<p>Syftet med studien är att utifrån lärandet och de förändringar som hittills skett i styrkortsarbetet beskriva och analysera hur Locum håller sitt balanserade styrkort levande. Forskare inom styrkortsområdet framhåller att styrkorten kontinuerligt måste</p><p>uppdateras för att kunna spegla företagets situation. Lärandet anses vara en förutsättning för förändring, därför inriktas studien på hur förändring och lärande i företaget håller det</p><p>balanserade styrkortet levande. I den teoretiska referensramen har en cirkelrutin för förnyelse av det balanserade styrkortet tagits fram utifrån befintlig teori inom området. Den kvalitativa studien omfattar datainsamling i form av interna dokument,</p><p>årsredovisningar och fyra semi-strukturerade intervjuer med medarbetare på olika nivåer i Locums organisation. Av studien har framkommit att aktivt involverande av medarbetare på alla nivåer i organisationen utgör grunden för att hålla styrkortet levande genom lärande. Locum har på det viset lyckats med sitt styrkortsarbete. Studien har även visat på att Locums styrkortsarbete är i linje med svensk forskning som pekar på vikten av att involvera medarbetare.</p> / <p>Title: Keeping the balanced scorecard alive: case</p><p>study in Locum</p><p>Authors: Katja Broxvall, Anders Galmén, Susanna Oktay</p><p>Key words: Balanced scorecard, change, renewal, circle routine, organizational learning</p><p>Purpose: The purpose of the case study is to find out how the company keeps its balanced scorecard up to date. We do this by studying change and learning occurred so far in Locum in relation to the renewal of the balanced scorecard.</p><p>Methodology: We have used a qualitative method based on</p><p>semi-structured interviews.</p><p>Theoretical perspectives: To understand the background and</p><p>prerequisites for renewal we have built up a theoretical framework consisting of theories concerning: Regular routines for maintenance and development of the balanced scorecard,</p><p>learning organizations through Senges five disciplines, single- and double loop learning, theory of action and theories on change and resistance to change. These theories have been summarized to a framework for analysis.</p><p>Empirical foundations: The study is based on data which we have received through internal documents, annual reports and four interviews with employees of the studied organization. By analyzing this data we have reached a conclusion.</p><p>Conclusion: An active involvement of employees throughout</p><p>the organization is the foundation for keeping the balanced scorecard alive. Learning is achieved by this involvement.</p>

<p>Based on the interlanguage hypothesis and with reference to skill learning and central concepts of connectionist language-acquisition theory, this study develops an explanatory model, with the help of which untutored acquisition of grammatical gender in German is shown to be a sequence of meta-individual developmental phases. The empirical evidence consists of linguistic data compiled from interviews with Italian, Portuguese, and Spanish foreign workers carried out within the framework of the ZISA- Cross-Sectional Study. </p><p>The acquisition process is promoted by a combination of two cognitive procedures, one analytic (restructuring) and the other reproductive (automation). Both contribute to the construction of a network of associative <i>form-function mappings</i> which, in the course of the process, assume the character of prefabricated linguistic elements or chunks, thus enabling automatic processing. Accordingly, the gender of a noun is not acquired separately as such, but rather as an integral component of an automatic form-function mapping. </p><p><i>Formula</i> and <i>routine</i> are central concepts. They denote the norm-language (formula) and interlanguage (routine) chunks used by the learner and thereby the subsumed forms of the respective determiners, that is, gender markers. Their creation and substitution, as well as the sequence of their acquisition, are described and elucidated by means of cognitive mechanisms and psycholinguistic principles. </p><p>For the interlanguage routine in particular, but to some extent for the norm-language formula as well, it was possible to confirm the fundamental concept of the interlanguage hypotheses, according to which the learner sets up provisional hypotheses about the perceived elements and gradually approaches the form of the target language, albeit with the assistance of a concept of language acquisition that does not primarily center on any rule-defined morphology of the target language but rather on the phonetic surface-level form of concrete linguistic communication. </p><p>Against this background some key concepts of previous language-acquisition research, such as <i>explicit/implicit, rules, chunks, simplification, omission, </i>and<i> over-generalization</i>, are discussed and partially reassessed.</p>

<p>The aim of the study was to describe immunization coverage for DPT, Polio and Measles among children of ages between 12 to 18 months in Kawempe Division and to investigate factors associated with immunization coverage. A cross-sectional survey was conducted in 239 households with children aged between 12-18 months in five villages that were selected through multi-stage cluster sampling. Information on demographic and socio-economic factors and immunization status was obtained from mothers and caretakers. Immunization coverage and analysis of associations between immunization coverage and demographic and socio-economic factors were done.</p>

Based on the interlanguage hypothesis and with reference to skill learning and central concepts of connectionist language-acquisition theory, this study develops an explanatory model, with the help of which untutored acquisition of grammatical gender in German is shown to be a sequence of meta-individual developmental phases. The empirical evidence consists of linguistic data compiled from interviews with Italian, Portuguese, and Spanish foreign workers carried out within the framework of the ZISA- Cross-Sectional Study. The acquisition process is promoted by a combination of two cognitive procedures, one analytic (restructuring) and the other reproductive (automation). Both contribute to the construction of a network of associative form-function mappings which, in the course of the process, assume the character of prefabricated linguistic elements or chunks, thus enabling automatic processing. Accordingly, the gender of a noun is not acquired separately as such, but rather as an integral component of an automatic form-function mapping. Formula and routine are central concepts. They denote the norm-language (formula) and interlanguage (routine) chunks used by the learner and thereby the subsumed forms of the respective determiners, that is, gender markers. Their creation and substitution, as well as the sequence of their acquisition, are described and elucidated by means of cognitive mechanisms and psycholinguistic principles. For the interlanguage routine in particular, but to some extent for the norm-language formula as well, it was possible to confirm the fundamental concept of the interlanguage hypotheses, according to which the learner sets up provisional hypotheses about the perceived elements and gradually approaches the form of the target language, albeit with the assistance of a concept of language acquisition that does not primarily center on any rule-defined morphology of the target language but rather on the phonetic surface-level form of concrete linguistic communication. Against this background some key concepts of previous language-acquisition research, such as explicit/implicit, rules, chunks, simplification, omission, and over-generalization, are discussed and partially reassessed.

Syftet med studien är att utifrån lärandet och de förändringar som hittills skett i styrkortsarbetet beskriva och analysera hur Locum håller sitt balanserade styrkort levande. Forskare inom styrkortsområdet framhåller att styrkorten kontinuerligt måste uppdateras för att kunna spegla företagets situation. Lärandet anses vara en förutsättning för förändring, därför inriktas studien på hur förändring och lärande i företaget håller det balanserade styrkortet levande. I den teoretiska referensramen har en cirkelrutin för förnyelse av det balanserade styrkortet tagits fram utifrån befintlig teori inom området. Den kvalitativa studien omfattar datainsamling i form av interna dokument, årsredovisningar och fyra semi-strukturerade intervjuer med medarbetare på olika nivåer i Locums organisation. Av studien har framkommit att aktivt involverande av medarbetare på alla nivåer i organisationen utgör grunden för att hålla styrkortet levande genom lärande. Locum har på det viset lyckats med sitt styrkortsarbete. Studien har även visat på att Locums styrkortsarbete är i linje med svensk forskning som pekar på vikten av att involvera medarbetare. / Title: Keeping the balanced scorecard alive: case study in Locum Authors: Katja Broxvall, Anders Galmén, Susanna Oktay Key words: Balanced scorecard, change, renewal, circle routine, organizational learning Purpose: The purpose of the case study is to find out how the company keeps its balanced scorecard up to date. We do this by studying change and learning occurred so far in Locum in relation to the renewal of the balanced scorecard. Methodology: We have used a qualitative method based on semi-structured interviews. Theoretical perspectives: To understand the background and prerequisites for renewal we have built up a theoretical framework consisting of theories concerning: Regular routines for maintenance and development of the balanced scorecard, learning organizations through Senges five disciplines, single- and double loop learning, theory of action and theories on change and resistance to change. These theories have been summarized to a framework for analysis. Empirical foundations: The study is based on data which we have received through internal documents, annual reports and four interviews with employees of the studied organization. By analyzing this data we have reached a conclusion. Conclusion: An active involvement of employees throughout the organization is the foundation for keeping the balanced scorecard alive. Learning is achieved by this involvement.

Bakgrund: Att förebygga, bedöma och behandla smärta är centralt i anestesisjuksköterskans arbete. Barns upplevelser och uttryckssätt vid smärta skiljer sig mycket från vuxnas. Det är därför en stor utmaning för anestesisjuksköterskor att tolka barns uttryck och känslor för att förstå barnet och kunna erbjuda trygghet och smärtlindring. Forskning har visat att barns postoperativa smärta underbehandlas, trots att kunskaperna om barns smärta ökat. Genom att belysa anestesisjuksköterskans upplevelser kan förståelsen för vad som bidrar till en god respektive mindre god postoperativ smärtlindring av barn öka. Syfte: Syftet med denna studie var att beskriva anestesisjuksköterskors erfarenheter i samband med postoperativ smärtlindring av barn. Metod: Semistrukturerade intervjuer genomfördes med åtta anestesisjuksköterskor från ett svenskt länssjukhus i mellersta Norrland.  Insamlad data analyserades med manifest innehållsanalys. Resultat: Utifrån analysen framkom tre kategorier och sju subkategorier. De tre kategorierna var: Att skapa kontakt är en utmaning, Helhetstänkande och Rutiner.  Det var en utmaning för anestesisjuksköterskan att skapa kontakt med ett barn som varit sövd. Det var viktigt att alla personalgrupper samt föräldrar samarbetade, och den egna erfarenheten var den viktigaste källan till kunskap samt att det fanns brister gällande skriftliga rutinbeskrivningar.Diskussion: Det är viktigt att det finns tydliga rutiner som underlättar smärtlindringen av barn postoperativt och barn bör bedöma den egna smärtan i så stor utsträckning som möjligt. Det var viktigt att ha en god planering t.ex. att påbörja smärtlindringen tidigt. Stress och oro innan operation kunde ge effekter långt tid efter. Föräldrarna var viktiga och skall involveras i vården för att vara ett stöd för sitt barn. Barn kan reagera kraftigt på anestesiläkemedel och därför bör de väckas långsamt och under lugna förhållanden. / Background: To prevent, assess and treat pain is central to anesthesia nurses work. Children's experiences and expression of pain are very different from adults. It is therefore a major challenge for anesthesia nurses to interpret children's expressions and emotions in order to understand the child, and to offer security and pain relief. Research has shown that children's postoperative pain is undertreated, despite that the knowledge of children's pain has increased. By highlighting anesthesia nurses’ experiences the understanding may increase concerning factors that contributes to a good or not so good postoperative pain relief in children. Objective: The purpose of this study was to describe anesthesia nurses' experiences when caring for children with a need of postoperative pain relief. Method: Semi-structured interviews were carried out with eight anesthesia nurses at a county hospital in the north central part of Sweden. Collected data was analyzed with a manifest content analysis. Results: From the analysis three categories and seven sub-categories emerged. The three categories were: To create communication is a challenge, Holistic thinking and Routines.  It was a challenge for the anesthesia nurses to communicate with a child that has been put to sleep. It was also of importance that all healthcare staff and parents cooperated. The anesthesia nurses own experiences was the main source of knowledge and there was a shortage of written routine descriptions.Discussion: It is of importance to have clear procedures to facilitate pain relief of children postoperatively and children should assess their own pain as much as possible. To have a good planning e.g. to initiate pain relief before the operation was also of importance. Stress and anxiety before surgery may have an impact long time after the treatment was over. Parents are important and should be involved in the care so they can support their child. Children may react strongly to the anesthesia drugs and therefore they should be brought back slowly postoperatively and in calm conditions.

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

Thèse d'exercice : Médecine. Médecine générale : Paris 12 : 2007. / Titre provenant de l'écran-titre. 74 f. : ill. Bibliogr. f. 60-67.

This study compares engineering expert problem-solving on a highly constrained routine problem and an ill-defined complex problem. The participants (n=7) were recruited from two large public Research I institutions. Using a think aloud methodology, the experts solved both routine and non-routine problems. The protocols were transcribed and coded in Atlas ti. The first round of coding followed a grounded theory methodology, yielding interesting findings. Unprompted, the experts revealed a strong belief that the ill-defined problems are developmentally appropriate for PhD students while routine problems are more appropriate for undergraduate students. Additional rounds of coding were informed by previous problem solving studies in math and engineering. In general, this study confirmed the 5 Step Problem Solving Method used in previous challenged based instruction studies. There were observed differences based on problem type and background knowledge. The routine problem was more automatic and took significantly less time. The experts with higher amounts of background knowledge and experience were more likely to categorize the problems. The level of background knowledge was most apparent in the steps between conducting an overall energy balance and writing more problem specific relationships between the variables. These results are discussed in terms of their implications for improving undergraduate engineering education. / text