Lung transplantation is a treatment for patients with end stage lung disease; they will not survive without such surgery. A caregiver is essential for a patient to become eligible for a lung transplant and the caregiver plays an essential role in the transplant recipient’s care both before and after transplant surgery. Most caregiver research has been conducted on caregivers of persons with Alzheimer’s disease, dementia or on elderly patients, however, it is important to examine caregivers’ experiences caring for other patient groups with disabling conditions. Caregivers of transplant recipients are one such group. The purpose of this qualitative study, using a hermeneutic phenomenological approach, was to examine the lived experiences of caregivers of lung transplant recipients pre- and post-lung transplantation. The study used semi- structured, face to face, tape recorded in- depth interviews to document the experiences of a purposive sampling of 20 caregivers of lung transplant recipients. Interviews (English, Spanish) were transcribed verbatim and analyzed for emerging themes. The resulting 4 themes and 12 sub themes were: 1) Establishing the diagnosis; 2) Caregivers roles; 3) Caregivers psychological and psychosocial Issues; and 4) Support. The 12 sub themes were:1) Caregivers reaction to transplant option; 2) Caregivers’ lack of basic knowledge as related to lung transplant 3) Disease progression: Reality of unanticipated changes/fear of death; 4) Pre- transplant experiences; 5) Hospital course; 6) Home care; 7) Lifestyle changes and Social activities;8) Physical health and Emotional health ; 9) Financial and Employment issues;10) Family/Friends;11) Professional support; 12) Support groups. Study results demonstrated caregivers’ lack of knowledge about transplantation, dramatic changes in caregivers ‘family life, social activities, employment, and often financial status. Results also demonstrated a need for health care providers and policy makers to recognize caregivers’ stressful life changes and implement informational, psychological and emotional interventions and policies to assist these caregivers during their stressful and tedious experiences.

<p>Insufficient competence among nursing staff is a major concern in elderly care worldwide as the healthcare needs of the elderly become increasingly complex. In previous research, insufficient competence has been associated with work dissatisfaction and stress among elderly care nurses, and with lower quality of care. This thesis describes the development, implementation and evaluation of an educational intervention for nursing staff in elderly care. In a prospective, controlled study, evaluation of the educational toolbox was based on nursing staff ratings of their competence and psychosocial work environment, as well as on care recipients’ and family relatives’ ratings of the quality of elderly care.</p><p>Paper I validated a questionnaire measuring care recipient relatives’ perceptions of quality of care. Paper II compared self-rated competence, work strain, stress, and work satisfaction between staff working in home-based care and nursing homes. Papers III and IV evaluated the impact of the educational intervention on staff perceptions of their competence and psychosocial work environment (Paper III) and on care recipients’ and relatives’ perceptions of the quality of care (Paper IV).</p><p>The results showed that staff ratings of their competence and psychosocial work environment, including work satisfaction and work stress, improved significantly over time in the intervention municipality, compared to the reference group. Neither care recipients’ nor relatives’ ratings of the quality of care changed significantly over time in the intervention organization. Furthermore, there were no significant interaction effects over time between the intervention and reference groups for quality ratings. These results indicate that an educational toolbox that can be used according to local workplace needs may be an effective and sustainable intervention for improving staff competence and the psychosocial work environment. However, further studies are needed to investigate whether, and under what conditions, improved staff competence and work environment have an impact on quality of care.</p>

Insufficient competence among nursing staff is a major concern in elderly care worldwide as the healthcare needs of the elderly become increasingly complex. In previous research, insufficient competence has been associated with work dissatisfaction and stress among elderly care nurses, and with lower quality of care. This thesis describes the development, implementation and evaluation of an educational intervention for nursing staff in elderly care. In a prospective, controlled study, evaluation of the educational toolbox was based on nursing staff ratings of their competence and psychosocial work environment, as well as on care recipients’ and family relatives’ ratings of the quality of elderly care. Paper I validated a questionnaire measuring care recipient relatives’ perceptions of quality of care. Paper II compared self-rated competence, work strain, stress, and work satisfaction between staff working in home-based care and nursing homes. Papers III and IV evaluated the impact of the educational intervention on staff perceptions of their competence and psychosocial work environment (Paper III) and on care recipients’ and relatives’ perceptions of the quality of care (Paper IV). The results showed that staff ratings of their competence and psychosocial work environment, including work satisfaction and work stress, improved significantly over time in the intervention municipality, compared to the reference group. Neither care recipients’ nor relatives’ ratings of the quality of care changed significantly over time in the intervention organization. Furthermore, there were no significant interaction effects over time between the intervention and reference groups for quality ratings. These results indicate that an educational toolbox that can be used according to local workplace needs may be an effective and sustainable intervention for improving staff competence and the psychosocial work environment. However, further studies are needed to investigate whether, and under what conditions, improved staff competence and work environment have an impact on quality of care.

Undersökningsområdet är äldre hemtjänsttagare som bor ensamma, där vi har studerat hur hemtjänsttagare blir påverkade av den så kallade upplevda ensamheten. Som teoretiska utgångspunkter används socialgerontologi och gerotranscendens då begreppen vi använder i studien återfinns i dessa båda teorier, samt att vi kopplar dessa till ett socialpedagogiskt perspektiv. Avsikten är att finna en brygga mellan de nämnda teoribildningarna.Syftet med studien är att synliggöra och analysera ensamhet som socialt fenomen för äldre hemtjänsttagare i relation till social identitet och olika sociala nätverksband. Den första frågeställningen som studien vill besvara är hur äldre upplever att vara hemtjänsttagare och den andra frågan är vilka sociala nätverksband som blir synliga och hur det påverkar hemtjänsttagarens känsla av ensamhet. Den slutliga frågan är hur hemtjänsttagarens känsla av ensamhet kan förstås genom social identitet. Studien har genomförts kvalitativt med fyra halvstrukturerade livsvärldsintervjuer. Studiens undersökningspersoner valdes utifrån kriterier såsom att de skulle bo själva och ha daglig hemtjänsthjälp. Ett andra kriterium var att de skulle kunna uttrycka sig muntligt. Utifrån studiens tre begrepp ensamhet, social identitet och sociala nätverksband görs en första analys av det empiriska materialet. I ett andra steg görs analys med hjälp av gerotranscendensens dimensioner och dess innebörder. Resultatet visar att de äldre uppskattar besöken de får av hemtjänstpersonalen samt att det påverkar deras upplevda känsla av ensamhet. Resultatet visar också på ett samband mellan ensamhet, social identitet och social nätverksband. Analysen av empirin utifrån gerotranscendensen visar på en positivt upplevd ensamhet och inte enbart negativ ensamhet. / The field of study is elderly home care recipient who live alone, where a study was made in how these recipients are influenced by the so-called perceived loneliness. The theoretical frameworks used in this study are social gerontology and gerotranscendence since the terminology used in the study occur in both theories, as well as we connect the theories to a social pedagogical perspective. The intention is to find a bridge between the mentioned theories. The aim of the study is to reveal and analyze loneliness as a social phenomenon for elderly recipient of home care in relation to social identity and various social ties. The first issue which the study tries to answer is how the elderly perceive to be home care recipient and a second issue is which social ties become visible and how does that affect the home care recipient´s feeling of loneliness. The final issue is how the home care recipient´s feeling of loneliness can be understood by social identity. The study has been done qualitatively with four semi-structured life-world interviews. The examined persons in the study were chosen by the criterion of that the persons should live alone and have daily home care. A second criterion was that they should be able to express themselves verbally. By the three terminologies of the study such as loneliness, social identity and social ties, an initial analysis is made of the empirical data. Furthermore, a second analysis is made with the gerotranscendence´s dimensions and its signification. The result shows that the elderly appreciate their visits by the home care staff and that it affects their perceived feeling of loneliness. The result also shows a relation between loneliness, social identity and social ties. The analysis of the empirical data by the gerotranscendence shows a positive perceived loneliness and not only negative loneliness.

This master thesis includes 65 pages, 5 pictures, 4 tables, 41 literary sources, in the Lithuanian language. The object of this final work is leasing. The purpose of this study is to discuss theory and practice of leasing, describe problems, which hinder Lithuanian leasing market development and prognoses leasing market perspectives. In order to reach the purpose of this work it is important to solve the following problems: • to specify the essence and necessity of a leasing; • to overdraw the advantages and disadvantages of leasing; • to research the main leasing stages in Lithuania; • to research main leasing evolution stages in world and in Lithuania; • to structure leasing payments; • to make an analysis of Lithuanian leasing market. Specifing the essence and necessity of a leasing, overdrawing the advantages and disadvantages of leasing, researching the main leasing stages in Lithuania and analysising the leasing market of Lithuanian it was used books of national and foreign authors, various literature source of teaching means and scientific articles. Also it was used the methods of comparison, calculation of real present value, structural analysis and quantitative (qualitative) changes analysis.

Les jeunes marins que nous sommes amenés à rencontrer dans le cadre de notre activité clinique semblent être dans un balancement entre le désir de voyager et une tendance naturelle à vouloir rester à terre, à proximité de leur famille. Au-delà de la description symptomatologique, qui évoque ce que l’on appelle communément une dépendance affective, définie par le fait que le sujet a des difficultés à s’éloigner de ses repères affectifs, et est en proie, lorsqu’il y est confronté, à la dépression, nous nous sommes demandés si cette dépendance n’était pas en tout point constitutive de la subjectivité humaine. En effet, l’enfant se développe au plan psychique dans une dépendance à la mère, avant de s’autonomiser progressivement, tout en gardant inscrites dans son inconscient les marques de cette dépendance. Qu’est-ce qui, dans ce contexte, invite les marins au voyage ? Dans cette perspective, nous avons, par l’étude de la littérature classique, exploré le déterminisme de ces êtres, tel qu’il a été perçu et décrit par les écrivains au fils des époques. Nous avons découvert chez ces marins un dualisme entre volonté de découverte, d’exploration, et besoin de demeurer sur la terre ferme. Nous avons également mis en évidence que la navigation faisait office de contenant pour le psychisme, et permettait de lutter contre la survenue d’une dépression secondaire à la séparation. Nous avons aussi démontré qu’il existait chez certains de ces marins une réactualisation de la problématique œdipienne. Enfin, nous en avons conclu qu’il s’agissait pour eux de mettre en œuvre, au travers de cette problématique, leur propre rapport à la vie et à la mort. / In our clinical domain, we are bound to come across young sailors who seem torn between a sheer desire to take to sea and a natural attraction to the shore, close to their loved ones. The symptomatogical description, more commonly know as an emotional dependence, refers to the patient's difficulty to move away from his emotional markers and his proclivity to depression in such instance. Our research work has consisted in reflecting on the close link between that very dependence and human subjectivity. Indeed, a child's psychological development depends on the mother, retaining unconscious traces of that dependence while gradually acquiring his autonomy. So we may wonder what attracts sailors to embark on a journey in that particular context. Therefore we have explored the determinism of those beings as felt and described in classical literature. We have found that these sailors waver between exploring the world and staying ashore. We have also highlighted that navigating takes the role of a recipient to the mind/psyche and enables the subject to fight any depression resourcing from separation. We have also shown that some sailors experience a return to an oedipal condition. Finally, we have come to the conclusion that, by means of experience, sailors work through their own relationship to life and death.

Adopting a Strategic Sustainable Development (SSD) approach to official bilateral development assistance could result in more effective development planning that yields lasting results in developing countries. A Framework for Strategic Sustainable Development Assistance (FSSDA) based on SSD and customised to the needs of a development agency offers guidance in planning for development towards sustainability. This it does by directing donor and recipient planners in generating holistic perspectives, setting the goal of development as an attractive and sustainable society, and providing a flexible decision-making framework to guide strategic planning. Development assistance donor agencies face several difficulties in ensuring aid effectiveness. The FSSDA offers support in addressing these challenges by: positioning the creation of sustainable societies as the fundamental goal of development; allowing progress against imminent sustainability threats while minimizing the risk of unforeseen negative impacts; balancing economic, environmental and social considerations; and providing a fairer basis for aid conditionality.

This work consists of three parts: the translation theory of drama and the specifics of school theatre, the translation of a play by David Llorente, Los árboles dormidos, and a commentary discussing the translation. The theoretical part focuses on problems and characteristics of translations of this genre. The commentary to the translation includes a translation analysis, a discussion of the translation problems and their solutions, and a typology of translation shifts. Keywords: Recipient, paradox, obsolescence of translation, scenic notes, school theatre, amateur theatre, translation analysis, translation shifts.

Throughout their existence, organizations face endless change. Organizational change programs, despite often being initiated by top management, inevitably involve employees at multiple levels in the organization, including middle managers, which could be argued to play an especially important role as they are both receivers and implementers of the change. The middle managers try to make sense of the changes initiated by top management while they simultaneously are expected to sell it down the organizational line, meaning that the middle managers are forced to balance multiple and sometimes competing roles during change. Moreover, negotiations arise during the unstable times of change for the new social order to be determined and for organizational work to take place. To better understand these phenomena, this study applies a change recipient perspective, specifically that of middle managers. The phenomena were explored through a case study, which included qualitative interviews with managers in an organization that during the study was undergoing multiple changes, with the aim to gain a better understanding of these complex social processes by recognizing the impact from contextual and cultural factors. The findings of the study illustrate that while the middle managers negotiated within themselves to make sense of the change, they did not get the same opportunity to negotiate with their superiors. Further, the middle managers made sense of the change in ways that were unique to them, depending on their individual experiences and backgrounds. Hence, there was no single “best way” to facilitate all middle managers’ sensemaking processes, rather, the middle managers needed differing support at differing points in time. The study concludes that the contextual factors, such as the organizational culture and subcultures, power relations and social dynamics, were what affected the middle manager's sensemaking processes and their room for negotiation. Therefore, these factors could be further addressed in theory and in practice before initiating change. / Organisationer står inför oändlig förändring under hela sin existens. Organisatoriska förändringsprogram, trots att de ofta initierats av högsta ledningen, involverar oundvikligen anställda på flera nivåer i organisationen, inklusive mellanchefer, vilka skulle kunna hävdas spela en särskilt viktig roll eftersom de är både mottagare och implementerare av förändringen. Mellancheferna försöker förstå den uppifrån initierade förändringen samtidigt som de förväntas sälja den längs organisationslinjen, vilket innebär att mellancheferna tvingas balansera flera, ibland konkurrerande, roller under förändring. Dessutom uppstår förhandlingar under den instabila tid som förändringar medför för att den nya sociala ordningen ska kunna bestämmas och för att organisationsarbete ska kunna äga rum. För att bättre förstå dessa fenomen tillämpar denna studie ett “förändringsmottagarperspektiv”, särskilt det av mellancheferna. Dessa fenomen utforskades genom en fallstudie, som innehöll kvalitativa intervjuer med chefer i en organisation som under studien genomgick flera förändringar, med syftet att få en bättre förståelse för dessa komplexa sociala processer genom att vidkänna påverkan från kontextuella och kulturella faktorer. Resultaten av studien illustrerar att medan mellancheferna förhandlade inom sig själva för att förstå förändringen, fick de inte samma möjlighet att förhandla med sina överordnade. Vidare skapade mellancheferna mening av förändringen på sätt som var unika för dem, beroende på deras individuella erfarenheter och bakgrunder. Därför fanns det inget enskilt "bästa sätt" att underlätta alla mellanchefers meningsskapande processer, snarare behövde mellancheferna olika stöd vid olika tidpunkter. Studien drar slutsatsen att de kontextuella faktorerna, såsom organisationskulturen och subkulturer, maktrelationer och social dynamik, var det som påverkade mellanchefens förhandlingsmöjligheter och förmåga att förstå förändringen. Därför kan dessa faktorer uppmärksammas ytterligare i teorin samt i praktiken innan förändringar initieras.

Ofrivillig ensamhet är en tydlig riskfaktor för ohälsa bland brukare och bör utifrån ett folkhälsoperspektiv prioriteras för att främja en god och jämlik hälsa för alla. Hemtjänsten utgör en central roll som är nära knuten till brukarens vardagliga liv och är en viktig aktör för att stödja brukaren i sin unika situation och därigenom minska de negativa upplevelserna av ensamhet.   Syftet med studien är att undersöka hemtjänstpersonals upplevelser av deras arbete mot ofrivillig ensamhet bland brukare de möter i sin yrkesroll. Studien omfattas av sex semistrukturerade intervjuer som analyserats med en manifest innehållsanalys. Samtliga informanter var kvinnor som under undersökningens genomförande arbetade inom kommunal hemtjänst inom Västmanland och Södermanlands län.  De mest framträdande aspekterna i resultatet var de utmaningar som hemtjänstpersonalen upplever i det dagliga arbetet och hur ledning och organisation tycks vara en avgörande faktor för vilken riktning arbetet med hanteringen av ofrivillig ensamhet tar. En annan betydande aspekt i resultatet var de aktiviteter som informanterna lyfte som minskar känslan av ensamhet och som i stället främjar brukarnas sociala samvaro.  Studiens slutsats lyfter att det behövs stärkt prioritering av hantering av ofrivillig ensamhet för att vidare öka förutsättningarna för brukarnas välmående. Det social-ekologiska perspektivet bidrar med en ökad förståelse för hemtjänstens arbete med att motverka ofrivillig ensamhet genom dess påverkan av inre och yttre faktorer som understryker komplexiteten i arbetet. Nyckelord; Brukare, Folkhälsa, Hemtjänst, Ofrivillig ensamhet / Involuntary loneliness is a clear risk factor for ill health among home care recipients and should be prioritized from a public health perspective to promote good and equitable health for all. Home care services have a central role closely tied to the user’s everyday life and is an important actor in supporting the home care recipients in their unique situation, thereby reducing negative experiences of loneliness. The purpose of the study is to investigate home care staff’s experiences in addressing involuntary loneliness among the home care recipients they encounter in their professional roles. The study comprises six semi-structured interviews, which were analyzed using a manifest content analysis. All the participants were women working in municipal home care services in the Västmanland and Södermanland counties of Sweden. The most prominent aspects in the results were the challenges that home care staff experience in their daily work and how management and organization appear to be a crucial factor in determining the direction of work related to addressing involuntary loneliness. Another significant aspect in the results was the activities that the informants highlighted as reducing feelings of loneliness and instead promoting social interaction among home care recipients in various ways.  The study’s conclusion emphasizes the need for enhanced prioritization of addressing involuntary loneliness to further improve the well-being of home care recipients. The social-ecological perspective contributes to a deeper understanding of home care services’ efforts in combating involuntary loneliness by considering both internal and external factors that underscore the complexity of this work. Keywords; Home care, Home care recipient, Involuntary loneliness, Public health