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  • Abrandt Dahlgren, Madeleine, et al. (författare)
  • Professions as communities of practice
  • 2004
  • Ingår i: Developing Practice Knowledge for Health Professionals. - Oxford : Butterworth & Heineman. - 0-7506-5429-5 - 978-0-7506-5429-6 ; s. 71-88
  • Bokkapitel (övrigt vetenskapligt)abstract
    • The current climate of accountability and public scrutiny in the health and social care professions demands a high level of responsibility by health professionals in terms of understanding, updating and credibly using their professional knowledge.To achieve this health professionals need to acknowledge the wide variety of sources from which their knowledge is generated: they need a sound working knowledge of practice epistemology which investigates the nature of knowledge and knowledge generation which underlies practice. The call from community, governments and employers is for evidence-based practice with the expectation that health professionals fully understand the knowledge which underpins their practice and can therefore justify their practice.This book examines the nature, generation and development of professional knowledge in the health professions with particular emphasis on physiotherapy, occupational therapy, medicine and nursing. It is a user-friendly resource book accessible for practitioners, clinical educators, tertiary educators, research students and researchers.What constitutes practice knowledge? How is this knowledge created and developed? What roles do health professionals play in understanding and developing their practice knowledge?Readers, whether from a practice, education or research background, are invited to consider the implications of these questions for their practice. More than ever the rapidly changing worlds of work and society are providing many challenges to the adequacy of the knowledge bases of the health professions and the capacity of health professionals to critique and develop their knowledge to meet community needs. These issues are explored in this book.
  • Addelyan Rasi, Hamideh, et al. (författare)
  • Can a psychosocial intervention programme teaching coping strategies improve the quality of life of Iranian women?
  • 2013
  • Ingår i: BMJ Open. - BMJ Publishing Group. - 2044-6055. ; 3:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To assess whether a psychosocial intervention teaching coping strategies to women can improve quality of life (QOL) in groups of Iranian women exposed to social pressures. Design: Quasi-experimental non-randomised group design involving two categories of Iranian women, each category represented by non-equivalent intervention and comparison groups. Setting: A large urban area in Iran. Participants: 44 women; 25 single mothers and 19 newly married women. Interventions: Seventh-month psychosocial intervention aimed at providing coping strategies. Primary outcome measures: Effect sizes in four specific health-related domains and two overall perceptions of QOL and health measured by the WHOQOL-BREF instrument. Results: Large effect sizes were observed among the women exposed to the intervention in the WHOQOLBREF subdomains measuring physical health (r=0.68; p<0.001), psychological health (r=0.72; p<0.001), social relationships (r=0.52; p<0.01), environmental health (r=0.55; p<0.01) and in the overall perception of QOL (r=0.72; p<0.001); the effect size regarding overall perception of health was between small and medium (r=0.20; not significant). Small and not statistically significant effect sizes were observed in the women provided with traditional social welfare services. Conclusions: Teaching coping strategies can improve the QOL of women in societies where gender discrimination is prevalent. The findings require reproduction in studies with a more rigorous design before the intervention model can be recommended for widespread distribution.
  • Adolfsson, Annsofie, et al. (författare)
  • Applicability of general grief theory to Swedish women's experience after early miscarriage, with factor analysis of Bonanno's taxonomy, using the Perinatal Grief Scale
  • 2010
  • Ingår i: Upsala Journal of Medical Sciences. - Informa UK Ltd.. - 0300-9734. ; 115:3, s. 201-209
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Grief is a normal phenomenon but showing great variation depending on cultural and personal features. Bonanno and Kaltman have nonetheless proposed five aspects of normal grief. The aim of this study was to investigate if women with miscarriage experience normal grief. Material and methods. Content analyses of 25 transcribed conversations with women 4 weeks after their early miscarriages were classified depending on the meaning-bearing units according to Bonanno and Kaltman’s categories. In the factor analyses, these categories were compared with the Perinatal Grief Scale and women's age, number of children and number of miscarriages, and gestational weeks. Results. Women with miscarriage fulfill the criteria for having normal grief according to Bonanno and Kaltman. All of the 25 women had meaning-bearing units that were classified as cognitive disorganization, dysphoria, and health deficits, whereas disrupted social and occupational functioning and positive aspects of bereavement were represented in 22 of 25 women. From the factor analysis, there are no differences in the expression of the intensity of the grief, irrespective of whether or not the women were primiparous, younger, or had suffered a first miscarriage. Conclusion. Women’s experience of grief after miscarriage is similar to general grief after death. After her loss, the woman must have the possibility of expressing and working through her grief before she can finish her pregnancy emotionally. The care-giver must facilitate this process and accept that the intensity of the grief is not dependent on the woman’s age, or her number of earlier miscarriages.
  • Alenljung, Beatrice (författare)
  • Decision-making in the Requirements Engineering Process : A Human-centred Approach
  • 2005
  • Licentiatavhandling (övrigt vetenskapligt)abstract
    • Complex decision-making is a prominent aspect of requirements engineering and the need for improved decision support for requirements engineers has been identified by a number of authors. A first step toward better decision support in requirements engineering is to understand decision-makers’ complex decision situations. To gain a holistic perspective of the decision situation from a decision-makers perspective, a decision situation framework has been created. The framework evolved through a literature analysis of decision support systems and decision-making theories. The decision situation of requirements engineers has been studied at Ericsson Microwave Systems and is described in this thesis. Aspects of decision situations are decision matters, decision-making activities, and decision processes. Another aspect of decision situations is the factors that affect the decision-maker. A number of interrelated factors have been identified. Each factor consists of problems and these are related to decision-making theories. The consequences of this for requirements engineering decision support, represented as a list that consists of desirable high-level characteristics, are also discussed.
  • Alenljung, Beatrice (författare)
  • Envisioning a future decision support system for requirements engineering
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Complex decision-making is a prominent aspect of requirements engineering (RE) and the need for improved decision support for RE decision-makers has been identified by a number of authors in the research literature. The fundamental viewpoint that permeates this thesis is that RE decision-making can be substantially improved by RE decision support systems (REDSS) based on the actual needs of RE decision-makers as well as the actual generic human decision-making activities that take place in the RE decision processes. Thus, a first step toward better decision support in requirements engineering is to understand complex decision situations of decision-makers. In order to gain a holistic view of the decision situation from a decision-maker’s perspective, a decision situation framework has been created. The framework evolved through an analysis of decision support systems literature and decision-making theories. The decision situation of RE decision-makers has been studied at a systems engineering company and is depicted in this thesis. These situations are described in terms of, for example, RE decision matters, RE decision-making activities, and RE decision processes. Factors that affect RE decision-makers are also identified. Each factor consists of problems and difficulties. Based on the empirical findings, a number of desirable characteristics of a visionary REDSS are suggested. Examples of characteristics are to reduce the cognitive load, to support creativity and idea generation, and to support decision communication. One or more guiding principles are proposed for each characteristic and available techniques are described. The purpose of the principles and techniques is to direct further efforts concerning how to find a solution that can fulfil the characteristic. Our contributions are intended to serve as a road map that can direct the efforts of researchers addressing RE decision-making and RE decision support problems. Our intention is to widen the scope and provide new lines of thought about how decision-making in RE can be supported and improved.
  • Andersson, S.-O., et al. (författare)
  • The criteria nurses use in assessing acute trauma in military emergency care
  • 2007
  • Ingår i: Accident and Emergency Nursing. - 0965-2302. ; 15:3, s. 148-156
  • Tidskriftsartikel (refereegranskat)abstract
    • Emergency medical care for seriously injured patients in war or warlike situations is highly important when it comes to soldiers' survival and morale. The Swedish Armed Forces sends nurses, who have limited experience of caring for injured personnel in the field, on a variety of international missions. The aim of this investigation was to identify the kind of criteria nurses rely on when assessing acute trauma and what factors are affecting the emergency care of injured soldiers. A phenomenographic research approach based on interviews was used. The database for the study consists of twelve nurses who served in Bosnia in 1994-1996. The criteria nurses rely on, when assessing acute trauma in emergency care, could be described in terms of domain-specific criteria such as a physiological, an anatomical, a causal and a holistic approach as well as contextual criteria such as being able to communicate, having a sense of belonging, the military environment, the conscript medical orderly and familiarity with health-caring activity. The present study shows that the specific contextual factors affecting emergency care in the field must also be practised before the nurse faces military emergency care situations. This calls for realistic exercises and training programs, where experience from civilian emergency care is interwoven with the knowledge specific to military medical care. © 2007 Elsevier Ltd. All rights reserved.
  • Berg, Sofia, et al. (författare)
  • Using sensitivity analysis to identify keystone species and keystone links in size-based food webs
  • 2011
  • Ingår i: Oikos. - Wiley-Blackwell. - 0030-1299. ; 120:4, s. 510-519
  • Tidskriftsartikel (refereegranskat)abstract
    • Human-induced alterations in the birth and mortality rates of species and in the strength of interactions within and between species can lead to changes in the structure and resilience of ecological communities. Recent research points to the importance of considering the distribution of body sizes of species when exploring the response of communities to such perturbations. Here, we present a new size-based approach for assessing the sensitivity and elasticity of community structure (species equilibrium abundances) and resilience (rate of return to equilibrium) to changes in the intrinsic growth rate of species and in the strengths of species interactions. We apply this approach on two natural systems, the pelagic communities of the Baltic Sea and Lake Vättern, to illustrate how it can be used to identify potential keystone species and keystone links. We find that the keystone status of a species is closely linked to its body size. The analysis also suggests that communities are structurally and dynamically more sensitive to changes in the effects of prey on their consumers than in the effects of consumers on their prey. Moreover, we discuss how community sensitivity analysis can be used to study and compare the fragility of communities with different body size distributions by measuring the mean sensitivity or elasticity over all species or all interaction links in a community. We believe that the community sensitivity analysis developed here holds some promise for identifying species and links that are critical for the structural and dynamic robustness of ecological communities.
  • Bu, H., et al. (författare)
  • Genotype < 21CAs/>= 21CAs and allele < 21CAs of the MANBA gene in melanoma risk and progression in a Swedish population
  • 2009
  • Ingår i: Molecular medicine reports. - 1791-2997. ; 2:2, s. 259-263
  • Tidskriftsartikel (refereegranskat)abstract
    • Cutaneous melanoma is characterized by poor patient outcome in its later stages. The search for genetic markers is therefore crucial for the identification of populations at risk for melanoma. Highly polymorphic CA repeats in 3 proximity in the MANBA gene were examined by PCR-capillary electrophoresis in 185 Swedish melanoma patients and 441 tumor-free age- and gender-matched individuals. The associations of the polymorphisms with melanoma risk, the pigment phenotypes of the patients and tumor characteristics were analyzed. A significant difference in allelic distribution between melanoma patients and tumor-free individuals was observed. The frequency of the MANBA genotype <21CAs/>= 21CAs was significantly higher in melanoma patients than in the controls. When comparing allele distribution in patients and their matched controls, the allele <21 CAs was found to be associated with the female gender (39.8 vs. 31.2%, P=0.041, OR=1.46, 95% Cl 1.02-2.10), but not with male gender (34.4 vs. 30.9%, P=0.39). Within the melanoma group, there were no differences in the distribution of the MANBA alleles associated with patient gender or age before or after 55 years at diagnosis, nor was there any association between the MANBA genotype and pigment phenotype or tumor sites. The MANBA allele <21CAs was, however, associated with thin melanomas at diagnosis (Breslow thickness <= 1.5 mm and Clark levels I and II). In conclusion, these data suggest that MANBA polymorphisms might be an indicator of tumor growth and progression and, together with other markers, could be used to identify individuals at increased risk of melanoma.
  • Charonis, Georgios, et al. (författare)
  • Prolonged use of intrauterine contraceptive device as a risk factor for tubo-ovarian abscess
  • 2009
  • Ingår i: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - 0001-6349. ; 88:6, s. 680-684
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. The intrauterine contraceptive device (IUCD) is the most preferred method of reversible contraception in the world today. The Swedish Medical Products Agency currently recommends that women who had a copper IUCD inserted around age 40 do not need to have it extracted until one year after the menopause. Design. Retrospective study. Setting. Skovde Central Hospital, Sweden. Population. All 114 women receiving in-patient treatment for pelvic inflammatory disease (PID) over five years between January 2001 and December 2005. Methods. Comparison between cases of tubo-ovarian abscesses and salpingitis with focus on the effects of IUCDs used continually for andgt; 5 years after insertion. Main outcome measures. Age-adjusted risk of PID within or after five years of use, microbiological findings in blood, intraabdominal pus, cervical secretions or on extracted IUCDs. Results. There were 31 cases of tubo-ovarian abscesses, 63 of salpingitis, four of endometritis, and 16 of mild genital infection. When comparing women with the same IUCD andgt; 5 years to women having the same IUCD andlt;= 5 years, the risk of tubo-ovarian abscess was higher than the risk of salpingitis (OR 19.7; 95% CI 4.5-87.2). The risk remained significant after adjustment for age, both on multiple regression analysis (OR 13.5; 95% CI 2.5-72.9) and in stratified analysis for the age group 35-50 years (OR 12.0; 95% CI 1.8-81.7). Blood or abdominal cultures from patients operated upon were positive in 47.7% of the sampled cases. Intestinal tract microbes and upper respiratory tract microbes were more common than sexually transmitted infection microbes. Conclusions. The current Medical Products Agency recommendation that a woman nearing the end of her reproductive phase can safely use the same IUCD for a period exceeding five years is challenged.
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