Shared-decision making in designing new healthcare environments : ready to take off for improved quality

Background Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. Discussion This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. Summary We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users’ perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

How initial vocational education and training (IVET) teachers in Sweden perceive their prospects of being able to prepare upper secondary school pupils for a future occupation

Vocational teachers in Swedish upper secondary schools are a heterogeneous category of teachers, connected to different types of trade. These teachers represent a broad set of trade skills varying in content and character. In their teacher role, they continue to wear the clothes, speak the language, share the culture and remain mentally in their former professions. Still, it is central that they keep up this contact to be able to school the pupils into the environment of the trade in question, but also to help them to understand what skills a profession demands. However, the individual teacher also has to distance himself from the negative elements in the culture of the profession: patterns and habits that, for various reasons, have to be broken or changed. This paper draws attention to the ways in which a group of vocational teachers, who were participants in a project that aimed to train unauthorized vocational teachers, expressed their ambitions to prepare the pupils for a future professional career. When collecting information, we used the degree dissertations they produced and discussed in seminars, and informal dialogues. The result shows that it is important that the instruction location resembles a real working site as far as possible. These places are more or less realistic copies of a garage, a restaurant kitchen, a hairdressing salon, and so on, in order to give the pupils a realistic setting for instruction. However, the fact that these simulated workplaces lack the necessary support functions that exist in a company creates problems, problems which make a lot of extra work for the teachers. Vocational teachers also have to instruct the pupil in the experienced practitioner’s professional skills and working situation, but the pupil herself/himself must learn the job by doing it in practice. Some vocational upper secondary programs lack relevant course literature and the businesses give little support. This also makes extra work for the teachers. Moreover, the distance between the vocational programs and the trainee jobs was experienced as being difficult to overcome. One reason seems to be differences between businesses and differing preconditions between small and big companies’ abilities to take care of these pupils. The upper secondary school vocational programs also play a role in cementing existing gender roles, as well as perpetuating class-related patterns on the labour market.

How initial vocational education and training (IVET) teachers in Sweden perceive their prospects of being able to prepare upper secondary school pupils for a future occupation

Vocational teachers in Swedish upper secondary schools are a heterogeneous category of teachers, connected to different types of trade. These teachers represent a broad set of trade skills varying in content and character. In their teacher role, they continue to wear the clothes, speak the language, share the culture and remain mentally in their former professions. Still, it is central that they keep up this contact to be able to school the pupils into the environment of the trade in question, but also to help them to understand what skills a profession demands. However, the individual teacher also has to distance himself from the negative elements in the culture of the profession: patterns and habits that, for various reasons, have to be broken or changed. This paper draws attention to the ways in which a group of vocational teachers, who were participants in a project that aimed to train unauthorized vocational teachers, expressed their ambitions to prepare the pupils for a future professional career. When collecting information, we used the degree dissertations they produced and discussed in seminars, and informal dialogues. The result shows that it is important that the instruction location resembles a real working site as far as possible. These places are more or less realistic copies of a garage, a restaurant kitchen, a hairdressing salon, and so on, in order to give the pupils a realistic setting for instruction. However, the fact that these simulated workplaces lack the necessary support functions that exist in a company creates problems, problems which make a lot of extra work for the teachers. Vocational teachers also have to instruct the pupil in the experienced practitioner’s professional skills and working situation, but the pupil herself/himself must learn the job by doing it in practice. Some vocational upper secondary programs lack relevant course literature and the businesses give little support. This also makes extra work for the teachers. Moreover, the distance between the vocational programs and the trainee jobs was experienced as being difficult to overcome. One reason seems to be differences between businesses and differing preconditions between small and big companies’ abilities to take care of these pupils. The upper secondary school vocational programs also play a role in cementing existing gender roles, as well as perpetuating class-related patterns on the labour market.

Tribology in Metal Working

This thesis focuses on the tribological performance of tool surfaces in two steel working operations, namely wire drawing and hot rolling. In all forming operations dimensions and surface finish of the products are of utmost importance. Forming basically includes three parts – forming conditions excluded – that may be changed; work material, tool and (possibly) lubricant. In the interface between work material and tool, the conditions are very aggressive with – generally or locally – high temperatures and pressures. The surfaces will be worn in various ways and this will change the conditions in the process. Consequently, the surface finish as well as the dimensions of the formed product may change and in the end, the product will not fulfil the requirements of the customer. Therefore, research and development in regard to wear, and consequently tribology, of the forming tools is of great interest. The investigations of wire drawing dies focus on coating adhesion/cohesion, surface characteristics and material transfer onto the coated steel both in laboratory scale as well as in the wire drawing process. Results show that it in wire drawing is possible to enhance the tribological performance of drawing dies by using a lubricant together with a steel substrate coated by a polished, dual-layer coating containing both hard and friction-lowering layers. The investigations of hot rolling work rolls focus on microstructure and hardness as well as cracking- and surface characteristics in both laboratory scale and in the hot strip mill. Results show that an ideal hot work roll material should be made up of a matrix with high hardness and a large amount of complex, hard carbides evenly distributed in the microstructure. The surface failure mechanisms of work rolls are very complex involving plastic deformation, abrasive wear, adhesive wear, mechanical and thermal induced cracking, material transfer and oxidation. This knowledge may be used to develop new tools with higher wear resistance giving better performance, lower costs and lower environmental impact.

A Linguistic Analysis of the Written Production of Second Language Learners : The Variation of Article Usage by Adult Chinese Learners of English

This study aims to test Robertson’s lexical transfer principle, which posits that Chinese learners use demonstratives (particularly this) and the numeral one as markers of definiteness and indefiniteness. This is tested by analysing Chinese learners’ written production collected from the Spoken and Written English Corpus of Chinese Learners 2.0 (SWECCL 2.0). The purpose is to understand the variation of article usage by adult Chinese learners of English. More specifically, the study examines to what extent articles, possessive and demonstrative pronouns are used in Chinese learners’ English and how definite and indefinite articles are used by the Chinese learners. Findings suggest that Robertson’s lexical transfer principle was corroborated by the present study. In addition, Chinese learners prefer to use demonstrative determiners, the possessive determiner our, and the numeral one to perform the function of marking definiteness and indefiniteness. In particular, the learners try to use the demonstrative determiners that and this in the anaphoric function instead of the definite article, and the demonstrative determiner those is frequently used in the cataphoric function. What is more, the learners use the numeral one as a marker of indefiniteness, and it is also used as a marker of definiteness in the anaphoric function. Further, the possessive determiner our is used as a marker of definiteness in larger situation uses referring to something unique. To this end, the study is able to show that the definite article is used to perform the function of marking indefiniteness, and in some particular contexts the definite article functions as a Chinese specifier in Chinese learners’ English. Also, the indefinite article is frequently used in quantifier phrases but is rarely used in other functions. There are three main reasons that may explain why Chinese learners use determiners variously. Firstly, the choice of determiners by Chinese learners is influenced by linguistic contexts. Secondly, because of learning strategies, Chinese learners try to ignore the anaphoric function and cataphoric function that they are not yet ready to process in article usage. Thirdly, interlanguage grammar influences the optionality in the use of articles. 

I Stormens Öga : En kvalitativ studie inspirerad av grundad teori, om väntade förändringar inom elitidrottsföreningar

Adapt or die. En omvärld i ständig rörelse ställer högre krav än någonsin på organisationer att utveckla sitt förändringsarbete och sättet man ser på förändringar, något som lett till att fenomenet "organisationsförändringar" blivit ett fokusområde för organisationsforskare. Inom denna forskning framhävs inte sällan vikten av att ta ställning till hur anställda tar emot, och påverkas av, detta förändringsarbete. En typ av förändringar som dock förblivit outforskade är väntade förändringar, förändringar där de anställda vet att en förändring kan komma att ske men inte när eller hur den kommer ske. Inom idrotten återfinns en viss typ av organisationer, elitidrottsföreningar, som ställs inför väntade förändringar med jämna mellanrum. Dessa situationer uppkommer när föreningarna omplaceras i det standardiserade seriesystem som återfinns i Sverige och ställs inför kraftigt omväxlande ekonomiska förutsättningar. För att kunna hantera denna osäkerhet förutsätts att organisationen konstant står redo att genomföra omvälvande förändringar, enbart baserat på föreningens sportsliga resultat. Syftet med uppsatsen är att skapa en förståelse för de anställdas reaktioner vid situationer av omplacering och väntad förändring. För att uppnå syftet utgick uppsatsen ifrån bristen på forskning och sökte, med hjälp av metoden Grundad teori, producera en serie väl underbyggda frågeställningar baserade i studiens fynd. Frågeställningarna producerades sedan via fyra semi-strukturerade intervjuer inom två olika elitidrottsföreningar. Resultatet visar på att en utbredd acceptans för väntade förändringar återfinns hos anställda inom elitidrottsföreningar. Uppsatsens fynd grundades i data från respondenterna och sammanställdes via en resultatmodell innehållandes en kärnkategori och fyra underkategorier. Uppsatsen erbjuder således, via metodvalet, en nyproducerad infallsvinkel på en situation som många organisationer inom idrotten – men även utanför – kan komma att ställas inför.