Problematisk skolfrånvaro har uppmärksammats efter att en statlig utredning 2016 kom fram till att det finns bristande kunskap inom området i Sverige. Studiens syfte är att undersöka hur specialpedagogen används i det främjande arbetet för skolnärvaro och det förebyggande och åtgärdande arbetet vid problematisk skolfrånvaro utifrån 20 kommunala handlingsplaner. Frågorna är: Vilka insatser för närvaro och problematisk skolfrånvaro, som beskrivs i de kommunala handlingsplanerna, kan kopplas till specialpedagogen? På vilka nivåer (individ-, grupp- och organisationsnivå) används specialpedagogen i arbetet med att främja närvaro och att förebygga och åtgärda problematisk skolfrånvaro? En kvalitativ dokumentanalys gjordes utifrån sex kategorier. Systemteori och specialpedagogiska perspektiv användes i analysen för att belysa studiens frågor. Sammanfattningsvis visar studien att specialpedagogen kopplas explicit till uppgifter som till exempel fördjupad kartläggning vid skolfrånvaro och specialpedagogiskt stöd till enskild elev på individnivå. Specialpedagogen nämns implicit genom elevhälsans arbete på organisationsnivå i ett fåtal handlingsplaner.  I diskussionen lyfts varför handlingsplanerna bör uttrycka det främjande och förebyggande arbetet och hur det förebyggande och åtgärdande arbetet kan utvecklas i det systematiska kvalitetsarbetet kopplat till specialpedagogens kompetens. Därutöver diskuteras även den specialpedagogiska kompetensen och dess roll i elevhälsan, riskerna med frånvaroteam och behovet av att utveckla ämnet problematisk skolfrånvaro i den specialpedagogiska utbildningen. / Problematic school absenteeism as first identified as a problem in 2016 when a government inquiry concluded that there was a lack of proper knowledge on the subject in Sweden. The purpose of this paper is to explore how 20 municipalities, via their schools’ action plans and policies, utilize special educators with regard to students’ problematic school absenteeism through the use of early intervention, and preventative and supportive measures. Examined will be: How is the special educator involved in the efforts to curb problematic school absenteeism? On what levels (individual, group or organizational) is the special educator engaged to promote attendance and to prevent and remedy problematic school absenteeism? The observational basis for this paper is a qualitative analysis of action plans from twenty different municipalities. This analysis was made based on six categories. Systems theory and special needs perspectives were used in the analysis to highlight the questions posed in this paper. In summary, the special educator is explicitly connected to certain tasks such as the in-depth tracking of absenteeism and the support for students with special needs. More often, the responsibilities included under the special educator’s purview are implicitly included in the framework for the team responsible for student well-being. The discussion addresses why action plans must describe supportive and preventative measures and ways in which preventive and remedial activities can be developed during systematic quality processes linked to the special educator's skills set. Additionally, discussed were the special educator’s roll in the team responsible for student well-being, the pros and cons with the absenteeism-teams and even the need to develop understanding for this subject in training for the special educator.

Barriers to Colorectal Cancer Screening in People Obtaining Care From Community Mental Health Agencies by Kelly Gardiner MSN, Wayne State University, 1997 BSN, Wayne State University, 1988 Dissertation Submitted in Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University August 2016 Despite being highly treatable with early intervention and preventative screenings, the overall mortality rate of colorectal cancer is substantially higher in participants with a preexisting mental disorder. Variables affecting the likelihood of completing screening for those with mental illnesses were unknown in people who obtain services from a Community Mental Health agency. Using the Health Belief Model, the proposed study investigated the effects of access to transportation, referral to screening, physical ability to complete the colonoscopy prep, type of procedure, awareness of the purpose of screening, anxiety, embarrassment, gender, race, and age to determine which affect completion of colorectal cancer screening. Significant relationships existed between embarrassment, fear of pain, fear of cancer, anxiety, physical ability to do testing, awareness of screening at age 50, FOBT vs Scope procedures, age of first screening, being told to get screening, knowing someone who had screening, and completion of colorectal cancer screening. In the binary logistic model Anxiety was negatively correlated and being told to get screening was positively correlated to completion of colorectal cancer screening and those choosing Scope were more likely to complete than those choosing FOBT. The results of this study may effect positive social change by providing healthcare providers with an increased understanding of variables that influence colorectal cancer screening completion among persons with a diagnosed mental illness, resulting in a changing agenda for effective mental and physical health care in this population.

<p>Health communication is a growing field of research under interpersonal and family communication. Gaining enough health information is primarily the duty of healthcare providers. However, our immediate source of health information is family members; but most people decide to privatize and keep their health information from other relatives. The criterion for withholding health information, what contributes to the information shared, and how communication patterns affect health communication were all examined to understand the reasons behind this action.</p> <p>This qualitative study used the narrations on health communication from various families to form themes. In addition,  responses were mostly from non-Western cultures, which helps to expand the applicability of the theory used.</p> <p>Some of the results were consistent with the criteria within the theory. However, other criteria were found that expand the theory in relation to health information. The new criteria found were when disclosing the information, age matter, I don’t understand the condition myself so how can my family, the number of people in the family matters. Also, reasons such as anticipated reactions from family members, and the severity of the condition came up when exploring what impacts how much health information family members share with one another. Finally, the frequency of communication and the initiator of conservations were found to influence health communication in families.</p> <p>To conclude, healthy communication in the family may impact individual communication on health. </p>

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With the world economy becoming unpredictable, it has become a necessity for businesses to relook at the way they do business. The world has become competitive and companies that aim to become profitable have seen the need to find ways to improve efficiencies and increase productivity to stay relevant. There has been an adoption of strategies that are aimed at improving the efficiencies in companies such as Total Productive Maintenance (TPM). The strategy is aimed at improving equipment efficiencies and increase productivity through the transfer of certain skills from maintenance personnel to operators. The aim is that the operators perform some of the activities that the maintenance people used to do and they do the more complex tasks. By transferring these skills to operators there is constant cleaning, inspections and lubricating of equipment. This frees up time for maintenance people to do planning and other jobs that require time and higher skills levels. The implementation of these activities allows companies to tap into unused capacity that was always hidden by breakdowns and unplanned stops. The process however requires commitment from management and all stakeholders involved in the organisation. There are prescribed implementation processes that can be followed or companies can follow their own processes but the fundamentals of involving people from the onset must be followed. The involvement of stakeholders creates commitment at all levels and in order to sustain this initiative people must be committed to it. The inclusion of the activities transferred from maintenance people to operators, will reinforce the knowledge and habits required from operators and perhaps sustain the initiative. / MBA, North-West University, Potchefstroom Campus, 2015

With the world economy becoming unpredictable, it has become a necessity for businesses to relook at the way they do business. The world has become competitive and companies that aim to become profitable have seen the need to find ways to improve efficiencies and increase productivity to stay relevant. There has been an adoption of strategies that are aimed at improving the efficiencies in companies such as Total Productive Maintenance (TPM). The strategy is aimed at improving equipment efficiencies and increase productivity through the transfer of certain skills from maintenance personnel to operators. The aim is that the operators perform some of the activities that the maintenance people used to do and they do the more complex tasks. By transferring these skills to operators there is constant cleaning, inspections and lubricating of equipment. This frees up time for maintenance people to do planning and other jobs that require time and higher skills levels. The implementation of these activities allows companies to tap into unused capacity that was always hidden by breakdowns and unplanned stops. The process however requires commitment from management and all stakeholders involved in the organisation. There are prescribed implementation processes that can be followed or companies can follow their own processes but the fundamentals of involving people from the onset must be followed. The involvement of stakeholders creates commitment at all levels and in order to sustain this initiative people must be committed to it. The inclusion of the activities transferred from maintenance people to operators, will reinforce the knowledge and habits required from operators and perhaps sustain the initiative. / MBA, North-West University, Potchefstroom Campus, 2015

Every child has the constitutional right to be protected from maltreatment, neglect or abuse. However, contrasting every child's constitutional right is the escalating worldwide prevalence of child sexual abuse. The incidence of child sexual abuse must be reduced as far as possible by a multi-faceted approach, including effective prevention programmes which facilitate disclosure and empower children. Since insufficient South African research on prevention programmes and preventative measures are available, the primary aim of the study was to develop a board game which can foster the prevention of sexual abuse of children. Scientifically, the motivation for the study was based on the improved understanding of the educational impact of a board game as primary prevention tool. The researcher developed the HOOC board game as part of the Hands Off Our Children Campaign. The board game, being practical and educational, has the goal of teaching children self-protective behaviours that can lower their probability of being abused. A representative sample of 1697 grade four learners, nine to twelve years of age, were selected from the Metropole East region. In order to determine the educational impact of the HOOC board game, the results of the children on the Children's Knowledge of Abuse Questionnaire-Revised (CKAQ-RIII) in the experimental and control groups were compared. The experimental group (n=407) received the board game as intervention. The control group (n=1290) did not receive any intervention. Performance on the test were also compared with gender and ethnicity. According to the obtained results, the HOOC board game correlated with the improvement of knowledge in an acceptable manner. No significant correlations were found between the scores of the tests and gender. The gender of a learner had no significant impact on the learner's ability to learn and retain information. A significant correlation was found between the difference in scores on the tests and the ethnic grouping of learners. It therefore seems that the ethnicity of a learner relates to the improvement of knowledge. Considering the overall results of the study, the use of the HOOC board game as preventative measure against the sexual abuse of grade four learners is acceptable. The HOOC board game offers a significant and valid preventative measure for sexual abuse of children in the middle age group within the South African context. / Practical Theology / D. Diac.

Events around conception such as maternal undernutrition and twinning may have effects on offspring physiology and disease risk in adulthood. Periconceptional undernutrition alters offspring physiology and adult pathology without affecting birth size, while twinning affects birth size and physiology but with inconsistent effects on adult pathology. We investigated the effects of these two periconceptional events and their interaction on maternal cardiovascular adaptation to pregnancy and fetal growth, physiology and endocrinology in late gestation in sheep. Pre and/or postconception undernutrition resulted in increased uterine blood flow in late gestation, but no change in maternal blood volume. Preconception undernutrition alone resulted in a relatively large placenta with a small, slow-growing fetus in late gestation. In contrast, postconception undernutrition alone resulted in a fetus with rapid late-gestation growth that was maintained through a maternal fast. Fetuses of ewes undernourished throughout both periods were similar in growth rate and size to controls. Maternal fasting also demonstrated that plasma levels of C-type natriuretic peptide are acutely and independently regulated by nutrient supply in mother and fetus. Fetuses of ewes undernourished both pre- and postconception had increased glucose disposal following a glucose challenge. Hypothalamic-pituitary-adrenal axis tests in these fetuses showed decreased pituitary adrenocorticotropin hormone response to direct stimulation but increased adrenal response to decreased cortisol negative feedback. Twin fetuses grew more slowly in late gestation than singletons. Twins also had a smaller insulin response to arginine and a greater insulin response to glucose, but periconceptional undernutrition abolished this difference. Twins had suppressed baseline hypothalamic-pituitary-adrenal axis function and decreased adrenal sensitivity compared to singletons, but increased fetal pituitary adrenocorticotropin hormone response to direct stimulation and decreased cortisol negative feedback. These studies suggest that firstly, fetal size is a poor reflection of fetal growth trajectory, physiology and endocrinology. Secondly, pre- and postconception undernutrition affect late-gestation fetal growth in different ways, while undernutrition in both periods alters fetal endocrine status in late gestation. Thirdly, the biology of twin fetal development is fundamentally different from that of singletons, which may explain the inconsistency of the relationship between birth weight and adult disease risk in twins. / Auckland Medical Research Foundation, Health Research Council of New Zealand

Events around conception such as maternal undernutrition and twinning may have effects on offspring physiology and disease risk in adulthood. Periconceptional undernutrition alters offspring physiology and adult pathology without affecting birth size, while twinning affects birth size and physiology but with inconsistent effects on adult pathology. We investigated the effects of these two periconceptional events and their interaction on maternal cardiovascular adaptation to pregnancy and fetal growth, physiology and endocrinology in late gestation in sheep. Pre and/or postconception undernutrition resulted in increased uterine blood flow in late gestation, but no change in maternal blood volume. Preconception undernutrition alone resulted in a relatively large placenta with a small, slow-growing fetus in late gestation. In contrast, postconception undernutrition alone resulted in a fetus with rapid late-gestation growth that was maintained through a maternal fast. Fetuses of ewes undernourished throughout both periods were similar in growth rate and size to controls. Maternal fasting also demonstrated that plasma levels of C-type natriuretic peptide are acutely and independently regulated by nutrient supply in mother and fetus. Fetuses of ewes undernourished both pre- and postconception had increased glucose disposal following a glucose challenge. Hypothalamic-pituitary-adrenal axis tests in these fetuses showed decreased pituitary adrenocorticotropin hormone response to direct stimulation but increased adrenal response to decreased cortisol negative feedback. Twin fetuses grew more slowly in late gestation than singletons. Twins also had a smaller insulin response to arginine and a greater insulin response to glucose, but periconceptional undernutrition abolished this difference. Twins had suppressed baseline hypothalamic-pituitary-adrenal axis function and decreased adrenal sensitivity compared to singletons, but increased fetal pituitary adrenocorticotropin hormone response to direct stimulation and decreased cortisol negative feedback. These studies suggest that firstly, fetal size is a poor reflection of fetal growth trajectory, physiology and endocrinology. Secondly, pre- and postconception undernutrition affect late-gestation fetal growth in different ways, while undernutrition in both periods alters fetal endocrine status in late gestation. Thirdly, the biology of twin fetal development is fundamentally different from that of singletons, which may explain the inconsistency of the relationship between birth weight and adult disease risk in twins. / Auckland Medical Research Foundation, Health Research Council of New Zealand

Events around conception such as maternal undernutrition and twinning may have effects on offspring physiology and disease risk in adulthood. Periconceptional undernutrition alters offspring physiology and adult pathology without affecting birth size, while twinning affects birth size and physiology but with inconsistent effects on adult pathology. We investigated the effects of these two periconceptional events and their interaction on maternal cardiovascular adaptation to pregnancy and fetal growth, physiology and endocrinology in late gestation in sheep. Pre and/or postconception undernutrition resulted in increased uterine blood flow in late gestation, but no change in maternal blood volume. Preconception undernutrition alone resulted in a relatively large placenta with a small, slow-growing fetus in late gestation. In contrast, postconception undernutrition alone resulted in a fetus with rapid late-gestation growth that was maintained through a maternal fast. Fetuses of ewes undernourished throughout both periods were similar in growth rate and size to controls. Maternal fasting also demonstrated that plasma levels of C-type natriuretic peptide are acutely and independently regulated by nutrient supply in mother and fetus. Fetuses of ewes undernourished both pre- and postconception had increased glucose disposal following a glucose challenge. Hypothalamic-pituitary-adrenal axis tests in these fetuses showed decreased pituitary adrenocorticotropin hormone response to direct stimulation but increased adrenal response to decreased cortisol negative feedback. Twin fetuses grew more slowly in late gestation than singletons. Twins also had a smaller insulin response to arginine and a greater insulin response to glucose, but periconceptional undernutrition abolished this difference. Twins had suppressed baseline hypothalamic-pituitary-adrenal axis function and decreased adrenal sensitivity compared to singletons, but increased fetal pituitary adrenocorticotropin hormone response to direct stimulation and decreased cortisol negative feedback. These studies suggest that firstly, fetal size is a poor reflection of fetal growth trajectory, physiology and endocrinology. Secondly, pre- and postconception undernutrition affect late-gestation fetal growth in different ways, while undernutrition in both periods alters fetal endocrine status in late gestation. Thirdly, the biology of twin fetal development is fundamentally different from that of singletons, which may explain the inconsistency of the relationship between birth weight and adult disease risk in twins. / Auckland Medical Research Foundation, Health Research Council of New Zealand