This dissertation is a study of a relatively new teacher function in nurse education, a teacher function that can be called clinical teacher, link lecturer, link teacher or lecturer involved in practice. The study departs from a constructivist perspective and the aim is to study the introduction, performance and regulation of this teacher function. The material consists of internationally and nationally published research 1978-2009, reports from the authorities, job ads for clinical teachers, job descriptions and contracts, archive material, evaluation studies, professional journals, texts on the Internet and 15 interviews with clinical teachers in Sweden. Using discourse analysis this material is studied in terms of interpretive repertoires, subject positions and ideological dilemmas. The primary focus of this dissertation concerns what problems the new teacher function is supposed to solve, how the problem should be solved, the effects of the chosen solutions and what´s staged, challenged and reproduced. Secondly, this dissertation highlights what categories of teachers are required and in demand for the new teacher function, how the teachers themselves manage their function and how the teacher function is maintained and challenged. The analysis identifies and highlights current interpretive repertoire, teachers possible subject positions and ideological dilemmas and how they are governed and challenged in the teaching function.

Bakgrund: Vid palliativ vård i hemmet förändras tillvaron såväl för den sjuke som för de närstående. Den sjuke har ofta svårt att äta vanlig mat och kan behöva tillförsel av konstgjord näring. Närstående kan uppleva ett stort ansvar för den sjukes näringsintag när han eller hon vårdas hemma. Adekvat näringsintag är av betydelse för det fysiska välbefinnandet. Men vad vi äter påverkar också livskvalitet i social, kulturell och psykologisk bemärkelse. Tillgänglig forskning om hur det kan vara att leva med någon som är beroende av konstgjord näring i relation till svår sjukdom har i stor utsträckning ett biomedicinskt perspektiv och fokus på praktiskt handhavande och tekniska problem relaterade till näringsbehandlingen. Syfte: Att få ökad kunskap om närståendes erfarenheter av att ha delat vardagen med en partner som fått konstgjord näring i livets slutskede. Metod: Kvalitativ induktiv ansats med datainsamling genom öppna enskilda intervjuer. Datainsamling/databearbetning genomfördes med tolkande beskrivning. Resultat: I resultatet har tre övergripande teman och dess inneboende variationer identifierats; situationer kring mat och näring skapar delaktighet och utmanar; strävan efter vardaglighet genom måltider i en förändrad tillvaro; näring skapar förhandlingsutrymme med döden. Den konstgjorda näringen skapade en trygghet för de närstående, både som en försäkran om en fortsatt existens och genom den kontinuerliga kontakt med hemsjukvårdsteamet som näringsbehandlingen medförde. Personerna i studien beskrev positiva aspekter av att vara delaktiga i vården av den sjuke, men också känslor av maktlöshet och skuld inför att inte lyckas överskrida den sjukes svårigheter att äta och dricka. I den förändrade tillvaron kunde de närstående personerna finna det goda men de upplevde också ett främmandeskap inför sin sjuka partner. I situationen kunde näringsintaget utgöra ett existentiellt hot eller hopp. Slutsats och diskussion: Resultatet illustrerar hur komplex situationen att leva med en svårt sjuk partner som i livets slutskede har svårt att äta och behöver tillskott av konstgjord näring, kan upplevas. Personernas erfarenheter var varierande och det kan antas vara av betydelse att vårdpersonal har stor öppenhet för hur den förändrade vardagen upplevs för varje enskild närstående. En öppen och ömsesidig dialog kring ätsvårigheter och konstgjord näring kan vara av stor betydelse för de närståendes förmåga att hantera vardagen med den sjuke.

National Health Insurance (NHI) can be said to play the most significant role among all the other social securing systems. People pay great attention to its policy and institution. NHI is an obligatory social insurance, protecting all the citizens in Taiwan. The insured is required to enroll into the NHI only by their employers¡V be it a school, a business company, an institution, an organization, private business employer or any other work unit. When the insured are underwritten by or withdrawing from the system, all the changes must be made through the employers who refer to and enroll their employees with the NHI. The Bureau of National Health Insurance, operating in coordination with the e-government policy that aims to provide much more convenience to the Taiwanese people and to improve government efficiency, as well as for the sake of energy conservation and carbon reduction, has been encouraging people to use on-line applications for the NHI affairs. As much effort as they have put on promoting such policy to the employers who are responsible to insure their employees with the NHI, currently, the popularity of using on-line applications for NHI affairs is barely satisfactory, as a matter of fact. Many parties are involved in the procedure of processing on-line applications for NHI affairs; therefore, this dissertation uses Nominal Group Technique (NGT) and Interpretive Structural Modeling (ISM) from Interactive Management (IM) theories conducting the research. All participating parties will have conversations with one another; therefore, there will be a workshop. The purpose and subject for this workshop is to explore practical strategies that would effectively promote the usage of on-line applications with the NHI affairs. Through such an interactive dialogue collecting diverse viewpoints, there are thirteen strategies concluded to be effectively helpful achieving the aim: The NHI sectors responsible for on-line applications should (1) provide favorable incentives for on-line applicants, (2) simplify the net identification procedure and the NHI operational network and (3) the logging-in system, (4) increase the network bandwidth, (5) resolve NHI insurers¡¦ qualms of network security using online-applications. Also, they may need to redesign the network platform and (6) simplify procedure for users, and (7) more frequently promote the advantages using on-line applications and expand contents of their service, so that (8) the web search function for the NHI will be able to provide wider, faster, more efficient service. (9) the relative NHI sectors should really receive guidance and assistance carrying out this project, and (10) negotiate the assigned policy with their superior supervisory sectors to give clear order to their subordinate sectors using on-line applications and (11) set up trainings for instructors to establish future training resource, and (12) hold workshops to give more information and verification on the scene permitting the participants of the workshops to use on-line applications, and (13) finally achieve the aim that to have applications for NHI affairs completely done on-line. Among them all, strategy 3, ¡¥simplifying logging-in system¡¦, ranks 11 using NGT sequencing (strategy 11, 12, 13 all get the same points in the vote). However, in the enhancement structure, strategy 3 ranks number 1, has net score points 10. Therefore, strategy 3 should be given as much priority as to and carried out with strategy 1 ¡¥providing favorable incentives for online applicants¡¦ that gets the most points, in the NGT sequencing process. This research has given the participants questionnaires at two stages during the interactive workshop. The participants¡¦ concern, or understanding of using on-line applications for NHI affairs, appears to have risen after the workshop. There is unexpected, significant satisfaction over the promising conclusions from the workshop, which proves the workshop to be non-redundant and have reached consentient results. Also, the research, primarily using ISM program, has reduced the voting numbers when comparing two strategies from 156 times to 58. This has saved great amount of the time from the voting procedure in discussion, so that the workshops was able to finish in one day and hence did not exhaust the participants¡¦ enthusiasm. ISM is therefore proved to be efficient in saving time and assures that not losing the participants in different stages of the workshop.

Meta-governance recently emerged in the field of governance as a new approach which claims that its use enables modern states to overcome problems associated with network governance. This thesis shares the view that networks are an important feature of contemporary politics which must be taken seriously, but it also maintains that networks pose substantial analytical and political challenges. It proceeds to investigate the potential possibilities and problems associated with meta-governance on both theoretical and empirical levels. The theoretical discussion examines meta-governance in relation to governmentality, and it puts forward the claim that meta-governance may be understood as a specific type of neo-liberal governmentality. The meta-governance perspective regards networks as a complementary structure to traditional administration that can be utilized in the implementation and realization of public policy, but which also preserves the self-regulating and flexible character of networks. This generates a contradiction between the goals of public management and the character of networks that requires further investigation. The combination of the specific dynamics of the political field of security, the diminishing role of sovereign powers, the emergence of security networks, and the meta-governance stance adopted by the Swedish state constitutes a situation that should have been favorable for the successful employment of meta-governance. The empirical investigation of meta-governance is divided into two parts. The first part reviews the historical process involved and shows how the Swedish government and public authorities have adopted a meta-governance stance. The second analyzes the specific instruments and strategies that have been deployed in the governance of security communications and in the management of Sweden’s new security communications system which is an important aspect of security networks. The historical study together with the analysis of the meta-governance tools deployed reveals that the meta-governors neither reached the goals specified, nor fulfilled the overall purpose of successful security communications. I argue on the basis of the theoretical and empirical findings obtained in the present study that it is very difficult to successfully employ meta-governance in respect to security and crisis management, and that we have sound reasons to suspect that meta-governance will run into similar difficulties in other political fields as well. I conclude that meta-governance is a far more difficult practice than has been anticipated by existing theories and policy recommendations. Turning to meta-governance as a way to govern and control organizations may in fact lead to further fragmentation and distortion of public politics.

Of the numerous public policy debates currently taking place throughout the United States, perhaps no issue receives more attention than the persistence of “chronically” low-performing public schools. As of 2009, approximately 5,000 schools—5% of the nation’s total—qualified as chronically low performing (Duncan, 2009d). Certainly, these statistics merit the attention of policy scholars, yet the political contestation of interests attempting to influence how the federal government should address such issues has reached a new fevered crescendo. Given the increased politicization of the federal government’s role in education and the growing number of interests attempting to influence the debates concerning school reform, education policy scholars have recognized the need to extend the field of policy studies by using analytical frameworks that consider both the discourse and performative dimensions of deliberative policy making. Therefore, this study addresses this particular need by employing a critical interpretive policy analysis that illustrates how both dominant discourses and the deliberative performances of the federal government shaped the policy vocabularies embedded within the Title I School Improvement Grant program of 2009 as the commonsense solutions for the nation’s chronically low-performing schools. In addition, this study provides a historical analysis, illustrating how the omnipresent threat of an economic crisis has been a primary influence in the politics of federal governance since the global economic collapse of the 1970s. This study demonstrates how over the course of the last four decades the United States has consistently reduced its commitment to the public sector, choosing instead to promote economic policies informed by the ideals of market-based liberalism. Subsequently, this study presents the argument that education, specifically the “chronic failure” of public schools, has emerged as a “primary emblematic issue” (Hajer, 1995) and now serves as an “effective metaphor for the nation’s economic crisis.” Thus, with such issues presented as a contextual backdrop, this study examines how the Obama/Duncan Administration operationalized dominant discourses and performative practices to establish consensual support for a turnaround reform agenda, effectively defining the policy solutions made available to those who participated in the revision of the Title I SIG program of 2009. / text

Contemporary urban planning emphasizes the need for practice to be collaborative and communicative. It stresses on the importance of public engagement and participation. To ensure informed participation, planners need to provide relevant information to the public. However, the relevance of that information depends on an understanding of the existing discourse about the issue of interest. My research examined Transit City as a case study to demonstrate how that understanding can be gained. The question that framed the research was: What are the characteristics of discourses surrounding urban planning issues? The research focused on examining media coverage to gain that understanding for two reasons. Firstly, the media are considered to be the main purveyors of public discourse. However, there are limitations in the way they represent issues as this research found. Secondly, the media play an informant role, however imperfectly, on topics that matter. In part, this role gives them their importance and influence. The research examined media discourse surrounding Transit City in 94 articles in National Post, the Toronto Star, CUTA Forum, and Ontario Planning Journal to answer the research question. Discourse analysis was used as a method to investigate the topic under the framework of interpretive policy analysis. The research found that four of the media outlets used discursive practices of representation that highlighted certain themes and excluded others. It also found that the discursive communities that were identified in the media discourse interpreted Transit City differently through their discursive frames that were informed by their interest and responsibility in regards to Transit City and their core belief systems. As such their “argumentative logic” highlighted some aspects of Transit City and excluded others in the debate that ensued. The understanding of such characteristics of discourse can help planners in two ways. First, it informs the planning and the tailoring of messages they relay to discursive communities of various relevance. It allows them to have a stronger participation in the shaping of media discourse and generation of informed debate in the public as well as the professional sphere. Second, it can help planners in developing solutions to address points of controversy and bridge differences among stakeholders effectively in their role as mediators and consensus builders. Both benefits have positive implications in creating informed participation and making the planning process a collaborative and communicative effort.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Background: Migration is a global phenomenon that characterize today’s globalized world. Although, the relationship between migration and health in the host countries is not always negative, many countries, including Sweden are concerned about possible spread of infectious diseases of public health significance such as HIV/AIDS and tuberculosis (TB). Moreover, apart from disease profiles, migrants also have different socio-cultural backgrounds, which may challenge health care access and provision. Objectives: To investigate, identify, and delineate potential challenges of relevance in the care and prevention of communicable diseases of public health significance in general and particularly HIV/AIDS and TB among migrants from countries where these infections are endemic, and eventually generate knowledge that could inform policies and practice. Methods: Data for this thesis were collected in four of the five counties of the Northern region in Sweden. Quantitative and qualitative methods were used including a survey of 268 migrant students in two language schools (I & II); an interview study with 10 care providers caring for patients with migrant backgrounds and observations of care encounters (III) and an interview study with 15 care providers experienced in screening migrants (IV). Descriptive and logistic regression analyses were used to summarize survey data whereas a thematic analysis approach was applied to the qualitative data within the interpretive description framework. Results: The students scored on average low on both HIV/AIDS and TB knowledge and displayed misconceptions and negative attitudes towards the two diseases and infected/sick persons. Knowledge level and attitude could be predicted by prior knowledge, years of previous education and geographic origin. In contrast, no association was found between being screened and the level of TB knowledge or attitude towards TB and infected/sick persons. However, fear of being deported appeared to be the main predictor of reluctance to seek HIV/AIDS care after controlling for socio-demographic factors, knowledge level, stigmatizing attitudes and fear of disclosure. Health care providers described complex and intertwined challenges that influenced both care delivery and receipt. The challenges described included language, the socio-cultural diversity within migrant groups and between migrants and the caregivers. These often resulted in divergent perceptions and expectations about care and caring. The participants highlighted the complexities of caring for diverse patients within different institutions with conflicting policies and frameworks. They also described the difficulties the migrants face in navigating the Swedish care system. Conclusions: This thesis illuminates complex challenges in the care of migrants. The findings emphasize the need for multilevel strategies in order to remove identified barriers. This requires accommodating diversity by improving care providers’ cultural competence and migrants’ health literacy. It further requires policies and practices that emphasize health services responsiveness in order to provide equal access and equitable care. Finally, it entails revisiting existing policies and legislative frameworks to promote a change in ways of thinking about and approaching migration, HIV/AIDS and TB issues, to address the specific vulnerabilities of mobile populations in a world on the move.

This project explores a reinterpretation process of a deindustrial site through landscape architecture. By using the industrial process to guide the formation of the landscape, spaces, and experiences, a semi-abandoned industrial site is transformed into a cultural park. The purpose of the project is to articulate the intriguing qualities of a deindustrial site and respond to them through a design process that is sensitive to the history and character of the site, while allowing contemporary uses and experiences to evolve.

This practicum investigates the application of ecological literacy theory to the practice of landscape architecture. Ecological literacy can be defined as the ability to comprehend the complex relationships of one’s surrounding environment and live life with greater environmental sensitivity. The Lake Winnipeg watershed is home to over 5 million people, and draws its water from four Canadian provinces and four American states. With the anthropogenic manipulation of the landscape, native watershed functions like water retention and filtration have been compromised. Each year, increasing amounts of phosphorus enter the lake from agricultural and urban fertilisers and effluents. This nutrient loading creates algal blooms toxic to humans and other species that rely on the lake for survival. The proposed programmatic framework and design interventions are intended to address these impacts by fostering watershed sustainability and ecological literacy, while engaging citizens in the processes associated with increasing local ecological integrity.