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  • 301.
    Dravins, Christina
    et al.
    The National Agency for Special Needs Education and Schools.
    Besouw, Rachel van
    ISVR, University of Southampton.
    Hansen, Kjetil Falkenberg
    KTH Royal Institute of Technology.
    Kuške, Sandra
    Latvian Children's Hearing Centre.
    Exploring and enjoying non-speech sounds through a cochlear implant: The therapy of music2010In: 11th International Conference on Cochlear Implants and other Implantable Technologies: Stockholm Sweden, June 30-July 3, 2010, Stockholm: Karolinska University Hospital , 2010Conference paper (Refereed)
    Abstract [en]

    Cochlear implant technology was initially designed to promote reception of speech sounds; however, music enjoyment remains a challenge. Music is an influential ingredient in our well-being, playing an important role in our cognitive, physical and social development. For many cochlear implant recipients it is not feasible to communicate how sounds are perceived, and consequently the benefits of music listening may be reduced. Non-speech sounds may also be important to persons with multiple functional deficits that relay on information additional to verbatim for participating in communication. Deaf-born children with multiple functional deficits constitute a special vulnerable group as lack of reaction to sound often is discouraging to caregivers. Individually adapted tools and methods for sound awareness may promote exploration and appreciation of the information mediated by the implant. Two current works involving habilitation through sound production and music will be discussed. First, the results from a pilot study aiming at finding musical toys that can be adapted to help children explore their hearing with engaging sounds and expressive interfaces will be presented. The findings indicate that children with multiple functional deficits can be more inclined to use the auditory channel for communication and play than the caregivers would anticipate. Second, the results of a recent questionnaire study, which compared the music exposure and appreciation of preschool cochlear implant recipients with their normally hearing peers will be presented. The data from this study indicate that preschool children with cochlear implants spend roughly the same amount of time interacting with musical instruments at home and watching television programmes and DVDs which include music. However, the data indicate that these children receive less exposure to recorded music without visual stimuli and show less sophisticated responses to music. The provision and supported use of habilitation materials which encourage interaction with music might therefore be beneficial.

  • 302.
    Duberg, Anna
    Örebro University, School of Health Sciences.
    Dance Intervention for Adolescent Girls with Internalizing Problems: Effects and Experiences2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Globally, psychological health problems are currently among the most serious public health challenges. Adolescent girls suffer from internalizing problems, such as somatic symptoms and mental health problems, at higher rates than in decades. By age 15, over 50 % of all girls experience multiple health complaints more than once a week and one in five girls reports fair or poor health.

    The overall aim of this study was to investigate the effects of and experiences with an after-school dance intervention for adolescent girls with internalizing problems. The intervention comprised dance that focused on resources twice weekly for 8 months. Specifically, this thesis aimed to: I) investigate the effects on self-rated health (SRH), adherence and over-all experience; II) evaluate the effects on somatic symptoms, emotional distress and use of medication; III) explore the experiences of those participating in the intervention; and IV) assess the cost-effectiveness.

    A total of 112 girls aged 13 to 18 years were included in a randomized controlled trial. The dance intervention group comprised 59 girls, and the control group 53. In paper I, the dance group showed increased SRH scores compared to the control group (p = .02). Girls in the intervention group showed high adherence and a positive overall experience. In paper II, the dance group exhibited a decrease in somatic symptoms (p = .021), emotional distress (p = .023) and use of medication (p = .020) compared to the control group. In paper III, a strategic sample of 24 girls was interviewed. Qualitative content analysis was performed, and five generic categories emerged. Two were “An Oasis from Stress” and “Supportive Togetherness”, which was shown to represent the fundamental basis and setting of the intervention. The main category, participants’ central experience, was understood as “Finding embodied self-trust that opens new doors”. Paper IV revealed that, due to decreased number of visits to the school nurse and an increase in health related quality of life; the intervention was considered to be cost-effective (combined with the usual school health services). In summary, the results of this thesis show that this dance intervention for adolescent girls with internalizing problems generated positive health effects and proved to be cost-effective. For this target group, a non-judgmental environment and supportive togetherness proved to be of importance for participation. The results of this study may provide practical information for school health care staff and caregivers in designing future interventions.

  • 303.
    Duberg, Anna
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Örebro County Council, Örebro, Sweden.
    Hagberg, Lars
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden; Örebro County Council, Örebro, Sweden.
    Sunvisson, Helena
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Möller, Margareta
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital, Örebro, Sweden.
    Influencing self-rated health among adolescent girls with dance intervention: a randomized controlled trial2013In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 167, no 1, p. 27-31Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate whether dance intervention influenced self-rated health for adolescent girls with internalizing problems.

    Design: Randomized controlled intervention trial with follow-up measures at 8, 12, and 20 months after baseline.

    Setting: A Swedish city with a population of 130 000.

    Participants: Girls aged 13 to 18 years with internalizing problems, ie, stress and psychosomatic symptoms. A total of 59 girls were randomized to the intervention group and 53 were randomized to the control group.

    Intervention: The intervention comprised dance classes twice weekly during 8 months. Each dance class lasted 75 minutes and the focus was on the joy of movement, not on performance.

    Main Outcome Measures: Self-rated health was the primary outcome; secondary outcomes were adherence to and experience of the intervention.

    Results: The dance intervention group improved their self-rated health more than the control group at all follow-ups. At baseline, the mean score on a 5-point scale was 3.32 for the dance intervention group and 3.75 for the control group. The difference in mean change was 0.30 (95% CI, −0.01 to 0.61) at 8 months, 0.62 (95% CI, 0.25 to 0.99) at 12 months, and 0.40 (95% CI, 0.04 to 0.77) at 20 months. Among the girls in the intervention group, 67% had an attendance rate of 50% to 100%. A total of 91% of the girls rated the dance intervention as a positive experience.

    Conclusions: An 8-month dance intervention can improve self-rated health for adolescent girls with internalizing problems. The improvement remained a year after the intervention

  • 304.
    Duberg, Anna
    et al.
    Örebro University, School of Health Sciences.
    Jutengren, Göran
    University of Borås.
    Hagberg, Lars
    Örebro University, School of Health Sciences.
    Möller, Margareta
    Örebro University, School of Health Sciences.
    Dance Intervention for Adolescent Girls: Effects on Somatic Symptoms, Emotional Distress, and Use of Medication. A Randomized Controlled TrialManuscript (preprint) (Other academic)
  • 305.
    Duberg, Anna
    et al.
    Örebro University, School of Health Sciences.
    Möller, Margareta
    Örebro University, School of Health Sciences.
    Sunvisson, Helena
    Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    “I feel free”: Experiences of a Dance Intervention for Adolescent Girls with Internalizing ProblemsManuscript (preprint) (Other academic)
  • 306.
    Dudenko, D.V.
    et al.
    Cardiff University.
    Williams, P.A.
    Cardiff University.
    Hughes, C.E.
    Cardiff University.
    Antzutkin, Oleg
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Sustainable Process Engineering.
    Velaga, Sitaram
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Brown, S.P.
    University of Warwick.
    Harris, K.D.M.
    Cardiff University.
    Exploiting the synergy of powder x-ray diffraction and solid-state NMR spectroscopy in structure determination of organic molecular solids2013In: The Journal of Physical Chemistry C, ISSN 1932-7447, E-ISSN 1932-7455, Vol. 117, no 23, p. 12258-12265Article in journal (Refereed)
    Abstract [en]

    We report a strategy for structure determination of organic materials in which complete solid-state nuclear magnetic resonance (NMR) spectral data is utilized within the context of structure determination from powder X-ray diffraction (XRD) data. Following determination of the crystal structure from powder XRD data, first-principles density functional theory-based techniques within the GIPAW approach are exploited to calculate the solid-state NMR data for the structure, followed by careful scrutiny of the agreement with experimental solid-state NMR data. The successful application of this approach is demonstrated by structure determination of the 1:1 cocrystal of indomethacin and nicotinamide. The 1H and 13C chemical shifts calculated for the crystal structure determined from the powder XRD data are in excellent agreement with those measured experimentally, notably including the two-dimensional correlation of 1H and 13C chemical shifts for directly bonded 13C-1H moieties. The key feature of this combined approach is that the quality of the structure determined is assessed both against experimental powder XRD data and against experimental solid-state NMR data, thus providing a very robust validation of the veracity of the structure

  • 307.
    Dziak, D.
    et al.
    Faculty of Electrical and Control Engineering, Gdansk University of Technology, Gabriela Narutowicza 11/12, Gdansk, Poland.
    Jachimczyk, B.
    Faculty of Electrical and Control Engineering, Gdansk University of Technology, Gabriela Narutowicza 11/12, Gdansk, Poland.
    Kulesza, Wlodek
    Blekinge Institute of Technology, Faculty of Engineering, Department of Applied Signal Processing.
    Wirelessly interfacing objects and subjects of healthcare system - IoT approach2016In: Elektronika ir Elektrotechnika, ISSN 1392-1215, Vol. 22, no 3, p. 66-73Article in journal (Refereed)
    Abstract [en]

    Wireless sensor networks, WSN, for which development has begun by military applications, are nowadays applied to all human activities; e.g. in medicine for patience monitoring or to reduce the effects of disasters. Therefore, the WSNs area has been also one of the emerging and fast growing scientific fields. Increasing interest of WSNs is even caused by equally intense growth of interest in the Internet of Things domain, IoT, in which WSNs constitute a significant part. These reasons have brought about developing low cost, low-power and multi-function sensor nodes. However, the major fact that sensor nodes run quickly out of energy has been an issue and many energy efficient routing protocols have been proposed to solve this problem. Case study presented in this paper concern design of WSN in IoT concept from system lifetime perspective. A hierarchical routing technique, which shows energy efficiency, has been validated. Simulation results show that chosen technique prolongs the lifetime of the WSN compared to other investigated clustering schemes. The advantages of this method are validated by comparative studies. Index Terms - Energy efficiency; Internet of Things, routing protocol; wireless sensor networks.

  • 308.
    Dziak, Damian
    et al.
    Politechnika Gdanska, POL.
    Jachimczyk, Bartosz
    BetterSolutions S.A., POL.
    Kulesza, Wlodek
    Blekinge Institute of Technology, Faculty of Engineering, Department of Applied Signal Processing.
    IoT-based information system for healthcare application: Design methodology approach2017In: Applied Sciences, E-ISSN 2076-3417, Vol. - 7, no - 6, article id 596Article in journal (Refereed)
    Abstract [en]

    - Over the last few decades, life expectancy has increased significantly. However, elderly people who live on their own often need assistance due to mobility difficulties, symptoms of dementia or other health problems. In such cases, an autonomous supporting system may be helpful. This paper proposes the Internet of Things (IoT)-based information system for indoor and outdoor use. Since the conducted survey of related works indicated a lack of methodological approaches to the design process, therefore a Design Methodology (DM), which approaches the design target from the perspective of the stakeholders, contracting authorities and potential users, is introduced. The implemented solution applies the three-axial accelerometer and magnetometer, Pedestrian Dead Reckoning (PDR), thresholding and the decision trees algorithm. Such an architecture enables the localization of a monitored person within four room-zones with accuracy; furthermore, it identifies falls and the activities of lying, standing, sitting and walking. Based on the identified activities, the system classifies current activities as normal, suspicious or dangerous, which is used to notify the healthcare staff about possible problems. The real-life scenarios validated the high robustness of the proposed solution. Moreover, the test results satisfied both stakeholders and future users and ensured further cooperation with the project. © 2017 by the authors.

  • 309.
    Eckard, Nathalie
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    The matter of economic evaluations in health policy decision-making: The case of the Swedish national guidelines for heart diseases2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Economic evaluations are used to inform decision makers about the efficient allocation of scarce healthcare resources and are generated with the direct intent to support decisions in healthcare. Producing guidelines is a complex process and the inclusion of health-economic aspects in the formulation of the Swedish national guidelines as a basis for the written recommendations (priority gradings), distinguishes them from their European counterparts. Despite the increased use of cost-effectiveness data in decision-making, little is known about the actual use of such data. This thesis covers issues concerning how economic evaluations matter in health policy decision-making. The thesis includes four papers based on the Swedish national guidelines for heart diseases, one of the most prominent examples in Sweden of following the notion of evidence-based policy (EBP), in order to inform explicit priority setting.

    Both Papers I and II followed a qualitative case study design, based on the same data set. Paper I explored how a specific working group, the Priority Setting Group (PSG), handled the various forms of evidence and values when producing the national guidelines. Two themes were identified in reaching collective agreement in priority gradings; group facilitation activities and avoiding deadlock in the discussion. The work process involved disagreement and negotiation as part of that task. Paper I contributes to the theoretical and practical debate on EBP. Paper II focused on the use of cost-effectiveness data as decision support in the PSG work process. The paper addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. Three themes were identified. The paper contributes to knowledge on how cost-effectiveness evidence was used in actual decision-making. The use of cost-effectiveness evidence was one of many tools employed to avoid deadlock in discussion and to reach a priority grading, when the overall evidence base was weak, in times of uncertainty and on the introduction of new expensive medical technologies.

    Quantitative research methods were used for both Papers III and IV. Paper III explored how the PSG was presented with cost-effectiveness evidence as decision support and as a basis for their priority gradings. Cost-effectiveness ratios (ICERs) were provided, based on a  systematic literature review, as well as how the results may be conveyed and communicated, for the treatment of heart diseases using a cost-effectiveness ranking or league and providing valid information within a limited space, aiding decision makers on the allocation of healthcare resources. The thesis also includes decision support in the form of cost-effectiveness analysis on catheter ablation treatment. Paper IV provides an example of presenting evidence in the form of a decision-analytic model. The modelling approach provides an analytic framework for decision-making, specifically under conditions of uncertainty as in the introduction of new medical technology. Catheter ablation was associated with reduced cost and an incremental gain in quality adjusted life years (QALYs), and was considered a cost-effective treatment strategy compared to the medical treatment strategy in a lifetime perspective.

  • 310.
    Eckard, Nathalie
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Nedlund, Ann-Charlotte
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Janzon, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Levin, Lars-Åke
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Reaching agreement in uncertain circumstances: the practice of evidence-based policy in the case of the Swedish National Guidelines for heart diseases2017In: Evidence and Policy: A Journal of Research, Debate and Practice, ISSN 1744-2648, no 4, p. 687-707Article in journal (Refereed)
    Abstract [en]

    This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that are based on both clinical and economic evidence and are established to support explicit priority-setting in healthcare. The study contributes to the theoretical and practical debate on evidence-based policy (EBP) by illustrating how the practical tensions of coming to agreement were managed, to a large extent, through deliberation and by creativity.

  • 311.
    Edenlilja, Annika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stress och utmattningssyndrom: individers upplevelser av arbets-och privatliv.2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 312.
    Edholm, Sigurd
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Alinder, Rasmus
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    En ny modell för att beskriva den posturala kontrollen hos underbensamputerade2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: För att minska risken för fallrelaterade skador hos amputerade är envaliderad modell som beskriver och undersöker balans viktigt. The invertedpendulum model (IPM) är en validerad modell som beskriver människans posturalakontroll vid stående. Validiteten är ifrågasättbar för transtibialtamputerade då desaknar aktiv plantarflektion i ankelleden. Därför hypotiserade Rusaw och Ramstrand(2016) att en ny modell krävdes.Metod: Protesanvändare (n = 8) och en kontrollgrupp (n = 7) utförde tre tester,stående på två kraftplattor, under tre olika villkor (totalt 9 tester). Villkoren var ögonöppna, ögon stängda samt feedback på viktfördelning. Data samlades in ochkorrelationskoefficienterna beräknades för att undersöka skillnaderna mellangruppernas medelvärden. För att validera modellen kinetiskt använde Alinder ochEdholm mekaniska begränsningar på kontrollgruppen. Detta i form av en anordningsom låste centre of pressure till en specifik punkt.Resultat: Som hypotiserat blev korrelationen mellan vänster sida för kontrollgruppen(r = -0.557) och den intakta sidan för protesbrukarna (r = -0.423) negativ. Dessutomvar korrelationen och för både protesanvändarna (r = 0.024) och kontrollgruppen (r= 0,207) nära 0 på högersida.Slutsats: Rusaw och Ramstrands (2016) nya modell kunde valideras utifrån resultatetpå denna studie.

  • 313.
    Edström, Evelina
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Löfgren, Sofia
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Förskolepersonalens faktiska och upplevda bullerbelastning på arbetet2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Buller är benämningen på icke önskvärda ljud och blir skadliga när ljudnivåerna blir tillräckligt höga. Effekterna av bullerexponering är många. Höga ljudnivåer förekommer bl.a. inom förskolor. Trots att detta är allmänt känt saknas det en del forskning kring hur just förskolepersonal upplever och påverkas av den höga ljudnivån på arbetet.

    Syfte: Syftet med studien är att undersöka ljudnivån på en förskola samt hur förskolepersonalen upplever och påverkas av ljudmiljön på arbetet.

    Metod: En egen tillverkad enkätundersökning riktad till förskolepersonal samt dosmätning genomfördes på en småbarnsavdelning och en äldrebarnsavdelning. Enkäten berörde frågor gällande ljudnivån på förskolan samt förskolepersonalens upplevelse och påverkan.

    Resultat: De ekvivalenta ljudnivåerna på småbarnsavdelningen låg mellan 73,2 – 78,5 dB(A) och på äldrebarnsavdelningen 71,7 – 78,1 dB(A). Impulstoppvärdena på småbarnsavdelningen låg mellan 110,6 – 135,7 dB(C) och på äldrebarnsavdelningen 116,5 – 143,4 dB(C). Majoriteten av förskolepersonalen upplever hög ljudnivå på arbetet dagligen.

    Slutsatser: Resultatet visar att förskolepersonalen inte utsätts för högre ekvivalenta ljudnivåer än tillåtet. Trots detta upplever majoriteten av förskolepersonalen att de dagligen utsätts för höga ljudnivåer på arbetet. En orsak till detta kan vara att impulstoppvärdena i vissa fall överskrider insatsvärdena. Denna studie är dock inte representativ för populationen, utan är enbart en deskriptiv studie för denna specifika förskola.

  • 314.
    Edvinsson, Johanna
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences.
    Flexibelt arbete: Utveckling och validering av ett kvantitativt frågeformulär2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of the present study was to develop and validate a Swedish questionnaire assessing conditions of actual work flexibility and its determinants. Data was collected by qualitative Think aloud- interviews with three persons, and through discussions with a reference group. The results from the interviews and discussions showed that corrections were needed for some of the concepts, questions, design and number of items. Next, a cross-sectional study was performed by sending the adjusted questionnaire to three companies in Sweden (N = 266), which was answered by 92 employees. The results supported the adjustments and the questionnaires’ content validity and face validity (> 95 % of the employees agreed). Three Principal component analyses showed comprehensible factors for the three main areas of questions: determinants of actual flexibility, technology use, and work-non-work balance, indicating structural validity of the questionnaire. Furthermore, hypothesis testing showed as expected that the most index variables of actual work flexibility could significantly separate the groups with varying extents of regulated work, indicating construct validity. To conclude, this Master thesis has revealed several question domains valid for inclusion in future surveys regarding actual work flexibility and associations with health and wellbeing at work.

  • 315.
    Ehn, Mattias
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Möller, Kerstin
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Danermark, Berth
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    Möller, Claes
    Örebro University, School of Health Sciences. Örebro University Hospital, Audiological Research Centre, Örebro, Sweden; Swedish Institute for Disability Research, Örebro University, Örebro, Sweden.
    The relationship between work and health in persons with Usher syndrome type 22016In: Journal of Visual Impairment & Blindness, ISSN 0145-482X, E-ISSN 1559-1476, Vol. 110, no 4, p. 233-244Article in journal (Refereed)
    Abstract [en]

    Introduction: Persons with deafblindness may have additional physical and psychological health problems. In this study we have focused on health from a work-life perspective in persons with Usher syndrome type 2 (USH2), a disorder with sensorineural hearing loss and retinitis pigmentosa. The aim of this study was to investigate the relationship between work and disability pension and physical and psychological health in persons with USH2.

    Methods: Participants were recruited from the Swedish Usher database. Eighty-four persons (aged 18 to 65 years) received a health-related questionnaire and 67 (36 women and 31 men) agreed to participate. The participants formed two groups (working group, n = 34; disability pension group, n = 33). A Swedish Health on Equal Terms questionnaire comprising questions on psychological and physical health, living conditions, work activity, and social relationships was used. A chi-square test of significance was used with a significance level of p < 0.05.

    Results: The two groups did not differ in terms of age, gender, degree of hearing loss, visual acuity, or visual field loss. The working group had statistically significant better health compared to the disability pension group in areas such as being overweight, handling problems, concentration, feeling unhappy, depressive symptoms, and feelings of worthlessness. Suicidal thoughts and attempts were significantly more common in the disability pension group.

    Discussion: Persons with USH2 generally reported very poor physical and psychological health, with significant differences between persons who were working and those who were not. This study highlights the need for early rehabilitation, vocational training, and opportunities to access the labor market. Implications for practitioners: It is important that persons with USH2 receive vocational support from an early age and that professionals in the field of rehabilitation always include work activity as a key element of interventions.

  • 316.
    Eivarsson, Marie
    Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
    Ett tryggare och säkrare överflyttningssätt från intensivvård till vårdavdelning.: Ett förbättringsarbete med fokus på övervakningsutrustning och läkemedelslistor.2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 317. Eivazzadeh, Shahryar
    Health Information Systems Evaluation2015Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    Health information systems have emerged as a major component in our response to the trends of rising demands in health care. The insight being gained from the evaluation of those systems can critically influence the shaping of the response. Summative or formative evaluation of health information systems assesses their quality, acceptance, and usefulness, creates insight for improvement, discriminates between options, and refines future development strategies. But the evaluation of health information systems can be challenging due to the propagation of their impacts through multiple socio-technological layers till the ultimate recipients, their heterogeneity and fast evolvement, and the complexity of health care settings and systems.

    Aim

    This thesis tries to explain the challenges of evaluation of health information systems with a narrow down on determining evaluation aspects and to propose relevant solutions. The thesis goes for solutions that mitigate heterogeneity and incomparability, recruit or extend available evaluation models, embrace a wide context of application, and promote automation.

    Method

    The literature on health information systems evaluation, methods of dealing with heterogeneity in other disciplines of information systems, and ontology engineering were surveyed. Based on the literature survey, the UVON method, based on ontology engineering, was first developed in study 1. The method was applied in FI-STAR, a European Union project in e-Health with 7 use-cases, for summative evaluation of the individual and whole e-health applications. Study 2, extended the UVON method for a formative evaluation during the design phase.

    Results

    Application of the UVON method resulted in evaluation aspects that were delivered to the seven use-cases of the FI-STAR project in the form of questionnaires. The resulted evaluation aspects were considered sensible and with a confirming overlap with another highly used method in this field (MAST). No significant negative feedback from the FI-STAR use-case owners (n=7) or the respondents (n=87 patients and n=30 health professionals) was received or observed.

    Conclusion

    In the evaluation of health information systems --possibly also in other similarly characterized systems-- ontology engineering methods, such as the proposed UVON method, can be applied to create a flexible degree of unification across a heterogeneous set of evaluation aspects, import evaluation aspects from other evaluation methods, and prioritize between quality aspects in design phase. Ontologies, through their semantic network structures, can capture the extracted knowledge required for evaluation, facilitate computation of that knowledge, promote automation of evaluation, and accommodate further extensions of the related evaluation methods by adding new features to their network structure.

     

  • 318.
    Eivazzadeh, Shahryar
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Larsson, Tobias
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mechanical Engineering.
    Fiedler, Markus
    Blekinge Institute of Technology, Faculty of Computing, Department of Technology and Aesthetics.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Most Influential Qualities in Creating Satisfaction Among the Users of Health Information Systems: A Study in Seven EU Countries2018In: JMIR Medical InformaticsArticle in journal (Refereed)
    Abstract [en]

    Background:

    Several models suggest how the qualities of a product or service influence user satisfaction. Models, such as the Customer Satisfaction Index (CSI), Technology Acceptance Model (TAM), and Delone and McLean Information Systems Success (D&M IS), demonstrate those relations and have been used in the context of health information systems.

    Objective:

    We want to investigate which qualities foster greater satisfaction among patient and professional users. In addition, we are interested in knowing to what extent improvement in those qualities can explain user satisfaction and if this makes user satisfaction a proxy indicator of those qualities.

    Methods:

    The Unified eValuation using ONtology (UVON) method was utilised to construct an ontology of the required qualities for seven e-health applications being developed in the FI-STAR project, a European Union (EU) project in e-health. The e-health applications were deployed across seven EU countries. The ontology included and unified the required qualities of those systems together with the aspects suggested by the Model for ASsessment of Telemedicine applications (MAST) evaluation framework. Two similar questionnaires, for 87 patient users and 31 health professional users, were elicited from the ontology. In the questionnaires, user was asked if the system has improved the specified qualities and if the user was satisfied with the system. The results were analysed using Kendall correlation coefficients matrices, incorporating the quality and satisfaction aspects. For the next step, two Partial Least Squares Structural Equation Modelling (PLS-SEM) path models were developed using the quality and satisfaction measure variables and the latent construct variables that were suggested by the UVON method.

    Results:

    Most of the quality aspects grouped by the UVON method are highly correlated. Strong correlations in each group suggest that the grouped qualities can be measures which reflect a latent quality construct. The PLS-SEM path analysis for the patients reveals that the effectiveness, safety, and efficiency of treatment provided by the system are the most influential qualities in achieving and predicting user satisfaction. For the professional users, effectiveness and affordability are the most influential. The parameters of the PLS-SEM that are calculated allow for the measurement of a user satisfaction index similar to CSI for similar health information systems.

    Conclusions:

    For both patients and professionals, the effectiveness of systems highly contributes to their satisfaction. Patients care about improvements in safety and efficiency, while professionals care about improvements in the affordability of treatments with health information systems. User satisfaction is reflected more in the users' evaluation of system output and fulfilment of expectations, but slightly less in how far the system is from ideal. Investigating satisfaction scores can be a simple, fast way to infer if the system has improved the abovementioned qualities in treatment and care.

  • 319.
    Ek, Viktor
    et al.
    Örebro University, School of Health Sciences.
    Pettersson, Linnéa
    Örebro University, School of Health Sciences.
    Frekvensförflyttningsstrategier – en explorativ studie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 320.
    Ekelund Book, Ekelund
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The consultant doctor`s experience of how their competence is being utilized and what impact this has o their perceived psychosocial work environment2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 321. Eklöf, Motzi
    Journalförda liv: Vårdpolitiska, juridiska och etiska aspekter på livsberättelser i vård och omsorg2015In: Livsberättelser, kultur & hälsa / [ed] Motzi Eklöf, Margareta Petersson, Växjö: Linnaeus University Press, 2015, p. 53-58Chapter in book (Other academic)
  • 322.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 323.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 324.
    Ekstedt, Malin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Arbetsmiljö i ny kontext: En diskursiv analys av krav-och kontrollmodellen2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 325.
    Ekstedt, Mirjam
    et al.
    KTH Royal Institute of Technology.
    Ödegård, Synnöve
    KTH Royal Institute of Technology.
    Exploring Gaps in Cancer Care Using a Systems Safety Perspective2015In: Cognition, Technology & Work, ISSN 1435-5558, E-ISSN 1435-5566, Vol. 17, no 1, p. 5-13Article in journal (Refereed)
    Abstract [en]

    Gaps in the continuity of care may appear as losses of information or momentum or as interruptions in the delivery of care. To systematically improve patient safety, we need to know more about how gaps in the continuity of health care are identified and mitigated. This study seeks to describe healthcare professionals’ understanding of how they anticipate, detect and handle gaps in cancer care. Ten focus-group interviews and two individual interviews were conducted with a total of 34 cancer-care professionals (physicians, nurses, managers and administrators)from three counties in mid-Sweden. Various specialties in cancer care were covered: primary care, inhospital care, palliative care, advanced home are, and children’s care. Interviews were analyzed inductively using qualitative content analysis. The results show that patient safety in cancer care is dependent on a resilient organization that is capable of anticipation, monitoring, adapting and learning at all levels of care. The professionals anticipated gaps in situations where contacts between healthcare providers were limited and when they were faced by time or resource constraints. The extent to which aps could be managed by professionals at the sharp end was largely determined by their bility to adapt to complex and unexpected situations in their daily work. The management of gaps was perceived differently by managers and clinicians, however. The study also indicates hat the continuity of care could be improved by patients’ participation in decisions about reatments and care plans, and by a mutual responsibility for the transfer of information and knowledge across professional boundaries. These results are discussed from a resilience ngineering perspective, and they emphasize the management’s responsibility to address gaps identified in the system. Designing resilient healthcare organizations enables professionals at  the sharp end to prevent human error or mitigate its consequences.

  • 326.
    Ekstrand, Magnus
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Ekstrand, Irina
    Mälardalen University, School of Health, Care and Social Welfare.
    Överviktiga barns upplevelser av hälsa och lidande2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In the background important concepts as health, suffering, obesity, consequences of overweight, treatment, vulnerability and importance of activity are described. This for the reader will be able to understand the extent of the problem. The study will focus on overweight children and adolescents. Problem: Overweight in children and adolescents are a growing problem, leading to a number of negative consequences, many physical but also psychological, spiritual and social. Objective: To describe overweight children and adolescents experiences of health and suffering. Method: A qualitative literature study with an inductive approach and manifest content analysis based on Graneheim & Lundmans (2004) methodology article. The study was conducted in autobiographies for adults to describe their experiences of growing up with being overweight. Results: The study shows that overweight children and adolescents experiences on the basis of its overweight relating to health and suffering. The results are presented in categories of self-esteem, self-loathing, despair, vulnerability, alienation and love. Conclusion: Many children and adolescents with overweight are experiencing considerable suffering and barely any health. They have poor self-esteem and are experiencing self-loathing and desperation. They are often teased and subjected to bullying which can lead to alienation. They feel they cannot find the true love because of their overweight.

  • 327.
    Ekstrand-Hammarström, Barbro
    et al.
    FOI, Umeå.
    Akfur, Christine
    FOI, Umeå.
    Andersson, Per Ola
    FOI, UMEÅ.
    Lejon, Christian
    FOI, Umeå.
    Österlund, Lars
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Solid State Physics.
    Buch, Anders
    FOI, Umeå.
    Human Primary Bronchial Epithelial Cells are more Responsive to Titanium Dioxide Nanoparticles than the Lung Epithelial Cell Lines A549 and BEAS-2B2012In: Nanotoxicology, ISSN 1743-5390, E-ISSN 1743-5404, Vol. 6, no 6, p. 623-634Article in journal (Refereed)
    Abstract [en]

    We have compared the cellular uptake and responses of fivepreparations of nanocrystalline titanium dioxide (TiO2) betweennormal human bronchial epithelial (NHBE) cells and epithelialcell lines (A549 and BEAS-2B). The P25 nanoparticles, containingboth anatase and rutile modifications, induced reactive oxygenspecies (ROS) and secretion of the neutrophil chemoattractantIL-8 in all three cell types used. Pure anatase and rutile particlesprovoked differential IL-8 response in A549 and no response inBEAS-2B cells despite similar formation of ROS. The pure TiO2modifications also provoked release of the inflammatorymediators: IL-6, G-CSF and VEGF, in NHBE cells but not in the twocell lines. We conclude that the responsiveness of lung epithelialcells is strongly dependent on both the physicochemicalproperties of TiO2 nanoparticles and the type of responder cells.The differential pro-inflammatory responsiveness of primarylung epithelial cells compared with immortalized cell linesshould be considered in the assessment of adverse reactions toinhaled nanoparticles.

  • 328.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, no 1, article id 275Article in journal (Refereed)
    Abstract [en]

    Background: Becoming parents for the first time is challenging. Mothers need both social and professional support to handle these challenges. Professionals’ attitudes affect quality of care and support. So to improve professional support, an intervention consisting of a process-oriented training was performed. Due to the positive results of the intervention there is a need to illuminate the methodological approach further. The overall aim was therefore to describe a methodological approach to improve and evaluate health care professionals’ attitudes toward breastfeeding and parental support in order to improve quality of care in childbearing.

    Methods: This study was a longitudinal randomized control intervention study, in which groups of mothers received care in childbearing from midwives and child health nurses. These health professionals had gone through a process-oriented training, or not. In order to improve attitudes of health professionals the training was based on evidence, practical skills and reflective processes (both private and professional experiences) in relation to breastfeeding and parental support. Included in the longitudinal study were health professionals from five intervention municipalities n = 36 and health professionals from five control municipalities n = 45. All mothers who fulfilled the inclusion criteria were consecutively identified from the hospital register and asked to participate in the study. Mothers who accepted to participate were included in the interventions group (n = 206) or control groups (n = 162, n = 172 respectively) based on which municipality they belonged to.

    Results: The results of the process-oriented training improved the professionals’ attitudes toward breastfeeding and parental support. These improved attitudes in health professionals increased intervention-group mother’s satisfaction with professional and social support. Intervention-group mother’s relation to and feelings for their baby as well as breastfeeding was also improved.

    Conclusion: These results stress the importance of professionals’ attitude in quality of care during childbearing, as well as pointing to the possibility to improve professionals’ attitudes with a process-oriented training.

    Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), trial registration:ACTRN12611000354987.

  • 329.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Validation of Measurement Scales in Health Care2015In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 4, no 2, article id 1000236Article in journal (Other academic)
  • 330.
    Elbadawi, Mohammed
    et al.
    Luleå University of Technology, Department of Health Sciences. Department of Mechanical Engineering, University of Sheffield.
    Meredith, James
    Department of Mechanical Engineering, University of Sheffield.
    Hopkins, Lynne
    Department of Material Science and Engineering, University of Sheffield.
    Reaney, Ian
    Department of Material Science and Engineering, University of Sheffield.
    Progress in Bioactive Metal and, Ceramic Implants for Load-Bearing Application2016In: Advanced Techniques in Bone Regeneration / [ed] Alessandro Rozim Zorzi and Joao Batista de Miranda, Croatia: INTECH, 2016Chapter in book (Other academic)
    Abstract [en]

    The field of biomaterials is an exuberant and enticing field, attracting interest across a number of scientific disciplines. Synthetic materials such as metals and ceramics have helped civilisation accomplish many feats, and this can also be said for the achievements in orthopaedic applications. Metals and ceramics have achieved success in non-load-bearing applications and attempts are made to translate the accomplishments into weight-bearing applications. For this, a material needs to be porous but with sufficient strength to withstand daily loading; however, both properties are mutually exclusive. The implant must also avoid causing adverse reactions and toxicity and, preferably, bond to the surrounding tissues. Metals such as stainless steels and chromium-cobalt alloys have been used due to their excellent mechanical properties that can withstand daily activities, but retrospective studies have alluded to the possibilities of significant adverse reaction when implanted within the human body, caused by the elution of metal ions. Lessons from metals have also demonstrated that materials with significantly higher mechanical properties will not necessarily enhance the longevity of the implant—such is the complexity of the human body. Ceramics, on the other hand, exhibit excellent biocompatibility, but their mechanical properties are a significant hindrance for load-bearing use. Thus, the chapter herein provides a select overview of contemporary research undertaken to address the aforementioned drawbacks for both metals and ceramics. Furthermore, the chapter includes a section of how metals and ceramics can be combined in a multi-material approach to bring together their respective properties to achieve a desirable characteristics.

  • 331.
    Elbadawi, Mohammed
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Meredith, James
    Mosalagae, Mosalagae
    Reaney, Ian M
    Porous hydroxyapatite scaffolds fabricated from nano-sized powder via honeycomb extrusion2017In: Advanced Materials Letters, ISSN 0976-3961, E-ISSN 0976-397X, Vol. 8, no 4, p. 377-385Article in journal (Refereed)
    Abstract [en]

    In this study, we have developed hydroxyapatite (HA) scaffolds for synthetic bone graft from nano-sized HA particles using ceramic extrusion. We also demonstrate that these HA scaffolds show enhanced compressive strength (29.4 MPa), whilst possessing large pore sizes (> 600 µm) that are suitable for bone grafting. The extrusion process involved forming a ceramic paste by mixing the HA powder with a binder and distilled water. The ceramic paste was then fabricated using a ram extruder that was fitted with a honeycomb die to impart large, structured pores. Several green bodies were extruded and then subjected to the same drying and thermal debinding treatment. The samples underwent three different sintering temperatures and two varied dwell times, in order to determine the optimum sintering parameters. The scaffolds were then analysed for their chemical, physical, mechanical and biological properties to elucidate the effects of the sintering parameters on extruded HA scaffolds. The results revealed that the nano-sized particles exhibited a high sinterability, and XRD analysis showed phase purity until 1300 oC. At 1300 oC, trace amounts of phase impurities were detected, however, scaffolds sintered at this temperature exhibited the highest mean compressive strength. The findings demonstrated that traces of phase impurities were not detrimental to the scaffold’s compressive strength. In addition, scanning electron microscopy and density measurements revealed a highly densified solid phase was attained.

  • 332.
    Elbadawi, Mohammed
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Mosalagae, Mosalagae
    Goodall, Russell
    Tape casting and lost carbonate sintering processes for production of heat sinks for portable electronics2017In: Advanced Materials Letters, ISSN 0976-3961, E-ISSN 0976-397X, Vol. 8, no 7, p. 807-812Article in journal (Refereed)
    Abstract [en]

    Porous copper was fabricated by means of a powder metallurgy process applied to tape casting. Lost Carbonate Sintering (LCS) was employed to control porosity within the component during processing. The weight ratio of the potassium carbonate introduced into the matrix ranged from 30-40 wt%. Additives such as; plasticizers, binders, dispersant and solvents were utilized to control the properties throughout the processes and ease fabrication. The component was debinded and sintered at 400 °C and 900 °C respectively, under vacuum. The potassium carbonate was removed from the sintered component via dissolution in water. By using X-ray Florescence (XRF) and Energy Dispersive X-ray Spectrometry (EDS) techniques, the effectiveness of the dissolution route at removing the space holder was investigated. The results shows that porous copper produced in this way has porosity ranging from 75-85 % and pore size from 500-766 mm. The component produced has thickness ranging from 1300 -1800 mm.

  • 333.
    Elbadawi, Mohammed
    et al.
    Luleå University of Technology, Department of Health Sciences, Medical Science. Department of Mechanical Engineering, University of Sheffield, Sheffield, United Kingdom; .
    Wally, Zena J.
    Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK.
    Reaney, Ian
    Department of Materials Science and Engineering, University of Sheffield, Sheffield, UK.
    Porous Hydroxyapatite-Bioactive Glass Hybrid Scaffolds Fabricated via Ceramic Honeycomb Extrusion2018In: Journal of The American Ceramic Society, ISSN 0002-7820, E-ISSN 1551-2916, Vol. 101, no 8, p. 3541-3556Article in journal (Refereed)
    Abstract [en]

    The successful fabrication of hydroxyapatite-bioactive glass scaffolds using honeycomb extrusion is presented herein. Hydroxyapatite was combined with either 10 wt% stoichiometric Bioglass® (BG1), calcium-excess Bioglass® (BG2) or canasite (CAN). For all composite materials, glass-induced partial phase transformation of the HA into the mechanically weaker β-tricalcium phosphate (TCP) occurred but XRD data demonstrated that BG2 exhibited a lower volume fraction of TCP than BG1. Consequently, the maximum compressive strength observed for BG1 and BG2 were 30.3 ± 3.9 and 56.7 ± 6.9 MPa, respectively, for specimens sintered at 1300 °C. CAN scaffolds, in contrast, collapsed when handled when sintered below 1300 °C, and thus failed. The microstructure illustrated a morphology similar to that of BG1 sintered at 1200 °C, and hence a comparable compressive strength (11.4 ± 3.1 MPa). The results highlight the great potential offered by honeycomb extrusion for fabricating high-strength porous scaffolds. The compressive strengths exceed that of commercial scaffolds, and biological tests revealed an increase in cell viability over seven days for all hybrid scaffolds. Thus it is expected that the incorporation of 10 wt% bioactive glass will provide the added advantage of enhanced bioactivity in concert with improved mechanical stability.

  • 334.
    Eldh, Ann Catrine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Education, Health, and Social Studies, Dalarna University, SE.
    Fredriksson, Mio
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Halford, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Wallin, Lars
    School of Education, Health, and Social Studies, Dalarna University, SE.
    Dahlström, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Vengberg, Sofie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Facilitators and barriers to applying a national quality registry for quality improvement in stroke care2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, p. 354-Article in journal (Refereed)
    Abstract [en]

    Background: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. Methods: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. Results: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. Conclusion: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

  • 335.
    Eliasson, Ann-Christin
    et al.
    Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Ullenhag, Anna
    Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Wahlström, Ulla
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Habilitation.
    Krumlinde-Sundholm, Lena
    Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Mini-MACS: development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy2017In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 59, no 1, p. 72-78Article in journal (Refereed)
    Abstract [en]

    To develop the Mini-Manual Ability Classification System (Mini-MACS) and to evaluate the extent to which its ratings are valid and reliable when children younger than 4 years are rated by their parents and therapists.

  • 336.
    Eliasson, Kristina
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Occupational health services in the prevention of musculoskeletal disorders: Processes, tools and organizational aspects2017Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Work-related musculoskeletal disorders are associated with high costs and it is essential to prevent them. Occupational Health Services(OHS) provide expert services regarding work environment, health and rehabilitation of work related disorders. Risk assessments of the work environment can be an initial step for preventive measures, and ergonomists can be assigned by clients to assess exposures in the work environment. For such assignments different tools can be used. The aim of this thesis was to explore prerequisites, processes and practices of OHS consultants in Sweden within the domain of primary prevention of work-related musculoskeletal disorders. This was explored through the work of ergonomists in their role of assessing ergonomics risks. The research methodology was both quantitative and qualitative. Data collection includes a web questionnaire, semi-structured interviews and inter- and intra-observer reliability tests. The results shows that ergonomics risk assessments were most commonly initiated reactively and a systematic work methodology for the risk assessment process was often lacking. Swedish ergonomists used only a few standardized tools for risk assessment. The Ergonomics provision from the Swedish Work Environment Authority, AFS-98, was widely used, but other observation-based tools were used far less often. Ergonomics risks were often assessed solely by means of observation, based on ergonomists’ knowledge and experience. The results also pointed to that that the reliability was not acceptable when risk assessment was performed without any standardized tool. Furthermore, the results point to that support from the OHS organizations is an important prerequisite for ergonomists to work with primary prevention. Further, opportunities for specialization within a specific industry sector seem to facilitate ergonomic interventions. It is also important to have close relationships with clients and to make them aware about ergonomists competence. Conclusively, this thesis identifies a numbers of areas in which OHS must develop to improve primary preventive services regarding work environment.

  • 337.
    Eliasson, Kristina
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Carl, Lind
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Nyman, Teresia
    Ergonomics Risk Assessment: Tool Use and ProcessesManuscript (preprint) (Other academic)
  • 338.
    Eliasson, Kristina
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Palm, Peter
    Nyman, Teresia
    KTH, School of Technology and Health (STH). Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University and Uppsala University Hospital, Sweden.
    Forsman, Mikael
    Inter- and Intra-Observer Reliability of Risk Assessment of Repetitive Work without an Explicit MethodIn: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126Article in journal (Refereed)
  • 339.
    Elisabet, Sundewall Thorén
    et al.
    Eriksholm Reserach Centre, Denmark.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Eriksholm Research Centre, Denmark.
    Rehabiliteringsprogram för vuxna hörapparatanvändare2012Conference paper (Other academic)
  • 340.
    Elisabeth, Cartaxo
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sophia, Montero
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Kvinnlig könsstympning: Kvinnors upplevelser av könsstympning och mötet med västerländsk vård efter ingreppet2014Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Kvinnlig könsstympning är ett ingrepp då kvinnans klitoris, inre blygdläppar och yttre blygdläppar skärs bort och sys ihop i ett icke-medicinskt syfte, det finns fyra olika typer. Är vanligast förekommande i 29 länder. Lagen förbjuder att utföra könsstympning med eller utan flickornas samtycke. Det blir allt vanligare att människor från andra länder med annorlunda seder och traditioner bosätter sig i Sverige, detta leder till att sjuksköterskor möter människor med annan härkomst.

    Syfte: Syftet var att studera hur kvinnor upplever könsstympning samt bemötandet inom västerländsk vård efter ingreppet.

    Metod: Den kvalitativa studien byggde på sex biografier där kvinnorna utsatts för könsstympning och sedan mött vården i västvärlden. Biografierna analyserades med kvalitativ innehållsanalys.

    Resultat: Tre kategorier genomlyser resultatet; Att lida i det tysta, Makt och kontroll och Mötet med vården.

    Slutsats: De krävs information och utbildning för förebyggandet av könsstympning och för att identifiera flickor i riskzon. Vårdpersonal måste vårda på ett varsamt sätt där kvinnan bejakas och hela upplevelsen förstås för att tillfredsställa kvinnors behov, för att kunna möta och ge god vård till de kvinnor som redan genomgått könsstympning.

  • 341.
    Ellonen, Noora
    et al.
    University of Tampere, Tampere, Finland.
    Lucas, Steven
    Department of Women's and Children's Health, Uppsala University, Uppsala Sweden.
    Tindberg, Ylva
    Department of Women's and Children's Health and Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences. Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Parents' Self-Reported Use of Corporal Punishment and Other Humiliating Upbringing Practices in Finland and Sweden: A Comparative Study2017In: Child Abuse Review, ISSN 0952-9136, E-ISSN 1099-0852, Vol. 26, no 4, p. 289-304Article in journal (Refereed)
    Abstract [en]

    Sweden and Finland were the first countries to ban corporal punishment 30years ago. Since then, the prevalence of attitudes supporting the use of corporal punishment and the practice itself have decreased. This study examines the current frequencies of corporal punishment and other humiliating upbringing practices in Finnish and Swedish families. The analysis is based on survey data among 3170 Finnish and 1358 Swedish parents with children from newborn to 12years of age. Data were analysed using univariate tests (chi-square) and logistic regression. According to the analysis, a larger proportion of Finnish parents, and especially mothers, use humiliating upbringing practices compared to Swedish parents. This difference is not found with regard to corporal punishment. A larger proportion of Finnish parents push their children compared to Swedish parents, while a larger proportion of Swedish parents shake their children. In both countries, corporal punishment is more frequently used by fathers, boys are more often victimised than girls, toddlers are more often exposed to corporal punishment and school-age children are more often subjected to psychologically abusive practices. Corporal punishment and other humiliating upbringing practices are strongly correlated in both countries. The differences found between countries were not explained by socio-demographic factors.

  • 342.
    Elmerstig, Eva
    et al.
    Malmö University.
    Wijma, Barbro
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Swahnberg, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Being “good in bed”: body concerns, self-perceptions and gender expectations among Swedish heterosexual female and male senior high-school students2017In: Journal of sex & marital therapy, ISSN 0092-623X, E-ISSN 1521-0715, Vol. 43, no 4, p. 326-342Article in journal (Refereed)
    Abstract [en]

    We investigated gender differences regarding body perceptions, self-perceptions, values and expectations in sexual situations, and factors associated with expectations, among Swedish heterosexual female and male high-school students. A total of 2,765 students (aged 18 to 22) completed questionnaires. Women reported lower satisfaction with themselves and their body appearance (p < 0.001), and felt more inferior to their partner (p < 0.001). Men felt more superior to their partner, and felt higher expectations (p < 0.001). Male sex, difficulty saying no to sex, dissatisfaction with the body, feeling inferior or superior to partner, and considering partner's satisfaction as more important, were all associated with feeling expectations during sex.

  • 343.
    Elofsson, Kieron
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sandin, Ida
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Delaktighetens mångtydighet: En begreppsanalys2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The concept of participation lacks a clear definition. Nevertheless, nurses in Sweden have an obligation under law to work to make their patients participate. The significance of what participation implies is not cleared and therefore problems may arise in the work for participation. Aim: The purpose is to clarify the meaning of the concept of participation from a health science perspective. Method: Concept analysis in eight steps according to care researchers Walker and Avant. Results: The term's five attributes are; active participation, confirmation, information, communication and partnership. All of which must be met in order for participation to be incorporated. Conclusion: Participation is a subjective experience that can be difficult to achieve. Work is required to create opportunities for all attributes to be met.

  • 344.
    Emmanouil, A.
    et al.
    Centre for Health Telematics, Karolinska Institute, Stockholm, Sweden.
    Klein, Gunnar O.
    Centre for Health Telematics, Karolinska Institute, Stockholm, Sweden.
    Anamnesis via the Internet: Prospects and pilot results2001In: MEDINFO 2001: Proceedings of the 10th World Congress on Medical Informatics, PTS 1 and 2 / [ed] V.L. Patel, R. Rogers, R. Haux, Amsterdam, Netherlands: IOS Press, 2001, Vol. 84, p. 805-809Chapter in book (Refereed)
    Abstract [en]

    A comprehensive computerized questionnaire was developed to obtain the anamnesis of patients seeking contact with a physician for any type of new problem. The purpose of this pilot study was to investigate ifa structured questionnaire filled out by the patient and complementing an interview at the physician’s office would contribute to a better quality of the total anamnesis and/or lead to savings in time at the visit. The results encourage further developments in this direction. The potential uses proposed are, in addition to being used to improve a visit, the correct assessment of the history for prioritization and scheduling of visits and in some situations, the anamnesis obtained over the net may be the basis for medical advice without a visit. This study emphasizes the great improvement of information captured by this type of questionnaire based on medical knowledge about associated symptoms and relevant questions depending on the problem presented compared to the results obtained by a simple open question used in many e-health services today.

  • 345.
    Enehall, Josefine
    Kristianstad University, Faculty of Natural Science.
    ”Jag tänker mycket på min hälsa, men inte så mycket på vad som är nyttigt.”: Unga kvinnors syn på relationen mellan kost och hälsa2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The interest around healthy food seems to be larger than ever. Daily we receive different advice from experts, bloggers, authority and friends who tell us what we should eat to achieve good health. The advice is often different depending who the sender is. This could lead to a confused image of health and what dietary advice you as a consumer should follow.

    The aim of this study is to examine young women’s view of what characterizes a healthy diet. The purpose is to obtain a deeper understanding around different perceptions regarding the relation between food and health.

    This study includes a qualitative method and focus groups. The data has been analyzed through Belasco’s theory about the culinary triangle of contradictions.

    The results show that healthy food is a balance between for example the enjoyable and the forbidden. The women have a subjective perception of what they consider healthy and the concept is therefore characterized by an individual interpretation. Furthermore healthy food is seen as something that is homemade. The results also show that healthy food is a pressure. For example the informants are experiencing demands to perform and anxiety regarding eating in a particular way. The women receive their information from different sources, but depend mostly on their own assessments. Factors that have an impact on the choice of food for the young women are mainly linked to identity and responsibility for the environment and their own health.

    Based on this study conclusions can be drawn that healthy food is perceived individually different. What is seen as healthy varies between individuals. To achieve balance and well being young women create their own picture of health. Based on public advice and advice from family and friends, women form a personal view of healthy food, which is seen as most reliable. It can thus be seen as a challenge for authorities to reach out to the public with evidence based advices regarding health and food. 

  • 346.
    Engberg, Amanda
    Halmstad University, School of Business, Engineering and Science.
    The weight lifting belt’s impact on power output, velocity and range of motion in a squat2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Using a weight lifting belt when performing a variety of resistance exercises is becoming more and more common. The purpose of using a weight lifting belt is its supposed ability to reduce compressive forces on the lumbar spine and enhancement of athletic performance. Although the weight lifting belt has been proven to increase the intra abdominal pressure that helps reduces the shear forces during a squat, little is known about the weight lifting belts effect on the performance.

    Studies have suggested that wearing a weight lifting belt during a squat can increase the vertical velocity and range of motion. Few studies have focused on the power output, but improvements have been seen while wearing a weight lifting belt when performing a deadlift. Variables such as power, velocity and range of motion are of importance for an athlete when making individual training plans as well as measuring the progress. Therefore more research is needed to identify the actual influence of the weight lifting belt on the performance.

    Aim: The purpose of this study was to examine if weight lifting belts have an impact on an athletes ability to develop power, velocity or improve range of motion in a squat.

    Methods: Fifteen healthy men and women familiar with the squat exercise participated in the study. During the study they performed six repetitions of the squat divided into two sets, one set without a weight lifting belt and one with a weight lifting belt. Power and velocity were measured during every squat with a linear encoder and videotapes were made to later calculate the angles in the hip- and knee joints at the lowest position of the exercise.

    Results: No significant differences were found in power (p = 0.25) or concentric and eccentric velocity (p = 0.61, p = 0.16) with or without a weight lifting belt. Range of motion in the knee joint was greater when not wearing a weight lifting belt (p = 0.03), but no differences in the hip angles were found (p = 0.70).

    Conclusion: The result from the current study shows that when performing a squat the weight lifting belt has little to no effect on power, velocity or range of motion. Although a noticeable change in range of motion of the knee joint were observed, further studies on larger populations are needed to determine if it is of clinical value. 

  • 347.
    Engberg, Sandra
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science.
    Stärka barnens integritet: En kvalitativ studie om hur förskolan arbetar med att stärka barnens integritet och förebygga sexuella kränkningar mot barn2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    2440 cases of sexual child abuse was reported in 2015 in Sweden that is about one out of five children. Research shows that prevention strategies that focus on strengthening children’s integrity have proven effective for helping children recognize abusive behaviors as well as gain confidence to disclose.

       The aim of this study is to investigate and describe the preschools role in strengthening children’s integrity to prevent child abuse, and describe how the work is done. The study has a qualitative approach with mix of semi-structured and unstructured interviews, called a qualitative interview form. This study used a purposive selection, four informants with management position within preschool were interviewed. The interviews were recorded and then transcribed, which will serve as a database for analysis.  For this study a content analysis was chosen.

       The results showed that the preschool work aims to strengthen children’s integrity, but that the pre-schools do not use any specific strategies to strengthen children’s integrity with the aim of preventing child abuse.

    The conclusion showed that the preschool does not work consciously to prevent sexual child abuse, instead they are focusing in strengthening children’s integrity and values.

  • 348.
    Englund, Ulrika
    Örebro University, School of Health Sciences.
    Samverkansprojekt, och sen då?: en uppföljande studie av samverkansprocessen kring barn och unga som far illa eller riskerar att fara illa2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Satisfactory collaboration regarding children and youth in need of a comprehensive support is particularly important. Despite extensive research on collaborative work, knowledge of long term development of the collaboration process is lacking. The present thesis concerns inter-organizational collaboration within the framework of a former Swedish policy effort – focusing collaboration between schools, social services, police and the child and youth psychiatry – for the benefit of children and young people in distress or at risk. Applying a critical realist perspective, the overall aim of the thesis is to describe how former collaboration projects develop over time, and to identify significant mechanisms within this development. Through three questionnaire studies, the collaborative process development within the same collaborative settings is described (n=66) over a period of close to seven years. Estimations of 58 collaboration quality indicators within three categories *rules and regulations, *structural aspects and *shared perspectives/ consensus were collected at baseline in 2008, after one year at the final project stage in 2009, as well as five years after the project period (and the policy effort) ended, in 2014 (n=38). Two developmental trends occur: I) an overall positive trend and II) a negative trend on a comprehensive level. I) Collaboration on the target group has increased over time, are mainly incorporated into permanent organizational structures and is judged to have worked well/very well over time. II) Overall deteriorations of high estimates of the 58 quality indicators for collaborations is seen over the five year period, following the project period. However, less dramatic changes is noted on quality indicators concerning shared perspectives/consensus than on matters regarding rules and regulations and structural aspects. Five mechanisms of particular importance for the collaboration development are identified: anchoring, holistic perspectives, engagement, knowledge and clarity.

  • 349.
    Englund, Victoria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Gustavsson, Maja
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    ÄR DET NU LIVET BÖRJAR?: En litteraturstudie om patienters upplevelser av att leva med ett transplanterat organ2016Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Ordet organtransplantation betyder överflyttning av ett organ från en individ till en annan. Att få ett nytt organ innebär många omställningar i individens vardag. Det kan för individen innebära fysiska, sociala och psykiska problem.

    Syfte: Syftet var att studera patienters upplevelser av att leva med ett transplanterat organ.

    Metod: Litteraturstudien grundade sig i en kvalitativ design baserad på fem självbiografiska böcker. Böckerna analyserades med hjälp av en manifest innehållsanalys enligt Lundman och Hällgren Graneheim (2012).

    Resultat: Fyra kategorier och elva underkategorier framkom efter analys; Nya möjligheter, Nya hinder (Ökad infektionsrisk, läkemedelsbiverkningar, en förändrad kropp, livslång läkemedelsbehandling och regelbundna sjukhusbesök), Emotionella upplevelser (Tacksamhet gentemot närstående, trygghet genom tröst och stöd från sjukvårdspersonal, känslor av sorg och tacksamhet gentemot donatorn, skuldkänslor och att födas till ett nytt liv), Gemenskap med andra transplanterade individer.

    Slutsatser: Att leva med ett transplanterat organ innebär en livsomvälvande upplevelse. Det ger en andra chans till livet, men det innebär även många nya risker och begränsningar. I mötet med en individ som lever med ett transplanterat organ är det viktigt att sjuksköterskan ser till dennes livsvärld, för att kunna ge en så god omvårdnad som möjligt.

  • 350.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Johansson, Maria
    Intensive Care Unit, Gällivare Hospital.
    Mattsson, Mia
    Intensive Care Unit 57, Sunderby Hospital.
    Strömbäck, Ulrica
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine2016In: Journal of Clinical Intensive Care and Medicine, Vol. 1, p. 5-13Article in journal (Refereed)
    Abstract [en]

    Background: Intensive care patients are often in need of sedation to endure being intubated. Lightsedation is increasingly common since it has been proved to offer benefi ts such as faster recovery to patients.Aim: The aim of this study was to describe critical care nurses’ experiences of nursing patients lightlysedated with dexmedetomidine.Research Methodology: Qualitative personal interviews were conducted during 2015 with 10 critical carenurses in Sweden. Interview transcripts were analysed using inductive qualitative thematic analysis.Results: Light sedation of the patient facilitated communication and interaction with him or her, and therelationship between the patient and his or her family members. Dexmedetomidine was described as a fairlynew drug, and the critical care nurses stated that they needed more knowledge about it and about sedationscales in order to learn more about the drug’s mechanism of action and its potential side effects on patients.Conclusion: It is important to critical care nurses to learn more about dexmedetomidine and about sedationscales to assess levels of sedation, as light sedation has been shown to benefi t the patient as opposed to deepsedation that can increase recovery time.

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