SAMMANFATTNING Introduktion: Att föda barn är en stor upplevelse som man bär med sig hela livet, oavsett om minnet är positivt eller negativt. Målet för oss som arbetar inom förlossningsvården är att alla blivande föräldrar ska ha en positiv förlossningsupplevelse.  Dagens förlossningsvård ställer stora krav på barnmorskan, vilken ska arbeta säkert, utveckla kompetens och ha ett stödjande samt individanpassat bemötande. Syfte: Syftet var att beskriva hur barnmorskor ser på stöd vid förlossning.                                                                Metod: Fyra fokusgruppintervjuer utfördes på fyra olika norrländska sjukhus där barnmorskans syn på stöd vid förlossning berördes. Datamaterialet analyserades med kvalitativ innehållsanalys.                                                                                                                      Resultat: Resultatet redovisas utifrån barnmorskornas beskrivning av vad stöd innebär vid förlossning. Texten indelades i två domäner: Möjligheter till stöd samt begränsningar till stöd. I dessa domäner framkom teman såsom: Bemötandets betydelse, beröringens betydelse, närvarons betydelse, betydelsen av att känna trygghet, kommunikationens betydelse, betydelse av respekt och ansvar, tillitens betydelse, känna otillräcklighet, känna sig vilsen samt sakna tilltro till det normala. Diskussion & slutsats: Barnmorskorna hade flera vägar till stöd, ett individuellt bemötande, de vågade vara fysiskt nära kvinnan och ansåg att de hade en intuition av att känna när de skulle vara närvarande. Att vara trygg var viktigt både för barnmorskan och för kvinnan. De gav fortlöpande information och respekterade kvinnan. De kände ett starkt ansvar för sin roll, och ville ge kvinnorna en tilltro att föda. Begränsningar till stöd var att de kände sig otillräckliga och vilsna i en förändrad organisation. Framtiden bringar stora utmaningar i att kunna förmedla empowerment, att få den födande kvinnan att tro på sig själv och att locka fram den inre styrkan för att föda barn. Nyckelord: Barnmorska, Kommunikation, Stöd. / ABSTRACT   Introduction: Giving birth is a very unique experience that influences the rest of a woman’s reproductive life, regardless if the memory is positive or not. Midwives goal is to give all parents a positive memory of this experience. Today´s maternity care put great demands on the midwife, who should be working safely, develop skills, support and individualized treatment. Objective: To describe a midwife`s opinion about support during labour. Method: Four focus group interviews were conducted at four different hospitals in the northern part of Sweden. Following issues was focused: How midwife´s practise support during labour. The results were analysed using qualitative content analysis. Results: The results are presented by the midwives description of the support during labour. Two domains emerged: Different possibilities about support and limitations of support. Through the domains we found several themes. The meaning of the first meeting, the meaning of  physical contact, the meaning of presence, the meaning of feeling safe, the meaning of communication, the meaning of respect and responsibility, the meaning of trust, the feeling of not being able to support, feeling lost and missing faith to the nature.  Discussion & conclusion: The Midwives had different ways of support during childbirth such as, individual care; they dared to be Physical involved whit the woman. And they could feel an intuition of when they had to be present. To be safe was important for both the midwife and the women. They gave continuous information and respected the woman. They felt a strong responsibility for its role, and wanted to give the women a confidence to give birth. Limitations in support were that they felt inadequate and lost in a changed organization. The future brings great challenges in order to convey empowerment to the women in labour, to believe in themselves and to elicit the inner strength to give birth. Keywords: Communication, Midwifery, Support

This study diagnoses performance in a mature manufacturing company based on an inquiry into contextual ambidexterity. Previous research has shown that creating a high performance context is founded upon the constructs of performance management and social support; however, this research has been conducted in fast evolving, relatively young companies such as software design firms. To date, no research has shown if a well established manufacturing firm can create a context with high levels of performance management and social support establishing a high performance environment and therefore be contextually ambidextrous. The presented contextual ambidexterity inquiry considers social support based upon four specific types of support, namely emotional, appraisal, informational, and instrumental support. Within social support, the concepts of trust and burnout are also vital in establishing the proper culture to achieve high performance. Further, performance management is founded upon human capital management established in a suitable corporate culture. In this study, this approach to a contextual ambidexterity inquiry is applied within the context of a U.S. based division of a global manufacturing company based on a survey, participant observation, and individual interviews. The research contributes to both the academic and practitioner environments with a greater understanding of the antecedents of high performance in an environment outside that of a young, fast evolving software firms. Further, it is shown that a high performance context may exist within organizations that are vastly different from those previously studied. In addition, this study offers an approach to a contextual ambidexterity inquiry with refined definitions and measures based on established constructs as well as new constructs. The implications of these additions to our understanding of contextual ambidexterity to both academia and practice are discussed and several avenues of future research are proposed.

Support provision is a personal and important element of daily life for many people with disabilities. The study examines the ways in which organizational mandates and philosophies shape interactions between people with disabilities and support providers at two unique organizations: a L’Arche community for people with intellectual disabilities and a Independent Living Resource Centre. The project is framed with the social model of disability, the work of Titchkosky (2003) and human geography. Data was collected through semi-structured interviews, including a scenario component, with administrators at each location, people with disabilities using the services and support providers. The findings demonstrate that both organizations have strongly articulated philosophies that the participants are familiar with. The L’Arche model creates an environment that determines certain ways of interacting and while the IL participants amend the philosophy to reflect the daily reality of support provision.

Background: Relatives to people with schizophrenia often experience a great burden and inmany cases takes a lot of responsibility for the person suffering from schizophrenia. Nationalguidelines emphasize the importance for relatives to be involved in mental health care, butunfortunately that is not always the case. Objective: The aim of this study is to investigateand describe how relatives to people with schizophrenia have experienced collaboration andsupport from mental health services, and what requests they might have for the futureregarding the design of collaboration and support. Method: Qualitative approach. Interviewbased study with qualitative content analysis as a method. Results: Two different themes andeleven categories describing the relatives experiences and preferences regarding collaborationand support from mental health services. These two themes are; To be taken for granted butstill left out and Lack of support leading to feelings of loneliness and insecurity. The firsttheme symbolizes collaboration and includes five categories. The second theme symbolizessupport and includes six categories. Conclusion: Relatives to people with schizophrenia havepredominantly negative experiences of collaboration with staff in psychiatric care. Governingdocuments states that relatives should be involved in patient care and treatment. To developand implement successful practices around this, it is important that the staff will discussissues such as confidentiality, attitude, responsibility, inclusion and accessibility. Therelatives have both positive and negative experiences of support from mental health services.If regards should be taken to the relative’s requests about how the support should be designed,their insecurities and feelings of loneliness would decrease. Relationships, knowledge, reliefand personalized support are crucial areas that should be discussed by the staff in psychiatriccare. Quality improvement and development in this area would make it easier for relatives,staff and patients. / Bakgrund: Närstående till personer med schizofreni upplever ofta en stor börda och tar imånga fall ett stort ansvar för den sjuke personen. Nationella riktlinjer betonar vikten av attnärstående ska involveras i den psykiatriska vården, det har dock i många fall visat sig att såinte är fallet. Syfte: Syftet med denna studie är att undersöka hur närstående till personer medschizofreni har upplevt samverkan med och stöder från den psykiatriska vården, samt vilkaönskemål de har för utformandet av samverkan och stöd i framtiden. Metod: Kvalitativansats. Intervjustudie med kvalitativ innehållsanalys som metod. Resultat: Två teman ochelva kategorier beskriver de närståendes upplevelser och önskemål angående samverkan medoch stöd från den psykiatriska vården. Dessa två teman är Att bli tagen för given men ändålämnas utanför och Brist på stöd leder till känsla av ensamhet och otrygghet. Det första tematsymboliserar samverkan, under detta tema finns fem kategorier. Det andra temat symboliserarstöd och under detta tema finns sex kategorier. Slutsats: Närstående till personer medschizofreni har övervägande negativa upplevelser av samverkan med personal inom denpsykiatriska vården. Styrande dokument beskriver att närstående ska involveras i patientensvård och behandling. För att utveckla och implementera fungerande rutiner kring detta är detviktigt att personalen diskuterar frågor som sekretess, bemötande, ansvar, delaktighet ochtillgänglighet. De närstående har både positiva och negativa upplevelser av stöd från denpsykiatriska vården, om de närståendes önskemål om hur stödet ska utformas tas tillvara iutvecklingsarbetet med dessa frågor kan deras otrygghet och känsla av ensamhet minska.Relationer, kunskap, avlastning och individanpassat stöd är viktiga områden som personalinom den psykiatriska vården bör diskutera. Kvalitetshöjande utvecklingsarbete inom dettaområde skulle underlätta för närstående, personal och patienter.

African refugees and immigrants are arriving in Manitoba in vastly increasing numbers and a review of the literature indicates that they are experiencing barriers to successful integration. The goals of this research are to understand the experiences of Sierra Leonean newcomers with seeking support and identify specific needs and services that might be helpful. Using qualitative methods, interviews were conducted with Sierra Leonean newcomers. The analysis of the data indicates that newcomers want financial independence and to fit into Canadian life. The process to get their foreign credentials accredited is difficult and affects their ability to gain economic security. They rely on informal networks with other Sierra Leoneans for assistance to acquire resources when they are unable to get help from service providers. As well, newcomers are concerned about their community image, feelings of isolation and sacrificing all of their dreams. Recommendations from this study include the need to recognize and support African community leaders in connecting with newcomers to share accurate and vital information. In addition, services for employment and the accreditation of foreign credentials should be appropriate, affordable and timely. Changes to policies and to the provision of settlement services are necessary to improve the accessibility and availability of resources required for the successful integration of African newcomers.

Floating offshore wind turbines have the potential to become a significant source of affordable renewable energy. However, their strong interactions with both wind- and wave-induced forces raise a number of technical challenges in both modelling and design. This thesis takes aim at some of those challenges. One of the most uncertain modelling areas is the mooring line dynamics, for which quasi-static models that neglect hydrodynamic forces and mooring line inertia are commonly used. The consequences of using these quasi-static mooring line models as opposed to physically-realistic dynamic mooring line models was studied through a suite of comparison tests performed on three floating turbine designs using test cases incorporating both steady and stochastic wind and wave conditions. To perform this comparison, a dynamic finite-element mooring line model was coupled to the floating wind turbine simulator FAST. The results of the comparison study indicate the need for higher-fidelity dynamic mooring models for all but the most stable support structure configurations. %It was also observed that small inaccuracies in the platform motion time series introduced by a quasi-static mooring model can cause much larger inaccuracies in the time series of the rotor blade dynamics. Industry consensus on an optimal floating wind turbine configuration is inhibited by the complex support structure design problem; it is difficult to parameterize the full range of design options and intuitive tools for navigating the design space are lacking. The notion of an alternative, ``hydrodynamics-based'' optimization approach, which would abstract details of the platform geometry and deal instead with hydrodynamic performance coefficients, was proposed as a way to obtain a more extensive and intuitive exploration of the design space. A basis function approach, which represents the design space by linearly combining the hydrodynamic performance coefficients of a diverse set of basis platform geometries, was developed as the most straightforward means to that end. Candidate designs were evaluated in the frequency domain using linearized coefficients for the wind turbine, platform, and mooring system dynamics, with the platform hydrodynamic coefficients calculated according to linear hydrodynamic theory. Results obtained for two mooring systems demonstrate that the approach captures the basic nature of the design space, but further investigation revealed limitations on the physical interpretability of linearly-combined basis platform coefficients.. A different approach was then taken for exploring the design space: a genetic algorithm-based optimization framework. Using a nine-variable support structure parameterization, this framework is able to span a greater extent of the design space than previous approaches in the literature. With a frequency-domain dynamics model that includes linearized viscous drag forces on the structure and linearized mooring forces, it provides a good treatment of the important physical considerations while still being computationally efficient. The genetic algorithm optimization approach provides a unique ability to visualize the design space. Application of the framework to a hypothetical scenario demonstrates the framework's effectiveness and identifies multiple local optima in the design space -- some of conventional configurations and others more unusual. By optimizing to minimize both support structure cost and root-mean-square nacelle acceleration, and plotting the design exploration in terms of these quantities, a Pareto front can be seen. Clear trends are visible in the designs as one moves along the front: designs with three outer cylinders are best below a cost of \$6M, designs with six outer cylinders are best above a cost of \$6M, and heave plate size increases with support structure cost. The complexity and unconventional configuration of the Pareto optimal designs may indicate a need for improvement in the framework's cost model. / Graduate / 0548 / mtjhall@uvic.ca

Background: About 250 000 children develops cancer every year. Most of them has a parent and a family who also is getting affected. During this time the parents go through a crisis and the nurse had a central role to help them through the hard time. Aim: The aim of this study was to illuminate parent´s experiences of living with a child with a cancer diagnose during the illness. Method: A literature -based study, qualitative content analysis of 14 qualitative articles. Result: The results are presented in three main themes: "The emotional roller coaster", "The balance of the uncertain" and "The swinging of the support". Conclusion: The parents experienced a lot of feelings during the child's illness and they changed their view of life. A fear of the unknown and a feeling of losing the sense of normality were expressed by the parents. A shuttle between security and disappointment appeared during the entire duration of the illness. Therefore it was important for the parents to get continuous information, opportunities for participation and support from someone they could rely on to feel safe.

No description available.

This research investigates the practical issues surrounding the development and implementation of Decision Support Systems (DSS). The research describes the traditional development approaches analyzing their drawbacks and introduces a new DSS development methodology. The proposed DSS methodology is based upon four modules; needs' analysis, data warehouse (DW), knowledge discovery in database (KDD), and a DSS module. The proposed DSS methodology is applied to and evaluated using the admission and registration functions in Egyptian Universities. The research investigates the organizational requirements that are required to underpin these functions in Egyptian Universities. These requirements have been identified following an in-depth survey of the recruitment process in the Egyptian Universities. This survey employed a multi-part admission and registration DSS questionnaire (ARDSSQ) to identify the required data sources together with the likely users and their information needs. The questionnaire was sent to senior managers within the Egyptian Universities (both private and government) with responsibility for student recruitment, in particular admission and registration. Further, access to a large database has allowed the evaluation of the practical suitability of using a data warehouse structure and knowledge management tools within the decision making framework. 1600 students' records have been analyzed to explore the KDD process, and another 2000 records have been used to build and test the data mining techniques within the KDD process. Moreover, the research has analyzed the key characteristics of data warehouses and explored the advantages and disadvantages of such data structures. This evaluation has been used to build a data warehouse for the Egyptian Universities that handle their admission and registration related archival data. The decision makers' potential benefits of the data warehouse within the student recruitment process will be explored. The design of the proposed admission and registration DSS (ARDSS) will be developed and tested using Cool: Gen (5.0) CASE tools by Computer Associates (CA), connected to a MSSQL Server (6.5), in a Windows NT (4.0) environment. Crystal Reports (4.6) by Seagate will be used as a report generation tool. CLUST AN Graphics (5.0) by CLUST AN software will also be used as a clustering package. Finally, the contribution of this research is found in the following areas: A new DSS development methodology; The development and validation of a new research questionnaire (i.e. ARDSSQ); The development of the admission and registration data warehouse; The evaluation and use of cluster analysis proximities and techniques in the KDD process to find knowledge in the students' records; And the development of the ARDSS software that encompasses the advantages of the KDD and DW and submitting these advantages to the senior admission and registration managers in the Egyptian Universities. The ARDSS software could be adjusted for usage in different countries for the same purpose, it is also scalable to handle new decision situations and can be integrated with other systems.

No description available.