Validering av Alberta Context Tool (ACT) för bruk inom svensk kommunal äldrevård : Ett verktyg för implementering av evidensbaserad vård

The aim of this study was to conduct an instrument test of the Canadian questionnaire Alberta Context Tool (ACT) version Long-Term care for Swedish conditions. ACT is designed in order to measure the context in the care environment and different behaviours related to the changes in clinical practice. In total, 159 Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) within municipality care of the elderly were included in the survey. The test included the instrument's reliability and face validity.The reliability test was implemented through calculation of Cronbach´s Alpha, and showed internal consistency for five of the scales of the ACT-instrument with Cronbach´s Alpha values ranging between 0,728 and 0,873. However, three dimensions got lower values (0,558 - 0,683).The analysis was carried out with content analysis and carried out for LPNs and RNs in separate groups. The majority of LPNs expressed that it was easy to respond to the questions (56%), while nine percent considered it as difficult. Eleven comments were given about questions that were perceived to be unclear, complicated or contained difficult words. In the RN group only 30 percent considered that the questions were easy to respond to. One third of the RNs considered that part of the questions were unclear, and six RNs expressed also which questions they experienced as unclear. In general, the questions in the ACT were perceived as relevant. The instrument's relevance as a tool to measure contextual factors that influence the implementation of evidence based nursing can also be considered to be determined. By modifying the content in the questionnaire in accordance with what appeared in this survey and to implement yet another test, the instrument should be considered to be relevant for use within Swedish municipality care of the elderly. ACT can be used both as a tool in the work on improvement of clinical practice and as a tool for further research about implementation of evidence based nursing.

Flerspråkighet i ett globaliserat samhälle : uppfattningar om minoritetsspråket som framtidsresurs

Multilingualism in a globalized society: The minority language as a future resource In this article the author investigates how the globalization of society is used as a reference in the discussion of future opportunities among minority language speaking youths in Sweden. A spatial typology of four different types of societies are constructed, the national, the multicultural, the diasporic and the transnational society, all giving the expression of different levels of globalization. These are used as layers of reference put upon the empirical data, functioning as a raster on a screen. The result is a pattern of expressions in three societal dimensions, the economic, the social and the cultural dimension. The findings of the investigation show that the minority language as a future resource of opportunities is anchored in all four societal types and in all three dimensions. In the empirical data (the youths interviewed) the ability of anchoring (finding stories, opportunities etc.) is less frequent when it comes to the diasporic and the transnational as a foundation for opportunity and more frequent when it comes to the national and the multicultural.

Europeisk familjelycka : Om användandet av familjemetaforen i EU

The re-unification of a family of nations: usages of the family metaphor in the EU This article analyses usages of the family metaphor in the EU. It starts up with a scrutiny of feminist theories of the nation-as-family metaphor. Introducing the concept of domopolitics, the author infers that the family, on the one hand, connotes to feelings of security and homelyness and, on the other hand, fears of the well-known, of immanent threats to in-group cohesion. The significance of the family metaphor in the EU rhetoric connects to a renewed emphasis on distinct values, principles and norms that balance the otherwise technocratic image of the EU. He further applies the nation-as-family metaphor to contemporary EU rhetoric. In the analysis, he infers that all three dimensions of the metaphor (ethnic, civil and hierarchic) are manifest in the EU political language making its use an enterprise that strives at moving beyond, but not completely away from the nation-state paradigm.

Revisorn och den institutionaliserade misstron : professionaliseringen av svensk bolagsrevision

The auditor and the insitutionalization of distrust: the professionalization of external auditing in Sweden This paper addresses professionalization with a focus on trust, rather than on issues of power and competition. It contains a conceptual analysis of trust/confidence, as well as a case study of the professionalization of external auditing in Sweden. The conceptual analysis discusses the “time-binding” aspect of trust/confidence, and the significance of social control mechanisms related to “persons”, “roles”, “values” and “programs” for creating and sustaining trust/confidence. The case study focuses on the role of trust/confidence for the organization and professionalization of external auditing in Sweden, and in particular on the ways in which trust in auditors and auditing have been stabilized. The latter issue is dealt with through a discussion attempting to capture a historic displacement in three dimensions: from reliance on the auditor’spersonal reliability, to trust in the professional role; from trust in the individual discretion of certain persons to trust in the regulation of auditing as a standardized program; and finally, from trust in the values represented by individual auditors to trust in the institutionalized professional values.

Identity and image – the story of expertise in a manufacturing company

This thesis is an investigation on the corporate identity of the firm SSAB from a managerial viewpoint (1), the company communication through press releases (2), and the image of the company as portrayed in news press articles (3). The managerial view of the corporate identity is researched through interviews with a communication manager of SSAB (1), the corporate communication is researched through press releases from the company (2) and the image is researched in news press articles (3). The results have been deducted using content analysis. The three dimensions are compared in order to see if the topics are coherent. This work builds on earlier research in corporate identity and image research, stakeholder theory, corporate communication and media reputation theory. This is interesting to research as the image of the company framed by the media affects, among other things, the possibility for the company to attract new talent and employees. If there are different stories, or topics, told in the three dimensions then the future employees may not share the view of the company with the managers in it. The analysis show that there is a discrepancy between the topics on the three dimensions, both between the corporate identity and the communication through press releases, as well as between the communication through press releases and the image in news press articles.

Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam

BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

Design and application of experimental methods for steel sheet shearing

Shearing is the process where sheet metal is mechanically cut between two tools. Various shearing technologies are commonly used in the sheet metal industry, for example, in cut to length lines, slitting lines, end cropping etc. Shearing has speed and cost advantages over competing cutting methods like laser and plasma cutting, but involves large forces on the equipment and large strains in the sheet material. The constant development of sheet metals toward higher strength and formability leads to increased forces on the shearing equipment and tools. Shearing of new sheet materials imply new suitable shearing parameters. Investigations of the shearing parameters through live tests in the production are expensive and separate experiments are time consuming and requires specialized equipment. Studies involving a large number of parameters and coupled effects are therefore preferably performed by finite element based simulations. Accurate experimental data is still a prerequisite to validate such simulations. There is, however, a shortage of accurate experimental data to validate such simulations. In industrial shearing processes, measured forces are always larger than the actual forces acting on the sheet, due to friction losses. Shearing also generates a force that attempts to separate the two tools with changed shearing conditions through increased clearance between the tools as result. Tool clearance is also the most common shearing parameter to adjust, depending on material grade and sheet thickness, to moderate the required force and to control the final sheared edge geometry. In this work, an experimental procedure that provides a stable tool clearance together with accurate measurements of tool forces and tool displacements, was designed, built and evaluated. Important shearing parameters and demands on the experimental set-up were identified in a sensitivity analysis performed with finite element simulations under the assumption of plane strain. With respect to large tool clearance stability and accurate force measurements, a symmetric experiment with two simultaneous shears and internal balancing of forces attempting to separate the tools was constructed. Steel sheets of different strength levels were sheared using the above mentioned experimental set-up, with various tool clearances, sheet clamping and rake angles. Results showed that tool penetration before fracture decreased with increased material strength. When one side of the sheet was left unclamped and free to move, the required shearing force decreased but instead the force attempting to separate the two tools increased. Further, the maximum shearing force decreased and the rollover increased with increased tool clearance. Digital image correlation was applied to measure strains on the sheet surface. The obtained strain fields, together with a material model, were used to compute the stress state in the sheet. A comparison, up to crack initiation, of these experimental results with corresponding results from finite element simulations in three dimensions and at a plane strain approximation showed that effective strains on the surface are representative also for the bulk material. A simple model was successfully applied to calculate the tool forces in shearing with angled tools from forces measured with parallel tools. These results suggest that, with respect to tool forces, a plane strain approximation is valid also at angled tools, at least for small rake angles. In general terms, this study provide a stable symmetric experimental set-up with internal balancing of lateral forces, for accurate measurements of tool forces, tool displacements, and sheet deformations, to study the effects of important shearing parameters. The results give further insight to the strain and stress conditions at crack initiation during shearing, and can also be used to validate models of the shearing process.