Bakgrund: Antalet barn som far illa ökar samtidigt befaras det finnas ett mörkertal av barn som far illa men som aldrig upptäcks eller uppmärksammas. Detta tros bero på att inte tillräckligt många upprättar orosanmälningar till Socialtjänsten. Att upprätta en orosanmälan kräver stöd och en yrkesgrupp som särskilt berörs av detta är de sköterskor som arbetar inom BHV. Syfte: Att belysa BHV-sköterskors uppfattningar av stöd i arbetet med barn som far illa. Metod: Sju BHV-sköterskor intervjuades. Datamaterial analyserades med fenomenografisk ansats. Resultat: Tre beskrivningskategorier och nio underkategorier utformades. Resultatet visar att stöd är ett begrepp med flera innebörder. Det belyser också betydelsen av stöd samt vilka konsekvenser uteblivet stöd kan få. Organisatoriska faktorer påverkar BHV-sköterskans stöd och kan utgöra ett hinder i BHV-sköterskans arbete och uppfattning av stöd. Konklusion: Stöd kan vara avgörande för BHV-sköterskans arbete och omvårdnadsansvar. Uteblivet stöd skulle kunna få förödande konsekvenser. Utvecklad samverkan genom ett multiprofessionellt team ger stöd åt BHV-sköterskan och förbättrar samtidigt vårdkedjan för de barn som far illa. Organisatoriska faktorer påverkar BHV- sköterskan vilket bör tas i beaktning vid utformning och utveckling av vården. / Background: The number of maltreated children are increasing and a great number of cases are estimated to never be detected or noted. This is believed to be caused by not enough reports to the Social Services which requires courage and support. A professional group that is affected by this are child health care nurses. Aim: To enlighten child health care nurses’ perceptions of support in working with maltreated children. Method: Seven child health care nurses were interviewed. The data were analysed through a phenomenographic approach.Results: Three description-categories and nine subcategories were formed. The results enlighten that support is a concept of several meanings, the meaning of support and what consequences lack of support can lead to. The results also show that organizational factors impact the support of the child health care nurse. Conclusion: Support can be a deciding factor in the child health care nurse’s work and responsibilities. Lack of support could have devastating consequences. A developed multi-professional team offers support to the child health care nurse and simultaneously improves the chain of care for the maltreated children. Organizational factors affect the child health care nurse, which should be taken into consideration in designing and developing health care.

This thesis examines decision making at executive level in Australian private hospitals as a social phenomenon, since individuals draw meaning from their own biographical and social environmental experiences. The researcher interpreted the constructed realities of the factors influencing executives' decisions within the context of private hospitals - a field that is rarely examined through the lens of social research. Using an Interpretivist research paradigm, the researcher conducted semi- structured and in-depth interviews with sixteen executive members who are experts in their field and represent both sectors of the private hospital industry: private for-profit and private not-for-profit. The data generated was transformed into technical accounts using an abductive research strategy and adopting Schütz's notion of first-order and second-order constructs. Using Giddens' Structuration Theory, that stressed the fundamental role of the human agent, the structure and their mutual dependence, the researcher moved beyond the interpretation of individuals' meanings, to incorporate the structure as an entity that can be formed and reformed. The researcher interpreted social actors' constructed meanings of these social phenomena in their work environment to form the elements of a two-dimensional decision making model at organisational level, incorporating the present with the future and the internal with the external factors. On an individual level, three different approaches to decision making were identified, based on whether executives perceived the decision making phenomenon as intuition, as a reasoned process or as an expected outcome. While being from a limited research sample, the findings of this study suggest that the paradox of mission / economic decisions restrained executives in the not-for-profit sector from strengthening their hospitals' financial performance, putting at risk, therefore, their ability to achieve social dividends as a way to proclaim their mission. On the other hand, in the for-profit sector, shareholders' dividends appeared to be a strong catalyst for attaining profit maximisation when making decisions. In both settings, the findings suggest that the role of stakeholder theory is questionable, particularly when executives remained hesitant to involve medical specialists, whom they considered to be major stakeholders and profit generators for private hospitals. This attitude appeared to be constant, despite the changes identified in executives' individual approaches to decision making. However, early signs of shifts towards adopting more commercially and socially accountable decisions were apparent in not-for-p rofit and for-profit sectors respectively. The thesis sets out recommendations to assist executives in managing the different factors that interplay to form executives' decisions. The importance of having a mission in business longevity and the integration, as opposed to alignment, of strategic goals with business operations when making executive decisions in private hospitals was highlighted. The implications for both sectors are described and recommendations for further research are suggested.

<p>This thesis deals with the dynamics of tundra living voles with emphasis on the most common one, the grey-sided vole (Clethrionomys rufocanus). The tundra area chosen for the study was Finnmarksvidda, a vast flatland in northernmost Norway. All small mammal herbivores in the area showed dramatic fluctuations, and field experiment were conducted in order to elucidate these density fluctuations. The specific subjects addressed included: 1/ Temporal and spatial appearance of density fluctuations of voles and lemmings in the area, 2/ The generality of the density patterns observed, 3/ The impact of predation by vole predators during summertime, 4/ The impact of grey-sided vole grazing on food plants of different preference in a predator free environment, in the presence and absence of extra food, and 5/ The impact of food availability on density and demography of grey-sided voles in a predator free environment.</p><p>The results achieved showed that voles in the slope and lowland had cyclic density fluctuations with 5 years duration. The cycles consisted of four phases: an increase phase, a peak phase, a decline phase and a crash phase. In the unproductive lowland and on the moderately productive slope, small pockets of productive habitats seemed to work as “triggers” for the cycles. The lemming fluctuations in the upper plateau (separated from the slope by a steep zone of boulders) differed markedly from the vole patterns in the lowland.</p><p>Only two lemming peaks were recorded in twenty years. Both peaks had very short increase phases, a knife-sharppeak phase and no decline phase before the crash. A comparison between our results and lemming and vole populations from two other areas in Fennoscandia revealed the same difference in fluctuation pattern between lemmings and voles as seen in our area. This results suggests that lemmings in barren tundra highlands and voles in slightly more productive tundra lowlands are regulated by different mechanisms.</p><p>The exclusion of vole predators from vole populations during summertime led to increase in overall vole density. Densities of the clumsy field vole (Microtus agrestis) and juveniles of all species showed the strongest positive effects of the exclusion.</p><p>An experiment analysing the effects of food availability was conducted in islands in a large lake where grey-sided voles were introduced to predator free islands . Supplemental food was given to the voles in two unproductive, and two productive islands. Two unproductive and two productive islands were used as reference islands. The density of voles and the vole weight were higher in both the islands with supplemental food and those with high natural productivity. Increased vole density did not significantly increase grazing damage to plants. The cyclic density pattern of the voles in the nearby mainland (that harboured resident vole specialist predators as stoat and weasel) showed little resemblance to the seasonal fluctuations found in the islands (devoid of resident vole specialist predators). This result suggested that predation by stoat and weasel on grey-sided vole populations may cause the cyclic vole fluctuations seen in the area.</p>

<p>In recent decades, the development of strategies to prevent or slow the loss of biodiversity has become an important task for ecologists. In most terrestrial ecosystems wild-bees play a key role as pollinators of herbs, shrubs and trees. The scope of this thesis was to study 1) pollinator effectiveness of specialist bees vs. generalist flower-visitors, 2) critical floral resources for wild-bees, and 3) methods to estimate the size of wild-bee populations. The wild-bee species <i>Andrena hattorfiana </i>and <i>A. marginata </i>were used as model species. These two species are specialized on pollen from the plant family Dipsacaceae.</p><p>The bee <i>A. hattorfiana </i>was found to be a frequent visitor but a poor pollinator of its preferred food-plant <i>Knautia arvensis</i>. The female bees exert such a strong preference for pollen-producing inflorescences that they likely have deleterious effects on the plant, harvesting valuable pollen that could have been transferred to conspecific stigmas by other flower-visitors. To explore the relationship between wild-bees and their food-plants, the concept of pollen budget was developed. We quantified pollen production in the food-plant population and pollen consumption of wild-bee nests. A survey of the visitation by all flower-visitor taxa indicated that the degree of utilization (the fraction of the total pollen amount that is harvested and utilized by <i>A. hattorfiana</i>) varied from 12% to 80% among <i>K. arvensis</i> populations (N=26). The bee <i>Andrena marginata</i> utilized 44% of the pollen production in a population of <i>Succisa pratensis</i>. The pollen budget suggests that with an average flower-visitor diversity and abundance, 330 individuals of the food-plant <i>K. arvensis </i>are required to sustain a population of 20 <i>A. hattorfiana </i>♀ (the approximate median natural population size). Based on a study of <i>A. hattorfiana</i>, considerable simplifications were proposed for the commonly used mark-recapture design for measuring wild-bee population size. For this species, population size estimated based on mark-recapture data was strongly correlated with the number of observations per survey-walk. The results suggest that large-scale surveys of solitary bee species can be simplified by performing survey-walks.</p><p>The pollen budget and the method proposed for estimating the size of bee populations have the potential to become valuable tools for monitoring and management of wild-bee populations.</p>

Licentiatavhandlingens övergripande syfte var att studera konsekvenser av ökad akademisering och akademiskt lärande inom Svensk specialist-sjuksköterskeutbildning efter genomförande av ny utbildningsreform enligt Bologna. Bakgrund: Specialistsjuksköterskor förväntas i dagens hälso– och sjukvård att kunna bedriva en patientsäker och evidensbaserad vård, vilket kräver akademisk kompetens. Utbildningen till specialistsjuksköterska fördes i och med Bolognaprocessens införande i Sverige 2007 till avancerad utbildningsnivå. Både yrkesexamen och akademisk examen (magisterexamen) skulle inkluderas och integreras i samma utbildning. Detta medförde en förändring från en ämnesinriktad (samlingskodsinriktad) läroplan till en läroplan som syftar till att integrera ämnen (integrationskodsinriktad). Förutom ämnesintegrering skulle yrkesspecifika mål integreras med akademiska mål. Metod: Artikel I genomfördes i form av ett didaktiskt aktionsforskningsprojekt som pågick under 2½ år. En projektledningsgrupp (n=15-18) från fem lärosäten bildades. Denna grupp har aktivt deltagit i hela aktionsforskningsprocessen och vid projektmöten. Vid varje lärosäte utsågs en projektansvarig som ansvarade för den lokala aktionsforskningsprocessen. Dessa personer samlande in data i form av kursplaner, utbildningsplaner, studiehandledningar, minnesanteckningar från lärarmöten och möten med vårdverksamheter samt minnesanteckningar från forskargruppensmöten. Analys har gjorts med hjälp av konstant komparativ analysmetod. I artikel II användes konstruktivistisk Grounded Theory för att samla in och analysera data. Datainsamlingen påbörjades utifrån specialistsjuksköterskestudenters svar på en enkäts öppna fråga (n=120) i samband med utbildningens avslutning 2009 och 2010. Enkätsvaren reste frågor om specialistsjuksköterskans akademiska lärande. För att inhämta en djupare förståelse genomfördes intervjuer med specialistsjuksköterskor (n=12) som yrkesarbetat mellan 5 och 12 månader efter sin examen. Intervjuerna genomfördes från juni till oktober 2011. Avslutningsvis jämfördes svaren på den öppna enkätfrågan med analysen av intervjuerna. Resultat: Vid utbildningsreformens införande fanns pedagogiska motsättningar och didaktiska svårigheter som gav upphov till spänningsförhållanden mellan vårdutveckling, forskning, yrkesspecifika mål och akademiska mål. Spänningsförhållanden framkom också när specialistsjuksköterskorna inte erfor att deras akademiska kompetens tillvaratogs och värderades i vårdverksamheten. När stöd inte fanns för akademiskt lärande uppkom villrådighet och specialistsjuksköterskorna blev ambivalenta över om akademiskt lärande var meningsfullt. För att främja meningsfullt akademiskt lärande framhåller deltagarna betydelsen av samverkan och gemensamma arenor mellan lärosäten och vårdverksamhet där nyttoaspekten med akademiskt lärande tydliggörs. De spänningsförhållanden som framkommer var av både positiv och negativ karaktär.

This thesis deals with the dynamics of tundra living voles with emphasis on the most common one, the grey-sided vole (Clethrionomys rufocanus). The tundra area chosen for the study was Finnmarksvidda, a vast flatland in northernmost Norway. All small mammal herbivores in the area showed dramatic fluctuations, and field experiment were conducted in order to elucidate these density fluctuations. The specific subjects addressed included: 1/ Temporal and spatial appearance of density fluctuations of voles and lemmings in the area, 2/ The generality of the density patterns observed, 3/ The impact of predation by vole predators during summertime, 4/ The impact of grey-sided vole grazing on food plants of different preference in a predator free environment, in the presence and absence of extra food, and 5/ The impact of food availability on density and demography of grey-sided voles in a predator free environment. The results achieved showed that voles in the slope and lowland had cyclic density fluctuations with 5 years duration. The cycles consisted of four phases: an increase phase, a peak phase, a decline phase and a crash phase. In the unproductive lowland and on the moderately productive slope, small pockets of productive habitats seemed to work as “triggers” for the cycles. The lemming fluctuations in the upper plateau (separated from the slope by a steep zone of boulders) differed markedly from the vole patterns in the lowland. Only two lemming peaks were recorded in twenty years. Both peaks had very short increase phases, a knife-sharppeak phase and no decline phase before the crash. A comparison between our results and lemming and vole populations from two other areas in Fennoscandia revealed the same difference in fluctuation pattern between lemmings and voles as seen in our area. This results suggests that lemmings in barren tundra highlands and voles in slightly more productive tundra lowlands are regulated by different mechanisms. The exclusion of vole predators from vole populations during summertime led to increase in overall vole density. Densities of the clumsy field vole (Microtus agrestis) and juveniles of all species showed the strongest positive effects of the exclusion. An experiment analysing the effects of food availability was conducted in islands in a large lake where grey-sided voles were introduced to predator free islands . Supplemental food was given to the voles in two unproductive, and two productive islands. Two unproductive and two productive islands were used as reference islands. The density of voles and the vole weight were higher in both the islands with supplemental food and those with high natural productivity. Increased vole density did not significantly increase grazing damage to plants. The cyclic density pattern of the voles in the nearby mainland (that harboured resident vole specialist predators as stoat and weasel) showed little resemblance to the seasonal fluctuations found in the islands (devoid of resident vole specialist predators). This result suggested that predation by stoat and weasel on grey-sided vole populations may cause the cyclic vole fluctuations seen in the area.

In recent decades, the development of strategies to prevent or slow the loss of biodiversity has become an important task for ecologists. In most terrestrial ecosystems wild-bees play a key role as pollinators of herbs, shrubs and trees. The scope of this thesis was to study 1) pollinator effectiveness of specialist bees vs. generalist flower-visitors, 2) critical floral resources for wild-bees, and 3) methods to estimate the size of wild-bee populations. The wild-bee species Andrena hattorfiana and A. marginata were used as model species. These two species are specialized on pollen from the plant family Dipsacaceae. The bee A. hattorfiana was found to be a frequent visitor but a poor pollinator of its preferred food-plant Knautia arvensis. The female bees exert such a strong preference for pollen-producing inflorescences that they likely have deleterious effects on the plant, harvesting valuable pollen that could have been transferred to conspecific stigmas by other flower-visitors. To explore the relationship between wild-bees and their food-plants, the concept of pollen budget was developed. We quantified pollen production in the food-plant population and pollen consumption of wild-bee nests. A survey of the visitation by all flower-visitor taxa indicated that the degree of utilization (the fraction of the total pollen amount that is harvested and utilized by A. hattorfiana) varied from 12% to 80% among K. arvensis populations (N=26). The bee Andrena marginata utilized 44% of the pollen production in a population of Succisa pratensis. The pollen budget suggests that with an average flower-visitor diversity and abundance, 330 individuals of the food-plant K. arvensis are required to sustain a population of 20 A. hattorfiana ♀ (the approximate median natural population size). Based on a study of A. hattorfiana, considerable simplifications were proposed for the commonly used mark-recapture design for measuring wild-bee population size. For this species, population size estimated based on mark-recapture data was strongly correlated with the number of observations per survey-walk. The results suggest that large-scale surveys of solitary bee species can be simplified by performing survey-walks. The pollen budget and the method proposed for estimating the size of bee populations have the potential to become valuable tools for monitoring and management of wild-bee populations.

ABSTRACT   Introduction: During the past 40 years the ambulance service in Sweden has evolved from mainly being a source of transport to today’s high-tech caring facilities that enable qualified care to start already in the patient’s home. This first level of care is now provided by registered nurses and registered nurses with specialist training in pre hospital care. At the same time as the care provided is becoming more advanced, results from studies demonstrate that the amount of dispatches to patients that lack the need for ambulance care and transport is increasing. Nurses in pre-hospital care possess the knowledge, training and authority to perform an initial assessment of patients and also treat patients according to local and national guidelines. After the treatment it would sometimes be possible for the patients to remain at home without having to use ambulance transport to an emergency department or in other cases find other means of transport to hospital. Today this is, in Sweden, an accepted standard for by district nurses who are mandated to refer, even after only telephone consulting, the patients to self-care. Ambulance nurses lack this according to present guidelines. If a patient is to remain on-scene or home, a strict protocol of documentation has to be filled-in as well as the ambulance crew being in contact with a doctor. In this study, the authors visualize what patient categories stay on-scene or home, what types of examinations was performed and if the patient safety is ensured.   Objective: The aim of this study was to visualize patient safety when the patient is not transported to hospital by ambulance.   Method: A quantitative, descriptive and retrospective design and analysis of 137 ambulance medical records where the patient was left at home after the initial assessment.   Results: The results demonstrate that the patients who wish to remain on-scene have various different conditions. The majority stayed home at their own request and without any further treatment being performed by the pre hospital care provider. In 28 per cent the patients received some kind of treatment, and in some of the cases patients refused ambulance transport even when the ambulance nurse strongly recommended this. This study also demonstrated that, in many cases, the patients´ history as well as the patients´ status were incomplete documented. The ambulance nurse performed, in median, four different examinations on the patients. In more than half of the cases the nurses had documented that the patient had some kind of attendance. Counseling was given both to patients and sometimes to the patients’ family member.  A lack of sufficient documentation in the patients’ medical record was found and also that consultation of a doctor only has been completed in 15 per cent. Of a total of 137 patients there were three patients who called for an ambulance within the following 24 hours. One of these became aggressive during the first time of visit, and therefore the nurse wasn´t able to examine her thoroughly.  The two other patients do not differ regarding the extent of the examination compared to those who didn´t call for ambulance again.   Conclusion:  Although this paper demonstrates that patients´ safety has not been compromised in the examined records, the authors recommend further studies on patient safety when patient remain on-scene. There is also a need for more specific and valid indicators. Documentation and adherence to guidelines were, however, in this study found to be insufficient.  Key words: patient safety, ambulance, patient, specialist nurse in pre hospital care science, nurse, transport, journal.

Title from PDF of title page. / Document formatted into pages; contains 124 pages. / Thesis (Ed.S.)--University of South Florida, 2003. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: This research study compared perceptions of family functioning among preadolescent children with behavior difficulties and their primary caregivers. Participants consisted of 29 caregiver-child dyads as well as each child's classroom teacher. Eligibility for the study was based on the child's placement within a self-contained Emotionally Handicapped (EH) or Severely Emotionally Disturbed (SED) classroom in one of three elementary schools within two west coast Florida counties. Data collection included teacher rating scales pertaining to the severity of each child's behavior and the presence of Callus Unemotional (CU) traits in addition to caregiver and child interviews tapping perceptions of family functioning. Results indicated that caregivers consistently viewed their families as more adaptive and cohesive than did children with a disruptive behavior disorder. / ABSTRACT: These findings are consistent with previous research showing a similar pattern among older adolescents with a disruptive behavior disorder. No relationship was not found between the child's perception of family functioning and CU traits, although it was noted that there was considerable restriction of range on CU traits. Overall, the results of this study contributes to the existing literature by demonstrating that preadolescents, like their older counterparts, also view their families as less adaptive and cohesive than do their caregivers. Limitations and directions for future research are discussed. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

School impact media studies indicate that a well-staffed and funded school library media program with a certified school library media specialist (SLMS) positively correlates with increased student achievement. SLMS must have a shared understanding of their roles and responsibilities to positively impact student success. In an effort to determine prior knowledge and differentiated learning objectives, the method of certification is critical for planning professional development. This dissertation presents a multi-method investigation of differences between Alternatively Certified (AC) and Traditionally Certified (TC) SLMS as it relates to their perceptions of collaboration, leadership and technology described in Information Power: Building Partnerships for Learning (1998). The overall findings were used to generate recommendations for SLMS professional development. Of 2350 total SLMS in Florida, 161 AC and 318 TC SLMS responded to an online job task analysis. The strength of association between method of certification and perceptions of job tasks under the three themes (collaboration, leadership, and technology) were compared using statistical analysis (i.e. variance, standard deviation, t-tests, chi-square tests, and ANOVA). Longitudinal comparisons were made between this study and baselines studies from 1996 and 2006. There were no significant differences between AC and TC overall perceptions of collaboration, leadership and technology as indicated by the job task analysis survey. Two tasks within collaboration and technology themes had large significant differences in AC and TC responses. TC SLMS were more likely to "Assist students and/or teachers with general references services (e.g., answer reference questions)" and to "Evaluate the adequacy and suitability of facilities, equipment, materials, and services with regard to their impact on learning outcomes." TC SLMS were significantly more familiar with IP2, made more attempts to implement IP2, and attended more in-services on IP2. Observations and interviews with two AC and two TC SLMS triangulated the survey data and explored questions related to professional development. Interview participants advocated for content developed by other SLMS and mentorship training. SLMS asserted that professional development should include school and county protocols, evaluation tools and methods, relevant and accessible technologies (i.e. school and district software, Student Information System, Library Databases Standards such as CORE Curriculum). The SLMS indicated a preference for the following professional development methods: SLMS designed and implemented professional development; formal and informal SLMS sharing; differentiation and options to opt-out based on prior experiences and expertise; relevant and accessible technology training; and mentorship. These findings inform ways to effectively recruit, train, certify, and differentiate instruction in SLMS programs and professional development courses. Furthermore, our qualitative findings indicate a need to examine the impact of reduced budgets on school library media programs. Future studies should investigate the impact of increased numbers of non-certified SLMS and cuts to library staff on student achievement and K-12 learning communities. While this study counted the total number of non-certified SLMS in addition to the AC and TC SLMS, results from the sample of non-certified SLMS collected during the job task analysis were not analyzed because it was too small for comparison or generalizability.