In this qualitative study the researcher explores the experiences of various caregivers at a day care centre for developmentally challenged children. This study also attempts to draw a distinction between the experiences of formal and informal caregivers’ experiences. The study is underpinned by two assumptions: 1) that in order to obtain a rich understanding of a phenomenon, the views and voices of a variety of individuals need to be considered and 2) that cultural values and practices play a significant role in the way individuals experience a certain phenomenon. The experiences of both formal and informal caregivers are documented using thematic analysis. An analysis of the participants’ global themes revealed that “education/learning/skills development” and “communication barriers” were common themes among both participant groups. Each participant group also expressed unique experiences such as “being a parent”, “becoming a foster parent” and “being useless as a professional-in-training”. Focal areas for further research are highlighted. / Clinical Psychology / M.A. (Clinical Psychology)

Made available in DSpace on 2014-09-24T12:57:15Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) danielle_machado_iff_mest_2014.pdf: 1189130 bytes, checksum: 3c1620324f3f13facc418ec9c710460e (MD5) Previous issue date: 2014 / Fundação Oswaldo Cruz. Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil. / O presente estudo trata de uma pesquisa qualitativa que objetivou compreender os significados atribuídos pelos cuidadores leigos e profissionais à tuberculose na criança. Foram realizadas entrevistas semiestruturadas com os profissionais e familiares envolvidos em seis situaçoes de saúde, num território de vulnerabilidade, localizado no município do Rio de Janeiro. Ao recolhimento dos dados seguiu-se uma análise de conteúdo temática com identificação de categorias temáticas e a interpretação dialogou com a literatura em conceitos como estigma, sentimento de infância, família, território vulnerável, redes, itinerários de tratamento e experiência de adoecimento. Os resultados demonstraram que não existe um estereótipo de criança com tuberculose, mas tipos de famílias que respondem à doença nas crianças conforme suas próprias crenças. A discussão sobre os significados de tuberculose na criança passa necessariamente pela revisão do conceito de família, a relativização da noção de núcleo familiar e valorização da rede de relaçoes que envolve esses sujeitos. Vários aspectos singulares dessa faixa etária trouxeram, no emaranhado de relaçoes do dia a dia, questoes não pensadas para o universo adulto que, no entanto, se apresentaram como relevantes para quem cuida de crianças. Em alguns aspectos, as explicaçoes dos profissionais não são, necessariamente, as mesmas dos familiares, para o adoecimento infantil por tuberculose, mas seu papel no acolhimento da família, bem como o reconhecimento e gerenciamento das dificuldades diagnósticas e terapêuticas em cada situação de adoecimento da criança por tuberculose permanece como importante ferramenta para a promoção da saúde na criança. / The current study focus on a qualitative research that objectified to understand the meanings attributed by layman caretakers and professionals to tuberculosis in children. Semi-structured interviews were performed with professionals and relatives involved in six health situations, in a vulnerability territory, located in the municipality of Rio de Janeiro. Data collection was followed by a thematic Content Analysis with identification of thematic categories and interpretation dialogued with literature in concepts like stigma, childhood feeling, family, vulnerable territory, networks, therapeutical itineraries, and experience of illness. The results showed that there is not a stereotype of a child with tuberculosis, but types of families that respond to the disease in children according to their own beliefs. The discussion about the meanings of pediatric tuberculosis runs necessarily through the re- evaluation of family concept, relativization of the notion of family core and valorization of the relationship network that involves these subjects. Many singular aspects of this age band brought, in the tangles of day-to-day relationships, issues not thought for the adult universe that, however, were shown as relevant to children caretakers. In some aspects, the professionals' explanations are not, necessarily, the same as relatives for tuberculosis disease in children but their role in embracing the family, as well as the recognition and management of diagnostic and therapeutic difficulties in every situation of child sickness by tuberculosis disease remains an important tool for child's health promotion.

This thesis deals with the issue of placing toddlers in day-care centers. It takes into account three main topics. The point of view of the psychological needs of children, the point of toddlers' inclusion into day-care centers from the perspective of the centers themselves and the aspect of the family status in the Czech Republic and economic needs of the state. The aim of this thesis is to describe the suitability of putting toddlers into day-care centers from a theoretical point of view and to assess the convenience of putting toddlers into day-care centers in the Czech Republic.

Submitted by Fernando Souza (fernandoafsou@gmail.com) on 2017-09-06T14:26:32Z No. of bitstreams: 1 arquivototal.pdf: 1497789 bytes, checksum: bac6ca9354cf93380e60214e5362bbc4 (MD5) / Made available in DSpace on 2017-09-06T14:26:32Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1497789 bytes, checksum: bac6ca9354cf93380e60214e5362bbc4 (MD5) Previous issue date: 2017-04-24 / Introduction: In the early years of a child's life are the main stages of evolution, growth and development. The monitoring of your health occurs in child care consultation and comprises a set of actions that provide the identification of changes in their health. Objective: To analyze the actions of care performed by nurses during routine visits. Method: an exploratory study, observational and quantitative, performed in the city of João Pessoa, from March to July 2016, attended by 31 nurses who were consulted for child care in the Family Health Strategy. We used a check-list previously structured and observed three random queries for each nurse participant, totaling 93 queries. The analysis was done by means of descriptive statistics and Chi-square test with a significance level of 5%. To validate the instrument and assess the performance of the nurses there were applied, respectively, the test of Cronbach's alpha and Cluster analysis. The research was approved by the Research Ethics Committee of the health science center of the Federal University of Paraíba, protocol n° 096/12 and CAAE: 02584212300005188. Result: Showed itself vulnerable in child care by nurses. The dimensions of care in greater proportion were the evaluation of immunization and vitamin A and iron supplements, monitoring of children's growth and the records in the chart and in the health of the child. While the dimensions of health education, physical examination, anamnesis and greeting were little effect in practice of nurses. Conclusion: the care dispensed by nurses still falls short of the recommended by guidelines for health care of the child, therefore, it is necessary to improve the quality of care, by means of permanent education and awareness of these professionals. / Introducción: En los primeros años de la vida de un niño son las principales etapas de la evolución, el crecimiento y el desarrollo. La vigilancia de la salud se realiza en consulta a los niños y comprende un conjunto de acciones que proporcionan la identificación de cambios en su salud. Objetivo: analizar las acciones de cuidado realizadas por enfermeras durante visitas de rutina. Método: un estudio exploratorio observacional, cuantitativa, realizada en la ciudad de João Pessoa, de marzo a julio de 2016, contó con la asistencia de 31 enfermeras que fueron consultados por el cuidado del niño en la Estrategia Salud de la familia. Hemos utilizado una lista de verificación previamente estructurados y observó tres consultas aleatorias para cada enfermera participante, por un total de 93 consultas. El análisis fue realizado mediante estadística descriptiva y prueba de Chi-cuadrado con un nivel de significancia del 5%. Para validar el instrumento y evaluar el desempeño de las enfermeras, se aplicaron, respectivamente, la prueba de análisis de Cluster y alfa de Cronbach. La investigación fue aprobada por el Comité de ética de investigación del centro de ciencia de salud de la Universidad Federal de Paraíba, protocolo n° 096/12 y CAAE: 02584212300005188. Resultado: ha mostrado debilidades en las acciones de cuidado del niño por parte de las enfermeras. Las dimensiones de la atención en mayor proporción fueron la evaluación de la inmunización y los suplementos de hierro y vitamina A, la vigilancia del crecimiento infantil y los registros en la pizarra y el libro de la salud del niño. Mientras que las dimensiones de la educación de salud, examen físico, la historia y la hospitalidad eran poco efecto en la práctica de las enfermeras. Conclusión: La atención prestada por las enfermeras está todavía por debajo de las recomendadas en las directrices de atención de la salud infantil, por lo tanto, es necesario mejorar la calidad de la atención, mediante la educación permanente y la toma de conciencia de estos profesionales. / Introdução: Nos primeiros anos de vida da criança estão as principais fases de evolução, crescimento e desenvolvimento. O acompanhamento de sua saúde ocorre na consulta de puericultura e contempla um conjunto de ações de saúde que proporcionam a identificação de alterações em sua saúde. Objetivo: Analisar as ações de cuidado realizadas pelo enfermeiro durante as consultas de puericultura. Método: Estudo exploratório, observacional e quantitativo, realizado no município de João Pessoa, de março a julho de 2016, do qual participaram 31 enfermeiros que realizavam consulta de puericultura na estratégia saúde da família. Foi utilizado um check-list previamente estruturado e observadas três consultas aleatórias por cada enfermeiro participante, totalizando 93 consultas. A análise foi feita por meio de estatística descritiva e teste qui-quadrado, com nível de significância de 5%. Para validar o instrumento e avaliar o desempenho dos enfermeiros, foram aplicados, respectivamente, o teste de Alfa de Cronbach e a análise de agrupamento. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa do Centro de Ciência da Saúde da Universidade Federal da Paraíba, parecer n° 096/12 e CAAE: 02584212300005188. Resultado: Evidenciaram-se fragilidades nas ações de cuidado dispensado à criança por parte dos enfermeiros. As dimensões do cuidado em maior proporção foram a avaliação da imunização e suplementações de ferro e vitamina A, o acompanhamento do crescimento infantil e os registros no prontuário e na caderneta de saúde da criança. Já as dimensões de educação em saúde, o exame físico, a anamnese e o acolhimento foram pouco efetivados na prática dos enfermeiros. Conclusão: O cuidado dispensado pelos enfermeiros ainda está aquém do recomendado pelas diretrizes de atenção à saúde da criança. Portanto, é preciso melhorar a qualidade da assistência, por meio de ações de educação permanente e da sensibilização desses profissionais.

This study critically examines how the decision-making of two-year-old children may take place and may be interpreted in dialogue. The aim is to increase adult understanding of the decision-making experiences of children. The decisions, as perceived by parents and practitioners as participants, are situated within the non-verbal as well as the verbal dialogue of the children and are interpreted through the dialogue of the interpreting adults. Case studies focus on three children drawn from families and settings willing to engage in extensive observation and analysis. The study is conducted with dialogism meta-theory containing a contextual social constructionist approach. The principal research methods are naturalistic video observations of the children over the course of their third year and video analysis sessions with parents and practitioners. I use a second-person approach to observation that acknowledges my presence with the children. Phenomenological principles underpin the interpretation. Multi-modal interaction analysis accesses aspects of the children’s phenomenal minds (here indicating no separation of mind and body), namely their expressions and responses to each other. The children’s dialogue is discussed in terms of Buber’s I-You relation and I-It attitude to the other, and in terms of what the children make relevant in their decisions in and with the world. Questions are raised about how decision-making in dialogue can be understood, discussing in particular the situated nature of this understanding, with the aim of contributing to the processes of observation and understanding in the future. A key contribution of the study is the exploration of mutuality and contextual knowing involving the perceptions of the adults closest to the children, and the contextual continuity of knowing in adults developing professional judgement in situations of uncertainty, and yet of relevance to the children.

Introdução: O relacionamento estabelecido entre profissionais de saúde, criança e família durante os cuidados de final de vida é complexo e multidimensional. Poucas evidências mostram como os relacionamentos são estabelecidos no contexto de final de vida da criança e influenciam no luto após a morte de um filho. Objetivo: Interpretar a experiência de pais sobre os relacionamentos estabelecidos com os profissionais de saúde durante o final de vida da criança com câncer no hospital. Método: Trata-se de uma pesquisa qualitativa, guiada pela hermenêutica filosófica de Gadamer. A coleta dos dados foi realizada por meio de observações de campo em um hospital oncológico pediátrico com famílias de crianças hospitalizadas em situação de final de vida, entrevista com pais enlutados pelo menos 6 meses após o óbito da criança e análise de prontuários. Para a análise dos dados, o processo de transcrição, leitura e releitura dos dados, revisão das notas de campo e reflexão sobre os dados com outros pesquisadores ajudaram na compreensão do fenômeno para a geração de interpretações. Para tanto, foram identificadas unidades de significados nos dados que, posteriormente, foram agrupadas por similaridade para a formação indutiva de temas. Resultados: Os relacionamentos entre pais e profissionais da saúde no final de vida da criança com câncer hospitalizada desvelam fenômenos do encontro e da interação interpessoal presentes na situação de doença, morte e perda. Esses relacionamentos são permeados pela presença de valores humanos e são estabelecidos de forma dinamica com vínculos diversos. Existem componentes evidentes no relacionamento durante o final de vida da criança no hospital, tal como o amparo, o silêncio, a deterioração, a tolerância, a hierarquia, o compartilhamento e a confiança, bem como, fatores internos e externos que influenciam nas interações. Por meio dos relacionamentos, os pais reavaliam o próprio papel, enquanto vivenciavam a experiência inesperada de perder um filho e significados atribuídos à doença e à perda são associados aos encontros mesmo anos após a morte do filho. Considerações finais: Os relacionamentos servem de base para fortalecer e suportar os pais a exercerem o papel de cuidadores para garantir a excelência no cuidado do filho. A qualidade dos relacionamentos entre pais e profissionais da saúde torna-se uma lembrança marcante no processo de luto e estabelecem uma conexão permanente com o filho falecido. Um olhar para o relacionamento entre familiares e profissionais integrando a ciência do cuidado proporciona a base de paradigmas não positivistas, que são urgentes nas situações de final de vida. Este estudo pode contribuir com as políticas de enfermagem na consolidação de futuras diretrizes sobre a qualidade na prática do cuidado de final de vida da criança, facilitando para as famílias manter vínculos significativos durante o processo de doença, perda e luto. / Introduction: The relationship established between family and healthcare providers during the childs end-of-life care is complex and multidimensional. There are few evidences which explore how these relationships during the childs last hospitalization influence familial adaptation after loss. Objective: To interpret parents experience in their relationship with healthcare providers during the childs end-of-life with cancer in the hospital. Methods: This is a qualitative research, guided by Gadamers philosophical hermeneutics. Data collection was through field observations conducted in a pediatric oncology hospital with hospitalized families in end-of-life situation, interviews with bereaved parents at least 6 month after the childs death and medical records analysis. For the data analysis, the process of transcription, reading and re-reading the data, reviewing field notes and reflection on the data with other researchers helped understand the phenomenon to generate interpretations. Therefore, units of meaning emerged from the data were grouped, and themes were inductively determined and submitted to an interpretation process. Results: Relationships between parents and healthcare providers during a childs end-of-life process unveil the encounters and interpersonal interactions phenomena in illness and loss trajectory. These relationships are permeated with human values and are established in a dynamic way with various bondings. There are evident components in a child´s end-of-life context, such as presence, silence, deteriorations, tolerance, hierarchy, collaboration and trusting, as well as internal and external factors which influence the interactions. Through relationships, parents reevaluate their own role, while they live the unexpected experience of losing a child and attribute meanings to the loss. Final considerations: Relationships serve as a basis for strengthening and supporting parents in providing excellence in the child\'s care. The quality of the relationship between parents and healthcare providers is a remarkable memory of the child\'s life during the bereavement process. Looking into the relationship between parents and providers integrating it with caring science provides a basis for non-positivist paradigms which are urgent in end-of-life situations. This study aims to contribute to end-of-life nursing policies in recognizing the components to improve the quality of the relationships as a starting point for care which will allow families to have a safe base while experiencing the child\'s illness and the bereavement process.

Submitted by Amanda Cappellazzo Arabage (amanda_arabage@outlook.com) on 2018-06-11T12:56:15Z No. of bitstreams: 1 Tese Amanda C A.pdf: 2902865 bytes, checksum: d10ee483dca9cc724f63a79e7e0f8643 (MD5) / Approved for entry into archive by Katia Menezes de Souza (katia.menezes@fgv.br) on 2018-06-11T13:23:23Z (GMT) No. of bitstreams: 1 Tese Amanda C A.pdf: 2902865 bytes, checksum: d10ee483dca9cc724f63a79e7e0f8643 (MD5) / Approved for entry into archive by Isabele Garcia (isabele.garcia@fgv.br) on 2018-06-12T19:05:57Z (GMT) No. of bitstreams: 1 Tese Amanda C A.pdf: 2902865 bytes, checksum: d10ee483dca9cc724f63a79e7e0f8643 (MD5) / Made available in DSpace on 2018-06-12T19:05:57Z (GMT). No. of bitstreams: 1 Tese Amanda C A.pdf: 2902865 bytes, checksum: d10ee483dca9cc724f63a79e7e0f8643 (MD5) Previous issue date: 2018-05-21 / This thesis is composed of three essays in applied microeconomics. In all essays, we investigate different aspects related to the Brazilian formal labor market using data from the Relação Anual de Informações Sociais - RAIS. In the first two chapters, we examine the impacts of two educational policies on labor market outcomes of those involved. In the third chapter, we study wage inequality in the formal labor market. We aim to contribute to the debate on inequality reduction policies by providing additional empirical evidence for Brazil. In the first chapter, we investigate the impacts of the provision of free child care for children aged 0-3 on mothers and fathers’ labor market outcomes in the formal sector of the economy. We exploit an exogenous variation introduced by the fact that, for the 2008 school year, access to public day care centers was randomly assigned in the municipality of Rio de Janeiro. Our results suggest that the provision of this service had no impacts on parents’ probabilities of being employed in the formal sector and related labor market outcomes (e.g. hours worked, wages) in the short or medium terms. We argue that high labor market participation, relatively low flexibility of the formal labor market and the fact that the majority of children eventually enroll in a public day care center or school in the years following the intervention may be possible explanations for these results. In the second chapter, we investigate if the introduction of quotas in public universities affects employers’ perception of its students and graduates, regardless of their actual quota status. We explore the different timing of introduction of quota systems in two public universities in the State of Rio de Janeiro to estimate impacts of this policy on its students and graduates’ probabilities of being employed in the formal sector and hourly wages for those employed. Our results suggest that the introduction of quotas does not seem to have effects on the probability of being employed in the formal sector but there seems to be some negative effects on hourly wages for those who are employed in the formal sector for some of the cases considered. In the third chapter, we study the decrease in wage inequality among working age men in the Brazilian formal labor market from 1994 to 2016. We decompose inequality into its permanent and transitory components and find that the downward trend in wage inequality can be attributed to reductions in the transitory component from 1994 to 2005 (related to the economic stabilization process), and in the permanent component from 2010 to 2016. Our results also suggest that the permanent component has an important role in explaining wage inequality in Brazil, with age and education being accountable for a great share of permanent inequality. / Esta tese é composta por três artigos na área de microeconomia aplicada. Em todos os artigos, são investigados aspectos relacionados ao mercado de trabalho formal brasileiro, utilizando dados da Relação Anual de Informações Sociais - RAIS. Nos dois primeiros capítulos, investigam-se os impactos de duas políticas educacionais em resultados no mercado de trabalho dos indivíduos envolvidos. No terceiro capítulo, estuda-se a desigualdade de salários no mercado de trabalho formal. Com os artigos, pretende-se contribuir para o debate sobre políticas de redução da desigualdade, fornecendo evidências empíricas adicionais para o Brasil. No primeiro capítulo, são investigados os impactos do oferecimento de creches gratuitas para crianças de 0 a 3 anos sobre os resultados de suas mães e pais no mercado de trabalho formal. Para isso, utiliza-se a variação exógena introduzida pelo fato de que, para o ano letivo de 2008, o acesso a vagas em creches públicas no município do Rio de Janeiro foi definido a partir de um processo de aleatorização. Os resultados sugerem que este serviço não teve impactos sobre as probabilidades das mães e pais de estarem empregados no setor formal e sobre outros resultados relacionados (por exemplo, horas trabalhadas e salários) tanto no curto quanto no médio prazos. Argumenta-se que a alta participação no mercado de trabalho, a reduzida flexibilidade do mercado de trabalho formal e o fato de que a maioria das crianças eventualmente foi matriculada em uma creche ou escola pública nos anos seguintes à intervenção são possíveis explicações para esses resultados. No segundo capítulo, é analisado se a introdução de cotas em universidades públicas afeta a percepção dos empregadores sobre seus alunos e ex-alunos, independentemente de eles terem ingressado no ensino superior via cotas. Para isso, utiliza-se o fato de que a adoção de sistemas de cotas em duas universidades públicas do Estado do Rio de Janeiro ocorreu em momentos distintos. Dessa forma, é possível estimar os impactos dessa política na probabilidade de seus alunos e ex-alunos de estarem empregados no setor formal e nos salários por hora para aqueles que estão empregados. Os resultados sugerem que a introdução de cotas não parece ter tido efeitos sobre a probabilidade de estar empregado no setor formal, mas são encontrados alguns efeitos negativos sobre os salários para aqueles que estão empregados nesse setor em alguns dos casos considerados. No terceiro capítulo, analisa-se a redução da desigualdade de salários entre homens em idade ativa no mercado de trabalho formal brasileiro de 1994 a 2016. A desigualdade é decomposta em seus componentes permanente e transitório e verifica-se que a tendência de queda da desigualdade salarial pode ser atribuída a reduções no componente transitório de 1994 a 2005 (relacionadas ao processo de estabilização econômica), e no componente permanente de 2010 a 2016. Os resultados também sugerem que o componente permanente tem um papel importante na desigualdade salarial no Brasil, sendo idade e educação responsáveis por uma parcela expressiva da desigualdade permanente.

La politique de l'Union européenne a suscité des débats académiques sur son impact potentiel et l'effet qu'elle exercerait sur les processus politiques au niveau national. les récentes réformes des politiques familiales allemandes et anglaises peuvent être attribuées à l'influence de l'Union européenne au travers de la participation dans les processus d'apprentissage initiés par cet organisme. Cette étude examine les éventuels glissements dans les objectifs des politiques familiales vers la politique de l'Union européenne. / The policy of the European Union has packed academic debate on its potential impact on the political process at national level. Recent reforms of german and english family policies can be attributed to the European Union influence through its participation in the learning process initiated by this organisation. This examines the potential shifts in the objectives of national families to European Union objectives.

This diploma thesis is focused on child protection in the context of divorce or separation of his parents and deals with the role of the authority of social - legal protection of children and the court in this matter. Mainly defines the terms of the applicable legislation in divorce matters (care of children after divorce, child's contact with the parents, alimony), which are usually the subject of protracted disputes between parents. The introductory section also mentions the importance of the family for the child and for society, the characteristics of the contemporary family, as well as divorce and its possible impact on the child and the wider surroundings of the family. In the empirical part, the work focuses on comparing the practices of social workers of the authority child protection offices in Prague with practices of social workers at the offices of towns in the Central Region in divorce issues, particularly in the area of investigation in the family. Next it examines also procedures of courts.

Abstract The purpose of the study was to create a comprehensive view and add understanding about the childcare practice of children sleeping outdoors in the context of Northern Finnish winter. A general view of the topic was described, the thermal insulation of clothing of infants sleeping outdoors in northern winter climate was evaluated and the relationships among thermal environment, infants’ skin temperatures and daytime outdoor sleep duration were described. Mixed methods research design was used. A questionnaire was distributed to the parents (n=116) of children under 2 years of age in the city of Oulu. Skin temperatures of about three-month-old infants were recorded from seven skin sites throughout a daytime sleep outdoors (n=34) and indoors (n=33) in the families’ homes. The duration of the infant’s sleep was observed and air temperature and velocity of the outdoor environment were recorded. Clothing data of infants were collected and microclimate temperatures and humidity inside middle wear measured. The insulation of clothing ensembles was measured by using a baby-size thermal manikin. The required clothing insulation was estimated according to ISO 11079. Mothers (n=21) from Northern Finland were interviewed. A fit can be found between family – cultural outdoor sleeping childcare practice – and Northern Finnish winter environment, but also factors that decreased the fit existed. Winter environment was seen as an affordance for the child to sleep outdoors. Infants usually slept outdoors in the daytime once a day in different kinds of environments, the best temperature being -5 °C. Outdoor sleeping was a self-evident and common culturally bound custom. Guidelines and encouragement were given to mothers from different sources, and by sharing their own experiences, mothers participated in the cultural knowledge-building processes. The outdoor sleeping practice was commonly accepted collective behavior. Many risk factors also existed, but when all security perspectives were first taken into account it promoted family well-being by creating rhythm and strengthening the fluency of everyday life. The optimal thermal insulation was difficult to adjust systematically and both cooling and sweating existed. When ambient temperature decreased, the cooling rate of Tsk increased. Children slept longest outdoors when the cooling rate of Tsk was minimal. The basic idea was that outdoor sleeping promoted children’s health. A comprehensive view of the phenomenon was gathered into the evaluation model, which can be utilized in nursing practice. The findings give detailed information that is utilized when updating guidelines. This study also creates ground for international comparative studies. / Tiivistelmä Tutkimuksen tavoitteena oli muodostaa kokonaiskuva ja lisätä ymmärrystä lasten ulkona nukuttamiskäytännöstä pohjoissuomalaisessa talvikontekstissa lasten ja perheiden hyvinvoinnin lisäämiseksi. Tarkoituksena oli kuvata lasten ulkona nukuttamiskäytäntöä, ympäristön ja ihon lämpötilojen sekä unen pituuden yhteyttä ja arvioida vaatetuksen lämmöneristävyyttä. Tutkimuksessa käytettiin mixed methods -lähestymistapaa monipuolisen kokonaiskuvan tavoittamiseksi. Pilottikysely tehtiin alle 2-vuotiaiden lasten vanhemmille (n=116) Oulun alueella. Ihon lämpötiloja mitattiin seitsemästä eri kehon osasta noin kolmen kuukauden ikäisiltä lapsilta (n=34) heidän nukkuessaan kotona päiväuniaan sisällä ja ulkona Pohjois-Suomessa talvella. Unen pituutta havainnoitiin ja ympäristön lämpötilaa ja tuulen nopeutta mitattiin. Lasten talvivaatetuksesta kerättiin tietoa ja lämpötiloja mitattiin vaatetuksen eri kerroksista sekä kosteutta välivaatetuksen alta. Vaatetuksen lämmöneristävyyksiä mitattiin lasten kokoa vastaavalla lämpönukella. Vaadittava lämmöneristävyys arvioitiin ISO 11079 – standardin mukaisesti. Pohjoissuomalaisia lapsiperheiden äitejä (n=21) haastateltiin kulttuurisen tiedon esille tuomiseksi. Yhteensopivuus perheen, kulttuurisen ulkona nukuttamiskäytännön ja pohjoisen talviympäristön välillä voidaan saavuttaa, mutta toisaalta myös tasapainoa vähentäviä tekijöitä löytyi. Talviympäristö nähtiin tarjoumana lapsen rauhalliselle nukkumiselle sen puhtaan ja raikkaan ilman ja luonnon sekä hiljaisuuden ja rauhallisuuden takia. Talvinen sää vaihteli auringon paisteesta kovaan lumipyryyn ja lämpötila muutamista lämpöasteista lähes kolmenkymmenen asteen pakkaseen lasten nukkuessa vaunuissaan. Paras lämpötila ulkona nukkumiselle oli -5  °C. Ulkona nukuttamista pidettiin itsestään selvänä kulttuurisena tapana. Äidit saivat ohjeita ja kannustusta lasten ulkona nukuttamiseen eri lähteistä. Vertailemalla ja jakamalla kokemuksiaan he osallistuivat myös itse kulttuurisen tiedon rakenteluun. Lasten ulkona nukuttaminen talvella osoittautui yleisesti hyväksytyksi kollektiiviseksi käyttäytymiseksi, joka toisinaan aiheutti paineita äideille. Lapsen ulkona nukkumiseen liittyi monia riskitekijöitä, mutta kaikki turvallisuusnäkökohdat ensin huomioon ottamalla se edisti perheen hyvinvointia luomalla säännöllistä rytmiä ja vahvistamalla arjen sujuvuutta. Optimaalisen vaatetuksen lämmöneristävyyden löytäminen systemaattisesti eri lämpötiloissa oli vaikeaa; sekä jäähtymistä että hikoilua esiintyi. Ympäristön lämpötilan laskiessa keskimääräisen ihon lämpötilan jäähtymisnopeus lisääntyi. Lapset nukkuivat ulkona pisimpään silloin, kun ihon lämpötilan jäähtyminen oli hitainta. Ensisijaisesti ulkona nukkumisen ajateltiin edistävän lapsen terveyttä. Lasten ulkona nukuttamisen arviointimallia voidaan hyödyntää käytännössä ohjauksen yhteydessä ja tutkimuksen tuottamaa yksityiskohtaista tietoa ohjeistusten päivittämisessä. Tutkimus antaa lähtökohtia kansainväliselle vertailevalle tutkimukselle.