The aim for this study was to investigate how young adults describe their emerging adulthood, when coming from problematic teenage years. Three people around the age of 25 were interviewed. They had experience of non-institutional community care during their teenage years. To capture the narrative the informants gave of their youth, a life course perspective and resilience theory was used to understand if and how they have managed stress and adversity in their life. The study shows similarities to earlier studies on youth leaving institutional care or foster care, with heightened risk of school failings, shortened transition between youth and adulthood and a continued problematic life situation. The study shows the importance of meaningful relations outside of the family context. Transition periods and other turning points offers the possibility to explore new roles and with time incorporate the interventions of the non-institutional community care which can lead to personal growth.

Background: Studies have described the aggregate results of federal funding for health professions education at the national level, but analysis of the long‐term impact of institutional participation in these programs has been limited. Purpose: To describe and assess federally supported curricular innovations at East Tennessee State University designed to promote family medicine and nurse practitioner graduate interest in rural and underserved populations. Methods: Descriptive analysis of a survey to determine practice locations of nurse practitioner graduates (1992‐2002) and graduates of 3 family medicine residencies (1978‐2002). Graduates’ (N = 656) practice locations were documented using specific federal designations relating to health professions shortages and rurality. Results: Overall, 83% of family medicine residency and 80% of nurse practitioner graduates selected practice locations in areas with medically underserved or health professions shortage designations; 48% of family physicians and 38% of nurse practitioners were in rural areas. Conclusions: Graduates who study in an educational setting with a mission‐driven commitment to rural and community health and who participate in curricular activities designed to increase their experience with rural and underserved populations choose, in high numbers, to care for these populations in their professional practice.

[pt] Diante do predomínio do número de crianças e adolescentes negros em situação de acolhimento institucional, elegeu-se como objetivo geral da pesquisa, analisar o processo de invisibilização da questão étnico-racial no contexto das unidades de acolhimento institucional para crianças e adolescentes. O campo de pesquisa se constituiu a partir da atuação em duas unidades de acolhimento do município de Itaguaí-RJ sob o seguinte aporte metodológico: 1) revisão bibliográfica, no qual identificamos as produções existentes que realizam uma análise sobre o acolhimento institucional de crianças e adolescentes, relacionando com a questão étnico-racial e englobando uma discussão Decolonial que discutem a invisibilização das questões étnico-raciais a partir de um olhar colonizador sobre os corpos negros; 2) análise documental dos prontuários das crianças e dos adolescentes acolhidos, na qual buscamos identificar a presença ou ausência da dimensão étnico-racial no espaço de acolhimento; 3) realização de grupos focais com trabalhadores das unidades de acolhimento, visando captar os sentidos atribuídos à invisibilização da questão étnico-racial. O estudo aponta para um processo contínuo e constante de invisibilização da questão étnico-racial considerando o racismo institucional e estrutural. Os profissionais ouvidos identificam que a maior parte das crianças e adolescente são negros, mas a inserção de classe sobrepõe a questão da raça, sem a compreensão que esses marcadores sociais estão intimamente relacionados. / [en] Facing the predominant number of black children and adolescents in institutional care situation, the process of invisibility of the ethnic-racial issue was chosen as a research problem. The research field was constituted from the work in two reception units in the city of Itaguaí (RJ), under the following methodology: 1) bibliographic review, in which we identified productions that carry out an analysis on the institutional reception of children and adolescents, relating to the ethnic-racial issue and encompassing a Decolonial discussion related to the invisibility of ethnicracial topics starting in a colonizing perspective on black bodies; 2) documental analysis of the medical records of children and adolescents who were sheltered, in which we sought to identify the presence or absence of the ethnic-racial dimension in the reception space; 3) holding focus groups with workers from the reception units, the meanings attributed to the invisibility of the ethnic-racial issue. The study points to a continuous and constant process of invisibility of the ethnic-racial issue, considering institutional and structural racism. The professionals consulted identify that most children and adolescents are black, but the social issue overrides the issue of race, without understanding that these markers are closely related.

[pt] A pesquisa se propõe a analisar as narrativas, construídas em conjunto, de três jovens e sua mãe afetiva, que passaram pelo acolhimento institucional na cidade do Rio de Janeiro. Busca-se compreender como os participantes constroem e narram suas estratégias de resistência, desenvolvidas para lidar com situações de violência e opressão pelas quais passaram. É observada a coconstrução narrativa articulada à presença de agência (Duranti, 2004; Ahrean, 2000) e de resistência na fala dos narradores (Castells 1999; Ewick e Silbey, 2003). A partir de uma visão qualitativa e interpretativa, a análise é conduzida com as perspectivas da Análise da Narrativa e a abordagem SocioInteracional. O estudo da história de vida (Linde, 1993) é feito considerando as contribuições da estrutura narrativa de Labov (1972) e a releitura de autores contemporâneos (Bastos, 2005; 2008; Bastos e Biar, 2015; Bamberg e Georgakopoulou, 2008). O conceito de estratégia de resistência é desenvolvido com base na existência de um poder dominante, no qual os atores, conscientes das desigualdades e das condições desfavoráveis, agem de forma a resistir e alterar a realidade em que vivem (Foucault, 1979; Castells 1999; Ewick e Silbey, 2003). Na análise, é possível perceber que os participantes constroem uma identidade agentiva por meio do discurso e das ações de resistência narradas. Para cada estratégia desenvolvida, é explicitada a sua organização, levando em consideração poder, agente e tomada de consciência. A resistência tem como objetivo a alteração do micro para o benefício dos irmãos, o que reforça e promove os laços familiares. / [en] This research aims at analyzing the narratives told by three young brothers who were once wards of the state at Rio de Janeiro, but received care and nurture from an affective mother. I seek to understand how these participants build and narrate their resistance strategies, which they had to develop throughout their lives in order to survive the violence and oppression scenarios they were inserted into. I scrutinize the articulation of such narratives with the narrators agency (Duranti, 2004; Ahrean, 2000) and resistance (Castells 1999; Ewick and Silbey, 2003). From a qualitative and interpretative point of view, the investigation is carried out using the Narrative Analysis and Interactional Sociolinguistics approaches. The participant s life stories (Linde, 1993) are studied with regard to the labovian model (1972) perspective and other contemporary authors contributions (Bastos, 2005; 2008; Bastos and Biar, 2015; Bamberg and Georgakopoulo, 2008). Based on the existence of a dominant power, responsible for creating all kinds of inequalities and unfavorable conditions, I develop the concept of resistance strategies, which depicts the act of resisting and fighting such power once the actor becomes aware of it (Foucalt, 1979; Castells, 1999; Ewick and Silbey, 2003). It is observable that the participants build an agentive identity in their narratives, for that each strategy developed by them in their lifetime is well organized in their speeches. Power, agency and awakening are central to these strategies. Resistance is a way of trying to change their micro environment to their benefit, strengthening family ties and connections.

​Denna studie syftar till att undersöka förutsättningar, hinder och möjligheter att bedriva behandling inom ungdomsvården på Statens institutionsstyrelse. Studien lutar sig mot bakgrund av en samhällsutveckling där allt fler unga begår grova brott och får allt svårare problem. Samtidigt kritiseras Statens institutionsstyrelse av media och andra myndigheter för att inte kunna hantera sitt uppdrag. Samtidigt som SiS behöver tvångsvårda fler ungdomar involverade i grov brottslighet, vilket i sin tur inneburit ett behov av skärpt säkerhet, behöver myndigheten också ge god omsorg och behandling till de ungdomar som placeras utifrån andra behov. Uppdraget är svårt, och i verksamheterna arbetar människor som valt att jobba på SiS utifrån en vilja och ambition att kunna påverka och hjälpa ungdomar med svåra problem. Med hjälp av Lipskys teori om gräsrotsbyråkrater och begreppet handlingsutrymme, undersöks hur personal som arbetar med behandlingsprogram hanterar de dubbla kraven från organisationens riktlinjer och ungdomarnas individuella behov. Med en kvalitativ ansats analyserades intervjuer med tematisk analys. Resultaten visar på organisatoriska hinder men också på en tro på förändring genom professionell erfarenhet och kunskap. Resultaten visade också att rätt kompetens är avgörande för att kunna bedriva behandling för myndighetens målgrupper och att finns en brist på behandlingsmetoder för grovt kriminella ungdomar. Resultaten betonar också ett behov av ökad medvetenhet, utbildning och möjligheter till för en kontinuerlig vårdkedja för att öka kvalitén på behandlingsarbetet. Slutligen belyser resultaten maktaspekter inom tvångsvården som ett hinder för behandlingsarbetet och föreslår ett förändringsarbete mot mer vårdande än straffande och kontrollerande strategier.

Twelve interdisciplinary (ID) teams in a residential facility for the mentally retarded were observed while conducting annual reviews of resident program plans. Observers used predetermined recording rules to code the responses of the ID team members into one of the following four content areas: (1) assessment; (2) program planning; (3) program implementation; and (4) placement alternatives. Additionally, the observers coded whether the statements made were: (1) questions; (2) informational type statements; or (3) recommendations or decision-making type statements. Following the observations, the observers also rated the teams on the following nine variables associated with group behavior: (1) group effectiveness; (2) leader approachability; (3) mutual influence; (4) personal involvement and participation; (5) intragroup trust versus intragroup competition; (6) worth of the meeting; (7) submission to versus rebellion against the leader; (8) leader control; and (9) role and idea conformity. The observational data revealed that the ID team~ spent most of their time discussing assessment related issues and the least amount of time discussing placement alternatives for the residents. The members seldom crossed territorial boundaries to give feedback to other members in areas outside of their discipline. Seldom did the members question information or propose any changes to information presented by others. In general, the purpose of the meetings seemed to be to review an already developed plan. Professional staff, including nurses, social workers, teachers, and psychologists, participated more frequently in the meetings than did para-professional staff. The professionals usually contributed concrete data including written assessment reports and implementation data. The para-professional staff's comments were usually informational in nature. Findings from this study raised concerns regarding the implementation of the interdisciplinary service delivery model in residential centers. While it is assumed that all members of the teams do participate in the meetings, the findings from this study do not support this assumption. Future research is needed to.more broadly examine participation in team meetings in PRFs across the nation. Additionally, alternative methods must be developed for increasing staff participation and assessing the quality of decisions reached by ID teams. / Ed. D.

Denna studie undersöker hur Statens institutionsstyrelse (SiS) arbetar med flickor som lever under hedersrelaterat våld och förtryck. Fokus ligger på behandlingspersonalens roll och deras kompetensutveckling samt hur regeringens satsningar på ökad förståelse och utbildning påverkar flickornas tillvaro på institutionen. Genom att analysera SiS insatser och strategier syftar studien till att identifiera tillsatta åtgärder för att förbättra välbefinnandet och säkerheten för dessa unga flickor. För att svara på frågeställningarna användes en kvalitativ metod med semistrukturerade intervjuer som analyserades med tematisk analys. Totalt intervjuades åtta personer med olika roller inom en institution som tar emot skolpliktiga flickor mellan 12–16 år. De teoretiska begreppen gräsrotsbyråkrati och totala institutioner tillämpades vid analysen av det insamlade materialet. Resultaten visar att det finns utbildningsmöjligheter, men dessa är varken obligatoriska eller tillgängliga för alla. Behandlingspersonalen upplever en brist på kompetens i relation till hedersrelaterat våld och förtryck, samtidigt som de uttrycker en vilja att utveckla sin kunskap. Studien visar även att institutionen genomför sitt säkerhetsarbete genom regelbundna riskbedömningar och individuella säkerhetsplaner anpassade efter varje flickas unika situation. Resultaten lyfter utmaningar i arbetet som inkluderar att förhindra kontakt mellan flickorna och obehöriga genom falska identiteter, samtidigt som personalen möter dilemman där flickorna lyfter önskemål om kontakt till obehörig. Studien visar också att institutionen fokuserar på att erbjuda adekvat vård och stöd anpassat efter flickornas individuella behov, men personalens varierande utbildningsnivåer och brist på specifik utbildning utgör en utmaning. / This thesis investigates how the Swedish National Board of Institutional Care (SiS) handles girls who live under honor-related violence and oppression. The focus is on the role of the treatment staff and their competence development, as well as how government initiatives for increased understanding and education affect the girls' situation at the institution. By analyzing SiS's efforts and strategies, the study aims to identify measures to improve the well-being and safety of these young girls. A qualitative method with semi-structured interviews was used to answer the research questions, and the interviews were analyzed using thematic analysis. A total of eight individuals with different roles within an institution, which accommodates school-aged girls between 12-16 years old, were interviewed. The theoretical concepts of street-level bureaucracy and total institutions were applied in the analysis of the collected material. The results show that there are educational opportunities, but these are neither mandatory nor accessible to everyone. The treatment staff experience a lack of competence in relation to honor-related violence and oppression, while also expressing a desire to develop their knowledge. The study also reveals that the institution conducts its safety work through regular risk assessments and individual safety plans tailored to each girl's unique situation. The results highlight challenges in the work, including preventing contact between the girls and unauthorized persons through false identities, while staff face dilemmas when the girls express desires for contact with unauthorized individuals. The study also shows that the institution focuses on providing adequate care and support tailored to the girls' individual needs, but the varying levels of education among the staff and the lack of specific training pose a challenge.

Caregivers in children’s homes are the front-end workers who care for looked-after children daily. Looked-after children in children’s homes constitute a particularly vulnerable group, who are known to reveal mental health problems, which complicate the care-giving role. In conjunction with the lack of training and support, caregivers experience great challenges. This research study explores and describes the training and holistic care-giving needs of caregivers, by applying qualitative needs assessment design, where the responses of 12caregivers are explored and described. Data from the literature and semi-structured interviews and questionnaires was categorised into themes. Overarching findings include altruistic needs, the need for support and to be valued, with the researcher making recommendations and providing a convincing argument for immediate therapeutic support for caregivers. / Social Work / M.Diac. (Play Therapy)

Text in Afrikaans / Die huisouermodel word tans internasionaal in kinderhuise gevolg. ’n Huisouer of huisouerpaar tree as surrogaatouer(s) op en woon saam met die kinders in ’n huis in ’n gewone woonbuurt, weg van die hoofkampus van die kinderhuis. Direkte waarneming van die daaglikse funksionering van huisouers binne die huisouermodel het die navorser bewus gemaak van die kompleksiteit van die huisouer(s) se take. Die doel van hierdie navorsing was gevolglik om ’n verkennende studie te onderneem, ten einde te bepaal watter bydrae kernrolspelers kan lewer om huisouers binne die huisouermodel van ’n kinderhuis in die uitvoering van hulle take te ondersteun. Om hierdie doel te bereik is ’n kwalitatiewe navorsingstudie uitgevoer waartydens semi-gestruktureerde onderhoude met huisouers en kernrolspelers van drie satelliethuise van ’n kinderhuis, as data-insamelingsmetode benut is. Die kwalitatiewe data is geanaliseer en die bydrae wat kernrolspelers kan lewer om huisouers in die uitvoering van hulle take te ondersteun, is beskryf. / Internationally, children’s homes follow the houseparent model. A houseparent or houseparent couple act as surrogate parent(s) and live with children in a home, away from the main campus of the children’s home. Direct observation of the functioning of houseparents within the houseparent model brought awareness with regards to the complexity of houseparents’ tasks. The goal of this research was to conduct an exploratory study to determine what contribution key role players can make to support houseparents within the houseparent model with the fulfilment of their tasks. To achieve this goal, data was gathered through the application of a qualitative research study, utilising semi-structured interviews that were conducted with houseparents and key role players within three satellite homes. The qualitative data was analysed and the contribution that key role players can make to support houseparents in the fulfilment of their duties was described. / Social Work / M. Diac. (Spelterapie-rigting)

The study was carried out to investigate the implementation of the Malawian ECD policy in CBCCC in Namatubi Kanyenjere area. Both primary and secondary techniques were used to carry out the research. Literature review was carried out to ascertain the evolvement of ECD over the years and establish the basis of the current policy. Interviews were carried out with three respondent groups namely CBCCC committees, care givers and government officials. This was done to assess perceptions, attitudes and knowledge of the ECD policy among communities as well as the roles played by different stakeholders in the policy implementation. Over 90% of the CBCCC in Chitipa were initiated by communities and duly registered by the government. However there is little monitoring thereof by the government officials which dwindles the activities of the centres. Communities, stakeholders and government face various challenges that require concerted efforts to help improve the implementation of the ECD policy. / Development Studies / M.A. (Development Studies)