| 1. |
- Öhlén, Joakim, 1958, et al.
(författare)
-
Students’ learning as the focus for shared involvement between universities and clinical practice : a didactic model for postgraduate degree projects
- 2012
-
Ingår i: Advances in Health Sciences Education. - Dordrecht : Springer Netherlands. - 1382-4996 .- 1573-1677. ; 17:4, s. 471-487
-
Tidskriftsartikel (refereegranskat)abstract
- In an academic programme, completion of a postgraduate degree project could be a significant means of promoting student learning in evidence- and experience-based practice. In specialist nursing education, which through the European Bologna process would be raised to the master’s level, there is no tradition of including a postgraduate degree project. The aim was to develop a didactic model for specialist nursing students’ postgraduate degree projects within the second cycle of higher education (master’s level) and with a specific focus on nurturing shared involvement between universities and healthcare settings. This study embodies a participatory action research and theory-generating design founded on empirically practical try-outs. The 3-year project included five Swedish universities and related healthcare settings. A series of activities was performed and a number of data sources secured. Constant comparative analysis was applied. A didactic model is proposed for postgraduate degree projects in specialist nursing education aimed at nurturing shared involvement between universities and healthcare settings. The focus of the model is student learning in order to prepare the students for participation as specialist nurses in clinical knowledge development. The model is developed for the specialist nursing education, but it is general and could be applicable to various education programmes. © 2011 Springer Science+Business Media B.V.
|
|
| 2. |
- Finnveden, Göran, et al.
(författare)
-
Evaluation of integration of sustainable development in higher education in Sweden
- 2020
-
Ingår i: International Journal of Sustainability in Higher Education. - : Emerald Group Publishing Limited. - 1467-6370 .- 1758-6739. ; 21:4, s. 685-698
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose Since 2006, higher education institutions (HEIs) in Sweden, should according to the Higher Education Act, promote sustainable development (SD). In 2016, the Swedish Government asked the Swedish higher education authority to evaluate how this study is proceeding. The authority chose to focus on education. This paper aims to produce a report on this evaluation. Design/methodology/approach All 47 HEIs in Sweden were asked to write a self-evaluation report based on certain evaluation criteria. A panel was appointed consisting of academics and representatives for students and working life. The panel wrote an evaluation of each HEI, a report on general findings and recommendations, and gave an overall judgement of each HEI in two classes as follows: the HEI has well-developed processes for integration of SD in education or the HEI needs to develop their processes. Findings Overall, a mixed picture developed. Most HEIs could give examples of programmes or courses where SD was integrated. However, less than half of the HEIs had overarching goals for integration of SD in education or had a systematic follow-up of these goals. Even fewer worked specifically with pedagogy and didactics, teaching and learning methods and environments, sustainability competences or other characters of education for SD. Overall, only 12 out of 47 got a higher judgement. Originality/value This is a unique study in which all HEIs in a country are evaluated. This provides unique possibilities for identifying success factors and barriers. The importance of the leadership of the HEIs became clear.
|
|
| 3. |
- Gustavsson, Anders, et al.
(författare)
-
Cost of disorders of the brain in Europe 2010.
- 2011
-
Ingår i: European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 0924-977X .- 1873-7862. ; 21:10, s. 718-79
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
|
|
| 4. |
- Lundmark, Linda, et al.
(författare)
-
Vilka är ute i naturen? Delresultat från en nationell enkät om friluftsliv och naturturism i Sverige
- 2008
-
Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Detta är en av fyra rapporter som ger en översiktlig bild av resultaten från en nationell enkätundersökning om friluftsliv och naturturism i Sverige. Studien är genomförd av forskningsprogrammet Friluftsliv i förändring. Resultaten som presenteras här fokuserar bl a på vilka som är ute i naturen och vilka aktiviteter man ägnar sig åt. Nästan alla uppfattar skogar, fjäll, sjöar och hav som ”natur” men det är inte alls lika självklart med t.ex. badstränder, trädgårdar och elljusspår. Mer än hälften av de svarande är ute i naturen ganska ofta, eller mycket ofta, under vardagar. Under längre ledigheter ökar denna andel till 89 %. Naturen är också en central miljö för barns uppväxt och t.ex. har hela 94 % av de svarande ofta, eller mycket ofta, tillbringat lov och semestrar i naturen. Nöjes- och motionspromenader är vanligast att ha ägnat sig åt åtminstone en gång under en 12- månadersperiod (nästan 95 % av de svarande), följt av strövat i skog och mark (90 %), arbetat i trädgården (84 %), solbadat (81 %), och haft picknick eller grillat i naturen (80 %). Även om vi ser till de aktiviteter som är vanligast att ägna sig åt ofta (mer än 60 gånger per år) så toppas listan av nöjes- och motionspromenader (ca 32 %), följt av cykla på vägar, arbeta i trädgården, ströva i skog och mark och promenera med hund. Vi har också gjort en fördjupad analys när det gäller de tio vanligaste aktiviteterna som de svarande angett att de utövat mer än 20 gånger under en 12-månadersperiod (ca 1-2 gånger per månad). Det visar sig då att kvinnorna generellt är mer aktiva. Jogging/terränglöpning, jakt och fiske är mer vanligt bland män medan solbad, picknick och stavgång är mer representerat hos kvinnor. Gruppen under 30 år skiljer ut sig något genom att promenera med hund är vanligare och arbete i trädgården mindre vanligt, jämfört med övriga grupper. Joggning/terränglöpning tycks också vara en aktivitet främst hos yngre och medelålders, medan det omvända gäller för stavgång. Föräldrarnas uppväxtland tycks inte ha så stor betydelse för vilka aktiviteter man väljer, men svarande med svenska föräldrar utövar aktiviteterna i större utsträckning jämfört med personer vars föräldrar vuxit upp utomlands. Ett undantag finns emellertid för picknick eller att grilla i naturen vilket är vanligare hos svarande med utländska föräldrar.
|
|
| 5. |
- Olsson, Helén, 1961-, et al.
(författare)
-
Reducing or increasing violence in forensic care : A qualitative study of inpatient experiences
- 2015
-
Ingår i: Archives of Psychiatric Nursing. - Maryland Heights, USA : Elsevier BV. - 0883-9417 .- 1532-8228. ; 29:6, s. 393-400
-
Tidskriftsartikel (refereegranskat)abstract
- Semi-structured interviews with 13 forensic psychiatric inpatients that had decreased their assessed risk of violence were analyzed using interpretive description. The main contribution from this study is a detailed description of patients' own strategies to avoid violence. Participants described having an ongoing inner dialog in which they encouraged themselves, thereby increasing their self-esteem and trying to accept their current situation. An unsafe and overcrowded ward with uninterested and nonchalant staff increased the risk of aggressive behavior. In the process of decreasing violence, the patients and the forensic psychiatric nursing staff interacted to create and maintain a safe environment.
|
|
| 6. |
- Andersson, Gerhard, et al.
(författare)
-
Therapeutic alliance in guided internet-delivered cognitive behavioural treatment of depression, generalized anxiety disorder and social anxiety disorder
- 2012
-
Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 50:9, s. 544-550
-
Tidskriftsartikel (refereegranskat)abstract
- Guided internet-delivered cognitive behaviour therapy (ICBT) has been found to be effective in several controlled trials, but the mechanisms of change are largely unknown. Therapeutic alliance is a factor that has been studied in many psychotherapy trials, but the role of therapeutic alliance in ICBT is less well known. The present study investigated early alliance ratings in three separate samples. Participants from one sample of depressed individuals (N = 49), one sample of individuals with generalized anxiety disorder (N = 35), and one sample with social anxiety disorder (N = 90) completed the Working Alliance Inventory (WAI) modified for ICBT early in the treatment (weeks 3-4) when they took part in guided ICBT for their conditions. Results showed that alliance ratings were high in all three samples and that the WAI including the subscales of Task, Goal and Bond had high internal consistencies. Overall, correlations between the WAI and residualized change scores on the primary outcome measures were small and not statistically significant. We conclude that even if alliance ratings are in line with face-to-face studies, therapeutic alliance as measured by the WAI is probably less important in ICBT than in regular face-to-face psychotherapy.
|
|
| 7. |
- Landstedt, Evelina, 1978-, et al.
(författare)
-
Disentangling the directions of associations between structural social capital and mental health : Longitudinal analyses of gender, civic engagement and depressive symptoms
- 2016
-
Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 163, s. 135-143
-
Tidskriftsartikel (refereegranskat)abstract
- The present paper analysed the directions of associations between individual-level structural social capital, in the form of civic engagement, and depressive symptoms across time from age 16-42 years in Swedish men and women. More specifically, we asked whether civic engagement was related to changes in depressive symptoms, if it was the other way around, or whether the association was bi-directional. This longitudinal study used data from a 26-year prospective cohort material of 1001 individuals in Northern Sweden (482 women and 519 men). Civic engagement was measured by a single-item question reflecting the level of engagement in clubs/organisations. Depressive symptoms were assessed by a composite index. Directions of associations were analysed by means of gender-separate cross-lagged structural equation models. Models were adjusted for parental social class, parental unemployment, parental health, and family type at baseline (age 16). Levels of both civic engagement and depressive symptoms were relatively stable across time. The model with the best fit to data showed that, in men, youth civic engagement was negatively associated with depressive symptoms in adulthood, thus supporting the hypothesis that involvement in social networks promotes health, most likely through provision of social and psychological support, perceived influence, and sense of belonging. Accordingly, interventions to promote civic engagement in young men could be a way to prevent poor mental health for men later on in life. No cross-lagged effects were found among women. We discuss this gender difference in terms of gendered experiences of civic engagement which in turn generate different meanings and consequences for men and women, such as civic engagement not being as positive for women's mental health as for that of men. We conclude that theories on structural social capital and interventions to facilitate civic engagement for health promoting purposes need to acknowledge gendered life circumstances. (C) 2016 Elsevier Ltd. All rights reserved.
|
|
| 8. |
- Landstedt, Evelina, et al.
(författare)
-
The role of social position and depressive symptoms in adolescence for life-course trajectories of education and work : a cohort study
- 2016
-
Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 16
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: While a vast amount of studies confirm the social reproduction of class and status from one generation to the next, less is known about the role of health in the child generation for these processes. Research has shown that particularly mental distress in adolescence is important for future life chances. This study aimed to examine the importance of parental socioeconomic position and depressive symptoms in youth for life-course trajectories of education and labour market attachment among men and women.METHODS: Based on four waves of questionnaire data from the Northern Swedish Cohort (n = 1,001), consisting of individuals born in 1965, three steps of gender-separate analyses were undertaken. First, the individual trajectories of education and labour market attachment from age 18 to 42 were mapped through sequence analysis. Second, cluster analysis was used to identify typical trajectories. Third, two indicators of parental socioeconomic position - occupational class and employment status - and depressive symptoms at age 16 were used in multinomial regression analyses to predict adult life-course trajectories.RESULTS: Four typical trajectories were identified for men, of which three were characterised by stable employment and various lengths of education, and the fourth reflected a more unstable situation. Among women, five trajectories emerged, characterised by more instability compared to men. Low parental occupational class and unemployment were significantly associated with a higher risk of ending up in less advantaged trajectories for men while, for women, this was only the case for occupational class. Youth levels of depressive symptoms did not significantly differ across the trajectories.CONCLUSIONS: This study found support for the intergenerational reproduction of social position, particularly when measured in terms of parental occupational class. Youth depressive symptoms did not show clear differences across types of trajectories, subsequently impeding such symptoms to trigger any selection processes. While this could be a consequence of the specific framework of the current study, it may also suggest that depressive symptoms in youth are not a root cause for the more complex processes through which how social position develops across life. The possible impact of welfare and labour market policies is discussed.
|
|
| 9. |
- Schön, Ulla-Karin, 1970-, et al.
(författare)
-
Psychiatric service staff perceptions of implementing a shared decision-making tool : a process evaluation study
- 2018
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden.Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact.Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations.Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.
|
|
| 10. |
- Ekdahl, A. W., et al.
(författare)
-
Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting : a systematic review and meta-analysis
- 2015
-
Ingår i: European Geriatric Medicine. - : Elsevier. - 1878-7649 .- 1878-7657. ; 6:6, s. 523-540
-
Forskningsöversikt (refereegranskat)abstract
- Background: With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care.Objective: To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings.Data sources: CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015.Study eligibility: Randomized controlled trials.Participants: Older adults aged ≥ 65 years who were admitted to hospital with a complex condition, divided into frail and moderately frail groups.Intervention: CGA.Control: Usual care.Outcomes: Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality.Study appraisal and synthesis: The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences.Results: Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group.Conclusion: There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.
|
|
