Hur barn förhåller sig till regler har belysts i forskning som visat att barnen lägger stor vikt vid moralrelaterade regler. Hur barnen accepterar konventionella regler beror på vilken funktion regeln upplevs fylla. Det som saknas i forskningen är ett dynamiskt perspektiv som tar hänsyn till interagerande aktörers ömsesidiga inflytande över varandra när förutsättningarna förändras och hur detta i sin tur skapar nya förutsättningar. För att belysa detta utgår studien från Giddens struktureringsteori som stipulerar att människors sociala handlingar både formar och formas av de strukturella förutsättningarna till skillnad från ett mer strukturalistiskt perspektiv där aktörerna ses som underkastade den struktur som de verkar inom. Struktureringsteorin möjliggör också för underordnade aktörer att utöva kontroll över de med mera makt. Datainsamlingen har genomförts genom deltagande observationer på en skola. Observationsobjektet har varit incidenter där eleverna agerat på ett sätt som inte är förenligt med verksamhetens konventioner. Fokus har legat på elevernas utnyttjande av resurser i form av material och lokaler. Resultatet visar att inbyggda motsättningar i de strukturella förutsättningarna öppnar en möjlighet för eleverna att ta kontroll över de resurser som personalen försöker reglera. När personalen försöker återta kontrollen resulterar det i oavsiktliga konsekvenser på grund av faktorer som inte uppmärksammats vilket i regel förskjuter problematiken och upprätthåller det olovliga resursutnyttjandet. / How children relate to rules has been highlighted in research in which children attach great importance to moral-related rules. How children accept conventional rules depends on what function the rule is perceived to fulfill. What is missing from the research is a dynamic perspective that considers how interacting actors influence each other when conditions change and how this in turn creates new conditions. To illuminate this, the study is based on Gidden's theory of structuration which stipulates that people's social actions both shape and are shaped by the structural conditions as opposed to a more structuralist perspective where the actors are seen as subjects to the structure in which they operate. The theory of structuration also enables subordinate actors to exercise control over those with more power. The data collection was carried out through participant observations at one school. The object of observation has been incidents where the students acted in a manner incompatible with the conventions of the school. The focus has been on students' utilization of resources in the form of materials and premises. The result shows that built-in contradictions in the structural conditions open opportunities for students to take control of the resources that the staff is trying to regulate. When staff try to regain control, it results in unintended consequences due to factors that have not been recognized, which usually offsets the problem and maintains the unwanted utilization of resources.

No description available.

Introduction and Background: Between 1999 and 2014 the number of patients in the labor and delivery that were on medication for opioid use disorder (MOUD) quadrupled. The rate of unintended pregnancies in pregnant patients of mOUD is at a tremendous high due to inconsistencies in the use of reliable contraception in this population. Purpose Statement: To reduce the number of unintended pregnancies and infants born with neonatal abstinence syndrome there is a need for prevention and required education for men and women in medication-assisted facilities. Literature Review: Twenty research studies were reviewed and evaluated. These articles were found by utilizing PubMed, CINAHL, One Search, and Google Scholar. Most articles were discovered in the following Journals: Medical, Contraceptive, Preventative Medicine, Women's Health, Addiction, and Neonatal Nursing Journals. Findings: Through this research, we found there is a need for prevention services and required education onsite at the facility where patients are receiving medication for opioid addiction (mOUD). The following articles show the lack of contraceptive education, and misinformation about reproduction while on methadone or other medication-assisted drugs. Conclusion: The accessibility of having contraceptives onsite with required education for patients who are in treatment has been proven to be more effective and can decrease the number of unintended pregnancies or infants born with Neonatal Abstinence Syndrome. To be able to give better patient care for this specific demographic it is crucial that nurses are allowed to educate clients.

One of the key components of international development is to provide adequate shelter for citizens of developing countries. This is often accomplished by governmental, non- governmental, and private organizations that seek to lower the cost, increase the quality, and expand the availability of safe, sustainable housing through the use of innovative technologies. These new technologies can affect the social and/or economic structure within communities. This paper is a case study resulting from the construction of a seventy-one-home village, including infrastructure, near Yogyakarta, Indonesia by a foreign, aid-based non-governmental organization (NGO). The village was relocated less than two kilometers from its original site after a massive landslide, triggered by the 2006 earthquakes of Central Java, virtually destroyed the entire community. Four years after construction the researcher took an inductive inquiry approach through interviews with residents of the community and residents of neighboring communities to understand the social and economic impacts. The research project explored the unintended consequences to the community resulting from the NGO's use of innovative housing technologies (steel reinforced concrete domes and planned community development) without a thorough understanding of underlying community culture and interactions.

Pedal misapplication (PM) is an error in which a driver unintentionally presses the wrong pedal. When drivers mistake the accelerator pedal for the brake pedal, the vehicle experiences a sudden unintended acceleration, and the consequences can be severe. A brief history of PM is covered, and several novel studies of PM are described. The goals of these studies were as follows: 1. Identify and analyze multiple samples of PM crashes from a variety of data sources using both established and novel methods to gain new insight into the characteristics and frequency of PM crashes. 2. Use the confirmed, real-world PM crash data to develop a custom vehicle dynamics simulation and evaluate the overall potential safety benefit of a theoretical PM advanced driver assistance system. Using an established keyword search identification method and two unique crash datasets, a PM crash frequency of approximately 0.2% of all crashes was found. These PM crashes were typically rear-end or road departure crashes in moderate- to low-speed commercial or residential areas. Female drivers and elderly drivers were more often involved in these PM crashes, which generally featured slightly lower injury severities and often involved inattention or fatigue. Anecdotally, PM crash narratives contained repeated evidence of unexpected events, driver inexperience, distraction, shoe-malfunction, extreme stress, and medical conditions/emergencies. A novel PM crash identification algorithm was developed to detect PMs from time-series pre-crash data. This algorithm was applied to a sample of crashes with event data recorder data available, and a frequency of 4.3% of eligible crashes were found to have exhibited PM behavior, suggesting that PM crashes may be more prevalent than previously thought. While the data from these crashes suggested that a PM occurred, this dataset lacked sufficient data regarding driver intention, which is necessary to confirm each crash as PMs. The characteristics of these PM-like crashes were analyzed and found to be largely similar to those of previous samples, with notable exceptions for higher proportions of male drivers, higher travel speeds, and higher maximum injury severities. More robust data from a naturalistic driving study (NDS) was acquired, and the novel algorithm was applied to all of the sample’s eligible crashes. Because the NDS data contained more data elements such as driver-facing video, crashes that exhibited PM behavior were individually inspected to confirm PM. This produced a PM crash frequency of 1.1%. The characteristics of these confirmed PM crashes were investigated, but a small sample size limits the generalizability of the results. Lastly, crash data from confirmed, real-world PM crashes was used to inform a custom vehicle dynamics model into which a theoretical PM advanced driver assistance system was simulated. The effect of the accelerator suppression system on crash avoidance and mitigation was evaluated to assess its potential safety benefit, which was found to be highly dependent on system threshold values and largely underwhelming in the absence of supplemental braking. The results indicated that a system that detected PM, suppressed acceleration, and applied braking could provide a substantially higher safety benefit. / M.S. / Pedal misapplication (PM) occurs when a driver presses the wrong pedal. When drivers mistake the accelerator pedal for the brake pedal, the vehicle experiences a sudden unintended acceleration, and the consequences can be severe. A history of the controversial subject of PM is covered, and several novel studies of PM are described. In these studies, PM crashes are identified among documented real-world crashes. This is done in three phases: (1) using narratives written by law-enforcement officers or crash investigators, (2) using event data recorders, or “black boxes,” that store vehicle data prior to crashes, and (3) using naturalistic driving study data, including video recordings of subjects during daily driving. These data are analyzed to develop the understanding of how often PM crashes occur and what factors are common among them. It is discovered that the frequency of PM crashes may be an order of magnitude greater than previously estimated. In the final study, real-world PM crash data is used to virtually reconstruct PM crashes and apply an advanced driver assistance system designed to detect PM, suppress the accelerator input, and reduce the severity of the crash or prevent it altogether. By simulating a wide range of system variations, we develop a sense of the feasibility of such a system’s implementation and overall safety benefit.

No description available.

No description available.

Unintended consequences of electronic health records represent undesired effects on individuals or systems, which may contradict initial goals and impact patient care. The purpose of this study was to determine the extent to which a new quantitative measure called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire (CG-UCE-Q) was valid and reliable. Then, it was used to describe acute care nurses' experience with unintended consequences of electronic health records and relate them to the professional practice environment. Acceptable content validity was achieved for two rounds of surveys with nursing informatics experts (n = 5). Then, acute care nurses (n = 144) were recruited locally and nationally to complete the survey and describe the frequency with which they encounter unintended consequences in daily work. Principal component analysis with oblique rotation was applied to evaluate construct validity. Correlational analysis with measures of the professional practice environment and workarounds was used to evaluate convergent validity. Test-retest reliability was measured in the local sample (N = 68). Explanation for 63% of the variance across six subscales (patient safety, system design, workload issues, workarounds, technology barriers, and sociotechnical impact) supported construct validity. Relationships were significant between subscales for electronic health record-related threats to patient safety and low autonomy/leadership (P < .01), poor communication about patients (P < .01), and low control over practice (P < .01). The most frequent sources of unintended consequences were increased workload, interruptions that shifted tasks from the computer, altered workflow, and the need to duplicate data entry. Convergent validity of the CG-UCE-Q was moderately supported with both the context and processes of workarounds with strong relationships identified for when nurses perceived a block and altered process to work around it to subscales in the CG-UCE-Q for electronic health record system design (P < .01) and technological barriers (P < .01).

It is generally held that economic sanctions have an adverse effect on human rights in sanctioned countries, but what about the non-sanctioned countries? Previous research has found that human rights sanctions appear to have a deterring effect on non-sanctioned countries in Latin America which, in turn, led to human rights improvements. The assumption from these findings suggests that countries improve their human rights in fear of being sanctioned themselves. Utilising a difference-in-differences method with data from CIRI and PTS for the time period 1977-1996, the present quasi-experimental study attempts to test these findings on Africa and Asia by posing the hypothesis that economic sanctions improve the level of human rights protection in the non-sanctioned countries of the same geographical region. The results show that, while there appears to be a positive effect on some measures of human rights in non-sanctioned countries, these effects are weak. Moreover, the results also show that the improvements correspond with the number of years following a sanction, where 1 year displays the weakest human rights improvements, whilst 10 years displays the strongest. The conclusion is that there, in some cases, appears to be a modest effect which needs to be examined further, but that sanctions, nevertheless, do not improve human rights in neighbouring countries in a meaningful way.

Globally, in low and middle-income countries 4 out of every 10 pregnancies is reported to be unintended. Having an unintended pregnancy increases the risk of maternal and infant morbidity and mortality, preterm birth, low birth weight, and decreases rates of breast-feeding. The United States (U.S.) consistently has some of the highest rates of preterm birth, infant and maternal mortality of all high-income countries and 45% of all pregnancies in the U.S. are reported to be unintended. The etiology of these outcomes and their relationship to pregnancy intention are complex and multifactorial, but we know this disproportionately effects women living in poverty both in the U.S. and globally. When couples have the knowledge, access, and power to decide when and whether to become pregnant they are more likely to seek preconception care, thus increasing the likelihood of planned pregnancies leading to improved maternal and child health outcomes. Primary prevention strategies to improve maternal/child health outcomes in the U.S. include sexual and reproductive health considerations such as increasing access to birth control. Globally, strategies include expanding access, as well as focusing on the empowerment of women and improving gender social norms. Focusing on community level norms and individual empowerment can lead to greater reproductive autonomy, which in turn leads to an increase in the uptake of birth control and family planning. This broader consideration of multiple levels of power or autonomy is often lacking in approaches taken in the U.S. More information is needed about the social context and determinants of pregnancy intention in our communities, particularly of women living in poverty. The purposes of this dissertation were to 1) to describe reproductive autonomy and family planning challenges in a population of marginalized Ecuadorian women; 2) develop a conceptual framework of reproductive autonomy from the global literature; 3) to validate a shortened form of an interpersonal violence scale used in a study of low-income pregnant women in Kentucky; and finally 4) to investigate the association between pregnancy intention and individual, interpersonal and community factors of impoverished women living in Kentucky. The qualitative study of women in Ecuador identified barriers and facilitators to family planning in a low-resource community. The major themes that emerged were that women’s autonomy was limited by men, shame was ‘keeping women quiet’, systems failed women, and as women aged they were able to build resilience in spite of these challenges. Many reported reproductive coercion, gender-based violence, and regret. Those who could leave unsupportive partners and found social support were more effective at planning their pregnancies. Evidence supports these themes are relatively common in the global literature, particularly of women living in poverty. The comprehensive review of these findings was used to develop a conceptual framework of reproductive autonomy. The Socio-Ecological Model was used to organize the data based on individual, interpersonal or community level determinants of pregnancy intention and reproductive autonomy. This new conceptual model, called the Power and Reproductive Autonomy (PARA) model, was used as a guide to analyze multiple levels of data in a secondary analysis of pregnant women living in poverty in Kentucky. Prior to this secondary analysis study, a measure used in the parent study needed to be validated. A short form of the Women’s Experience with Battering (WEB) scale was found to be psychometrically valid to measure of the impact of intimate partner violence for this population. Findings from the secondary analysis included high rates of unintended pregnancy (66%), and women with unintended pregnancy were more likely to report exposure to interpersonal violence, poor social support, and anxiety at the bivariate level. At the community (county) level those with an unintended pregnancy were more likely to live in counties with fewer social associations, and in rural communities. None of the access, gender equity, income inequality, or violence variables were correlated to pregnancy intention. In the final multilevel model, controlling for demographic variables, only being unmarried and answering the question in English were significant predictors of unintended pregnancy. The rate of social associations in a county was marginally significant with pregnancy intention, in that the presence of social associations appeared to decrease the likelihood of unintended pregnancy. Operationalizing the PARA framework to examine predictors of unintended pregnancy in Kentucky proved to not yield expected results; county level variables related to access, gender equity, and violence were not found to be significantly correlated. Women answering the question in Spanish had significantly higher rates of planned pregnancy, which is a new finding. Having opportunities for social engagement also seemed to be a protective factor in preventing unintended pregnancies. Limitations of cross-sectional data also make it a challenge to capture cumulative life stressors which could contribute to poor reproductive autonomy. Future studies may yield a greater understanding of the social context of pregnancy intention if more interpersonal data related specifically to reproductive autonomy are in the model, such as reproductive coercion, relationship power, communication, and contraceptive decision making. Additionally, further examination of structures or systems that provide economic opportunities in the community is a promising area of reproductive autonomy and pregnancy intention research.