Learning objects have received attention because of their potential to improve current methods of teaching and learning. Despite perceived importance, there has been lack of studies that examine the use of learning objects across various contexts. In response, this study examined the actual use of learning objects and their perceptions among Instructional Design and Technology (IDT) practitioners in U.S. This study was based on the data from 191 IDT practitioners from various sectors, including higher education, business, government, and K-12. The study results contribute to the body of knowledge on learning objects in terms of four areas: conceptualization, utilization, benefits, and adoption. First, the study results should allay the concern that the conceptualization of learning objects focuses too much on technical aspects. IDT practitioners emphasized both technical and learning aspects in conceptualizing learning objects. In conclusion, the present study laid the foundation for a working definition of learning objects. Second, the study showed that IDT practitioners were utilizing learning objects to empower learners to have control over their own learning. The current study identified design strategies that IDT practitioners were frequently using. The most frequently utilized strategy was the provision of concrete, authentic examples and problems. Along with design strategies, this study identified the frequently adopted granularity levels: assets, combined media, one complete instructional unit, lesson or module, and course. Combined media, which consists of content and optional media, was the most frequently utilized granularity level of the five levels. The study provided empirical data to help determine formal design strategies and optimal granularity levels in utilizing learning objects based on the frequent use among IDT practitioners. Third, this study filled the research gap on the benefits of learning objects from an IDT perspective. Study results showed that IDT practitioners were positive about the overall benefits for the ID process, along with reusability and the support for the motivation and interactivity features. However, they were less convinced of the time and cost savings. Generally, IDT practitioners were satisfied with the benefits of learning objects. Fourth, the present study improved the understanding of the adoption status of learning objects. Currently, many of the participants' organizations were adopting or exploring the implementation of learning objects. The adoption of learning objects has a promising future, as IDT practitioners were positive about their organizations' intentions to use learning objects in the future. At the individual level, IDT practitioners were found to use learning objects for their professional role and across various projects. As an adoption factor, IDT practitioners showed the positive reactions to learning objects' perceived usefulness. / Ph. D.

Mid-level administrators are underrepresented within the literature despite years of research on university administration. Moreover, there is significantly less knowledge about administrators of color in higher education. While the reason for their decreased prominence is unclear, Jackson and O'Callaghan (2009) offer that people of color were historically not part of the leadership landscape as an explanation for the minimal formal analysis and categorization of them and their work. Despite the surge of research interest in Black administrators, there still remains limited knowledge about who they are, their professional lives, and their overall lived experiences. As such, the purpose of this study was to understand the career journeys and the experiences of Black mid-level student affairs administrators (BMLSAAs) as they navigate transitions and advancements within their careers. Guided by a conceptual framework using tenets of Critical Race Theory, Space and Place, and the Great Migration, this study investigated the following questions: (1) What are the career migration patterns of BMLSAAs? (2) What role does race and racism combined with location play in the career journeys of BMLSAAs? (3) How do BMLSAAs make meaning of their career journey and their experiences? I employed a qualitatively driven multimethod research design consisting of narrative inquiry and a Critical Race Spatial Analysis (CRSA) with a sample size of 11 BMLSAAs across the U.S. Data sources included a demographic questionnaire, documents (i.e., current resume/curriculum vitae), a career journey map, and a semi-structured interview. Findings provided insight into the racialized engagement of spatial features throughout participants' career journeys; on the campuses where they worked and the geographic regions where participants have lived. Ultimately findings expressed what it is like being Black not only in a mid-level student affairs administrative role, but also traversing one's career as a Black person. Additionally, this study has implications for research, practice, and policy. / Doctor of Philosophy / As a whole, middle managers in higher education are underrepresented in university research. There is even less knowledge about administrative leaders of color in higher education because they have been historically excluded from those roles. Despite an increase of interest in researching Black administrators, there still remains limited knowledge about who they are, their professional lives, and their overall lived experiences. As a result, the purpose of this study was to understand the career journeys experiences of Black administrative leaders, specifically those in middle management who are employed in student affairs departments. Through interviews and map making, this study explored patterns within Black mid-level student affairs administrators (BMLSAAs) career moves; the role that race and racism combined with location played within their careers; and how BLMSAAs made sense of their career journey experiences. Findings provided insight into what shaped participants' careers; how they navigated their careers; their career related experiences; and how they thought about the futures of their careers. Findings also illuminated participants' racialized experiences navigating campus organization structures; work cultures and environments; and living in the different geographic regions where they were employed. This study has an impact on higher education employment research, professional practice, and policy.

no / Personalised Nutrition allows individual variation in dietary, lifestyle, anthropometric, phenotypic and/or genomic information to be considered when giving dietary advice. Compared to ‘generic’ dietary health messages, personalised dietary advice has been shown more likely to result in healthy dietary change. Personalised regimes can help clients in this endeavour by putting them in control and taking into consideration individual propensity for behaviour change, motives for food choice as well as social and lifestyle factors impacting upon the eating context. Provision of personalised nutrition services across Europe should consider inter-country differences in perceived barriers to uptake of personalised nutrition including those associated with the process from the collecting of information and taking of biological samples through to how the results are interpreted and delivered. Irrespective of European country, potential consumers appear to trust health professionals such as dietitians over commercial agents to provide personalised nutrition. Dieticians, therefore, are likely to play a key role in making personalised nutrition happen in the future. Organisations representing nutrition and dietetics professionals will need to be consulted for guidance on how to address the ethical and legal issues around personalised nutrition and regulate practice. A future is envisaged where commercial personalised nutrition will work with existing health providers in bringing the benefits of personalised nutrition to the wider public. / The full text is unavailable in the repository due to copyright restrictions.

Bakgrund: Det finns ett växande intresse för att tillhandahålla palliativ vård för personer med intellektuell funktionsnedsättning, och därmed ett erkännande av deras särskilda behov och svårigheter att få tillgång till rättvis vård i livets slutskede. Detta ställer krav på att vårdpersonal ska kunna identifiera palliativa behov, samt inte minst bedöma när livets slut närmar sig. Denna kunskap gynnar både individen och hela samhället. Då tillgången till palliativ vård för personer med intellektuell funktionsnedsättning är sämre än för övrig befolkning sökte denna litteraturstudie identifierade orsaker till denna ojämlikhet. Syfte: Att beskriva vårdpersonals upplevelser av faktorer som möjliggör och försvårar palliativ vård för personer med intellektuell funktionsnedsättning. Metod: Studien är en litteraturöversikt. En tematisk analys med induktiv ansats genomfördes där inkluderade artiklar analyserats utifrån Braun och Clarkes tematiska analysmetod. Totalt valdes 14 artiklar ut från databaserna CINAHL och PubMed. Resultat: I resultatet framkom fem huvudteman – hur etiska värderingar påverkar vårdpersonals upplevelser av palliativ vård, kunskapsnivåns betydelse för möjligheten att ge god palliativ vård, de praktiska förutsättningar som arbetsgivare tillhandahåller, vårdpersonals upplevelse av hur närstående påverkar den palliativa vården samt hur vårdpersonals känslor påverkar deras upplevelse av att ge palliativ vård – vilka belyste vårdpersonalens erfarenheter. Slutsats: Resultatet visade både hinder och möjligheter för palliativ vård för personer med intellektuell funktionsnedsättning. Vårdpersonalens upplevelser präglas av ett fokus på hinder där bristande utbildning samt bristande samarbete tydligast försämrar möjligheten till jämlik vård till patientgruppen. Utifrån dessa resultat finns förutsättningar att utveckla framtida vård. / Background: There is a growing interest in providing palliative care for people with intellectual disabilities, and as a consequence a growing interest in recognizing their special needs and difficulties in accessing equitable end-of-life care. This places demands on healthcare staff to be able to identify palliative needs, not least to assess when the end of life is approaching. This knowledge benefits both the individual and society as a whole. As palliative care for people with intellectual disabilities is less avaliable than for the rest of the population, this literature study looked for identified reasons for this inequality. Aim: To discribe healthcare professional’s experperinces of factors that facilitates or hinder palliative care for people with intellectual disabilities. Method: This study is a literature review. A thematic analysis with an inductive approach was carried out, where included articles were analyzed using Braun and Clarke's thematic analysis method. A total of 14 articles were selected from the databases CINAHL and PubMed. Results: Five main themes emerged in the result – How ethical values affect the way healthcare professional´s experiences palliative care,  How the level of knowledge impacts the possibility to provide good palliative care, The practical conditions that an employer offers, How healthcare professionals experience the impact of the patients' family members on the palliative care and How the emotions of the healthcare professional’s affects their experience of providing palliative care – which illuminated the experiences of the healthcare professionals.  Conclusion: The result showed both obstacles and opportunities for palliative care for persons with intellectual disabilities. The healthcare professionals' experience is characterized by a focus on obstacles, where insufficient training and cooperation are the most prominent factors in making it more difficult to provide equal care for the patient group. Based on these results there are possibilities to develope future care.

Alkohol och droger finns och används världen över och kan ibland leda till ett beroende, detta kan för de drabbade personerna innebära ett stort antal kontakter med vården. Syftet med studien var att beskriva vårdpersonalens attityder gentemot patienter med missbruksproblematik genom en integrativ litteraturöversikt, detta gjordes genom att söka i ett flertal databaser. Med hjälp av inklusions- och exklusionskriterier framkom 15 artiklar som upplevdes svara på syftet och därefter utfördes en analys baserat på Kristenssons analysförfarande där meningsbärande enheter kondenserades till kategorier, koder och underkategorier.  Resultatet visade att ett flertal av vårdpersonalen i studierna hade negativa attityder gentemot personer med missbruk. Det uppgavs även att det kan finnas flera olika faktorer som påverkar, som kan göra att attityderna kan vara negativt eller positivt laddade, till exempel genom olika erfarenheter som kan vara både av personlig och professionell karaktär. Vårdpersonalens attityder kan genomsyras av negativitet och rädsla men även av en tilltro till patienten och dennes möjligheter till välmående.  Genom våra resultat har vi dragit slutsatsen att negativa attityder gentemot patienter med missbruksproblematik finns hos vårdpersonal världen över och detta kan leda till negativa upplevelser av vården samt att patienten därigenom inte alltid får den vård som vore önskvärd. Attityder kan påverkas av tidigare erfarenheter och kan då både påverkas att bli negativa eller positiva och för att förbättra attityderna gentemot dessa patienter och för att en god vård ska kunna ske behövs mer utbildning, som i sin tur kan ge en ökad förståelse för behoven i vården. / Alcohol and drugs can be found and are used worldwide and can sometimes lead to an addiction, which for the affected persons can mean a large number of contacts with healthcare. The purpose of this study was to describe the healthcare personnels attitudes towards patients with addiction problems through an integrative literature review. This was done by searching a number of databases. With the help of inclusion and exclusion criteria, 15 articles appeared that were felt to answer the purpose and then an analysis was performed based on Kristensson's analysis procedure where meaningful units were condensed into categories, codes and subcategories.  The results showed that a majority of the healthcare personnel in the studies had negative attitudes towards people with an addiction. It was also stated that there can be several different influencing factors that can cause the attitudes to be negative or positive, for example through different experiences that can be both of a personal and professional nature. The attitudes of the healthcare staff can be permeated by negativity and fear, but also by a belief in the patient and his possibilities for well-being.  Our conclusion is that negative attitudes towards patients with addiction problems exist among healthcare personnel worldwide and this can lead to negative experiences of the care and that the patient thereby does not always receive the care that would be desirable. Attitudes can be influenced by previous experiences and can create both negative and positive attitudes, To improve attitudes towards these patients and for good care to take place, more education is needed, which in turn can provide an increased understanding of the needs in care.

No / Regulatory bodies governing health professions and professional education set clear expectations regarding fitness to practise. Within the UK, the Equality Act, 2010, poses a challenge to regulators, educators and employers to ensure that people are not excluded on the basis of disability and to facilitate inclusion. This research took a mixed methods approach to exploring the tensions between Higher Education providers and placement providers in the health sector. Disabled and nondisabled students and health professionals engaged in semistructured interviews and a survey in order to explore their beliefs and experiences. The findings suggest that applying equality legislation within health settings may be particularly difficult and that ¿disability¿ is an ambiguous and multifaceted concept. Whilst small in scale, the findings have given a voice to a professional group who are underrepresented in research and have raised a number of important issues that merit discussion and further scrutiny.

The article traces the history of the Poly Implant Prosthesis (PIP) scandal from an ethical perspective and explores the underpinning moral dilemmas inherent in the act of ‘whistleblowing.’ It goes on to consider the consequential stakeholder and broader societal reaction to whistleblowing which is discussed through deontological and teleological perspectives of ethically driven motives to act. It draws on the duty of care responsibility of healthcare professionals and the dilemma of personal consequence by the act of whistleblowing, whereby the objective of that act is the maintenance or improvement of patient standards and care. It argues that a cultural shift in organisational behaviour is urgently required to abrogate the needs for whistleblowing by means of internal systems and processes. Whistleblowing would thus become a supererogatory act of moral courage rather than carrying negative consequences in the interests of short-term saving face.

Yes / The use of problem-based learning (PBL) in Health Professional curricula is becoming more wide spread. Although the way in which the tutor facilitates PBL can have a major impact on students’ learning (Andrews and Jones 1996), the literature provides little consistency as to how the tutor can effectively facilitate PBL ( Haith-Cooper 2000 ). It is therefore important to examine the facilitation role to promote effective learning through the use of PBL. This article is the first of two parts exploring a study that was undertaken to investigate tutors’ experiences of facilitating PBL. This part focuses on the methodology and the combining of innovative processes with traditional philosophical traditions to develop a systematic educational research methodology. The study was undertaken respecting the philosophy of hermeneutic phenomenology but utilised alternative data collection and analysis technique. Video conferencing and e-mail were used in conjunction with more traditional processes to access a worldwide sample. This paper explores some of the issues that arose when undertaking such a study. The second article then focuses on exploring the findings of the study and their implications for the facilitation of PBL.

Yes / The profile of an effective facilitator has been likened to that of a saint, unfazed by ambiguity, undaunted by student irritation or personal frustration (Katz 1995, p 52). With the increasing popularity of using problem-based learning (PBL) within health professional curricula, it could be argued that the health lecturer’s role in education is changing. As a lecturer, I have only recently become involved in using PBL. With increasing exposure to the process and through reviewing the literature, I have come to realise that the role of the lecturer is fraught with difficulty. The literature is often conflicting with PBL meaning different things to different people (Barrows 1986). It provides no consistent guidelines as to how the lecturer should adapt to undertake this new role. This article explores the issues around the role of the lecturer within PBL and through reviewing the literature, investigates the level of intervention the lecturer should provide when students are undertaking the PBL process. Suggestions will be made to ‘facilitate’ the lecturer into facilitating an effective teaching strategy.

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