Syfte: Syftet med studien var att belysa barnmorskans upplevelse av att möta flyktingfamiljer på BB.Design: En intervjustudie baserad på enskilda semistrukturerade intervjuer med kvalitativ innehållsanalys.Omgivning: Två BB-enheter varav en i södra och en i norra Sverige.Deltagare: 10 barnmorskor, varav fem i södra och fem i norra Sverige intervjuades. Samtliga deltagare gav sitt muntliga och skriftliga samtycke till att delta i studien.Resultat: Barnmorskorna upplevde att de hade samma resurser som tidigare trots en ökad arbetsbelastning sedan flyktingkrisen. Vidare upplevde barnmorskorna svårigheter att kommunicera med flyktingarna trots professionell tolk vilket kunde leda till risker inom vården. Det önskades utbildning inom kulturella skillnader samt information och ett fördjupat samarbete med migrationsverket. Barnmorskorna upplevde möten med flyktingar lärorika och spännande samtidigt som det fanns en splittring inom arbetsgruppen vid vård av flyktingar som var svår att hantera. Majoriteten av barnmorskorna ansåg att de kunde ge en ändamålsenlig vård men att flyktingarna behövde få en ökad kunskap om det svenska vårdsystemet.Slutsats: Resultatet visar vikten av utbildning och samarbete. Barnmorskorna måste få bättre kunskap inom kulturella skillnader samt få redskap från arbetsgivaren för återkoppling och återhämtning. Det anses även vara av stor vikt att minska barnmorskornas ökade arbetsbelastning och fler tolkar behövs med bättre tolkkunskaper.Klinisk betydelse: Det behövs mer utbildning bland barnmorskorna för att möta kulturella skillnader på BB-enheter. Vidare anses det vara av stor vikt att barnmorskor får mer resurser i form av tid och mer personal för att minska barnmorskornas ökade arbetsbelastning. Barnmorskorna behöver en mer organiserad återkoppling på arbetsplatsen samt utbildning i hur de ska hantera familjer utsatta för traumatiska händelser. Studien skulle kunna leda till ny kunskap som kan vara ett redskap för att förbättra barnmorskornas arbetssituation samt flyktingfamiljers omhändertagande på BB. / Objective: The purpose of this study was to elucidate the midwife experience to meet refugee families in postnatal ward. Design: An interview based on individual semi-structured interviews with qualitative content analysis. Setting: Two maternity units, one in southern and one in northern Sweden. Participants: Ten midwives, five from southern Sweden and five from northern Sweden were interviewed. All participants gave their verbal and written consent to participate in the study. Findings: The midwives experienced that they worked with the same resources as before the refugee crisis despite the increased workload at the maternity unit. Furthermore, the midwives experienced difficulties in communicating with the refugees despite professional interpreter which could cause damage within the given care. The midwives request education in cultural differences and an enhanced information and cooperation with the immigration office. The midwives experienced the meetings with the refugee families as exiting and educational but they had noticed there was a split within the working group about the refugee families that was difficult to handle. The majority of the midwives felt like they could provide the appropriate care but that the refugees needed to get a better knowledge in the Swedish health care system. Key conclusion: The results show the importance of education and cooperation. The midwives must have improved knowledge of cultural differences and get improved ways of feedback and recovery from the employer. It is also considered to be of great importance to reduce the midwives increasing workloads and additional interpreters is needed to receive feasible interpreting skills. Implications for practice: We need more education among midwives to meet the cultural differences in maternity units. Furthermore, it is considered essential that midwives receive more resources in terms of time and more staff to reduce the midwives' workload. The midwives need a more organized feedback in the workplace and training in how to deal with families exposed to traumatic events. The study could generate the new knowledge that can be a tool to improve the midwives work situation and the refugee families’ disposal at prenatal ward.

Houston's Fifth Ward neighborhood is one of the last remaining areas of the inner city to have not yet seen large-scale redevelopment. Situated just northeast of downtown, the neighborhood's population is predominantly low- to mid-income African Americans; demographics are similar today as they were during the neighborhood's prime, from the 1920s-60s, when the Fifth Ward was a cultural hub of Houston famous for its musical culture of zydeco and blues. The ward's rich history also has dark spots, however, specifically its longstanding reputation as a center of poverty and violent crime, and its physical vulnerability to damaging floods. Much of the neighborhood's built history is unpreserved and unprotected, at risk of being wiped off the map by both development interests and extreme weather events. By modernizing the city's approach to stormwater management and infrastructure and strengthening its historic preservation and emergency management practices, Houston could help preserve one of its oldest communities, while also decreasing flood volumes, improving air and water quality, saving money, and establishing a pattern of smart growth citywide. In addition, neighborhood level efforts to promote placemaking via preservation and sustainability efforts can help the Fifth Ward leverage the redevelopment process to change its reputation, ensuring a future for the community that respects its past. / text

Pertvarkant vaikų globos įstaigų tinklą, siekiama gerinti vaiko gyvenimo kokybę. Aktualu periodiškai tirti globos įstaigos vaikų ir globėjų santykių ypatumus. Darbo tikslas: ištirti globojamų vaikų santykius su personalu ir įvertinti vaikų dalyvavimo priimant sprendimus galimybes. Tyrimo metodika. 2008.09.09 - 2008.09.12 laikotarpiu Valkininkų vaikų globos namuose „Spengla“ buvo atliekama anketinė globotinių apklausa. Statistinė duomenų analizė atlikta SPSS 11 versijos programiniu paketu. Išvados atskleidžia, kad dauguma įstaigos vaikų palankiai vertina personalo veiklą, tačiau jų nuomonė į sėkmigo pasirengimo savarankiškam gyvenimui galimybes yra neigiama: tik kas dešimtas vaikas (9,4 proc.) žino, ką veiks pabaigęs mokyklą ; nei vienas vaikas nepaminėjo šeimos kaip gyvenimo vertybės; mokslas ir profesija svarbi tik kas trisdešimtam apklaustajam (2,8 proc.). Toks požiūris sumažina globotinių sėkmingos socializacijos galimybes. Daugiau savarankiškumo turi vaikai, kurie aktyviai dalyvauja visuomeniniame gyvenime. Kas trečias vaikas, dalyvaujantis priimant sprendimus dėl savo gyvenimo sąlygų, turi galimybę savarankiškai vertinti savo darbą. Tai didina sėkmingos socializacijos galimybes. / Restructuring of the children’s foster home network aims at improving the children’s quality of life. Periodic studies of the peculiarities of the relationships between children’s foster home inmates and caregivers are relevant. The aim of this study was to analyze the relationships between children in foster homes and the personnel, and to investigate the possibilities for children’s participation in decision-making. The methods of the study. Between September 09, 2008 and September 12, 2008 we performed a questionnaire-based inquiry of children in Valkininkai children’s foster home “Spengla”. Sta¬tis¬ti¬cal data analysis was performed using the SPSS 11 statistical software package. The analysis of the findings showed that the majority of the studied children positively evaluated the personnel’s activity, but their opinion about possibilities for successful preparation for independent was negative – only every-tenth child (9.4%) knew what they would do after finishing school, none of the children mentioned family as a value in life, and only every thirtieth child (2.8%) was interested in studies and profession. Such attitudes reduce the children’s possibilities for successful socialization. A greater level of independence was observed in children who actively participate in social life. Two-thirds (61.5%) of children who had not made up their mind concerning their future life did not participate in making decisions about the living conditions in the foster home. Meanwhile... [to full text]

The concept public participation as the bedrock of participatory democracy has the advantages of empowering civil society in decision-making skills and in legitimizing execution of programmes and projects. The vehicle driving public participation is the system of Ward Committees. legislations such as White Paper on Local Government and the Constitution obligate municipalities to involve communities in facilitating development. Participation is an essential part of local democracy and is a statutory prerequisite for the local community to be drawn into decision-making through processes such as the integrated development planning. The task of Mafube Local Municipality is not only to provide services that encourage sustainable living standards but, to also guarantee that the Mafube community is involved in council strategies and activities that affect the lives of local community. The study was undertaken to determine the effectiveness of ward committees in becoming partners in the developmental role of Mafube Local Municipality. For the purpose of the study, hypothesis was formulated that ward committees are necessary mechanisms for facilitating service delivery and yet social and administrative challenges confront their efficient functioning at Mafube Local Municipality which needs to be resolved. To test the hypothesis, empirical research method of open ended questionnaires and interviews was used to test attitudes and perceptions of councillors, ward committees and the community of Mafube Local Municipality on the effectiveness of ward committees. Amongst other findings, it was found that: * Ward committees as community structures are well known by the community of Mafube. * Ward committees need an on-going training with regard to their roles and responsibilities so that they are empowered to execute their duties as is required of them. * The literacy level among certain ward committee members poses a challenge in enabling them to understand municipal programmes or projects. * Public participation is viewed as consultation because there is minimal participation of the community during the planning and decision making of the municipal programmes or projects. * Majority of community members do not attend ward or public meetings. * Elections of ward committees are sometimes not fair and transparent, depending on political affiliation. The study concludes with recommendations for consideration and implementation by Council of Mafube Local Municipality in enhancing service delivery. / M Development and Management (Public Management and Governance), North-West University, Vaal Triangle Campus, 2014

Aim: The overall aim is to examine how a patient perspective, grounded in caring science, can be preserved and developed in the context of hospital care.   Methods: The first study examines attitudes towards caring science in a clinical practice. Data were collected through focus group interviews with seven nurses, three head nurses and four senior preceptors. An interpretive approach guided the study. The results called for collaboration between clinical praxis and the academy, according to how caring science can be preserved and developed. Study II–III functioned in accordance with this goal and were conducted in collaboration with a hospital ward for people over seventy-five years of age. In an attempt to develop care the patients were invited to attend a team meeting. The data in these studies were collected using interviews and observations. Fifteen patients (study II) and nine nurses (study III) who had experienced patient participation in a team meeting participated. In these studies, a reflective lifeworld approach guided the research process. Study IV is presented as a general structure and philosophical examination in the light of Heidegger and Merleau-Ponty’s philosophies.   Main Findings: To preserve and develop a patient perspective is strongly connected to existential issues, such as lived time, intersubjectivity and a meaningful existence. For the patients, vulnerability is exposed and increased when the need for hospital care arises. The team meeting is experienced as an emotional situation where existential dimensions need to be recognized. The nurses desire to develop caring is challenged by organizational and economic demands. Time presents both a possibility for an encounter as well as a threat to excellent care.   Conclusions: There is a need to challenge narrow processes in modern health care that value the staffs’ work and the patients’ vulnerability in quantifiable measures of efficiency. The challenge is to take into account something that is invaluable - human existence.

William Carey (1761-1834) and a printer from Derby--William Ward (1769-1823)--are central figures in discussions concerning missiology. Generally, the importance of Carey and Ward to the early formation of the Baptist Missionary Society (hereafter, BMS) and their ministry to Hindus are accepted points of conversation. Despite the existence of a large body of writings concerning their efforts in India, one of the most important aspects of Carey's and Ward's ministry remains unexplored. The primary goal of this dissertation is to address the two-part question: what was Carey's and Ward's understanding of Bengali Islam and what was their resulting ministry to Muslims in Bengal during the first twenty years of BMS efforts in India? This dissertation argues that Carey and Ward had a deeply-held interest in Muslim evangelization and carried out that interest in an active ministry to Muslims. The first chapter discusses the context within which Carey and Ward received the Particular Baptist inheritance that they took to India, surveys the current state of scholarship on Carey and Ward in relation to this dissertation, and establishes the research questions that this work addresses. Also, this chapter states the thesis of this work, which answers the research questions based upon the defined parameters. Chapter 2 establishes a framework through which one should interpret the ministry of Carey and Ward. This framework becomes the answer to the dissertation's secondary research question: they conducted their ministry to Bengali Muslims according to the Serampore Form of Agreement. Surveying the philosophy of missions that guided Carey and Ward provides an essential and foundational insight into their ministry to Muslims. The third chapter of this dissertation provides clarity concerning the theology and religious expression of Islam in Bengal as interpreted by Carey and Ward. In Bengal, these two missionaries found a deeply embedded relationship between Islam and the Indian caste system, which had tremendous implications for Bengali Islamic theology and practice. The fourth chapter of this dissertation addresses Carey's efforts to evangelize his Muslim neighbors in Bengal. Carey's established ministerial pursuits shaped Ward during his early ministry to Muslims. The model that Carey established included his pursuit of evangelizing Muslims personally, receiving the inquiries of Bengali Muslims, and a specific message to his hearers. Chapter 5 turns to William Ward's efforts to propel the ministry forward through his print ministry. His efforts enabled the BMS effort in Bengal to reach out to individuals through the means of print in ways that were inconceivable through personal interaction. Additionally, Ward participated in Muslim evangelism through consistent preaching and occasional debate as well as pastoral ministry over the budding Bengali church. The sixth chapter concerns a framework that Andrew Fuller and William Ward used to determine the best way to carry out Ward's print contribution discussed in chapter 5. Ward's print ministry caused turmoil in some situations, particularly in regards to his Muslim ministry, almost causing war between Britain and Denmark in late 1807. Fuller and Ward, despite this episode, sought to abide by a principle of selectively representing the missionaries' work in a particular way to their various reading audiences. Finally, the conclusion summarizes this dissertation's primary contributions to the field of Carey-Ward scholarship based on the material argued throughout this work. Truly, the ministry of Carey and Ward to Bengali Muslims is well represented in this work as restated in the conclusion.

This research is about examining the way in which racialized environmental violence contributes to exploitative social relations becoming embedded in the everyday world. I argue that the space of the everyday has been produced through cycles of social relations proceeding from and/or tied to racialized environmental violence. I continue the work of critical scholars in asserting that social and environmental violence is linked in the same ideological impulse which seeks to hide itself behind a variety of alienating processes. The slow way in which environmental violence works is particularly impactful in these processes because of its attritional lethality, contributing to premature death. I studied these processes by examining the histories surrounding the site of a construction day labor firm in Richmond, Virginia. My methodology includes archival research on newspapers, public documents, and secondary sources establishing that the patterned co-location of social and environmental violence does not occur by chance.

Att handleda studenter på klinisk undervisnings avdelning (KUA) har bedrivits under ett tjugotal år. Studenter från olika utbildningsprogram inom hälso- och sjukvårdsutbildningar utvecklar sin interprofessionella kompetens under en tvåveckorsperiod. Studier visar att interprofessionellt lärande ger studenter en möjlighet att dels få en helhetssyn av patientens vårdbehov dels ökar förståelsen för varandras yrkesroller och kunskaper. Få studier har fokuserat på handledarnas erfarenheter inom detta ämne och om sin roll på KUA. Studiens syfte var att beskriva fenomenet KUA handledare genom handledares uppfattning om rollen som interprofessionell handledare och interprofessionellt lärande på KUA. En kvalitativ metod användes och 19 interprofessionella handledare från professionerna, arbetsterapi, läkare, sjukgymnast och sjuksköterska intervjuades individuellt. Texterna bearbetades och analyserades utifrån innehållsanalys. Utifrån analysen identifierades tre kategorier, ”handledaren”, ”handledningen” och ”KUA konceptet”. Det visade sig att interprofessionella handledare har ett genuint intresse och engagemang för handledning, studenter, pedagogik och samarbete. Olika strategier används i den interprofessionella handledningen. Handledarna arbetar med teamet i fokus dels för studenters lärande, dels för att visa på teamets betydelse för patientens vård i hälso- och sjukvård. KUA konceptet kräver både tid och engagemang av handledarna men uppfattas som ett bra koncept där studenterna tillsammans kan utveckla det interprofessionella samarbetet. Handledarnas inställning till studenters lärande och handledning gör skillnad i handledningen. Att vara interprofessionell handledare kräver kunskaper om såväl pedagogik som grupp och grupprocess. Studentteamens kunskaper driver KUA vilket påverkar handledningen. KUA konceptet har en positiv inverkan på handledarna och interprofessionell handledning uppfattas som stimulerande och utmanande. / Supervising students in a clinical training ward (CTW) has been used for some 20 years. Studies show that interprofessional learning gives students an opportunity to get a comprehensive view of a particular patient’s health-care needs, as well as an increased and mutual understanding of their colleague’s position and knowledge. Only a few studies have focused on the supervisor’s view of his or her own role within the activity of the CTW. The purpose of the study was to describe the CTW supervisor and his or her own perception of her role as an interprofessional supervisor as well as to describe interprofessional learning on its own at the CTW. A qualitative method was used, and 19 interprofessional supervisors from and within occupational therapy, along with physicians, physiotherapists, and nurses, were interviewed. The texts were content-analysed. Three categories were identified: ‘the supervisor’, ‘the supervision’, and ‘the concept of CTW’. It turned out that the interprofessional supervisor has a genuine interest and commitment to supervise, to work pedagogically, to collaborate, and to work with students. The supervisors all used different strategies, and they worked with the team in focus, partly for the benefit of the students but also to show the team’s importance in relation to the patient’s health care situation. The CTW concept requires lots of time and dedication from the supervisor, but it is perceived as a good concept where students can develop interprofessional collaboration. The supervisor’s understanding and approach to student learning makes a huge difference in the process of supervision. Being an interprofessional supervisor requires a pedagogical knowledge and understanding of a group and of the group process. The student’s team knowledge influences the CTW, which affects the supervision. The concept of the CTW has a positive impact on the supervisors, and the interprofessional supervision is perceived to be stimulating and challenging.

Bakgrund: Att vara patient innebär att befinna sig i en utsatt situation. Inom omvårdnad är därför de etiska frågorna av stor betydelse och rätten till värdighet är en grundläggande princip. Sjuksköterskan har en viktig roll för att bevara och främja patientens upplevelse att bli bemött med värdighet. Syfte: Syftet var att undersöka hur sjuksköterskor tänker kring värdighet inom omvårdnad och hur de arbetar för att bevara patienters värdighet i det dagliga omvårdnadsarbetet. Metodbeskrivning: Kvalitativ studie med individuella intervjuer som analyserats genom innehållsanalys. Resultat: Resultatet visar att bemötande, respekt för autonomi, integritet och delaktighet lyftes fram som grundläggande aspekter inom värdighet. Att utgå från individen, skydda kroppen och främja autonomi, genom att utforska vad patienten själv kan göra och därefter främja självständigheten, beskrevs som betydelsefulla faktorer i omvårdnadsarbetet. Slutsats: Intervjupersonerna var samstämmiga kring vad värdighet innebär och hur det kan främjas. Tidspress och stress lyftes som den främsta orsaken som försvårade deras främjande av patientens värdighet. / Background: Being a patient puts you in an exposed position. Therefore the ethical questions within nursing have a significant role, and the right to dignity is a basic principle. The nurse holds a key role to preserve and promote the patient's experience of being met with dignity.   Purpose: The aim was to explore nurses’ thoughts about dignity within nursing and how they work to preserve the patients’ dignity in the daily routine.  Method: Qualitative study with individual interviews that are analyzed through content analysis.  Result: The result shows that personal treatment, respecting autonomy, integrity, and patient participation were highlighted as key aspects within preserving dignity. To emanate from the individual, protect the body, and promote autonomy by exploring what the patient is capable of doing independently and support this, were described as key aspects in nursing.  Conclusion: All the interviewed subjects were consistent in what dignity means and how it can be preserved. Time pressure and stress were flagged as the main reasons of making the promotion of patient dignity more difficult.

Bakgrund: Patientnära rond är ett teamarbete mellan framförallt patient, sjuksköterska och läkare. Ett bra samarbete förbättrar relationen dem emellan. Dessutom har en framgångsrik rond mellan patient och sjukvårdspersonal stor betydelse för att patienten ska kunna få en säker och personcentrerad vård. Därför är det viktigt att få en djupare förståelse för hur patienter och sjukvårdpersonal upplever patientnära rond samt för betydelsen av teamarbetet vid patientnära rond. Syfte: Att belysa vilka effekter patientnära rond har på vårdteam samt att undersöka upplevelsen av patientnära rond utifrån perspektiven från både patienter och sjukvårdspersonal (sjuksköterskor, läkare och medicinstudenter). Metod: En litteraturstudie baserad på 14 vetenskapliga originalartiklar. Databaser som användes i studien var PubMed, Cochrane Library, Cinahl, SBU och SveMed. Resultat: Resultatet av denna studie indikerar att både patienter och sjukvårdspersonal upplever en ökad tillfredsställelse vid patientnära rond. Vidare visar resultatet att patientnära rond bidrar till att sjukvårdpersonal kan ge patienter en proaktiv omvårdnad, att samarbetet sjukvårdpersonal emellan blir mer effektivt och att patientnära rond gynnar medicinstudenters utveckling samt ökar studenters tillfredsställelse med sin utbildning. En utmaning som sjuksköterskor upplever i samband med patientnära rond är tidsbegränsning – framför allt upplever de att det tar tid för sjuksköterskor och läkare att synkronisera och koordinera mötet mellan patient och vårdpersonal samt att tid för dokumentation är bristande. Läkare upplever dessutom att deras autonomi minskas i samband med patientnära rond. Slutsats: Överlag kan patientnära rond vara ett effektivt sätt att främja personcentrerad vård. Patientnära rond har en positiv inverkan på teamarbete sjukvårdpersonal emellan samt bidrar till ökad tillfredsställelse hos både patienter och sjukvårdspersonal. Det finns dock behov av ytterligare forskning om patienters upplevelse av patientnära rond och vilka specifika åtgärder som kan vidtas för att sjukvårdpersonalen ska kunna samarbeta på ett mer effektivt sätt. / Background: The ward round is a team collaboration mainly between patient, nurse and physician. A good collaboration enhances the relationship between them. In addition, a successful round between the patient and the medical personnel is of great significance for the patient to have a safe and person-centered care. Therefore it is important to gain a deeper understanding of how patients and medical staff experience ward rounds, as well as of the importance of team work during the ward rounds. Aim: To shed light upon the effects of ward rounding on healthcare teams and to explore the experience of ward rounds from the perspectives of both patients and medical staff (nurses, physicians and medical students). Method: A literature study based on 14 scientific articles. Databases used in the study were PubMed, Cochrane Library, CINAHL, SBU and SveMed. Results: The results of this study indicate that both patients and medical personnel experience an increased satisfaction during ward rounds. Furthermore, the results show that ward rounds contribute in making medical personnel provide a proactive care to their patients, that cooperation between medical staff becomes more efficient, and that ward rounding benefits medical students’ development and increases students’ satisfaction with their education. A challenge that nurses experience during ward rounds is time limitation – mainly they experience that it takes time for nurses and physicians to synchronize and coordinate the meeting between patient and medical personnel, and also that the time for documentation is inadequate. Physicians also experience that their autonomy is reduced in relation to ward rounds. Conclusion: Overall, ward rounding can be an effective way to promote person-centered care. Ward rounds have a positive impact on teamwork between medical personnel and contribute to increased satisfaction among both patients and medical staff. However, there is need for further research on patients' perception of ward rounding and which specific measures that can be taken for the medical staff to be able to collaborate more efficiently.