<p dir="ltr">Agricultural diversification stands out as a critical strategy for addressing challenges and seizing opportunities within the agricultural landscape, especially in regions like the Midwest of the U.S. This research delves into the dynamics, opportunities, challenges, and key success drivers associated with agricultural diversification in the Midwest, focusing on three primary crops: oats, peas, and wheat. Employing a case study methodology grounded in empirical and contextual inquiry principles, the research aims to grasp the nuances of diversified agriculture. Data collection integrates primary and secondary sources, including semi-structured interviews and participation in field days. The data collection period spanned from October 2022 to February 2024. Interviews with 29 stakeholders, including farmers, industry representatives, agricultural cooperatives, and non-profits, provided insights into diversified agriculture practices.</p><p dir="ltr">Each case study provides in-depth insights into the opportunities, challenges, and key drivers of success associated with promoting diversified agriculture initiatives. These case studies underscore the significance of innovation, market access, sustainability, and collaboration in driving success within the industry. The cross-case analysis offers a comprehensive examination of the potential for agricultural diversification in the US Midwest. Through a comparative analysis of the three case studies, commonalities and key themes emerge, shedding light on stakeholder dynamics, business strategies, operational aspects, and scalability factors.</p><p dir="ltr">In summary, this research significantly contributes to the body of knowledge on agricultural diversification, offering insights that can guide future decisions, agricultural practices, and research endeavors aimed at promoting sustainability and resilience in the agricultural sector in the US Midwest.</p>

No / Purpose. This article contrasts community hospital and general hospital philosophies of care and examines how they relate to patients' and caregivers' experiences. Methods. Semi-structured interviews with 42 staff were used to produce care setting vignettes in six community hospitals and four general hospitals in the midlands and north of England. The vignettes were used with 26 patients and 10 caregivers in semi-structured interviews. Results. Community hospital and general hospital staff identified shared understandings of requirements for post-acute rehabilitation care for older people. Distinctive features were: general hospital – medical efficiency, helping patients get better, high standard of care, need for stimulation; community hospital – homelike setting, quiet, calm ambience, good views, orientated to elderly people, encouragement of social interaction, involvement of relatives in care. In the main there was symmetry between staff aspirations and patients' experience. However some concepts used and assumptions made by staff were not recognised by patients. These were characteristically reframed in patients' answers as if they were discussing subjective dimensions of care. Conclusions. There was patient and caregiver preference for the homelike environment of community hospitals. In care of older people, where the focus is rehabilitation, patient preferences are particularly pertinent and should be considered alongside clinical outcomes and cost-effectiveness.

Yes / Health and care services for patients may improve or harm the wellbeing of their family carers. Formal consideration of these effects (also known as spillovers) in decision-making is advocated, but, to date, little is known about how they occur. This paper presents the first empirical study to determine the mechanisms by which health and care services affect family carers' wellbeing. The study focused on three major health conditions: dementia, stroke, and mental health. Focus groups and interviews were conducted with 49 purposefully sampled care professionals and family carers in the UK between December 2016 and September 2017. Transcripts were coded and analysed thematically, using descriptive accounts and an explanatory account. The analysis generated six over-arching mechanisms by which health and care services affect family carers' wellbeing, through: (i) information (degree to which service delivery informs and trains family carers); (ii) management of care (shifts of responsibility for care between formal and family sectors); (iii) patient outcomes (services changing patient outcomes); (iv) alienation (feelings of alienation or inclusion created by service delivery); (v) compliance (barriers to patients complying and engaging with services); and (vi) timing or location (changes in the timing or location of services). Each mechanism was associated with sub-themes relating to both positive and negative spillovers on the family carers. The six mechanisms can be summarised with the mnemonic ‘IMPACT’. The IMPACT mechanisms may be useful in designing and evaluating services to optimise the wellbeing of carers as well as patients. / Hareth Al-Janabi is funded by a National Institute for Health Research (NIHR) Career Development Fellowship (CDF-2015-08-025) for this research project. Mel Calvert is partially funded by the NIHR Birmingham Biomedical Research Centre and the NIHR Surgical Reconstruction and Microbiology Research Centre at the University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham. This paper presents independent research funded by the National Institute for Health Research (NIHR).

Šio magistrinio darbo tikslas buvo identifikuoti veiksnius darančius įtaką privataus miško savininkų ir valstybinio miško valdytojų, miškininkavimo sprendimų priėmimui. Šio tikslo įgyvendinimui buvo atliktos kokybinės apklausos dviejuose tyrimo vietovėse: „Suvalkijoje“ ir „Žemaitijoje“. Duomenų analizei buvo pasitelkti kokybinės analizės metodai. Tyrimo metu buvo paklausti 29 respondentai: 18 privataus miško savininkų ir 11 valstybinių miškų valdytojų. Analizuojant duomenis buvo atskleisti veiksniai darantys įtaką privataus miško savininkų ir valstybinio miško valdytojų miškininkavimo sprendimams. Nustatyta, kad miškininkavimo sprendimų priėmimui įtakos turi vidiniai (įvairios motyvacijos ir tikslai) ir išoriniai veiksniai (gamtinės sąlygos, teisinis reguliavimas, visuomenės poreikiai). Remiantis darbo rezultatų analize buvo išskirtos keturios privataus miško savininkų miškininkavimo motyvacijų grupės: paslaugos; aplinkosauga; socialinės funkcijos; ekonomika. Atskleista, kad privataus miško savininkų miškininkavimo sprendimams įtaką daro grupė motyvacijų. Valstybinio miško valdytojų apklausų kokybinė analizė nustatyta, kad valstybinių miškų valdytojai vadovaujasi ne tik miškininkavimą reguliuojančiais dokumentais, bet jų darbo sprendimams įtaką daro asmeninis požiūris į miškininkavimą. Apklausų duomenys parodė visuomeninius, aplinkosauginius ir ekonominio efektyvumo, tikslus ir motyvacijas darančius įtaką valdytojų miškininkavimo sprendimams. Nustatyti išoriniai veiksniai... [toliau žr. visą tekstą] / In this master thesis, analysis was done to identify factors influencing the decision making process of private forest owners and state forest managers’. In order to identify these factors an interview method was used throughout, this involved qualitative inquiries into two research areas: “Suvalkija” and “Žemaitija”. Data analysis was also performed using qualitative methods. During the research, 29 interviews were conducted: 18 with private forest owners and 11 with state forest managers. Results of the analysis revealed the following main factors that affected the decision making process of private forest owners and state forest managers. The main factors were internal factors such as motivations and objectives. Fr main groups of motivations and objectives of private forest owners were found: amenities, environmental protection, social and economic. The study showed that usually there is not one but multiple motivations and objectives affecting the decision making process. Qualitative analysis of state forest managers’ interviews revealed that they make decisions not only following rules and regulations but also are driven by their individual view about forestry. The motivations and objectives of state forest managers that influenced the decision making process were as follows: societal, environmental protection, economic efficiency. In addition there were external factors that influenced the decision making process of both private forest owners and state forest managers... [to full text]

A technological community has hastily been developed and nowadays it is a majority of the Swedish population available. This study is about the constant accessibility of social media from a health perspective. The purpose of the study is to examine why university students use social media and how they feel that the health is affected through constant availability. The method used is qualitative with seven semi-structured interviews. The study result shows that university students consider that constant accessibility through social media affects the health in several ways, both positively and negatively. Positively by facilitating contact and communication, for example, study contexts and that it contributes to tighter social networks. Negatively as it contributes to stress, creates insomnia and low self-esteem. The conclusion to be drawn from the study is that university students seeing social media as a natural part of the life and the mental and physical health is negatively affected, while the social well-being positively affected. / Ett teknologiskt samhälle har hastigt vuxit fram och numera är en majoritet av den svenska befolkningen tillgänglig. Denna studie handlar om ständig tillgänglighet via sociala medier ur ett hälsoperspektiv. Syftet med studien är att undersöka varför högskolestudenter använder sociala medier och hur de upplever att hälsan påverkas genom ständig tillgänglighet. En kvalitativ metod har används med en manifest innehållsanalys. Deltagarna i studien valdes via ett målstyrt urval och sju semistrukturerade intervjuer har genomförts. Studiens resultat visar att högskolestudenter anser att ständig tillgänglighet via sociala medier påverkar hälsan på flera sätt, både positivt och negativt. Positivt genom att det underlättar kontakt och kommunikation vid exempelvis studiesammanhang samt att det bidrar till tätare sociala nätverk. Negativt då det bidrar till stress, skapar sömnsvårigheter och låg självkänsla. Slutsatsen som kan dras av studien är att högskolestudenter ser sociala medier som en naturlig del av tillvaron och att den psykiska och fysiska hälsan påverkas negativt, samtidigt som det sociala välbefinnandet påverkas positivt.

Patients in psychiatric care experience a need for and expect to develop interpersonal relationships with professional caregivers and to be respected and listened to. Despite demands for care to be person-centred and recovery-oriented, patients experience that psychiatric inpatient care fails to meet their expectations. Nursing research suggest that nurses aspire to engage with and meet the needs of patients, but that the strenuous reality of inpatient care prevents them from doing so. Exploring the content and context of psychiatric inpatient care from the perspective of professional caregivers might provide valuable insights regarding what caregivers do, and more importantly it can aid in understanding why they do what they do.This thesis aimed to explore the content and context of adult psychiatric inpatient care from the perspective of professional caregivers. This was achieved by clarifying the concept of person-centred care in the context of inpatient psychiatry, describing staff members’ reasoning on their choice of action and perceptions of interprofessional collaboration in challenging situations in inpatient psychiatric care settings, and exploring nurses’ experiences of good nursing practice in the specific context of inpatient psychiatry. A systematic review of the literature identified 34 scholarly papers that were analysed using evolutionary concept analysis. Focus group interviews were conducted with 26 professional caregivers and analysed using qualitative content analysis. Individual qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and analysed using an interpretive descriptive approach to qualitative analysis.Reviewing the literature on person-centred care in inpatient psychiatry clarified how person-centred care is expected to result in quality care when interpersonal relationships are used to promote recovery. Professional caregivers’ reasoning on choice of action described different concerns in caregiver-patient interaction resulting in a focus on either meeting patients’ individual needs or solving staff members’ own problems. Describing professional caregivers’ perceptions of interprofessional collaboration suggested that they are being constrained by difficulties in collaborating with each other and a lack of interaction with patients. Exploring nurses’ experiences of good nursing practice revealed how circumstances in the clinical setting affect nurses’ ability to work through relationships. It is argued that these findings describe the workings of two opposing forces in psychiatric inpatient care. The concept of caring as a process forms the basis for discussing the content of care as a moral endeavour in which nurses strive to do good. The concept of demoralizing organizational processes is used to discuss the context of care as demoralizing and allowing for immoral actions.The main conclusions to be drawn are that, from a nursing perspective, nurses in psychiatric inpatient care need to focus on patients’ experiences and needs. For this they need sufficient resources and time to be present and develop relationships with patients.Nurses in psychiatric inpatient care also need to take personal responsibility for their professional practice. Attempts to transform psychiatric care in a person-centred direction must consider all of these aspects and their interrelatedness. Further research on psychiatric inpatient care is needed to understand more about how the content of care relates to the context of care. / <p>Godkänd; 2015; 20150526 (sebgab); Akademisk avhandling som med vederbörligt tillstånd av Filosofiska fakulteten vid Luleå tekniska universitet för avläggande av Filosofie doktorsexamen kommer att offentligen försvaras i Deltasalen, D 770, Luleå tekniska universitet fredagen den 25 september 2015, kl. 10.00. Fakultetsopponent: Docent Ulla Hällgren Graneheim, Institutionen för omvårdnad, Umeå universitet Betygsnämnd: Professor Margareta Lilja, Institutionen för hälsovetenskap, Luleå tekniska universitet Professor Johan Sandström, Institutionen för ekonomi, teknik och samhälle, Luleå tekniska universitet Docent Lauri Kuosmanen, Institutionen för omvårdnad, Åbo universitet Huvudhandledare: Professor Stefan Sävenstedt, Institutionen för hälsovetenskap, Luleå tekniska universitet Biträdande handledare: Universitetslektor Malin Olsson, Institutionen för hälsovetenskap, Luleå tekniska universitet Professor Rolf Adolfsson, Institutionen för klinisk vetenskap, Umeå universitet</p>

Insourcing, outsourcing and co-sourcing are three approaches to procuring an information system. This research contributes to the body of knowledge on insourcing an information system; exploring and discussing the enabling and inhibiting factors of the insourcing of an information system in selected government agencies in Malaysia. This study was undertaken in response to a paucity of similar projects and a limited literature focused on developing countries. It considers the post outsourcing context following the decision to insource a major Malaysian Government Information System in 2011. A qualitative research method was used to obtain empirical evidence from selected government agencies through 69 semi-structured interviews in two data collection periods: 2013-2014 and 2015. Interviews were conducted with civil servants at all levels, from senior management to clerical staff, including users of the government information system. By using coding principles from grounded theory to analyse the data, seven exciters and six inhibitors of insourcing a government information system were identified and mapped in the analytical framework. Further, this is the first research to use an enhanced model, devised by combining the OPTIMISM model and two distinct theoretical traditions: institutional theory and the capability approach; in order to analyse the insourcing of government information system adoption. The enhanced model was created by mapping the OPTIMISM model (that has a set of dimensions) to an analytical framework comprising the capability approach, institutional theory and technology (ICTs). The main research contribution of this thesis is in the area of capacity building of the internal development team. The increased budget for training, the selection of appropriate training providers and knowledge sharing among experienced and novice developers all contribute to building capacity in the internal development team; and consequently help to improve the quality of the system which will improve service delivery to the general public. The approach and findings of this study contribute to the body of knowledge and understanding of the subject in government information system development and implementation, and can also be applied to improving the quality of service delivery. While this study has focused on government information systems, the wider area of eGovernment, and applications serving the needs of the general public, is equally important, and therefore the researcher suggests that insourcing eGovernment applications would also assist in the capacity building of internal IT staff.

research aims to examine evidence concerning the implementation of learning theories in the QU PharmD programme, utilising a case study research approach. The research is divided into four stages, conducted under the umbrella of a social constructivist interpretative framework and the constructivist and social theories of learning. In the first stage, the perceptions of full-time students, faculty and preceptors in the QU PharmD programme were explored; these raised questions regarding the role of learning theory in the design and delivery of the programme. The second stage explored the extent to which the programme is based on learning theories by interviewing two programme designers, a pharmacy education scholar and an accreditation agency administrator. This stage proposed a disconnect between learning theories and educational practice in the QU PharmD programme, and suggested the need for investigating the implications of the proposed disconnect from a Communities of Practice (CoP) theory perspective. In the third stage, a novel CoP theory-informed framework was developed through an extensive review of the literature. In the fourth stage, the CoP framework was used as a theoretical instrument to analyse the evidence of CoP theory in the QU PharmD programme by conducting three focus groups and five interviews with key stakeholders, and by performing document analysis. The research suggests that the disconnect between CoP learning theory and the educational practices in the QU PharmD programme is at the “implicit disconnect” level, meaning that some elements of the CoP framework were implicitly evident. This implicit disconnect contributes to the challenges found in the programme. This study concludes with the creation of a case study-developed theory emphasising the importance of the full and explicit implementation of learning theory in educational practices. The theory calls for better integration of academic, practice, accreditation, and governmental sector efforts in professional healthcare educational reform initiatives.

Objective. To use cognitive interviewing techniques to determine faculty and student interpretation of a subset of items from the AACP faculty and graduating student surveys. Methods. Students and faculty were interviewed individually in a private room. The interviewer asked each respondent for his/her interpretation of 15 randomly selected items from the graduating student survey or 20 items from the faculty survey. Results. While many items were interpreted consistently by respondents, the researchers identified several items that were either difficult to interpret or produced differing interpretations. Conclusion. Several interpretational inconsistencies and ambiguities were discovered that could compromise the usefulness of certain survey items.

In the United States, microenterprises, critical segment of the small business population, accounts for 110 million small businesses that source new jobs. Despite the increase in the number of created businesses in the U.S., more than 70% of microenterprise business owners are unsuccessful after 2 years. The multiple case study included 6 participants living in Houston, Texas, and intended to explore business strategies microenterprise event management owners used to succeed in business beyond 2 years. The conceptual framework that grounded the study was the 5-stage small business growth model and the 5-stage of the evolution of entrepreneurship theory. The data collection process consisted of interviews resulting in transcripts, review of company documents, and interview observations notes. The data analysis process while triangulating the data consisted of creating thematic codes, and clustering keywords, and ideas from the data. Development of visual aids assisted with organizing information, synthesizing, and generating new ideas. Text, word, and matrix coding queries were conducted and summarized for a cross-case analysis as relating to the interview questions. Thematic analysis and cross-case analysis revealed 3 major themes: customer relationship management, education/work experience, and promotional activities. Implications for social change include encouraging entrepreneurial and small business development programs to develop innovative curriculums that microenterprise business owners may benefit from to increase more business opportunities. An increase in microenterprises may help provide more employment opportunities that meet the needs of local communities, and improve socioeconomic conditions.