How to avoid Copenhagen : An experimental economic approach to climate negotiations

This study got its origin in the failed climate negotiations in the Copenhagen 2009 summit. By conducting a public good game, with participants from China and Sweden, my study indicates that previous studies on public good games can predict the outcome of the game to a quit large extent even though most of my statistical tests came out statistically insignificant. My study also indicates that by framing the game as climate negotiations there were no statistical significant difference on the level of contributions in comparison to the unframed versions of the game. The awareness of the issues with emissions, global warming and other environmental problems are pretty high but even so when push comes to shove gains in the short run are prioritized to gains in the long run. There are however hypothetical willingness to come to term with the environmental issues. The results of the study indicate that the outcome of the Copenhagen summit can be avoidable but would need additional experiments made on cultural differences and behavior.

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.

Det är värre att inte börja studera än att hoppa av: En fenomenologisk studie om hur icke traditionella studenter upplever studieavhopp från högskoleutbildning

In Sweden we have the highest rate of nontraditional students among Europe. Coincidently, we also have the highest rates of drop outs among OECD. In this particular field, drop out from higher education, there is a need fore more qualitative studies that can support the "statistics". Studies about experiences of drop outs are significant for society, university and individual. The aim of this study is to describe and understand how nontraditional student experiences drop out from higher education. What do they tell regarding their meeting with the university? How is the drop out visible before the decision to quit? How can the way forward to the drop out be described? What does the university mean for them? The theoretical point of departure is the concept lifeworld and the method is phenomenological hermeneutic with narrative interviews with 5 students. The result points out that the meeting with the university implies a meeting with other individuals, and also a "meeting" within the student himself, by inner questioning and reflection. The students’ relationship to the studies is characterized by the experience of understanding. The dropouts are visible through different events. The decision per se has increased over time and the students have also grown personally by the decision. To understand or not understand is crucial for the experience of learning. The drop out can also be seen as a transition and a turning point. The drop out is an effort and takes place without professional staff, therefore needs to be discussed in public.

Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care

Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes. Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care. Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations. Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communicationwasmainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation. Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking. Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.