Health and quality of care from older peoples' and formal caregivers' perspective

Aim: The overall aim of this thesis was to gain a deeper understanding of older people's view of health and care while dependent on community care. Furthermore to describe and compare formal caregivers' perceptions of quality of care, working conditions, competence, general health, and factors associated with quality of care from the caregivers' perspective. Method: Qualitative interviews were conducted with 19 older people in community care who were asked to describe what health and ill health((I), good and bad care meant for them (II). Data were analyzed using content analysis (I) and a phenomenological analysis (II). The formal caregivers; 70 nursing assistants (NAs) 163 enrolled nurses (ENs) and 198 registered nurses (RNs), answered a questionnaire consisting of five instruments: quality of care from the patient's perspective modified to formal caregivers, creative climate questionnaire, stress of conscience, health index, sense of coherence and items on education and competence (III). Statistical analyses were performed containing descriptive statistics, and comparisons between the occupational groups were made using Kruskal-Wallis ANOVA, Mann-Whitney U-test and Pearson's Chi-square test (III). Pearson's  product moment correlation analysis and multiple regression analysis were performed studying the associations between organizational climate, stress of conscience, competence, general health and sense of coherence with quality of care (IV). Results: The older people's health and well-being were related to their own ability to adapt to and compensate for their disabilities and was described as negative and positive poles of autonomy vs. dependence, togetherness vs. being an onlooker, security vs. insecurity and tranquility vs. disturbance (I).  The meaning of good care (II) was that the formal caregivers respected the older people as unique individuals, having the opportunity to live their lives as usual and receiving a safe and secure care. Good care could be experienced when the formal caregivers had adequate knowledge and competence in caring for older people, adequate time and continuity in the care organization (II). Formal caregivers reported higher perceived quality of care in the dimensions medical-technical competence and physical-technical conditions than in identity-oriented approach and socio-cultural atmosphere (III). In the organizational climate three of the dimensions were close to the value of a creative climate and in seven near a stagnant climate. The formal caregivers reported low rate of stress of conscience. The RNs reported to a higher degree than the NAs/ENs a need to gain more knowledge, but the NAs and the ENs more often received training during working hours. The RNs reported lower emotional well-being than the NAs/ENs (III). The formal caregivers' occupation, organizational climate and stress of conscience were associated with perceived quality of care (IV). Implications: The formal caregivers should have an awareness of the importance of kindness and respect, supporting the older people to retain control over their lives. The nursing managers should employ highly competent and adequate numbers of skilled formal caregivers, organize formal caregivers having round the clock continuity. Improvements of organizational climate and stress of conscience are of importance for good quality of care.

The Music Salon in Falun During the 19th Century

The aim of the project is to examine the music salon in Falun as a part of the mining community and in the historical context of European salon culture. A specifc goal is to develop a deeper understanding about the salon when it comes to education and pedagogic ideas. Of a certain interest is Johan Henrik Munktell’s (1804-1861) education travelling (bildningsresor). Inspired by Mendelssohn’s music salon in Berlin and the early salons in Upp-sala he created his own salon in Grycksbo. A letter collection from J.H. Munktell to his father J.J. Munktell in 1828-30 can be considered a unique historical material, which places the salon in Falun in a continental context of culture, education and industrial pretensions. The results have potential to extend the knowledge of Nordic salon culture and how it has infuenced general pedagogy and music education.

Electricity Supply Solutions for an Educational Center in Tanzania

The aim of this study was to investigate electricity supply solutions for an educationalcenter that is being built in Chonyonyo Tanzania. Off-grid power generation solutions andfurther optimization possibilities were studied for the case.The study was done for Engineers Without Borders in Sweden. Who are working withMavuno Project on the educational center. The school is set to start operating in year 2015with 40 girl students in the beginning. The educational center will help to improve genderequality by offering high quality education in a safe environment for girls in rural area.It is important for the system to be economically and environmentally sustainable. Thearea has great potential for photovoltaic power generation. Thus PV was considered as theprimary power generation and a diesel generator as a reliable backup. The system sizeoptimization was done with HOMER. For the simulations HOMER required componentdata, weather data and load data. Common components were chose with standardproperties, the loads were based on load estimations from year 2011 and the weather datawas acquired from NASA database. The system size optimization result for this base casewas a system with 26 kW PW; 5.5 kW diesel generator, 15 kW converter and 112 T-105batteries. The initial cost of the system was 55 875 €, the total net present cost 92 121 €and the levelized cost of electricity 0.264 €/kWh.In addition three optimization possibilities were studied. First it was studied how thesystem should be designed and how it would affect the system size to have night loads(security lights) use DC and could the system then be extended in blocks. As a result it wasfound out that the system size could be decreased as the inverter losses would be avoided.Also the system extension in blocks was found to be possible. The second study was aboutinverter stacking where multiple inverters can work as one unit. This type of connectionallows only the required number of inverters to run while shutting down the excess ones.This would allow the converter-unit to run with higher efficiency and lower powerconsumption could be achieved. In future with higher loads the system could be easilyextendable by connecting more inverters either in parallel or series depending on what isneeded. Multiple inverters would also offer higher reliability than using one centralizedinverter. The third study examined how the choice of location for a centralized powergeneration affects the cable sizing for the system. As a result it was found that centralizedpower generation should be located close to high loads in order to avoid long runs of thickcables. Future loads should also be considered when choosing the location. For theeducational center the potential locations for centralized power generation were found outto be close to the school buildings and close to the dormitories.

COMPARISON OF PARTIAL SHADING LOSSES IN FREE FIELD PV-PLANTS WITH DIFFERENT ARRAY CONFIGURATIONS

A common problem when planning large free field PV-plants is optimizing the ground occupation ratio while maintaining low shading losses. Due to the complexity of this task, several PV-plants have been built using various configurations. In order to compare the shading losses of different PV technologies and array designs, empirical performance data of five free field PV-plants operating in Germany was analyzed. The data collected comprised 140 winter days from October 2011 until March 2012. The relative shading losses were estimated by comparing the energy output of selected arrays in the front rows (shading-free) against that of shaded arrays in the back rows of the same plant. The results showed that landscape mounting with mc-Si PV-modules yielded significantly better results than portrait one. With CIGS modules, making cross-table strings using the lower modules was not beneficial as expected and had more losses than a one-string-per-table layout. Parallel substrings with CdTe showed relatively low losses. Among the two CdTe products analyzed, none showed a significantly better performance.

What Happens When IKEA Comes to Town?

Using data from 2000-2011, the effects of a new IKEA store on retail revenues, employment, and inflow of purchasing power in the entry municipalities, as well as in neighboring municipalities were investigated. A propensity score matching method was used to find non IKEA entry municipalities that were as similar as possible to the entry municipalities based on the situation before entry. Our results indicate that IKEA-entry increased entry-municipality durable-goods revenues by about 20% and employment by about 17%. Only small and, in most cases, statistically insignificant effects were found in neighboring municipalities.

Exploring 'Samoaness' in the Samoan language film The Orator (O Le Tulafale)

The Pacific nation of the Independent Samoa (formerly Western Samoa)  is not known for having a developed film industry.   In 2011, a Samoan languge film called The Orator (O le Tulafale) placed the spotlight on Samoa, its people, and the Samoan culture when it became the country’s first ever film to be accepted into major international film festivals such as the 68th Venice Film Festival.  Samoans the world over have embraced the film for its richness, compassion, and authenticity. Yet at times, the film portrays the Samoan culture as harsh and cruel.   Samoans are usually quick to criticise negative portrayals of their culture but the thousands of comments on the film’s official Facebook page show otherwise.  From April 2011 to March 2012, there were only 11 comments criticising the film on Facebook, and these criticisms were denounced as ‘un-Samoan’. This raised the question as to why Samoans did not react to the unflattering portrayals of their culture, but instead react against legitimate criticisms of the film.  By using Foucault’s concept of heterotopia and the Samoan narrative structure of fāgogo, a heterotopia space and a utopia space are created in which past memories confirming Samoan cultural identity and bonds to the culture are evoked and are (re)experienced by Samoans while viewing the film.  Thus the film’s ability to encourage this is what Samoans praise rather than the actual film.  

Understanding the "black box" of a health-promotion program : keys to enable health among older persons aging in the context of migration

Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researcher-community partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

Travel Report from the first field trip within the SIDA supported project "Mini-grids supplied by renewable energy - improving technical and social feasibility : Including visits to Ihushi Development Center, Tweyambe Secondary School and Mavuno Project in Tanzania. Conducted in April 2011

This report describes the outcome of the first visit to Tanzania, within the project "Mini-grids supplied by renewable energy - improving technical and social feasibility". The trip included visits to three different organizations; Ihushi Development Center (IDC) near Mwanza, TIDESO near Bukoba, and Mavuno Project in Karagwe. At IDC, a brief evaluation of the current power system was done and measuring equipment for long term measurements were installed. At all three locations investigations regarding the current and future electricity demand were conducted and connections to people relevant to the study were established. The report is including as well some technical specifications as some observations regarding organization and management of the technical systems. The trip was including only short visits and therefore only brief introductions to the different organizations, based on observations done by the author. The report is hence describing the author’s understanding of the technical system and social structures after only short visits to each of the organizations, and may differ from observations done at another point in time, over a different time period, or by some other person.This report describes the outcome of the first visit to Tanzania, within the project "Mini-grids supplied by renewable energy - improving technical and social feasibility". The trip included visits to three different organizations; Ihushi Development Center (IDC) near Mwanza, TIDESO near Bukoba, and Mavuno Project in Karagwe. At IDC, a brief evaluation of the current power system was done and measuring equipment for long term measurements were installed. At all three locations investigations regarding the current and future electricity demand were conducted and connections to people relevant to the study were established. The report is including as well some technical specifications as some observations regarding organization and management of the technical systems. The trip was including only short visits and therefore only brief introductions to the different organizations, based on observations done by the author. The report is hence describing the author’s understanding of the technical system and social structures after only short visits to each of the organizations, and may differ from observations done at another point in time, over a different time period, or by some other person.