The purpose of this paper is to investigate and to analyse didactic considerations and decisions made by pre-school teachers in the context of a multi-cultural pedagogical environment. The basic theoretical perspective is social constructivism, but notions from Donald A. Schön and John Dewey's theories of thinking and reflection have also informed the study; even Hans Lorentz' definition of a multi-cultural pedagogical environment has been employed as an analytic tool. The empirical study consists of a qualitative field study at a pre-school, where participatory observation and a group interview have been used in order to collect data. Those who participated were teachers at the pre-school. The results of the study, when analysed in accordance with the method, shows mainly three things. First of all that the teachers at the pre-school, in their didactic considerations, make use of the following methods of knowledge formation: knowledge-in-practice, reflection-in-practice, reflection on practice, reflection on knowledge-in-practice, and reflection on reflection-in-practice. Secondly, that no reflection particularly on the learning conditions in a multi-cultural pedagogical environment takes place. Finally, that there is little time available for the teachers for reflection at all, either individually or collectively. A conclusion I draw from the study is that, if the teachers at pre-schools should be able to reflect consciously about their work, and to transform not consciously reflected thinking about it into consciously reflected thinking, it is necessary for them to resort to explicit and focused conversations with one another. A further conclusion is that lack of time for reflection among teachers at pre-schools renders difficult a conscious discussion among them about the multi-cultural pedagogical aspect of their work context. This means that, unless they are given the time they need they are bound to end up in a kind of dilemma: In order to fulfil their special mission they need to reflect on it, but there is no time for them to do so.

SAMMANFATTNING Enligt Socialstyrelsen finns det 70 stycken akutmottagningar i Sverige. Patientflödet ökar stadigt år för år till akutmottagningarna. Åtgärder för att effektivisera vården och minska ledtiderna samtidigt som patientsäkerheten säkerställs har påbörjats. Bland de åtgärder som införts berör utveckling av sjuksköterskearbetet. Däribland införandet av behandlingssjuksköterskor på akutmottagningen, vilka utför enklare bedömningar och behandlingar på patienter äldre än 14 år med skador på bland annat nedre extremiteter. Utvecklingen av sjuksköterskors arbete har sedan länge pågått i andra länder så som USA, Storbritannien och Australien. I dessa länder har begreppet Nurse Practitioner etablerats. Syftet var att beskriva patienters upplevelse av att tas emot och behandlas av en behandlingssjuksköterska på sjuksköterskemottagning ansluten till en akutmottagning. Eftersom syftet med studien var att beskriva patienters upplevelse av att bedömas och behandlas av en behandlingssjuksköterska har studien en kvalitativ ansats. Semistrukturerade intervjuer genomfördes med sammanlagt sju stycken informanter. Intervjuerna transkriberades efter genomförande och analyserades enligt innehållsanalys alltefter Graneheim och Lundman. Resultatet av analysen gav två teman. De tema som analyserades fram var upplevelse av snabb bedömning och upplevelse av tillit till sjuksköterskans behandlande kunskaper. Varje tema delades vidare in i fyra kategorier. De fyra kategorierna var: upplevelse av effektiv vård, upplevelse av att vara med om något nytt, upplevelse av sjuksköterskans kompetens samt upplevelse av tillit. I denna studie har patienters upplevelser av att behandlas av en behandlingssjuksköterska beskrivits av sju stycken informanter. Resultaten som framkommit i studien kan tenderar att påvisa att patienter har övervägande positiva upplevelser av att behandlas av en behandlingssjuksköterska. Informanterna upplever att bedömningen och behandlingen som de erhöll på sjuksköterskemottagningen var snabb. De upplevde att behandlingen var effektiv då väntetiderna var komprimerade. Resultaten kan även tolkas som att informanterna upplevde tillit till behandlingssjuksköterskans behandlande kunskaper.

Nurse practitioners (NPs) have been undergoing a rapid transition in their entry-level degree, from Master of Science in Nursing (MSN) to Doctor of Nursing Practice (DNP). At this time, it is important to establish research evidence on the effects of doctoral education on NP practice. Therefore, a qualitative study of practicing NPs that have returned for the DNP degree was conducted. The purpose was to describe NPs' perceptions of their DNP education, and particularly its influence on their professionalism and patient care. A literature review and evidence synthesis process showed that the available body of research provides little insight into the question of how DNP education affects NP practice; therefore, qualitative description methodology was used to describe this phenomenon. The research questions that guided the study were: 1) What changes do practicing NPs describe about their clinical practice after the experience of completing a DNP?; and, 2) What are the NPs' perceptions of and concerns about the influences of their DNP educational experience on their clinical practice? Two published models and the DNP Essentials (AACN, 2006) informed and guided the data collection and analysis process. Purposive sampling and analyses continued concurrently until data saturation was achieved. Ten DNP prepared NPs were interviewed, and there was wide variation in the sample. The overarching theme Growth into DNP Practice summarizes the participants' perceptions of the changes that have occurred as a result of their DNP educational experience. Four major themes that support the overarching theme are: (a) Broader Thinking and Work Focus; (b) New Knowledge and Interests; (c) New Opportunities; and, (d) "Doctor" Title an Asset. Conceptual categories under each major theme are described. Participants were overwhelmingly positive about the influences of their DNP education on their practice, but the role of the DNP graduate in knowledge translation has yet to be fully operationalized.

This research is a four-step process. 1) Development of the Park, Recreation and Tourism (PRT) Planning Web site to meet the needs of rural communities, indicated through the Texas Community Futures Forum needs assessment process. 2) Evaluation of the PRT Planning Web site by experts in the field of PRT Sciences. 3) Inspect differences in the information needs and use between rural and urban PRT practitioners. 4) Examine factors contributing to the flow experience while utilizing the PRT Planning Web site. Evaluation information provided insight about strengths, weakness and modifications to be made to the PRT Planning site. Programming was reported as the service provided most by survey participants. Internet information is considered the most effective information resource, with suppliers/manufacturers and libraries being the least effective. When acquiring information on developing and providing PRT services, not knowing where to find information was the problem experienced most, while not understanding the information was the problem encountered the least. Marketing information was deemed the most useful type of information, and increasing community well being is the most important service benefit provided by respondents. No significant differences were reported between groups' perception of Internet information as the most effective information resource, intent to return to the PRT Planning Web site, or education levels. Significant differences were reported between groups' Internet connection speed, use of a dial-up modem, computer experience and Internet experience. Study findings also reported less computer and Internet experience for rural and small communities when compared to large and urban communities. In Skadberg's (2002) proposed model of flow in human-computer interaction, the factors that contribute to the flow experience are, experience, ease of use, response speed, interactivity, vividness, telepresence, knowledge of the information being presented, and challenge of the information being presented. Of these factors, experience was the only variable that did not show a significant or positive relationship with factors in the flow model. Increased learning and change in attitude and behavior are considered outcomes of achieving the flow state; both reflected a positive and significant relationship with the variable flow.

At the time of this study (2009) the role of the nurse practitioner (NP) was new to the province of British Columbia (BC). The provincial government gave the responsibility for implementing the role to health authorities. Managers of health authorities, many of whom were unfamiliar with the role, were responsible for identifying the need for the NP role, determining how the NP would function, and gaining team members’ acceptance for the new role. The purpose of the study was to explain the process of NP role implementation as it was occurring and to identify factors that could enhance the implementation process. An explanatory, single case study with embedded units of analysis was used. Three primary health care (PHC) settings in one health authority in BC were purposively selected. Data sources included semi-structured interviews with participants (n=16) and key documents. Propositions and a conceptual framework developed from the review of the literature guided the study. Key components of the framework were the concepts of intention, involvement and acceptance. The results demonstrate the complexity of implementing the NP role in settings unfamiliar with it. The findings suggest that early in the implementation process and after the NP was hired, team members needed to clarify intentions for the role and they looked to senior health authority managers for assistance. Acceptance of the NP was facilitated by team members’ prior knowledge of either the role or the individual NP. Community health care providers needed to be involved in the implementation process and their acceptance developed as they gained knowledge and understanding of the role. Although relatively new in their roles, NPs were enacting, to some degree, all competencies of the role, as defined by College of Registered Nurses of BC. The findings suggest that the interconnectedness of the concepts of intention, involvement and acceptance influences the implementation process and how the NP is able to function in the setting. Without any one of the three concepts not only is implementation difficult, but it is also challenging for the NP to fulfill role expectations. Implications for research, policy, practice and education are discussed. / case study research

Appreciative Inquiry (AI) has gained increasing popularity as a form of organisation development and action research worldwide, yet little research has been published outside of the USA and Canada. This thesis explores the application and evaluation of Appreciative Inquiry (AI) in the unique context of New Zealand through the perspectives of facilitators of AI. I conducted semi-structured, in-depth interviews with nine experienced AI facilitators in order to understand their perspectives on how AI works, under which circumstances it is most effective and how they evaluate AI. Facilitators tend to come from backgrounds that embrace humanistic values, a premise shared by AI. Participants in this study regard the underlying principles of AI as central, whereas they consider concrete processes, such as the 4D-cycle, to be useful but not essential. Facilitators are very concerned about the appropriate use of AI and clearly identified circumstances supportive or detrimental to AI processes. For example, AI may be inappropriate in situations where there is a pre-determined agenda or leadership is very autocratic. Facilitators are also concerned that AI as a methodology should be applied more wholesomely, acknowledging and working through negative emotions rather than suppressing them. Facilitators face a paradox: They embrace values that put the individual centre stage and regard people as human beings rather than human resources. At the same time, they are external service providers to clients who are at times more concerned with quick fixes, and do not want to invest the time necessary to engage in deep reflection on values and transformative change. Findings suggest that we need to reconsider our interpretation of AI towards embracing the underlying humanistic values more, rather than focusing on the concrete applications (e.g. 4D-cycle). The paradox between embracing humanistic values inherent in AI and bottom-line orientation in most organisations warrants further research.

In this thesis I claim that dominant realist, interpretive and postmodern research methodologies, taken together, provide necessary but not sufficient tools for use within educational research. Understandings of material, social and linguistic worlds do not, in themselves, cater for teachers' pragmatic needs to consider (a) the social consequences of educational practices, both their own and those of the institutions within which they work, and (b) the complexity of teaching in a postmodern world. I draw on ideas from pragmatism, post-structuralism, critical pedagogy, complexity theory, reflective practice, and personal experience in order to invite the emergence (or social construction) of new phenomena: these I hope, may enable teachers and other educationalists to take a vibrant part in ongoing debates and actions concerning educational policy and practice. I argue that the assumption that educational theory can be applied in practice is flawed and needs to be replaced by theory which recognises the dynamic nature of theory-in-practice: all theory is data within practice. This is a late-career thesis written by a practitioner with an unusually broad experience of the New Zealand educational system. I argue that the purpose of theory is to guide practice, that practice must drive theory, and that theory and practice need to join together to focus on the consequences of planned actions. This is neo-pragmatism, but, as stated thus far, it is not enough for my purposes because it does not include a commitment to social justice. Praxis is a term which ties emancipatory political goals to theory-and-practice. I invite the construction of the understandings of praxitioner activities where collective praxis and individual praxis might co-emerge in the interests of social justice. I promote the expansion of fresh discourses through research into collective praxis within teaching and teacher education.

På senare tid har fråga om jäv vid konkursförvaltaruppdrag uppkommit i samband med flera större konkurser. Konkursförvaltarnas uppgifter blir allt mer avancerade och idag tar förvaltarna många viktiga beslut i sin förvaltning. Det är givetvis väldigt viktigt att en konkursförvaltare är oberoende vid sin handläggning av en konkurs. Att någon i en maktposition med behörighet att ta beslut som kan påverka någon annan negativt om den i maktpositionen är jävig strider mot grundregeln för en objektiv och opartisk rättsskipning. Det stipuleras i lag att en konkursförvaltare inte får anta ett förvaltaruppdrag om han står i ett sådant förhållande till gäldenären, en borgenär eller någon annan att det är ägnat att rubba förtroendet för hans opartiskhet i konkursen. Utöver regleringen i lagen finns rekommendationer om god förvaltarsed. Oaktat bestämmelserna antar vissa konkursförvaltare uppdrag trots att en beaktansvärd risk för jäv föreligger. Systemet bygger på självgranskning och någon strängare påföljd saknas. Konkursförvaltarna följer inte alltid rekommendationerna, utseendeprocessen av förvaltarna är oreglerad och systemet med att en person kan föreslå en förvaltare leder ofta till att en osund relation uppstår. I förarbeten, utredningar och artiklar har jävsproblematiken diskuterats och det har under åren givits alternativ på förbättringar av systemet. Förslag som har uppkommit har exempelvis varit att en auktorisation av konkursförvaltarna ska införas, att en ny tillsynsmyndighet ska inrättas och/eller att en ny lag för konkursförvaltarna ska konstrueras. Genom införandet av en auktorisation skulle utseendeprocessen för det första bli reglerad samt skulle kunskapsnivån för förvaltarna förbättras och lättare kunna upprätthållas. Dessutom skulle en konkursförvaltare om han missköter sitt uppdrag kunna fråntas sin auktorisation, med rätt att överklaga beslutet. En ny tillsynsmyndighet skulle innebära att en specialiserad myndighet infördes. Myndigheten skulle kunna handha auktorisationen, utseendet av förvaltarna samt utöva tillsyn över förvaltarna. Ett sådant system används idag för revisorerna, där det är Revisorsnämnden som auktoriserar och granskar revisorerna. Eftersom dagens reglering i frågan om konkursförvaltarjäv är undermålig är resultatet av uppsatsens utredning att en reform är nödvändig.

The formalized nurse practitioner (NP) role in British Columbia is relatively new with the majority of roles implemented in primary care. The majority of primary care is delivered by physicians using the fee-for-service model. There is a shortage of general practitioners (GP) and difficulties with recruitment and retention, particularly in rural and remote locations. The uptake of the primary care NP role has been slow with challenges in understanding the extent of its contributions. This study was to identify the impacts and outcomes associated with the NP role in collaborative primary care practice. Multiple case studies where NPs were embedded into rural fee-for-service practices were undertaken to determine the outcomes at the practitioner, practice, community, and health services levels. Interviews, documents, and before and after data, were utilized to identify changes in practise, access, and acute care service utilization. The results showed that NPs affected how care was delivered, particularly through the additional time afforded each patient visit, the development of a team approach with interprofessional collaboration, and a change in style of practise from solo to group practise. This resulted in improved physician job satisfaction. Patient access to the practice improved with increased availability of appointments and practice staff experienced improved workplace relationships and satisfaction. At the community level, access to primary care improved for harder to serve populations and new linkages developed between the practice and their community. The acute care services experienced a statistically significant decrease in emergency use and admissions to hospital (p= .000). The presence of the NP improved their physician colleagues desire to remain in their current work environment. This study identified the diversity of needs that can be addressed by the NP role; the importance of time to enhance patient care, and its associated benefits, especially in the fee-for-service model; the value of the NP’s role in the community; the acceptance of the clinical competence of NPs by their physician colleagues; the outcomes generated at the practice level in terms of organizational effectiveness and service provision; and substantiated the impact of the role in improving primary care access and reducing acute care utilization. / Graduate

This thesis investigates two intertwined themes. The first concerns the development of a framework for understanding, and making appropriate use of, simulations and games as tools for learning. The second concerns the utilisation of the term PractitionerResearcher to reflect the unity of practice and research activity in creating 'working knowledge' (Symes 2000). These themes are intertwined in the sense that the route I take to understanding simulations and games is through the stance of a PractitionerResearcher. Conversely the thesis aims to draw out what it means to be a PractitionerResearcher through my engagement as a facilitator of simulations and games. I argue that the knowledge I generate as a PractitionerResearcher is utilitarian and pragmatic. Grounded in my practice as an adult educator it utilises theoretical perspectives chosen for immediate relevance rather than because of any claims to 'truth' or permanence. Understanding how this shapes and influences my practice was a complex, difficult process. Using an auto-ethnographic approach, Chapter 1 outlines the development of my 'working knowledge' as a PractitionerResearcher. It draws on selected personal experiences in my work as an adult educator using simulations and games for teaching and learning. While curiosity about historical facts initiated the research reported in Chapter 2, the chapter focuses on uses of historical precedent for generating greater understanding, and acceptance by participants, of simulations and games as teaching/learning strategies. It identifies a range of contributions - from war games, religious games, and children's play - to the structuring of modern educational simulations and games. Chapter 3 explores approaches to classifying simulations and games. Its development brought a gradual realisation of the futility of trying to establish a single definitive categorisation system for all simulations and games. Understanding how they can be arranged in a variety of different relationships provides a better insight into their general features and helps in making decisions about when and how to use specific activities. One outcome of the work for this chapter was the realisation of some simulations as 'open and infinite' in nature, and that XB - simulation of importance in my practice - is such a simulation. Chapter 4 uses concepts developed in the field of chaos theory to illustrate how certain simulations create messy but 'chaordic' (Hock 2002) rather than dis-orderly learning contexts. 'Chaos/chaotic' once meant only dis-order, 'messiness' and unpredictability. Twentieth century scientific discoveries illustrate that order is concealed within 'chaos' producing richly complex patterns when viewed from the right perspective. I argue that 'chaos' concepts can be usefully applied to open and infinite simulations to demonstrate how they are similarly 'chaordic'. XB (for eXperience Based learning) is an open, infinite chaordic simulation, and has been a driving force in my practice for six years. The case study in Chapter 5 introduces the 'world according to XB' and takes the reader 'inside' participants' experiences as the unfolding nature of their learning is revealed in the way they apply theories of organisational behaviour to immediate behaviours. Chapter 6 reflects on my experiences of facilitating XB, via a review of interactions with some past XB participants. The influence of such a learning process on my practice is analysed. The emotional impact of these interactions has brought a better understanding of my own practice, and the chapter considers the concept of 'dispassionate reflexivity' as an aid for the facilitator in such contexts. Chapter 7 examines the evolution and distinctive features of the PractitionerResearcher in more detail. As an educator, a consistent focus of my work has been simultaneously 'to know more' and 'to be able to do better' - and it is the interdependence of these that lies at the heart of what it means to be a PractitionerResearcher. It is my hope that this thesis offers a solution for practitioners wanting to combine 'research' and 'practice' into a practical and scientifically rigorous 'whole'. For such professionals the PractitionerResearcher model offers an integrated approach, combining and validating 'learning in action' and 'learning for action'.