Bakgrund: Specialistsjuksköterskan i en prehospital miljö ställs inför utmaningar när en svår luftväg inte längre kan hanteras genom basal luftvägshantering. Denna situation kräver spetskompetens inom avancerad luftvägshantering och anestesi, samt särskilda hjälpmedel. Inom vissa regioner finns en prehospital förstärkningsenhet som har som uppgift att komplettera ordinarie verksamhet med spetskompetens när det finns behov av avancerad luftvägshantering. Syfte: Syftet med studien var att studera anestesisjuksköterskors strategier vid hantering av svår luftväg i en prehospital förstärkningsenhet. Metod: En kvalitativ studie med datainsamling via enkät tillämpades och analyserades med kritisk incident teknik (CIT). Sexton anestesisjuksköterskor i en prehospital förstärkningsenhet i Sverige besvarade enkäten. Resultat: Analysen ledde fram till fyra betydelsefulla strategier för att hantera en svår luftvägprehospitalt. Förberedelse i att ställas inför en svår luftväg, mental förberedelse på väg ut på larm, möjligheten att lägga upp en primär samt en sekundär plan tillsammans med kollegan och att våga agera direkt var strategier som identifierades för att hantera en svår luftvägprehospitalt. Detsamma gällde att ta beslut i tid, att flytta patienten så att omhändertagandet inte behövde anpassas i onödan av omständigheter som kanske gick att undvika, att skapa åtkomst och insyn till patientens luftväg och ha närhet till egen utrustning vid hantering av en svår luftväg. Kollegan, teamkänsla, kommunikation, igenkännande, förståelse för varandras uppdrag och kännedom om varandras arbetssätt och utrustning var framgångsfaktorer för att få ett bra och effektivt teamarbete runt den svårt sjuka patienten. Utrustning som normalt inte fanns i en akutambulans som videolaryngoskop, endotrakealtub förberedd med ledare, kapnograf och en bra sug var framgångsfaktorer för att hantera en svår luftväg prehospitalt. Slutsats: Resultatet kan komplettera specialistutbildningar och introduktionsutbildningar för att göra specialistsjuksköterskan bättre förberedd på luftvägshantering i en prehospital miljö. Kunskapen kan bidra till en större förståelse för hur den svåra luftvägen på olika sätt kan undvikas eller hanteras. Basal luftvägshantering skall ambulanssjuksköterskan behärska i sin akutambulans men för hantering av den svåra luftvägen behövs särskild spetskompetens, hjälpmedel och förmåga.

La relation mère-enfant a une influence sur le développement de l’enfant. Cette étude vise principalement à vérifier si la sensibilité maternelle modère l’expression du tempérament difficile de l’enfant à 9 mois. Elle vise également à vérifier si la relation d’attachement sécurisante / insécurisante modère le développement de comportements perturbateurs chez les enfants de 24 mois. Les données de l’étude La mère veille ont été employées. L’échantillon compte 96 mères adolescentes, âgées entre 14 et 19 ans, provenant de deux (2) milieux distincts : une école spécialisée pour mères adolescentes et un foyer de groupe. Des analyses de régression multiple n’ont pas confirmé l’effet modérateur de la sensibilité maternelle sur l’expression du tempérament difficile de l’enfant à 9 mois. Les analyses ont cependant montré un effet prédictif de l’attachement sécurisant / insécurisant sur le développement des comportements perturbateurs à 24 mois. En effet, un enfant qui a développé un attachement sécurisant envers sa mère est moins à risque d’émettre des comportements perturbateurs à l’âge de 24 mois. Les résultats ne permettent cependant pas de confirmer que l’effet observé est modérateur. / Mother-child relationship has an influence on children’s development. This study aims to verify if maternal sensitivity moderates the expression of a difficult temperament at 9 months, and if a secure or insecure attachment relationship with the mother moderates the development of disruptive behaviors in 24 month-old children. Data come from the study «La mère veille». The sample includes 96 teenage mothers (14-19 years old) recruited from two different resources: A specialized school for teenage mothers and a group home. Multiple regression analyses did not confirm the moderating role of maternal sensitivity in the expression of child difficult temperament at 9 months. Analyses nevertheless demonstrated a predictive relation between secure/insecure attachment and disruptive behaviors at 24 months: Children who had developed a secure attachment relationship with their mother were less likely to exhibit disruptive behaviors at 2 years. The current results did not support the hypothesis of a moderating role of attachment security.

La relation mère-enfant a une influence sur le développement de l’enfant. Cette étude vise principalement à vérifier si la sensibilité maternelle modère l’expression du tempérament difficile de l’enfant à 9 mois. Elle vise également à vérifier si la relation d’attachement sécurisante / insécurisante modère le développement de comportements perturbateurs chez les enfants de 24 mois. Les données de l’étude La mère veille ont été employées. L’échantillon compte 96 mères adolescentes, âgées entre 14 et 19 ans, provenant de deux (2) milieux distincts : une école spécialisée pour mères adolescentes et un foyer de groupe. Des analyses de régression multiple n’ont pas confirmé l’effet modérateur de la sensibilité maternelle sur l’expression du tempérament difficile de l’enfant à 9 mois. Les analyses ont cependant montré un effet prédictif de l’attachement sécurisant / insécurisant sur le développement des comportements perturbateurs à 24 mois. En effet, un enfant qui a développé un attachement sécurisant envers sa mère est moins à risque d’émettre des comportements perturbateurs à l’âge de 24 mois. Les résultats ne permettent cependant pas de confirmer que l’effet observé est modérateur. / Mother-child relationship has an influence on children’s development. This study aims to verify if maternal sensitivity moderates the expression of a difficult temperament at 9 months, and if a secure or insecure attachment relationship with the mother moderates the development of disruptive behaviors in 24 month-old children. Data come from the study «La mère veille». The sample includes 96 teenage mothers (14-19 years old) recruited from two different resources: A specialized school for teenage mothers and a group home. Multiple regression analyses did not confirm the moderating role of maternal sensitivity in the expression of child difficult temperament at 9 months. Analyses nevertheless demonstrated a predictive relation between secure/insecure attachment and disruptive behaviors at 24 months: Children who had developed a secure attachment relationship with their mother were less likely to exhibit disruptive behaviors at 2 years. The current results did not support the hypothesis of a moderating role of attachment security.

This thesis deals with the Low threshold facilities (shortly LTF) for children and youth and a method of work with high risk youth The aim is to desribe and analyse the methods of work in this facilities. In the theoretical part, this analysis is based on the study of professional literature. The theoretical part explains the situation that affects children and adolescents in a risk ways. The practial part is based on qualitative research, which were provided in concrete LTF through the interview with clients and employee of LTF. Method of interview was supplied by involved observation. The data analysis resulted in several facts. Free time activities became the important motive for attendace at club. Through free time activities, social work is provided with the help of other method such as consultancy, informative service, situation and crisis intervention. Streetwork is a specific method, where all services are provided to the target group at the street.

我國農業用地實施休耕補貼之相關政策迄今已逾32年，該政策因長期推行，導致大量農田連續休耕及廢耕，致使生產環境惡化及農地資源浪費，龐大的休耕補貼金額不僅侵蝕國家財政亦讓農民產生不勞而獲之錯覺。農委會冀望透過「調整耕作制度活化農地計畫」的政策目標，本研究選取彰化縣福興鄉、芳苑鄉、大城鄉等領取補貼金額將近該縣半數之農業鄉為樣區，目的在於檢視該政策施行是否具有農業多功能性及永續發展，並就計畫產生的問題擬定對策和修正建議。 　　本研究以文獻分析及深度訪談作為研究方法，透過多功能性的多項評估指標檢視研究結果發現：在經濟生產面向中，量化成果達成率極高，活化農地減少影響鄰地耕作，創造小地主大佃農契機，政策執行成果整體偏向經濟生產面；至於社會生活面，則因農村人口老化、青農返鄉誘因不足與耕地取得不易等，不甚彰顯。另於生態環境面，因多施行慣行農法對於環境較不友善。因而，農業多功能性聯合產出特徵不明顯，離農業永續發展目標仍有距離。 　　本研究建議，政府對休耕地活化補貼政策應再作調整，就商品產出面言，加重申報不實罰責及建立政策退場機制，以確保農業競爭力，並考量因地制宜明定復耕作物項目；就非商品產出面言，應排除耕作困難地補貼，增加環境生態或景觀維護補貼，俾利展現農業多功能，實現永續農業目標。 / Taiwan has been subsidizing the fallowing of agricultural land for 32 years. Due to the long period of execution of the fallowing policy, large areas of agricultural land have been continuously fallowed or abandoned, causing the deterioration of production environment and waste of agricultural resources. In addition, the large amount of subsidy has not only eroded the country’s financial situation, but also caused misconception of farmers of reaping without sowing. The Council of Agriculture expects to achieve the policy objective through adoption of “Adjustment of Farming System and Plan of Revitalizing Fallow Agricultural Land.” This study selects half of the agricultural townships receiving subsidies in Changhua County such as Fuxing Township, Fangyuan Township and Dacheng Township as examples. It aims to examine whether or not this policy is able to facilitate agricultural multi-functionality and sustainable development, in order to formulate countermeasures and suggestions. 　　 　This study utilizes literature review and in-depth interviews as research methods. Through various Multi-functional indices, this study discovered the following phenomenon. First, from the perspective of economic production, the extremely high achieving rate for revitailzing fallow farm land reduces the impact on the farming of neighboring fields, and creates opportunity for small landowners to become big tenant-farmers. The outcomes of policy execution are tilted to the economic production. Second, in terms of the aspect of social life, due to the aging population in the farming villages, less incentives for young farmers to return to hometowns and difficulty of acquiring arable lands, it is difficult to manifest results. Last, regarding the ecological environment, owing to the unfriendliness of conventional farming skill, the characteristics of Multi-functional agricultural outputs are unclear. There is a certain distance to go to reach to goal of sustainable agricultural development. 　This study suggests that the government should adjust the Fallow Land Subsidy Policy. As for the output of Commodity outputs, government should aggravate the penalties for false declaration and establish the exit mechanism, in order to keep the competitiveness of Taiwan’s agriculture. It is essential to clearly indicate the replanting items that suits local circumstance. With regard to the Non Commodity outputs, the subsidy for difficult arable land should be abolished. Nevertheless, the subsidy for maintaining environmental ecology and scenery should be increased. These measures can help achieve the Multi-function of agriculture and realize the goal of sustainable agriculture.

No description available.

Superligas são materiais utilizados nas indústrias aeronáuticas, nucleares, metal-mecânicas, petroquímicas, automotivas e biomédicas, sendo considerados de difícil retificação (Difficult To Grind - DTG), devido às suas características peculiares. Para a retificação eficiente destes materiais, frequentemente utiliza-se rebolos superabrasivos com grãos de cBN (cubic boron nitride) e ligante vitrificado, devido a seu desempenho superior, quando comparado aos rebolos convencionais. Entretanto, é necessária a utilização de periféricos e sistemas auxiliares eficientes, elevando-se, assim, os custos. Visando a redução dos custos operacionais, os rebolos convencionais com grãos cerâmicos e ligantes com alta capacidade de retenção surgem como uma alternativa promissora. Neste cenário de comparação ferramental, torna-se necessário mensurar o desempenho das mesmas, que incluem requisitos técnicos e indicadores de sustentabilidade do processo. Assim, o objetivo desta dissertação é avaliar um rebolo convencional modificado tecnologicamente (grão cerâmico e ligante de alto desempenho), comparando-o com um rebolo de cBN vitrificado, buscando-se mensurar as diferenças de desempenho e critérios de sustentabilidade (econômicos, ambientais e sociais) do processo, quando da retificação de superligas, com diferentes graus de usinabilidade. A metodologia de análise comparativa do desempenho dos rebolos deu-se pela avaliação da influência de parâmetros de entrada (velocidade de corte, material e taxa específica de remoção utilizada) nas variáveis de saída, a serem monitoradas, relativas ao processo (potência; energia específica; desgaste - relação G e força tangencial por grão-; superfície do rebolo; e cavacos), à qualidade final da peça (rugosidade, circularidade e análise superficial - topografia, microestrutura e microdureza) e custos associados ao processo, além dos indicadores de sustentabilidade. Como resultados, em relação ao impacto da velocidade de corte, demonstrou-se que seu aumento é benéfico ao processo, devido à diminuição da espessura de corte e menores forças por grão, acarretando em menores desgastes do rebolo (maior relação G) e melhor qualidade superficial da peça retificada. Tal resultado é inversamente proporcional à taxa de remoção. No tocante aos materiais, comprovou-se que as superligas analisadas possuem diferentes capacidades de retificação, devido às diferentes microestruturas e propriedades químico-mecânicas, que impactam no desempenho da ferramenta abrasiva. O material Inc.751 apresentou a pior capacidade de retificação dentre os materiais analisados, devido, principalmente, à sua matriz austenítica e presença de Alumínio e Titânio na composição química. Pela análise dos cavacos, comprovou-se que os mesmos possuem formatos alongados, típico de materiais dúcteis e ratificou-se a eficiência da refrigeração na região de contato rebolo/peça. Com a curva característica dos rebolos, verificou-se que as ferramentas possuem comportamentos distintos, com superioridade ao rebolo de cBN, devido à maior capacidade de retenção dos grãos pelo ligante. Pela verificação superficial dos rebolos, não se observou empastamento evidente, constatando a eficiência do sistema de limpeza de alta pressão. Pela análise topográfica das peças, verificou-se que a retificação não induziu danos térmicos às mesmas. A avaliação dos indicadores de sustentabilidade proporcionou uma melhor análise da eficiência do processo, facilitando na tomada de decisão quanto ao desempenho do rebolo e/ou condição ideal. Como conclusão, a aplicabilidade do rebolo convencional em substituição ao rebolo de cBN foi confirmada para a retificação das superligas testadas. / Superalloys are materials used in aeronautical, nuclear, metal-mechanical, petrochemical, automotive, and biomedical industries, and they are considered Difficult To Grind (DTG) due to their peculiar characteristics. For efficient grinding of these materials, superabrasive grinding wheels with cBN (cubic boron nitride) grains and vitrified bond are often used because of their superior performance when compared to conventional grinding wheels. However, it is necessary to use efficient peripheral and auxiliary systems, thus raising costs. Aiming to reduce costs, conventional wheels with ceramic grains and binders with high retention capacity appear as a promising alternative. In this tool comparison scenario, it is necessary to measure their performance, which includes technical requirements and process sustainability indicators. Thus, the objective is to evaluate a engineered conventional grinding wheel, comparing it with a vitrified cBN wheel, aiming to measure performance differences and sustainability criteria (economic, environmental, and social) of the process, when grinding superalloys with different degrees of grindability. The methodology of comparative analysis of the performance of the grinding wheels was based on the evaluation of the influence of input parameters (cutting speed, material, and specific removal rate) in the output variables to be monitored related to the process (power, specific energy, roughness - ratio G and tangential force per grain, Ft1g, grinding wheel surface, and chips), to the final quality of the piece (roughness, roundness, and surface analysis - topography, microstructure, and microhardness) and costs, in addition to the sustainability indicators. As results, in relation to the impact of the cutting speed, it was demonstrated that its increase is beneficial to the process, due to the reduction of the cutting thickness and lower Ft1g, causing less wheel wear and better surface quality of the ground piece. This result is inversely proportional to the removal rate. Regarding the materials, it was verified that the analyzed superalloys have different grinding capacities due to the different microstructures and chemical-mechanical properties that impact the performance of the abrasive tool. The material Inc.751 presented the worst grinding capacity among the analyzed materials, mainly due to its austenitic matrix and the presence of Aluminum-Titanium in its composition. By the analysis of the chips, it was verified that they have elongated formats, typical of ductile materials, and it was ratified the efficiency of the cooling system. With the wheel characteristic curves, it was verified that the tools have different behaviors, superior to the cBN wheel, due to the greater capacity of retention of the grains by the binder. Through the investigation of the grinding wheels, no evident wheel loading was observed, noting the efficiency of the high-pressure cleaning system. By the analysis of the pieces, it was verified that the grinding did not induce thermal damages to them. The evaluation of the sustainability indicators provided a better analysis of the efficiency of the process, making easier the decision-making on the performance of the grinding wheel and/or ideal condition. Concluding, the feasibility of the conventional wheel in substitution of the cBN wheel was confirmed for the grinding of the tested superalloys.

This thesis shares the results of oral history interviews with members of the heterogeneous Doukhobor community in Canada. The stories and memories of fifteen different voices highlight the influence of intersecting demographic variables (age, gender, ideological affiliation, and geographic location) on the experience of Doukhobor life in Canada during times of sensationalized conflict. The interviews are framed and analyzed through broader questions of history and cultural sustainability. What considerations influence the representation of difficult Doukhobor pasts in Canada? In the contemporary context of unification and reconciliation, how does one speak of conflict? This thesis shows that discussions of the past surface considerable contradiction in the collective memory of the Doukhobor community; the results outline various individual and community strategies that are used to manage the past in favour of the present. Ultimately, this thesis locates memory as a social and cultural anchor that must support a history for the future.

This thesis shares the results of oral history interviews with members of the heterogeneous Doukhobor community in Canada. The stories and memories of fifteen different voices highlight the influence of intersecting demographic variables (age, gender, ideological affiliation, and geographic location) on the experience of Doukhobor life in Canada during times of sensationalized conflict. The interviews are framed and analyzed through broader questions of history and cultural sustainability. What considerations influence the representation of difficult Doukhobor pasts in Canada? In the contemporary context of unification and reconciliation, how does one speak of conflict? This thesis shows that discussions of the past surface considerable contradiction in the collective memory of the Doukhobor community; the results outline various individual and community strategies that are used to manage the past in favour of the present. Ultimately, this thesis locates memory as a social and cultural anchor that must support a history for the future.

Drawing upon data from a qualitative interview study on the life stories of young women, the aim of this study is to analyze young womens experiences of difficult life events. Special interest is directed to how cultural frameworks are reflected in young women’s stories about themselves and the family and school worlds they have lived in. During a period of almost four years, I conducted deep interviews with ten young women on two to four occasions. They were between the ages of sixteen and twenty at the time of the first interview and of different classes and local origins. The young women were recruited to the study through leaders of a youth detention home and of a girl group activity. Methodologically, the thesis is based in the general field of narrative research and more specifically in the field of feminist life story research. I employed a holistic and thematic content analysis inspired by hermeneutic interpretation and the mainly focus has been on what was told in the stories. The thesis is written in a context of feminist epistemology and from a critical perspective (cf. Harding, 1986, 2004). It includes, among other things, an assumption that there is a social, cultural and historically created imbalance of power between different groups in society (cf. Anderson, 2003). The theoretical concepts that form the basis of this part of the theoretical framework are social worlds (cf. Shibutani, 1955), exclusion (cf. Goffman, 1963; Young, 1990, 2000), belonging (cf. Molin, 2010; Spånberger Weitz, 2011), agency (cf. McNay, 2003, 2004), space of agency (cf. Eduards, 2002) and social positions (cf. Anderson, 2003). The young women´s stories about family gathered around experiences of parents’ separation, family violence, parental substance abuse and the separation from parents. Their stories of school life gathered mainly around experiences of being different and othered, and these experiences of otherness and alienation were closely linked to bullying, school difficulties and to a general unhappiness at school (cf. Andersson, 1995). In contemplation of life as a series of life events, the young womens stories highlight the importance of difficult life events and the impact they have had on their ability to live their lives. The results portray the importance of considering life as a series of moving events, instant and recurring, and of understanding the consequences of social structures on how life and its conditions change and are linked across borders, between different worlds and different times. In a consideration of the life events as variable, instantaneous and sometimes recurring and changing, every life event has to be viewed as new and important to pay attention to, both as an event in itself and also how this event spreads to other moments and contexts than the time and world in which it occurred. In the assumption of life as moving and of life events as essential elements in a changeable life course, available positions and spaces of agency are made visible in the young womens stories. The cultural frameworks of the good family, the real schoolgirl and an authentic I represent structuring principles for how the events are possible to understand and talk about for the young women. They can be considered as ideal images that both increase and limit their opportunities to make difficult life events and their own actions in relation to the events understandable. In this thesis, it becomes visible that, in order to understand young women’s experiences of difficult life events, we need to place experiences in a context where the different circumstances, such as social positions and local structures, are made visible, analyzed and reflected upon.