Give me the environment that I need:the importance of social climate for the well-being of adolescents in therapeutic residential youth care

The research described in this dissertation concerns the living environment (social climate) in Norwegian therapeutic residential youth care (TRC). This is an intensive (24/7) and specialized form of youth care that is used for youths with serious psychosocial problems, and only when all other options, including foster care, have been unsuccessful.Social climate was the central aspect of this study because a good living environment is a basic condition for good mental health, quality of life, autonomy, and personal growth of young persons. However, little was known about which determinants (youth and organizational characteristics) contribute to a positive social climate and how these determinants via social climate are associated to treatment outcomes (quality of life). This dissertation aimed to investigate the relationships between these factors.First, the results showed that social climate can reliably and validly be measured with a short instrument in TRC. Next, the results showed that there is evidence for two types of organizations (family-style TRC and larger TRC-settings) and four youth groups (youth with severe problems, with incidental problems, with family problems, and youth with a migrant background). There were few differences between the two types of organizations regarding social climate and quality of life, but significant differences depending on youth groups. Youth with family problems experienced a more involved social climate in family-style TRC compared to a larger TRC-setting. Youth with severe problems evaluated the social climate and their quality of life structurally more negative, while youth with a migrant background evaluated the social climate and their quality life most positively. The results also showed that a positive social climate can be a protective factor for a good quality of life for youth with severe problems, with incidental problems, and youth with a migrant background. Especially for youth with severe problems, a positive social climate in TRC can contribute to a higher quality of life, buffering the influence of their problems.In conclusion, this research emphasizes the importance of a good living environment (care) in combination with good treatment (cure). We also conclude that, despite the presence of mental health problems, youth still can experience a relatively good quality of life. This research provides indications for a development towards therapeutic care, where care and cure are integrated as much as possible in order to contribute to positive outcomes for young people living in TRC

Them and Us?

Produced by The Center on Disability Studies, University of Hawai'i at Manoa, Honolulu, Hawai'i and The School of Social Sciences, The University of Texas at Dallas, Richardson, Texas for The Society for Disability Studies

Alternative blood risk categorization models for South Africa

Thesis (M. Tech.) -- Central University of Technology, Free State, 2008Blood transfusions carry a number of risks, one of which is transmitting HIV/AIDS from an infected donor. Since HIV is sexually and parenterally transmitted, the initial HIV risk management of donated blood in the early 1980‟s consisted of screening by visual assessment and completion of a lifestyle questionnaire, followed by deferral of practicing homosexual and bisexual male donors and intravenous drug addicts. The visual assessment was replaced by tests for antibodies directed against HIV, from the middle 1980‟s. In the early 1990‟s HIV was increasingly found in the black population of South Africa, particularly among black women. By 1998 0.26% of the received donations returned a positive test for HIV-1. In 1999 the South African Blood Transfusion Service (SABTS) Blood Safety Policy was introduced, including a donation HIV-risk categorization model which used the donor ethnic group, gender and donation history as indicators of the risk of exposure to HIV. The unacceptable use of the donor ethnic group as an indicator was the motivation to seek a suitable alternative donation risk categorization model which excludes the donor‟s ethnic group. The use of a more acceptable model with a high level of accuracy in predicting the risk of exposure to HIV has the potential of contributing to the reduced risk of HIV transmission through blood transfusion in South Africa. The aim of this study was to compare the suitability of four alternative models based on the information obtained from donors. Donations from new and lapsed donors were categorized in the highest applicable risk category in each model. The study was divided into two phases to achieve the aim. The first phase needed to determine suitable parameters for a model which uses the donor‟s age as an indicator. For this phase the ages of the regular donors returning an HIV-positive test result, were analysed. The second phase was to evaluate the effectiveness of the four suggested alternative blood donation risk categorization models against the model introduced by the SABTS in 1999. During this phase the donor demographic data and donation histories of donors who made donations at the Bloemfontein branch of the South African National Blood Service (SANBS) between October 2004 and September 2005, were analysed statistically. This phase honed in on two aspects to evaluate the effectiveness of the alternative models. Firstly the percentages of HIV-positive donations found in each risk category of each model, were determined as indicators of the residual risk of HIV-positive donations within the window period. Secondly the percentages of the collected blood donations allocated to each risk category within each model, were analysed to give an indication of the availability of “safe” blood associated with each of the models. The first phase of the study highlighted the difference in the age-group prevalence between male and female regular donors who returned an HIVpositive test result. Potentially suitable parameters for an Age-based Model were formulated by comparing this data with the ages of the donors who donated in Bloemfontein during the twelve months covered by this study. The second phase compared a Donation Interval Model, a Combination Model (using donation interval, gender and ethnic group as indicators), the SANBS 2005 Model (using age and gender as indicators) and an Agebased Model (using age and gender as indicators) with the SABTS 1999 Model (using gender and ethnic group as indicators). This study has shown that each of the models analysed has its advantages and disadvantages. The SANBS 2005 Model proved the best model without an ethnic indicator, for SANBS. Several recommendations regarding further investigation emanating from the results of this study were made

Good life in the balance: A cross-national study of Dutch and Australian disability perspectives on euthanasia and physician-assisted suicide

This is a cross-national qualitative study with the purpose of obtaining perspectives held by people with quadriplegia and leading figures in disability movements in the Netherlands and Australia on the issues of euthanasia and physician-assisted suicide (EPAS). A disability voice is not prominent in public debate on EPAS in Australia or the Netherlands, even though people with disabilities are often thought to be vulnerable in relation to EPAS policies. Disability perspectives are potentially valuable in illuminating issues in relation to euthanasia and physician-assisted suicide, because issues of dependence, independence, and individual autonomy play important roles in relation to both EPAS and to living with disability. The study\u27s methodology uses a phenomenological approach and incorporates aspects of heuristics and grounded theory. Its conceptual framework incorporates MacIntyre\u27s (1999) theory of acknowledged dependency and vulnerability; Habermas\u27 (1989) theory of knowledge; and Festinger\u27s (1959) theory of cognitive dissonance. The main sample of twenty people with quadriplegia (the grassroots sample) was interviewed in the Netherlands and in Australia

Aboriginal people with disability and their use of advocacy: A phenomenological approach

The reasons for an apparent low use of advocacy agencies in Perth by Aboriginal and Torres Strait Islander people who have a disability, in a context of high vulnerability, were investigated. A high incidence of disability exists amongst this group. No previous research in this area has been conducted. Nine Aboriginal people with disability were interviewed about their experiences with regard to their disabilities and any need for advocacy. This study used a qualitative, phenomenological approach as its conceptual framework, including also, a minor quantitative component. The quantitative component consisted of a brief survey of Perth-based disability advocacy agencies. It employed a semi-structured interview approach. This approach is a departure from the traditional, open-ended phenomenological method. Interviews were recorded on audio tape, transcribed and then analysed, using Colaizzi\u27s phenomenological method. Aboriginal contact persons were used where possible to overcome cultural barriers and heighten the researcher\u27s sensitivity to the vulnerabilities of the participants\u27s double disadvantages of Aboriginality and disability. The researcher\u27s own disability was considered an advantage in gaining the participants\u27 acceptance . The findings of this study include a complete absence of awareness of advocacy or advocacy agencies among participants. As well Aboriginal \u27shyness\u27, poverty, effects of long-term discrimination, powerlessness, the wider Aboriginal background of abuse, not having Aboriginal workers in advocacy agencies and tensions between Aboriginal groups were identified us barriers to accessing advocacy. The use of 20 \u27wounds\u27, obtained from Social Role Valorization theory, confirmed the validity of the findings. Citizen Advocacy was found to advocate for higher numbers of Aboriginal people than other advocacy forms and this finding may lead to further research on suitable advocacy forms and adequate funding. implications of this study, regarding funding of advocacy and development of suitable advocacy models in participation with Aboriginal people are highlighted. The study contributes to greater understanding of the reasons for low Aboriginal use of advocacy agencies

Social climate in residential youth care:A systematic review of predictors and treatment outcomes

Residentiële jeugdzorg (RJZ) richt zich op zorg en behandeling van jongeren met gedrags- en emotionele problemen. Deze zorg kan zowel vrijwillig als gedwongen zijn. Effectonderzoek in de RJZ laat op korte termijn kleine tot middelmatige effecten zien op verbetering in gedrags- en emotionele problemen, en op minder recidiverende jongeren. Langetermijneffecten zijn echter minder overtuigend. Er is veel minder duidelijk over hoe de RJZ de gewenste effecten behaald (het “black-box” probleem). Om meer duurzame behandelresultaten te behalen is het noodzakelijk om te focussen op hoe resultaten worden behaald in plaats van wat er wordt behaald. Een mogelijke factor die meer inzicht kan verschaffen in hoe doelen worden behaald is het sociale klimaat in de instelling.Een positief sociaal klimaat kan worden omschreven als een omgeving met hoge niveaus van ondersteuning, autonomie, structuur en een focus op positief gedrag. Een negatief sociaal klimaat wordt gekenmerkt door lage niveaus van ondersteuning en autonomie, een slechte relatie tussen jongeren en groepsleider en hogere niveaus van repressie, onduidelijkheid en agressie. Verschillende studies hebben aangetoond dat het sociale klimaat een belangrijke factor is voor het welzijn van jongeren in verschillende typen jeugd(gezonheids)zorg, waaronder jeugdzorg(plus), psychiatrische klinieken en woongroepen. Studies in de jeugdzorg hebben bijvoorbeeld aangetoond dat er negatieve verbanden bestaan tussen ondersteuning en autonomie en wegloopgedrag alsmede met gedragsproblemen. In jeugdzorgplus instellingen werd gevonden dat een positief sociaal klimaat positief geassocieerd is met behandelmotivatie en actieve coping strategieën.Er zijn momenteel vele definities van sociaal klimaat en instrumenten in omloop waardoor het lastig is om resultaten te vergelijken. Het is ook nog niet goed bekend welke factoren bijdragen aan de vorming van het sociale klimaat en welke aspecten van het sociale klimaat positief of negatief bijdragen aan uitkomsten in de RJZ. Het doel van het huidige onderzoek is daarom om met behulp van systematisch literatuuronderzoek (1) voorspellers voor een positief en negatief sociaal klimaat te identificeren en (2) te identificeren welke aspecten van het sociaal klimaat positieve of negatieve uitkomsten in de RJZ voorspellen.Er zijn zes literatuurdatabases geraadpleegd met een collectie van zoektermen die zich hebben gericht op de cliënt/medewerker, type instelling en het sociale klimaat. Na een zorgvuldig selectieproces werden uiteindelijk 38 studies geïncludeerd. Vier studies richten zich op determinanten voor een positief en negatief sociaal klimaat en 34 studies focussen op het verband tussen het sociale klimaat en uitkomsten. Vervolgens zijn er gestandaardiseerde effectmaten berekend om een duidelijker beeld te krijgen van de sterkte van de gevonden verbanden.De voorlopige resultaten op het gebied van determinanten tonen aan dat er middelmatige tot grote effecten bestaan voor de constructen autonomie, ondersteuning, duidelijkheid, betrokkenheid, en spontaniteit. Een focus op positief gedrag van de jongeren, continue training en supervisie van groepsleiders, kleinere instelling, consistent gedrag van groepsleiders, en een sociale match tussen groepsleiders en jongeren dragen bij aan de effecten van de bovenstaande sociaal klimaat constructen. In de lezing gaan we verder in op de resultaten van de behandeluitkomsten en bespreken we implicaties voor vervolgonderzoek

Gedrag van pekingeenden met variatie in drinkwatersysteem en bodembedekking

Op initiatief van en financiering door de afdeling Welzijn Landbouwhuisdieren van de Veterinaire Dienst van het Ministerie van LNV heeft het Praktijkonderzoek voor de Pluimveehouderij onderzoek gedaan naar het gedrag van mesteenden. De resultaten van het onderzoek zijn van belang voor de invulling van de Gezondheids- en Welzijnswet voor Dieren. Het onderzoek moet uiteindelijk bijdragen tot huisvestingssystemen voor eenden, die voor de Overheid aanvaardbaar en voor de eendenhouders aantrekkelijk zijn. Hoe het ook zij, de resultaten van dit onderzoek geven voldoende stof tot nadenken en aanleiding tot discussi