Surge Free Added Resistance testing in variable head wave conditions were completed for a container ship model. The added resistance experiments include calm water, head wave, and oblique wave cases with a focus on establishing a validation benchmark for CFD codes computing the added resistance and motions of the ship model during maneuvering. The ship used is a 1/85.19 scale KRISO Container Ship, KCS, model with a length of 2.70 m. Tests were performed at the IIHR wave basin. The 20 x 40 x 4.5 m wave basin is equipped with 6 inline plunger type wave makers and a 3 degrees of freedom carriage. A 4 degrees of freedom, surge, heave, roll, and pitch free mount with a mass spring damper system was used to tow the model. Calm water tests were performed for 13 Froude numbers between 0.0867 and 0.2817. The resistance coefficients, sinkage, and trim were found for each test. The calm water results were obtained and compared to results from towing tank facilities, with traditional mounts, to estimate facility biases at the IIHR wave basin. The results show that the size difference of the IIHR model and surge free motion create magnitude differences between facilities. Head and oblique wave tests were performed at Froude number 0.26 and wave height to wavelength ratio, H/λ, of 0.0167. For all wave tests, time histories of wave amplitude, resistance, and 4 DOF were measured. Fourier analysis was completed for all time histories of waves, forces, and motions and the 0th, 1st, and 2nd harmonic amplitudes and phases are presented. All head wave results are compared to other facilities data taken in a towing tank with a traditional mount. The data from all wave heading data was analyzed with a focus on the trends with incremented wave encounter angle. Most harmonic amplitudes show good agreement between all facilities, but removal of the small model used by IIHR shows even better agreement between facilities. The oblique wave heading data shows good agreement with the only other experimental oblique wave added resistance testing. Complete uncertainty analysis was completed for select cases for calm water, head wave, and oblique wave conditions. The uncertainty showed accurate data form most wavelength settings.

With approximately 65 stillbirths occurring each day in the United States, a significant number of parents are left to navigate a difficult grieving process. An event like stillbirth presents many individual and relational challenges. For this study, researchers focused on the hospital experience for couples following notification of stillbirth. Interviews were held with 8 couples that had experienced stillbirth within the past 10 years. Researchers wanted to know what similarities and differences existed in how mothers and fathers described the clinical encounter. The data for this study were collected through interviews. Couples were encouraged to share as much or as little as they’d like about the hospital experience. Couples were also asked to describe how they experienced the clinical encounter as individuals and as a couple. Participants in this study were also given the opportunity to provide feedback on what doctors and other hospital staff could do to assist individuals and couples during this difficult time. Participants discussed how hospital staff helped to shape the experience. This was done both in their interactions with staff and the accommodations that were made. Some parents described hospital staff as “gems” or their “angels” while others reported the pain of hospital staff invalidating their experience. While similarities existed in how parents experienced the clinical encounter, each participant’s experience was unique. Studies should continue to be conducted in an effort to further develop evidence-based practices in hospitals meant to help parents navigate this difficult experience.

Context: This study was founded on the notion that opportunities for individuals to improve their knowledge of and appreciation for design should be accessible to a broad population. If design is considered a driver in the development of environments that people encounter as part of their everyday activities, they may learn about design from those encounters. With a visual database of environments that include positive design examples, the population will benefit. Firstly, they have the capacity to use their informed encounters to contribute with some authority to discourse that shapes the future of their individual and collective surroundings. Secondly, they hold a greater expectation for design which can increase economic activity through design-related industry. Aim: The Australian post office (PostShop) was chosen as an example of an everyday environment that has the capacity to capture a large audience, due to an ever-increasing and proven catchment of the population-currently one in eighteen Australians will visit each day. To understand the role of design in the PostShop environment it is essential to understand the process through which the environment is developed, and those criteria that drive the final outcome. Therefore, the aim of this study is to investigate the extent to which the key development drivers of the PostShop influence the inclusion of design as a driver. Background: To enable this investigation to take place within an established context, a review of background literature was undertaken. This included themes supporting design literacy; the history of the PostShop built environment; brand; fitout and landlord guidelines for the built environment; global postal models; organisational behaviour; the development process; and the role of design in improving economic growth. / Methodology: The qualitative approach was used during the research undertaken in this study. Semi-structured interviews were held with participants from Australia Post and other (external) organisations to capture data relating to the development process of the Postshop, and the role of design in that process. This data was categorised and coded according to themes that emerged from the interview data. This allowed the reduction of data for analysis and presentation. The presentation is primarily rich narrative descriptions and includes responses from interview participants. Key findings: The data uncovered thirty-three individual drivers that have contributed to the development of the postal environment over time. These drivers were presented to illustrate their changing importance over time, from early traditional post offices through to the current PostShop. Seventeen drivers were considered to be relevant today. These were distilled to four chief driver groups that influence the current PostShop. In rank order, these are : financial motivation: including minimisation of rental outgoings, capital fitout costs and business downtime during refurbishment; and queue operation organisational behaviour: including authority of internal opinion: and competition and personal imprimatur brand strategy: including the desire to be a modern retailer; national and tiered fitout standards; and measurement of the built environment as a brand medium external authority: including postal and other industry models; government pressure; and landlord guidelines. / Conclusions: The aim of this study was to investigate the extent to which the key development drivers of the PostShop influence the inclusion of design as a driver. It was concluded that: all chief driver groups limit opportunities for design to contribute as a driver towards enhanced PostShop success. Despite being one of the leading international postal providers in terms of economic results, the chief drivers fail to embrace further potential for economic growth. The chief drivers also prevent the PostShop acting as an everyday environment that could successfully enhance the design literacy of the one million Australians that visit each day.

Bakgrund: Övervikt och fetma är den största folkhälsosjukdomen i dagens samhälle. Överviktiga patienter blir allt vanligare i hälso- och sjukvården och vårdpersonal upplever det svårt att behandla dem korrekt. Sjuksköterskor använder sig av olika strategier för att nå dessa patienter men är osäkra på hur patienterna uppfattar deras råd. Patienter med övervikt står inför allvarliga hälsorisker. Syfte: Syftet med studien är att belysa överviktiga patienters upplevelser av mötet med vården. Metod: Metoden är litteraturöversikt och tio vetenskapliga artiklar ligger till grund för resultatet i studien. Resultat: Fyra teman framkom vid analysen, och dessa var kränkning, behov av stöd, okunskap och att undvika sjukvård. Temat kränkning innehåller tre subteman, diskriminering, att bli anklagad och att bli avvisad. Behov av stöd innehåller två subteman, bristande stöd och tillfredställande stöd. Diskussion: Patienterna upplever mötet med vårdpersonalen både positivt och negativt. Det diskuteras om vikten av utbildning till vårdpersonalen i detta ämne. / Background: Obesity is the biggest national disease in the world today. Though these patients are becoming more common in the health service, nurses doesn’t know how to treat them correctly. Nurses develop different strategies to reach these patients but they are insecure on what the patients will think about their advice. The patients are facing serious health concerns. Purpose: This study aims to investigate how overweight and obese patients experience the encounter with health services. Method: The method is literature review and ten different articles are included in the result of this study. Result: Four themes emerged from the analysis; they were violation, the need of support, ignorance and health care avoidance. The theme violation has three subthemes, discrimination, too be accused and too avoid health care. Need for support has two subthemes, inadequate support and satisfied with the support. Discussion: Patients experience the encounter with health care both positive and negative. It’s discussed around the importance of education to health care professionals about this subject.

The present study focuses on the phenomenology of the violent encounter, and is to be understood as the study of the violent encounter as a phenomenon, i.e. as experienced. The overall aim is to elucidate, analyse and describe violent encounters within psychiatric care as experienced by carers and patients. Moreover, the study aims at promoting the development of a phenomenological research approach in caring science in general and elucidating tacit caring knowledge in particular. The thesis includes three empirical studies and one methodological study. The research is guided by a phenomenological and lifeworld theoretical approach. Research data consist of narratives and qualitative interviews, as well as reenactment interviews with carers and patients. Data are analysed for meaning. The analysis and synthesis of meaning are aimed at openness and meaning sensitivity through a reflective attitude characterised by the intent to bridle the process of understanding. The goal of the analysis is to describe the general structure of the phenomenon and its meaning constituents. The result shows that violence and threat do not evolve in “naked” caring, characterised by encounters where carers are able to touch their patients at the same time as being touched, speaking both literally and figuratively. It is through “naked” caring and caring touch that the carers are able to reach the patients and to give undisguised invitations to genuine presence. The possibilities of touch rely on the carers’ capacity to be authentic and to genuinely wish well. Violence is on the contrary nourished by touch without caring intention, or non-touch, i.e. caring where the reciprocity of touching and being touched is missing between patients and caregivers. In the discussion, the different meanings of the violent encounter are related to the philosophy of Merleau-Ponty and Lévinas. The philosophical dimensions of touch are investigated and it is discussed how the “naked” encounter can be understood from a phenomenological ethical standpoint. The discussion focuses on the caregivers’ vulnerability and the high demands they are subjected to. It is also argued that a foundation of caring science is needed in caring practice in order to make possible a development of a caring attitude that prevents violence.

Titel: Våld i nära relationer – Sjuksköterskors erfarenheter av att möta våldsutsatta kvinnor, en systematisk litteraturstudie. Bakgrund: År 2011 anmälde 12 471 kvinnor att de blivit utsatta för våld i en nära relation. Skador som våldsutsatta kvinnor drabbas av är allt från psykiska besvär till svåra fysiska skador. Många av dessa kvinnor behöver komma i kontakt med sjukvården och sjuksköterskor i olika organisationer. Syfte: Syftet med litteraturstudien är att beskriva sjuksköterskans erfarenheter av att möta kvinnor som utsätts för våld i nära relationer. Metod: En systematisk litteraturstudie där inkluderade studier granskades och kvalitetsbedömdes. Resultaten analyserades och tematiserades utifrån likheter och skillnader. Resultat: Huvudresultatet påvisade sjuksköterskornas känslomässiga svårigheter att möta kvinnor som utsätts för våld i nära relationer, då det bland annat påverkade sjuksköterskans privatliv. Det var även svårt för sjuksköterskan att ställa frågan till kvinnan angående våldsförekomst om sjuksköterskan misstänkte det, samt hur sjuksköterskan skulle ställa frågan. Sjuksköterskan fann även svårigheter att finna tid och en bra miljö för dessa kvinnor att känna sig trygga i. Många sjuksköterskor strävade efter att få utbildning inom ämnet våld i nära relationer eller att få ytterligare utbildning inom ämnet. Slutsats: Litteraturstudiens resultat visar att utbildning inom området våld i nära relationer är en nödvändig och central faktor som i dagsläget inte är tillräcklig. Nyckelord: “intimate partner violence”, “domestic violence”, “encounter*”, “experienc*” och “nurse- patient relations”

Denna uppsats undersöker implementeringen av styrdokument i organisationer utifrån ett meningsskapande perspektiv. Styrdokument ses som en viktig del i organisationers arbete men tidigare forskning visar att det finns skäl att ifrågasätta hur väl de fungerar i praktiken. Det föreligger svårigheter när samtliga organisationsmedlemmar på alla organisatoriska nivåer ska skapa förståelse runt samma innehåll.       Under 2011 infördes en nationell värdegrund för äldreomsorgen i Sverige. Detta har aktualiserat arbetet med styrdokument och värdegrund inom äldreomsorgen. Den empiriska bakgrunden till denna studie är detta arbete men studien avgränsas till det innehåll som gäller bemötande. Detta område är särskilt intressant då begreppet bemötande kan ha olika innebörd för olika personer samt beroende på kontexten. Studien undersöker därför medarbetarnas förståelse av innehållet i styrdokument och hur förståelsen översätts i arbetet.       I uppsatsen presenteras teori beträffande styrdokument, ledarskap, organisationslärande, sensemaking och organisationskultur. Viktiga poänger i detta kapitel är: Att styrdokument måste konkretiseras för att kunna användas. Att ledarskap allt mer handlar om kommunikation och att förmedla idéer och värderingar. Att lärande är en social konstruktionsprocess och att kunskap är subjektiv. Att organisationskultur är gemensamma föreställningar, skapade genom kommunikation. Att sensemaking är en ofullständig process i vilken människor ständigt försöker förstå sin omvärld.    Undersökningen genomfördes som en fallstudie på ett vårdboende i Karlstad kommun. Tio medarbetare samt enhetschefen intervjuades. Intervjuerna med medarbetarna utgick ifrån förutbestämda teman vilka var Bemötande, Styrdokument, Ledarskap, kultur och lärande, samt bakgrundsfrågor. Dessutom diskuterades vissa citat ur styrdokument under intervjuerna.       På vårdboendet har medarbetarna arbetat mycket med organisationens styrdokument. Trots det visar resultatet från intervjuerna på att majoriteten av respondenterna var osäkra på innehållet i styrdokument. De har svårt att uttrycka sin förståelse vilket kan bero på att den är implicit kunskap. Istället uppgav de att de lärde sig av varandra eller att de arbetade efter sunt förnuft. Styrdokumenten kändes långt borta i det vardagliga arbetet och respondenterna verkar ha ersatt dem med en gemensam förståelse om hur      4   deras arbete ska utföras. Dock säger flera att styrdokument kan fungera som ett verktyg för reflektion vilket innebär att styrdokumenten ändå är en faktor vid skapandet av den förståelsen. I denna process har enhetschefen vid det undersökta vårdboendet en viktig roll.       Slutsatsen blir att medarbetarnas förståelse för styrdokument är indirekt och i hög grad beroende av organisationskultur och kommunikation med enhetschefen. Implementeringen eller översättningen sker via den gemensamma förståelsen, det vill säga genom till exempel APT och samtal. / This essay investigates the implementation of steering documents within organizations from a sensemaking perspective. Steering documents are seen as an important part of the organizations work but previous research shows that there are reason to question how well this works in practice. There seems to be difficulties when majority of members of the organization on all organizational levels are meant to create understanding around same content.  During 2011, a national value system of the elder health care was implemented in Sweden. This has highlighted the work of the steering document and values within the elder health care.  The empirical background to this study is this work with the national value but the study is limited to the content regarding patient encounter. This subject is especially interesting when the meaning of encounter can have a different meaning to different people depending on the context.  That’s why this study investigates co-workers understanding of the content in the steering document and how the understanding is translated into work.   In the essay theory is presented regarding the steering document, leadership, organizational learning, sensemaking and organizational culture.  Important points in this chapter are: that steering document must be concretized to be used. That leadership is increasingly all about communication and to mediate ideas and values. That learning is a social construction process and that knowledge is subjective. That organizational culture is same visions created through communication. That sensemaking is an incomplete process in which people are constantly trying to understand their world. This investigation was made as a case study at a senior living in Karlstad. Ten co-workers and their head director were interviewed. The interviews with the co-workers were taken from prepared themes which where encounter, steering document, leadership, culture and learning and background questions. Also some quotes from the steering document were discussed during the interviews.  The co-workers at the senior living have worked a lot with the organizational steering document. Still the result from the interviews shows that the majority of the workers where not sure of it´s content. They have difficulties to express their understandings,      6   which may be because it is implicit knowledge. Instead they explained that they have learned from each other or that they were working for common sense.  Steering document felt far away within everyday work and co-workers have replaced it with a common understanding of how their job should be done. However some co- workers say that steering document works as a tool for reflection which means that steering document is a factor for creating understanding. In this process the head director has got a greater roll. Conclusion is that the co-workers understanding for the steering document is indirect and largely dependent on organizational culture and communication with the head director. Implement or translation happens thru the common understanding, which means through APT and discussions.

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Background: Sweden is one of many countries which have a long history of immigration during the past decades. Each yearSweden receives numerous immigrants from different parts of the world, which has madeSweden to a multi-culture country. Aim: The aim was to describe nurses’ experiences of encounters with patients from different cultures. Method: A literature-based study based on qualitative research, nine scientific articles were performed. Result: The analysis of the data resulted in four themes such as; insufficient communication, family members as a link to the patient, unfamiliar situation, and attentive to the patients’ vulnerability with seven subthemes. Conclusion: For a well functioning encounter between nurse and patient from different cultures, a prerequisite is that the nurses establish a relationship based on good communication with the patient and relatives. This can prevent inequality, suffering based on lack of nursing, violation and misunderstandings. / Bakgrund:  Sverige  är  ett  av  de  länder  som  har  en  lång  historia  av  invandring  de  senaste decennierna.  Varje  år  tar  Sverige  emot  ett  stort  antal  personer  med  utländsk  bakgrund  och flyktingar från olika delar av världen. Detta har gjort Sverige till ett mångkulturellt land.  Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av möten med patienter från olika kulturer.  Metod:  En  litteraturbaserad  studie  med  grund  i  kvalitativ  forskning  baserad  på  nio vetenskapliga artiklar genomfördes.  Resultat:   Analysen   av   datamaterialet   resulterade   i   fyra   teman   såsom;   bristfällig kommunikation,  anhöriga  som  länk  till  patienten,  ovan  situation  samt  uppmärksam  på patientens utsatthet med sju underteman.  Konklusion: För ett välfungerande möte mellan sjuksköterska och patient från olika kulturer, förutsätts  att  sjuksköterskan  kan  etablera  en  relation  grundad  på  god  kommunikation  med patient  och  dennes  anhöriga. Detta  kan  förebygga  ojämlikhet,  vårdlidande,  kränkning  och missförstånd.

BAKGRUND: HIV (Humant Immunbrist Virus) är en infektion som är spridd över hela världen. År 1981 då HIV beskrevs för första gången associerades smittan med homosexualitet och bisexualitet bland män samt intravenöst missbruk. Trots mer kunskap om hur viruset sprids förekommer fördomar och diskriminering av patienter med HIV från både allmänheten och vårdpersonalen. Tidigare forskning visar att det finns en ovilja bland vårdpersonal att vårda patienter med HIV. SYFTE: Studiens syfte var att beskriva HIV-patienters upplevelser av mötet med vårdpersonal. METOD: En litteraturöversikt av befintlig forskning inom det specifika området genom granskning av 12 vetenskapliga artiklar. RESULTAT: Studien resulterade i tre teman; kränkning, avståndstagande och rädsla samt professionellt bemötande. Många patienter har negativa upplevelser av mötet med vårdpersonal såsom stämpling, skuldbeläggning, nekad vård och ignorans. Även många positiva erfarenheter framkom där patienterna upplever en god relation med sin vårdgivare. KONKLUSION: Trots mer kunskap om HIV upplever patienterna ett osympatiskt bemötande från vårdpersonalen. Kunskap om patienternas upplevelser av mötet med vårdpersonal har betydelse för att förbättra förståelsen för patientens situation och därmed även omvårdnaden. Därför är det viktigt att vårdpersonalen införskaffar sig kunskap om hur deras bemötande påverkar patientens tillfredsställelse av vården. / BACKGROUND: HIV (Human Immunodeficiency Virus) is an infection that is spread all over the world. In 1981, when HIV was described for the first time, the infection was associated with homosexuality and bisexuality among men, and intravenous misuse. Despite greater understanding of how the virus is spread prejudice and discrimination against HIV patients still occurs from both the community and health professionals. Previous research shows that there is an unwillingness to care for patients with HIV among health care personnel. OBJECTIVE: The aim of this study is to describe HIV patients' experiences of the encounter with health care personnel. METHOD: A literature review of previous research in the specific area by analyzing 12 scientific articles. RESULT: The study found three themes; insult, rejection and fear and professional treatment. Many patients have negative experiences of the encounter with health personnel such as labeling, blame, denied care and ignorance. The positive experiences showed that patients experienced a good relationship with their caregivers. CONCLUSION: Despite more awareness about HIV, patients experienced unsympathetic treatment from health care provider. Knowledge of patients' experiences of the encounter with health professionals is important to improve understanding of the patient's situation and the care. It is therefore important that health professionals obtain knowledge about how their treatment affects the patient’s satisfaction of care.