<p><strong>Background.</strong></p><p><strong>Telephone advice increases the accessibility to health care and the streamlined work at primary health care centres. The goal of telephone advice nursing is to give the caller a correct advice, adapted to the caller’s situation, in order to reach correct care level. However, registered nurse’s telephone advice includes risks for misjudgement. </strong></p><p><strong>Aim.</strong></p><p><strong>The aim was to describe the view of registered nurse’s telephone advice at primary health care centres and call canters. The issues were if registered nurse perceived difficulties in their telephone advice and in that case, which the difficulties are. </strong></p><p><strong>Method.</strong></p><p><strong>A literature study was used, with systematic search in Cinahl and Pubmed, and also a manual search. In total 13 articles were included in this study. Content analysis was used. </strong></p><p><strong>Results.</strong></p><p><strong>Registered nurse’s had difficulties in telephone advice in following areas: computerized decision aids, non-visual communication, third-part communication, limited resources, the registered nurse's vulnerability, genus and ethnicity, and also ethical questions. </strong></p><p><strong>Conclusion.</strong></p><p><strong>Registered nurses perceive difficulties in telephone advice. Registered nurses should take part in the development of computerized decision support and receive continuous training in communication skills. Registered nurse’s telephone advice should be facilitated by the existence of an open climate at the workplace, to discuss and to reflect on difficulties in telephone advice. </strong></p><p><strong><p>Keywords.</p>Perception, telenursing, telephone consultation, literature review. </strong></p> / <p><strong><p>Bakgrund.</p>Telefonrådgivning ökar tillgängligheten till sjukvården och effektiviserar vårdcentralernas arbete. Målet med telefonrådgivning är att ge rådsökande rätt råd, anpassade efter dennes unika situation för att rådsökande ska nå rätt vårdnivå. Men sjuksköterskans telefonrådgivning innefattar risker för felbedömningar. <strong><p>Syfte.</p>Syftet var att beskriva sjuksköterskan syn på sin telefonrådgivning vid vårdcentraler och sjukvårdsrådgivningar. Frågeställningar var om sjuksköterskan uppfattar svårigheter i sin telefonrådgivning och i så fall vilka svårigheterna var. <strong><p>Metod.</p>En litteraturstudie med systematisk sökning i Cinahl och Pubmed samt manuell sökning. Sökningen resulterade i totalt 13 vetenskapliga artiklar, vilka analyserade enligt innehållsanalys. <strong><p>Resultat.</p>Sjuksköterskans hade svårigheter i telefonrådgivning inom följande områden: datoriserat beslutstöd, icke-visuell kommunikation, uppgifter i andrahand, begränsade resurser, sjuksköterskans utsatthet, genus och etnicitet samt etiska frågor. <strong><p>Slutsats:</p>Sjuksköterskans uppfattar svårigheter i telefonrådgivning. Sjuksköterskorna bör vara med att utveckla det datoriserade beslutstödet och få fortlöpande utbildning i kommunikationsfärdigheter. Sjuksköterskans telefonrådgivning bör underlättas av att det råder ett öppet klimat på arbetsplatsen för att diskutera och reflektera de svårigheter som finns med telefonrådgivning. <strong><p>Nyckelord.</p>Svårigheter, sjuksköterskor, telefonrådgivning, litteraturstudie. </strong></strong></strong></strong></strong></strong></p>

Background Patients’ preferences, needs and desires are important when discussing treatment. In consultations between patients with atrial fibrillation (AF) and health professionals, knowledge, understanding and insight about communication patterns are of vital importance for strengthening patient involvement in decision-making about their care and treatment. Aim The general aim of this thesis was to describe communication patterns in consultations between patients with AF and health professionals. Specific aims (1) To describe (i) the topics patients with AF and their nurses and physicians discuss; (ii) the use of discursive space in consultations between these participants; and (iii) the frequencies with which patients and nurses/physicians introduce the identified topics. (2) To describe the types of patient resistance to accepting treatment with warfarin and how cardiologists respond to such resistance. Methods An inductive design was used. In study I, the sample consisted of 23 consultations between patients with AF (13 women and 10 men) and health professionals (5 women and 5 men) who were employed in six different cardiologic outpatient clinics. Content analysis was used to obtain a description of topics discussed. The patterns of dominance for the various topics and participant were explored from the framework of an analysis of dominance (I). In study II, the sample consisted of 11 consultations between patients with AF (7 women and 4 men) and cardiologists (2 women and 3 men). Conversation analysis was used to describe interactions concerning resistance to treatment with warfarin. Findings Study I. Four topics were introduced by both nurses and physicians during the consultations. These were “pathophysiology”, “treatment”, “diagnostic procedures”, and “activity”. In the nurse–patient consultations an additional topic, “routines related to the physician’s responsibilities”, emerged. With respect to the number of words and turns, the distribution of the discourse space was almost equal between nurses and patients, and unequal between physicians and patients. The patients were the dominant initiators of the topic “activity”, which refers to adaptation of activities in daily life in relation to AF. Study II. There were four types of patient resistance to accepting treatment with warfarin. These included “Giving reasons for their resistance”, “Suggesting other treatment options”, “Stating treatment preferences” and “Questioning or challenging the cardiologist’s treatment recommendations”. The cardiologists’ responses to the patients’ resistance included “Repeating the treatment recommendation”, “Negotiation with the patient”, “Providing additional information about the recommended treatment” and “Extending their explanation of the purpose of the treatment”. Conclusions The medical-driven agenda dominated over the patient-driven agenda in consultations between health care professionals and patients with AF. During conversations in consultations with nurses, the patients initiated discussion of living with AF and were more talkative than they were with physicians. An awareness of types of patient resistance to treatment would enable cardiologists to consider patients’ experience-based views about their treatment;

The secessionist conflict in Transdniestrian region of the Republic of Moldova have led to more than a decade of political dialogueon finding a peaceful solution to conflict resolution, proving that the current format of negotiations is inefficient. The increased interest of the EU in the resolution of this conflict is caused by prospective inclusion of Romania in the EU, placing the Transdniestrian conflict at EU periphery, where confrontation is contrary to the all-European orientation at stability and integration. Presumably the involvement of the EU could lead to finding a political solution to the Transdniestrian conflict. Thus, the purpose of this research is to explore how EU involvement in the Transdniestrian conflict could lead to its prospective resolution. The results of this research, in form of conclusions and recommendations, depict that a more active involvement of the EU in Transdniestrian conflict resolution, as consulter and mediator, make it feasible to find a solution to the long-lasting disputes in the Republic of Moldova.

<p>This study is aimed at empirically examining health seeking behaviours in terms of illness response on household level at South Africa using 2007 General Household Survey and other<br /> relevant secondary sources. It provides an assessment of health seeking behaviours at the household level using individuals as unit of analysis by exploring the type of health care provider sought, the reason for delay in health seeking and the cause for not consulting. This study also assesses the extent of dissatisfaction among households using medical centres and this factor in health care utilisation is considered as the main reason for not consulting health care services. All the demographic and health seeking variables utilised in this study are controlled for medical aid cover because it is a critical variable in health care seeking. Therefore this study makes distinction on illness reporting and they type of health care consulted by medical aid holders and non medical aid holders. Statistical analyses are conducted to explore and predict the way in which demographic variables and socio economic variables affect health care seeking behaviours.</p>

ABSTRACT ACCEPTABILITY, INTEGRITY AND PERCEIVED EFFECTIVENESS OF KINDER TRAINING by Natalya A. Edwards There has been limited research on the effectiveness of kinder training, but those studies that have been conducted show promising results. The majority of past kinder training studies utilized quantitative methods. The current study implemented a qualitative approach to examining the acceptability, integrity and perceived effectiveness of kinder training. The researchers explored the perceptions that a group of elementary school teachers had of the content and process of kinder training, including its impact on teaching beliefs and practices, student behavior, the teacher-child relationship, and classroom management skills. Findings indicated acceptability related to the content and structure of the kinder training model for all teacher participants. The researchers also examined the degree to which participants implemented the kinder training language and skills as originally taught. The results suggested moderate integrity based on the observations of the Principal Investigator. Additionally, the teachers reported an enhanced teacher-child relationship, improved student behavior and improved classroom management skills. Implications for research and practice, as well as the limitations of the study are discussed.

In a mineral development scenario, Aboriginal groups rely heavily on Environmental Assessment (EA) and Impact and Benefit Agreements (IBAs) to address their interests and concerns. While EA and IBAs are separate processes – EA is legislated and informed by the Crown, and IBAs operate in the realm of private contract law – together, the two are ostensibly part of a parallel process that connect the Aboriginal group(s), Government and the mining proponent. Indisputably, IBAs support a more inclusive development based on consultation, partnership and participation. IBAs and EA have the potential to enhance Aboriginal involvement in mineral development and positively influence the design and planning of the mine. This thesis examines the Tahltan Nation’s involvement and participation in the Galore Creek Project in British Columbia, and demonstrates the challenges and opportunities that arose during the EA and IBA process. It uses key informant interviews to gain multiple perspectives – from the proponent, Tahltan, and Government, to understand how the Tahltan utilized the EA and IBA to participate in the mineral development.

No description available.

La médecine homéopathique fait partie de ce que certains auteurs nomment maintenant « les systèmes complexes » propres aux médecines non conventionnelles (MNC). Ces médecines ne s'inscrivent pas de la même manière que les médecines alternatives et complémentaires (MAC) dans la réalité médicale ou sociale. Certaines recherches sociologiques ont été faites à propos des MNC ou des MAC, toutes thérapies confondues, mais très peu exclusivement sur la médecine homéopathique. L'homéopathie est à la fois, la plus controversée des MNC et la plus utilisée dans le monde. Comme dans la plupart des sociétés occidentales, le recours à la consultation en médecine homéopathique est en croissance constante, mais n'a pas chez nous de légitimité juridique. Dans ce contexte social, comment les gens arrivent-ils à consulter un homéopathe et pour quelles raisons ? Pourquoi adoptent-ils par la suite, cette pratique de santé? Quel en est l'impact médical et social sur leur santé à long terme et dans leur vie? Pour répondre à ces questions il est nécessaire de considérer d'abord le paradigme holiste selon lequel la médecine homéopathique aborde la santé, la maladie et les soins de santé. Ensuite, il convient de tenir compte de la façon dont l'homéopathe s'adresse à la personne qui consulte en l'envisageant comme un sujet actif, savant et compétant. Cette recherche, prenant la perspective du constructivisme social féministe et se servant de l'analyse thématique descriptive, présente le résultat de l'étude d'entrevues menées auprès de mères québécoises qui ont consulté un ou une homéopathe pour elles-mêmes et leurs enfants. En redonnant la place à leur discours et à leur expertise, ces femmes nous révèlent la complexe démarche qui les a conduites à la consultation en médecine homéopathique, les transformations qui s'y sont opérées à travers un empowerment et leur perception sur l'efficacité sans équivoque de cette médecine face à leurs divers problèmes de santé. Cette étude dévoile ainsi la singularité de la consultation homéopathique comme espace social unique, laquelle autorise un partage des savoirs, un apprentissage incomparable sur le couple santé-maladie et pourrait représenter une solution à long terme pour les besoins de santé d'une population. ______________________________________________________________________________ MOTS-CLÉS DE L’AUTEUR : Santé, Médecine homéopathique, Efficacité, Sociologie, Pratique de santé, Mères, Constructivisme social féministe, Consultation médicale.

The Nursing Coordinators (NCs) at the University of Ottawa Heart Institute (UOHI) fields phone calls from patients who have been discharged and are undergoing home care procedures at a daily basis. The project described in this thesis aims to provide tools for the Personal Digital Assistant (PDA) that the NCs can use during the phone calls. The Cognitive Work Analysis (CWA) and Ecological Interface Design (EID) approach are used to identify the information requirements to design the system. Major challenges of the telephone consultation process that are additionally identified by literature review and interviewing the NCs included visibility of patients, individual differences, and lack of standardized procedures. A combination of decision trees and visualization techniques is proposed to aid the process. Implementation of decision trees would help unload mental workload especially accesses to "knowledge in the head" as well as facilitate expert knowledge transfer to less experienced nurses. Visualization tools display integration of multiple-cues from patients in an abstract nature and can be accessed by users at any point of decision process. <br /><br /> Preliminary experiment with static images showed that visualization tools helped the decision makers more when the judgement tasks were more complex. The effects of different types of decision support on the cardiac nurses in simulated telephone consultation processes were examined. The system improved the performance of the decision makers and induced different types of strategic behaviours: a standardized checklist, OLDCAR, induced more through assessment, the decision algorithms induced efficient and more detailed recommendation, and the semantic network symptom map induced information gathering more relevant to diagnosis. <br /><br /> The research also explored methodologies to examine multi-layered decision process, where many decision makers with varying expertise are involved in modeling the strategic behaviours. This type of process can be applicable when the primary decision makers do not monitor the work domain, but can be alerted when something goes wrong.

Advances in information and communication technology and the ready availability of Global Positioning Systems (GPS) have made it possible for citizens to create information on the internet expressing their personal perceptions in the form of pictures, videos and text narratives associated with geographic locations. The term Volunteered Geographic information (VGI) was coined to describe the processes whereby non-professionals or “citizen scientists” participate directly in spatial data creation, editing and shared use. VGI offers promise as an innovative way for members of the public to participate directly in the use, production and sharing of spatial information that is relevant to issues of personal or community concern and as a means of addressing some of the issues associated with traditional public participation methods. Planners can find meaning in the heterogeneous, time-sensitive, geo-social geographic information created by citizen volunteers in a bottom-up participation process where planners give up some control over what data is collected and from whom. However, uncertainties associated with volunteered geographic information include relevance, credibility, representativeness and quality of the geographic information. This thesis investigates the opportunities and barriers to the use of volunteered geographic information as public participation in planning. A framework and methodology for collaborative quality control of VGI through multi-criteria subjective relevance ratings of the VGI by its producers and users is put forward in this thesis. The relevance rating framework for quality control of VGI is based on the use of relevance in information retrieval in information science to improve the relevance of search engine results. This concept is transferred to the quality control of VGI contributions to determine the best VGI contributions to be used in planning as public participation. A VGI web application prototype, including the subjective relevance rating system, was created and a methodology and demonstration of its use for public participation was presented.