Childbirth self-efficacy inventory in Tanzania : a pilot study

Background. To give birth can be a stressful experience and women cope with thisstress in many different ways and have different personal outcomes. Self-efficacy orconfidence in ability to cope with labour can be considered as an important factoraffecting pregnant women’s motivation of normal childbirth and their interpretation ofthe childbirth event.The aim. The purpose of this study was to test the Chinese short form of theinstrument Childbirth self-efficacy instrument (CBSEI) in Tanzania, that measurepregnant women’s self-confidence and coping abilities during childbirth.Method. The Chinese short form of the CBSEI was used to pilot test the pregnantwomen’s confidence of childbirth to see if the questions were understood in theTanzanian culture. Besides this instrument socio-demographic data was collectedtogether with two open questions asking about attitudes and experiences of childbirth.The instrument was translated into Kiswahili. A sample of 60 pregnant women whowere visiting antenatal clinic (ANC) regularly were asked to participate and with helpfrom midwifes at two ANC places the questionnaires were filled out.Result. The result shows that the validity and reliability of the two subscales OE-16and EE-16 were established. The internal consistency reliability of the two subscaleswere high, suggesting that each of the subscale mean score provides a good overviewof self- reported belief in coping ability for childbirth.The results further show that the instrument, CBSEI in this pilot study is not able toidentify women who need extra support during childbirth.Conclusion. The reliability and validity of information presented in this pilot studysupport the use of the Chinese short form of the CBSEI as a research instrument in theTanzania culture. Further studies are recommended to get a wider understandingabout women’s coping abilities in a culture like Tanzania.

En analys av testprocesser med TMap som testmetod

Today there are many system development projects that break both budget and time plan. Often this depends on defects in the information systems that could have been prevented. The cost of test can in some cases be as high as 50 % of the projects total cost and it's at the same time an important part of development. Test as such has moved its focus from the software it self and its faults to a wider perspective on whole infrastructures of information systems where assure a good quality is important. Sogeti in the Netherlands have developed a test method called TMap (Test Management approach) that can be used for structured testing of information systems. TMap haven't been used as much as desired in the office in Borlänge. Because Microsoft is releasing a new version of their platform Visual Studio Team System (VSTS 2010) some colleges at Sogeti in the Netherlands are about to develop a template that can support the use of TMap in VSTS 2010. When we write this the template is still in development. The goal for Sogeti was to find out the differences between the test functionality in VSTS 2008 and 2010. By using the purpose with this essay, which was to analyze the test process in VSTS 2008 with TMap against the test process in VSTS 2010 together with the template we got much help to achieve the goal. The analysis was done with four different aspects: The TPI and TMMi models, problem and strength analyses and a few question formulations. The TPI and TMMi models where used to analyses and evaluate the test process. The analysis showed that there were differences between the both test processes. VSTS 2010 together with the template gave a better support to use TMap and perform test. In VSTS 2010 the test tool Camano is connected to TFS and the tool is also to make the execution and logging of tests easier. This leads to a test process that is easier to handle and has a better support for TMap.

Self-Service Business Intelligence verktyg – möjligheter ochbegränsningar : En jämförelse av teorier om Self-Service Business Intelligence verktyg och praktiska resultat av verktyget PowerPivot

Inom Business Intelligence har begreppet Self-Service Business Intelligence (Self-Service BI) vuxit fram. Self-Service BI omfattar verktyg vilka möjliggör för slutanvändare att göra analyser och skapa rapporter utan teknisk support. Ett av dessa verktyg är Microsoft PowerPivot.På Transportstyrelsens Järnvägsavdelning finns behov av ett Self-Service BI-verktyg. Vi fick i uppdrag av Sogeti att undersöka om PowerPivot var ett lämpligt verktyg för Transportstyrelsen. Målet med uppsatsen har varit att testa vilka tekniska möjligheter och begränsningar PowerPivot har samt huruvida PowerPivot är användbart för Transportstyrelsen.För att få en djupare förståelse för Self-Service BI har vi kartlagt vilka möjligheter och begränsningar med Self-Service BI-verktyg som finns beskrivna i litteraturen. Vi har sedan jämfört dessa med våra testresultat vilket har varit syftet med uppsatsen.Resultatet av testerna har visat att Transportstyrelsens Järnvägsavdelning initialt behöver teknisk support för att använda PowerPivot. Testerna har även visat att vissa av Transportstyrelsens krav inte kan uppfyllas. Detta minskar användbarheten för Transportstyrelsen.Vidare har vi kommit fram till att Self-Service BI inte alltid är enkelt att använda för slutanvändare utan teknisk support. Resultatet visar även att det krävs en BI-infrastruktur för att enkelt skapa rapporter med god kvalitet och högsta möjliga korrekthet.

Communication in Smoking Cessation and Self-management : a study at Nurse-led COPD-clinics in Primary Health Care

ABSTRACTThe general aim of this thesis was to investigate behavioral change communication at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary health care, focusing on communication in self-management and smoking cessation for patients with COPD.Designs: Observational, prospective observational and experimental designs were used.Methods: To explore and describe the structure and content of self-management education and smoking cessation communication, consultations between patients (n=30) and nurses (n=7) were videotaped and analyzed with three instruments: Consulting Map (CM), the Motivational Interviewing Treatment Integrity (MITI) scale and the Client Language Assessment in Motivational Interviewing (CLAMI). To examine the effects of structured self-management education, patients with COPD (n=52) were randomized in an intervention and a control group. Patients’ quality of life (QoL), knowledge about COPD and smoking cessation were examined with a questionnaire on knowledge about COPD and smoking habits and with St. George’s Respiratory Questionnaire, addressing QoL. Results: The findings from the videotaped consultations showed that communication about the reasons for consultation mainly concerned medical and physical problems and (to a certain extent) patients´ perceptions. Two consultations ended with shared understanding, but none of the patients received an individual treatment-plan. In the smoking cessation communication the nurses did only to a small extent evoke patients’ reasons for change, fostered collaboration and supported patients’ autonomy. The nurses provided a lot of information (42%), asked closed (21%) rather than open questions (3%), made simpler (14%) rather than complex (2%) reflections and used MI non-adherent (16%) rather than MI-adherent (5%) behavior. Most of the patients’ utterances in the communication were neutral either toward or away from smoking cessation (59%), utterances about reason (desire, ability and need) were 40%, taking steps 1% and commitment to stop smoking 0%. The number of patients who stopped smoking, and patients’ knowledge about the disease and their QoL, was increased by structured self-management education and smoking cessation in collaboration between the patient, nurse and physician and, when necessary, a physiotherapist, a dietician, an occupational therapist and/or a medical social worker.Conclusion The communication at nurse-led COPD clinics rarely involved the patients in shared understanding and responsibility and concerned patients’ fears, worries and problems only to a limited extent. The results also showed that nurses had difficulties in attaining proficiency in behavioral change communication. Structured self-management education showed positive effects on patients’ perceived QoL, on the number of patients who quit smoking and on patients’ knowledge about COPD.

Module property verification : A method to plan and perform quality verifications in modular architectures

Modular product architectures have generated numerous benefits for companies in terms of cost, lead-time and quality. The defined interfaces and the module’s properties decrease the effort to develop new product variants, and provide an opportunity to perform parallel tasks in design, manufacturing and assembly. The background of this thesis is that companies perform verifications (tests, inspections and controls) of products late, when most of the parts have been assembled. This extends the lead-time to delivery and ruins benefits from a modular product architecture; specifically when the verifications are extensive and the frequency of detected defects is high. Due to the number of product variants obtained from the modular product architecture, verifications must handle a wide range of equipment, instructions and goal values to ensure that high quality products can be delivered. As a result, the total benefits from a modular product architecture are difficult to achieve. This thesis describes a method for planning and performing verifications within a modular product architecture. The method supports companies by utilizing the defined modules for verifications already at module level, so called MPV (Module Property Verification). With MPV, defects are detected at an earlier point, compared to verification of a complete product, and the number of verifications is decreased. The MPV method is built up of three phases. In Phase A, candidate modules are evaluated on the basis of costs and lead-time of the verifications and the repair of defects. An MPV-index is obtained which quantifies the module and indicates if the module should be verified at product level or by MPV. In Phase B, the interface interaction between the modules is evaluated, as well as the distribution of properties among the modules. The purpose is to evaluate the extent to which supplementary verifications at product level is needed. Phase C supports a selection of the final verification strategy. The cost and lead-time for the supplementary verifications are considered together with the results from Phase A and B. The MPV method is based on a set of qualitative and quantitative measures and tools which provide an overview and support the achievement of cost and time efficient company specific verifications. A practical application in industry shows how the MPV method can be used, and the subsequent benefits

Narration, Visualization and Mind : Movies in everyday life as a resource for utopian self-reflection

The paper is analyzing how people in late modern society characterized by de-traditionalization, use moving images as a cultural resource for the construction of meaningful subjective world views. As a theoretical concept with several dimensions, “sacralization of the self” (Woodhead & Heelas 2000: 344), is related to media theory. With a critical focus on ‘the self’, as a core aspect in contemporary media society Eric W. Rothenbuhler labels the individual self as one of “the sacred objects of modern culture” (Rothenbuhler 2006: 31).I want to emphasize the need for case studies in order to undertake a critical investigation about ‘the self’ and how consumption of fiction film is interconnected to spectator´s creation of self images, but also to understand how film engagement elicits self-reflection (Giddens 1991, Axelson 2008, Vaage 2009a). The paper make use of empirical data to illustrate and theoretically develop perspectives on how the audience uses fiction film in every-day life for the construction of the self, as well for the construction of more profound and long-lasting ideas of being part of a moral community (Brereton 2005, Jerslev 2006, Klinger 2008, Mikkola et al. 2007, Vaage 2009b). Some empirical findings support a conclusion that moving images creates a transitional space for the human mind, with the capacity of transporting the spectator from real life to fiction and back to real life again, helping the individual with an ongoing process of transforming the self, dealing with who you actually are, and who you want to become (Axelson 2008, Vaage 2009b).

Torrenting values, feelings and thoughts : cyber nursing and virtual self care in a breast augmentation forum

Earlier research shows that breast augmentation is positively correlated with positive psychological states. The aim of this study was to explore the shared values, feelings, and thoughts within the culture of breast enlargement among women visiting Internet-based forums when considering and/or undergoing esthetic plastic surgery. The study used a netnographic method for gathering and analyzing data. The findings show that the women used the Internet forum to provide emotional support to other women. Through electronic postings, they cared for and nursed each others’ anxiety and feelings throughout the whole process. Apart from the process, another central issue was that the women's relationships were frequently discussed; specifically their relationship to themselves, their environment, and with the surgeons. The findings suggest that Internet forums represent a channel through which posters can share values, feelings, and thoughts from the position of an agent of action as well as from a position as the object of action. These dual positions and the medium endow the women with a virtual nursing competence that would otherwise be unavailable. By introducing the concept of torrenting as a means of sharing important self-care information, the authors provide a concept that can be further explored in relation to post modern self-care strategies within contemporary nursing theories and practice.

The Nurse Professional Competence (NPC) scale : self-reported competence among nursing students on the point of graduation

BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated. RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

Simulation model using meta heuristic algorithms for achieving optimal arrangement of storage bins in a sawmill yard

Bin planning (arrangements) is a key factor in the timber industry. Improper planning of the storage bins may lead to inefficient transportation of resources, which threaten the overall efficiency and thereby limit the profit margins of sawmills. To address this challenge, a simulation model has been developed. However, as numerous alternatives are available for arranging bins, simulating all possibilities will take an enormous amount of time and it is computationally infeasible. A discrete-event simulation model incorporating meta-heuristic algorithms has therefore been investigated in this study. Preliminary investigations indicate that the results achieved by GA based simulation model are promising and better than the other meta-heuristic algorithm. Further, a sensitivity analysis has been done on the GA based optimal arrangement which contributes to gaining insights and knowledge about the real system that ultimately leads to improved and enhanced efficiency in sawmill yards. It is expected that the results achieved in the work will support timber industries in making optimal decisions with respect to arrangement of storage bins in a sawmill yard.

Patients' experiences of support for learning to live with diabetes to promote health and well-being : A lifeworld phenomenological study

Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.