The aim of this study is to describe and analyse three different discourses on elderly care, as they emerge in statements from care staff and research. Each discourse centres on a sign, or pair of signs: care, education/professional competence, and the elderly/ageing. Drawing its main inspiration from Laclau and Mouffe, and Foucault, the analysis is made with regard to how the discourses are constructed, what they include and exclude. The discourse on care interconnects family, homeliness and mutuality. Empathy, a good attitude, family ideals endow elderly care with distinctly feminine connotations. Theoretical concepts such as rationality of care and an almost exclusive research focus on women’s work have tended to construct the same nexus. Unknowingly, or sometimes despite intentions, the discourse in this way reproduces conservative gender roles. A discourse on ‘anti-care’, exemplified by disorganisation and incompetent management, is also created and invested with responsibility for shortcomings. The discourse on education and professional competence centres on claims to medical and executive tasks by nurses, the struggle against deprofessionalisation of assistant nurses, and the attempt of nurse aids to resist categorisation as ‘anybody’. Education/training are considered important to raise work status, but also leading to an instrumental attitude and distance from the core of the occupation – care. The discourse on the elderly and ageing characterises them as lonely and depressed. Also being violent and ungrateful, their behaviour undermine the notion of mutuality. Social interaction and outdoor walks are presented as means to improve their situation. Fundamental to the discourse is an ambiguous approach to ageing as both natural and something to be deferred. Ageing is further presented as decivilisation process, in which gradual loss of control over the body is also a loss of human-ness. The body is, paradoxically, what both defines and disqualifies the elderly as fully human. The depersonalising and biographing procedures of elderly care, sequential but overlapping, display its proximity to Goffman’s total institution and Foucault’s panopticon. Conversation plays an important disciplinary part in encouraging the elderly to want to do right, i.e., be socially active, and avoid amoral or asocial habits like drink, sex or solitude.

I Sverige finns det idag ett stort antal yrken och en del av dessa är i en professionaliseringsprocess. Studie- och yrkesvägledaryrket är ett exempel på ett yrke i denna process. Syftet är att beskriva utvalda aktörers syn på studie- och yrkesvägledaryrkets avgränsningar, kompetens samt eventuella auktorisation i ett professionaliseringsperspektiv. En kvalitativ metod har använts och fem elitintervjuer har genomförts med representanter från Lärarförbundet, Lärarnas Riksförbund, Sveriges vägledarförening, Högskoleverket samt Skolverket. Samtliga respondenter ansåg att det finns specifika kompetenser som endast studie- och yrkesvägledare besitter men åsikten om vilka kompetenser detta är, gick isär. Majoriteten av respondenterna ansåg att studie- och yrkesvägledaryrket borde auktoriseras/legitimeras, dock inte alla. Avgränsningen mot andra yrken när det gäller arbetsuppgifter fanns det skilda meningar om. Den slutsats man kan dra av studien är att fackförbunden och Sveriges vägledarförening arbetar för professionalisering av studie- och yrkesvägledaryrket men utan en gemensam strategi. Yrket har inom olika områden kommit olika långt i sin professionaliseringsprocess.

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.

Context: Self-learning (i.e., students learning independently) and clinical simulation are essential components in contemporary health professions education (HPE). Self-learning is discussed often, yet the concept is seldom the target of rigorous study. Likewise, simulation modalities are abundant, though educational theory that guides their use in HPE remains elusive. Objectives: This dissertation investigates the effects of directed self-guided learning (DSGL) on novice health professions students’ skill acquisition, retention, and transfer in the context of simulation-based education. The objective is to explore how the combination of external direction and student self-guidance influences: students’ cognitive and metacognitive processes, students’ interactions with the learning environment and available resources, and how students learn in different DSGL contexts. Methods: Three research studies used randomized, controlled experimental designs to address five hypotheses. All studies included a performance assessment one-week after the initial practice session that evaluated skill retention and/or skill transfer. Data analysis employed univariate and multivariate analyses of variance and correlational techniques. Results: Regarding students’ cognitive and metacognitive processes, the data show a relation between DSGL and goal-setting. The results suggest that self-guided students benefit when they are directed to set goals related to performance processes, rather than performance outcomes. Regarding the learning environment, when students are directed to practice on simulators that increase progressively in fidelity (i.e., realism) they self-guide their advancement between those simulators effectively and display successful skill transfer. Finally, self-guided students that controlled their learning progression and learning sequence selected the theoretically most appropriate practice schedule (i.e., progressive learning). Students in this latter group seemed able, surprisingly, to direct their own self-guidance. Conclusions: This dissertation adds support to the hypothesis that self-guided students benefit due to their autonomy in controlling practice conditions to meet their own learning needs. Thus, the question of whether or not DSGL is effective, becomes how best to augment the DSGL experience. The instructional design of elements such as goals lists and task structuring (e.g., progressive increases in simulator fidelity) represent techniques that an educator can use to fulfill the role of director in a student’s SGL.

When the population is getting older, the need for complex care and nursing interventions in elderly care increases. To create a holistic view of the elder and their life situation, interprofessional team collaboration is often desirable and necessary. Teamwork is often described in positive terms, but previous research has shown that this work method is complicated and requires constant reflection and development. The purpose of this study was to investigate how elderly care teamwork is formed in the interaction between representatives of different professionals. To accomplish this purpose, we have studied how the team members define a well-functioning teamwork and difficulties, and how consensus is achieved in the team. This qualitative case-study combines observation and semi-structured interviews with five informants from different professions working together in an elderly care team: one manager, one assistance case worker, one nurse, one physiotherapist and one of the nursing staff. The results of the study were then analyzed with the terms domain consensus and domain conflict taken from the new institutionalism. The study shows that the informants define a well-functioning teamwork as a work method where openness and mutual respect towards each other’s competence, creates a better holistic view of the elder and their needs. The informants also present teamwork difficulties as disagreements and gabble. The study finally suggests that there is a consensus regarding teamwork goals, and regarding who is entitled to claim knowledge in the different fields of the working area. / I takt med en åldrande befolkning ökar också behovet av komplexa vård- och omsorgsinsatser inom äldreomsorgen. Detta leder till att interprofessionell teamsamverkan i många fall är önskvärd och nödvändig för att skapa en helhetssyn över den äldre och dennes livssituation. Teamarbete beskrivs ofta i positiva ordalag, men tidigare forskning har visat att detta arbetssätt är komplicerat och kräver ständig reflektion och utveckling. Vårt syfte med denna studie har varit att studera hur teamarbete i äldreomsorgen formas i samspelet mellan representanter av olika yrkesgrupper. För att uppnå detta syfte har vi studerat hur teamets aktörer definierar ett väl fungerande teamarbete och svårigheter, samt på vilket sätt det råder samförstånd i teamet. Vi har genomfört en kvalitativ fallstudie där vi genom observation och fem intervjuer med yrkesgrupperna enhetschef, biståndshandläggare, sjuksköterska, sjukgymnast och undersköterska har studerat ett team inom äldreomsorgen. Studiens resultat analyserades sedan utifrån begreppen domänkonsensus och domänkonflikt hämtade ur den nyinstitutionella teorin. Studien visar att informanterna definierar ett väl fungerande teamarbete som ett arbetssätt där öppenhet och respekt gentemot varandras kompetenser bidrar till en ökad helhetssyn över den äldre och dennes behov. Informanterna beskrev i sina intervjuer även att svårigheter i form av meningsskiljaktigheter och ”kackel” kan förekomma. Studien visar slutligen att det råder samförstånd gällande teamarbetets mål, samt gällande vem som har rätt att göra anspråk på de olika kunskaperna inom verksamhetsområdet.

Syftet med denna uppsats är att undersöka hur utlandsfödda gymnasielever ser på yrken och den egna framtiden på arbetsmarknaden. Den teoretiska utgångspunkten för att undersöka detta är Brown´s teori om kulturella värderingar och arbetsvärderingar som styr individer i deras karriärsval. Metoden som uppsatsen bygger på är kvantitativ, enkäter har delats ut till utlandsfödda gymnasielever på två olika skolor i stockholmsområdet. I resultatet framgår att yrken med hög status är de yrken som traditionellt sätt har hög status och är välkända yrken internationellt. En slutstats som kan dras är att vid en begränsad kunskap om arbetsmarknaden sker karriärutvecklingen genom en samverkan mellan värderingar och sociala faktorer. Respondenterna är till stor del födda i samhällen som domineras av grupporienterade kulturer där egenskaper som att hjälpa varandra värderas högt vid val av yrke samt yrkens status. Föräldrar har en stor inverkan i respondenternas framtida karriär. Respondenternas framtida yrkesval görs utifrån ett transnationellt perspektiv där de värderar yrken utifrån den kulturella omgivning i vilken de lever nu och i vilken de är födda i. / The aim of the present study is to examine how foreign-born secondary school students look at careers and their own futures in the labor market. The theoretical starting point to explore this is Brown's theory of cultural values and work values that govern individuals in their career path. We used a quantitative method, where surveys were distributed to foreign-born high school students in two different schools in the Stockholm area. The results show that occupations with high status are professions that traditionally have high status and are well-known professions internationally. In conclusion, when the knowledge of the labor market is limited, career development follows through an interaction between values and social factors. Respondents are largely born in societies dominated by group-oriented cultures where properties such as helping each other is highly valued in the choice of occupation and professions status Our results also indicate that parents strongly influence the future career choice of the respondents. Respondents' future career choices are made using a transnational perspective in which they value occupations based on the cultural environment in which they live now and where they were born in.

Texte remanié de: Thèse de doctorat--Sciences de gestion--Lyon 3, 2003. / En appendice, choix de documents. Bibliogr. p. 279-290.

Title from PDF of title page (University of Missouri--Columbia, viewed on March 10, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Thesis advisor: Dr. Lee Wilkins. Includes bibliographical references.

Breastfeeding support for mothers and their babies historically was the informal work of family and community members. In the United States today, breastfeeding support is embedded in the biomedical system, and is provided by a new allied health professional: the International Board Certified Lactation Consultant (IBCLC). This dissertation explores this professionalization of breastfeeding support and the origins of this new profession. It studies how IBCLCs working in the U.S. cultural context perceive and practice the profession and examines the relationship between the profession of lactation consulting and the medicalization of breastfeeding. Oral history interviews with 17 founders of the profession, which was established in 1985, and a content analysis of the professional journal (the Journal of Human Lactation) from 1985 to 2010, allowed me to build the story of how and why breastfeeding support became professionalized and how experiential breastfeeding knowledge entered the domain of expert knowledge. While constrained by the biomedical system in which they created the profession, the founders exhibited a both agency and creativity in their production and reproduction of professional values and practices. Interviews with 30 currently certified IBCLCs and observations of the clinical practice of 3 IBCLCs provided insight into the daily practice of IBCLCs working in different settings--hospitals, WIC clinics, pediatric offices, and private practice. The data collected from these ethnographic methods demonstrated how the medical knowledge base of IBCLCs translates into clinical practice with patients, and allowed me to understand the relationship between the profession of lactation consulting and the medicalization of breastfeeding. While IBCLCs' draw on medicalized knowledge and evidence about breastfeeding and human lactation, their interactions with clients are best described as empathetic and humanistic, and are derived from nursing and mother-to-mother breastfeeding support models rather than from a technocratic, biomedical approach to care. While the appropriation of certain biomedical values and standards helped to legitimize the professionalization efforts of the founders, in practice, lactation consultants apply their medical knowledge and clinical experience in a way that reflects the compassionate, empowering care approach of mother-to-mother breastfeeding support and that thus resists the overt medicalization of breastfeeding.

Denna studie har undersökt professioners lärande inom äldreomsorg, förskola och musikskola i det tillfälliga nätverket "sång- och musikstunden" som är en del av projektet "Barn och äldre sjunger tillsamman". Studien är inspirerad av Aktör-nätverksteorin. Studiens är kvalitativ och data har insamlats med hjälp av intervjuer och observationer. Studien har studerat samspelet mellan mänskliga och icke-mänskliga aktanter och hur dessa påverkat det tillfälliga nätverket. Resultatet visar på att aktanterna har betydelse för hur kommunikationen uppstår i det tillfälliga nätverket. Studien har också visat att det tillfälliga nätverket bidragit till lärande hos professionerna som deltagit. / This study examined professions learning in elderly care, kindergarten and music school in the temporary network "song- and music time" as part of the project "Children and the elderly are singing together" The study is inspired by actor-network theory. The study is qualitative and the data was collected through interviews and observations. The study has studied the interaction between human and non-human actants and how these affected the temporary network. The results show that the actants are important for how communication occurs in the temporary network. The study has also shown the temporary network contributed to the learning needs of the profession who participated.