Research Doctorate - Doctor of Philosophy (PhD) / In this dissertation, Van Davy makes a case for a cohesive system of schools which can serve the public — both the national interest and individual interests — while directly addressing the current national schooling system’s failure: * to replace, for the entire student cohort...high levels of student boredom with high interest and engaging curriculum and pedagogy; * to replace, for low SES and indigenous students...low levels of learning outcomes, low enrolment levels in senior schooling, and only brief experience of curriculum choice with a curriculum paradigm providing intrinsic value, understanding of pathways from disempowerment to empowerment, curriculum choice from the earliest years, and schooling outcomes which, over time, equal those of the national cohort of students * to replace a citizenry divided in its support for public, church-based, and exclusionary schools with a community united in its support for a socially agreed set of social purposes for schooling and a new curriculum paradigm, one half of which is generated by this set of social purposes * to address a major political issue: social cohesion The proposed new and cohesive system of schools is envisaged to meet the needs - both Common Good and Individual Good - of the citizenry. It will grow from an earlier and pre-requisite national social agreement around a set of political goals which together sketch a preferred future society - these political goals in the hands of education specialists will generate an "essential" curriculum as one of two elements in a new two-tiered curriculum to be followed from the earliest until the latest years of schooling. The second element, occupying the other half of the curriculum from the earliest to the latest years of schooling, will be an elective curriculum designed to encourage all students to pursue their own interests in as much depth as desired. Studies of sectarian studies will be included in the elective curriculum. Davy’s analysis ranges across a number of disciplines, fusing together a number of viewpoints: historical, political theory, educational performance, and educational theory. It searches Australia’s schooling outcomes, identifies low SES and Aboriginal outcomes as major areas of failure, and challenges a number of widely accepted schooling practices. In the process, Davy discovers OECD and ACER data, but little official interest or analysis, concerning widespread boredom amongst Australia’s students. He argues that, in respect of both low SES students and student boredom, system responsibilities such as the nature of Australia’s curriculum, could be just as implicated as concerns for “teacher quality.” Davy’s interest extends beyond the purely educational. He examines the purposes that public and non-public school authorities articulate, as well as reasons parents give for enrolling their children in schools. From this research Davy identifies several issues and suggests that very considerable “choice” in schooling could be found in a different curriculum paradigm, and that both public and non-public schools are deficient when measured against widely-accepted concerns for religious freedom, social cohesion, and fundamental democratic principles. For Davy, a major political issue confronting Australia is the national imperative of “social cohesion.” He searches Australia’s schooling history for evidence of any social agreement around the social purposes of schooling, including more recent attempts to formulate “essential" and “new basics” and “national” curriculum. He concludes that while many educators, and the OECD, refer to the need for a pre-requisite set of social purposes that outline a preferred future society, the politics of schooling has not permitted this to eventuate and, given the absence of this management fundamental, “it is not surprising that schooling systems are shaped by internal logics (ideologies, religions, personalities, internal politics, quest for advantage and/or privilege) rather than wider concerns for the shape of the globe’s and nation’s future, and the advancement of the twins: Common Good and Individual Good.” With these problems laid bare — low SES and indigenous outcomes, student boredom, and social cohesion — Davy addresses all three simultaneously. He draws confidence from contemporary political theorists proposing political processes which engage the public in a “deliberative democracy.” He constructs a surrogate “foundation of agreed principles” which, he deduces, the processes of deliberative democracy might lead the Australian people to construct, then outlines a step-by-step means by which these principles can generate an essential curriculum for all Australian children, while encouraging a full range of choice within an elective stream. The political processes of open collaboration throughout civil society which produces the social agreement may produce a new political context. This new, less adversarial and more trusting political context is seen to be fertile ground for the replacement of Australia’s fractured schooling system with a cohesive schooling system for the Australian public — an Australian schooling system — to be managed nationally.

<p>The overall aim of this thesis was to expand the knowledge and understanding of the processes of breastfeeding and becoming a mother in mothers of preterm infants. </p><p>For this purpose, in-depth interviews were conducted with 25 mothers, whose very preterm infants had received care in seven neonatal units (NU) in Sweden, 1-12 months after discharge (I-II). In addition, prospective population-based register studies were performed of infants born 1993-2001; among 35 250 term and 2093 preterm infants (III), and a subpopulation of 225 very preterm infants (IV). Data were obtained from the Child Health Service registry of breastfeeding in Uppsala and Örebro, the Medical Birth Registry, and Statistics Sweden. </p><p>The experiences of mother-infant separation, institutional authority, emotional exhaustion and disregard of breastfeeding as a relational interplay, comprised major hindrances to mothers’ experiences of breastfeeding as reciprocal and of a secure mother-infant relation, during and after the discharge from an NU (I-II). All studied socioeconomic factors, i.e. lower educational level, receiving unemployment benefit or social welfare or having a low equivalent disposable income, were individually adversely associated with breastfeeding up to six months of infants’ postnatal age, but were not found more decisive for weaning in mothers of preterm infants compared to those of term infants (III). Preterm infants were breastfed for a shorter time than term infants (III), but a long breastfeeding duration was evident. In addition, gestational age and neonatal disorders were not associated with breastfeeding duration in very preterm infants (IV).</p><p>In conclusion, this thesis shows that improvements in the NU environment and the caring paradigm are called for. Furthermore, as socioeconomic status clearly has an impact on breastfeeding duration, increased equity in health care in accordance with the individuals’ needs must be sought, where resources are allocated to ensure fulfilment of needs in more vulnerable mothers and infants. </p>

In Sweden and elsewhere there is evidence of poorer cancer survival for patients of low socioeconomic status (SES), and in some settings differences in treatment by SES have been shown. The aim of this thesis was to explore factors which influence cancer treatment decisions, such as knowledge reaped from clinical trials, patient-related factors, and physician-related factors. In a register study of colorectal cancer, all stages, patients were stratified for SES-factors. Differences were seen with regards to clinical investigation, surgical and oncological treatment and survival, with the highly educated group being favored. Survival was better for highly educated patients in stages I, II and III but not in stage IV. In a Scandinavian cohort of newly metastasized colorectal cancer patients, recruitment to clinical trials was studied. Patients entering clinical trials had better performance status and fewer cancer symptoms than those who were treated with chemotherapy outside of a clinical trial. Median survival was 21.3 months for trial-patients and 15.2 months for those treated with chemotherapy outside a  trial. Those not treated with chemotherapy had a median survival of just 2.1 months. Patients in clinical trials are highly selected and conclusions drawn from studies cannot be applied to all patients. In the same cohort, treatment and survival were stratified for education, smoking and indicators of social structure. Highly educated patients did not have a survival advantage. Patients who lived alone were offered less combination chemotherapy and surgery of metastases than other patients and had 4 months shorter survival than those who lived with a spouse or child. In a fourth study, 20 Swedish gastrointestinal oncologists were interviewed on which factors they considered when deciding on oncological treatment. Oncologists feared chemotherapy complications due to lack of social support, and ordered less combination chemotherapy for patients living alone. Highly educated patients were seen as well-read and demanding, and giving in to these patients’ requests for treatment was regarded as a way of pleasing patients and relatives and of avoiding conflict.

The overall aim of this thesis was to expand the knowledge and understanding of the processes of breastfeeding and becoming a mother in mothers of preterm infants. For this purpose, in-depth interviews were conducted with 25 mothers, whose very preterm infants had received care in seven neonatal units (NU) in Sweden, 1-12 months after discharge (I-II). In addition, prospective population-based register studies were performed of infants born 1993-2001; among 35 250 term and 2093 preterm infants (III), and a subpopulation of 225 very preterm infants (IV). Data were obtained from the Child Health Service registry of breastfeeding in Uppsala and Örebro, the Medical Birth Registry, and Statistics Sweden. The experiences of mother-infant separation, institutional authority, emotional exhaustion and disregard of breastfeeding as a relational interplay, comprised major hindrances to mothers’ experiences of breastfeeding as reciprocal and of a secure mother-infant relation, during and after the discharge from an NU (I-II). All studied socioeconomic factors, i.e. lower educational level, receiving unemployment benefit or social welfare or having a low equivalent disposable income, were individually adversely associated with breastfeeding up to six months of infants’ postnatal age, but were not found more decisive for weaning in mothers of preterm infants compared to those of term infants (III). Preterm infants were breastfed for a shorter time than term infants (III), but a long breastfeeding duration was evident. In addition, gestational age and neonatal disorders were not associated with breastfeeding duration in very preterm infants (IV). In conclusion, this thesis shows that improvements in the NU environment and the caring paradigm are called for. Furthermore, as socioeconomic status clearly has an impact on breastfeeding duration, increased equity in health care in accordance with the individuals’ needs must be sought, where resources are allocated to ensure fulfilment of needs in more vulnerable mothers and infants.

Stroke is one of the leading causes of death and disability in Sweden and in the Western world. Despite this, stroke with focus on elderly is a field where few studies have been conducted from a gender and socioeconomic perspective. The objectives in this thesis were to analyse from a gender, age and socioeconomic perspective how women were affected by stroke compared with men. The focus was on what it meant for elderly women and men to live with stroke and to explore various gender constructions among men and women. The study also included aspects such as incidence, medical treatment and case fatality after stroke. Both quantitative and qualitative methods were used. During a two-year period (15 October 2000–14 October 2002), uniform information was collected for all cases of first-ever and recurrent (&gt;28 days) stroke occurring in people of all ages living the region of Umeå, admitted to the University Hospital. Five different registers were used to achieve maximum coverage; the Riks-Stroke (RS) register, the Hospital Discharge Register (HDR), the Cause of Death Register, the northern Sweden WHO MONICA study, and one case-finding study in nursing homes and homes for elderly performed for this thesis. For the qualitative study a maximum variation sampling procedure was used to retrieve participants for in-depth interviews in a follow-up study. Nine women and seven men were interviewed about their experiences of treatment and care after suffering a stroke, as well as about their perceptions and experiences of help from others (health care personnel, relatives and home help personnel). The first-ever incidence of stroke was higher among low-educated than high educated men and women. Our study showed that there was an education-related age-dependent difference in stroke incidence, where elderly women had the highest incidence of stroke. The 28-day case fatality was shown to be associated with low educational level in patients above 75 years, after controlling for sex, risk factors and acute care variables. The elderly stroke patients experienced subordination in their contacts with health care personnel and the medical context. The participants used different ways to negotiate in the subordinate position, and some of these negotiations were interpreted as being gendered. We have also shown how the elderly stroke patients minimized their own needs of help, strove for independence and accepted help. The men and the women differed in their perceptions and experiences of help from others. Also, the participants expressed multiple types of needs. The elderly stroke patients’ perceptions and experiences of help from others must be studied in relation to their life circumstances and expectations from society. Further analyses of the patients’ perceptions and experiences of help from others were interpreted as being different examples of constructions of masculinities and femininities. Stroke with a focus on the elderly is a field where few studies have been conducted from a gender and socioeconomic perspective. With further community-based stroke incidence studies including elderly men and women and with the development of appropriately targeted interventions, the burden of stroke in the population could be reduced. More research is needed where both qualitative and quantitative methods are used, as this can provide a richer and perhaps more authentic description of the issue under investigation.

Family quality of life (FQOL) refers to the degree to which families of individuals with disabilities are able to meet their basic needs, enjoy time together, and pursue leisure interests and activities (Park et al., 2003). Researchers have identified barriers that families of individuals with disabilities encounter as they pursue a life of quality including elevated parental stress (Hauser-Cram, Warfield, Shonkoff, & Kraus, 2001), low socioeconomic status (SES) (Park, Turnbull, & Turnbull, 2002) and inadequate social service support (Soresi, Nota, & Ferrari, 2007). This study utilized data collected from a sample of parents (N = 389) of children receiving special education services from preschool through fifth grade to determine parental stress levels, satisfaction with social service supports and FQOL. Instruments included a demographic questionnaire, Parental Stress Scale (PSS; Berry & Jones, 1995), Client Satisfaction Questionnaire-8 (CSQ-8; Larsen, Attkisson, Hargreaves, & Nguyen, 1979) and Family Quality of Life Survey (FQOLS; Turnbull et al., 2004). A MANCOVA analysis failed to reflect significant differences between parental stress levels and FQOL based on child disability type. Point biserial correlations did not reveal significant relationships between children’s free or reduced lunch (FRL) status, parental stress, satisfaction with social services, and FQOL. Initial linear regression analysis indicated that parental stress was a significant predictor of FQOL (p < .001) while satisfaction with social services approached significance (p = .057). However, a subsequent linear regression analysis that included the interaction between satisfaction with social services and parental stress failed to support a moderation effect between satisfaction with social services and parental stress in the prediction of FQOL (p = .142). The examination of parental stress and FQOL within a school-based setting was a unique contribution to the literature that focuses primarily on FQOL and families of children with disabilities within clinical, medical and mental health settings. Limitations of this study, future research directions, and implications for school-based mental health providers are presented.

Context information brings new opportunities for efficient and effective applications and services on mobile devices. Many existing work exploit the context dependency of mobile usage for specific applications, and show significant, quantified, performance gains by utilizing context. In order to be practical, such works often pay careful attention to the energy and processing costs of context awareness while attempting to maintain reasonable accuracy. These works also have to deal with the challenges of multiple sources of context, which can lead to a sparse training data set. Even with the abundance of such work, quantifying context-dependency and the relationship between context-dependency and performance achievements remains an open problem, and solutions to manage the and challenges of context awareness remain ad-hoc. To this end, this dissertation methodologically quantifies and measures the context dependency of three principal types of mobile usage in a methodological, application agnostic yet practical manner. The three usages are the websites the user visits, the phone numbers they call, and the apps they use, either built-in or obtained by the user from the App Store . While this dissertation measures the context dependency of these three principal types of mobile usage, its methodology can be readily extended to other context-dependent mobile usage and system resources. This dissertation further presents SmartContext, a framework to systematically optimize the energy cost of context awareness by selecting among different context sources, while satisfying the system designer’s cost-accuracy tradeoffs. Finally, this thesis investigates the collective effect of social context on mobile usage, by separating and comparing LiveLab users based on their socioeconomic groups. The analysis and findings are based on usage and context traces collected in real-life settings from 24 iPhone users over a period of one year. This dissertation presents findings regarding the context dependency of three principal types of mobile usage; visited websites, phone calls, and app usage. The methodology and lessons presented here can be readily extended to other forms of context and context-dependent usage and resources. They guide the development of context aware systems, and highlight the challenges and expectations regarding the context dependency of mobile usage.

Educational attainment is a key component of occupational attainment and social mobility in America. Special education is a policy intervention geared toward ensuring equal educational opportunities for students distinctive from the majority. Students labeled with learning disabilities (LDs) comprise about half of the special education population, and are typically assigned the LD label for achievement levels that are lower than would be expected given their IQ. Although they have average or high IQs, students labeled with an LD continue to experience disparities in educational outcomes. In this dissertation, I use sociological perspectives and a large nationally representative dataset, The Education Longitudinal Study of 2002, to investigate the social and structural roots of the LD label, and to explore ways in which the LD label produces stigma or stratification during high school. In general, I find that (1) the disproportionate labeling of various status groups is indicative of the social and structural roots of the LD label, and that the process of assigning the LD label may not be uniform across schools; (2) labeled students have poorer educational outcomes than even unlabeled students who achieved at similar levels in early high school; (3) stigma related to the LD label is suggested by parents’ and particularly teachers’ much lower educational expectations for labeled students than for similar students not labeled with disability; (4) stratification related to the LD label is suggested by the placement of labeled students into lower levels of coursework than unlabeled students who performed similarly in a comparable level of coursework during the prior year; and (5) stigma and stratification related to the LD label are magnified among labeled students who are more socially advantaged, or who are higher achieving. Overall, the results suggest that the experiences of students labeled with an LD can be improved by addressing these social and structural factors that differentiate the likelihood of carrying the LD label, and have negative implications for labeled students’ social and academic experiences during high school. / text

Rågsved är en förort i södra Stockholm som byggdes under 1950-talet. Rågsved har länge karaktäriserats för att vara ett segregerat område med en befolkning av lägre socioekonomisk status. Rågsved har som många andra segregerade områden problem med att bostadsområden och allmänna platser är i behov av upprustning och renovering. Syftet med studien är att undersöka hur det går att höja socioekonomisk status i utsatta områden. Målet med studien innebar att undersöka om områdesförnyelse genom fysiska åtgärder i miljön skulle kunna vara en lämplig strategi för att höja socioekonomisk status i segregerade områden. Studien har fokuserats till förorten Rågsved i Stockholm. Strategin som utarbetades är tillämpbar i andra områden som är karaktäriserande av segregering och utanförskap.Studien har utförts genom tre metoder, varav två av dem har inneburit att involvera medborgarna i processen. Den första metoden innebar att undersöka hur elever på Rågsvedsskolan uppfattade området samt om de ville se några förbättringar i den fysiska miljön. Därefter följde en medborgardialog genom en fokusgrupp med vuxna boende i Rågsved angående hur den fysiska miljön skulle kunna förbättras. Slutligen undersöktes den socioekonomiska statusen i Rågsved genom en statistisk analys. Resultatet av studien påvisar att elever vid Rågsvedsskolan tror att området skulle kunna förbättras om åtgärder i den fysiska miljön ägde rum. Medborgardialogen påvisar att genom upprustning av allmänna platser som centrum skulle åtgärden bidra till att förbättra identiteten för Rågsved och leda till attitydförändring gentemot området. Den statistiska analysen kring den socioekonomiska statusen i Rågsved visar på att området har den lägsta socioekonomiska statusen bland de södra förorterna i Stockholm.Studien påvisar slutligen att det behövs ändrat fokus inom områdesförnyelse genom att satsa på identitetshöjande åtgärder såsom att rusta upp allmänna platser som centrum för att öka attraktiviteten av området. Det är även viktigt att satsa på att ge medborgare i segregerade stadsdelar en möjlighet att flytta till ett annat boende inom området vilket innebär en möjlighet till boendekarriär genom att möta de boendes efterfrågan på bostäder. / Rågsved is a suburb of Stockholm. It is located on the city’s south side and it was built in the 1950s. Rågsved’s population has lower socioeconomic status and it’s neighborhood has long been characterized as a segregated area. Rågsved’s residential areas and public spaces like those in many other segregated communities have problems and are in need of modernization and renovation. The purpose of the study is to examine how it is possible to increase the socioeconomic status of vulnerable areas. The goal of the study is to examine if area renewal through physical measures in the environment could be an appropriate strategy for increasing the socioeconomic status in segregated areas. The study focusses on the suburb Rågsved in Stockholm. The strategy formulated is applicable for other areas that are characterized by segregation and exclusion.The study was carried out using three methods, two of which involved meeting with citizens. The first method explores how students of Rågsved’s school perceive the area as well as the improvements in the physical environment they want to see. A public dialogue using a focus group with adults living in Rågsved also explored how the physical environment could be improved. Finally, the socio-economic status in Rågsved was examined by a statistical analysis. The results of the study indicate that students at the Rågsved School believe that the area could be improved if changes to the physical environment are undertaken. The public dialogue demonstrate that renovations to public spaces would help improve the identity of Rågsved and change attitudes towards the area. The statistical analysis regarding the socio-economic status in Rågsved shows that the area has the lowest socioeconomic status among the southern suburbs of Stockholm.The study finally demonstrated that renewal strategies should change focus and invest in identity-enhancing measures such as renovating public places in Rågsved’s centrum to increase the attractiveness of the area. It is also important to provide a variety of housing in segregated neighborhoods so that changes in demand can be met throughout residents’ life cycles.

American Indians suffer disproportionately from mental disorders such as depression and substance abuse. American Indians have lower socioeconomic status than white Americans making them more vulnerable to mental health stressors and disorders, such as depression. Unfortunately, the causal processes and mechanisms producing negative psychological outcomes remain unclear. Despite the disadvantages faced by many American Indians, the Native American community offers cultural norms and values that facilitate treatment of and recovery from mental stressors. The Native American community offers its members an extended social support network as well as healing ceremonies, which could mitigate the effects of depression. In my dissertation, I compare the level of psychological distress between two tribal populations from a study from the Centers for American Indian and Alaska Native Health (CAIANH) at the University of Colorado at Denver. I use logistic regression to examine the relationship between the psychological distress score and tribal identity. The logistic regression analysis also explores the relationship between self-rated health and socioeconomic attainment. Finally, I compare the outcomes between the Northern Plains tribe and the Southwest tribe. The results suggest that individuals with a strong sense of cultural spirituality have lower psychological distress than individuals who do not have strong cultural spirituality. Also, individuals of the Southwest tribe who spent part of their lives off the reservation or near the reservation experience lower psychological distress compared to those who spent their entire lives on the reservation; in contrast, individuals of the Northern Plains tribe are disadvantaged in terms of mental health if they spent part of their lives off or near the reservations than those who stay on the reservation their whole lives. Members of either the Northern Plains tribe or Southwest tribe who feel socially isolated are very likely to experience severe psychological distress or rate their health poorly. The findings of the study indicate that resiliency factors among the tribes such as cultural-spirituality, reservation community and social support are protective, but the findings also encourage further understanding of mechanisms and utilization of the resources available. / text