The meaning of the disability rights movement for the professional field of social pedagogy in Iceland

The Convention on the Rights of Persons with Disabilities (UNCRPD) is a landmark for the international disabled people’s independent living movement (ILM). The ILM has been a platform and a tool to resist the traditional medicalisation of disability by calling for a broader understanding where independence is no longer seen as the opposite of needing assistance. The field of social pedagogy in Iceland has evolved parallel with the paradigm shift grounded in the UNCRPD that replaces the medical model with the social and human rights models of disability. The aim of this article is to explore and interpret social pedagogues’ and disabled people’s perspectives on how the human rights principles and values embedded in the UNCRPD and independent living (IL) ideology can best be put into practice, as well as to cast a light on existing barriers and challenges. This study draws on qualitative data from two sources; the participants provided texts from a semi-structured questionnaire and public accounts written by disabled people. We utilise the five summarising principles of cultural-historical activity theory to further analyse and interpret the data. The contradictions drawn out of the findings show conflicts and structural tensions that have accumulated historically due to the massive legislative and policy shifts in disability services in past decades. The findings also indicate the need for a reconceptualisation of the object and the motive of the activity, i.e. disability-related social services, in order to embrace the principles, values and recommended practices grounded in the UNCRPD and the IL ideology

Forprófun á íslenskri útgáfu Sjálfsmatskvarða Becks fyrir börn og unglinga

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenGerð var forprófun á Sjálfsmatskvörðum Becks fyrir börn á aldrinum 7-14 ára til þess að athuga próffræðilega eiginleika íslenskrar útgáfu af kvörðunum. Þátttakendur voru 293 úr 12 grunnskólum í Reykjavík. Próffræðilegir eiginleikar reyndust sambærilegir við erlendar rannsóknir. Innri áreiðanleiki var hár og fylgni atriða við heildarskor hvers kvarða viðunandi. Samleitni kvarða var athugað með þáttagreiningu og niðurstöður sýndu að þunglyndi, kvíði og hegðunarvandi voru einsleitir kvarðar en atriði sjálfsmyndar og reiði mynduðu tvo þætti. Gerð var þáttagreining á öllum 100 atriðum kvarðanna. Niðurstöður sýndu þrjá þætti sem skýrðu 38,6% dreifingar. Fyrsti þáttur samanstóð af þunglyndi, reiði og kvíða. Á annan þátt lögðust þrjú atriði reiði og 18 atriði hegðunarvanda og á þriðja þátt lögðust 18 atriði sjálfsmyndar. Há fylgni reyndist vera milli kvíða, þunglyndis og reiði en það er sambærilegt niðurstöðum erlendra rannsókna. Réttmæti kvarðanna var athugað með þremur spurningum um líðan í skóla og stríðni. Spurning um líðan í frímínútum hafði hæstu fylgni við þunglyndi sem bendir til þess að nemendur sem sýna þunglyndiseinkenni líður frekar illa í frímínútum. Spurning um líðan í kennslustundum hafði hæstu fylgni við hegðunarvanda og reiði og loks var hæst fylgni milli hegðunarvanda og stríðni. Enginn kynja- eða aldursmunur kom fram á kvörðum fyrir þunglyndi, reiði og kvíða. Hins vegar var meðaltal eldri hóps og drengja hærra á kvarða fyrir hegðunarvanda en hjá yngri hóp og stúlkum. Meðaltal á sjálfsmyndarkvarða var lægra í hópi eldri þáttakenda og meiri munur var á milli yngri og eldri stúlkna sem bendir til að sjálfsmynd verði neikvæðari á unglingsárum og sérstaklega hjá stúlkum. Próffræðilegir eiginleikar reyndust í megindráttum góðir en safna þarf meiri gögnum um áreiðanleika og réttmæti kvarðanna áður en hægt er að mæla með almennri notkun þeirra hér á landi.A pilot study of the Beck Youth Inventories (BYI) for children 7-14 years was undertaken to evaluate the psychometric properties of the Icelandic version. Participants were 293 from 12 elementary schools in Reykjavík. Psychometric properties revealed similar findings as other studies abroad have revealed. The internal consistency reliability was high and item total correlation acceptable. A principal axis factor analysis was conducted to evaluate the homogeneity of the BYI. Depression, anxiety and disruptive behavior were unidimensional but self-concept and anger revealed two factors. Additionally a principal axis factor analysis of all items of the inventories indicated three factors explaining 38,6% of variance. Items of depression, anxiety and anger loaded on the first factor. Disruptive behavior and 3 items of anger loaded on the second factor. Items of self-concept loaded on the third factor. Depression, anxiety and anger correlated highly, consistent with studies abroad and the factor analysis results. The scales´ validity was evaluated by three items assesing emotional well being in school and teasing other pupils. The highest correlation was between emotional well being in school breaks and depression, emotional well being in classrooms and disruptive behavior and anger, and between teasing other pupils and disruptive behavior. No significant age and gender differences were found on depression, anxiety and anger. Mean score for boys was higher than for girls on disruptive behavior and older students scored higher than younger students. Older students´ mean score was lower than younger students´ mean on self-concept and this difference was greater for girls than boys. Psychometric properties were good, but additonal studies need to be undertaken on the scales´ reliability and validity before we can recommend general use of the scales for clinical purposes in Iceland

Health care needs and quality of life of elderly in home care in Reykjavik, 1997

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: It is increasingly emphasized that the elderly should be supported to live at home as long as possible. The purpose of this study was to describe the health and conditions of people in home care. Material and methods: Individuals who received home care in the Reykjavik area in autumn of 1997 were assessed with the Minimum Data Set-Resident Assessment Instrument for Home Care, MDS-RAI HC. Results: The study evaluated 257 individuals at four primary care health centers. The mean age was 82.7 years, women were 78.6%, living alone were 62.5%, and they had received home care on average of 2.4 years. Almost all were independent in primary activities of daily living, ADL, but about half needed help with instrumental activities of daily living (IADL). Impaired cognition was observed in 40% of individuals, depressive symptoms in 18%, daily pain was noted in 47% and 47% assessed their health as poor. Loneliness was expressed by 21%, 18% had not gone out doors in over 30 days and 27% were always alone during the day. The mean number of hours during two weeks was 3.5 hours in nursing care and 9.5 hours in home help. Thirty-four percent took 9 or more medications. Conclusion: Individuals in home care were independent in ADL but needed assistance with IADL. There are important quality of life issues that are of concern. Further research is needed in home care with particular emphasis on improvement of well being.Tilgangur: Vaxandi áhersla er lögð á að aldraðir geti búið heima sem lengst, en rannsóknir á högum aldraðra Íslendinga sem njóta þjónustu í heimahúsum eru takmarkaðar. Markmið rannsóknarinnar var að lýsa heilsufari, líðan og aðstæðum fólks í heimaþjónustu. Aðferð: Einstaklingarnir sem nutu heimaþjónustu heilsugæslunnar á Reykjavíkursvæðinu haustið 1997 voru metnir með MDS-RAI HC (Minimum Data Set-Resident Assessment Instrument for Home Care) mælitækinu. Niðurstöður: Metnir voru 257 einstaklingar á fjórum heilsugæslustöðvum. Meðalaldur var 82,7 ár, 62,5% bjuggu einir, og höfðu þeir notið heimaþjónustu að meðaltali í 2,4 ár. Konur voru 78,6%. Nær allir voru sjálfbjarga með persónulegar athafnir daglegs lífs (ADL), en 53% þurftu aðstoð við böðun. Um helmingur þurftu mikla aðstoð við almennar athafnir daglegs lífs (IADL). Skert minni var hjá tæplega 40% einstaklinganna en dapurt yfirbragð hjá 18%. Átján prósent höfðu aldrei farið út úr húsi á 30 daga tímabili, 27% voru alltaf einir yfir daginn, en 21% tjáði sig um einmanaleika. Daglegir verkir greindust hjá 47% einstaklinganna og 47% töldu heilsufar sitt vera lélegt. Á 14 dögum var meðalfjöldi klukkustunda á skjólstæðing í heimahjúkrun 3,5 klukkustundir og heimilishjálp 9,5 klukkustundir. Lyfjanotkun var mikil og voru 34% á níu lyfjum eða fleiri. Ályktun: Einstaklingar í heimahjúkrun eru sjálfbjarga með ADL en þeir þurfa aðstoð við almenn dagleg verk og böðun. Ýmis atriði sem snerta lífsgæði þyrfti að skoða nánar með hliðsjón af því hvort bæta megi líðan þeirra sem njóta þjónustunna

Changes in immunocompetent cells after interstitial laser thermotherapy of breast cancer

To access publisher full text version of this article. Please click on the hyperlink in Additional Links field.BACKGROUND: Local tumour destruction has been shown to give rise to changes in immunocompetent cells. The aim of this study was to describe the effect of interstitial laser thermotherapy (ILT) of breast carcinoma in the tumour and in regional lymph nodes. METHODS: Seventeen women that underwent radical surgical excision after non-radical ILT were studied. ILT was performed at a steady-state temperature of 48°C for 30 min. Surgical excision was performed 12 (6-23) days after ILT. Six patients with breast cancer not treated with ILT before surgery served as controls. Immunohistological reactions were performed on core needle biopsies prior to treatment and on the excised specimens. RESULTS: ILT resulted in more CD8 lymphocytes and CD68 macrophages within the tumour (P < 0.05 and P < 0.01, respectively) and higher counts of CD20 (P < 0.05), CD68 (P < 0.001) and CD83 (P < 0.01) at the tumour border, when compared to pre-treatment values. In the control patients not receiving ILT, CD8 cells increased within the tumour after resection (P < 0.05). With the probable exception of CD25 Foxp3 cells, the presence of cancer in a lymph node influenced the findings in lymph nodes (examined for CD1a, CD25, Foxp3 CD25, CD83 cells). Thus, comparisons between ILT and control patients were restricted to patients without lymph node metastases. In these patients, ILT and resection were followed by a decrease in CD25 Foxp3 lymphocytes (P < 0.05), when compared to surgical resection alone. CONCLUSIONS: ILT induced changes in immunocompetent cells in patients with breast cancer. The stimulation of the immune system is an added feature of ILT in treatment of patients with breast cancer

Health care needs and quality of life of elderly in home care in Reykjavik, 1997

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: It is increasingly emphasized that the elderly should be supported to live at home as long as possible. The purpose of this study was to describe the health and conditions of people in home care. Material and methods: Individuals who received home care in the Reykjavik area in autumn of 1997 were assessed with the Minimum Data Set-Resident Assessment Instrument for Home Care, MDS-RAI HC. Results: The study evaluated 257 individuals at four primary care health centers. The mean age was 82.7 years, women were 78.6%, living alone were 62.5%, and they had received home care on average of 2.4 years. Almost all were independent in primary activities of daily living, ADL, but about half needed help with instrumental activities of daily living (IADL). Impaired cognition was observed in 40% of individuals, depressive symptoms in 18%, daily pain was noted in 47% and 47% assessed their health as poor. Loneliness was expressed by 21%, 18% had not gone out doors in over 30 days and 27% were always alone during the day. The mean number of hours during two weeks was 3.5 hours in nursing care and 9.5 hours in home help. Thirty-four percent took 9 or more medications. Conclusion: Individuals in home care were independent in ADL but needed assistance with IADL. There are important quality of life issues that are of concern. Further research is needed in home care with particular emphasis on improvement of well being.Tilgangur: Vaxandi áhersla er lögð á að aldraðir geti búið heima sem lengst, en rannsóknir á högum aldraðra Íslendinga sem njóta þjónustu í heimahúsum eru takmarkaðar. Markmið rannsóknarinnar var að lýsa heilsufari, líðan og aðstæðum fólks í heimaþjónustu. Aðferð: Einstaklingarnir sem nutu heimaþjónustu heilsugæslunnar á Reykjavíkursvæðinu haustið 1997 voru metnir með MDS-RAI HC (Minimum Data Set-Resident Assessment Instrument for Home Care) mælitækinu. Niðurstöður: Metnir voru 257 einstaklingar á fjórum heilsugæslustöðvum. Meðalaldur var 82,7 ár, 62,5% bjuggu einir, og höfðu þeir notið heimaþjónustu að meðaltali í 2,4 ár. Konur voru 78,6%. Nær allir voru sjálfbjarga með persónulegar athafnir daglegs lífs (ADL), en 53% þurftu aðstoð við böðun. Um helmingur þurftu mikla aðstoð við almennar athafnir daglegs lífs (IADL). Skert minni var hjá tæplega 40% einstaklinganna en dapurt yfirbragð hjá 18%. Átján prósent höfðu aldrei farið út úr húsi á 30 daga tímabili, 27% voru alltaf einir yfir daginn, en 21% tjáði sig um einmanaleika. Daglegir verkir greindust hjá 47% einstaklinganna og 47% töldu heilsufar sitt vera lélegt. Á 14 dögum var meðalfjöldi klukkustunda á skjólstæðing í heimahjúkrun 3,5 klukkustundir og heimilishjálp 9,5 klukkustundir. Lyfjanotkun var mikil og voru 34% á níu lyfjum eða fleiri. Ályktun: Einstaklingar í heimahjúkrun eru sjálfbjarga með ADL en þeir þurfa aðstoð við almenn dagleg verk og böðun. Ýmis atriði sem snerta lífsgæði þyrfti að skoða nánar með hliðsjón af því hvort bæta megi líðan þeirra sem njóta þjónustunna