Bakgrund: Specialistsjuksköterskans kompetensområde omfattar att utveckla omvårdnaden kring varje patient samt att leda medarbetare i omvårdnadsarbetet. Inom psykiatrisk vård är dock specialistsjuksköterskans roll otydlig och hens kompetens synliggörs inte i det dagliga arbetet. Syfte: Att beskriva sjuksköterskans upplevelse av nyttan av sin specialistutbildning i den psykiatriska vården. Metod: En intervjustudie med en kvalitativ ansats. Sex specialistsjuksköterskor inom psykiatrisk vård med magisterexamen som arbetat inom psykiatrisk vård minst två år i sin nuvarande profession intervjuades i denna studie. Resultat: Informanterna upplevde att utbildningen gav dem ett större helhetsperspektiv på människan och ett ökat vetenskapligt medvetande vilket ansågs nödvändigt för det dagliga patientarbetet och ledarskapet. Informanterna beskrev också en ökad yrkesstolthet. Fler informanter upplevde dock att deras kompetens inte var känd av andra medarbetare och inte bekräftades eller tillvaratogs av organisationen. Diskussion: Studier som beskriver vilka faktorer som hindrar respektive kan främja specialistsjuksköterskans möjligheter att använda sin kompetens inom psykiatrisk vård behövs. / Background: The specialist nurse has knowledge on how to improve and develop the care of every patient and lead staff in the nursing process. It's not always the role of the psychiatric specialist nurse is obvious, the role is usually not visible or confirmed in the daily work. Aim: To describe the nurse's experience of the benefits of the specialist competencies in psychiatric care. Method: An interview study with a qualitative approach. Six specialist nurses in psychiatric nursing with a master's degree who worked in psychiatric care for a minimum of two years in their current profession were interviewed for this study. Results: The informants experienced the education giving them necessary skills for the work, increased professional pride, and a holistic approach in the treatment of patients, increased scientific awareness and significance for the leadership. On the other hand informants experienced that their competences and skills were unknown to other team members and not confirmed and looked after by the organization. Discussions: Studies describing the factors that prevent or promote specialist nurse's ability to use its expertise in psychiatric care is needed.

Bullying is a serious problem for many adolescents, and one that can have detrimental effects on normal developmental processes, as chronic and severe bullying can obstruct the fulfilment of essential psychological needs. However, there are currently few targeted interventions available for chronic and severe bullying cases. The purpose of this study was to evaluate the effectiveness of the Red Balloon Learner Centres (RBLC) which are a full time personal and academic recovery programme for bullied adolescents. A mixed-methodology was utilised, and quantitative outcome measures included: depression, anxiety and trauma symptoms, self-esteem and academic engagement and self-concept. The study was non equivalent groups design (NEGD) and incorporated a comparison group of bullied adolescents from Hertfordshire local authority (LA). The aim was to compare the recovery process between groups over time by taking an initial baseline measure, and conducting follow-up assessments every three months. Both groups demonstrated significant improvements in outcome variables over time, but there were no significant differences between groups at six month follow-up on any outcome variable. Both groups reported similar recovery themes that related to need fulfilment in the areas of safety and security, control, belonging and self-esteem. Recovery is not just the absence of internalising symptomology, but constructive fulfilment of needs. Social needs were felt to be most affected by chronic and severe bullying and most difficult to fulfil constructively. It is recommended that interventions for chronically and severely bullied adolescents should enable constructive need fulfilment, which may involve changes to the ethos and culture of schools, collaborative therapeutic intervention and targeted skill building.

The thesis called "Expert proofs" deals with one of the types of proper evidence which is applied in cases when an expert report is necessary to clarify facts important for criminal trial proceedings. Thesis is divided into 5 basic chapters. The first chapter is introductory and talks about some of the general problems of expert laws - evaluation of the current legal regulations of expert's function - expert law and expert ordinance, especially from the point of view of the changes that these legal regulations have undergone as well as the forthcoming changes in the form of updating of the current law and preparation of a brand new law. It also talks about definition of an expert, especially the difference between a witness and a consultant, then briefly about their rights and duties in the criminal trial proceedings in general. The second chapter deals with the presence of an expert explicitly in criminal trial proceedings and is divided into three parts. The first one provides basic information about admitting an expert and its form. The second one concerns the definition of an expert's assignment and the third one concerns preparation of an expert report, in which the expert familiarizes themselves with the criminal case. The third chapter deals with the actual output of an expert's investigation, its...

In this small-scale, qualitative study, the experiences of nine teachers who support learners identified with social, emotional and behavioural difficulties (SEBD) in mainstream primary schools are considered. A narrative approach enabled teachers to share their complex portrayals of practices and feelings about their roles. Perspectives on models of disability and disability rights, performativity, professional identity for teachers, and SEBD, have informed analysis and understanding of the stories teachers told. The study explores how the relationship between teachers’ professional identity and well-being and the expectations imposed upon them in a neoliberal influenced education system brings about pressures and concerns. Attempts by the teachers to achieve a balance between what they feel they ought to do (to meet policy expectations) and what they feel they should do (to meet the entitlements of children) has led to excessive workloads and complex emotional responses. Reflections on the way these teachers constructed discourses about why some children exhibit disruptive and challenging behaviours provide an understanding of how their negotiation of this challenging context impacts on the relationships they form with the children. The findings suggest that teachers experience confusion due to the complexities and contradictions they are faced with when trying to support learners identified with SEBD in an education system which incorporates policies guided by different models of disability. The study concludes by suggesting that teachers’ critical reflection on the discourses they have constructed in relation to models of disability could bring about a new way of shaping their practice. It is argued that a rights-based approach to teaching children who exhibit challenging, disruptive and concerning behaviours would emancipate children from the restrictive views and beliefs teachers seem to have developed. Approaches which focus on children’s rights to inclusive learning opportunities, which reflect their entitlement to an education, would go some way to addressing the confusion, contradiction and pressures these teachers described.

The contamination of sterile pharmaceutical products is a serious event which has in the worst case scenario led to patient death. Operators are the primary source of clean room contamination, with the majority of their detritus being identified as skin squames and their related microorganisms. The ability of operator associated bacterial contamination to disseminate through specialist garments worn in the clean room environment is apparent in the literature. However, despite the fibres of such garments being identified as a suitable substrate for bacteria to adhere to and grow upon, the bacterial bioburden of the surface of clean room operators’ garments is an area which severely lacks in published research. Reported here is the recovery, enumeration and comparison of the levels of bacteria on the surface of reusable antistatic carbon filament polyester clean room garments, using the direct agar contact method, following their laundering with and without terminal gamma sterilisation, immediately following their donning with operators dressing wearing either no gloves, non – sterile gloves or sterile clean room gloves, and following their wear within the clean room environment, with respect to gender. The aforementioned method, with its recovery efficiency shown to be unaffected by agar composition (NA or TSA), recovered bacteria from the surface of garments laundered with and without gamma sterilisation. Such terminal decontamination was shown to reduce the surface bacterial bioburden of the garments, especially at the chest and umbilicus regions, which were shown to harbour higher levels of bacteria than the other sites tested. The direct agar contact method, showing an increase in recovery efficiency following a 48 hour agar incubation period as opposed to a 24 hour period, also recovered bacteria from the surface of clean room garments donned by operators dressing wearing either no gloves, non – sterile gloves and sterile clean room gloves. Bacteria were transferred onto the surface of these garments via the hand borne route, with the chest and oral cavity regions being found to harbour more bacteria than the other sites tested. Overall, glove type was shown to have no effect upon the resultant bacterial bioburden of the surface of the garments, suggesting expensive clean room gloves could be substituted for their cheaper non – sterile equivalents or no gloves during the donning process without subsequently increasing the surface bacterial bioburden of the garment. The direct agar contact method also recovered bacteria from the surface of clean room garments worn by male and female operators, following their working period within a clean room environment. Gender was found to significantly affect the surface bacterial bioburden of the garments, with the surface of those garments worn by male operators being more contaminated than the surface of those worn by their female counterparts. In addition, the donning of a clean room hood was shown to reduce the levels of bacteria at the chest and posterior cervicis regions of suits worn by both genders. Overall, the direct agar contact method was identified as a successful tool to recover, enumerate and estimate the surface bacterial bioburden of reusable antistatic polyester carbon filament clean room garments. Finally, using 16S rRNA gene sequencing, found to be more reliable and accurate at identifying unknown isolates than traditional phenotypic first - stage tests, which were subsequently found to misidentify > 85 % of the isolates tested, a self - selected representative number of isolates recovered from the surface of garments during the laundering and gender comparison studies were predominantly identified as skin commensal species of Staphylococcus and Micrococcus, as well as environmental species of Bacillus. The knowledge contained within this thesis, with respect to clean room operators and their specialist garments, contributes towards improving contamination control standards within clean room facilities.

The purpose of this research is to facilitate the development and understanding of inclusive education for students with Autism Spectrum Disorder (ASD) in Saudi Arabia. The study is located within Riyadh, a city in Saudi Arabia. The culture and religion of Saudi society are central themes in this study. ASD is a complex disorder due to its characteristics, which include a lack of social skills, communication difficulties, and behaviour problems. A range of qualitative methods were adopted; interviews with twenty general education teachers (GT) and special education teachers (SET) as well as participant observation in five schools. The research seeks to identify the attitudes and practices of primary school teachers in terms of their support for children in mainstream schools. The study shows that teachers are mostly supportive and have positive attitudes toward the inclusive education of learners with ASD. The study shows barriers to inclusive education, for example, lack of time, overcrowded classrooms, curriculum, attitudes, lack of training, teaching methods and school environments and the extent to which mainstream school buildings and classrooms are suitable for inclusion of students with Special Educational Needs (SEN) in general and, more specifically, for students with ASD. Another factor that emerged from the study to support inclusive education was peer tutoring. All the teachers involved in the study are qualified in education but they need additional training and knowledge about inclusion and ASD. Finally, the study provides some practical recommendations as well as some ideas for future research and other activities.

Social work supervision is a core component of the social work profession that is often absent for social workers in interprofessional teams. In capital defense practice settings, social workers are hired as mitigation specialists to work as members of the legal team. Informed by systems theory, the purpose of this action research study was to explore the practice challenges of social work mitigation specialists (SWMS) and how an interprofessional-focused supervision approach could be applied to resolve those issues. Six SWMS employed with capital defense agencies in Georgia and Texas were interviewed. Using a thematic coding analysis, several key themes emerged: (a) role navigation, (b) ethical dilemmas as practice challenges, (c) increased competence, and (d) team cohesion as dynamics that will improve with the implementation of an interprofessional-focused supervision approach. These findings provide understanding as to how supervision can be tailored to guide SWMS and other social workers in interprofessional settings. Recommendations for future research involve developing supervision guidelines for social work practice in interprofessional settings. Adhering to these suggestions might provide insight as to how interprofessional teams can work collaboratively, improving practice approaches and interventions to alter systems of service delivery and client outcomes. This provides the opportunity to effect social change by impacting individual practitioners and clients, as well as organizations, systems, and from a political perspective.

The purpose of the study was to identify the reasons stated by ACT primary school teachers for referral of students for specialist assistance, and the type of specialist assistance given to referred students. The study also compared student referrals in Resource Teacher and Non-Resource Teacher Schools, and examined what patterns were reflected in this sample of primary school student referrals. This study had two sections; an examination of: 1) primary school student referrals and 2) primary school teacher attitudes towards learning difficulties and behavioural difficulties children. The identification of courses undertaken by teachers which were helpful in teaching students with learning and behavioural difficulties were also compared to teacher attitudes. These results were compared with those of Bourke (1985), a previous study of ACT teacher attitudes towards learning difficulties students. The study confirmed findings within the literature review that classroom teachers were the major source of student referrals for specialist services and that two important student variables impacted upon referral. The student variables, student gender and behaviour were found to have a significant effect upon referral. Boys were referred more often in both samples of schools with girls more likely to be referred in Resource Teacher Schools. Referred students were more likely to have no reported behaviour problems in Resource Teacher Schools. There were differences in the patterns of referral in Resource and Non-Resource Teacher Schools, ie service response to referral, parents' role and attitudes of teachers.

<p>The study aimed to evaluate the information and training the stoma therapist at Uppsala University Hospital has given to patients who have recently undergone stoma surgery. The study was a descriptive cross-sectional study using qualitative and quantitative design. A total of 22 patients who completely or partially took care of their stomas and recently had undergone stoma surgery participated by answering a questionnaire. At discharge most of them experienced they were relatively well-informed but they wanted more information. Before the revisit they weren’t especially safe or comfortable. The participants felt they were better informed and more safe and comfortable three weeks to six months after surgery. Whether the patients had undergone a planned or acute surgery did not influence how wellinformed, safe and comfortable in stoma management they were. No differences were found regarding how safe and comfortable in stoma management the patients were related to how long time ago they underwent the operation. Patients wanted additional information about diet, intestinal function and stoma care and more practice in changing stoma materials. Recently operated stoma patients need information and training until they feel sufficiently well-informed, safe and comfortable in order to better manage their stoma at home after discharge.</p> / <p>Studien syftade till att utvärdera den information och utbildning som stomiterapeuten vid Akademiska sjukhuset har gett till patienter som nyligen genomgått en stomioperation. Studien var en deskriptiv tvärsnittsstudie med såväl kvalitativ som kvantitativ design. Sammanlagt 22 patienter som helt eller delvis skötte sin stomi och nyligen genomgått en stomioperation deltog i studien genom att svara på ett frågeformulär. Vid utskrivning upplevde de flesta av deltagarna att de var relativt välinformerade men de önskade mer information. Innan återbesöket var de varken särskilt säkra eller trygga med stomiskötseln. Patienterna upplevde att de var mer välinformerade, trygga och säkra tre veckor till sex månader efter operation. Huruvida de hade genomgått en planerad eller akut operation påverkade inte hur välinformerade, trygga och säkra på stomiskötseln de var. Det kunde inte heller påvisas någon skillnad mellan hur trygga och säkra på stomiskötseln patienterna var relaterat till hur länge sedan de genomgick operationen. Patienterna önskade ytterligare träning på att byta stomimaterial samt mer information kring kost, tarmens funktion samt stomiskötsel innan utskrivning. Nyopererade stomipatienter skulle behöva information och utbildning tills de känner sig tillräckligt välinformerade, trygga och säkra för att bättre kunna sköta sin stomi i hemmet efter utskrivning.</p>

The study aimed to evaluate the information and training the stoma therapist at Uppsala University Hospital has given to patients who have recently undergone stoma surgery. The study was a descriptive cross-sectional study using qualitative and quantitative design. A total of 22 patients who completely or partially took care of their stomas and recently had undergone stoma surgery participated by answering a questionnaire. At discharge most of them experienced they were relatively well-informed but they wanted more information. Before the revisit they weren’t especially safe or comfortable. The participants felt they were better informed and more safe and comfortable three weeks to six months after surgery. Whether the patients had undergone a planned or acute surgery did not influence how wellinformed, safe and comfortable in stoma management they were. No differences were found regarding how safe and comfortable in stoma management the patients were related to how long time ago they underwent the operation. Patients wanted additional information about diet, intestinal function and stoma care and more practice in changing stoma materials. Recently operated stoma patients need information and training until they feel sufficiently well-informed, safe and comfortable in order to better manage their stoma at home after discharge. / Studien syftade till att utvärdera den information och utbildning som stomiterapeuten vid Akademiska sjukhuset har gett till patienter som nyligen genomgått en stomioperation. Studien var en deskriptiv tvärsnittsstudie med såväl kvalitativ som kvantitativ design. Sammanlagt 22 patienter som helt eller delvis skötte sin stomi och nyligen genomgått en stomioperation deltog i studien genom att svara på ett frågeformulär. Vid utskrivning upplevde de flesta av deltagarna att de var relativt välinformerade men de önskade mer information. Innan återbesöket var de varken särskilt säkra eller trygga med stomiskötseln. Patienterna upplevde att de var mer välinformerade, trygga och säkra tre veckor till sex månader efter operation. Huruvida de hade genomgått en planerad eller akut operation påverkade inte hur välinformerade, trygga och säkra på stomiskötseln de var. Det kunde inte heller påvisas någon skillnad mellan hur trygga och säkra på stomiskötseln patienterna var relaterat till hur länge sedan de genomgick operationen. Patienterna önskade ytterligare träning på att byta stomimaterial samt mer information kring kost, tarmens funktion samt stomiskötsel innan utskrivning. Nyopererade stomipatienter skulle behöva information och utbildning tills de känner sig tillräckligt välinformerade, trygga och säkra för att bättre kunna sköta sin stomi i hemmet efter utskrivning.