“In what ways does the experience of caregiving for a terminally ill family member affect the experience and process of bereavement?” The identity of family caregivers in palliative care has been ambiguous: caregivers are often unaware they fit the description of ‘carer’. Previous research describes two contrasting constructs that shape the identity of the caregiver: burden and privilege. Research, including this study, suggests that the emergence of identity as a carer impacts on the course and experience of bereavement. Two semi – structured interviews were conducted with a small number of caregiving family members: during the caregiving role and in their subsequent bereavement. This exploratory study used phenomenological research to examine the experiences of those caregivers interviewed. The data were examined using the existential themes uncovered in analysis. This paper reports on those themes.

This thesis examines residential relocation process within the Seoul Metropolitan Region (SMR) in the Republic of Korea at both a macro and micro level. The thesis makes theoretical and methodological contributions to residential mobility, housing vacancy chains and location choice behaviour in urban geography. The empirical study specifically focused on the relationship between housing opportunity and residential relocation process in the SMR during the 1990s. In developing countries, large scale suburban land and housing development on the fringe of metropolitan areas is seen as an important issue in the process of rapid urbanization and capital accumulation. This is particularly true of Korea where the population of the capital city, Seoul (SCC) has declined since the introduction of massive scale of new suburban housing developments in the 1990s. This is the first time the SCC’s population has decreased in Korean modern history. However there is still debate about the impact of government proposed suburban new housing construction initiatives on residential relocation within the SMR. In addition there remain uncertainties concerning the impact of large suburban housing development on residential relocation behaviour. To date little evaluation of outcomes of the policies has been undertaken, a deficiency which this research seeks to address. Like other capital cities in the developing world, Seoul (SCC) has undergone significant urban expansion throughout its contemporary history, fuelled by the movement of refugees from North Korea in the period immediately following the end of the Korean War (1953) and by significant rural-to-urban, and later by intra urban movement. The SCC, in particular grew significantly, with the metropolitan area of Seoul soon expanding beyond its borders in a process akin to suburbanisation. The rapid urban growth in the Seoul Metropolitan Region (SMR) was accompanied by a series of urban problems including housing shortages, a decline in housing and urban quality, and the concentration of population in large cities, especially in the SCC. To counter these problems the national government in the Republic of Korea initiated a series of policies. Most prominently among these was a massive scale new housing development program initiated in 1988, aimed at developing large scale new satellite cites in Kyonggi, with the objective of decentralising the SCC’s population and thus alleviating an urban housing shortage. This research focuses on two main issues charactering contemporary housing and land development policies in the SMR. The first relates to government efforts to redirect migration from the capital city, Seoul, to the outlying jurisdictions of Kyonggi and Inchon in an attempt to diffuse the concentration of population in the SCC and to alleviate housing shortages. The second issue concerns the determinants of residential mobility and residential location choice behaviour in the SMR. Mirroring the two issues, two approaches have been used to address these issues: a macro level study of residential relocation and a micro behavioural analysis. At macro level the research attempts to measure the impact of new housing developments on easing urban housing markets in the SMR during the 1990s, notwithstanding the continuous population movement from other regions in the Republic of Korea. The macro investigation addresses the questions: • What are the changes in spatial mobility patterns occurring in the SMR since the introduction of government’s suburban residential developments? • Are the size of housing vacancy chains different by spatial mobility patterns among the three regional housing markets in the SMR? Multi-regional vacancy chain models are used to examine whether vacant housing opportunity spills over into neighbouring regions in the SMR, particularly the city of Seoul. The models focus mainly on the structural determinants of household mobility, such as local new housing construction, household formation, household mobility rate and demolition rate, and their role in creating and absorbing vacant housing opportunities in the three jurisdictions comprising the SMR: Seoul (SCC), Kyonggi and Inchon. The vacancy chain analysis uses a Markov chain model and Leontief input-output model to assess the impact of these structural differentials on household mobility in the multiregional system of the SMR. This macro study provides a structural framework for the subsequent micro behavioural approach to residential mobility occurring in the SMR. The micro behavioural approach investigates the following questions: • What are the socio demographic profiles of people who relocate within the SMR?’ • What are the housing transitions that occur after moving to regions of the SCC in the SMR? • What are the reasons households give for moving within the SMR? This micro approach focuses on the behavioural aspects of residential mobility decision process as influenced by age, marital status, employment status, education level, duration of residence, dwelling size and tenure status. Apart from the mover’s socio demographic profile, the study further investigates longitudinal housing transitions before and after a move by their origin and destination within the SMR, particularly those movers who relocated to suburban rings (Kyonggi/Inchon). However the reasons for movers to choose a particular location vary and they are socio demographically diverse. The research also discusses these behavioural reasons for moving within the SMR.

No Brasil, os Centros de Atenção Psicossocial (CAPS) têm sido considerados experiências inovadoras no cuidado às pessoas em sofrimento psíquico. Estes dispositivos territoriais organizam suas práticas em pressupostos da Reforma Psiquiátrica devendo transpor as práticas tradicionais da psiquiatria. Esta pesquisa visa analisar o Centro de Atenção Psicossocial - Espaço Vivo - localizado em um município do interior paulista, enquanto um dispositivo que apresenta-se como intermediário à internação psiquiátrica e cujo eixo institucional tem se baseado nos pressupostos da Reabilitação Psicossocial. Para a realização deste estudo, primeiramente, descrevi a estrutura e dinâmica do CAPS e, em um segundo momento, pretendi entender como o processo terapêutico oferecido pelo serviço é percebido pelos usuários atendidos. Para a apreensão do proposto trilhei o caminho da pesquisa qualitativa, realizando um estudo de caso, descritivo e analítico. Para a coleta dos dados foram realizadas observação participante e entrevistas semi-estruturadas com os usuários atendidos pelo serviço, totalizando onze pacientes. Os dados colhidos foram submetidos à análise temática. Os resultados apresentados na pesquisa foram estruturados por meio de três grandes temas emergidos dos depoimentos dos sujeitos da pesquisa. O primeiro deles foi A influência organicista no cuidado prestado pelo serviço. A partir deste recorte foi analisado e discutido como os usuários têm percebido as práticas terapêuticas no serviço. Sendo assim, surgiram outros subtemas vinculados a esta questão: a valorização do profissional médico, a ênfase na terapêutica medicamentosa e a importância da abordagem terapêutica sobre os sintomas apresentados pelos usuários. O segundo tema que emergiu durante a análise foi O CAPS enquanto cenário favorecedor da rede de relações sociais. Neste, discuti como o espaço do CAPS tem se conformado dentro das ações terapêuticas, nas relações usuário/serviço e usuário/profissional, a formação do vínculo, e, também, como os usuários têm percebido e utilizado do CAPS. O último tema apresentado é o que traz a emergência do Trabalho terapêutico voltado à vida cotidiana do usuário. Nele, foram abordadas as dificuldades e facilidades dos usuários em enfrentar os desafios da vida cotidiana e como as práticas terapêuticas do serviço têm se conformado nesta direção. Constatei que a ação cotidiana do serviço acontece em terreno contraditório, uma vez que foi possível apreender práticas ainda ligadas ao modelo tradicional da psiquiatria mas, também, ações inovadoras e que vão ao encontro da reforma psiquiátrica e reabilitação psicossocial. Ao final deste estudo pretendo colaborar nas reflexões sobre o trabalho em saúde e, também contribuir para a organização dos serviços de saúde mental, a fim de melhorar o cuidado oferecido aos usuários que passam por uma experiência de sofrimento psíquico. / In Brazil, the Psychosocial Care Centers (CAPS) have been considered to be innovative experiences in caring for people who have psychiatrical sufferings. These territorial facilities organize their practices in principles from the Psychiatric Reformation and must go beyond the traditional psychiatric practices. This research aim to analyze the Psychosocial Care Center - Espaço Vivo - located in a city in the countryside of São Paulo state, as an apparatus which is presented as an intermediate way to the psychiatric hospitalization and whose institutitional axis has been based in the Psychosocial Rehabilitation principles. For this study to be carried out, firstly, I described the structure and dynamics of CAPS and, in a second moment, I intended to understand how the therapeutic process offered by the service is experienced by the users served by it. For the aprehension of this purpose, I followed the path of qualitative research, performing a case study, descriptive and analytical.. For collecting the data, participating observation and semi-structured interviews with the users helped by the service were used, making a total of eleven patients. The collected data were submitted to theme analysis. The results presented in the research were structured by three large topics coming from the testimonials of the research subjects. The first topic was The organicist influence in the care provided by the service. From this idea, the way the users have been experiencing the therapeutic practices in the service could be analysed and discussed. This way, other subtopics came from this question: the medical professional value, the emphasis in the medicine-based therapeutics and the importance of the therapeutic approach on the symptons presented by the users. The second topic which came from the analysis was The CAPS as a helping scenario in the social relations network. On this topic, I discussed how the CAPS space has been conforming within the therapeutic actions, in the user/service and user/professional relations, the bonding formation, and also, how the users have experienced and used the CAPS. The last presented topic is the one which brings the Therapeutic work towards the users daily life. In this topici, the difficulty and readiness of the users in facing the daily life challenges and how the service therapeutic practices have been conforming in this direction were approached. I concluded that the daily action of the service happens in a contradictory area, once it was possible to aprehend practices which are still connected to the traditional psychiatric model but also innovative actions which go towards the psychiatric reformation and psychosocial rehabilitation. In the end of this study, I intend to be helpful in the reflexions on the health work and, also to be able to contribute in the mental health service organization, in order to improve the care offered to the users who pass through a psychiatric suffering experience.

This thesis evaluated a program of the Lutheran Community Services of Oregon, an English as a Second Language training program for Somali refugee women. This study examined the English test results and questionnaires of 28 pairs of Somali women and North American volunteers involved in tutoring. The evaluation included communicating with the Somali women, North American tutors, and Lutheran Community Services staff. The researcher created a literacy test, piloted it, and created questionnaires with the assistance of the staff. Before the tutoring began, the researcher created a needs assessment for the Somali participants and visited each Somali woman's home with a Somali interpreter to administer the initial student questionnaire, B.E.S.T. Test, Written Form Test, and needs assessment. The researcher administrated the initial questionnaire to the tutors. Next, the researcher observed the literacy and cultural trainings for the tutors and observed three pairs of tutors and students during tutoring sessions at the students' homes. The researcher attended an informal party for tutors and staff during the middle of the program and administrated the mid-term questionnaire at the party and over the phone. The evaluator discussed the program with the staff every couple months. The final step was going to each Somali woman's home to conduct the final student questionnaire, B.E.S.T. Test, Written Form Test. The final tutor questionnaire was completed over the phone. The researcher and Lutheran Community Services staff presented the findings at the 2000 Oregon Teachers of English to Speakers of Other Languages (ORTESOL) Conference. Some of the more significant findings about creating effective programs are that programs for pre-literate refugees should use quantitative and qualitative methods of evaluation and should offer a non-threatening atmosphere for pre-literate adult refugees. Arranging for students to study in their own homes with tutors has positive as well as negative points. The views and languages all of the stakeholders during an evaluation should be considered. It is recommended that programs make materials specifically for their participants, create and offer literacy training specifically made to help tutors teach the targeted populations, and include cultural training for the students and tutors.

<p>The study aimed to understand and advance the dynamics that influence psychological aggression. Psychological aggression can be defined as, verbal and non-verbal communication with the intent to harm another person mentally or emotionally, and/or control another person. In our society, the occurrence of psychological aggression in relationships is far more tolerated then physical aggression, but the effects can be more long term and harmful. The study hypothesized that an individual’s level of differentiation of self--a person’s ability to differentiate between feeling and thinking in times of stress--and their gender have a role in the severity of psychological aggression. The study was approved by IRB and using an online survey through MTurk asked participants about experiencing and perpetrating psychological aggression in their romantic relationships. The study had 192 participates in the multiple regression analyses, who provided some support that the level of differentiation of self and severity of psychological aggression, experiencing and perpetrating, have a negative significant relationship. Gender was found to not impact the relationship between differentiation of self and severity of psychological aggression. Clinical implications, limitations, and future directions for research were addressed. </p>

How support workers enable, regulate or constrain the sexual expression of intellectually disabled people who live in service agency group homes is the subject of this thesis. A general literature search of what intellectually disabled people currently experience in their lives, including their experiences in the area of sexuality and intimacy, begins this investigation. Secondly, an extensive literature review of the support role, incorporating an appraisal of past and current issues related to the support position in general and to the area of sexuality support in particular, was completed. What intellectually disabled people themselves would like in relation to sexuality and intimacy support was included in this section. Thirdly, a review of research studies focussing on the operation of the support position within service agency systems was undertaken. These explorations revealed a high degree of reluctance on the part of workers to provide assistance in the sexuality area, despite a proven necessity for support to be made available to the intellectually disabled people they worked with. Review research studies suggested a variety of causal factors in explanation of this reluctance. These suggestions link to two meta-reason positions. Failure to prove support either stemmed from individual worker’s inactions due to ignorance and/or incompetence, or from wider systemic failures on the part of agency services to positively value and support this key service role in this area. However, little if any analysis of the possible influence of the broader social, emotional and cultural contexts, in which the concepts ‘sexuality’ and ‘(intellectual) disability’ are located, could be found in the studies reviewed. Eleven in-depth interviews were conducted with front-line support workers about their sexuality support practice. Preliminary readings of the interview texts revealed a similar reluctance on the part of the workers concerned to assist those they worked with in this area. Interview texts were then subjected to a post-modernist inspired, interpretive discursive analysis. This analysis uncovered and tracked how key power/knowledge effects inherent in the terms ‘(intellectual) disability’, ‘sexuality’, ‘gender’ and ‘desire’ inhering in the concept of an ‘ideal (sexual) couple’ interweave to shape the ‘no support necessary’ practice responses held in worker’s interview talk. From this exploration it is suggested that research studies of workers’ practices as an aspect of the promotion of change in support outcomes in the sexuality support area need to go beyond the parameters of recommendations that stem from considerations of either individual or systemic limitation alone. It remains a convincing point to suggest that poorly performing workers need retraining in this area and the overall value of the support role within service organizations needs reshaping. However, future research recommendations also need to engage more directly and effectively with the effects of the wider social and emotional “ideal (sexual) couple” ambiguities that also influence worker’s lack of assistance in this complex and sensitive support area. The use of a post-modern perspective as a helpful conceptual tool in unpacking the power these ambiguities hold within the support position is offered as a productive way forward for future research and practice development.

This thesis addresses the implications of Australian and South Australian government policies for the provision of online health information. It focuses on subjective meanings about internet use and access by questioning the use of information and communications technology (ICT) for health information. It analyses egalitarian approaches by government entities for universal access and explores how the phenomenon of the internet is claimed to be a potential conduit for social inclusion to reduce health inequalities.

This study centres on Church involvement in community development. The study seeks to demonstrate that the model adopted by the Christian Community Services is a fruitful experiment of church involvement in community development - one that has a tremendous potential to shed theological as well as practical light on church involvement in community development. After offering the statement of the problem and a brief geographical and social analysis of Kirinyaga Diocese, the study traces the genesis, vision and the modus operandi of the Christian Community Services. It then discusses the CCS 'Food Increase Programme' through the organisation's Rural Development Department. The Community Health and Social Services Programmes are presented as some of the CCS's interventions to reduce poverty in the community. The impact of these interventions was evident after the data collection, analysis and interpretation. The study then offers a theological evaluation and reflection of the work of the CCS as a model of church involvement in development activities in the community.The study argues that Christian theology has a particularly significant contribution to make to the debates about community development. In a pluralistic society in a secular age, a special responsibility is laid on the Church to present its distinctive understanding and insights to address the abject poverty among the vast majority of her followers. Without this, her public life is impoverished. Theology of development is the tool of the Church to achieve this vision. Although difficult to define, development is seen as the process of transforming the conditions of life of the people referred to as 'the poor' such that they can lead a more holistic life. The main objective of the CCS development activities is to allow the poor to become the subject, not the object, of development strategies. Given the opportunity to do so, they have shown themselves to be capable of making rational choices regarding their own destinies. In this context, it is hoped that this dissertation will help to contribute to an increased understanding of Church involvement in development from within for, by and with the poor. As a result, therefore, new optimism for the role of the Church in development may emerge from the current pessimism. The study has concluded that the Church's involvement in development is not an 'extra' but a bona fide function of the Church. / Thesis (M.Th)-University of Natal, Pietermaritzburg, 1999.

This qualitative research enquiry sought to develop an understanding from forty-four women, comprising twenty-two couples in committed lesbian partnerships, of how they managed the long-term impacts of child sexual abuse, both on themselves and on their relationships. This is an area that is under- theorised in the literature. A number of key findings emerged from the analysis. The sexual abuse that women had experienced had impacted their adult lives in various ways. Of these the personal aspect featured most highly, with feelings of self-blame, shame and low self esteem commonly reported. Those women who reported physically invasive sexual abuse also reported a wider variety of effects, and in proportionately greater numbers, than women whose abusive experience had not encompassed that particular dimension. Just as the survivors were impacted in a variety of ways by their abuse, so too were their partners, although the effects upon the partner varied over time and in intensity depending on the length of the relationship and the degree of resolution experienced by the survivor. Despite challenges the over all view of couple relationships was positive, and couples were able to articulate coping strategies they felt would be useful to others in similar circumstances. Partners were able to identify with many of the relationship issues outlined by heterosexual male partners of female survivors, although lesbian partners had more a positive view of counselling. The emotional support and commitment of a caring partner was clearly valued although in these partnerships both women wanted their relationship to be based on more than the reparative needs of one member. Finally, being lesbian was no barrier to seeking counselling assistance. A large proportion of the participants had used counselling as a way of working through their experiences of child sexual abuse and had found this to be valuable. These findings have implications for social work practice with child and adult female survivors. They emphasise the long term impacts of sexual abuse, the important contributions made by partners and counsellors in supporting women sexually abused as children and the levels of inter-sibling sexual abuse perpetrated by brothers. The research findings also contain information from the women themselves on what facilitated their ability to cope with the effects of child sexual abuse from the varying perspectives of survivor, partner and couple. This will be essential information for counsellors and social workers wishing to employ strengths and evidence-based approaches in their work with this client group and others, particularly heterosexual women and heterosexual couples.

No description available.