京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22885号 / 医博第4679号 / 新制||医||1048(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊佐 正, 教授 古川 壽亮, 教授 高橋 淳 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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A better understanding of task allocation for the registered nurse (RN) within the scope of the multidisciplinary care team model is required. Patients, healthcare staff, and medical facilities that utilize RNs in multidisciplinary care teams will benefit from improved role identification. A multidisciplinary care team consists of a variety of health care professionals and without role identification, confusion, miscommunication, and negative patient outcomes can occur. A literature review demonstrated that a gap in knowledge existed related to task allocation and role identification of RNs within a multidisciplinary care team. The purpose of this study was to evaluate RNs’ scope of practice within a multidisciplinary care team of an acute care medical center and identify a new theory regarding RNs’ perceptions of their role. A grounded theory approach was used to explore and reveal these perceived role identifications through the lens of the accountability theory. The research questions and the guided interview explored RNs’ self-perceived role identifications that have shaped RNs’ expectations of their scope within the multidisciplinary care team model. The results found nurses to be experts of patient care and that the nursing role has a 24/7 responsibility while being the closest, most personal role to the patient, thus, the RN feels accountable for all the needs to the patient, even if the needs or actions are outside of the nursing assigned role or tasks. From these results emerged a new theory, the perpetual accountability theory. Identified recommendations regarding RNs’ roles and their utilization within the multidisciplinary care teams allow a positive social change of greater success at delivering best practices and optimum patient outcomes.

Idag har människor friheten att välja var, när och på vilket sätt de vill använda sina smartphones och dess funktioner, oavsett ändamål. Hur går den användarmöjligheten ihop med inlärning? Hur mycket av koncentrationen kan behållas under en inlärningsprocess med en smartphone närvarande och användandes? Påverkar närvaron och användningen av smartphones användarnas förmåga att skilja och bearbeta information från olika källor? Den här studien syftar till att undersöka deltagarnas förmåga och uppfattning att kunna särskilja och bearbeta information ifrån olika källor genom diagnosiska prov, baserade på föreläsningarnas innehåll som deltagarna fick ta del av under två föreläsningstillfällen. Deltagarna delades in i två grupper där den ena gruppen fick behålla sina smartphones under första föreläsningen medan den andra gruppen ombads lägga undan sina smartphones. Inför andra föreläsningen var gruppernas instruktioner det omvända. Deltagarna ur de båda grupperna fick svara på enkäter efter respektive föreläsning, samt även på en avslutande enkät i slutskedet av studien. Studien visade att inga slutsatser av smartphones inverkar på inlärnings- och koncentrationsförmåga kunde dras av resultaten, pga. för få deltagare och undersökningstillfällen. Resultatet gällande hur deltagarna uppfattade sina inlärnings- och koncentrationsförmågor med och utan smartphone påvisade ingen skillnad i tre av fyra fall. Detta trots att deltagarna själva ansåg att användandet av en smartphone kunde vara en distraktion under föreläsningstillfällen. Studien påvisar även att deltagarna anser sig själva ha en bättre förmåga än andra att hantera en smartphone och samtidigt bearbeta information under en inlärningsprocess. / Today people have the freedom to choose where, when and how they want to use their smartphones and its functions, for whatever purpose. How does this opportunity relate to learning? How much concentration can be maintained during a learning process with a smartphone present and used? Does the presence and usage of the smartphone affect the users’ ability and opinion to distinguish and process information from different sources? This study explores the participants’ ability to distinguish and process information from different sources through diagnostic testing based on the content of lectures, which the participants had access to during two lecture sessions. The participants were divided into two groups where one group got kept their smartphones during the first lecture, while the other group was asked to put away their smartphones. Before the second lecture the groups’ instructions were reversed. Participants from both groups were also asked to answer questionnaires after each lecture and a finishing survey in the final stage of the study. The study showed that no conclusions concerning the smartphones’ affect on learning ability could be drawn from the results, due to too few participants and study occasions. The result concerning how the participants perceived their learning- and concentration abilities with and without smartphones during the study demonstrated no difference between them in three of four cases. This despite the fact that the participants felt that the use of a smartphone could be a distraction during lectures. The study also showed that the participants consider themselves to have a greater ability than others to manage a smartphones while processing information during a learning process.

Voice over the Internet Protocol (VoIP) is one of the latest and most successful Internet services. It takes advantage of Wireless Local Area Networks (WLANs) and broadband connections to provide high quality and low cost telephony over the Internet or an intranet. This project exploits features of VoIP to create a communication scenario where various conversations can be held at the same time, and each of these conversations can be located at a virtual location in space. The report includes theoretical analysis of psychoacoustic parameters and their experimental implementation together with the design of a spatial audio module for the Session Initiation Protocol (SIP) User Agent “minisip”. Besides the 3D sound environment this project introduces multitasking as an integrative feature for “minisip”, gathering various sound inputs connected by a SIP session to the “minisip” interface, and combining them altogether into a unique output. This later feature is achieved with the use of resampling as a core technology. The effects of traffic increment to and from the user due to the support of multiple streams are also introduced. / Röst över Internet Protocol (VoIP) är en av de senaste och mest framgångsrika Internettjänsterna. Det utnyttjar Trådlösa Nätverk och bredband för att erbjuda högkvalitativ och billig telefonering över Internet eller ett Intranät. Det här projektet använder sig av VoIP för att skapa ett kommunikationsscenario där flera olika konversationer kan hållas samtidigt och där varje konversation kan placeras på en virtuell plats i rymden. Rapporten innehåller en teoretisk analys av psykoakustiska parametrar och deras experimentella genomförande tillsammans med design av en 3D ljud modul för Session Initiation Protocol (SIP) User Agent ”minisip”. Förutom ljudmiljön i 3D introducerar projektet multitasking som en integrerbar del av ”minisip”. Alla tänkbara ljudkällor baserade på SIP förbindelser samlas med ”minisip” interfacet och kombineras till en enda utsignal. Detta uppnås med hjälp av resampling som kärnteknologi. Effekterna av att mer trafik når användaren på grund av stödet av multiple källor introduceras också.

<p>With increasing demands in people’s work and life, successful self-regulation of multiple goals/tasks becomes important to one’s well-being and performance. One individual difference in this process is one’s preference for multitasking (i.e., polychronicity), which was found to be important in individuals’ psychological experience and performance. However, in terms of our understanding of the nature of this construct, there are at least two issues: 1) most research has assumed that preference for multitasking and preference for sequential pursuit are opposite ends of one continuum, which has not been directly tested; 2) different scales of polychronicity differ on their definitions of multitasking. To address these gaps, the present research seeks to clarify the relationships among individuals’ multitasking preferences and to develop a new and improved scale of these individual differences for future research in multitasking. To do so, three studies (<em>N</em> = 1367) were conducted to create and validate a scale that measures three potentially distinct preferences: concurrent preference, switching preference, and sequential preference. These studies empirically tested the relationships among the three preferences. The results were replicated in both goal and task contexts and with different response anchors. Findings suggest that it is questionable to assume multitasking preference and sequential preference are antithetical, while concurrent and switching preferences were highly correlated. I conclude with a discussion of the theoretical implications and future directions for multitasking research.</p>

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In Sweden almost three persons over the age of 65 years dies every daybecause of fall injuries. The overall societal costs of elderly fall accidentswere estimated to to be 14 billion SEK, and if no action is taken this cost isestimated to increase to 22 billion SEK until 2050. The individual decreasein life of quality due to pain, decrease of independence and, for those stillworking, a decrease in income is of course also well worth considering.It is well known that multitasking while walking will decrease attentionon the surroundings and gait behaviour which increases the risk of falling. Itis known that walking uses both sensory input and visual inputs to guide themotion. The visual input prepares the body to adjust itself before a step istaken to optimize the outcome.This study aimed to investigate the effect of multitasking on gaze strategiesand gait performance. Five healthy adults walked over a setup of ramps and astep while performing three different levels of cognitive loading: just walking,walking and performing mental arithmetic’s and walking and scrolling on amobile cell phone.The eye tracking device Pupil Core (Pupil Labs, Berlin, Germany) wasused to capture the gaze points of the participants and Vicon Nexus togetherwith force plates were used to capture data to compute the kinematics of theparticipants during the walking.The results revealed that four out of four participants had a lower ratio ofgaze fixations on objects of interest when scrolling on the phone comparedto just walking, and three out of four participants had a lower ratio of gazefixations on objects of interest when doing mental arithmetic’s compared tojust walking. Simultaneously the gait parameters and kinematics changed in away that might increase the risk of falling. Four out of four participants had adecrease in average stride length and average stride velocity when walkingwhile scrolling on a phone and a decrease in average stride velocity whenperforming mental arithmetic’s compared to just walking. Three out of fourparticipants had a decrease in average stride length when performing mentalarithmetic’s compared to just walking.Since the participant number was low more studies are needed to confirmthese results. The experimental design would benefit from adjustments to tryto separate the effect on gaze behaviour between altered cognitive loading andaltered gait pattern, but are a good base to use for further studies.

Instant messaging with Internet-based software is a ubiquitous form of communication in industrialized nations. In fact, many educators are observing that students engage with instant messaging while simultaneously engaged in academic activity. Though this type of multitasking is pervasive, educational researchers have not examined how the practice of instant messaging impacts learning outcomes. This dissertation describes the background, empirical and theoretical foundations, methods and results of a study examining the impact of instant messaging activity on learning, where instant messaging and learning are simultaneous activities. The question posed is grounded in the related areas of instant messaging practices, the Generation M profile, Cognitive Load Theory, and integration of instant messaging in K-16 classrooms. This work presents empirical evidence pointing out the necessity of conducting empirical study regarding how instant messaging activity might impact learning. Quantitative methods used to conduct the study are presented including data collection instruments. The results of the study are discussed in broad terms related to Generation M and Cognitive Load Theory. Methodological limitations related to practice opportunities for the research sample as well as the performance measure used are detailed. In addition, implications of the results in relationship to those teaching members of Generation M in K-16 classrooms as well as those designing instruction for this population are discussed. The discussion concludes with recommendations for further research in this area.

In this thesis, well-being is the main focus to contradict the consequences of efficiency and instead value the concepts of presence, non-action and slow-living. I aim to explore, through design, the effects of technological connectedness and the benefits of practicing presence. To rephrase what we currently perceive as productive, to not be ignorant or reject reality, but rather ask how to reform the understanding of time and its potential reflection on society. Throughout the project, the values of slow, speculative and ontological design shape the process to formulate a critical product that reforms the current culture of multitasking through languaging the concept of presencetasking. Irony and humor is used to engage conversation and norm-creative tactics are used to suggest procedures for change for an utopian future that values the mental health of the individual, the community and beyond.