published_or_final_version / abstract / Dentistry / Doctoral / Doctor of Philosophy

In the age of the risk society, when several actors at an international, national, and local level converge in order to find solutions that help mitigate the global effects of natural disasters, there is a need to study the patterns for communicating and interacting with the public that eventually feel the impact of crises. In the richer parts of the world ICTs have facilitated a framework for having instant information regarding threats that make crisis management a discipline that is centered more in preparing and planning, rather than mitigating actual crises.  In developing countries, the contextual idiosyncrasies of each nation provide a fragmented array of settings that prevents a rapid flow of information in the event of natural disasters. The phenomenal growth of mobile telephony use and its rapid diffusion in developing countries offers a game changing scenario where crisis managers could benefit from new applications and functionalities of mobile devices. In a confluence of multidisciplinary nature, this study aims to explore the role of mobile technology and internet in crisis management, as well as the state of accessibility of mobile technology when addressing the general public in Ghana. This study follows a three-pronged approach with the aim of answering its research questions. First, a qualitative study of the communication processes between crisis managers and the public and the role of mobile technologies during those processes. Second, a quantitative study of the uses of mobile internet and the current mobile internet infrastructure. Finally, a study on the accessibility level of Ghana’s national crisis management organization’s website. Several conclusions can be drawn from this study. Mobile technologies have an important role in the communication process of crisis managers and the public, however the use of internet still has no part in the flows of communication due to deficits in infrastructure and socio-economic factors, leading to a disconnection between international risk policy requirements and local needs. The lack of resources is seen as the biggest challenge for crisis managers; a challenge that leads to issues of trust in the public and non-compliance. Finally, while there have been improvements in accessibility efforts, there is still a wide gap between international web accessibility best practices and the one provided by authorities in Ghana.

This thesis is a conversation analytic investigation of the social organisation of talk in telephone and computer-mediated calls to NHS Direct, a telephone health helpline in England. The data represent fifty-six routinely audio recorded telephone consultations between nurses and callers between June 2003 and June 2004 at one NHS Direct call centre. Data were transcribed using the Jefferson (2004) transcription system. Data analysis follows the broad trajectory of the call. Chapter three illustrates the overall structural organisation of the call as mediated by the Clinical Assessment System (CAS); Chapter four examines how CAS prompted history taking questions are tailoured and delivered by the nurse; Chapter five examines the delivery by the nurse, of the CAS output in the form of the 'disposition' or course of action the caller may take to manage their concern, and Chapter six examines caller's responses to the disposition. The results draw attention to the complexities of telephone and computer-mediated help in which nurses and callers must design their talk to take account of the CAS as a 'third party'. Analysis reveals that nurses typically orient to the CAS output as potentially troublesome. First nurses regularly deviate from and modify CAS prompted questions which works to 'cushion' the system and build rapport between the nurse and the caller. Second nurses regularly simultaneously produce and labour to deny hearably candidate diagnoses. Third callers regularly respond to the CAS produced disposition as dispreferred. In conclusion, this research has revealed how nurses and callers employ a range of interactional practices which work to skilfully tailor and fashion 'embodied help' from an otherwise disembodied CAS technical system. Thus, we can observe nurses and callers artfully displaying through talk the ordinary practical methods for accomplishing telephone and computer-mediated help in this setting.

Bakgrund: Kommunikationen är ett viktigt redskap för sjuksköterskor och inte minst vid telefonrådgivningen som utvecklats under de senaste årtiondena. Syftet med föreliggande studie var att beskriva distriktssköterskornas erfarenheter och reflektioner av telefonrådgivning inom primärvården. Metod: Studien var av kvalitativ ansats med en deskriptiv design. Nio distriktssköterskor intervjuades med hjälp av en semistrukturerad intervjuguide. Kvalitativ innehållsanalys användes som dataanalys. Resultat: Distriktssköterskorna ansåg telefonrådgivning som utmanande då det var många olika patienter, i olika åldrar och med olika vårdbehov som ringde telefonrådgivningen. Arbetet med telefonrådgivning beskrev informanterna som stimulerande då de via telefon hade möjlighet att hjälpa många patienter med enkla medel. Distriktssköterskorna upplevde även arbetet som stressigt vissa dagar. Distriktssköterskorna beskrev att bristen på visualisering i samband med att bedöma vårdbehovet hos patienten som det svåraste med telefonrådgivning. Flera svårigheter som distriktssköterskorna beskrev var att ställa rätt frågor samt svårigheterna med att hantera missnöjda patienter. Informanterna beskrev att de inte endast hade patientens önskemål att tillgodose utan även krav från hälsocentralen då det var brist på tider att boka samt att de fördelade arbetet på hälsocentralen via telefonrådgivningen. Informanterna beskrev arbetet med telefonrådgivning som betydelsefull då det var vägen in på hälsocentralen för patienterna. Slutsats: Distriktssköterskorna beskrev arbetet med telefonrådgivning inom primärvården som utmanande och svårt med begränsade möjligheter att tillgodose allas behov. Distriktssköterskorna som arbetade med telefonrådgivning inom primärvården upplevde liknande svårigheter som sjuksköterskorna på call-centers. Det svåraste distriktssköterskorna upplevde med telefonrådgivning var att de inte fysiskt såg patienten. Distriktssköterskorna upplevde även telefonrådgivningen som betydelsefull och stimulerande. / Background: Communication is an essential tool for nurses, especially when working with the telephone advice nursing (from here on mentioned as telenursing) that has been developed in recent decades. The aim of the present study was to describe the primary healthcare nurse´s experiences and reflections of telenursing in primary healthcare. Method: The present study was of qualitative approach with a descriptive design. Nine primary healthcare nurses was interviewed using a semi-structured interview guide. Qualitative content analysis was used as data analysis. Results: Primary healthcare nurses experienced telenursing as challenging because there were many different patients of different ages and with different health needs who contacted the telenursing. The informants described working with telenursing as stimulating because they easily were able to help many patients. Primary healthcare nurses also experienced the work stressful. The most difficult thing with telenursing described the primary healthcare nurses as the lack of visualization when assessing the need of care. Other difficulties the primary healthcare nurses described were difficulties in dealing with dissatisfied patients and to ask the right questions. The informants described they were not only the patient's wishes to meet. The primary healthcare center made demands of the primary healthcare nurses when it was lack of doctors’ appointments and because the nurses distributed the work on the healthcare center by the telenursing. The informants described the telenursing important because that is the only way for the patient to get an appointment at the healthcare center. Conclusion: The primary healthcare nurses described working with telenursing in primary healthcare as challenging and difficult with limited opportunities to ensure everyone is satisfied. The primary healthcare nurses working with telenursing in primary healthcare experienced similar difficulties as nurses at the call-centers did. The most difficult thing the primary healthcare nurses experienced with telenursing was that they did not met the patient physically. Primary healthcare nurses also experienced telenursing as important and stimulating.

D.Phil. / A modern day N-P complete problem is the assigning of frequencies to transmitters in a cellular network in such a manner that, ideally, no two transmitters in the same cell or neighbouring cells use the same frequency. Considering that an average cellular network provider has over 29 000 transmitters and only 55 frequencies, choosing these frequencies in an optimal way is a very difficult computational problem. Swarm intelligence allows the acceptable minimization and optimization of the frequency assignment problem (FAP). Swarm intelligence is a concept modelling the processes in natural systems such as ant colonies, beehives, human immune systems and the human brain. These systems are selforganizational and display high efficiency in the execution of their tasks. A number of simple automated agents interacting with each other and the environment form a collective. Specifically, there is no "central agent" directing the others. A collective can display surprising intelligence which emerges out of the interaction of the individual agents. This collective intelligence, referred to as swarm intelligence, is displayed in ant colonies when ants build elaborate nests, regulate nest temperature and efficiently search for food in very complex environments. In this thesis a proposal is made to utilize swarm intelligence to build a swarm automatic frequency planner (swarm AFP). The swarm AFP produces frequency plans that are better, or on par with existing frequency planning tools, and in a fraction of the time. A swarm AFP is presented through an in-depth investigation into complex adaptive systems, agent architectures and emergence. Based on an understanding of these concepts, a swarm intelligence model called ACEUS is constructed. ACEUS forms the platform of the swarm AFP. It is a contribution to multi-agent technology as it is a new multi-agent framework that exhibits swarm intelligence and complex distributed computation. What differentiates ACEUS from other multi-agent technologies is that ACEUS works on the basis that the tasks or constructions that have been created by the agents actually guide the agents in their endeavours. There is no centralised agent controlling or guiding the process. The agents in ACEUS receive information and stimulation from their tasks or constructions in the environment. As these constructions or tasks alter the environment, the agents receive stimulus from the changing environment and then react to the changing environment. The changing environment acts as an emergent guiding force to the agents. This is the important contribution that stigmergy contributes to ACEUS. Utilizing this concept, ACEUS is used to create a swarm AFP. The swarm AFP is benchmarked against the COST 259 Siemens benchmarks. In all the COST 259 Siemens scenarios the swarm AFP produced the best results in the shortest time. The swarm AFP was also tested in a real cellular network and the resulting statistics before and after the swarm AFP implementation are presented.

This research conducted an interdisciplinary field experiment to identify relationships between productivity, user satisfaction and IS Helpdesk USP's use of effective communication behavior. An experimental group of Helpdesk USPs of a large retail organization were trained by communication professionals in communication effectiveness, with emphasis on the needs of the telephone environment.

Bakgrund: Tanken med telefonrådgivningen var både att minska antalet besök hos läkarna men även öka tillgängligheten genom att slussa patienterna till rätt vårdnivå i början av sjukdomsprocessen. Sjuksköterskan i telefonrådgivningen ska göra adekvata och välgrundade omvårdnadsbedömningar utifrån den vårdsökandes individuella hälsoproblem. De ska även kunna bemöta och kommunicera på ett sätt som inger trygghet. Telefonrådgivning är en självständig och utmanande arbetsuppgift som kräver kompetens hos sjuksköterskan. Syfte: Att belysa sjuksköterskans upplevelser och erfarenheter av att arbeta med telefonrådgivning. Metod: Semi-strukturerade intervjuer genomfördes med åtta sjuksköterskor som arbetar med telefonrådgivning. Kvalitativ innehållsanalys användes för att granska och tolka materialet. Resultat: Genom bearbetning av analysen framkom fem kategorier vilka benämns; Att ge ett bra bemötande, Behov av återhämtning, Att möta utmaningar, Att vara professionell, Att utvecklas inom arbetet samt underkategorier. Slutsats: Denna studie har belyst komplexiteten i att arbeta med telefonrådgivning för människor med olika symtom i alla åldrar. Det är ett arbete som kräver gedigen erfarenhet, kompetens och självständighet. Studien har synliggjort en positiv upplevelse av arbetet och visar att det krävs tydliga strategier för att kunna utföra arbetet på ett patientsäkert sätt. / Background: The purpose of having telephone triage is to decrease the number of doctor appointments and to increase the availability by getting the patient to the right level of care from the start. The nurses working with telephone triage should make adequate and informed decisions based on the patient's health problem. They should also give the patient a sense of security. Telephone triage is an independent and challenging work task that requires the nurse to be competent.   Purpose: To illustrate how nurses experience working with telephone triage Method: Eight nurses working with telephone triage were interviewed using semi-structured questions. A qualitative analysis was performed to review and interpret the results.   Results: By performing the qualitative analysis five categories and some subcategories were found to be important. The five categories are; To give good service, The need of recovery, To be challenged, To be professional and To develop at work. Conclusion: This study has given light to the complexity of working with telephone triage to people with various symptoms in all ages. The job requires extensive experience, competence and the ability to work independently. The study has shown that the nurses have a positive experience of working with telephone triage and shows that it requires clear strategies for it to be performed without risking the patient safety.

The purpose of this research is to determine the linearity and monotonicity of the THS5651IDW digital to analog converter (DAC), a prototype of the future Texas Instruments TLV5651, 10-bit, 125 MHz communication DAC. Testing was conducted at the Texas Instruments facility on Forest Lane, Dallas, Texas. Texas Instruments provided test equipment, software and laboratory space to obtain test data. Analysis of the data found the DAC to be monotonic since the magnitude of the differential nonlinearity (DNL) was less than ± 1 least significant bit (LSB) and the integral nonlinearity (INL) was less than ± 0.5 LSB. The study also showed that the DAC has primarily negative DNL although the DNL is well within the desired specification.

En ce début de siècle, l'information a pris une dimension capitale grâce aux nouvelles technologies. On parle de la société mondiale de l'information, réduisant la planète en un « village global ». Cependant, les pays des Suds, à la périphérie de ce processus, souffrent de la fracture numérique. Néanmoins, une dynamique des Tic s’y développe à travers des modèles d’accès adaptés aux réalités socio-économiques. A Dakar, ces modèles populaires ont permis une appropriation profonde du mobile alors qu’Internet, l’élément essentiel de cette révolution numérique, tarde à s’ancrer dans l’espace urbain. Dakar, ville primatiale est marquée par une forte polarisation des activités au niveau du centre historique. Cette répartition déséquilibrée est à l’origine des dysfonctionnements territoriaux quotidiens. Le caractère immatériel de la manifestation des nouvelles technologies semble représenter alors un moyen pour atténuer les effets de la question cruciale de la déficience de l’aménagement du territoire, notamment en termes de mobilités. Ainsi, grâce aux usages d’Internet, quelques pratiques urbaines dans divers domaines d’activités se déroulent sur le cyberespace. Mais en raison de leurs impacts peu conséquents sur les territoires réels, les attentes parfois exagérés des acteurs gouvernementaux, la société civile et les opérateurs, tardent à se concrétiser. En effet, malgré la bonne connexion du pays à la dorsale internationale, le taux de pénétration d’Internet au Sénégal ne permet pas pour le moment d’infléchir les dysfonctionnements. En réalité, sur le web sénégalais, la dynamique des usages associés aux pratiques urbaines n’a pas fait émerger de véritables liens entre Internet et l’aménagement territorial urbain à Dakar / Since the turn of the century, communications play a key role thanks to information technology. We now talk of a global community of information, shrinking our planet to a mere ‘global village’. Nevertheless, the countries of the developing countries still lingering outside this network, have trouble catching up. However IT industries are picking up slowly in keeping with the reality of the social and economic developments in these countries. In Dakar, for instance, mobile phones have become increasingly popular while the Internet, the key element to a numerical revolution, has been rather slow to take root in the urban environment. Moreover, Dakar seems to suffer from a lack of balance when it comes to the activities of its historical city center, due to a seemingly malfunctioning of its territorial administration. Information technology which requires few material investments could reduce the effects of this imbalance and the deficiency in its infra structure, making it possible for a variety of activities to take place in a cyberspace. In fact, inspite of efficient connection of the country with the international networking, it still is not enough to cope with the malfunctions of its local infrastructure. Thus the network in Senegal does not reveal truly strong links between the Internet and urban territorial infrastructures in Dakar

Knowledge in organizations today is considered as one of the most important assets the organization possesses. A considerable part of this knowledge is the knowledge possessed by the individuals employed by the organization. In order for intelligent systems to perform some of the tasks their human counter parts perform in an organization the intelligent systems need to acquire the knowledge their human counter parts possess for the specific task. To develop an intelligent system that can perform a specific task in an organization, the knowledge needed to perform the task will have to be extracted from the individuals in the organization via knowledge acquisition. This knowledge will then be presented so that the intelligent system can understand it and perform the task. In order to develop an intelligent system an ontology representing the domain under consideration as well as the rules that constitute the reasoning behind the intelligent system needs to be developed. In this dissertation a development environment for developing intelligent systems called the Collaborative Ontology Builder for Reasoning and Analysis (COBRA) was developed. COBRA provides a development environment for developing the ontology and rules for an intelligent system. COBRA was used in this study to develop a Cellular telecommunications Network Consistency Checking Intelligent System (CNCCIS), which was implemented in a cellular telecommunications network. / Prof. E.M. Ehlers