The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision

Background: The concerns of undergraduate nursing and medical students’ regarding end of life care are well documented. Many report feelings of emotional distress, anxiety and a lack of preparation to provide care to patients at end of life and their families. Evidence suggests that increased exposure to patients who are dying and their families can improve attitudes toward end of life care. In the absence of such clinical exposure, simulation provides experiential learning with outcomes comparable to that of clinical practice. The aim of this study was therefore to assess the impact of a simulated intervention on the attitudes of undergraduate nursing and medical students towards end of life care.
Methods: A pilot quasi-experimental, pretest-posttest design. Attitudes towards end of life care were measured using the Frommelt Attitudes Towards Care of the Dying Part B Scale which was administered pre and post a simulated clinical scenario. 19 undergraduate nursing and medical students were recruited from one large Higher Education Institution in the United Kingdom.
Results: The results of this pilot study confirm that a simulated end of life care intervention has a positive impact on the attitudes of undergraduate nursing and medical students towards end of life care (p < 0.001).
Conclusions: Active, experiential learning in the form of simulation teaching helps improve attitudes of undergraduate nursing and medical students towards end of life. In the absence of clinical exposure, simulation is a viable alternative to help prepare students for their professional role regarding end of life care.

Desistance from Sexual Offending: Do the Mainstream Theories Apply?

The literature on desistance from crime has become well established in recent years with strong bodies of evidence supporting the role of factors such as employment, relationships and identity change in this process. However, the relevance of this literature to individuals convicted of sexual crimes is not known as such individuals are almost always excluded from this research. This article presents the results from one of the first empirical studies on desistance from sexual offending based on 32 in-depth life story interviews with adult males previously convicted of child sex offences. In this analysis we explore the significance of work, the role of relationships, and changes in imagined selves in the self-identities of individuals successfully desisting from sexual offending. The findings provide support for all three factors in helping to sustain desistance from sex offending, but also suggest clear differences between desistance from sex offending and other types of crime in these regards.

Theoretical and Quantitative Comparison of SensibleThings and GSN

This project is aimed at making comparison between current existing Internet- of-Things (IoT) platforms, SensibleThings (ST) and Global Sensors Networks (GSN). Project can be served as a further work of platforms’ investigation. Comparing and learning from each other aim to contribute to the improvement of future platforms development. Detailed comparison is mainly with the respect of platform feature, communication and data present-frequency performance under stress, and platform node scalability performance on one limited device. Study is conducted through developing applications on each platform, and making measuring performance under the same condition in household network environment. So far, all these respects have had results and been concluded. Qualitatively comparing, GSN performs better in the facets of node’s swift development and deployment, data management, node subscription and connection retry mechanism. Whereas, ST is superior in respects of network package encryption, platform reliability, session initializing latency, and degree of developing freedom. In quantitative comparison, nodes on GSN has better data push pressure resistence while ST nodes works with lower session latency. In terms of data present-frequency, ST node can reach higher updating frequency than GSN node. In the aspect of node sclability on one limited device, ST nodes take the advantage in averagely lower latency than GSN node when nodes number is less than 15 on limited device. But due to sharing mechanism of GSN, on one limited device, it's nodes shows more scalable if platform nodes have similar job.

Utveckling av lojalitetsprogram - individanpassade erbjudanden : Marknadsföring genom CRM-strategier

Den ökade konkurrenssituationen mellan företag är ett resultat på att handeln har globaliserats. Konsumenter är idag mer medvetna om vad företag har att erbjuda, och det är lätt att välja alternativa företag om ett specifikt företag inte lever upp till konsumentens förväntningar. Detta ställer krav på att företag ständigt måste arbeta med och utveckla sina strategier för att skapa konkurrensfördelar. Idag arbetar många företag med lojalitetsprogram som är ett typexempel på en CRM-strategi. CRM-strategier och lojalitetsprogram syftar till att göra konsumenten mer lojal, för att möjliggöra att konsumenten skall välja att göra återupprepande och mer frekventa köp. Lojalitetsprogrammen måste dock uppdateras och förändras, för att ständigt kunna vara konkurrenskraftiga. Företag arbetar därmed för att skapa ett mervärde, det vill säga erbjuda en servicelösning som är utöver vad konsumenten förväntar sig att få från företag. Kundlojalitet kan utvecklas genom att företag skapar långsiktiga relationer med konsumenterna, och en relation mellan parterna kan utvecklas genom att företag lyssnar på konsumenterna, för att få reda på dess behov och önskemål. Forskning indikerar att individanpassade erbjudanden kan bidra till att konsumenterna än mer tenderar att bli lojala, detta eftersom individanpassade erbjudanden är erbjudanden som baseras på konsumentens unika köpbeteende, vilket möjliggör för träffsäkerhet och relevans. Syftet med denna studie är att mäta konsumenters efterfrågan på individanpassade erbjudanden, för att undersöka om konsumenterna faktiskt efterfrågar och kommer ta till sig dessa erbjudanden. Frågeställningarna är; på vilket sätt kan efterfrågan på individanpassade erbjudanden bidra till ett företags konkurrensfördelar samt på vilket sätt skiljer sig efterfrågan på individanpassade erbjudanden beroende på butikernas geografiska placering. Studien är baserad på en kvantitativ surveyundersökning riktad till konsumenter, med en kvalitativ semi-strukturerad intervju för att erhålla viktig information vid utformandet av frågeformuläret. Resultatet för studien visade att konsumenter värdesätter att få individanpassade erbjudanden, och att dessa erbjudanden kan bidra till ett företags konkurrensfördelar eftersom erbjudandena möjliggör att servicekvaliteten kan öka vilket innebär att dessa erbjudanden kan upplevas ha ett mervärde. I denna studie återfanns dock inte några skillnader på efterfrågan av individanpassade erbjudanden beroende på butikernas geografiska placering.

Retour post-isolement en milieu psychiatrique : développement, implantation et évaluation d’une intervention en soins aigus

L’isolement avec ou sans contention (IC) en milieu psychiatrique touche près d’un patient sur quatre au Québec (Dumais, Larue, Drapeau, Ménard, & Giguère-Allard, 2011). Il est pourtant largement documenté que cette pratique porte préjudice aux patients, aux infirmières et à l’organisation (Stewart, Van der Merwe, Bowers, Simpson, & Jones, 2010). Cette mesure posant un problème éthique fait l’objet de politiques visant à la restreindre, voire à l’éliminer. Les études sur l’expérience de l’isolement du patient de même que sur la perception des infirmières identifient le besoin d'un retour sur cet évènement. Plusieurs équipes de chercheurs proposent un retour post-isolement (REPI) intégrant à la fois l’équipe traitante, plus particulièrement les infirmières, et le patient comme intervention afin de diminuer l’incidence de l’IC. Le REPI vise l’échange émotionnel, l’analyse des étapes ayant mené à la prise de décision d’IC et la projection des interventions futures. Le but de cette étude était de développer, implanter et évaluer le REPI auprès des intervenants et des patients d’une unité de soins psychiatriques aigus afin d’améliorer leur expérience de soins. Les questions de recherche étaient : 1) Quel est le contexte d’implantation du REPI? 2) Quels sont les éléments facilitants et les obstacles à l’implantation du REPI selon les patients et les intervenants? 3) Quelle est la perception des patients et des intervenants des modalités et retombées du REPI?; et 4) L’implantation du REPI est-elle associée à une diminution de la prévalence et de la durée des épisodes d’IC? Cette étude de cas instrumentale (Stake, 1995, 2008) était ancrée dans une approche participative. Le cas était celui de l’unité de soins psychiatriques aigus pour premier épisode psychotique où a été implanté le REPI. En premier lieu, le développement du REPI a d’abord fait l’objet d’une documentation du contexte par une immersion dans le milieu (n=56 heures) et des entretiens individuels avec un échantillonnage de convenance (n=3 patients, n=14 intervenants). Un comité d’experts (l’étudiante-chercheuse, six infirmières du milieu et un patient partenaire) a par la suite développé le REPI qui comporte deux volets : avec le patient et en équipe. L’évaluation des retombées a été effectuée par des entretiens individuels (n= 3 patients, n= 12 intervenants) et l’examen de la prévalence et de la durée des IC six mois avant et après l’implantation du REPI. Les données qualitatives ont été examinées selon une analyse thématique (Miles, Huberman, & Saldana, 2014), tandis que les données quantitatives ont fait l’objet de tests descriptifs et non-paramétriques. Les résultats proposent que le contexte d’implantation est défini par des normes implicites et explicites où l’utilisation de l’IC peut générer un cercle vicieux de comportements agressifs nourris par un profond sentiment d’injustice de la part des patients. Ceux-ci ont l’impression qu’ils doivent se conformer aux attentes du personnel et aux règles de l’unité. Les participants ont exprimé le besoin de créer des opportunités pour une communication authentique qui pourrait avoir lieu lors du REPI, bien que sa pratique soit variable d’un intervenant à un autre. Les résultats suggèrent que le principal élément ayant facilité l’implantation du REPI est l’approche participative de l’étude, alors que les obstacles rencontrés relèvent surtout de la complexité de la mise en œuvre du REPI en équipe. Lors du REPI avec le patient, les infirmières ont pu explorer ses sentiments et son point de vue, ce qui a favorisé la reconstruction de la relation thérapeutique. Quant au REPI avec l’équipe de soins, il a été perçu comme une opportunité d’apprentissage, ce qui a permis d’ajuster le plan d’intervention des patients. Suite à l’implantation du REPI, les résultats ont d’ailleurs montré une réduction significative de l’utilisation de l’isolement et du temps passé en isolement. Les résultats de cette thèse soulignent la possibilité d’outrepasser le malaise initial perçu tant par le patient que par l’infirmière en systématisant le REPI. De plus, cette étude met l’accent sur le besoin d’une présence authentique pour atteindre un partage significatif dans la relation thérapeutique, ce qui est la pierre d’assise de la pratique infirmière en santé mentale. Cette étude contribue aux connaissances sur la prévention des comportements agressifs en milieu psychiatrique en documentant le contexte dans lequel se situe l’IC, en proposant un REPI comportant deux volets de REPI et en explorant ses retombées. Nos résultats soutiennent le potentiel du développement d’une prévention tertiaire qui intègre à la fois la perspective des patients et des intervenants.

Integrated Housing Approach for Riyadh’s hot arid Climate: solutions from the desert vernacular

Thesis (Master's)--University of Washington, 2016-06

Is Trading Behavior Stable Across Contexts? Evidence from Style and Multi-Style Investors

In this paper we study priming of identity within the context of inherent vs. contextual financial decision making. We use a sample of individual trading accounts in equity-style funds taken from one fund family to test the hypothesis that trading styles are inherent vs. contextual. Our sample contains investors who invest either in a growth fund, a value fund, or both. We document behavioral differences between growth fund investors and value fund investors. We find that their trades depend on past returns in different ways: growth fund investors tend towards momentum trading and value fund investors tend towards contrarian trading. These differences may be due to inherent clientele characteristics, including beliefs about market prices, specific personality traits and cognitive strategies that cause them to self-select into one or the other style. We use a sample of investors that trade in both types of funds to test this proposition. Consistent with the contextual hypothesis, we find that investors who hold both types of funds trade growth fund shares differently than value fund shares.

Doctoral Supervisor: Coach, Mentor or Master? Developing an Alternative Paradigm for Doctoral Supervision

This working paper is the second in a series of working papers presenting the on-going findings from a longitudinal research project grounded in exploring the experience of doctoral supervision and developing practice. In the first paper and phase one of this research study, Cook, Nichol and Loon (2014) explored the existing context for doctoral supervision and, drawing from literature on the problematic nature of doctoral supervision and coaching and mentoring, considered the value of drawing on coaching and mentoring models in formulating alternative paradigms for doctoral supervision. This paper reports the findings of phase one, a mixed methods study of experiences of doctoral supervision with supervisors and students in one UK university business school, from which the Collaborative Action Doctoral Supervision conceptual model emerged. The paper also introduces phase two, a collaborative action research study with doctoral supervisors and students who are applying, reflecting on and developing further this doctoral supervision model. We are aiming to answer the question of whether the use of coaching and mentoring in doctoral supervision enables the transfer and sustainability of learning from the doctoral supervision session to outside the experience and improves the quality. Is the doctoral supervisor coach, mentor or master? Key words Doctoral supervision, coaching, mentoring, collaborative action research.

Public Risk Interpretation and Community Resilience Planning: A Case Study in Aberdeen, Washington

Thesis (Master's)--University of Washington, 2016-06

Étude communicationnelle des pratiques culturelles au Québec: analyses des enquêtes ministérielles (1979-2009). Facteurs et prédicteurs, générations et cycles de vie, et découpages territoriaux

Cette thèse porte sur les pratiques culturelles des Québécois et des Québécoises et, plus spécifiquement dans un premier temps, sur les facteurs qui les influencent. Elle traite ensuite des comparaisons entre les individus selon les générations et les cycles de vie. Finalement, elle porte sur les découpages territoriaux régionaux sur le plan des pratiques culturelles et sur les questions liées au territoire. Tous les résultats sont tirés des enquêtes sur les pratiques culturelles au Québec menées à tous les cinq ans depuis 1979 par les ministères en charge de la culture. Les deux principaux référents théoriques sont la théorie de la légitimité de Bourdieu et la figure de l’omnivore de Peterson. Dans la première partie, cette thèse a cherché à savoir si les usages d’Internet sont associés à une ouverture culturelle ou à un confinement. Les résultats montrent que l’âge, la scolarité et les usages culturels que l’on fait d’Internet sont des prédicteurs importants des visites des lieux culturels et des sorties au spectacle. Les modèles qui incluent les usages d’Internet et des variables sociodémographiques sont plus performants que ceux ne considérant que ces dernières. Dans la deuxième partie, les quasi-cohortes à l’étude ont été comparées afin de voir si leurs comportements culturels diffèrent selon les cycles de vie et si leur parcours culturel a varié dans le temps. Finalement, la diversification des pratiques des quasi-cohortes a été étudiée afin d’estimer si elles deviennent plus omnivores avec le temps et d’une quasi-cohorte à l’autre. Le modèle explicatif créé affiche des différences dans le parcours culturel selon les cycles de vie, de même qu’au fil du temps. Il met également en lumière des différences d’une génération à l’autre, de même que des différences entre les générations lorsqu’elles traversent un même cycle de vie. À la différence de ceux de Peterson (2004), les résultats ne permettent pas de conclure que les quasi-cohortes plus âgées sont plus omnivores qu’avant ni que les jeunes sont plus omnivores que leurs aînés. La troisième partie de ce travail avait un objectif comparatif : il s’agissait de voir si les régions administratives du Québec, lorsqu’elles sont étudiées sous l’angle des pratiques culturelles, se regroupent conformément à la typologie des espaces culturels régionaux développée par Harvey et Fortin (1995) sur la base de l’offre culturelle. Les résultats montrent que les regroupements ne sont pas toujours conformes à la typologie et que les pratiques sont très hétérogènes, ce qui permet difficilement d’établir une constance dans les regroupements. Aussi semble-t-il indiqué de fonder la comparaison des territoires sur la prise en compte de l’objet (p. ex. offre ou pratique culturelle), de l’échelle territoriale (p. ex. bibliothèque municipale ou musée national) et de la nature du produit ou de la pratique (p. ex. mobile ou immobile). En conclusion, la pertinence d’élargir l’horizon des pratiques culturelles mesurées dans les enquêtes et d’y inclure des phénomènes transcendants, comme les valeurs, les contraintes et la motivation a été remise en question. À titre d’exemple, l’étude de la motivation pourrait permettre de préciser la figure de l’omnivore au Québec. Il est également apparu pertinent de poursuivre la réflexion en étudiant la manière dont les pratiques culturelles sont consommées afin de voir si, et comment, le cas échéant, s’opère la distinction.

Resilience of small-scale societies’ livelihoods: a framework for studying the transition from food gathering to food production

The origins of agriculture and the shift from hunting and gathering to committed agriculture is regarded as one of the major transitions in human history. Archeologists and anthropologists have invested significant efforts in explaining the origins of agriculture. A period of gathering intensification and experimentation and pursuing a mixed economic strategy seems the most plausible explanation for the transition to agriculture and provides an approach to study a process in which several nonlinear processes may have played a role. However, the mechanisms underlying the transition to full agriculture are not completely clear. This is partly due to the nature of the archeological record, which registers a practice only once it has become clearly established. Thus, points of transitions have limited visibility and the mechanisms involved in the process are difficult to untangle. The complexity of such transitions also implies that shifts can be distinctively different in particular environments and under varying historical and social conditions. In this paper we discuss some of the elements involved in the transition to food production within the framework of resilience theory. We propose a theoretical conceptual model in which the resilience of livelihood strategies lies at the intersection of three spheres: the environmental, economical, and social domains. Transitions occur when the rate of change, in one or more of these domains, is so elevated or its magnitude so large that the livelihood system is unable to bounce back to its original state. In this situation, the system moves to an alternative stable state, from one livelihood strategy to another.

Skolan är en lättköpt arena - livskunskap i kritisk belysning

During the last decade a school subject with the designation of Life Competence Education ("Livskunskap" in Swedish) has emerged in many Swedish schools. The aim of this article is to describe and analyse the subject Life Competence Education, its historical and ideological roots and current place in the curricula of some selected schools. The article is based on analyses of policy documents, interviews and participant observations from fieldwork in two upper secondary schools and in one course for further training of teachers arranged by a municipality. Work by Foucault, especially on governmentality, is used as an analytic tool, as well as work developed from Foucault by Nicolas Rose and Stephen J. Ball. The analyses show that the subject Life Competence Education is constructed in many varied ways in Swedish schools due to different influences, both from the state, but also from private policy entrepreneurs (Ball, 2006). It is also shown that the SET-programme, which is only one example of programmes used for this type of education, is quite widely used in Life Competence Education in Swedish schools. In light of analyses from Foucault and Rose, I suggest that these programmes can be seen as the "psy", i.e. the "psychological domains" (Rose, 1999), entering into the educational arena and with the help of behaviouristic theories constructing "governable subjects" (Foucault, 1988, 1991). This raises questions regarding what kind of subjects are constructed in Life Competence Education, with what kind of methods, as well as how these methods are construed in the light of the Swedish National Curriculum

Big Bath and Impairment of Goodwill : A study of the European telecommunications industry

Income decreasing strategies conducted by management could be harmful for various stakeholders. One example is big bath accounting, which could be accomplished in numer- ous ways. This study focus on big baths achieved by recognising impairments of goodwill. Purpose - The purpose of this study is to examine patterns of association between big bath accounting and impairment of goodwill within the telecommunication service industry in Europe. Further, this study aim at contributing to the discussion regarding utilisation of big baths through impairments of goodwill, and takes the perspective of an external stakehold- er. Delimitations - The study is restricted to European telecommunication entities comprised in STOXX Europe 600 Index. Method - This study was conducted using a hybrid of qualitative and quantitative research strategy with a deductive approach. The five indicators used to identify various big bath behaviours were inspired and derived from theory and previous research. Data from 2009 to 2015 was collected from the companies’ annual reports and websites, and analysed by the help of codification of each fulfilled indicator where 2009 merely served as a compara- tive year for 2010. By the use of a scoreboard the collected data was summarised on an ag- gregated yearly basis as the industry, not the specific companies, were analysed. Empirical findings - The results of this study suggests that big baths are executed among tele- communication companies within Europe. These are conducted simultaneously as impair- ments of goodwill are present, facilitated by earning management. A possible explanation is considered to be the room for interpretation inherent in IAS 36, enabling goodwill impair- ments to be recognised on managers’ command. Thereby an impairment could be “saved” for better or worse circumstances, or recognised when there exist an opportunity to max- imise (the manager's) wealth in the future. This study reveal the co-occurrence of goodwill impairments and big bath-indications, however a review of causal relationships are not en- abled by the limitations of the chosen method. 

SMILE: Simulator for Maryland Imitation Learning Environment

As robot imitation learning is beginning to replace conventional hand-coded approaches in programming robot behaviors, much work is focusing on learning from the actions of demonstrators. We hypothesize that in many situations, procedural tasks can be learned more effectively by observing object behaviors while completely ignoring the demonstrator's motions. To support studying this hypothesis and robot imitation learning in general, we built a software system named SMILE that is a simulated 3D environment. In this virtual environment, both a simulated robot and a user-controlled demonstrator can manipulate various objects on a tabletop. The demonstrator is not embodied in SMILE, and therefore a recorded demonstration appears as if the objects move on their own. In addition to recording demonstrations, SMILE also allows programing the simulated robot via Matlab scripts, as well as creating highly customizable objects for task scenarios via XML. This report describes the features and usages of SMILE.

O aprender em ambientes de aprendizagem configurando uma cultura escolar

Nesta tese problematizamos o aprender, a partir do olhar dos estudantes do 7º e 8º anos, em uma escola da rede pública de ensino do município do Rio Grande/RS/Brasil. A escola, em 2011, optou por realizar um trabalho coletivo e cooperativo e modificou sua dinâmica de funcionamento transformando as salas de aula convencionais em Ambientes de Aprendizagem, nos quais os estudantes têm acesso a uma maior diversidade de recursos e a interação com os colegas é permanente, possibilitando o desenvolvimento de estratégias diferenciadas motivando o aluno a estabelecer relações entre o conhecimento escolar, a sua vida e o mundo. Nesta escola, são os estudantes que se deslocam de um ambiente para outro, a cada duas horas, os professores permanecem com a sala organizada, conforme as necessidades e materiais pedagógicos e tecnológicos por área de conhecimento. Para conhecer como os estudantes aprendem neste novo ambiente realizamos diversos questionamentos como: o que significa aprender em Ambientes de Aprendizagem, como eram as aulas nas salas de aulas convencionais e como são as aulas nos Ambientes de Aprendizagem. Adotamos o Discurso do Sujeito Coletivo (DSC) como metodologia de análise, buscando a recursividade nos discursos individuais o que permitiu a construção dos discursos coletivos que denominamos Aprender “ontem” nas salas de aula, Aprender “hoje” nos Ambientes de Aprendizagem e Aprender com o material pedagógico. Os discursos evidenciam mudanças no aprender, em decorrência da transformação das salas de aula convencionais em Ambientes de Aprendizagem. Mostram ainda que os estudantes percebem as aulas mais dinâmicas e que agora tem liberdade para levantar e dialogar com os colegas e/ou para usar o material didático disponível no ambiente. Destacam um maior interesse de ambas as partes evidenciando que a ação docente está mais acolhedora e que acreditam em uma grande mudança na educação. A análise dos discursos nos possibilitou compreender que trabalhos realizados em ambientes coletivos e desafiadores modificam o aprender pela liberdade de ação, de expressão e pelo respeito ao outro como legítimo outro na convivência.