RESUME : La communauté internationale s’est engagée à mettre fin à l’épidémie de sida d’ici à 2030. L’atteinte de cet objectif repose sur la capacité des programmes de lutte contre le VIH à apporter le traitement à toutes les personnes vivant avec le VIH et à maintenir ces personnes sous traitement avec une charge virale contrôlée le plus longtemps possible. Des progrès considérables ont été réalisés ces dernières années en matière d’accès au traitement, mais la performance des programmes reste insuffisante en Afrique, en particulier en Afrique occidentale.Afin de mieux comprendre les obstacles dans la mise en œuvre des programmes de lutte nous proposons dans ce travail de décrire l’évolution de la prise en charge du VIH dans un Centre de référence au Sénégal sur une période de 20 ans, en la replaçant dans le contexte des recommandations internationales et nationales. Nous nous intéressons successivement à la mise sous traitement antirétroviral (TAR) des patients éligibles, à la rétention sous TAR à 12, 24 et 36 mois et à l’accès et au contrôle de la charge virale au cours du suivi.Ce travail repose sur l’analyse des données disponibles dans le dossier médical informatisé de 3651 personnes naïves de traitement, âgées de plus de 15 ans et ayant ouvert un dossier entre 1998 et 2015 au Centre de Traitement ambulatoire (CTA) de Fann à Dakar, Sénégal. L'éligibilité est définie selon les recommandations de l’Organisation Mondiale de la Santé en prenant en compte le taux de CD4 (<200, <350 et <500 cellules/µl jusqu’à 2010, 2013 et 2015, respectivement) et le stade clinique. La gratuité du TAR est effective au Sénégal à partir de 2004. Ainsi, l’évolution de la prise en charge en charge est étudiée sur quatre périodes : 1998-2003 (P1), 2004-2010 (P2), 2011-2013 (P3), 2014-2015 (P4).Sur les 3651 personnes naïves de TAR, 2535 (69%) sont éligibles et 1503 (41%) ont été mises sous TAR au cours de leur suivi au CTA. La proportion des patients éligibles mis sous TAR est de 25%, 47%, 75% et 82%, respectivement en fonction des périodes. Cette évolution s’accompagne d’une réduction importante du délai médian de mise sous TAR qui passe de 5,6 mois en 1998-2003 à 0,8 mois à la période 4. Les individus éligibles ayant des taux de CD4 bas sont mis sous traitement en priorité.Les taux de rétention sont de 84%, 77% et 73% à 12, 24 et 36 mois, respectivement. On note une amélioration de la rétention pour la période la plus récente (2014-2016) avec des taux qui atteignent 90% et 82% à 12 et 24 mois. A 36 mois, cette amélioration dans la dernière période ne s’observe plus. A 36 mois, le sexe masculin et la résidence hors de Dakar sont des facteurs prédictifs d'être perdu de vue alors que, l'âge avancé, le stade clinique avancé et les CD4<200 cellules /mm3 sont associés à un risque plus élevé de mortalité. La disponibilité de la charge virale à 12, 24 ou 36 mois atteint environ 40% et reste stable en fonction des périodes d’étude. Le succès virologique mesuré à partir des charges virales disponibles, est globalement de 64% à un seuil de 50 copies/ml et atteint 84 % au seuil de 1000 copies/ml.L’évolution de la prise en charge au CTA est marquée par des progrès importants en termes de mise sous traitement dont le bénéfice est limité par la persistance de difficultés dans la continuité des soins et dans le suivi du contrôle virologique, difficultés auxquelles il faudra trouver des solutions pour espérer atteindre les objectifs ambitieux de l'ONUSIDA. / ABSTRACT : The international community is committed to ending the AIDS epidemic by 2030. Achieving this goal depends on the ability of HIV programs to provide treatment to all people living with HIV / AIDS and maintain these people on treatment with a suppressed viral load for as long as possible. Considerable progress has been made in recent years in access to treatment, but program performance remains weak in Africa, particularly in West Africa.To better understand the obstacles in the implementation of HIV programs we describe the evolution of HIV care in a reference center in Senegal over a period of 20 years and in the context of international and national recommendations. We investigate initiation of antiretroviral therapy (ART) for eligible people, retention on ART at 12, 24 and 36 months and access to and control of viral load during follow-up.This work is based on the analysis of the data available in the computerized medical file of 3651 treatment-naive people over the age of 15 who entered the Fann Outpatient Treatment Center (ATC) in Dakar, Senegal between 1998 and 2015. Eligibility is defined according to the recommendations of the World Health Organization taking into account the level of CD4 count (<200, <350 and <500 cells / μl until 2010, 2013 and 2015, respectively) and the clinical stage. Free ART is provided in Senegal from 2004. Thus, the evolution of HIV care is studied over four periods: 1998-2003 (P1), 2004-2010 (P2), 2011-2013 (P3), 2014-2015 (P4).Of the 3,651 ART-naïve patients, 2535 (69%) are eligible and 1503 (41%) initiate ART during their follow-up at CTA. The proportion of eligible patients on ART is 25%, 47%, 75% and 82%, at P1, P2, P3 and P4 respectively. This increase is associated with a significant reduction in the median time to ART, from 5.6 months in 1998-2003 to 0.8 months in period 4. Eligible individuals with low CD4 count were more likely to initiate timely treatment.Retention rates are 84%, 77% and 73% at 12, 24 and 36 months, respectively. There is an improvement in retention for the most recent period (2014-2016) with rates reaching 90% and 82% at 12 and 24 months. At 36 months, this improvement in the last period is no longer observed. At 36 months, male sex and residence outside Dakar are predictors of being lost to follow-up, whereas advanced age, advanced clinical stage and CD4 <200 cells / mm3 are associated with higher risk of mortality. The availability of viral load at 12, 24 or 36 months reaches about 40% and remains stable according to study periods. The virological success measured from the available viral loads reaches 64% at a 50 copies/ml threshold and 84% at a 1000 copies/ml threshold.The evolution of HIV care in CTA is marked by significant progress in access to treatment, the benefit of which is limited by the persistence of difficulties in retention on ART and in the follow-up of virological control, difficulties that need to be addressed to achieve the ambitious goals of UNAIDS.

Com a Política Nacional de Educação Especial na perspectiva da Educação Inclusiva (2008), as escolas regulares vêm recebendo um número maior de estudantes surdos ou com deficiência auditiva (S/DA), que antes frequentavam escolas especializadas. No entanto, dados apontam a diminuição do número de estudantes S/DA matriculados no ensino fundamental para o ensino médio, e do ensino médio para o ensino superior; ou seja, existem razões para se acreditar que barreiras educacionais se impõem no caminho desses estudantes para que conquistem uma formação educacional completa. Neste contexto, o objetivo deste trabalho é propor um modelo de aceitação de tecnologias levando em consideração fatores que envolvam aspectos do contexto da educação inclusiva, bem como efetuar experimento da interação de usuários S/DA com uma tecnologia para avaliar o modelo. Dentre os fatores mencionados um deles se refere às potenciais barreiras educacionais vivenciadas pelos estudantes S/DA em salas de aula inclusivas. Com relação à metodologia de pesquisa, o estudo desenvolveu-se em ciclos. Na medida em que as investigações avançavam, um novo estudo iniciava, se desenvolvia e se fechava. Isso permitiu que a proposta inicial tivesse sucessivos refinamentos ao longo do tempo até o ponto em que os questionamentos iniciais foram respondidos e o objetivo foi atingido. O modelo proposto mostrou resultados positivos, no sentido de conseguir capturar os fatores que podem influenciar a aceitação de tecnologias considerando o contexto de aplicação específico, uma vez que estes incorporam os aspectos da qualidade pragmática e os aspectos da qualidade hedônica, questões relacionadas à utilidade percebida da minimização de potenciais barreiras educacionais, expectativas futuras, e condições facilitadoras. Conclui-se que o modelo engloba tanto a investigação sobre questões motivacionais pessoais dos usuários quanto a investigação de aspectos do contexto de uso, e que o modelo pode ser utilizado para a finalidade a qual foi proposto, a avaliação de aceitação de tecnologias em ambientes de educação incluvisa. / With the foundation of the National Policy on Special Education on the Perspective of Inclusive Education (2008), mainstream schools are receiving a greater number of deaf or hard of hearing (D/HH) students, that once before were attending specialized schools. However, data point to the declining number of D/HH students enrolled from primary school to high school, and from high school students to higher education; ie, there are reasons to believe that educational barriers are imposed on the way of these students to conquer a complete education. In this context, the goal of this work is to propose a technology acceptance model that takes into account factors that ivolve aspects of the inclusive education context, as well as performing experiment on the interaction of D/HH users with a technology to evaluate the model. Among the factors, one of them refers to the potential educational barriers experienced by D/HH students in inclusive classrooms. With regard to research methodology, the study was developed in cycles. To the extent that the investigations progressed, a new study began, was unfolded and closed. This allowed successive refinements over time to the point where the initial questions were answered and the goal was reached. The proposed model has shown positive results in capturing factors that influence technology acceptance given the domain specific context, since they incorporate aspects of pragmatic quality and hedonic quality, also issues related to perceived usefulness in minimizing potential educational barriers, future expectations, and facilitating conditions. We conclude that the model encompasses both users personal motivation and context of use aspects, and the model can be used for the purpose for which it was proposed, technology acceptance evaluation considering inclusive education contexts.

Urbane Gesundheit ist von globalem Interesse, da schon jetzt die Mehrheit der Menschen in Städten wohnt und dies zunehmend in Entwicklungsländern. Obwohl mentale Gesundheitsprobleme (z.B. Depressionen) in Entwicklungsländern stark verbreitet sind, wurden diese für die rasant anwachsenden Städte dieser Länder bisher nicht zufriedenstellend untersucht. Mit einem räumlich-epidemiologischen Ansatz werden in der vorliegenden Dissertation Faktoren identifiziert, welche das mentale Wohlbefinden der Slumbewohner Dhakas beeinflussen. Hierfür wurden Baseline Daten einer Kohortenstudie verwendet, welche Anfang 2009 in neun Slums in Dhaka durchgeführt wurde. Es wurden Daten von 1.938 Erwachsenen (≥15 Jahre) erhoben. Der WHO-5 Well-being Index wurde als Instrument zur Selbsteinschätzung des mentalen Wohlbefindens verwendet. Mentales Wohlbefinden war signifikant mit verschiedenen Faktoren der natürlichen Umwelt, der Sicherheit vor Überflutungen, sanitären Verhältnissen, sowie mit qualitativ hochwertiger, zufriedenstellender und beständiger Behausung assoziiert. Weitere mentale Gesundheitsassoziationen wurden in Bezug auf Bevölkerungsdichte, Zufriedenheit mit der Arbeitsstelle und mit der Einkommensgenerierung identifiziert, während für individuelle Faktoren wie Alter, Geschlecht, Krankheiten, Gesundheitswissen und Migrationshintergrund angepasst wurde. Räumliche Konzentrationen von gutem und schlechtem mentalem Wohlbefinden wurden festgestellt, welche auf massive Gesundheitsungleichheiten innerhalb der Slums hindeuten. Verschiedene Nachbarschaftskontexte wirken sich zudem in anderer Weise auf das Wohlbefinden aus als persönliche und Haushaltscharakteristika. In der Annahme, dass mentale Gesundheitsprobleme das Risiko physischer Krankheiten sowie die Unfallgefahr erhöhen, liefert diese Dissertation wichtige Informationen, um sowohl eine bessere Krankheitsversorgung als auch sinnvolle Krankheitspräventionsprogramme für die Slums von Dhaka und vergleichbarer Gebiete zu entwickeln. / Urban health is of global concern because the majority of the world’s population lives in urban areas, mainly in the global south. Although mental health problems (e.g., depression) in developing countries are highly prevalent, such issues are not yet adequately addressed in the rapidly urbanising megacities of these countries, where a growing number of residents live in slums. Little is known about the spectrum and burden of mental disease in urban slums. Using a spatial-epidemiological approach, this thesis identifies factors that contribute to mental well-being in the slums of Dhaka, the capital of Bangladesh, which currently accommodates an estimated population of more than 14 million, including 3.4 million slum dwellers. The baseline data from a cohort study conducted in early 2009 in nine slums of Dhaka were used. Data were collected from 1,938 adults (≥15 years). The WHO-5 Well-being Index was used as a measure of self-rated mental well-being. It was found that mental well-being was significantly associated with various factors such as selected features of the natural environment, flood non-affectedness, sanitation, and housing quality, sufficiency and durability. Further associations with population density, job satisfaction, and income generation were identified while adjusting for individual factors such as age, gender, diseases, health knowledge, and migration. Spatial clusters of poor and good mental well-being among different population groups were detected and point to severe health disparities both within and between the slums. Diverse neighbourhood conditions affected mental well-being differently from personal and household level characteristics. Given that mental health conditions could elevate the risk for physical diseases and contribute to injuries, this thesis may provide crucial information for developing better health care and disease prevention programmes in Dhaka’s slums and other comparable settings.

Made available in DSpace on 2016-04-29T13:31:23Z (GMT). No. of bitstreams: 1 O caicara de Ubatuba.pdf: 1446326 bytes, checksum: ffb12023ad6243b064d219a663808134 (MD5) Previous issue date: 2006-05-15 / nenhum / Ubatuba´s history studies, the formation of the caiçara collective identity and the main problems faced nowadays by this county and its population. Problems also responsible for the continuing fragmentation and dilution that the caiçara culture has been suffering along the years. Several movements in order to preserve or recover such culture could be observed, however, there is no use thinking about preserving populations considered traditional , as it should preserve the Atlantic Forest, as an example. Trying to keep it alive in the actual world, self-transformation is the path indicated in this work. But it will only be accomplished through the awareness and critique appropriation of its own traditions by the people involved, if they desire it, through the development of political projects. The theory developed by Habermas (1983;1987;2002;2004) helps to develop such reflections and to propose the communication as a way to reach the understanding to the actual existent problems. The analysis of the facts has as a main point a critique to the functioning of the capitalist system, responsible for the exclusion of the groups, mainly of those who have the mark of their cultural and traditional identity, which distinguish them / Estuda a história de Ubatuba, a formação da identidade coletiva caiçara e os principais problemas enfrentados atualmente por este município e sua população. Problemas responsáveis também pela continuidade da fragmentação e diluição que a cultura caiçara vem sofrendo ao longo do tempo. Vários movimentos no sentido de se preservar ou recuperar tal cultura puderam ser observados; entretanto, não se pode pensar em conservar populações consideradas tradicionais como se deve preservar a Mata Atlântica, por exemplo. Para tentar se manterem vivas no mundo atual, a autotransformação é o caminho apontado neste trabalho. Mas ela se dará somente a partir da conscientização e apropriação crítica das próprias tradições pelos envolvidos, se assim o desejarem, através do desenvolvimento de projetos políticos. A teoria desenvolvida por Habermas (1983;1987;2002;2004) auxilia a desenvolver tais reflexões e a propor a comunicação como uma maneira de se buscar o entendimento para os atuais problemas existentes. A análise dos fatos tem como eixo principal uma crítica ao funcionamento do sistema capitalista, responsável pela exclusão de grupos, principalmente daqueles que carregam a marca de sua identidade cultural e tradicional , que os diferenciam

Com a Política Nacional de Educação Especial na perspectiva da Educação Inclusiva (2008), as escolas regulares vêm recebendo um número maior de estudantes surdos ou com deficiência auditiva (S/DA), que antes frequentavam escolas especializadas. No entanto, dados apontam a diminuição do número de estudantes S/DA matriculados no ensino fundamental para o ensino médio, e do ensino médio para o ensino superior; ou seja, existem razões para se acreditar que barreiras educacionais se impõem no caminho desses estudantes para que conquistem uma formação educacional completa. Neste contexto, o objetivo deste trabalho é propor um modelo de aceitação de tecnologias levando em consideração fatores que envolvam aspectos do contexto da educação inclusiva, bem como efetuar experimento da interação de usuários S/DA com uma tecnologia para avaliar o modelo. Dentre os fatores mencionados um deles se refere às potenciais barreiras educacionais vivenciadas pelos estudantes S/DA em salas de aula inclusivas. Com relação à metodologia de pesquisa, o estudo desenvolveu-se em ciclos. Na medida em que as investigações avançavam, um novo estudo iniciava, se desenvolvia e se fechava. Isso permitiu que a proposta inicial tivesse sucessivos refinamentos ao longo do tempo até o ponto em que os questionamentos iniciais foram respondidos e o objetivo foi atingido. O modelo proposto mostrou resultados positivos, no sentido de conseguir capturar os fatores que podem influenciar a aceitação de tecnologias considerando o contexto de aplicação específico, uma vez que estes incorporam os aspectos da qualidade pragmática e os aspectos da qualidade hedônica, questões relacionadas à utilidade percebida da minimização de potenciais barreiras educacionais, expectativas futuras, e condições facilitadoras. Conclui-se que o modelo engloba tanto a investigação sobre questões motivacionais pessoais dos usuários quanto a investigação de aspectos do contexto de uso, e que o modelo pode ser utilizado para a finalidade a qual foi proposto, a avaliação de aceitação de tecnologias em ambientes de educação incluvisa. / With the foundation of the National Policy on Special Education on the Perspective of Inclusive Education (2008), mainstream schools are receiving a greater number of deaf or hard of hearing (D/HH) students, that once before were attending specialized schools. However, data point to the declining number of D/HH students enrolled from primary school to high school, and from high school students to higher education; ie, there are reasons to believe that educational barriers are imposed on the way of these students to conquer a complete education. In this context, the goal of this work is to propose a technology acceptance model that takes into account factors that ivolve aspects of the inclusive education context, as well as performing experiment on the interaction of D/HH users with a technology to evaluate the model. Among the factors, one of them refers to the potential educational barriers experienced by D/HH students in inclusive classrooms. With regard to research methodology, the study was developed in cycles. To the extent that the investigations progressed, a new study began, was unfolded and closed. This allowed successive refinements over time to the point where the initial questions were answered and the goal was reached. The proposed model has shown positive results in capturing factors that influence technology acceptance given the domain specific context, since they incorporate aspects of pragmatic quality and hedonic quality, also issues related to perceived usefulness in minimizing potential educational barriers, future expectations, and facilitating conditions. We conclude that the model encompasses both users personal motivation and context of use aspects, and the model can be used for the purpose for which it was proposed, technology acceptance evaluation considering inclusive education contexts.

Made available in DSpace on 2016-04-29T14:17:31Z (GMT). No. of bitstreams: 1 Luciana Mattos.pdf: 620724 bytes, checksum: 0e26f4cadeb369fe7be2efdd4b80a399 (MD5) Previous issue date: 2008-07-31 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The present research paper aims to carry out an analysis based on reports, accounts and assessments structured by psychologists and Judicial Power social workers, focusing on issues related to family dynamics, markedly expressions such as disorganized family , father frailty and others alike, present in the aforementioned documents, dialoging with the social issue. This research has emerged from the work I developed, as a psychologist, at the then FEBEM/SP São Paulo s State Foundation for The Well-Being of Minors and at AMAR Association of Mothers and Friends of Children and Adolescents at Risk , opportunity in which I had access to various reports by adolescents, as well as the chance to get in contact with their parents. Concerning the latter, a tendency towards excessive blaming has been observed, especially with regard to both the presumed failures by the father in the exercise of his role, and, on the other hand, the low relevance attributed to other life instances of the adolescent, evidenced by the absence of data on socio-economic factors. The sample, obtained with the authorization of DEIJ (São Paulo s Department of Enforcement of Childhood and Youth), comprised twenty-nine lawsuit cases related to adolescents who had committed transgressions and were serving socioinstructional penalties of the internment type. The methodology applied was that of content analysis, by L. Bardin, and thereby material analysis categories were determined. As for the result, in the majority of social studies, no reference to social issues was observed, highlighting a silence with regard to the State s lack of commitment to formulating and executing public care policies. The so-called problems are reduced to family and personality issues, with depoliticized observations, erased of their violent historical conditions / O presente trabalho objetiva realizar uma análise por meio de relatórios, laudos e avaliações elaborados por psicólogos e por assistentes sociais do Poder Judiciário, enfatizando-se as considerações acerca da dinâmica familiar, notadamente expressões como família desorganizada , fragilidade do pai e similares, as quais aparecem nesses documentos, em diálogo com a questão social. A construção desta pesquisa deu-se a partir do trabalho desenvolvido na qualidade de psicóloga na ex-FEBEM/SP Fundação do Bem-Estar do Menor - e na AMAR Associação de Mães e Amigos da Criança e do Adolescente em Risco -, ocasião em que se teve contato com diversos laudos de adolescentes e, outrossim, com seus familiares. Observaram-se, então, uma tendência à excessiva culpabilização destes últimos, sobretudo às supostas falhas do pai no exercício de suas funções, e, por outro lado, a pouca relevância dada a outras instâncias de vida do adolescente, o que está consubstanciado na ausência de dados sobre os fatores sócio-econômicos. A amostra obtida, após autorização do Departamento de Execuções da Infância e da Juventude de São Paulo (DEIJ), açambarca vinte e nove processos referentes a adolescentes autores de ato infracional em cumprimento de medida sócio-educativa, na modalidade de internação. A metodologia utilizada foi a análise de conteúdo, de L. Bardin, definindo-se categorias de análise do material. Em relação aos resultados, na maioria dos estudos sociais, não se observaram referências a questões sociais, silenciando-se a respeito do descompromisso do Estado na formulação e na execução de políticas públicas de atendimento à população. Os problemas esgotam-se em questões familiares e de personalidade, com observações despolitizadas e abstraídas de suas violentas condições históricas

<p>Syftet med denna uppsats är att utforska socialtjänstens arbete med brottsoffer i Sverige enligt 5 kapitlet 11 § i socialtjänstlagen. I studien undersöktes hur socialsekreterare definierar brottsoffer samt hur de bedömer och prioriterar offrens behov. Det har också varit centralt att studera hur socialsekreterare tolkar och förstår regleringen av socialtjänstens ansvar för brottsoffer. Kvalitativa intervjuer med 18 socialarbetare är grunden för studien. Analysen av socialtjänstens arbete med brottsoffer baseras på ovan nämnda intervjuer. Intervjuerna analyseras med hjälp av rättssociologiska teorier. För att illustrera hur socialsekreterare definierar brottsoffer har teorier om brottsoffer använts i analysen. Studien visar att ett brottsoffer måste vara oskyldig, svag och lida av brottet för att personen skall definieras som brottsoffer av socialsekreterarna. Socialsekreterarna har dock olika prioriteringar. Vissa socialsekreterare baserar sin bedömning efter varje enskilt fall, medan andra socialsekreterare anser att det är specifika målgrupper som ska få hjälp av socialtjänsten. Undersökningen visar också att de brottsoffergrupper som främst får hjälp inom socialtjänsten kvinnor och barn som fallit offer för våld i nära relationer. Stöd till brottsoffer som ges genom socialtjänstens arbete är ofta i syfte för att anpassa de kvinnor och barn som utsätts för våld, såsom kvinnojourer, rådgivning och ekonomiskt stöd.</p> / <p>The purpose of this essay is to explore the social services work with crime victims in Sweden, according to Chapter 5, § 11 of the Social Services Act. The study examined how social workers define the victim and assessing and prioritizing victims' needs. It has also been central to study how social workers interpret and understand the regulation of social services responsible for crime victims. Qualitative interviews with 18 social workers is the basis for the study. The analysis of the social services work with victims based in the above-mentioned interviews. The interviews analyzed using the sociology of law theory. To illustrate how social workers define victims of crime have theories of crime victims been used in the analysis.</p><p>The study shows that a crime victim must be innocent, weak and suffering from the crime to be defined as crime victims by social secretaries. Social workers do, however, different priorities. Some are based on an assessment of each individual victims need help, while others believe that the specific target groups will be using social services. The study also indicates that the groups which mainly receive help in the social services are victims of violence women and children. Assistance to victims in the social services designed to adapt the groups exposed to violence against women and children, such as women’s shelters, counseling and financial help.</p>

<p>Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005 / Bergman &amp / Jurisco, 1994 / Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.</p>

In this dissertation the question of why people want to stay in the county-side has been analysed from an economic-historic perspective. The specific research question has been: Using which formal economic means of sustenance could those who remained in Ängersjö parish ensure their survival in the years 1950 to 1990? A number of different types of sources have been used, including income tax registers, data on migration, agricultural statistics, parish registers, interviews, and printed public statistics. The population of Ängersjö parish decreased through the entire period of investigation. In the early 1950s the population pyramid in Ängersjö resembled Sweden’s quite considerably. After this point, the tendencies towards depopulation grew stronger. By the early 1990s, the population had returned to the levels of the early 1800s, i.e. before the forest became valuable. This time, however, the proportion of older inhabitants was much larger. Most of the remaining households supported themselves through wage labour in the forestry sector, which essentially was a male preoccupation. At the margin, supplementary incomes, such as the renting of cottages and capital revenues, could add to household earnings, and contributions by women probably played an important part in that context. In addition, informal economic activities, such as berry-picking and the exchange of labour, could expand the means of support by a maximum of 20 percent. In spite of all these efforts, most of the remaining households earned less than an average Swedish industrial worker. The income differences could to some degree be compensated by lower housing and living costs, but many households probably enjoyed a lower material standard of living. Demonstrably, most of the remaining inhabitants of Ängersjö were willing to pay the economic price associated with the “feelings of freedom” or the upkeep of their ancestral home of which many inhabitants spoke. / Flexibilitet som tradition

The aim of this essay was to describe how school social workers can help and support students with parents who abuse alcohol or other drugs. We wanted to see how school social workers room for action is presented and how it affects their work with students living with parents who are abusing. We used a qualitative method to elucidate how school social workers handle this issue in a more profound way. By conducting semistructured interviews with six school social workers in one province in southern Sweden we gained exhaustive and detailed answers. In the analysis we used street level bureaucracy and theory of recognition. The result showed that the school social workers regard their overarching room of action as very wide inside school but limited outside. At school the school social worker can support the students with supportive counseling and adapted school attendance. One important task of the school social worker is to help the student to get in contact with other organizations for example, support groups for children. We also found that cooperation is an important part as the school social workers describe themselves as “the spider in the web” with the task of connecting and sharing knowledge with other personnel and organizations. The relation with the student is important to be able to support the students or guide them further. School social workers also regard school as a good place to detect and identify these students, but that it can be difficult to know who these students are. If a specific plan for working with students whose parents abuse alcohol or drugs would affect the school social workers work is difficult to say since none that we interviewed in this study had experience of one.