos. A presente pesquisa tem como objetivo investigar as redes de cuidadores de crianças de zero a seis anos por cuidadores familiares e não familiares em uma comunidade de baixa renda da cidade do Recife. De forma específica, buscou-se identificar, descrever e discutir rotinas, práticas e redes sociais de apoio que configurem o cuidado da criança, bem como perquirir modos compartilhados de cuidar da criança e as significações atribuídas ao cuidado por familiares ou outros adultos que compartilham essa tarefa. Participaram da pesquisa trinta mulheres: 16 mães, 9 avós, 2 babás, 2 empregadas domésticas e 1 tia, na faixa etária de 20 a 80 anos que tinham pelos menos uma criança de zero a seis anos sob seus cuidados. Os dados foram coletados mediante visitas à comunidade com a realização de entrevistas nas residências das participantes, o que possibilitou observar importantes aspectos do cuidado da criança e complementar os dados das entrevistas. O material coletado foi organizado de modo quantitativo, sendo, assim, possível indicar o número de integrantes das redes de cuidado, o número de homens e mulheres e de familiares e não familiares dessas redes, a frequência de crianças a instituições educacionais e outros aspectos relevantes para a caracterização da tarefa de cuidar das crianças. Realizou-se também uma análise qualitativa, buscando-se identificar núcleos de sentidos realçados nas falas das participantes. Os resultados apontam as redes de cuidadores como um importante apoio às famílias e como estratégia para compartilhar o cuidado da criança, sendo tais redes constituídas majoritariamente por mulheres familiares que residem com a criança. A prevalência feminina nas tarefas de cuidado tanto da criança quanto da casa também é um aspecto de destaque, sinalizando a manutenção de uma divisão tradicional das tarefas de cuidado e a sobrecarga de atividades enfrentada pelas mulheres. E, por fim, a instituição educacional se sobressai como um importante componente na maioria das redes de cuidadores, porém se identifica pouca confiabilidade na creche ou no CMEI, o que instiga um olhar mais atento para as questões que envolvem a opção dos pais em compartilhar ou não o cuidado/educação da criança com essa instituição e para o tipo de serviço que ela oferece. Conclui-se que investigar a rede de cuidadores da criança suscita importantes aspectos acerca da dinâmica do grupo familiar com poucos recursos financeiros. Além disso, estudos como este têm um potencial de subsidiar políticas públicas que promovam melhores condições para a criança e a família. / Child care involves different people, concepts and practices in specific cultural contexts. Based on Psychoethology, an interactionist perspective that has a biopsychosocial look on the human being – considering that their behavior and their organic and body structure constitute both a product and an instrument of their process of evolution – the child care can be understood from parental care. This is conceived as a set of actions and behaviors selected along the evolutionary history of the species, as to ensure the survival of the offspring, adjusting it to sociocultural changes that characterize the way of living of human beings. This research aims to investigate the network of caregivers of children aged zero to six years by family and nonfamily caregivers in a low income community in Recife. Specifically, it was sought to identify, describe and discuss routines, practices and social support networks that constitute the child's care as well as to assert shared modes of child care and the meanings assigned to care by relatives or other adults who share this task. Thirty women participated in the study: 16 mothers, 9 grandmothers, 2 babysitters, 2 maids and 1 aunt, aged 20-80 years who had at least one child from birth to six years under their care. Data were collected by means of visits to their community with interviews held in the homes of the participants, which made it possible to observe important aspects of child care and complement the interview data. The collected material was organized in a quantitative manner, indicating the number of participants of the networks of care, the number of men and women as well as the family and nonfamily members of these networks, the attendance of children in educational institutions and other aspects relevant to the characterization of the task of taking care of the children. A qualitative analysis was also conducted, seeking to identify nuclei of meaning highlighted in the speech of the participants. The results indicate the networks of caregivers as an important support for families and as a strategy to share the care of the child, and that those networks are mostly consisted of women members of the family residing with the child. The female prevalence in care of both the child and the house is also a prominent aspect, signaling the maintenance of a traditional division of care tasks and activity overload faced by women. And finally, the educational institution stands out as an important component in most networks of caregivers, but poor reliability is identified in the day care or CMEI, which instigates a closer look into the issues involving the choice of parents to share or not to share the care / education of the child with that institution and the type of service it offers. The conclusion is that investigating the network of caregivers of children raises important issues about the dynamics of the family group with poor financial resources. Furthermore, studies like this have the potential to support public policies that promote better conditions for children and families.

This thesis explores the roles that medicine, human rights discourse, and the arts play in the project to improve the lives of patients suffering from severe forms of mental illness in the context of the post-socialist transformation of the Czech Republic. It is a study of the ways in which social solidarity and social exclusion intersect in the spaces of mental illness in a particular historical setting, and how the responsibility for care is negotiated between families, communities, the medical profession, and the state. The first part of the thesis focuses on the proposed reform of care for patients with severe mental illness that was put forward in the two decades after 1989. I examine the origins and aims of the attempted institutional change – the ‘humanization of psychiatry’ – in the context of the influential Charter 77 movement which demanded respect for the rights of those who are unable to claim them for themselves. I also trace how the re-establishment of a civil society that owed much to the concept of ‘apolitical politics’ and the process of the reintegration of Czech Republic into the European community impacted the attempted reforms. More than twenty years after the revolution, Czech Psychiatry still does not comply with international standards of care and, as I show, despite the explicit disclaimer with the totalitarian past and great hopes for change, there is in fact a clear continuation of many of the practices, ideas, interactions, as well as forms of governance of the preceding decades. These historical legacies, in combination with other factors, such as ideological disagreements within the psychiatric profession, a lack of political interest in this area, and a strong focus on other economic priorities have all contributed to the failure to improve mental health care. The second part of the thesis offers a complementary perspective on these processes – a view from ‘inside’ of the institutions that provide psychiatric care. The origins of institutional care in Central Europe date back to late nineteenth century, when large hospitals were built within parks as self-sufficient complexes surrounded by walls, outside of large cities. My research took place in two contrasting institutions: one a highly specialised clinical and research center for treatment of acute conditions, and the other a hospital for treatment of chronic conditions originally devoted to those with ‘incurable’ conditions. I show how the notion of ‘curability’ is a crucial factor in both the experience of the patients and the social responses to their conditions. In this part I also explore some epistemological issues in psychiatry, including knowledge, practices, and ideology, in the context of a strong scientific materialism where – unlike in many parts of the world – the tradition of psychoanalysis has been absent. Specifically, I examine the role of neurobiological paradigm in various interpretations of psychotic experience, its affect on patient’s self-understanding, and its role in the externalization of agency and responsibility. Finally I address the phenomenon of using ‘unclaimed bodies’ of psychiatric patients for anatomical teaching and research, and interpret this practice through notions of liminality, impurity, and sacrifice. I conclude the thesis by examining the ethical dimension of psychiatric care in the light of the writings by Emmanuel Lévinas.

For many years, great attention has been devoted to the care of the elderly due to global aging of population. Almost all people want to spend their old age at home in their environment. This idea is supported by many experts who deal with the issue of old age and point to the advantages that it entails for both the senior and for the society. Therefore, it is paradox that many old people are placed in various health and social care facilities despite a wide range of various external services that enable seniors to stay in their home environment. That is why this master thesis aims to compare the nursing care provided to elderly people in their home environment with the care provided in institutions, both from perspective of a nurse who provides the care and from perspective of the elderly person or members of their family. The thesis is divided into two main parts. The theoretical part focuses on explaining the old age and the changes that come along with the old age. It also points out how old age is perceived in contemporary society. Further, it deals with different types of senior care that is most frequently divided into family, health and social care. The practical part is focused directly on individual families of seniors who live at home supported with home care, and to families who have a member in the department for the chronically ill (DCI). In the practical part I also focused on nursing staff, particularly nurses who come into contact with the seniors every day. A qualitative research method was used for the research survey. The technique of in-depth interview was used for data collection. The first part of the research group consisted of nurses working in DCI and nurses working in home care. The second part of the group consisted of seniors who reside in DCI and their families and the elderly who use home care services and their families. Interviews with the nurses, seniors and their families are divided into individual categories: awareness, reason for placement to DCI, satisfaction with the care provided, the advantages and disadvantages of home care/DCI, differences in care in DCI and at home, in foods and drinks, positioning and incidence of pressure sores, hygiene, administering medicines, re-bandaging, in bowel habits, behavior of staff/family, facilities for a senior. The investigation shows that families consider hospital care and home care to be very good, but it can be seen that home care nurses enjoy greater trust of the family and have much closer relationship than those in a hospital. Both groups of nurses think that the care they provide is of high quality and professional, but point to the lack of funding that a hospital and a home care agency have. A very surprising fact emerged that families that have an elderly person in institutional care are eager for the placement since they believe that they would not be able to care of them properly themselves. The investigation cannot clearly assess which type of care is best because both methods have their positives and downsides for every party involved and there are different variables, such as the health condition of the elderly, their family or social background. Quantitative research over a longer period of time would be required for thorough mapping of the entire situation which could monitor the provided care in the long run and also take into account the above variables that may change over time.

(in English): The aim of the thesis is to compare children's ideas about their future after leaving institutional facilities with the view of caregivers. The diploma thesis deals with forms of substitute care, specifics of children in institutional care including emotional deprivation, preparation and leaving the children's home. It analyses children's ideas about education, employment, finances, housing, relationships with the original family, partnership, parenting, and rescue network after leaving the children's home. The thesis combines interviews with children focused on their life ideas and questionnaires that were presented to their caregivers to assess the reality and the possibility of their fulfilment.

The summary goal of this thesis is to characterize how the issue of alternative child care in the Czech Republic is solved, to characterize the system of alternative child care and it's problematical areas, and also to analyze the role of non-profit organizations in the society generally, and specifically in the solving of issue of alternative child care in the Czech Republic. The theoretical part of this thesis deals with concept of civil society, with typology of its organizations and their functions in the society, and also with chosen theories which explain functions of non- profit organizations in the society, and also with the history and the present of these organizations in the Czech Republic. Afterwards this theses characterize the system of the care of endangered children in the Czech Republic, the system of the alternative care of children and also contemporary reform of the care of endangered chidren and its important concepts of psychological deprivation of the children in institutional care and of rehabilitation of family. In the empirical part of thesis is on the basis of qualitative analysis of texts and documents and realized semistructured interviews presented which form, in which fields and also which specific activities engage non-profit organizations in the solving of issue of...

This thesis deals with children from orphanages. The content of the theoretical part consists of the legislative framework of the issue, explaining basic concepts, description of historical development of institutional care and the scope of institutions of social and legal protection of children. The main objective is to monitor the situation of children's home of clients in the institutional education. Approach the situation before the regulation of institutional care during their stay in institutional care, not only in the orphanage itself, but also diagnostic facilities, and also after leaving the facility and must be included in everyday life. The practical part deals with how children stay in foster homes also affects their lives. Key terms Children's home, Institutional Education, alternative family care, socio-legal protection of children, family, Diagnostic Institute.

Anotation: This work is dedicated to substitutional family care, especially adoption. It engages in comparation of institutional and family care, motivation for being parents, types of substitutional family care, adoption, its history, types, biological an psychological points of view and other aspects. The main subject is the process of endorsement of applicants for adoption that is compulsory for all applicants who decided to adopt a child. I analyzed the whole process and its particular parts. In the research I made an analyzis of experience of the applicants with this process. The last part of the work includes profiles of six families that show differences of the applicants and their family background.

My thesis deals with the attitude of public to foster care. One of the paradoxical issues is the fact that the number of children who are not reared by their biological parents remains quite high while the number of childless partnerships (though desiring offspring) is growing. In the Czech Republic, similarly as in other European countries, about 1% of children (about 20,000) do not grow up in their biological families. Only 2% of that group are full orphans. The remaining 98% of children have living biological parents who do not or cannot take care of them. I endeavored to find out how well individual members of the Czech society are informed about one of the possible solutions of infertility: alternate family care. Using questionnaires, I focused on several age and level of education groups and asked general as well as more personal questions. In the general part, I wanted to find out whether the individual knew what alternate family care was, the different kinds of alternate family care, who provides support during the process, what are the different options, the difference between adoption and foster care, etc. Then I inquired about their own willingness to take in a child, whether sex of the child, somatic and intellectual predisposition were criteria for them and whether they would take in a child of a different ethnicity. It is interesting to note that women are usually more prone to blame themselves for infertility.