The prehospital management of patients with acute myocardial infarction (AMI)now includes 12-lead electrocardiogram transmission directly from the ambulance to hospital.If the ECG shows ST-elevated myocardial infarction the patient should be transported directlyto a hospital with capability for percutaneous coronary intervention (PCI).                                               Aim: The aim of this study was to describe how ambulance nurses experienced the prehospital management of patients with AMI who are transported by ambulance directly to hospital for PCI.                                                Method: Semi structured interviews were conducted with eight ambulance nurses. Data were analysed using qualitative content analysis. The categories that emerged were: Use ofcompetence, Responsibility and Insufficiency. Result: The result showed that the ambulance nurses felt secure when they cared for patients transported directly to PCI. The nurses assessed the patient and decided how he or she should be cared for. The contact with doctors was considered good. However the nurses discussed the noisy environment in ambulances and bad connection in the cellular phone network as a source of insecurity when prescriptions were given to them. They would like to have a written prescription as a text message from the doctor. The nurses also felt that they had the sole responsibility for the patient.                      Conclusions: The capability of working alone, ability to act in complex situations andspecialist knowledge in order to assess the patient correctly is important. Prescriptions should be verified with a text message to the ambulance from prescribing doctor. / Prehospital omvårdnad av patienter med akut hjärtinfarkt innefattar numera att 12-avledningsleds elektrokardiogram (EKG) sänds från ambulansen till sjukhus. Om EKG visar ST-höjningsinfarkt skall patienten transporteras direkt till sjukhus med möjlighet att utföra perkutan coronar intervention.          Syfte: Syftet med studien var att beskriva hur sjuksköterskor i ambulans upplever den prehospitala omvårdnaden av patienter med akut hjärtinfarkt som transporterats med ambulans direkt till sjukhus för perkutan coronar intervention (PCI).                                                                            Metod: Semistrukturerade intervjuer genomfördes med åtta sjuksköterskor inom ambulansverksamheten. Kvalitativ innehållsanalys valdes för att analysera data och utmynnade i tre kategorier: Kompetensnyttjande, Ansvarstagande och Otillräcklighet.                                                  Resultat: Resultatet visade att sjuksköterskorna upplevde trygghet i uppdraget att omhänderta patienter med hjärtinfarkt som transporteras direkt till PCI. Sjuksköterskorna bedömde patientens tillstånd och tog ställning till hur den fortsatta omvårdnaden skulle utformas. Kontakten med mottagande läkare upplevdes mycket bra. Något som upplevdes som mindre positivt var dels den bullriga miljö som förekom i några ambulansmodeller, samt när det var dålig mottagning i mobiltelefonnätet. Båda dessa störningsmoment upplevdes som en källa till osäkerhet när det gällde läkemedelsordinationer från mottagande läkare. Det fanns önskemålom att dessa ordinationer borde verifieras med ett textmeddelande till ambulansen. Vidare visade resultatet att sjuksköterskorna kunde uppleva ensamhet med omvårdnadsansvaret för patienten.    Slutsatser: Vikten av att kunna arbeta ensam, ha handlingsberedskap i komplexa situationer och specialistkunskaper för att kunna göra korrekta bedömningar är av stor betydelse. Läkemedelsordinationer till sjuksköterskan ska verifieras genom att ordinerande läkare skickar ordinationen skriftligt via textmeddelande till ambulansen.

Objectives. The purpose of this study is to determine whether or not the mainstream reproductive rights organization Planned Parenthood of the Atlanta Area (PPAA) considered reproductive justice issues typically advocated for by non-traditional reproductive rights organizations. Methods. This research was a qualitative content analysis of discourse internal to PPAA (meeting minutes) and discourse communicated to the public externally via print media channels. Results. A total of 105 documents were analyzed as part of this study: 57 meeting minutes and 48 press clippings. The analysis revealed that, internally, PPAA did consider reproductive justice issues but that this was not directly communicated to the public via print media channels. Most noticeably, press characterizations of PPAA were slanted too heavily on the organization’s proliferation of population control as a goal and did not give enough consideration to its consideration of racial diversity.

Destination image is a concept created by different demand and supply agents. The balance between what is expected and what is being delivered is essential in promoting the destination. The main goal of this study is to describe the different destination images related to Dracula tourism in Transylvania. This is accomplished by looking at the Western tourists’ expectations and demands as expressed in their travel blogs, and by analyzing the supply side through the elicitation of information from locals and Bran Castle tour guides through qualitative interviews. Qualitative content analysis was used to analyze the content, visual and audio information on sampled blogs and interviews. This method identified 11 different themes which captured the overall destination image. The themes focused primarily on historical and fictional images of the destination, on the type of tourists visiting Bran Castle, but also on the locals’ image and response to Dracula tourism. The findings of this study reveal that the majority of Western bloggers visit Bran in search for Count Dracula; however, the Bran Castle tour guides focus on presenting the historical truth. Local residents, although seeing Dracula as a national hero, sometimes adopt the mythical image as a marketing or product development tactic in selling to visitors. Nevertheless, the stakeholders involved in the creation of the image each fit into different destination image frameworks, allowing for the creation of an overall destination image based on historical and fictional elements.

Information exchange is an essential component for all involved in the paediatric care encounter. Despite this, most of the research about information exchange concerns adults and the significance of the child’s existence in the encounter have not been given sufficient attention. Therefore, the overall aims of this thesis were twofold. Firstly, the aim was to identify, describe and generate concepts in information exchange between minors, parents/guardians and health care professionals in paediatric care situations. Secondly, the intention was to formulate a theoretical construction, a theory, of the phenomenon of information exchange in paediatric care situations. This thesis is based on four studies. In studies I, II and III grounded theory was used according to Glaser and data have been analyzed using the constant comparative analysis method. Data have been collected through observations and medical records (I, II and III) and also with additional follow-up interviews (III). In study IV, at first a qualitative content analysis of Løgstrup’s ethical demand was conducted and, second, a simultaneous concept analysis of the findings from studies I, II and III and the findings from the qualitative content analysis was carried out. There were a total of 67 participants in the three observational studies: 28 minors (I), 24 parents/guardians (II) and 15 health care professionals (III), who exchanged information in different paediatric care encounters. The information exchange interaction process was resolved by the minors “balancing the circumstances” (I), the parents/guardians used “firm handling” (II) and the health care professionals were “sharing and contributing the responsibility” (III). The qualitative content analysis of Løgstrup’s ethical demand provided the mediation and the social norms. The simultaneous concept analysis finally gave the advanced outcome to intergrade, which means to merge gradually with another through a continuous series of intermediates. At the same time as we intergrade in paediatric care, we protect the totality of minors, recognize the dependency of the parents/guardians and the social interplay by the health care professionals, the information exchange is improved. This thesis emphasizes the importance of health care professionals’ communication skills and the need for education and practice in this topic, in order to improve the information exchange with minors and their parents/guardians from an ethical viewpoint. The theory intergrade explains how this could be applied and implemented.

The rise of ethical consumerism has contributed to that organisations increasingly include CSR policies in their business and marketing strategies. Consumers want to make more ethically based purchasing decisions, and are guided by organisations’ ethical claims and by product labels. However, there are many different ethical organisations and labels on the market today and consumers find it difficult to separate them and know what each of them stands for. Ethical consumerism stems from green consumerism and has contributed to the development and rise of the Fair Trade movement. The general idea of Fair Trade is to support producers in poor countries, and by purchasing Fair Trade products consumers can contribute to realising the Fair Trade objectives. Previous research has identified a gap between consumers’ attitudes and actual behaviour regarding Fair Trade consumption. Consumers clearly express a positive attitude towards the Fair Trade movement and Fair Trade products, but their attitudes are not reflected in actual purchases. Researchers suggest that the gap could depend on lack of information and proof that Fair Trade actually contribute to better working and living conditions of producers in poor countries, but this had not yet been investigated. Our main purpose with this degree project is to identify factors that could affect the attitude-behaviour gap, and more precisely how access to information affects the existing gap. Our conclusions and recommendations are providing valuable insights for Fair Trade and other ethical organisations and businesses that are part of ethical value chains. We therefore formulated the following research question: In what ways can Fair Trade certification organisations and retailers diminish consumers’ attitude-behaviour gap in Fair Trade consumption? In order to answer our research question, we formulated the following four sub-purposes; to investigate the dialogue between Fairtrade and consumers; to investigate how Fairtrade and retailers communicate and share information with each other; investigate retailers’ expected and perceived responsibility as part of the Fairtrade value chain; identify what factors consumers believe are important regarding Fairtrade and their Fairtrade consumption. Our study is delimited to Sweden and is based on content analysis of communication between Fairtrade Sweden, consumers and retailers, on Fairtrade Sweden's Facebook page. The study has both qualitative and quantitative characteristics, although focus is on qualitative data analysis. We collected a total number of 1671 posts and comments, where 357 were published by Fairtrade, 1215 by consumers and 99 by retailers and other businesses. All data were collected and categorised manually and copied into an excel sheet where each post and comment were coded. The analysis and discussion of our empirical findings are further based on theory within the fields of Fair Trade consumption, ethical and political consumerism, online communication, retail marketing and branding. The main findings from this research are that consumers view retailers as an important actor in the Fair Trade value chain. Consumers put high value in communication and cooperation between Fair Trade and retailers, but these two actors have not realised the advantages and opportunities of it. We have also observed that consumers seek to maximise utility and that the existing attitude-behaviour gap thereby is influenced by several factors. Branding and labelling within Fair Trade consumption are important for consumers' purchasing decisions. Although, we have observed that product brands that have the Fairtrade mark are perceived as more important than the Fairtrade brand itself. Consumers are loyal to brands and do not show a willingness to switch brands to buy a Fairtrade marked product. Moreover, Fair Trade consumption is influenced by other ethical and environmental concerns. Consumers want Fair Trade organisations to be ethical and also environmentally friendly at all stages and throughout the entire value chain.

Abstract Purpose. To identify symptoms/distress among patients with colorectal cancer, from the viewpoint of the next of kin, before and after chemotherapy, and to establish whether there are any barriers to reporting these.   Methods. Individual face-to-face interviews with fourteen next of kin were conducted. Qualitative content analysis was used to analyze the transcripts.  Results. Three areas were identified: symptoms presented, influences on life for the next of kin, and barriers to reporting symptoms/distress. Nine symptoms were raised as most common by the next of kin. All next of kin talked to a large extent about how the patient’s disease and treatment affected them. It affected them psychologically, they had to revaluate their life, and it influenced their social life. Almost all next of kin denied that they experienced any barriers to reporting symptoms/distress though they mentioned the lack of properly communication and lack of time. Conclusions. Although it was not the main purpose of the study, the next of kin raised concerns about the patient’s disease and treatment and how it influenced their life. They mentioned barriers to reporting symptoms, but not to a large extent. The symptoms reported before and during chemotherapy were similar to those found in other studies.

Det finns fyra hörnpelare för gott åldrande: social gemenskap, meningsfull sysselsättning och delaktighet, fysisk aktivitet samt goda matvanor. Syftet med föreliggande studie var att beskriva vad äldre individer upplever bidrar till den egna hälsan och välbefinnandet. Kvalitativa semistrukturerade intervjuer genomfördes med 15 personer över 75 år. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Tre kategorier framkom under det latenta temat ”känsla av att ha tillgång till och kontroll över resurser som gör det möjligt att leva ett fortsatt aktivt och meningsfullt liv som äldre”: ”leva i en bra fysisk miljö”, ”känsla av meningsfullhet” och ”känsla av oberoende”. Det var viktigt för informanterna att ha en bra bostad och en trivsam närmiljö. Meningsfullhet kom av social gemenskap och tillhörighet, meningsfulla aktiviteter och en positiv attityd och tro. Oberoende bestod av att vara frisk och att anpassa sina aktiviteter samt att ha god ekonomi och tillgång till transportmedel. Tillgång till och kontroll över dessa förutsättningar möjliggjorde att fortsätta leva ett aktivt och meningsfullt liv. Resultatet stämmer väl överens med tidigare forskning inom området. Det är viktigt att hälsofrämjande insatser kring äldres hälsa präglas av en helhetssyn och att samtliga behov hos äldre tillgodoses i största möjliga mån. Framtida forskning kan undersöka ämnet hos äldre med sämre självupplevd hälsa än i föreliggande studie. / There are four main factors contributing to good ageing: social community, meaningful occupation and participation, physical activity and good eating habits. The purpose of this study was to describe what elderly people experience contribute to their own health and well-being. Qualitative semi structured interviews were conducted with 15 people aged 75 or more. The interviews were analyzed with qualitative content analysis. Three main categories emerged under the latent theme of “feeling of having access to and control over resources making it possible to live a continued active and meaningful life as an elderly”: “living in a good physical environment”, “feeling of meaningfulness” and “feeling of independence”. It was important to the informants to have a good home and a nice neighbourhood. Meaningfulness came from social sense of community and belonging, meaningful activities and a positive attitude and faith. Independence consisted of feeling well and healthy and adapting activities as well as having a good economy and access to transportation. Access and control over these conditions made it possible to keep living an active and meaningful life. The result is in accordance to previous research within the area. It is important that health promoting efforts for the elderly has a comprehensive view and that all needs of the elderly are met as far as possible. Future research could investigate the subject in elderly with a lower self-perceived health.

Learning to care and first encounter to care patients for male nursing students introduce a unique set of dilemmas to the predominantly female nursing educational process. The purpose of this study was to describe the experience male nursing students learning to care and first encounter care patients in their first nursing practice. A purposive sampling of seven male nursing students were interviewed by internet interview and analyzed by Qualitative content analysis. The results show that the Thai male nursing student stairway to confidence in nursing they start with feelings of stressfulness, developing sensitiveness, developing co—operation and developing strategies to care and encounter with patient. The results also seem to include gender specific questions on how to handle dilemmas in the predominantly female nursing education. These may reflect facilitators and barriers of developing a caring mind among male nursing students. Implication for nursing education and practice are presented and discussed.  In the clinical practice, the method of teaching was important to encourage, but also to gain additional knowledge and support peer groups as a suitable learning environment.

Destination image is a concept created by different demand and supply agents. The balance between what is expected and what is being delivered is essential in promoting the destination. The main goal of this study is to describe the different destination images related to Dracula tourism in Transylvania. This is accomplished by looking at the Western tourists’ expectations and demands as expressed in their travel blogs, and by analyzing the supply side through the elicitation of information from locals and Bran Castle tour guides through qualitative interviews. Qualitative content analysis was used to analyze the content, visual and audio information on sampled blogs and interviews. This method identified 11 different themes which captured the overall destination image. The themes focused primarily on historical and fictional images of the destination, on the type of tourists visiting Bran Castle, but also on the locals’ image and response to Dracula tourism. The findings of this study reveal that the majority of Western bloggers visit Bran in search for Count Dracula; however, the Bran Castle tour guides focus on presenting the historical truth. Local residents, although seeing Dracula as a national hero, sometimes adopt the mythical image as a marketing or product development tactic in selling to visitors. Nevertheless, the stakeholders involved in the creation of the image each fit into different destination image frameworks, allowing for the creation of an overall destination image based on historical and fictional elements.

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