Purpose: the aim with this study was to examine how managers in healthcare services, focusing on people with functional variants, work with threats and violence that users exercise against caretakers. Method: Study was conducted through qualitative interviews based on the theoretical framework; hermeneutics. To collect empirical data seven managers in personal assistance and LSS housing in southern Sweden were interviewed. Theory: The results shows that the managers need discretion to handle threat and violence that occur within their operations. The discretion is partly controlled by the conditions that exist in the organization and the managers therefore deem that they need to look at all aspects of the situation. Results: The result shows that there are different variants of threats and violence in the managers operations and that the severity level differs. Further emerges that the managers perception of the incidents is for example based on their knowledge of the functional variant that the users have or on the caretakers treatment towards them. The result also shows that the managers are responsible for creating routines, guidelines, action plans and investigating incidents. Furthermore, they are responsible for ensuring that employees can handle situations that arise. It appears in the result that the caretakers are responsible for following routines, guidelines and action plans that have been established and for reporting incidents that occur to their manager. However, reporting is not always done for various reasons. When incidents have been reported to the managers the result shows that the managers assessments differ. This means that the statistics on reports could be misleading. Circumstances that the respondents believe can make preventative work more difficult are, among other things, lack of time, finances, knowledge, unclear directives from the work environment authority and large staff turnover.

Orientador: Ivete Dalben / Coorientador: Silvia Cristina Mangini Bocchi / Banca: Wilza Carla Spiri / Banca:Raul Aragão Martins / Banca: Luiz Roberto Romero / Banca: Maria Odete Simão / Banca: Regina Stella Spagnuollo / Banca: Maria Irene Bachega / Banca: Maria da Graça Girade Souza / Resumo: O consumo crescente e precoce de substâncias psicoativas acarretou, em todas as partes do mundo, importantes questões sociais e de saúde, demandando o aprofundamento compreensivo das experiências dos atores envolvidos no processo. Dessa forma, o presente trabalho objetivou compreender a interação de alunos adolescentes, com as substâncias psicoativas e desenvolver um modelo teórico representativo desta experiência. Teve como população alvo 21 alunos do terceiro ano do ensino médio de uma escola pública estadual do município de Penápolis/SP, mediante aprovação do Comitê de Ética em Pesquisa, UNESP-Araçatuba, com o referencial teórico Interacionismo Simbólico, referencial metodológico Grounded Theory ou Teoria Fundamentada em Dados (TFD) e técnica de coleta de dados grupos focais. O referencial metodológico possibilitou a identificação da categoria central representativa da experiência dos alunos com substâncias psicoativas, "Movendo-se entre a experimentação e a dependência: o autocontrole do adolescente como componente interveniente.". Este processo é constituído por três subprocessos ou categorias, que representam o significado simbólico da experiência dos alunos com as substâncias psicoativas: Iniciando a interação com o álcool e com o cigarro - o álcool é a substância inicial, consumida para acompanhar os amigos, superar tristezas, obter prazer e coragem e enfrentar as situações próprias da adolescência. As bebidas de predileção são a cerveja e vodka com energético, consumidas abusivamente em festas open bar, momento em que experimentam o cigarro e Narguile, com a possibilidade de agregar outros psicoativos. Mantendo o controle: Vivenciando a fase de experimentação - A incorporação da maconha e da cocaína é uma segunda fase de experimentação, que ocorre de modo coletivo em festas rotineiras. A maconha é a mais consumida, seguida pela cocaína que é ... / Abstract: The growing consumption of psychoactive substances and led early in all parts of the world, important social and health issues, requiring a deeper understanding of the experiences of the actors involved in the process. Thus, the present study aimed to understand the interaction of adolescent students with psychoactive substances and develop a theoretical model of this experience. Target population was 21 students of the third year of high school to a public school in the municipality of Penápolis / SP, with the approval of the Ethics Committee in Research, UNESP-Araçatuba, with Symbolic Interactionism theoretical, methodological reference Grounded Theory or Theory Based on data (TFD) and technical data collection focus groups. The methodological framework enabled the identification of the core category "Moving between experimentation and addiction: the self as a component of the adolescent actor.". This process consists of three sub-processes or categories, which represent the symbolic meaning of the students' experience with psychoactive substances: Starting interaction with alcohol and cigarettes - alcohol is starting substance, consumed to keep up with friends, overcome grief, get pleasure and courage and face the situations own adolescence. The predilection drinks are beer and vodka with energy consumed abusively open bar at parties, at which time try cigarettes and Narghile, with the possibility of adding other psychoactive. Keeping control: Experiencing the experimentation phase - Incorporation of marijuana and cocaine is a second phase of testing, which occurs at parties so collective routine. Marijuana is the most commonly used, followed by cocaine which is used as a strategy to stop the effects of alcohol abuse, finding no impediments to consumption. They point to the ease of access by ace drug availability and lack of supervision combined with the household consumption of alcohol, tobacco ... / Doutor

O presente trabalho analisa a implantação de uma metodologia de cobrança pelo uso da água no qual os aspectos econômicos e ambientais são considerados como variáveis fundamentais na determinação do valor a ser cobrado. Evidencia formas de mensurar a capacidade de pagamento dos usuários de água, a fim de confrontar este dado com os valores da cobrança. Os resultados apontam que dependendo do grau de saturação do corpo d\'água, mesmo com capacidade de pagamento positiva, alguns setores teriam dificuldades de honrar com o pagamento de cobrança, o que evidencia a importância de um processo de gestão que considere o binômio localização - tipologia no processo de tomada de decisão quanto à implantação de atividades econômicas. Outro aspecto interessante se refere a elasticidade preço da demanda. Dependendo das condições de elasticidade uma unidade de produção, mesmo com situação financeira precária, estaria em condições de honrar com o pagamento da cobrança. / This study analyses the introduction of a method for levied on the use of water in which economic and environmental aspect, are considered as basic variables in the determination of the amount to be charged. It presents various ways for measuring the willingness of the users to pay for water in order to compare it to the the charges levied. The willingness to pay is an important mechanism for obtaining information about the economic impact of the policy of levying taxes. The results show that, depending upon the saturation degree of the water bodies, some sectors would have difficulty in paying the charges even when they show positive willingness to pay. It shows the importance of a management policy that considers the duality site-type in the decision-making process as regards the implantation of economic activities. Elasticity in demand prices is another important factor in this process. Depending upon the conditions of elasticity, a production unit would be able to honor its tax liabilities despit its delicate financial situation.

Thesis (M.Inf.) --University of Limpopo, 2018 / The purpose of this research is to investigate the information needs of rural communities in Bushbuckridge. Investing information of communities is vital because information plays an important role in enabling communities to meet their development needs, such as employment, education, health, safety, food security, and leisure. Libraries are therefore instrumental in helping library users to meet these needs. The study utilised triangulated (quantitative) and (qualitative) research methods. Participants in this study included 100 library users, four librarians and one library manager drawn from four local libraries through a combination of random (probability) and purposive (non-probability) sampling. The quantitative part of the study i.e. survey measured the perceptions of users on library services through questionnaires, while unstructured interviews elicited the experiences of librarians in addressing the information needs of library users in the four libraries of Bushbuckridge. Findings from the survey revealed, inter alia, that: most (65%) users had access to library services, although high travelling costs were a major barrier for those living in remote villages; a large number of users (60%) still depended on librarians to help them find information, while a growing number of users (33% had begun using computers and the internet to meet their information needs; the most important reasons for using the library were: assignments, study and careers, and, the majority of users in all four libraries were generally satisfied with the quality of the services rendered, although significant improvements were required in the supply of materials and water. Findings from interviews with librarians demonstrated that significant steps had been taken to address information needs of users across the four libraries. Common examples include: books and materials; computers and internet services; study groups; user training, and outreach programmes – although these were hampered by shortage of staff and vehicles. Cross-cutting problems included delays in purchasing of library materials; shortage of water and low perceptions about the benefits of library services in the community. In light of these results, it was concluded that information needs of library users had been partially met, with greater room for improvement in areas like human resources, information technology, transport and procurement systems and processes. The research findings have demonstrated that if provided well, library information services may help reduce the challenges of illiteracy, poverty and unemployment in this area. In light of these findings, the study recommended, inter alia, that the skills of library staff along with procurement systems and processes be upgraded in order to satisfy the information needs of library users in the study area. The study further recommended that outreach programmes be scaled up to increase awareness in the community about the role and benefits of library services in facilitating community development, particularly in Bushbuckridge where challenges of illiteracy, poverty and unemployment continue unabated.

Orientador: Silvio Yasui / Banca: Cristina Amélia Luzio / Banca: Ricardo Sparapan Pena / Resumo: O presente estudo tem como objetivo conhecer os itinerários terapêuticos dos usuários de álcool e outras drogas de um município de grande porte no Estado de São Paulo e investigar a percepção dos gestores e trabalhadores da saúde sobre a rede de atenção à saúde ao usuário de álcool e outras drogas e identificar quais os serviços que compõem essa rede. Foi realizada uma pesquisa de campo, de outubro de 2013 a março de 2014, em um centro de Atenção Psicossocial álcool e drogas (CAPSad), Hospital Psiquiátrico, Atenção Básica (AB) e Direção Regional de saúde (DRS). Os sujeitos da pesquisa foram quatro usuários de álcool e outras drogas, três trabalhadores da saúde e três gestores. Foi utilizado, como instrumento de coleta de dados, o roteiro de entrevista aberta para que os participantes pudessem produzir as narrativas. Os resultados mostram que o itinerário terapêutico dos participantes é plural, contemplando o cuidado informal dos familiares, a crença religiosa e os cuidados profissionais, não se restringindo somente às instituições de saúde mental. Os sujeitos tendem a recorrer simultaneamente a diversos lugares em busca do cuidado. Verificou-se que os usuários circulam em uma rede de cuidados pouco articulada, que reflete diretamente no itinerário terapêutico deles, fixando-os em determinados serviços. Concluímos que a rede ao usuário, muitas vezes, é compreendida somente como serviços especializados, como o CAPSad e lugares para internação. Frente aos resultados, destaca-se a necessidade de aprimorar a atenção ao usuário de álcool e outras drogas por meio de uma rede de atenção à saúde articulada e que atue na lógica da atenção psicossocial / Abstract: This study aimed to assess the therapeutic itineraries of users of alcohol and other drugs from a large city in the state of São Paulo and investigate the perception of managers and health workers on the network of health care to the user of alcohol and other drugs and identify which services make this network. A field survey was held from October 2013 to March 2014 in a center of Psychosocial Care alcohol and drugs (CAPSad), Psychiatric Hospital, Primary Care (AB) and Regional Health Directorate (DRS). Survey subjects were four users of alcohol and other drugs, three health workers and three managers. Was used as data collection instrument the interview script opened to the subjects to produce narratives. The results showed that the therapeutic path of participants is plural, contemplating the informal care of family, religious beliefs and professional care, not limited mental health institutions only. The subjects tend to resort simultaneously to several places in search of care. However users circulating in a network of little articulated care, which directly reflects the therapeutic itinerary of these users, fixing them in certain services. We conclude that the network to the user, it is often understood only as specialized services such as CAPSad and places to hospital. Based on the results stands out the need to improve the attention to the user of alcohol and other drugs; through a network of articulated attention to health and that they act in the logic of psychosocial care / Mestre

The objective of this study was to investigate a population of identified inhalant users at Intermountain Intertribal School, comparing and contrasting two user groups to a control group of nonusers on a number of selected research variables. The subjects included 42 identified inhalant users. Subjects were further classified into two user groups: one-time users and repeat users, and 20 nonusers. The nonuser group comprised the control group. Each subject was individually interviewed and administered the research and data collection instruments. In addition, other essential information was taken from permanent school records. A one-way analysis of variance was computed to ascertain the relationship between group membership and 11 selected research variables. A discriminant function analysis was computed to determine differences in the 11 research variables as well as to classify and predict group membership. A descriptive analysis of a questionnaire was also reported. Statistically significant differences were found among the three research groups on six of the 11 variables. The discriminant function correctly classified 72% of the subjects, and analysis of the group centroids indicated that the greatest distinctions among the groups were between the nonuser group and the repeat user group. The data present a pattern of inhalant use similar to other populations. The importance of early identification and treatment as well as preventative programs is discussed. Implications of the study and recommendations for further research were made.

Coarticulation occurs in running speech when one speech sound or phoneme overlaps with another. It can be considered a result of the way we sequence and organize our articulators to efficiently produce consecutive consonants and vowels in fluent speech. Previous research has suggested that measures of coarticulation can provide insight into the maturity of the motor speech planning system (Barbier, Perrier, Ménard, Payan, Tiede, & Perkell, 2013; Zharkova & Hewlett, 2009; Zharkova, Hewlett, & Hardcastle, 2011). Speech stability has also been suggested as an indicator of motor speech maturity in previous research using ultrasound imaging of velar-vowel targets (Frisch, Maxfield, & Belmont, 2016). This study extends research by Frisch, Maxfield, & Belmont (2016) to investigate patterns of velar-vowel coarticulation and speech stability in bilingual children who wear cochlear implants. Ultrasound and acoustic data were recorded from one English-Spanish bilingual participant (P1) who wears bilateral cochlear implants, one English-Spanish bilingual control child (P2) with no hearing impairment, and one English-Spanish bilingual adult speaker. Measures of velar-vowel coarticulation and speech stability across three productions of English and Spanish words were recorded and analyzed following procedures of Wodzinski and Frisch (2006). The participants were asked to produce three repetitions of fifteen English and fifteen Spanish target words starting with a /k/+ vowel sequence. Ultrasound imaging was used to record and trace tongue movement at the point of maximum velar closure. Data was compared between English and Spanish words, across participants, and between repetitions of the same word. In comparing English and Spanish words, child participants (P1 and P2) demonstrated increased coarticulation during Spanish productions. All participants showed decreased stability in Spanish productions when compared to English. Adult participant (P3) showed greater overall stability in productions and consistent coarticulation across both languages. Measures of coarticulation and overall stability were relatively equal across P1 and P2, while P3 showed greater and more stable coarticulation across both languages. Preliminary results support findings in previous research suggesting that anticipatory coarticulation and speech stability could be used as an index for assessing speech motor planning in bilingual and clinical populations (Barbier, Perrier, Ménard, Payan, Tiede, & Perkell, 2013; Frisch, Allen, Betancourt, & Maxfield, 2016; Frisch, Maxfield, & Belmont, 2016; Frisch & Wodzinski, 2014; Zharkova & Hewlett, 2009; Zharkova, Hewlett, & Hardcastle, 2011). Results additionally indicate that a young cochlear implant user who receives early intervention and is learning two languages can develop commensurate motor speech planning systems to that of a typical bilingual peer and that patterns of coarticulation and stability may be different in English and Spanish contexts.

Current clinical practice regarding upper body prosthesis prescription and training is lacking a standarized, quantitative method to evaluate the impact of the prosthetic device. The amputee care team typically uses prior experiences to provide prescription and training customized for each individual. As a result, it is quite challenging to determine the right type and fit of a prosthesis and provide appropriate training to properly utilize it early in the process. It is also very difficult to anticipate expected and undesired compensatory motions due to reduced degrees of freedom of a prosthesis user. In an effort to address this, a tool was developed to predict and visualize the expected upper limb movements from a prescribed prosthesis and its suitability to the needs of the amputee. It is expected to help clinicians make decisions such as choosing between a body-powered or a myoelectric prosthesis, and whether to include a wrist joint. To generate the motions, a robotics-based model of the upper limbs and torso was created and a weighted least-norm (WLN) inverse kinematics algorithm was used. The WLN assigns a penalty (i.e. the weight) on each joint to create a priority between redundant joints. As a result, certain joints will contribute more to the total motion. Two main criteria were hypothesized to dictate the human motion. The first one was a joint prioritization criterion using a static weighting matrix. Since different joints can be used to move the hand in the same direction, joint priority will select between equivalent joints. The second criterion was to select a range of motion (ROM) for each joint specifically for a task. The assumption was that if the joints' ROM is limited, then all the unnatural postures that still satisfy the task will be excluded from the available solutions solutions. Three sets of static joint prioritization weights were investigated: a set of optimized weights specifically for each task, a general set of static weights optimized for all tasks, and a set of joint absolute average velocity-based weights. Additionally, task joint limits were applied both independently and in conjunction with the static weights to assess the simulated motions they can produce. Using a generalized weighted inverse control scheme to resolve for redundancy, a human-like posture for each specific individual was created. Motion capture (MoCap) data were utilized to generate the weighting matrices required to resolve the kinematic redundancy of the upper limbs. Fourteen able-bodied individuals and eight prosthesis users with a transradial amputation on the left side participated in MoCap sessions. They performed ROM and activities of daily living (ADL) tasks. The methods proposed here incorporate patient's anthropometrics, such as height, limb lengths, and degree of amputation, to create an upper body kinematic model. The model has 23 degrees-of-freedom (DoFs) to reflect a human upper body and it can be adjusted to reflect levels of amputation. The weighting factors resulted from this process showed how joints are prioritized during each task. The physical meaning of the weighting factors is to demonstrate which joints contribute more to the task. Since the motion is distributed differently between able-bodied individuals and prosthesis users, the weighting factors will shift accordingly. This shift highlights the compensatory motion that exist on prosthesis users. The results show that using a set of optimized joint prioritization weights for each specific task gave the least RMS error compared to common optimized weights. The velocity-based weights had a slightly higher RMS error than the task optimized weights but it was not statistically significant. The biggest benefit of that weight set is their simplicity to implement compared to the optimized weights. Another benefit of the velocity based weights is that they can explicitly show how mobile each joint is during a task and they can be used alongside the ROM to identify compensatory motion. The inclusion of task joint limits gave lower RMS error when the joint movements were similar across subjects and therefore the ROM of each joint for the task could be established more accurately. When the joint movements were too different among participants, the inclusion of task limits was detrimental to the simulation. Therefore, the static set of task specific optimized weights was found to be the most accurate and robust method. However, the velocity-based weights method was simpler with similar accuracy. The methods presented here were integrated in a previously developed graphical user interface (GUI) to allow the clinician to input the data of the prospective prosthesis users. The simulated motions can be presented as an animation that performs the requested task. Ultimately, the final animation can be used as a proposed kinematic strategy that a prosthesis user and a clinician can refer to, during the rehabilitation process as a guideline. This work has the potential to impact current prosthesis prescription and training by providing personalized proposed motions for a task.

Doctor of Philosophy (PhD) / After two decades of public management reform, the ‘new accountability’ of performance measurement is a routine feature in the relationships between Australian government agencies and the non-profit organisations they fund to provide child and family services. While performance measurement offers to resolve tensions about how governments manage the quality and productivity of contracted services, the indicators they commonly adopt raise well-documented practical, political and epistemological challenges in social services. Left unresolved, these challenges risk biasing representations of service performance, by emphasising the most tangible dimensions of service activities (such as measures of client throughput) over relationship building and care. Capturing only part of service activity compromises the usefulness of performance data for managing quality and outcomes, and denies policy makers critical information about the value and meaning of care in users’ lives. This thesis identifies and critically explores one set of challenges for performance measurement: the role of service users. Uniquely, I explore how user involvement in social service evaluation can make visible how these services enhance the quality of family and personal life. Using a case study of family support services in New South Wales, the research makes a series of empirical and theoretical contributions to problems of user involvement in social service evaluation. Firstly, the research examines the performance indicators currently used by government to monitor the efficiency and effectiveness of family support services in NSW. This shows that performance indicators in family support capture output more thoroughly than outcome, and confirms the minimal role that service users play in assessing service quality and outcomes. But while service users are largely excluded from participation in performance measurement, theoretical perspectives as diverse as managerialism and feminism treat service users as well placed to capture and report otherwise elusive information about care quality and outcomes. Further, participation in evaluation facilitates the exercise of users’ rights to self-expression and self-determination in the social service delivery and policy process. After identifying the widespread exclusion of service users’ perspectives from performance measurement in NSW family support, the thesis makes its more substantial contribution, in documenting findings from a detailed study involving adult family support service users (parents) and their workers (the ‘Burnside Study’). This qualitative study was conducted in four socio-economically disadvantaged service delivery sites located around New South Wales. Using focus group, interview and observational methods and a modified grounded theory approach, the study contributes exploratory evidence of what these service users think of, and how they think about service quality, outcomes, and evaluation in family support. The parents’ accounts of using family support capture their unfulfilled social ideals and the broader visions of the justice they hoped these social services would help them achieve. Their criteria for measuring service outcomes and service quality, and their views on evaluation methods embody core themes that social theorists have struggled to analyse, about the purpose of social services and the nature of ‘a good life’. The theoretical framework I develop highlights the role of family support in the context of service users’ struggles for social justice, and in particular, their struggles for self-realisation, recognition and respect (Honneth, 1995). The research extends theories of recognition beyond publicly articulated social movements to those struggles in social life and social politics that exist in what Axel Honneth terms the ‘shadows’ of the political-public sphere (2003a: 122). After establishing a conceptual framework that facilitates deeper interpretation of users’ perspectives, I present the findings in three categories: users’ perspectives on service outcomes; users’ perspectives on service quality; and users’ perspectives on evaluation methods. The findings show how service users define ‘service outcomes’ in the context of their struggles for recognition and respect, highlighting the contribution welfare services and welfare professionals make beyond the managerial ‘Three E’s’ of economy, efficiency, and effectiveness. Further, the findings confirm the importance of ‘helping relationships’ to the quality of service delivery in family support, despite the invisibility of service relationships in existing performance indicators. The complexity of worker-client bonds highlights the difficulty of evaluating social services using simple numerical counts of client or service episodes, and plays into broader debates about strategies for revaluing care work, and the role of care recipients. Finally, the findings show the role performance measurement processes and methods might play in facilitating users’ struggles for recognition. Users identified a role for evaluation in making visible the contribution of family support in pursuing their social justice goals, and saw evaluation as an opportunity in itself to facilitate recognition and respect. Overall, the thesis offers concrete evidence about how family support service users experience and define service quality and outcomes, and how they see their own role in evaluating the services they use. The research shows how users’ perspectives both contest and confirm the ‘new accountability’ of performance measurement, pointing to new directions, and further challenges, for conceptualising – and evaluating – social services.

This study explores the internet experiences of women living in rural and regional Australia, their motives for internet uptake and use, the benefits they gain from using the internet, the difficulties they encounter in using the internet and whether the benefits are affected by technical factors, such as computer equipment and telecommunication infrastructure, availability of opportunities for developing online skills, and perceptions of the internet. Data was collected via an email snowball technique to contact women living in rural and regional Australia, resulting in participation by 40 women from throughout rural and regional areas. The research drew on the literature of internet research and media uses-and-gratifications. Although the internet is a relatively new communication technology, it has attracted a large amount of scholarly interest. However, there has been little research into internet use by individual populations. Women living in rural and regional areas of Australia experience geographical and social isolation, with limited access to goods, services and information, and could be expected, therefore, to gain significant benefits from use of the internet. However, the potential benefits of the internet could be offset by difficulties with internet use in rural and regional areas. A narrative approach was used to determine the motives for internet use by women living in rural and regional Australia, the benefits they gain from using the internet, the difficulties they encounter in using it and whether the difficulties affect the benefits they gain from internet use. The research findings show that, more than anything else, women living in rural and regional Australia use the internet to build and maintain relationships, including keeping in touch with family and friends, re-connecting with friends for the past and making new friends online. They also use the internet to facilitate involvement in community organisations, to contribute to social issues at the national, state and local level and to participate in community projects and events. In addition, women living in rural and regional Australia use the internet to undertake business and education related activities, pursue personal interests, seek emotional support and undertake practical tasks, such as finding and disseminating information, banking and shopping. However, the many benefits of the internet are offset to some extent by the many frustrations encountered in using it, particularly in regard to technical factors and developing online skills. Spam mail and viruses also cause considerable inconvenience.