Syfte: Avhandlingen syftar till att följa upp, beskriva samt generera tentativ teori om pågående förändringsprocesser inom hälso- och sjukvården på såväl makronivå genom studier av sjukhusfusioner som mikronivå genom studier av delat ledarskap. Metod: ”Sjukhusfusioner” beskriver två genomförda sjukhussammanslagningar utifrån en kvalitativ ansats, Grounded Theory med intervjuer av vårdpersonal (I, II). ”Delat ledarskap” utgår från en förändrad ledarskapsmodell på en intensivvårdsavdelning med intervjuer (III-IV) samt frågeformulär (V) som datainsamlingsmetod. Vårdpersonalens uppfattningar av ledarskap redovisas genom en fenomenografisk ansats (III). Vidare beskrivs två avdelningschefers upplevelser av att ha arbetat i ett delat ledarskap genom Grounded Theory (IV). I den sista delstudien (V) används en kvantitativ metod i form av ett frågeformulär. En del av dessa frågor ingår i instrumentet QPSNordic som belyser vårdpersonalens åsikter om arbete, ledarskap och delat ledarskap. Resultat: Vårdpersonalen uttryckte behov av delaktighet och balans mellan olika behov och krav i ett förändringsarbete. Ledarskapets betydelse lyftes fram som en framgångsfaktor för att utveckla hälso- och sjukvårdsorganisationer i förändring. Vårdpersonalens idealbild av sjuksköterskans ledarskap utgjordes av en chef som var närvarande och tillgänglig i den dagliga verksamheten. Begreppet stödjande tvåsamhet lyftes fram som kärnan i delat ledarskap. Stödjande tvåsamhet, en tillitsfull relation mellan avdelningscheferna, bidrog till en god arbetsmiljö då ansvar och befogenheter delades av aktuellt ledarpar. Vårdpersonalen hade en positiv syn på sitt arbete och ledarskapet. De ansåg att det delade ledarskapet ökade avdelningschefernas möjligheter att vara engagerade och tillgängliga i det dagliga arbetet. Konklusion: Resultatet har bildat underlag för två empiriskt grundade modeller; engagerat ledarskap och stödjande tvåsamhet. Engagerat ledarskap utgår från begreppen delaktighet och stöd i en vårdande kultur. Stödjande tvåsamhet bygger på en gemensam värdegrund och olikheter i kompetens hos ledarparet som ligger till grund för utveckling av en tillitsfull relation. Vidare har teorin om det caritativa ledarskapet vidareutvecklats genom begreppet stödjande tvåsamhet som belyser relationen chef till chef i en vårdande kultur. / Aim: The overall aim of this thesis is to follow up, describe and generate a tentative theory on ongoing processes of change in health care. This will be done at a macro level, through the study of hospital mergers as well as a micro level through studies of shared leadership. Method: ”Hospital Mergers” is based on a qualitative approach; Grounded Theory, with interviews of health professionals (I, II). ”Shared leadership” considered a change of the leadership model with interviews (III-IV) and questionnaires (V) as methods for data collection. Health professionals’ conceptions of leadership were described by a phenomenographical approach (III). In addition, two nurse managers’ experiences of working together as equal partners within a shared leadership model have also been presented by Grounded Theory (IV). In the last paper (V), a quantitative method has been used by means of a questionnaire. Some of these questions are included in the QPSNordic focusing on health professionals’ approach to work, leadership and shared leadership. Results: Participation and balancing involvement in a change process was emphasised by the health professionals. Leadership was highlighted as an important factor for healthcare organisations in change. Nurse leadership was seen as an ideal image by the health professionals and emphasised the importance for being present and available in order to provide support and feedback to improve practice. Supportive ”two-getherness” in a shared leadership are described as a relationship based on trust and confidence. Shared leadership made it possible to share responsibilities and tasks, which gave nurse managers a good working environment. Health professionals believe that shared leadership contributes to increased availability of committed nurse managers in day-to-day work. Conclusion: Two empirical models; committed leadership and supporting ”two-getherness” were developed. Committed leadership is built on participation through support in a caring culture. Supporting ”two-getherness” uses concepts such as common value and confident relationship. Moreover, the theory of Caritative Leadership was further developed from another perspective which is that of the relationship between managers. This relationship is known as supporting ”two-getherness”.

Over the last two decades research into the notion of empowerment has been focused on the three primary dimensions of process, outcomes and environment within the contexts of the individual, community groups and business organisations. As a psychological attribute, empowerment at the individual level has been investigated significantly by such theorists as Rappaport (1995) and Zimmerman (2000). However, studies in this field neglect deep understanding of the reality of the individual's experiences of the empowerment process. Definitions within the literature refer to empowerment as being a process which occurs over time for the individual who is personally challenged to achieve power and control within his/her own life context by the application and reflection of learning new knowledge and skills. The purpose of this investigative case study is to examine the reality of the empowerment process as it occurs in the individual lives of a group of women who have actively participated in the learning environment of an investment club over a 2 year period in Brisbane. The three dimensions of empowerment support the structure of the study with the findings evidencing 'authentic empowerment' is achieved when the individual seeks to operate within the dual learning environments of the supportive group as well as the solo learning environment. The reality of individual authentic empowerment proved to be a continuum of experience dependent upon the individual's levels of motivation, energy, decision-making abilities, knowledge, risk taking, confidence, time and goals. Sustainability of empowerment related to the participant's level of active involvement in the dual learning environments while accepting complete responsibility for actions and consequences.

The thesis deals with the issue of inclusive education of pupils with mild intellectual disabilities in Czech mainstream schools focusing on attitudes and experiences of teachers of a selected elementary school on this issue. The theoretical part defines the concept of inclusion in the context of the Czech educational system and legislative measures related to this topic. It summarizes the concept of intellectual disability, describes what an intellectual disability is, what families of a child with intellectual disabilities are facing, and defines the specifics of educating a pupil with an intellectual disability. It also deals with special educational needs and measures for the education of pupils with this disability, which are embedded in the education act and aim to support the inclusive education of pupils with mild intellectual disabilities. The empirical part of the thesis analyses the interviews with teachers of a selected elementary school in the Central Bohemian Region. While conducting the research, the semi-structured interviews were gathered and the attitudes of teachers towards the explored issues were described. The final part summarizes and graphically elaborates findings of the qualitative research and suggests recommendations for possible further research and teaching practice.

The purpose of this study was to develop guidelines to enable the members of acne sufferers' support networks to become better sources of practical, emotional and social support. A literature study and an empirical investigation were done to investigate which factors could enable members of the acne sufferer’s support network to become better sources of support. A questionnaire was developed as an aid to identify the perceptions and emotions of acne sufferers, which was published on a website, (www.acnediaries.co.za) specifically designed for this purpose. Two semi-structured interviews with acne sufferers were also done to enrich the findings. Results of the study identified several guidelines for parents, teachers, siblings, friends and boyfriends or girlfriends of acne sufferers to enable them to give support to teenagers suffering from acne. / Further Teacher Education / M. Ed. (Guidance and Counselling)

RODRIGUES, Maria Fernanda de Sousa. Deus criou o mundo e nós construímos o Conjunto Palmeiras: a constituição da idéia de um bairro solidário. 2012. 212f. – Tese (Doutorado) – Universidade Federal do Ceará, Programa de Pós-graduação em Sociologia, Fortaleza (CE), 2012. / Submitted by Márcia Araújo (marcia_m_bezerra@yahoo.com.br) on 2014-03-20T14:30:26Z No. of bitstreams: 1 2012-TESE-MFSRODRIGUES.pdf: 7899757 bytes, checksum: c3db7272b248e3fe3ea567027afb7a37 (MD5) / Approved for entry into archive by Márcia Araújo(marcia_m_bezerra@yahoo.com.br) on 2014-03-20T16:26:42Z (GMT) No. of bitstreams: 1 2012-TESE-MFSRODRIGUES.pdf: 7899757 bytes, checksum: c3db7272b248e3fe3ea567027afb7a37 (MD5) / Made available in DSpace on 2014-03-20T16:26:42Z (GMT). No. of bitstreams: 1 2012-TESE-MFSRODRIGUES.pdf: 7899757 bytes, checksum: c3db7272b248e3fe3ea567027afb7a37 (MD5) Previous issue date: 2012 / The aim of this thesis is to understand how the neighbourhood Conjunto Palmeiras, located in the suburbs of Fortaleza, has built throughout time the image of a supportive neighbourhood. It is understood that this image is the result of movements related to social demands, such as the development of experiences considered to be innovative in the field of the supportive economy. Those movements, therefore, made Conjunto Palmeiras a target of an uncountable amount of academic studies, many of them awarded, which turned it into an internationally known and acknowledged neighbourhood, especially in the late 90’s. In the mid-2000s, those initiatives have been expanded as a Government policy by the National Secretary of Supportive Economy - SENAES (Brazilian initials). Hence, the main point of this work is to understand which ways those initiatives were widespread and gained legitimacy before the State and the civil society as well as which are the implications of this process, that connects two apparently contradictory rationales. Therefore, guided by a qualitative methodological perspective, the thesis focuses on: Who are the social actors who take part in the process of building this image? How do they work? What is the extent of the so-called supportive initiatives? What perceptions of solidarity permeate the correlation of partnership between the social actors involved? Which implications tend to occur with the institutionalisation of those initiatives before the supportive character that originally particularised? As a result, we conclude that, currently, Conjunto Palmeiras’s supportive initiatives, from an institutional point of view, develop themselves into a field not yet specified. If on one hand, it is sought applicable instruments to its legal autonomy, on the other hand, by institutionalising such experiences, a new path is open in order to allow other references to demarcate those initiatives, probably different from those ones in its genesis. / O objetivo desta tese é compreender como, no Conjunto Palmeiras, um bairro situado na periferia de Fortaleza, construiu-se, ao longo do tempo, a imagem de um bairro solidário. Entende-se que tal imagem resultou tanto da mobilização em torno das demandas sociais para o bairro como do desenvolvimento de experiências consideradas inovadoras no campo da economia solidária que o tornaram conhecido e reconhecido internacionalmente, sobretudo ao final da década de 1990, alvo de inúmeros estudos acadêmicos, detentor de visibilidade midiática e premiações. Em meados de 2000, tais iniciativas expandiram-se como política de governo, por meio da Secretaria Nacional de Economia Solidária (SENAES). O ponto central, desta forma, é entender de que modo essas iniciativas ditas solidárias foram sendo difundidas e adquiriram legitimidade perante o Estado e a sociedade civil e quais as implicações desse processo que une duas lógicas aparentemente contraditórias. Para tanto, orientada por uma perspectiva metodológica qualitativa, a tese teve como foco as seguintes questões: que atores sociais participam do processo de construção dessa imagem? De que maneira atuam? Qual a extensão das iniciativas ditas solidárias? Que percepção de solidariedade perpassa as relações de parcerias firmadas entre os atores sociais envolvidos? Quais implicações tendem a ocorrer com a institucionalização dessas iniciativas diante do caráter solidário que originalmente as particularizaram? Conclui-se que, atualmente, as iniciativas solidárias no Conjunto Palmeiras desenvolvem-se, do ponto de vista institucional, em um campo ainda não definido. Se por um lado, buscam-se instrumentos cabíveis à sua autonomia legal, por outro, ao se institucionalizarem tais experiências, abre-se o caminho para que outros referenciais passem a demarcar estas iniciativas, provavelmente distintas daqueles que a embasaram em sua gênese.

The central theme of the diploma thesis is incorporation of media education at the first stage of primary school. The theoretical part of the thesis briefly defines the basic concepts related to media education, offers an insight into historcal background and gradual integration of media education into the Czech educational system and, last but not least, introduces current state of this cross-curricular topic at Czech schools. The practical part is devoted to a research survey aimed at finding out which didactic topics of media education are mostly reflected in educational materials intended for the first stage of primary school and at the same time at ascertaining how the pupils are mostly involved in media education in terms of task assignments contained in teaching materials. The results of the research show that the most frequently reflected topics of media education that appear in educational materials are advertising, its regulation and influence and characteristics and function of traditional media. In case of the method of pupils involvement in media education, the research findings show that pupils are mostly called upon to receptive activities. To obtain the results of the research survey, qualitative content analysis of selected teaching materials was used.

Bakgrund: Evidensbaserad Design (EBD) är en process som har utvecklats för att säkerställa att beslut om planering och utformning av vårdmiljön bygger på trovärdig forskning med målet att skapa bästa möjliga resultat för personal, patienter och närstående. Vårdmiljöforskning visar att en välplanerad och genomtänkt fysisk vårdmiljö spelar en viktig roll för patientsäkerhet, patientnöjdhet och arbetstillfredsställelse hos personalen. Inom begreppsramen för EBD ingår den visuella miljön som en variation av den fysiska miljön. Det finns redan mycket forskning som undersöker olika aspekter av den visuella miljön inom vården, men det finns dock lite forskning som beskriver åtgärder som syftar till att förbättra vårdmiljön på en akutmottagning.   Syfte: Att beskriva personalens upplevelse av den visuella miljön på akutmottagningen.   Metod: En kvalitativ induktiv intervjustudie genomfördes vid två akutmottagningar i södra Sverige. Femton (n = 15) intervjuer med legitimerade sjuksköterskor, undersköterskor och läkare utfördes. Intervjuerna analyserades med hjälp av innehållsanalys. Resultat: Personalen vid akutmottagningen upplevde att en balanserad visuell miljö främjar välbefinnande. Balansen består av en integration av klinisk funktionalitet och estetiska intryck. Den visuella miljön kan distrahera på olika sätt, vilket skapar en avledning från stressiga upplevelser. Det kan också uppmuntra nyfikenhet och reflektion. Aspekter av den visuella miljön kan emellertid vara distraherande på ett provocerande sätt vilket i sin tur kan ökar stress. En balanserad visuell miljön skapar atmosfär för vårdande. Den visuella miljön har en stimulerande känslomässig inverkan som kan vara både positiv och negativ samt stimulera delaktighet och dialog.   Slutsats: Att skapa en balanserad visuell miljö på akutmottagningen kräver en helhetssyn som inkludera funktionella och personliga perspektiv. Man kan dra slutsatsen att en balanserad visuell miljö i slutändan kan förbättra atmosfären på akutmottagningen och därmed bidra till en stödjande miljö som främjar en känsla av välbefinnande hos personal, patienter och närstående. / Background: Evidence-based Design (EBD) is a process that has been developed to ensure that decisions on planning and design of the healthcare environment are based on credible research with the goal of creating the best possible outcomes for staff, patients and next-of kin. Research on health care design shows that a well-planned and thought out physical environment plays an important role in patient safety, patient satisfaction and job satisfaction for the staff.  Within the conceptual framework of EBD, the visual environment is included as a variation of the physical environment. There is a substantial amount of research that examines different aspects of the visual environment within healthcare, there is however little research describing interventions aimed at improving the healthcare environment in an emergency department (ED). Purpose: To describe the staff experiences of the visual environment at an ED. Method: A qualitative inductive interview study was conducted at two emergency departments in southern Sweden.  Fifteen (n=15) interviews including registered nurses, assistant nurses and emergency physicians were conducted. The interviews were analyzed using content analysis. Result: The staff at the emergency department experienced that a balanced visual environment promotes well-being. The balance consists of an integration between clinical functionality and aesthetic impressions. The visual environment can be distracting in various ways, creating a diversion from stressful experiences. It can also encourage curiosity and reflection. Aspects of the visual environment can however be equally distracting in a provocative manner, reinforcing stress. The visual environment has a stimulating emotional impact that can be both positive and negative as well as stimulating participation and dialogue. A balanced visuell environment creates an atmosphere which supports caring. Conclusion: Creating a balanced visual environment in the emergency requires a holistic approach incorporating practical and personal perspectives. It can be concluded that providing a balanced visual environment can ultimately improve the atmosphere of the emergency department and thereby promote a sense of well-being in staff, patients and next-of kin.

Introduktion: Ohälsosamma matvanor är en av de största riskfaktorerna för ohälsa och förekommer oftare i socioekonomiskt svagare grupper. Tillgängligheten av livsmedel påverkar både vilka kostval vi gör och hur mycket vi konsumerar. Marknadsföring påverkar tillgängligheten och används för att styra konsumenternas livsmedelsval. För att främja hälsosamma val behövs stödjande miljöer med tillgängliga, prisvärda och hälsosamma livsmedel. Syfte: Syftet är att undersöka hur hälsosamma livsmedelsval har samband med konsumenters upplevelser av dagligvaruhandelns bidrag till stödjande miljöer för hälsosamma livsmedelsval. Metod: En kvantitativ tvärsnittsdesign tillämpades. Datainsamlingen skedde genom webbenkät vilken länkades till informanter via sociala medier. Deskriptiv analys användes samt positiv oddskvot för att belysa det salutogena perspektivet. Ett p-värde på <0,05 ansågs signifikant. Resultat: Respondenterna (n=346) var kvinnor och män över 21 år. Majoriteten var kvinnor i medelåldern, med högskole- eller universitetsexamen samt medelinkomst. Konsumenter som väljer hälsosamma livsmedel har samband med sinnesstämning, naturliga livsmedel och tillgänglighet. Slutsats: Det är viktigt att hälsofrämjande insatser riktas mot hela samhället och stärker medvetenheten om hälsosam kost. Då studien visade samband mellan konsumenters upplevelser av dagligvaruhandelns stödjande miljöer och hälsosamma livsmedelsval, bör hela livsmedelskedjan medvetandegöras om hur folkhälsan påverkas av stödjande miljöer. / Introduction: Unhealthy eating habits are one of the major risk factors för unhealth and occur more frequently in low socioeconomic areas. The availability of food affects both the dietary choices we make and how much we consume. Marketing affects accessibility and is used to guide consumers' food choices. In order to promote healthy choices, supportive environments with available, affordable and healthy foods are needed. Aim: The aim is to investigate how healthy food choices are linked to consumers' experiences of the grocery retailer's contribution to supportive environments for healthy food choices. Methods: A quantitative cross-sectional design was applied. Data was collected with a web survey. Descriptive analysis applied as well as logistic regression analysis and positive odds ratio was used to illustrate the salutogenic perspective. A p-value of <0.05 was considered significant. Result: The respondents (n = 346) were women and men over 21 years. The majority were middle-aged women, with a college or university degree and middle income. There is an association between consumers who choose healthy foods and mood, natural foods and availability. Conclusion: It is important that health promotion efforts are directed at the entire society and strengthen the awareness of healthy eating. As the study showed a correlation between consumers' experiences of the grocery's supportive environments and healthy food choices, the entire food supply chain should be made aware of how public health is affected by supportive environments.

Syftet med denna studie var att bidra med fördjupad förståelse för vilka friskfaktorer som är avgörande för långtidsfriskhet ur ett medarbetarperspektiv. Detta genom att studera vad medarbetare inom sociala sektorn i Borlänge kommun upplever bidrar till välbefinnande och friskhet på arbetsplatsen. Vidare ämnade denna studie ge förslag på hur arbetet med friskfaktorer inom Borlänge kommun kan utvecklas. För att på bästa sätt kunna besvara syftet valdes en kvalitativ metod där tillvägagångssättet för insamling av empiri var semistrukturerade intervjuer med långtidsfriska medarbetare från verksamhetsområdet personlig assistans.  Resultatet visar att begreppen stödjande ledarskap, god kommunikation, delaktighet i beslutsfattande, balans mellan arbetsliv och privatliv samt ett positivt arbetsklimat är faktorer som tenderar att ge positiva effekter för hälsa då de finns på arbetsplatsen. Ytterligare faktorer som kunde identifieras var trygghet till följd av lång erfarenhet samt arbetsmoral kopplat till lojalitet. Erfarenheten beskrivs som ett hjälpmedel att hantera olika situationer som kan tänkas uppstå i arbetssituationen samt som stressreducerande eftersom det skapar en tydlighet kring vilka förväntningar som finns i arbetet och mellan kollegorna. Hög arbetsmoral till följd av lojalitet verkar bottna i en vilja att bidra till en medmänniskas nytta genom att vara en viktig resurs i dennes liv.   Denna studie visar betydelsen av ett stödjande ledarskap för förtroendet och tilliten dels mellan chef och medarbetare, dels medarbetare emellan, vilket i förlängningen även påverkar möjligheten till delaktighet samt tryggheten i den egna arbetssituationen. Slutligen visar studiens resultat att friskfaktorer under vissa omständigheter kan bidra med nya möjligheter till främjande arbetsmiljöarbete. / The purpose of this study was to contribute to a deeper understanding of factors that are crucial for long-term well-being and health from an employee perspective. This by studying what employees in the social sector in Borlänge municipality experience contributes to well-being and health in the workplace. Furthermore, this study intended to give suggestions on how the work with health factors in Borlänge municipality can be developed. To best answer the purpose, a qualitative method was chosen in which the approach for collecting empirical data was semi-structured interviews with long-term healthy employees from the area of personal assistance. The results showed that factors such as supportive leadership, participation, autonomy, positive work climate and work-life balance were common in the respondents work situation, which are factors that has shown to have a positive effect on employees' health. Furthermore, the respondents' long-term well-being and health could also be explained by additional health factors that were identified in their work environment. The respondents described that security due to long work experience and work ethic linked to loyalty were factors that contributed to their well-being. The experience is described as a means of handling various situations that may arise in the work situation as well as stress reducing as it creates a clarity about what expectations are in the work and between colleagues. High work ethic due to loyalty seems to be rooted in a desire to contribute to the benefit of another human by being an important resource in his or her life. All in all, the results show that the foundation for successful environment work with health factors requires security and trust partly between the manager and employees and partly between the employees. Finally, the study's results show that, in certain circumstances, health factors may contribute to new opportunities for promoting work environment work.

The problem of the study was determining the supportive conditions related to instructional rounds (rounds) to understand better what conditions may allow for sustained systemic improvement over time. Three Texas school districts were studied to understand the perceptions of district leaders, principals, teacher leaders, and teachers with regard to the sustainability of instructional rounds as a systemic improvement practice, the supportive conditions necessary for sustainability, the salient characteristics that differentiated rounds from other improvement practices, and the potential of rounds to build organizational capacity. Observation of network rounds visits and document analysis was conducted to determine alignment of perception with observation and documents. Findings include perceptions, themes, and critical factors for the sustainability of rounds as an effective systemic improvement practice. Supportive conditions emerged as the most significant perception expressed by the participants. Implications for action for school districts beginning or continuing implementation of instructional rounds are suggested based upon findings from participant perceptions and observation of networks. Suggestions for future research are shared. With supportive conditions in place, instructional rounds has the potential to serve as an effective systemic improvement practice.