Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers' perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers' experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers' attitudes and patients' responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers' experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients' expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.

Aim: To generate a theoretical model how patients experience their management of rheumatoid arthritis (RA) in everyday life.Method: An explorative design with the grounded theory approach was used by interviewing 16 informants with RA.Results: The generated theoretical model emerged in a core category- Striving for a good life with two categories; making use of personal resources and grasping for support from others, which formed the base of managing RA. When relating these categories together, four dimensions emerged which characterised patients’ different ways of managing RA: mastering, relying, struggling and being resigned.Discussion: The management of RA incorporated the use of personal resources and the grasping for support from others. Both self-management strategies and patients’ need of support were highlighted as aspects that were of importance when managing RA. Patients’ experiences of their need of support to manage RA give extended knowledge that is of importance for nurses and other healthcare providers. The relationship between patients and healthcare providers is always the key to a good encounter. Interventions to increase self-management in RA have to incorporate this knowledge when trying to increase patients’ self-efficacy and with their experience of support

Using a grounded theory approach to investigate the multidimensional reflections of two Reading Recovery teachers, this inquiry responds to calls for research on reflection and provides information for the field of education in understanding the nature of teachers’ reflections and how they inform teaching practices. Reading Recovery is a progressive intervention program which brings the lowest performing readers and writers to average levels of achievement in twelve to twenty weeks through daily, thirty minute one-on-one tutoring sessions that follow the same lesson pattern daily. Reading Recovery teachers are carefully trained to use reflection to design, implement, and observe children’s reading and writing practices to accelerate their reading and writing skills. To investigate the nature of participants’ reflections and how those reflections informed their teaching practices the data sources, collected over eight weeks, for each participant included field notes from seventeen observations, two semi-structured interview transcripts, thirty-six course documents, and two member checks transcripts. Open coding, memoing, and axial coding were used to examine all data sources. Further, each of the three dimensions of reflection, time, type, and context, were accounted for to fully explore participants’ reflections. Three interrelated major themes connected to the nature of Reading Recovery teachers’ reflectivity and practice were identified: (1) participants’ reflections are situated within the contextual framework of Reading Recovery and inform practices by serving as a roadmap to scaffold individualized instruction and examine personal philosophies of teaching and instructional assumptions; (2) Teacher identity as a reflective practitioner is a natural outcome participants and fosters the interconnectedness of practice and automaticity in their reflective practices; and (3) Systematic observations of the child during instruction focus on actions of the child and themselves as a teacher and serve as a trigger for reflection in a data-driven response sequence linking theory to practice. This study offers insight into how reflective practices of teachers of reading may be fostered through teacher education and into their own teacher development by linking their theoretical perspectives to their teaching practices.

The rate of development for large-scale wind energy in the Canadian province of Saskatchewan is a complex issue such that the various actors of the surrounding policy community (decision-makers, influential stakeholders, and the attentive public) cannot reach consensus. Inaction on resource and environmental issues like this one is often the result of complexity, either the inherent complexity of the problem being targeted or the complexity of the communicated information surrounding the problem. Inherent complexity is managed chiefly by central decision-makers and influential stakeholders of the policy community, while information complexity must be dealt with primarily by the attentive public of the policy community. This thesis uses a case study of large-scale wind energy development in Saskatchewan to explore complexity as a root cause of environmental inaction. In manuscript style, this thesis investigates two types of environmental complexity and two segments of the wind energy policy community. Through an exploration of barriers to wind energy expansion in Saskatchewan, the first manuscript focuses on the complexity of environmental problems themselves as dealt with by decision-makers and other influential policy actors. Interviews were conducted with a range of experts and stakeholders where participants were asked to describe barriers to development in each of six categories: agreement, knowledge, technology, economic, social, and political barriers. A number of key issues are identified: disagreement regarding the balance between environment and economy, contradictory knowledge about the benefits of wind energy, conflicting faith in technology to accommodate high levels of wind energy, unquantified non-economic benefits of wind energy, lack of social interest in and support for wind energy, and lagging provincial political leadership on the issue of wind energy. Perhaps more importantly, the interviews reveal that experts disagreed on many facets of the wind energy issue, which demonstrates that the complexity of the issue makes consensus and any resulting action difficult to accomplish. Intuitive solutions for managing complexity through the more effective reconciliation of disagreement are also suggested. The second manuscript focuses on the complexity of environmental information by examining policy information regarding wind energy implementation in Saskatchewan for complications that might reduce understanding about and participation in the issue by the attentive public. Through a review of publicly available reports, articles, and documents, four complexity-related problems are uncovered: non-intuitive information, misreported information, obsolete information, and absent information. Such occurrences may well be problematic for environmental policy information in general, so intuitive solutions involving clarification and elaboration are suggested for managing each one. Together, the two manuscripts illustrate that both inherent and information complexity can be problems for environmental issues, especially when one causes or feeds back into the other. Results from this thesis provide a way of thinking about environmental complexity and understanding environmental inaction as managed by policy communities.

This study is an exploration of the process of accessing dementia care for Aboriginal Older Adults living in Northern Saskatchewan. The research question for this project was, What is the process of accessing formal healthcare for dementia from the perspective of Northern Saskatchewan Aboriginal communities, and what factors specifically impede or encourage accessing formal care? <p>Grounded theory methodology informed the research process. Theoretical sampling resulted in a sample of thirty participants. Data were generated through eighteen in-person, semi-structured interviews; two in-person, semi-structured group interviews; and three focus group discussions including a directed activity led by participants. Analysis of data using the grounded theory constant comparison method led to an emergent theory that was verified by research participants.<p>The theory that emerged explains the basic social process at the heart of the research question. The grounded theory, The process of negotiating culturally incongruent healthcare systems explains the access to and use of formal healthcare from the perspective of those living in Northern Saskatchewan. Specific attention to the social context of healthcare access helped to illuminate the challenges faced by Aboriginal Older Adults when accessing healthcare services. The findings indicate a need for enhancing the cultural competence of healthcare provision to Older Adults with dementia in Northern Saskatchewan while providing formal support for those persons with dementia as well as for their informal caregivers.

Vi har alltsedan våra praktikperioder haft en grundläggande förståelse för hur mankan arbeta inom organisationer där innovation är ett centralt begrepp. Vi har dockaldrig kommit i kontakt med beslutsprocesserna runt dessa projekt. Efter praktikenhar vi ifrågasatt de värderingsmetoder som vi tidigare sett som relativt heltäckande.Vi är båda aktiva på börsen vilket är ytterligare en faktor som ökat vårt intresse förämnet då börsens värdering av bolag med hög risk och hög innovationshöjd ärosäker. Där saknas analyser som belyser problemet. Detta har lett till att vi söktvärderingar på dessa bolag med hjälp av olika metoder och ökat förståelsen för hurextern värdering går till.Författarnas studier har naturligtvis inspirerat valet av uppsatsämne. Studierna harockså påverkat hur vi ser på värdering och vilka resultat vi förväntar oss av studien.Vi har läst finansiering där värdering är väldigt centralt eftersom det är viktigt att sättamöjligheter i relation till varandra. Här har vi under hösten berört flera metoder där deflesta är baserade på diskonterade kassaflöden. Den andra parametern förutomkassaflöden är risken. Eftersom risk och avkastning alltid ska följa varandra så måsteavkastningen vara hög nog för risknivån. Risken har vi beräknat med hjälp av CAPMeller WACC. Dessa metoder använder sig av antingen marknadsförhållanden ellermer specifika förhållanden inom bolaget för att mäta risken. Vi har också kommit ikontakt med BASEL-fördragen och därmed Value-at-Riskmåtten som beräknar hurmycket man riskerar att förlora under en viss tid med en specificerad säkerhet. Medhjälp av dessa metoder och genom att jämföra nyckeltal har vi värderat allt frånprojekt till portföljer. Vi har alltid haft kassaflöden som grund för beräkningarna dockmed osäkerhet kring omfattningen av dessa.Under våra praktikperioder så arbetade vi båda två i väldigt innovativa miljöer. Ingenav oss kom i direktkontakt med beslutsprocessen då man valde mellan projekt, menett intresse för hur det gick till föddes. Bristen på förklaringar hur man hanteradeprojekt utan säkra kassaflöden under vår utbildning och även i de rapporter vi läst harbara ökat vårt intresse kring företag och deras projektval.Eftersom vi vill sätta oss in i hur beslutsprocessen ser ut på innovativa företag har vivalt en abduktiv metod, dvs. att utgå från vår data och teori för att utforska ettforskningsgap. Vår förhoppning är att den här studien kan vara en inspirationskälla tillandra abduktiva eller induktiva studier liksom vara en grund för vidare deduktivforskning i ämnet.Vi vill också passa på att tacka de medverkande företagen och personerna viintervjuat. Vi vill också rikta ett tack till vår handledare Anders Isaksson för all hjälpgenom denna snåriga process.

It is now widely recognized that society’s over-reliance on the automobile contributes to environmental problems, especially in urban areas. Nevertheless, efforts to bring about modal shifts through transportation demand management strategies typically have had limited success. As a result, transportation research is increasingly focused on understanding the decision-making process of travel behaviour changes including mode choice and automobile ownership. The purpose of this study is to explore how individuals arrive at a decision to live either car-free or car-lite. Using a grounded-theory approach, this thesis explores the factors involved in a car-free/car-lite decision and the manner in which those factors work together to create the decision making process(es). Semi-structured interviews were conducted with 20 driving members of a car-sharing organization, each of whom made a decision to go car-lite (car-sharing is their additional vehicle) or car-free (car-sharing is their primary vehicle). Five main interconnected themes emerged from the analysis: finances, personal values and attitudes, personal history, perceived accessibility and situational life events. In particular, the participants’ experiences reinforce the importance of situation life events in the decision-making process, a factor not commonly identified in behaviour change theory. Additionally, the participants’ narratives illustrate that intention is created from an individual’s inclination and ability to make a travel behaviour change. However, translation from intention into action appears to be conditionally dependent on contextual and/or situational changes, most often in the form of situational life events, that provide a push into or out of the decision-making process. Findings underscore the importance of life events as catalysts for bringing travel behaviour in line with an individual’s sense of what is important and what is possible. This research illustrates the relevance of qualitative work in advancing transportation research – particularly in understanding human travel decisions. While the current transportation-planning paradigm is appropriate for making short-term forecasts, we must recognize that non-linear, non-utilitarian, long-term, often qualitative factors, such as those identified in this research, are not exogenous to travel decision making. Results also provide a basis for reflecting on the appropriateness of various metrics for evaluating the effectiveness of transportation demand management initiatives.

During the last decades, immigration to Sweden has increased. As a result of this, a larger number of individuals are growing up with two languages. This means that the field of bilingualism has emerged as topic of relevance in Sociology, as well as other disciplines of Social Sciences. Bilingualism has been studied from different perspectives in Linguistics. However, in Sociology, focus has been mostly on the questions of integration, culture and ethnicity, where language has been seen as one of many aspects. I argue that bilingualism is an important social phenomenon in its own right, since it shapes the everyday lives of bilingual individuals and changes the landscape of our society. Using Grounded Theory, bilingualism in the everyday life is analyzed and explored, using material from qualitative interviews with ten individuals who have grown up with Swedish and one other language. It is here suggested that bilingualism in the everyday life can be understood as a process of handling ambivalence. This process takes place between the social context and the self and is influenced by and influences them both. A central part of this process is bilingualism seen simultaneously as tension and as resource.

It is now widely recognized that society’s over-reliance on the automobile contributes to environmental problems, especially in urban areas. Nevertheless, efforts to bring about modal shifts through transportation demand management strategies typically have had limited success. As a result, transportation research is increasingly focused on understanding the decision-making process of travel behaviour changes including mode choice and automobile ownership. The purpose of this study is to explore how individuals arrive at a decision to live either car-free or car-lite. Using a grounded-theory approach, this thesis explores the factors involved in a car-free/car-lite decision and the manner in which those factors work together to create the decision making process(es). Semi-structured interviews were conducted with 20 driving members of a car-sharing organization, each of whom made a decision to go car-lite (car-sharing is their additional vehicle) or car-free (car-sharing is their primary vehicle). Five main interconnected themes emerged from the analysis: finances, personal values and attitudes, personal history, perceived accessibility and situational life events. In particular, the participants’ experiences reinforce the importance of situation life events in the decision-making process, a factor not commonly identified in behaviour change theory. Additionally, the participants’ narratives illustrate that intention is created from an individual’s inclination and ability to make a travel behaviour change. However, translation from intention into action appears to be conditionally dependent on contextual and/or situational changes, most often in the form of situational life events, that provide a push into or out of the decision-making process. Findings underscore the importance of life events as catalysts for bringing travel behaviour in line with an individual’s sense of what is important and what is possible. This research illustrates the relevance of qualitative work in advancing transportation research – particularly in understanding human travel decisions. While the current transportation-planning paradigm is appropriate for making short-term forecasts, we must recognize that non-linear, non-utilitarian, long-term, often qualitative factors, such as those identified in this research, are not exogenous to travel decision making. Results also provide a basis for reflecting on the appropriateness of various metrics for evaluating the effectiveness of transportation demand management initiatives.

Recreational shopping has long been of interest to business academics and practitioners, but research on it has been underdeveloped in the leisure field. Although the leisure literature and business literature represent distinct perspectives, there appears to be many significant parallels between recreational shopping and leisure. The purpose of this study was to examine the intrinsic meanings of shopping; to explore the experiential aspects of the recreational shopping experience (including the influences of the retail environment on individuals who regularly engage in recreational shopping). This study took place in Toronto, Ontario. The sample included five female self-proclaimed recreational shoppers. The researcher accompanied each participant on a shopping excursion which took place at a shopping mall selected by the participant. Data were collected through three qualitative methods. First, participant observation involved the researcher walking alongside the participant as she shopped. Following the shopping session, the researcher conducted an in-depth face-to-face interview with each participant; the interview was guided by a set of open-ended questions. In addition, this study utilized photo-elicitation in which the participants were asked to photograph ‘anything’ that made an impression during their visit to the mall. The photographs offered tangible illustrations of shopping experiences and were used as a catalyst for discussion during the interviews. The data was analyzed using Grounded Theory coding which lead to the identification of two main themes and six respective subthemes. The emergent themes are all connected to the key idea that shoppers are motivated by their expectations and desires when they partake in the recreational shopping activity. Shopping offers numerous opportunities that provide immediate hedonic pleasure as well as intrinsic rewards. Such opportunities often include, the ‘before and after’ phases of experiences of acquisition and unexpected discoveries, the positive interactions which occur both inside and outside a retail environment, and lastly, the individual’s use of shopping as a means of self-expression and a tool to manage their self image. Satisfaction, spontaneity, familiarity, mastery, accomplishment, and feelings of escape were all present in these shopping experiences. The findings also described the role of shopping malls as a leisure space and as facilitators of recreational shopping activities. Furthermore, this study demonstrated that shopping can offer a profound leisure experience for many people and the activity should not only be researched in terms of just ‘recreational shopping’ or ‘utilitarian shopping.’ Rather, the findings indicate several overlaps between the two types of shopping and further research is needed to more fully understand the complexities of the activity.