| 41. |
- Lood, Qarin, 1981, et al.
(författare)
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Bridging barriers to health promotion : A feasibility pilot study of the 'Promoting Aging Migrants' Capabilities study'
- 2015
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Ingår i: Journal of Evaluation In Clinical Practice. - : John Wiley & Sons. - 1356-1294 .- 1365-2753. ; 21:4, s. 604-613
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectivesImproving the possibilities for ageing persons to take control over their health is an increasingly important public health issue. Health promotion has previously been visualized to succeed with this goal, but research has primarily focused on ageing persons who are native-born, leaving the generalizability to persons who are foreign-born unexplored. Therefore, as part of the development of a larger health promotion initiative for ageing persons who have experienced migration, this study aimed to assess the feasibility of an adapted protocol. The specific feasibility objectives were to assess recruitment procedure, retention rates, study questionnaire administration and variability of collected data.MethodForty persons who were ≥70 years, and who had migrated from Finland, Bosnia and Herzegovina, Croatia, Montenegro or Serbia to Sweden were randomly allocated to a health promotion programme or a control group. The programme was linguistically adapted with regard to translated information material, bilingual health professionals and evaluators, and a person-centred approach was applied to both programme development and provision. The data analysis was explorative and descriptive.ResultsThe results visualized structural and linguistic barriers to recruitment and study questionnaire administration, and describe strategies for how to bridge them. Retention rates and data variability were satisfying.ConclusionsCalling for iterative and pragmatic programme design, the findings describe how to move towards a more inclusive health care environment. Person-centred and bilingual approaches with attention to the possibilities for building authentic relationships between participants and providers are emphasized, and a structured methodology for developing study questionnaires is suggested.
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| 42. |
- Johansson, Gunvi, et al.
(författare)
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Measuring oral health from a public health perspective
- 2008
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Ingår i: Swedish Dental Journal. - Stockholm : Swedish Dental Journal. - 0347-9994. ; 32:3, s. 125-137
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Tidskriftsartikel (refereegranskat)abstract
- The paper aims to analyse measures of oral health-related quality of life (OHQOL) from a Public Health perspective. Twenty-two measures were analysed conceptually as to their mirroring of the Public Health principles: empowerment, participation, holism and equity. Elements of empowerment were found in connection with application of the measures. Participation was found in using lay opinions during development in 12 measures. All measures analysed had elements of a holistic approach so far that they were not wholly biological. Two measures captured positive health effects. Measures were available for all ages, various languages and populations, an element of equity. No measure was wholly compatible with Public Health. They were based on a utilitarian theory not in full accordance with modern health promotion. There is a need to develop measures that more obviously capture the positive aspects of health and health as a process, as well as the personal perspective of oral health.
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| 43. |
- Truong, Anh, et al.
(författare)
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Studying intraprofessional and interprofessional learning processes initiated by an educational intervention applying a qualitative design with multimethod approach : a study protocol
- 2022
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Interprofessional collaboration in education and practice has been highlighted as a premise for providing good care. Both the intraprofessional and interprofessional impacts have bearing on healthcare professionals' performance and learning. Likewise, from the perspective of work-integrated learning, intraprofessional and interprofessional learning play an enduring part in studies about the development of healthcare organisations and professional competence. Educational-intervention research has become significant, which may indicate challenges the healthcare, for example, the area of disabilities is confronting. Earlier studies on intraprofessional and interprofessional learning have often focused on the learning outcome, whereas the learning process remains unexplored. The learning process is complex and is normally influenced by several factors. Therefore, develop knowledge about the intraprofessional and interprofessional learning processes initiated by an educational-intervention and the factors influencing this process may contribute to educational-intervention research, which is also the aim of the forthcoming study. Methods and analysis An inductive qualitative study design with interpretivism as the epistemological stand will be applied. Professionals in healthcare services for people with intellectual disabilities in four residential settings in Sweden are included in the educational-intervention based on web-based training and structured group reflections. Intended data collections are videorecordings of group reflections and individual interviews. An ethnomethodological approach will be applied for studying the details of conversation and interaction in group reflections. The interviews will be analysed using qualitative content analysis to gain participants' viewpoints of the intervention. Ethics and dissemination Approval was obtained from the Swedish Ethical Review Authority, Dnr 35 517. In Addition, a supplemental application to the extended part of the intervention in the forthcoming study has been submitted and approval was received on 21 September 2021. Ethical principles following the Declaration of Helsinki will be strictly followed.
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| 44. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Health-promoting factors in higher education for a sustainable working life : protocol for a multicenter longitudinal study
- 2020
-
Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.
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| 45. |
- Pepic, I., et al.
(författare)
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Early detection of sepsis using artificial intelligence : a scoping review protocol
- 2021
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Ingår i: Systematic Reviews. - : Springer Nature. - 2046-4053. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. To decrease the high case fatality rates and morbidity for sepsis and septic shock, there is a need to increase the accuracy of early detection of suspected sepsis in prehospital and emergency department settings. This may be achieved by developing risk prediction decision support systems based on artificial intelligence.Methods: The overall aim of this scoping review is to summarize the literature on existing methods for early detection of sepsis using artificial intelligence. The review will be performed using the framework formulated by Arksey and O’Malley and further developed by Levac and colleagues. To identify primary studies and reviews that are suitable to answer our research questions, a comprehensive literature collection will be compiled by searching several sources. Constrictions regarding time and language will have to be implemented. Therefore, only studies published between 1 January 1990 and 31 December 2020 will be taken into consideration, and foreign language publications will not be considered, i.e., only papers with full text in English will be included. Databases/web search engines that will be used are PubMed, Web of Science Platform, Scopus, IEEE Xplore, Google Scholar, Cochrane Library, and ACM Digital Library. Furthermore, clinical studies that have completed patient recruitment and reported results found in the database ClinicalTrials.gov will be considered. The term artificial intelligence is viewed broadly, and a wide range of machine learning and mathematical models suitable as base for decision support will be evaluated. Two members of the team will test the framework on a sample of included studies to ensure that the coding framework is suitable and can be consistently applied. Analysis of collected data will provide a descriptive summary and thematic analysis. The reported results will convey knowledge about the state of current research and innovation for using artificial intelligence to detect sepsis in early phases of the medical care chain.Ethics and dissemination: The methodology used here is based on the use of publicly available information and does not need ethical approval. It aims at aiding further research towards digital solutions for disease detection and health innovation. Results will be extracted into a review report for submission to a peer-reviewed scientific journal. Results will be shared with relevant local and national authorities and disseminated in additional appropriate formats such as conferences, lectures, and press releases.
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| 46. |
- Björkman, Kristoffer, et al.
(författare)
-
Clinical course of patients with single large-scale mtDNA deletions and childhood onset anemia
- 2022
-
Ingår i: 14th European Paediatric Neurology Society Congress, Glasgow, UK (ISBN 978-3-00-072065-9).
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To add to our knowledge of the clinical spectrum of patients with single large-scale mitochondrial DNA (mtDNA) deletion and childhood onset anemia. Methods: Retrospective collection of clinical data from medical records for patients, both living and deceased, with a single large-scale mtDNA deletion from seven mitochondrial disease centers in five countries. Statistical analysis with descriptive methods and Kaplan-Meier survival analysis. Results: Seventeen patients matching the genetic criterium and with anemia onset before six years of age. Exocrine pancreatic insufficiency was only seen in five patients in this group. Multiple organs were involved in all patients, with the most common non-hematologic ones being skeletal muscle, central nervous system, endocrine, eyes, gastrointestinal system, kidneys, hearing, liver and heart. Psychomotor retardation was seen in ten patients, hearing impairment in nine patients, failure to thrive in eight patients. Eight later developed Kearns-Sayre syndrome. Eleven patients were deceased, with a median age at death of 7.5 years. Conclusions: The classically described phenotype of patients with large-scale mtDNA deletions and early onset anemia is Pearson marrow-pancreas syndrome, characterized by sideroblastic anemia and exocrine pancreas dysfunction. Only a minority of our patients fulfill the original criteria of Pearson syndrome though. Involvement of other organs than the pancreas is more common. The clinical course vary, but multi-system impact is the rule and life-expectancy is low. Early onset anemia in patients with large-scale mtDNA deletions is most frequently not associated with exocrine pancreas dysfunction. Better knowledge of the phenotype is helpful for diagnosis and more accurate prognosis.
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| 47. |
- Ali, Muhaddisa Barat, 1986, et al.
(författare)
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A novel federated deep learning scheme for glioma and its subtype classification
- 2023
-
Ingår i: Frontiers in Neuroscience. - 1662-4548 .- 1662-453X. ; 17
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Deep learning (DL) has shown promising results in molecular-based classification of glioma subtypes from MR images. DL requires a large number of training data for achieving good generalization performance. Since brain tumor datasets are usually small in size, combination of such datasets from different hospitals are needed. Data privacy issue from hospitals often poses a constraint on such a practice. Federated learning (FL) has gained much attention lately as it trains a central DL model without requiring data sharing from different hospitals. Method: We propose a novel 3D FL scheme for glioma and its molecular subtype classification. In the scheme, a slice-based DL classifier, EtFedDyn, is exploited which is an extension of FedDyn, with the key differences on using focal loss cost function to tackle severe class imbalances in the datasets, and on multi-stream network to exploit MRIs in different modalities. By combining EtFedDyn with domain mapping as the pre-processing and 3D scan-based post-processing, the proposed scheme makes 3D brain scan-based classification on datasets from different dataset owners. To examine whether the FL scheme could replace the central learning (CL) one, we then compare the classification performance between the proposed FL and the corresponding CL schemes. Furthermore, detailed empirical-based analysis were also conducted to exam the effect of using domain mapping, 3D scan-based post-processing, different cost functions and different FL schemes. Results: Experiments were done on two case studies: classification of glioma subtypes (IDH mutation and wild-type on TCGA and US datasets in case A) and glioma grades (high/low grade glioma HGG and LGG on MICCAI dataset in case B). The proposed FL scheme has obtained good performance on the test sets (85.46%, 75.56%) for IDH subtypes and (89.28%, 90.72%) for glioma LGG/HGG all averaged on five runs. Comparing with the corresponding CL scheme, the drop in test accuracy from the proposed FL scheme is small (−1.17%, −0.83%), indicating its good potential to replace the CL scheme. Furthermore, the empirically tests have shown that an increased classification test accuracy by applying: domain mapping (0.4%, 1.85%) in case A; focal loss function (1.66%, 3.25%) in case A and (1.19%, 1.85%) in case B; 3D post-processing (2.11%, 2.23%) in case A and (1.81%, 2.39%) in case B and EtFedDyn over FedAvg classifier (1.05%, 1.55%) in case A and (1.23%, 1.81%) in case B with fast convergence, which all contributed to the improvement of overall performance in the proposed FL scheme. Conclusion: The proposed FL scheme is shown to be effective in predicting glioma and its subtypes by using MR images from test sets, with great potential of replacing the conventional CL approaches for training deep networks. This could help hospitals to maintain their data privacy, while using a federated trained classifier with nearly similar performance as that from a centrally trained one. Further detailed experiments have shown that different parts in the proposed 3D FL scheme, such as domain mapping (make datasets more uniform) and post-processing (scan-based classification), are essential.
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| 48. |
- Berbyuk Lindström, Nataliya, 1978, et al.
(författare)
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Person- and Family-Centeredness in Ethiopian Cancer Care: Improving Communication, Ethics, Decision Making and Health
- 2020
-
Ingår i: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 9:5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cancer is a major burden in Ethiopia. The Oncology Department of Tikur Anbessa (Black Lion) Specialized Hospital (TASH) in Addis Ababa is the country's sole specialist unit for cancer care. With only a handful of oncologists, a lack of resources, and a huge patient load, the work is challenging, especially in terms of achieving effective and ethical patient consultations. Patients, usually accompanied by family members, often wait for a long time to receive medical attention and frequently depart without treatment. Handling consultations effectively is essential in order to help patients as much as possible within such limitations. OBJECTIVE: The project addresses three main aims: (1) to enhance and expand the understanding of communicative and associated ethical challenges in Ethiopian cancer care; (2) to enhance and expand the understanding of the implications and use of person- and family-centered solutions to address such communicative challenges in practice, and (3) to plan and evaluate interventions in this area. METHODS: This project develops and consolidates a research collaboration to better understand and mitigate the communicative challenges in Ethiopian cancer care, with a focus on the handling and sharing of decision making, and ethical tensions between patients, staff, and family. Using theoretical models from linguistics, health communication, and health care ethics, multiple sources of data will be analyzed. Data sources currently include semi-structured interviews with the Ethiopian staff, patients, and family caregivers (91), survey data on cancer awareness (150) and attitudes to breaking bad news (450), and video-recordings of medical consultations (45). In addition, we will also develop clinical and methodological solutions to formulate educational interventions. RESULTS: The project was awarded funding by the Swedish Research Council in December 2017 for the period 2018-2021. The research ethics board in Sweden and in Ethiopia approved the conduct of the project in May 2018. The results from the studies will be published in 2020 and 2021. CONCLUSIONS: The project is a first step towards producing unique and seminal knowledge for the specific context of Ethiopia in the area of physician-patient communication research and ethics. It contributes to an understanding of the complexity around the role of family and ethical challenges in relation to patient involvement and decision making in Ethiopia. Improved knowledge in this area can provide a fundamental model for ways to improve cancer care in many other low resource settings in Africa and the Middle East, which share central cultural prerequisites (such as a strong patriarchal family structure, combined with strong and devout religiosity). The project will also serve to develop greater understanding about current challenges in Western health systems associated with greater family and patient participation in decision making. In addition, the project will also contribute to improving the education of Ethiopian health professionals working in cancer care by developing a training program to help them better understand and respond to identified challenges associated with communication.
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| 49. |
- Munthe, Christian, 1962
(författare)
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Pure Selection. The Ethics of Preimplantation Genetic Diagnosis and Choosing Children without Abortion
- 1999
-
Bok (övrigt vetenskapligt/konstnärligt)abstract
- Preimplantation ge¬netic diagnosis (PGD) is taken to mark the starting-point of a new phase in human reproduction, where the possibility of choosing children on genetic grounds without having to resort to ethi¬cally controversial procedures (such as abortion) will grad¬ually increase. Ethical and political issues actu¬alised by this develop¬ment are addressed. The discussion touches upon issues regarding the moral status of em¬bryos and gametes, the moral import of respecting individual auton¬omy and its implications for the requirement of informed consent in health-care, the connec¬tion between sickness, dis¬ability and the value of life, the moral status of possible future people, and the connection between choosing children and eugenic policies of the past. Practical policy issues are adressed on the basis of this, as well as an empirical case-study of the intro¬duction of PGD in Sweden. The book ends up in a set of recommendations regarding the management of re¬search on, introduction and routine use of procedures for pure se¬lection, both within health care and from the point of view of society as a whole. It is argued that research on such procedures should be allowed and supported by society. However, tight restrictions regarding the clinical introduction of new procedures in this area is highly desirable. A rough model for implementing such re¬strictions is also pre¬sented. It is further asserted that, although reasons of economy and safety should limit the access to pure se¬lection, society should not apply any explicit restrictions based on ideasregarding how different traits affect a person’s quality of life. It is stressed that, in order to to avoid a re¬sur¬rection of eugenic policies of the past, the development in this field un¬der¬lines the need for continued and strengthen public support to the sick, dis¬abled and mentally retarded.
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| 50. |
- Wild, Verina, et al.
(författare)
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Covid-19: Eine Ad hoc Public-Health-Ethikberatung : Covid-19: An ad hoc public health ethics consultation
- 2020
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Ingår i: Das Gesundheitswesen. - : Georg Thieme Verlag KG. - 0941-3790 .- 1439-4421. ; 82:6, s. 507-513
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Tidskriftsartikel (refereegranskat)abstract
- In diesem Dokument beschreiben wir den Prozess und den Inhalt einer ad hoc Public-Health-Ethikberatung vom 22. März 2020 für eine regionale Gesundheitsbehörde (Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit) zu Entscheidungen im Zusammenhang mit Covid-19. In this paper we describe the process and content of our ad hoc public health ethics consultation for a Bavarian health authority in relation to Covid-19.
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