In taking into account the vast body of literature that exists on the topic of international humanitarianism, this thesis aims to provide a contribution to the field by way of an analysis of the dubious manner in which states apply the principles of humanitarianism. It derives conclusions around the level of commitment and sincerity of the international humanitarian regime to the principles of humanitarianism by exploring the dynamic relationship between the two of the main areas of humanitarianism: humanitarian intervention and refugee protection. From this analysis stems the argument is that while the governments of the wealthy Western states are often amongst the loudest trumpeters of humanitarian principles, they fail to live up to their humanitarian obligations. For, rather than committing to humanitarian action on the basis of need, they are only willing to commit to humanitarian action in cases that serve in their own national interests; cases of human suffering from which they do not stand to benefit remain caught in the margins of the international humanitarian regime.

I den akutte postoperative fase er obstipation et forsømt problem. International forskning er sparsom, selvom det er vist, at obstipation kan forringe livskvaliteten for patienterne. Symptomerne er mavesmerter, oppustethed, kvalme, anstrengelse ved defækation, alment ubehag for patienterne. Obstipation øger risikoen for postoperative komplikationer, kan forlænge hospitalsindlæggelsen, øge de økonomiske udgifter samt antallet af plejetimer per patient.Formål: At beskrive proportionen af patienter der påvirkes af postoperativ obstipation under indlæggelsen og de første 30 dage postoperativt. At beskrive hvornår obstipation udvikles. At beskrive patientens gener ved postoperativ obstipation og om de påvirker patienternes dagligliv.Metode: En prospektiv forløbsundersøgelse blev valgt. Hvor patienter indlagt til thoraxkirurgi, indgår konsekutivt. Ved indlæggelse, udskrivelse og en måned efter operation blev defækationsmønster, afføringsform og konsistens vurderet ved hjælp af Bristol Stool Scale og et selvudviklet interviewskema. Data er indsamlet af forfatteren som led i MPH - uddannelsen.Resultater: 139 patienter med en gennemsnitsalder på 60 år (+/-14) deltog. 69 % var mænd. 18 % var obstiperede ved indlæggelsen. Efter operationen var 67,2 % obstiperede, og 31,5 % angav, tendens til obstipation en måned postoperativt. Normalt defækationsmønster blev reetableret 11 dage postoperativt med en spredning fra 2 – 30 dage. 22,5 % angav, ifølge Bristol Stool Skalaen at deres fæces ikke havde normaliseret sig en måned efter operationen. Ingen signifikant forskel i angivelse af postoperativ obstipation mellem mænd og kvinder. Patienterne rapporterede mange symptomer på grund af obstipation.Konklusion: Resultaterne af dette studie viser, at postoperativ obstipation påvirker op mod 70 % af patienterne og komplicerer den postoperative fase for patienterne. Resultaterne viser at obstipation påføres patienten under indlæggelsen og at de også har problemer efter udskrivelsen. Litteraturens beskrivelse af, at kvinder har to gange højere risiko for obstipation end mænd, er i kontrast til dette studies resultater. Mere forskning må afgøre om litteraturens resultater kan overføres til patienter, der gennemgår kirurgi. Resultaterne viser at der er behov for systematiske sygeplejeinterventioner i den første postoperative fase og efter udskrivelsen. / In the acute postoperative phase constipation is a neglected problem. International research is sparse, eventhough constipation is shown to reduce quality of life for patients. Symptoms are abdominal pain, bloating,nausea, straining to defecate and a general discomfort for the patients. Constipation increases the risk forpostoperative complications, can prolong hospital stay, increase financial cost, and staff nursing care time.Purposes: To describe the proportion of patients experiencing postoperative constipation during hospital stayand first 30 days after surgery. To describe when constipation develops. To describe the inconvenience patientsfeel with postoperative constipation and if it effects patients daily life.Method: A prospective follow up survey was chosen. Were patients consecutive admitted for cardiothoracicsurgery was included. At admission, discharge and 30 days after surgery defecation pattern, stool form andconsistency were assessed using Bristol Stool scale and a self-developed questionnaire. The data was collectedby the writer as a MPH-education.Results: 139 patients mean age 60(+/-14) participated. 69 % were men. 18 % reported to be constipated whenadmitted. The first period after surgery 67,2 % reported they were constipated and 31,5 % reported tendency toconstipation one month after surgery. Normal pattern of defecation was established at 11 days postoperative(range 2–30 days) and 22,5 % indicated that there stools, had not normalized 30 days after surgery according toBristol Stool Scale. No significant difference in report of postoperative constipation between men and women.The patients reported a number of complaints due to constipation.Conclusion: This survey shows that postoperative constipation affected up to 70% of the patients andcomplicates the postoperative phase for the patients. Results show that constipation is induced the patients atadmission and that they also have problems after discharge. The literatures description of women having 2times higher risk of constipation than men, are in contrast with this survey’s results. More resurge must decideif literatures results can be applied to patients who undergo surgery. Therefore there is a need for systematicnursing intervention in the acute postoperative phase after cardiothoracic surgery and after discharge. / <p>ISBN 978-91-85721-44-3</p>

Children with childhood apraxia of speech (CAS) are likely to experience severe and persistent spoken and written language disorder. There is a scarcity of intervention research, however, investigating techniques to improve the speech and literacy outcomes of this population. The series of 5 experiments reported in this thesis investigated phonological awareness and early reading development in children with CAS and trialled a new intervention designed to advance the spoken and written language development of those affected. In the first experiment (presented in Chapter 2), a comparison of 12 children with CAS, 12 children with inconsistent speech disorder (ISD), and 12 children with typical speech-language development (TD) revealed that children with CAS may be particularly susceptible to phonological awareness and reading deficits. There was no difference in the articulatory consistency and speech severity of the CAS and ISD groups, and no difference in the receptive vocabulary of the CAS, ISD, and TD groups. The children with CAS exhibited poorer phonological awareness scores than the comparison groups and had a greater percentage of participants performing below the expected range for their age on letter knowledge, real word decoding, and phonological awareness normative measures. The children with CAS and ISD performed inferiorly than the children with TD on a receptive phonological representation task. The results showed that the children with CAS had a representational component to their disorder that needed to be addressed in intervention. In the second experiment (presented in Chapter 3), a follow-up pilot study was conducted to examine the long-term effects of a previously conducted intensive integrated phonological awareness programme (7 hours of intervention over 3 weeks) on 2 children with CAS. The children aged 7;3 and 8;3 at follow-up assessment had previously responded positively to the intervention. Results showed that the children were able to maintain their high accuracy in targeted speech repeated measures over the follow-up period. One child was also able to maintain her high accuracy in phonological awareness repeated measures. The children performed superiorly on a standardised phonological awareness measure at follow-up than at pre-intervention. Non-word reading ability showed a sharp increase during the intervention period, while minimal gains were made in this measure over the follow-up period. The findings suggested that an integrated intervention was a potential therapeutic approach for children with CAS. In the third experiment (presented in Chapter 4), the effectiveness of an integrated phonological awareness programme was evaluated for the 12 children (identified in the first experiment) aged 4 to 7 years with CAS. A controlled multiple single-subject design with repeated measures was employed to analyse change in trained and untrained speech and phoneme segmentation targets. A comparative group design was used to evaluate the phonological awareness, reading, and spelling development of the children with CAS compared to their peers with TD over the intervention. The children participated in two 6- week intervention blocks (2-sessions per week) separated by a 6-week withdrawal block. Seven children with CAS made significant gains in their production of trained and untrained speech words with 7 of these children demonstrating transfer of skills to connected speech for at least one target. Ten children showed significant gains in phoneme awareness, and 8 of these children demonstrated transfer of skills to novel phoneme awareness tasks. As a group, the children with CAS demonstrated accelerated development over the intervention period in letter knowledge, phonological awareness, word decoding, and spelling ability compared to their peers with typical development. In the fourth experiment (presented in Chapter 5), the speech, phonological awareness, reading, and spelling skills of children with CAS and TD were re-evaluated 6- months following completion of the intervention programme. A measure of reading accuracy and reading comprehension in a text reading task was administered to the children with CAS. There was no difference in the performance of the children with CAS in post-intervention and follow-up assessments. The children with CAS and children with TD presented with similar relative change in phonological awareness, reading, and decoding measures over the follow-up period. The connected reading performance of children with CAS mirrored their phonological awareness and decoding skills. The findings demonstrated that children with CAS were able to maintain gains achieved during the intervention but may need further support to promote sustained development in written language. In the fifth experiment (presented in Chapter 6), the long-term effects of the integrated phonological awareness programme for identical twin boys who participated in the research intervention at pre-school were examined. The study examined Theo and Jamie's spoken language, phonological awareness, reading, and spelling development during their first year of schooling. The results pointed to the benefit of providing phonological awareness within a preventative framework for children with CAS. Theo and Jamie experienced continued growth in speech and phonological awareness skills. They exhibited age-appropriate reading and spelling development during their first year of formal literacy instruction. It was concluded from this series of experiments that children with CAS are particularly vulnerable to phonological awareness and early reading difficulty, and that an integrated phonological awareness intervention is an effective means of developing speech, phonological awareness, reading, and spelling skills in most children with CAS. The intervention appears to target processes underlying spoken and written language development in this population. The results are discussed within a phonological representation deficit hypothesis of CAS and clinical implications of the findings are highlighted.

Submitted in fullfilment of the requirements for the degree of Master of Arts (Research) Macquarie University, Division of Humanities, Dept. of Modern History. 2005. / Thesis (MA)--Macquarie University, Division of Humanities and Social Sciences, Dept. of Modern History, 2005. / Bibliography: p. 268-290. / Introduction -- 1. Norms, interests and humanitarian intervention -- 2. Bosnia and Somalia -- 3. Rwanda -- 4. The Clinton Administration and the Balkan Wars -- Conclusion. / A number of Constructivist and English school scholars have investigated the degree to which humanitarian intervention is allowed and legitimised by international society. In other words, they have examined the nature and strength of a norm permitting humanitarian intervention. It is the contention of this dissertation that another norm of humanitarian intervention - parallel but discrete - has been neglected. It is argued that ideas and beliefs shared by members of international society not only permit intervention but prescribe it in certain circumstances and this has been largely ignored in the literature. / Mode of access: World Wide Web. / 290 p

Zugl.: Münster (Westfalen), Univ., Diss., 2008

Background: Informal caregivers provide unpaid support to a family member, which has been shown to more positively affect their relatives’ health outcomes than equivalent paid caregivers. The provision of this support, however, comes at a cost to the carers’ health and wellbeing through meeting the demands of the caring role. Efforts have been made to alleviate these consequences through various forms of interventions aimed to enable the carers to meet these demands. The reported success of these interventions is varied in regards to their effectiveness; an argument supported by literature review papers on the subject that questions the methodologies and evaluations of these interventions. Rationale: There is a need to explore the ways to enhance the health and wellbeing of informal carers by means of a robust design and evaluation. This thesis reports a study, the aim of which is to provide information about how to reduce the negative effects of the carer role whilst enhancing the positive effects using an intervention developed using lived experience. Method: The self-care intervention was developed and piloted with those caring for a relative with bipolar disorder. This was achieved in three stages: (i) qualitative interviews with carers to explore and understand the role, (ii) developing the intervention informed by qualitative findings, and finally by (iii) piloting the intervention. Effectiveness of the intervention was determined using health and wellbeing outcomes, the results of which were compared to a control group who did not take part in the intervention. Results: A positive potential for psychoeducational, cognitive behavioural and mindfulness techniques in enhancing the health and wellbeing of those caring for a relative diagnosed with bipolar disorder was found. From the exploration of lived experience, “Being Bound” was elicited from the data representing the conflict between the detrimental effects of providing care and being unable to take respite or reprieve through guilt and anxiety. Conclusion: Professionals who work with family members, individually or as part of a family unit, should consider the benefits of targeted information for carers. Provision of information is not enough to engage the carer in the process of understanding their relative’s behaviours, but requires a process of interaction and personalisation. In contributing to existing research, the use of hermeneutic phenomenology provided new insight in to the experiences of those providing care. The outcome of the intervention pilot shows positive potential for the use of interventions beyond psychoeducation alone and the use of a self-care approach.

Andelen äldre personer ökar i Sverige och i takt med det ökar även prevalensen av demenssjukdomar. Problematik med att inta tillräckligt med näring är särskilt förekommande hos personer med demenssjukdomar och kan innebära en ökning av en rad olika riskfaktorer och komorbiditet. Syfte: Beskriva effekter av omvårdnadsåtgärder för att stödja nutritionsintag vid demenssjukdom, samt beskriva de olika etiska aspekterna som diskuteras i de undersökta studierna. Metod: En beskrivande litteraturöversikt som utgår ifrån 14 vetenskapliga artiklar med kvantitativ ansats. Huvudresultat: Resultatet analyserades och utgår ifrån tre teman av åtgärder; Anpassning av kost, Anpassning av miljö och Utbildning. Signifikanta resultat kunde påvisas i områden såsom, tillskott av näringsämnen till vanlig kost, serveringsmetod, hög kontrast på porslin, att lyssna på musik, en mer hemmalik miljö, utbildning i nutrition och träningsprogram för minnet. Slutsats: Det finns ett flertal verksamma och kostnadseffektiva åtgärder för att stödja näringsintag hos personer med demenssjukdomar. Antalet studier i området är omfattande och går in på detaljnivå, med variation i graden av reella förändringar som kan uppstå. Studier med högre evidensstyrka behövs inom forskningsområdet för att undersöka vilka multiplikativa effekter som kan uppstå när olika interventioner kombineras. / Background: The number of elderly people are increasing in Sweden and it correlates with a higher amount of people with dementia. Struggling with an intake of a sufficient amount of nutrients is especially prevalent in people with dementia and could result in an increase of several risk factors and comorbidities. Aim: The aim of this study was to describe the effects of nursing interventions with the intentions of improving the nutritional intake of people with dementia, aswell as compiling the ethical considerations that are described in the selected studies. Method: A descriptive literature study that is based on the results of 14 scientific articles with quantitative approaches. Main results: The results of this study was categorized into three main themes; changes to the food itself, changes in the external environment and education. Significant results were obtained in areas that included, adding nutrients to ordinary food together with supplements, serving methods, high contrast in crockery, listening to music, a more homelike environment, education in nutrition and memory promoting training programs. Conclusion: There are a number of valid and cost-effective methods to support the intake of nutrients in people with dementia. The number of studies on the subject is substantial and often examines on a high level of detail, with a variance in the amount of realistic change that occurs. The research subject requires studies with a higher grade of evidence to examine the possibility of multiplicative effects when different interventions are combined.

Military Democratic Intervention is a common strategy of foreign interaction especially since World War II. However, the question why some interventions are successful in implementing democracy and others are still not answered satisfactorily. Whereas the scientific debate so far focused on mission specific characteristics including variables such as personnel or financial equipment of interventions, the underlying assumption of this work is that external democratized countries need to exhibit the same preconditions as countries internally democratized. Therefore, the transition and state-building literature is investigated and five clusters of preconditions for successful democratization is developed. With a Qualitative Comparative Analysis, a dataset comprising 27 cases, eight variables and the outcome variable, the author provides evidence for the significance of all five clusters. Most importantly, the level of human development and modernization as well as the predecessor regime type and the experience with democratic experience strand out. Further, the combination of the variables of high GDP, an ethnically homogeneous society and a democratically ruled neighborhood are identified as variables sufficiently influencing successful democratization after a military intervention. These results...

SAMMANFATTNING Bakgrund: Brist på sömn och störningsmoment under sömnen har negativa inverkningar på immunförsvar, återhämtningstid, smärta med mera. Trots sömnens betydelse sover patienter signifikant sämre på sjukhus än de gör i hemmet. Kroppen följer en dygnsrytm som varar i ungefär 24 timmar. Ljud, ljus, temperatur och andra stimuli påverkar kroppens dygnsrytm för att anpassa den till omgivningen. En störande omgivning kan ge kroppen falska signaler vilket kan påverka sömnen. Sjuksköterskan behöver därför evidensbaserade interventionsmetoder för att förbättra patienters sömn. Syfte: Att undersöka vilka åtgärder som är effektiva för att förbättra patienters sömnkvalitet och sömnkvantitet på sjukhus. Metod: En litteraturöversikt med 13 kvantitativa studier har sammanställts och analyserats med narrativ metod. Resultat: Tre olika kategorier av interventioner framkom. Minskat stimuli i form av öronproppar och ögonmasker, utbytt stimuli i form av musik och naturljud samt farmakologisk intervention i form av melatonin har alla visats vara effektiva åtgärder då patienter själva har bedömt sin sömnkvalitet och sömnkvantitet. Minskat stimuli genom Quiet time och utbytt stimuli genom aromterapi har inte visat på något statistiskt signifikant resultat. Slutsats: Att stänga ute eller ersätta störande stimuli har genom flera interventionsmetoder visats förbättra patienters självskattade sömnupplevelse. Placeboeffekten går dock inte att utesluta. En sovmeny där patienter själva får välja sömnstödjande åtgärder med evidensbaserade alternativ är fördelaktig och ger en ökad patientdelaktighet. / ABSTRACT Background: Lack of sleep and disturbance during sleep has a negative impact on the immune system, recovery, increased pain etc. Despite the importance of sleep, patients sleep significantly worse in hospitals than they do in their own homes. The body follows a circadian rhythm that lasts approximately 24 hours. Sounds, light, temperature and other stimuli affect the circadian rhythm to synchronize it to its environment. A disturbing environment can give the body false signals that may affect its sleep. The nurse therefore needs evidence-based intervention methods to improve patients sleep. Aim: To examine which interventions are effective in improving patients sleep quality and sleep quantity in hospitals. Method: A review of literature with 13 quantitative studies has been compiled and analyzed with a narrative method. Results: Three different categories were found. Reduced stimuli in form of earplugs and eye masks, replaced stimuli in form of music and nature sounds and pharmacological intervention in form of melatonin have all been shown to be effective when patients’ have self-assessed their own sleep quality and quantity. Reduced stimuli through Quiet time and replaced stimuli through aromatherapy have not shown any statistically significant results. Conclusion: Reducing or replacing disturbing stimuli has shown through several interventions to improve the patients subjective sleep experience. Placebo effect could not be ruled out. A sleep menu containing evidence-based interventions for improving sleep for patients to pick from is a beneficial idea that improves patient participation.

The purpose of this study was to examine special education populations, special education reading achievement, and regular education reading achievement in relation to the implementation of the Reading First three-tiered model as a response to Intervention platform. The population for this study focused on rural schools with Grades K-3 in attendance. Schools participated in the reading first grant period of the 2003-2009 school years. Forty-seven Texas Reading First schools were compared to 47 campuses having similar populations, socioeconomic makeups, and grade structures. This study utilized quantitative research measures to evaluate the level of special education populations on Reading First campuses using a response to intervention model. Quantitative measures were also used to evaluate those same campuses achievement rates of both special education and regular education students on the Texas Assessment of Knowledge and Skills reading tests. The study's outcome data showed little to no statistic significance for the three research questions. However, the inferential statistics showed a decrease in the special education population of the Reading First schools. Inferential statistics also indicated both the special education and the regular education students showed growth on the Texas Assessment of Knowledge and Skills reading tests. The use of a response to intervention program can be effective in the reduction of special education students identified on school campuses. Response to intervention programs can boost achievement levels of students receiving special education services. Students not enrolled in special education can benefit from effective response to intervention services.