8 resultados para complex communication needs

em Dalarna University College Electronic Archive


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The main objective of this thesis work is to develop communication link between Runrev Revolution (IDE) and JADE (Multi-Agent System) through Socket programming using TCP/IP layer. These two independent platforms are connected using socket programming technique. Socket programming is considered to be newly emerging technology among these two platforms, the work done in this thesis work is considered to be a prototype.A Graphical simulation model is developed by salixphere (Company in Hedemora) to simulate logistic problems using Runrev Revolution (IDE). The simulation software/program is called “BIOSIM”. The logistic problems are complex, and conventional optimization techniques are unlikely very successful. “BIOSIM” can demonstrate the graphical representation of logistic problems depending upon the problem domains. As this simulation model is developed in revolution programming language (Transcript) which is dynamically typed and English-like language, it is quite slow compared to other high level programming languages. The object of this thesis work is to add intelligent behaviour in graphical objects and develop communication link between Runrev revolution (IDE) and JADE (Multi-Agent System) using TCP/IP layers.The test shows the intelligent behaviour in the graphical objects and successful communication between Runrev Revolution (IDE) and JADE (Multi-Agent System).

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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.

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Interaction involves people communicating and reacting to each other. This process is key to the study of discourse, but it is not easy to study systematically how interaction takes place in a specific communicative event, or how it is typically performed over a series of repeated communicative events. However, with a written record of the interaction, it becomes possible to study the process in some detail. This thesis investigates interaction through asynchronous written discussion forums in a computer-mediated learning environment. In particular, this study investigates pragmatic aspects of the communicative event which the asynchronous online discussions comprise. The first case study examines response patterns to messages by looking at the content of initial messages and responses, in order to determine the extent to which characteristics of the messages themselves or other situational factors affect the interaction. The second study examines in what ways participants use a range of discourse devices, including formulaic politeness, humour and supportive feedback as community building strategies in the interaction. The third study investigates the role of the subject line of messages in the interaction, for example by examining how participants choose different types of subject lines for different types of messages. The fourth study examines to what extent features serving a deictic function are drawn on in the interaction and then compares the findings to both oral conversation and formal academic discourse. The overall findings show a complex communicative situation shaped by the medium itself, type of activity, the academic discipline and topic of discussion and by the social and cultural aspects of tertiary education in an online learning environment. In addition, the findings may also provide evidence of learning.  

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The overall aim of this thesis is to increase our knowledge of different occupational groups´ views on work with children in need of special support. This is explored in four separate studies. The first study investigates the views of occupational groups in preschools and schools in one municipality. A questionnaire was handed out to all personnel (N=1297) in the municipality in 2008 (72.5 % response rate). The second study explores the views of educational leaders (N=45) in the same municipality. Questionnaire # 2 was distributed in 2009. All the educational leaders responded to the questionnaire. The third study describes the views of different occupational groups concerning special educational needs coordinators´ (SENCOs) role and work. This was highlighted by comparing responses from questionnaire #1 and # 2. Responses concerning SENCOs´ work were also added using a third questionnaire. This questionnaire was handed out in 2006 to chief education officers (N=290) in all municipalities in Sweden. The response rate was 90.3%. Finally, the fourth study presents five head teachers´ descriptions of their work with special needs issues. Study four was a follow-up study of questionnaire # 2. These head teachers were selected because of their inclusive values and because they seemed to be effective according to certain criteria. They were interviewed in January 2012. The results reveal a number of interesting findings. For example, there are both similar and different views among the occupational groups concerning work with children in need of special support. A majority of the respondents in all groups state that children´s individual deficiencies is one common reason why children need special support in preschools/schools. Differences between the occupational groups become especially visible regarding their views of SENCOs‟ work. Critical pragmatism (Cherryholmes, 1988) is applied as a theoretical point of departure. Skrtic´s (1991) critical reading and analysis of special education relative to general education is specifically used to interpret and discuss the outcome of the studies. Additionally, Abbott´s (1988) reasoning concerning the “division of expert labor” is used to discuss the occupational groups´ replies concerning “who should do what to whom”. The findings in the studies are contextualized and theoretically interpreted in the separate articles. However in the first part of this thesis (in Swedish: Kappa), the theoretical interpretations of the empirical outcome are discussed in more detail and the results are further contextualized and synthesised. Inclusion and premises for inclusive education are also discussed in more depth in the first part of the present thesis.

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BACKGROUND: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice. OBJECTIVE: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden. METHODS: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.'s model of SDM. RESULTS: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

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BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

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Bakgrund: All sjukvård i Sverige styrs av Hälso-och sjukvårdslagen [HSL]. Under vissa omständigheter kan denna lag behövas kompletteras med Lagen om psykiatrisk tvångsvård [LPT]. Dessa personer vårdas inom psykiatrisk slutenvård. Omvårdnadens syfte är att patienten samtycker till vården och tvångsvården kan över gå till frivillig vård. Dessa personers problematik är dock ofta komplex och omvårdnaden upplevs innebära många svårigheter för sjuksköterskorna. Syfte: Att beskriva sjuksköterskors erfarenheter och upplevelse av omvårdnad i samband med LPT-vård inom sluten psykiatrisk vård. Metod: Empirisk kvalitativ studie med deskriptiv design. Studien baseras på sju semistrukturerade intervjuer med sjuksköterskor. Dessa analyserades med manifest innehållsanalys. Resultat: Resultatet visade att en förutsättning för att uppnå målet med tvångsvården genom omvårdnad var att skapa en allians med patienten. Kommunikation som innefattade individuellt anpassad information var en nyckelfaktor till alliansskapande. Omvårdnadsarbetet innefattade samverkan och sjuksköterskorna upplevde ett behov av kompetensutveckling. Slutsats: Sjuksköterskor upplever att omvårdnad enligt LPT är en utmaning och sammankopplat med flertalet svårigheter. Erhålls kompetens, tid för reflektion och trygghet i arbetsgruppen ses dock inte omvårdnaden som en omöjlighet utan kan upplevas som positivt för både den som vårdar och för den som vårdas.

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Intresset för hur HR och ledning kan påverka medarbetarnas beteendemönster och den sociala strukturen inom organisationer har gett upphov till denna undersökning. Med utgångspunkt i teorier om komplexa adaptiva system som perspektiv har jag försökt fånga medarbetarnas förutsättningar att nå organisationers vision och därmed förverkliga medarbetarpolicyn i praktiken. Tillsammans med kontaktpersoner från den undersökta kommunen har jag gjort en djupdykning i en offentlig organisation i syfte att förklara byråkratins inverkan på beteendemönstret hos medarbetarna och hur de tillsammans skapar en social struktur vilken speglar organisationens vision. Syftet med studien är att undersöka hur det adaptiva systemet fungerar i en byråkratisk organisation och vad det betyder för medarbetarnas möjligheter att förverkliga organisationens vision och medarbetarpolicy. Undersökningen har genomförts på en socialförvaltning i en kommun i mellan Sverige och med en kvalitativ metod och semistrukturerade intervjuer har sex respondenter deltagit i undersökningen. Samtliga respondenter har olika befattningar inom organisationen och bidrar därmed med olika perspektiv på samma fenomen. Undersökningens resultat visar att den offentliga verksamhetens byråkratiska organisationsstruktur bidrar till att det bildas olika adaptiva system inom organisationen, där medarbetarnas beteendemönster bildar en social struktur som leder till att visionen och medarbetarpolicyn inte förverkligas. Undersökningen visar även att de adaptiva systemen inom organisationen inte påverkar varandra, då de inte interagerar med varandra inom organisationen. Det som ligger till grund för hur medarbetarnas beteendemönster etableras inom organisationen är kraven från omvärlden, hög arbetsbelastning och avsaknaden av stabilitet i den organisatoriska och sociala arbetsmiljön och inte vad tidigare forskning visat; att det skulle vara hög regelstyrning som ligger till grund för beteendemönstret inom den offentliga sektorn. Slutsatsen är att för att medarbetarna ska kunna förverkliga organisationens vision och medarbetarpolicy kräver det att HR, ledning och medarbetare alla ingår i samma adaptiva system. För att det ska vara möjligt behöver HR upprätta strategier för hur samtliga inom organisationen ska interagera med varandra i det dagliga arbetet. Ledningen och medarbetarna behöver även ha goda möjligheter att kommunicera med varandra regelbundet i en större omfattning än vad de gör idag. Konkreta åtgärder för hur det lämpligen bör genomföras presenteras under diskussionen.