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abstract: Newer communication technologies (CTs) will always vie with more mature technologies for the attention of time-constrained legislators. As continual advances in CT make new methods of communication available to legislators, it is important to understand how newly introduced CTs influence novel and changing legislator behaviors. The mixed-method research presented in this study provides deep insights into the relationships between legislators and the CTs they use. This study offers many contributions, among them: it effectively bridges a gap between existing Internet Enabled CT (IECT) behavioral studies on non-legislators by expanding them to include legislator behavior; it expands existing narrowly focused research into the use of CT by legislators by including both IECT and mature CTs such as face-to-face meetings and telephone; it provides a fresh perspective on the factors that make CTs important to legislators, and it uncovers legislator behaviors that are both useful, and potentially harmful, to the process of democracy in the United States. In addition, this study confirms and extends existing research in areas such as minority party constituent communication frequency, and extends the topic of legislator CT behavior into some unanticipated areas such as constituent selective behaviors and the use of text messaging during floor debates which effectively enable lobbyists and paid consultants to participate real-time in floor debates in the Arizona House and Senate. / Dissertation/Thesis / Ph.D. Public Policy 2014

Abstract Occupational safety in the construction industry has improved during the past few years with the help of target setting. Still, the accident frequency rate is doubled compared to other industrial sectors. The aim of this study is to clarify the mind-set of the actors in the building and construction trade towards occupational safety. Furthermore, identifying the factors affecting occupational accidents and the possibility of their prevention are investigated. There have been ample studies conducted on occupational safety and attitudes towards it, whereas research into construction safety perceptions has been scarce. The research is a Mixed Method Case Study in which the data consist of three cases. Case 1: Interviews of the workers (n=10) severely injured in falling from heights at the construction sites. Case 2: Interviews of construction professionals (n=20). Case 3: A two-phase (before and after) questionnaire to construction students in a HSEQ Training Park (Rudus) in Espoo (n=128) and in Northern Finland, Oulu (n=44). On the basis of this study it can be stated that the actors in the building and construction business consider occupational safety a matter of the utmost importance. On the other hand, while deemed desirable, workplace safety issues also create a great deal of cognitive dissonance. The mind-set for occupational safety is challenging. The actors in the construction industry demand investments in occupational safety but also flexibility. The conflicts are caused by the requirements for efficiency, high quality, and safety in construction, yet, for which there are, limited resources available. Safety measures are defied because of schedules, for instance, and risks may be ignored. Accidents are regarded as self-inflicted. According to the professionals, the construction business has been polarized into the companies that either pay attention to or neglect occupational safety and educated versus uneducated workers. Qualified workforce with a high standard of training is desired in the recruiting process. Investing in health and safety education is considered crucial at an early stage. Safety is realizing the importance of adopting effective health and safety management systems to eliminate work-related hazards and taking a positive approach to providing specialized training and education programs that improve the skills and experience of the workforce. Young people may lack an overall understanding of the dangers of their line of work. The injured workers assessed the risks through their subjective experiences. Although the reasons for occupational injuries are multi-causal in nature, employee mind-sets are often associated with exposure to worksite hazards. The visits to the HSEQ Training Parks improve the students’ understanding of occupational safety, and particularly those who had more experience in the building trade than their fellow students. However, first-year students and those less experienced became disconcerted and their uncertainty levels increased. The visits should consequently be target-oriented, well designed and carried out in a timely manner. The HSEQ Training Parks should utilize trauma survivors as experiential educators in providing valuable, practical information about workplace injuries and their prevention. / Tiivistelmä Työturvallisuus rakentamisessa on parantunut asetettujen tavoitteiden avulla, silti tapaturmataajuus on kaksinkertainen muihin teollisuusaloihin verrattuna. Tämän tutkimuksen tavoitteena on selvittää, miten alan toimijat suhtautuvat työturvallisuuteen. Mitkä tekijät vaikuttavat tapaturmiin ja voidaanko niihin vaikuttaa? Työturvallisuutta ja asennetta on tutkittu, mutta suhtautumista työturvallisuuteen rakentamisessa ei. Tapaustutkimus (Case Study) sisältää kolme Tapausta, joita on lähestytty monimenetelmällä. Tutkimukseen haastateltiin putoamistapaturmissa vakavasti loukkaantuneita (n=10) ja alan asiantuntijoita (n=20). Lisäksi kerättiin kaksivaiheiset kyselyt opiskelijoilta Rudus (n=128) ja Pohjois-Suomen (n=44) Turvapuistoissa. Tutkimuksen perusteella voi todeta toimijoiden pitävän työturvallisuutta tärkeänä ja tavoiteltavana asiana. Suhtautuminen on kuitenkin ristiriitaista. Loukkaantuneiden mielestä työturvallisuus lähtee turvallisen työskentelyn mahdollistamisesta. Siihen tulee panostaa ja myös antaa mahdollisuus joustaa. Haasteita aiheuttavat vaatimukset tehokkaasta, laadukkaasta ja turvallisesta rakentamisesta, johon ei ole riittävästi resursseja. Turvallisuutta uhmataan mm. kiireen vuoksi, eikä riskeihin välttämättä puututa. Asiantuntijat kokevat turvallisuuden olevan yksilölähtöistä. He näkevät alan polarisoituneen turvallisuudesta huolehtiviin ja sitä laiminlyöviin yrityksiin sekä koulutettuihin ja kouluttamattomiin työntekijöihin. Alalle kaivataankin lisää pätevyyksiä. Turvallisuuskasvatukseen tulee panostaa yhä nuorempana, kuten aiemminkin on todettu. Turvallisuus on ymmärrystä ja suhtautuminen osa ammattitaitoa, mikä kehittyy kokemuksen myötä. Nuorilla ei ole kokonaisvaltaista ymmärrystä alan vaaroista. Vaikka tapaturmien syyt ovat multikausaalisia, on yksilön suhtautumisella suuri merkitys tapaturmiin. Turvapuistovierailut lisäsivät opiskelijoiden ymmärrystä työturvallisuudesta. Vierailuilla oli vaikutusta opiskelijoihin, joilla oli kokemusta rakentamisesta. Opintojen alussa olevia vierailu hämmensi ja lisäsi epävarmuutta. Turvapuistovierailun tulee olla tavoitteellinen, hyvin suunniteltu ja toteutettu – oikea-aikaisesti. Puistoissa tulee hyödyntää todellisia kokemuksia työtapaturmista ja loukkaantuneet ovat itse valmiita kertomaan kokemuksiaan ja toimimaan kokemusasiantuntijoina.

Utbildning pekas ofta ut i såväl internationella som nationella styrdokument som centralt för att kunna skapa hållbar utveckling. Det saknas dock fortfarande en hel del kunskap om hur utbildning kan utformas och genomföras för att stärka handlingskompetens och miljömedvetenhet hos elever och studenter. Syftet med denna studie är att undersöka hur en grupp lärare i grundskolans årskurs f-5 uppfattar begreppet lärande för hållbar utveckling och hur de uttrycker att de förhåller sig till det i  sin egen undervisningspraktik samt om och på vilket sätt deras uppfattningar förändras under en kompetensutvecklingsinsats utformad som en studiecirkel som pågår under ett års tid. Studien är genomförd med blandad metod. Forskningsdesignen är en före-efter experimentell design med en kvalitativ uppföljning till den experimentella delen av datainsamlingen. En enkätundersökning genomfördes före och efter studiecirkelns genomförande och analyserades med SPSS icke-parametriskt Wilcoxon signed rank-test. De uppföljande intervjuerna analyserades med en fenomenografisk ansats. Resultaten visar att lärarna ändrade sina uppfattningar om vad lärande för hållbar utveckling kan vara till både innehåll och uttryck. Lärarna ger uttryck för ett större mod att utveckla sin undervisning att bli mer utmanande för elevernas tänkande och innehålla fler inslag av verkliga kontexter. Det går däremot inte att säga något om vad som faktiskt händer i deras undervisning och vad det som sker i undervisningen gör för elevernas förståelse, utveckling av nyckelkompetenser, motivation och engagemang för att arbeta för en hållbar framtid.

The process and outcome of psychoanalytic psychotherapy have been studied for a long time. However, the experiences of patients, particularly in therapies where goals were not met, have not yet been the target of extensive research. Psychoanalytic psychotherapy with young adults might face particular challenges. The overall aim of this thesis was to explore the experiences of young adults in psychoanalytic psychotherapy, with a particular focus on differences between suboptimal therapies and therapies with generally good outcome. The setting was naturalistic, and perspectives of the patient, therapist and observer were combined. Qualitative and quantitative methods were used. Study I explored experiences of psychotherapy process and outcome among seven patients in psychoanalytic psychotherapy, who expressed dissatisfaction. Interviews at termination and 18 months later were analysed using grounded theory and compared to therapist experiences. Patients experienced abandonment with their problems in and after therapy, since therapy according to the patients lacked connections to daily life, as well as flexibility, activity and understanding from the therapist. Therapists presented a different picture of the same therapies, mainly focused on the difficulties of the patients. Study II analysed the experiences of 20 non-improved or deteriorated young adult psychotherapy patients at termination of therapy and 36 months later. Non-improvement and deterioration were calculated based on the reliable change index on self-rating scores. The grounded theory analysis of interviews established spinning one’s wheels as a core category. The relationship to the therapist was described as artificial, although at times helpful. Participants experienced their own activity in life and active components of therapy as helpful, but thought focus in therapy was too much on past experiences. Study III explored the experiences of 17 young adult patients, in psychoanalytic individual or group therapy, overcoming depression. The analysis of interviews from therapy termination and 18 months later indicated that finding an identity and a place in life were perceived as intertwined with symptom relief. Negative experiences included difficulties to change oneself, fear of change, and problems in therapy, such as too little activity on the therapist’s part. The results were discussed in relation to young adulthood, therapeutic alliance, mentalization, and attachment. The conclusion was expressed in a comprehensive process model of suboptimal therapy with young adults, with suggested ways to prevent such a development. The therapist’s meta-communication and correct assessment of the patient’s mentalization capacity from moment to moment are proposed as crucial. Regarding clinical implications, therapists of young adult patients need to establish meta-communication on therapy progress, as even experienced therapists might be unaware of dissatisfaction or deterioration. Meta-communication could be considered part of the treatment itself, as it may foster mentalization and good outcome. Further, the period of young adulthood entails decisions and developing an adult life, and therapists need to make room for this by active interventions.

En France, les programmes d’éducation thérapeutique du patient (ETP) à destination de l’adolescent diabétique de type 1 visent à rendre l’adolescent autonome pour gérer sa maladie et son traitement. En s’appuyant sur la théorie sociale cognitive de Bandura, les effets des activités éducatives de l’ETP devraient conduire au renforcement du sentiment d’efficacité personnelle, couplé à d’autres facteurs socio-cognitifs, favorisant l’adhésion thérapeutique de l’adolescent, une meilleure qualité de vie et un meilleur équilibre glycémique.Les travaux de thèse se sont déclinés en trois buts principaux :1) Réaliser une clarification de concept sur les spécificités de l’ETP dans un contexte pédiatrique, à partir d’une analyse de la littérature selon la méthode de Rogers (2000).2) Réaliser une revue systématique ayant pour objectif de décrire le contenu et les effets des programmes éducatifs de 2009 à 2014 sur le contrôle glycémique, la gestion de la maladie, les critères psychosociaux des enfants et des adolescents diabétiques de type 1, et d’évaluer la concordance de ces programmes avec les recommandations de l’ISPAD.3) Décrire l’évolution du profil socio-cognitif et clinique sur trois mois d’une cohorte d’adolescents diabétiques ayant participé à un programme d’ETP en France.Ces travaux ont permis de développer les connaissances sur le concept d’ETP dans le contexte pédiatrique, sur l’état de la recherche concernant les programmes éducatifs structurés dans le diabète de type 1 de l’enfant et de l’adolescent, mais aussi de mettre en application une étude pilote dans le contexte de l’ETP en France. / In France, therapeutic patient education programs (ETP) to adolescents with type 1 diabetes are designed to make the teenager to self-manage their disease and its treatment. Based on social cognitive theory of Bandura, the effects of educational activities should lead to the strengthening of self-efficacy, coupled with other socio-cognitive factors, favoring the therapeutic adherence of teenager, a better quality of life and improved glycemic control.The thesis work was broken down into three main goals:1) Perform concept clarification on the specificitiess of TpE in a pediatric context, from a literature analysis method according to Rogers (2000).2) To conduct a systematic review aimed to describe the content and effects of educational programs from 2009 to 2014 on glycemic control, disease management, psychosocial criteria of children and adolescents with type 1 diabetes, and assess the consistency of these programs with the recommendations of the ISPAD.3) Describe the evolution of the socio-cognitive and clinical profile on three months of a diabetic adolescent cohort participated in an ETP in France.This work helped to develop knowledge on the concept of TPE in the pediatric context, the state of research on structured educational programs in type 1 diabetes in children and adolescents, but also implement a pilot study in the context of the ETP in France

This mixed-method case study examined effects of high school musicians' participation in the jam session, a student-directed, extracurricular music activity. The single case study site was a rural British Columbia high school exceptional for its support of jamming. Forty-four subjects, including 21 who fully met stated criteria for jammers, and 13 non-jamming subjects, were studied over a period of four months. The general research question was: Does participation in a band room jam session benefit students cognitively and motivationally? Specific research questions were: Do students who informally jam on various forms of music enhance their music skills in the perception and meaningful manipulation of music elements, and if so, how? In what ways does Csikszentmihalyi's flow theory explain the continued participation of students in the jam session? Three quantitative instruments were administered to 13 jammers capable of playing a Bb Concert scale on a melody instrument as well as to a comparable group of 13 non-jammers. These instruments included Gordon's Advanced Measures of Music Audiation (AMMA), Froseth's Test of Melodic Ear-to-Hand Coordination (TMEHC), and a researcher-developed test of ear-to-hand coordination (SOR). An ANOVA test showed no significant difference between jammer and non-jammer groups on AMMA scores (p<0.05). ANOVA showed a notable but not significant difference (p<0.056) between groups on the TMEHC, while a Repeated Measures Analysis of pre/post test TMEHC scores showed no effect of jamming over a period of 10 weeks. ANOVA showed a very clear difference between groups on the SOR (p<0.001). Qualitative data collected via journaling, interviews, observation, and participant-observer tasks indicated that jammers were perceiving and manipulating music elements in meaningful ways, and also supported Csikszentmihalyi's flow theory as an explanation for jam session participation. In particular, flow characteristics including transformation of time, loss of self-consciousness, and challenge/skill balance were both observed and reported. The role of the teacher, the presence of a music subculture, and the pseudo-curricular nature of jamming were noted as possible topics for further research. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

L’approche de la problématique des agirs via les tests projectifs en se penchant sur l’expression des défaillances narcissiques du sujet, propose, le plus souvent, une vision unitaire basée sur le mécanisme du recours à l’acte tel que définit par Balier. Nous proposerons de traiter cette question à partir d’une dimension plurielle différenciant deux types d’agirs : le recours à l’acte (Balier) et l’acting-out (Lacan). Nous présenterons une étude mixte, quantitative et qualitative, à partir de la comparaison de Rorschach et TAT administrés à 24 sujets. Notre analyse de ces deux formes d’agir portera principalement sur la capacité du sujet à pouvoir ou non se différencier de l’environnement. Le groupe recours à l’acte se caractérise par une continuité intérieur / extérieur et un transitivisme morbide expression d’une absence de constitution d’un soi différencié. Le groupe acting-out présente une problématique narcissique spécifique dans la validation du spéculaire par le symbolique. Les prises en charges thérapeutiques peuvent ainsi s’aider de ces résultats pour proposer des approches différentielles au sein desquelles les tests projectifs pourraient avoir une fonction pré-thérapeutique. / In the modern societies, the answer to the criminal act is a prison sentence. Due to the nature of certain acts, with this prison sentence, some court-ordered treatments (COT) (obligations and injunctions of treatments) have been added. Ethically, this law request and its social asking don’t exempt to think about the prisoner ‘asking, which is the trigger of psychotherapies. There is any retroactivity of the law and of pronounced sentence. For this research, the prisoners were selected on their own asking of care (the court-ordered treatments couldn’t applicate). The asking of the prisoners is therefore a criterion common to them (these prisoners). In this context, the acts have distinguished according to the mechanisms which have governed the nature of the act: recourse of act or acting out. Many experts agree on the existence of premature narcissistic failures. However, discussions persist on the nature of the act and on its aspect, either single dimension or multiple and complex dimensions (objective behavior, social consequences and underlying mechanisms ...). Yet all these theoretical models on narcissistic failures lean on the “recourse to act” as if there was only a simple nature to act.

Purpose. To systematically develop and field test an intervention to engage families and healthcare teams in the decision-making process about life support for critically ill patients in the Intensive Care Unit (ICU). Setting. Adult medical-surgical ICU at a Canadian academic teaching hospital. Methods. The International Patient Decision Aid Standards (IPDAS) criteria and the Interprofessional Shared Decision Making (SDM) model guided the study of families facing decisions about life support for their relative in ICU that involved:1) systematic review; 2) qualitative descriptive study; 3) mixed methods field test of a novel patient decision aid (DA). Systematic review findings. Of 3162 citations, four trials evaluated interventions to improve communication between health professionals and patients/families. One intervention met eight of nine criteria for SDM but did not evaluate its effect on the benefit to communication. Qualitative study findings. Six family members and nine health professionals identified two options (life support or comfort care) and values associated with these options. Values included maintaining quality of life, surviving critical illness, minimizing pain and suffering, not being attached to machines, giving the family enough time to adapt emotionally to the patient’s health situation, and the judicious use of healthcare resources. Families were unlikely to become engaged without healthcare professionals making the decision explicit and minimizing other barriers across the decision-making process. Field test findings. Family members and health professionals for eight patients indicated that the DA was feasible to use, acceptable to users, had the potential to do what was intended, and did not seem to present adverse consequences to users. An enhanced delivery strategy is needed for future evaluation of its effect on facilitating patient/family involvement in decisions. Conclusions. Limited involvement of families in the process of decision-making about life support in the ICU reinforced the need for effective interventions to facilitate SDM. These studies validated the operationalization of the IPDAS criteria, as part of a systematic process for developing and field testing DAs. However, IPDAS criteria stop short of elements necessary to consider when implementing the DA in the processes of care.

Why do individuals derive different value when working remotely using Enterprise Collaboration Systems during Covid-19? This mixed methodology research used a Service-Dominant Logic lens and undertook a literature review, qualitative interviews and a quantitative survey to identify the characteristics and variables that impacted perceived value for individual Australian Actors. To assist future studies it also developed an equivalency model of value and the desire to work remotely. The research found the strongest predictive variable is the suitability of the workspace, followed by a list of a dozen significant variables. By knowing these variables and their predictive weights, Actors can adjust them to optimise the value derived from working remotely through ECSs.