Background: Considerable attention has been paid to evaluating the roles and relationships of professionals participating in team-based or collaborative practice; however, less attention has been paid to exploring the patients’ views and impact of such practice despite claims of it being patient-centred. Objectives: To examine the relationship between patient and provider characteristics and patients’ ratings of measures of quality of care and integration, and to explore the patient views of care delivered in a patient-centred collaborative study involving chiropractors and physicians. Design: Cross-sectional survey. Method: A mixed methods sequential approach with a quantitative priority was used in data analysis. Quantitative data were collected from 2597 patients participating in a collaborative study involving chiropractors and physicians and 530 patients attending chiropractors not involved in collaborative care. All participants presented with musculoskeletal pain. The Primary Care Assessment Survey (PCAS) was modified and scores from six of its scales were used to assess attributes of quality patient-centred care between the two study groups. Qualitative transcript-based data from six purposefully selected focus groups was analyzed using an interpretivist approach. Results: The revised PCAS demonstrated acceptable psychometric properties. Patients in both study groups received quality, patient-centred care. Patients’ reporting being completely satisfied and feeling improved by their care was positively associated with rating chiropractors as high performers on all scales. Survey findings were confirmed in focus groups of study patients. Patients appreciated positive interpersonal interactions, sharing in the treatment decision-making process, having a choice in provider and treatment, and the provision of holistic care. Patients perceived that collaboration between chiropractors and physicians varied, favouring those who were co-located. Patients with chronic or co-morbid conditions desired greater involvement in their care. Patients felt sharing of clinical information was more important than co-location as facilitating coordination and integration of collaborative care. Conclusion: The study suggests that patients suffering from musculoskeletal pain benefit from interprofessional collaborative care that includes improved access to and choice of providers and treatment options, as well as enhanced interprofessional communication and coordination of care.

In this paper we elaborate on a framework, a set of guidelines, for teachers when designing project based courses. The emergent framework presented in this paper will focus on six themes: (1) overall course design, (2) project task, (3) project group, (4) examination, (5) feedback and (6) course evaluation and improvement and is initially grounded in theory and practice. The framework elaborated in this paper should support teachers' development of a professional autonomy within the norms of a professional group and an active curriculum.

Benämningen patient är ett kollektivt begrepp, som sätter sjukdomen och dess behandling i fokus. Hälso-och sjukvården har haft svårt att förändra sitt traditionella perspektiv där patienten betraktas längst ner i den hierarkiska sjukvårdsorganisationen. För att förändra det traditionella perspektivet så har ett nytt synsätt utformats där begreppet "patient" byts ut till "person". Personcentrerad vård började införas inom äldre- och demensvården, men tankar finns om att det även ska införas inom specialistvården. Syftet med studien var att utifrån litteraturen beskriva vad som kännetecknar personcentrerad vård ur ettomvårdnadsperspektiv. Studien genomfördes som en litteraturstudie och baserades på 13 vetenskapliga artiklar. Tre huvudgrupper kännetecknade personcentrerad vård; Att patientens livsvärld beaktas av sjuksköterskan, Att en ömsesidig vårdrelation skapas genom sjuksköterskan förhållningssätt och Att en gynnsam arbetsmiljö och vårdkultur skapas. Resultatet visade att personcentrad vård hade ett värde för patienten eftersom det leder till en maktförflyttning från sjuksköterskan till patienten. Sjuksköterskans förhållningssätt och attityd till yrkesrollen påverkar förmågan att utöva personcentrerad vård. Ombyggnation av lokaliteter och vårdmiljöer är betydelsefullt, men det mest centrala är att sjuksköterskan reflekterar, vågar utmana traditionellt rutinbeteende, föra patientens talan och att ledningen är positivt inställd till personcentrerad vård. Vidare forskning behövs om sambandet mellan personcentrerad vård och en effektivare vård med kortare vårdtider samt patientens upplevelse av delaktighet och tillfredställelse med vården. / The term patient is a collective term that sets the disease and its treatment in focus. Health care has had difficulties to change traditional ways of thinking in which the patient is classified at the bottom of the hierarchical medical care organization. In order to change traditional thinking a new approach has been designed where the term "patient" is changed to "person". Personcentred care is being brought into elderly and dementia care, but there are intentions also to integrate it in specialist care. The purpose of this study was that from literature describe the characteristics of personcentred care from the nursing perspective. The study was conducted as a literature study and was based on 13 scientific articles. The results showed what signifies personcentred care out of three main groups: patient's life-world observed by the nurse, a mutual care relationship is created by the nurse attitude and a favorable safety and health culture is created. Personcentred care makes a difference for the patient because it leads to a control transfer from the nurse to the patient. The nurses approach and attitude to the professional role affects the ability to practice personcentred care. Re-building of facilities and health care environment is important, but the most important is that the nurse reflects, dare to challenge the traditional routine behavior, speak for the patient and that the management is supportive to the personcentred care. Further research is needed whether personcentered care will lead to more efficient care with shorter hospital stays and if the patient feels more involved and satisfied with the quality of care.

The aim of this thesis is to explore design directions to minimize a food wastage problem in western domestic kitchens. Central to the thesis is an understanding of people&rsquo / s behavior towards the food waste phenomenon. Three interconnected studies and one design project are included. In Study I, 18 participants were interviewed to explore their perceptions and attitudes towards food waste, revealing the most wasted food types and reasons for food wastage. The findings of Study I are clustered under four phases of food handling: acquisition, preparation, consumption and storage. Study II comprised a generative session with three users and two designers, devised to explore latent and tacit knowledge regarding food wastage. Study II resulted in user-generated ideas for minimizing food waste, which were analyzed so as to reveal possible design directions. From these results, a set of criteria for a &lsquo / perfect&rsquo / kitchen appliance, which could minimize food waste, was drawn-up. The design project took the research findings of Study I and II and devised a collection of design concepts as possible ways to help reduce domestic food waste. Two concepts &ndash / Philips Dispense and Canvas - are taken further because they relate to the most wasted food types: &lsquo / bread&rsquo / and &lsquo / vegetables and fruits&rsquo / . In Study III, Philips Dispense and Canvas were evaluated with a questionnaire. According to the results, in households containing busy couples without children, Philips Dispense is valued highest (it takes the food waste responsibility away from users) whereas Philips Canvas was valued lower (it gives feedback on current stocks and persuades homeowners not to waste food).

<p>The purpose with this thesis was to study user activities in a business system, MediusFlow. The overall objective was to identify user related problems and to analyse which of the usability data gathering methods to use in the future development process of the company Medius.</p><p>The outcome of this study indicated that a cognitive related user problem was the most important problem to solve. A Star Life Cycle method was preferred. Two low-fidelity prototypes were developed to exemplify an alternative design solution to the identified cognitive user problem. Furthermore, the two best methods to use when gathering user related requirements were heuristic evaluation and expert review.</p><p>In addition a company specific Style Guide was created with generic guidelines as a foundation for development of future applications within Medius.</p>

Bakgrund: Användning av djur i vården har visat sig ge många positiva effekter på människan. Oavsett människors ålder och tillstånd kan djur bidra med att förbättra psykiska, fysiska och sociala funktioner. Bra bemötande, personcentrerat förhållningssätt och goda mellanmänskliga relationer krävs för att kunna ge god omsorg. Närhet och tillhörighet är en del av de grundläggande mänskliga behoven. Livskvalitet handlar om hur individen värderar sitt psykiska, fysiska och sociala välbefinnande och att förbättra livskvalitet kan ofta ses som målet med omvårdnaden. Syfte: Att beskriva hur djurassisterade interventioner påverkar hälsorelaterad livskvalitet hos vårdtagare. Metod: Deduktiv litteraturöversikt genomfördes med nio kvantitativa artiklar. I dataanalysen användes Fribergs trestegsmodell. Resultat: Det framkom sex domäner som ingick i hälsorelaterad livskvalitet: fysiskt, socialt, mentalt, emotionellt, aktivitet och funktion samt tillfredsställelse. Utöver domänerna framkom generell livskvalitet. Inget enhetligt resultat kunde påvisas inom de olika domänerna, dock sågs signifikant förbättring i den generella livskvaliteten i majoriteten av studierna. Signifikant förbättring var mest förekommande i den sociala domänen. Slutsats: Djur inom vården påverkar hälsorelaterad livskvalitet i varierande utsträckning hos olika vårdtagargrupper. Djur kan påverka vårdtagarnas livskvalitet positivt och är därmed lämpligt att använda som ett komplement i behandling och rehabilitering inom vården. / Background: The use of animals in healthcare has shown to give many positive effects on humans. Regardless of people’s age and conditions, animals can contribute to the improvement of mental, physical and social functioning. A positive attitude, a person-centred approach and good interpersonal relationships are needed to provide good care. Intimacy and belonging are a part of the basic human needs. Quality of life is about how individuals value their mental, physical and social well-being. To improve quality of life often can be seen as the goal of nursing. Purpose: To describe how animal-assisted interventions influence health related quality of life in patients. Method: Deductive literature review was conducted with nine quantitative articles. To analyze the data Friberg’s three-stage model was used. Results: Six domains emerged in the concept of health related quality of life: physical, social, mental, emotional, activity and function and satisfaction. In addition to the domains a general quality of life emerged. No homogenous results could be seen in the different domains; however, in the majority of the studies there was significant improvement in the general quality of life. The most significant improvement was seen in the social domain. Conclusion: Animals in healthcare have different levels of impact on health related quality of life in different patient groups. Animals may positively affect patient’s quality of life and it is therefore suitable for use as a supplement in treatment and rehabilitation in healthcare.

Computer users often suffer from poorly designed support systems that hinder them from performing their work efficiently and with satisfaction. The evidence is found in observations of users at work, interviews, evaluations of systems, and numerous reports of systems with poor usability that fail from start. Those who use the systems are proficient in their work, and those who develop systems are proficient in software engineering. These two groups have often little knowledge and understanding of each other’s worlds and their vocabularies are quite different. In systems development projects, users are often confronted with representations of their work that they hardly recognize. Systems designers compose these representations in an attempt to reduce the complexity of the work practices in a way that is appropriate for systems development. It is very difficult for users to appreciate the consequences fully on their future work situation from such representations, since they are removed from the social setting and often describe work in a fragmentized way. The unfamiliar view of their work may make the users less inclined to participate in the forthcoming design process. This thesis presents research performed to increase the usability of systems in working life and to explore conditions that facilitate the design of systems that really support the users work. The research comprises field studies in different work contexts, e.g. health care, dentistry, public service, and transportation. Information on the essentials of work has been gathered and analyzed to learn how such findings can be translated into systems design. Another goal has been to explore how to make the most of users’ experiences and skills to assure systems that better fit their work. Along with a growing awareness of the importance of user involvement in design, a participatory design process including the analysis and design of work has evolved.

Since the use of computers and IT systems has become an essential part of many people’s daily work, the quality of IT systems’ is becoming more important for efficient, healthy and sustainable work. It has often been argued that the full potential of a new, supportive IT system seldom is achieved, because – despite implementation of the new system - outdated work procedures are still being preserved. We can also see an increase in occupational health problems that are related to the use of poorly designed IT systems. This thesis addresses the questions of how to create a process for developing a sustainable, IT- supported work for the future and how to provide a solid foundation for the development of IT systems. What underlying perspectives should be applied and how can such a process be carried out in practice? Utilizing an action research approach inspired by participatory design methods, a user-centred seminar process called the Vision Seminar Process (VSP) has been developed to address these questions. Observations are presented from three cases in which the VSP has contributed to the organizations’ development and during which the Vision Seminar Process itself continued to evolve. The process provides a framework where practitioners and designers cooperate in the design of both sustainable work and usable IT systems. It is of central importance that a reflective in-depth analysis of users’ work practices is carried out, that their entire work situation and organization is questioned and discussed, and that the design process is carried out with a focus on healthy and sustainable work. Underlying perspectives that advocate a focus on a future work are essential for the successful implementation of the process, in that IT should be the engine that drives the development of work and creates the conditions for a healthy, sustainable work.

This thesis is about the recent education reform in Laos as a global and a local process. When the economy was deteriorating in Lao People’s Democratic Republic (PDR), the so called New Economic Mechanism (NEM) was introduced and the country opened up for global donors and markets. This also had an effect on the education system. To get hold of financial support there were demands on Lao PDR to replace the previous strong centralised governing of education with more decentralised strategies. There were further demands to replace teacher-led lessons and rote learning with more student-centred classroom practices. The research questions asked in this thesis are: How are education reform and the new methods of teaching governed in policy and through the formal education organisations from ministry level to school level? How do teachers and students in teacher education respond to the education reform and the new methods of teaching? What attention is put to gender and ethnic minorities in these matters? The thesis is inspired by Gita Steiner-Khamsi’s global perspectives on education reform; consensus, conflict and culturalist perspectives. It is also based on a local understanding taking its starting point in a pragmatic approach and a mosaic epistemology and a qualitative inductive methodological approach. The empirical findings are based on 36 documents that govern the education reform, 119 individual interviews with teachers and students in social science and science at teacher education, some observations and a contextual analysis of education, gender and ethnicity in Laos. The findings show that there is a consensus with the international community about bringing education to all people in Lao PDR. However, the political understanding is in conflict between neoliberal and socialist traditions. Democratic centralism is the foundation which built the governing system in Laos; information flows up through the system and decisions down. Even though the system leaves 20 percent autonomy to teachers to develop local curricula in line with the new methods of teaching, there are yet no major signs that such curricula exist. Teacher educators and teacher students understand new methods of teaching mainly as group learning and individual learning with only small variations between the two subjects. According to current policy the goal is to improve access to education for females and ethnic minority students. The ethnic minority students regarded individual studies as difficult because of language problems. They preferred group learning because they could be supported in language issues. Females also felt supported in group learning. However, because of old gender traditions especially females from the dominating Lao Loum group also found individual learning supportive. In individual learning females got opportunities to show individual capacities without being constrained by societal norms. The thesis ends up in a pragmatic tradition where possibilities and constraints with the education reform in Lao PDR are commented on.

This thesis considers how statistics about adult literacy have produced a new transnational norm of what it means to “be literate” and asks what has been produced by demarcating a calculable threshold of capable literate conduct. Analyzing literacy as a form of conduct enables investigation of the political dimensions of governmental interest in literate conduct and consideration of what subjects, relationships and forms of power are produced by various problematizations. Genealogical analysis of the currently dominant governing rationality, what is termed the psychometrological regime, revealed that Level Three of the International Adult Literacy Survey (IALS) has been constructed as a threshold between people who can act as autonomous, entrepreneurial subjects and those who cannot. In the case of Ontario, this threshold becomes an indicator of “employability” and produces a singular and problematic population who are subjected to coercive educational interventions. Tactics and techniques in the province’s Literacy and Basic Skills (LBS) policy construct literacy programs as sites responsible for transforming subjects below the threshold into human capital assets; this represents a significant departure from the original mission of community-based agencies. Data from interviews with educators in these programs indicate that adult literacy workers occupy an uneasy position between the demands of policy, their pastoral relationships with learners, and the complex realities faced by adults who struggle with print. While these educators may choose to disobey some policy imperatives they nonetheless act, at times unwittingly, as agents of governance. By highlighting the impossibilities produced by the neoliberal problematization of literacy, and the negotiations that literacy workers perform in the face of such dilemmas, this research contributes to thinking through how to transform coercive and authoritarian tendencies currently governing literate conduct.