Sammanfattning Bakgrund: Att lida av försämring i psykisk ohälsa med tillhörande medicinering, kan medföra att det egna engagemanget i den psykiatriska vården påverkas. Under senare år har politiska initiativ gjorts för att stärka patienters delaktighet under pågående vård. Tidigare forskning påvisar dock att vårdpersonalen utgår från en paternalistisk syn, där man besitter en expertroll där patienten genom informationsförlust och bristande dialog utesluts från möjlighet att delta i beslutsfattande, vilket medför att rätten till delaktighet inte efterlevs. Teoretisk referensram: Tidvattenmodellen har utgjort ramverk för studien samt i Utvecklingsprojekt teamrond. Syftet: Att beskriva personers erfarenheter av delaktighet under vårdtiden på en allmänpsykiatrisk slutenvårdsavdelning före och efter implementering av utvecklingsprojekt Teamrond. Metod: Studien utfördes med Mixed Method embedded concurrent design. Datainsamlingen utfördes genom semistrukturerade intervjuer vid mättillfällena. Den dominerade kvalitativa datan analyserades induktivt genom innehållsanalys och kvantitativ data hanterades med deskriptiv statistik. Resultat: I kvantitativa resultatet framgick att samtliga variabler frånsett delaktighet i beslutsfattandet förbättrades vid utvärderingsmätningen. Vid sammanställning med det kvalitativa resultatet tydliggjordes att målsättningen med Utvecklingsprojekt teamrond avseende ökad patientdelaktighet kunde uppnås. Slutsats: Vårdpersonalen kan genom att visa intresse för personens unika kunskap om sitt liv, skapa en känsla av förståelse, vilket genom ett vidgat perspektiv medför att vården utformas tillsammans. Nyckelord: Mixed Method, Patientdelaktighet, Patientupplevelser, Personcentrerad vård, Psykiatrisk slutenvård, Psykisk ohälsa.

Syfte: Att beskriva problem- och känslofokuserade copingstrategier hos personer med ALS. Metod: En induktiv litteraturöversikt med mixed metod design har gjorts. Kvalitetsgranskade artiklar har analyserats noga och sammanställts i ett resultat. Resultat: Personer med ALS använder sig av både problemfokuserade och känslofokuserade copingstrategier. De strategier som visade sig i resultatet var kontroll, engagemang, support, acceptans och social support. Känslan av kontroll och acceptans av livssituationen är de mest använda strategierna. Genom kontroll kan personen med ALS kompensera de förluster sjukdomen medför och med hjälp av att acceptera sin situation kan personerna sätta upp nya mål och hålla fokus på nutid. Engagemang kan öka energin till hanteringen av sjukdomen. Hjälp utifrån var en del som gjorde livet meningsfullt, användandet av hjälpmedel ökade i samband med förändring av sjukdomen. Social support kan vara familj och vänner som ger styrka och närvaro. Slutsatser: Litteraturöversikten har visat att personer med ALS använder problem- och känslofokuserade copingstrategier för att hantera sjukdomen.  Faktorer som sjukdomens framskridande och vilka resurser som individen har kan påverka vilken copingstrategi som används. De mest använda copingstrategierna är acceptans och kontroll / Aim: The aim of this study was to describe problem focused and emotional focused coping strategies among persons with ALS Method: A literature review with a mixed method design have been done. Articles with reliability and high quality have been analysed and was summerized to a result. Result: Persons with ALS use problem focused and emotional focused coping strategies. The strategies found was control, engagement, support, acceptance and social support. The sense of control and acceptance of the life situation is the most common used strategies. Through control, the person with ALS can compensate for the losses that the disease causes. With help of acceptance, the individuals can set new goals and keep focus on the present. Engagement can increase the power of management to the disease. Support was a strategy who made life worth living, the use of equipment increased in the connection of the progress. Family and friends can be a social support and give strength and presence. Conclution: The literature review has shown that persons with ALS uses problem and emotional focused coping strategies to management the disease. Factors that affect the use of coping strategy is the progression and what resources the person has. The most common used coping strategies are acceptance and control.

Aim The thesis set out to examine validations of three observational pain assessment tools and establish nurses’ expectations of them and the factors that might influence them within intensive care unit (ICU) settings. Background The guidelines to pain assessment specific to ICU patients have been of great interest to health professionals over the last 20 years. Pain assessment remains a challenge for most ICU patients due to the difficulty of assessing pain with any precision. Evidence suggests that the Behavioural Pain Scale (BPS) and Critical- Care Pain Observation Tool (CPOT) have demonstrated sound psychometric properties. A review of the relevant literature highlighted the fact that no such studies have yet been conducted with a similar homogenous group in Asia. The Wong-Baker Face Pain Rating Scale (FPRS) is currently widely used for nonverbally communicating patients (NVCPs) with pain in ICU settings, and is even recommended for use with children. Valid assessment tools are required for effective pain assessment in ICU settings, particularly in patients who are experiencing communication difficulties. Design An embedded mixed methods design was employed to: 1) translate Chinese versions of BPS and CPOT, 2) test their validity and reliability of in comparison with FPRS, and 3) establish the nurses’ expectations about the three study scales when undertaking pain assessment by using semi-structured focus group interviews. Methods This thesis initially reviews the literature available to select the most appropriate scales for assessing pain in critically-ill NVCPs. The selected scales were then translated into a Traditional-Chinese version using established procedures for the Taiwanese context. Evaluations of the three pain scales were gathered using quantitative measures of pain scores in NVCPs experiencing painless/painful interventions. These were further compared with a few focus groups to establish the feasibility and utility of the three pain scales. The psychometric properties of the pain scales were assessed for reliability by using internal consistency and inter-rater agreement) and for validity by using content validity, concurrent validity, discriminant validity, and responsiveness. The validity was evaluated using ANOVA to compare the changes between the different procedures. The significance level was set at 0.05. As for the analysis of the qualitative data, this study typically follows the path of aggregating the words into themes of information and presenting the diversity of ideas gathered during the data collection. Results For the 2068 observations in 237 patients, there were no statistical differences between the characteristics of the BPS, CPOT, and FPRS groups. Validity was demonstrated by changes from baseline in the scores of the three groups, which were significantly higher during suction (p < 0.001). In regard to the result for the criterion validity, both BPS and CPOT had moderate positive correlations with FPRS. The internal consistency was excellent; the Cronbach’s α was 0.700 for BPS and 0.821 for CPOT when all items were included. The majority of nurses preferred to use BPS to assess pain in their clinical practice. When the nurses were asked how long they needed and how easy they found it to complete the assessments using these tools, they all agreed that each patient assessments were easier and took the least time when they used FRPS. However, the nurses considered that the most effective pain reaction during nociceptive procedures had been assessed by using BPS. Even though all of the participant nurses stated that CPOT provides a detailed item-description about pain behaviour, it also provided the biggest obstacle to use because of its ambiguous indicators. Conclusions BPS, CPOT and FRPS provide potentially useful measurement scales for assessing pain in ICU NVCPs. However, judging from the inconsistencies between the nurses’ replies, the results could reflect a conflict between the need to use a validated measure of pain for NVCPs on the one hand and managing a heavy workload in the ICU on the other. This study opens up an avenue for investigating further the link between the underlying conceptions of pain behaviour and the effectiveness of pain assessments in NVCPs when using an objective pain measurement.

This thesis reports on the social structures underpinning interschool collaboration in the context of Shared Education and the networks of staff relations that have been developed for the purpose of overcoming systemic separation. Drawing upon social network theory, it is argued that in order to further the model of Shared Education the corresponding research and academic enterprise must move beyond the analogous use of the term ‘network’ and consider the concept in a more analytical manner. In this sequential mixed methods case study, an exploratory network analysis of the staff members (n=97) from five collaborating primary schools in a Shared Education partnership was performed using a socio-metric instrument to examine four collaborative interactions—exchanging resources, seeking professional knowledge, discussing personal matters, and meeting socially. This was then followed by semi-structured interviews with the staff members (n=16) observed as most central within the partnership's network. The findings of this study suggest that Shared Education can facilitate network structures that overcome systemic separation; that partner preference is based upon desirable structural characteristics; that partnership sustainability may be an extension of social network adaptability; that Shared Education offered an alternative model for collegial engagement; that the model can facilitate learning relationships and knowledge creation; and that relational embeddedness is also observed to be a critical aspect of the partnership's leadership. Therefore, it is advocated that those researching Shared Education must develop a more nuanced approach to thinking about the structure of partnerships and the relationships that constitute them.

Syftet med detta examensarbete är att undersöka lärares och elevers uppfattning av hur läsförmågan, lusten och motivationen att läsa påverkas av digitala verktyg. Tolkningar, jämförelser och analyser av resultaten som omger den här studien förklaras med hjälp av en mixed method som består av genomförda elev- och lärarenkäter samt lärarintervjuer som analyserats ur ett sociokulturellt perspektiv. Elevers och lärares inställning till att använda digitala verktyg i skolarbetet och hur de upplever att verktygen hjälper dem i läsningen har undersökts. Webb- baserade enkäter med elever och lärare och intervjuer med lärare i form av gruppintervjuer har genomförts för att nå en djupare förståelse av enkätsvaren. Resultaten indikerar att en mer aktiv bearbetning av olika lässtrategier är något som krävs för att elever ska motiveras i sin läsning, men visar också att digitala verktyg påverkar förmågan och lusten att läsa främst inom området motivation och lust. Från resultaten i elevenkäten kan utläsas att digitaliseringen i skolan till trots så väljer de flesta elever fortfarande att läsa en fysisk bok framför att lyssna eller läsa digitalt. En tydlig uppmaning från eleverna till skolan är att de önskar att det ges tid för läsning under skoltid.

Background: Women prefer to eat plant-based food more frequently than men. Previous studies show that there is a difference in what we eat depending on which gender we belong to. The experience of food can be influenced by various aspects such as colour, shape, serving, and food information. Objectives: The purpose of the study was to investigate if there were any differences between men and women's attitudes towards vegan desserts. Moreover, four vegan desserts were developed using creative design and molecular gastronomy, to investigate how the colour and shape of vegan desserts affects the experience of taste, flavour and texture. Material and methods: To answer the research question, two focus group interviews were conducted. Moreover, a creative design containing an online cross-sectional survey was performed to develop four vegan desserts using molecular gastronomy. The desserts had the same ingredients in equal quantities, but they differed in colour and shape.These desserts were subsequently tested in a sensory evaluation. Results: The results show that there is a difference between men and women regarding attitudes towards a vegan dessert. Women are more positive and curious, while men are more sceptical whether a vegan dessert tastesgood. There was sometimes a significant difference in taste, but never in flavour and texture. Conclusions: There are differences in men and women's attitudes towards vegan desserts, where women are more positive than men. Shape may affect the experience of taste, but not of flavour and texture in this study.

The current study examined the parenting beliefs and practices of Taiwanese, Chinese immigrant (all first-generation immigrants in the UK) and English mothers, and the compliance of their young children (aged 5–7), in order to elucidate the effects of child temperament, culture and acculturation strategies on reported parenting beliefs and practices, observed parental behaviour, child behaviour, mother–child interaction dynamics and children’s compliance. The data were collected from a total of 90 families with 5- to 7-year-old children in Taiwan and the UK. Child temperament, parenting beliefs and practices and acculturation were assessed using questionnaires, and parental behaviour, child behaviour, dyadic interaction dynamics and child compliance were assessed using observation in two tasks (Etch-A-Sketch and clean-up). Semi-structured interviews were also conducted with the Chinese immigrant parents to gather more information regarding their acculturation and parenting. Cultural differences were found between groups in reported as well as observed parenting and children’s compliance. The Taiwanese mothers reported greater use of Chinese-specific parenting and physical coercion and were observed to use more (gentle and assertive) physical intervention than both the Chinese immigrant and English mothers. The Chinese immigrant mothers reported a higher degree of child autonomy than the Taiwanese and English mothers, and also reported cultivation of their children’s independence. The stronger the Chinese immigrant mothers' affiliation with Chinese culture, the more they reported adopting the Chinese-specific parenting style; the longer they had been in the UK, the less they reported authoritarian parenting. The English mothers were rated as more responsive and less negatively controlling than the Chinese immigrant mothers; they also showed more positive affect than both the Chinese immigrant and Taiwanese mothers. There were few cultural differences between groups in the children’s behaviour, although Taiwanese children showed more situational compliance than Chinese immigrant children. Further regression analyses showed that child characteristics, such as child age and temperament, affected the parents’ and children’s behaviour as well as dyadic interactional dynamics. Committed compliance, situational compliance and opposition were associated with different predictors, suggesting that they are qualitatively different and are associated with different developmental processes. Committed compliance may develop as children grow older, mediated by surgency; situational compliance, on the other hand, was associated with authoritarian parenting and mothers’ use of negative control, which varied by culture. Child opposition was predicted by neither child characteristics nor parenting. These findings provide valuable insights into parenting and children’s compliance in different cultural contexts. The results underscore the importance of looking at human development from a holistic perspective. The active role that children play in shaping their developmental process, their parents’ parenting and the culture they live in should all be taken into account when attempting to understand their development.

Construction literature forwards innovation as a desirable objective for firms. Innovation is argued to; improve the firm s performance, increase market share, establish a competitive advantage, and ultimately ensure firm survival. Literature has overlooked the role of organisational slack within construction firms as a determinant of innovation despite the concept being well developed within the general management literature. This research uncovers and examines the impact of organisational slack on firm-level innovation as a determinant of innovation within the construction sector. This work forwards organisational slack as an unexplored firm level determinant of innovation within the construction context. Using the resource-based view of the firm, as a framework for firms, the thesis develops links between previously established firm level determinates of innovation to and slack to support its proposal as a determinant of innovation. Following this traditional measures of innovation argued fail to accurately capture innovation in the construction context, with patents represent inventions, while R&D expenditure is not applicable within the construction. Due to these failures of traditional approaches to measuring innovation, firm level performance is forwarded as a proxy measure for innovation outcomes. Developing existing slack literature, this thesis develops hypotheses proposing inverse U-shaped (n) and U-shaped (u) relationships between the level of slack and innovation outcomes. The thesis presents mixed method research. Study 1 adopts a deductive research strategy, incorporating statistical analysis to test the hypothesised relationships. The Research Design develops and Archival analysis research method; mirroring the approaches of econometric research found in slack literature. The data analysis explores two contexts: construction and manufacturing, allowing a comparative baseline to be established. The analysis of data from this study reveals that discrepancies in the R2 between the contexts is largely the result of the inability of control variables (Age, Size and Number of employees), to explain variation in firm performance (as a proxy for innovation outcomes) in a construction context, rather than the unsuitability of slack in the construction context. In construction firms, Unabsorbed Slack and Financial Slack demonstrated statistically significant results supporting an inverse U-shaped relationship with firm performance (n) supporting Hypothesis 1a and 1b. Contrary to this Absorbed Slack and Human Resource Slack demonstrated statistically significant results demonstrating a U-relationship (u) between slack and performance supporting hypothesis 2b (H2b). Study 2 adopts a deductive research strategy, incorporating semi-structured interviews as a source of primary data in order to explore the slack-innovation relationship in greater depth. Primarily, this study provided evidence to suggest that construction firms do not directly measure innovation. Instead, firms choose to measure outcomes of changes within the firm, typically in terms of measure relating to firm financial performance. Evidence from this study supports the proposal of firm financial performance as a viable proxy for innovation outcomes in Study 1. In addition to this when faced with changes to their environment, participants responses typically supported a positive linear relationship between the level of organisational slack and the firm. This research is the first to examine the impact of organisational slack on construction firm financial performance (as a proxy for innovation). This relationship is curvilinear in nature, however, the results are inconclusive if it is inverse U shaped (n) or U shaped (u) based upon conflicting evidence from different slack variables. What can be ascertained however, is that the level of slack impacts firm level performance and theoretically impacts firm level innovation.

Significant research has investigated Jack Gibb’s model of defensive and supportive communication, but little has explored the influence of the type of talk -- defensive or supportive -- on perceptions of communication climate and the role that verbal aggressiveness may play in influencing both the types of talk and these perceptions. This thesis explored the relationship between defensive and supportive talk, verbal aggressiveness and communication climate using a mixed-method approach. Specifically, the Verbal Aggressiveness Scale was used to group participants for a dyadic problem solving exercise which generated conversational data that was analyzed qualitatively. Then, the Communication Climate Inventory was used to measure participants’ perceptions of the communication climate that emerged in their problem-solving dyad. The findings highlight factors that may influence the perception of communication climate. Examples of supportive talk that builds positive communication climates and limits the effects of verbal aggressiveness and examples of defensive talk that leads to negative communication climates are provided. This research demonstrates that language has an influence on communication climate through the words that shape the complex ways people perceive and understand each other and, interestingly, that the negative impact of defensive communication overrides the positive impact of supportive communication on the emergent communication climate.

Introduction: Suicide is a global public health and social problem affecting the most productive age group, and the elderly. In Addis Ababa, despite high suicide rates there is no proper registration and certification that is meant for public health purpose. This study is conducted to look into the incidence and explore societal views towards suicide in Addis Ababa. Methods: Secondary data was collected from registers of Forensic Pathology Department at Menilik II Hospital and Homicide Crimes Investigation Unit at Addis Ababa Police Commission. Qualitative data was also collected from experts having experience in helping suicide victims.   Results: Between January 01 and December 31st 2015, 267 residents of Addis Ababa, majority of who are males, died due to suicide. Hanging being the most frequently used means, social isolation, mental illness, family conflict, economic problems and lack of religious commitment are perceived causes of suicide. Unavailability helping institutions and individual preference as to the method of suicide and individual nature of suicide are conditions that get the attention. While respect for social and religious values is considered as protective factors, the act of suicide is religiously criminal act. The victims of suicide include family and community members.   Conclusion: There is a need to consider policy and programmatic actions directed towards suicide prevention and control. In addition to conducting community wide research in suicide, it is important to preserve social and cultural values; institutionalize traditional family conflict resolution practices and strengthen mental health institutions. / <p>Enbart abstract.</p>