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  • Nilsson, Jan, et al. (författare)
  • Development and validation of a new tool measuring nurses self-reported professional competence - The nurse professional competence (NPC) Scale
  • 2013
  • Ingår i: Nurse Education Today. - Elsevier. - 0260-6917.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To develop and validate a new toll intended for measuring self-reported professional competence among both nurse students prior to graduation and among praticing nurses. The new tool is based on formal competence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHO guidelines.Design: A methodological study including construction of a new scale and evaluation of its psychometric propersties.Participants and settings: 1086 newly graduated nurse student from 11 universities/university colleges.Results: The analyses resulted in a scale named the NPC (nurse Professional Competence) Scale, consisting of 88 items and covering 8 factors: "Nursing Care", "Value-based Nursing Care", "Medical/technical care", "Teaching/learning and support", "Documentation and information technology", "Legislation in nursing and safety planning", "Leadership and development of nursing care" and "Education and supervision of staff/students". All factors achieved Cronbach´s alpha values greater than 0.70. A second-order exploratory analysis resulted in two main themes: "Patient-related nursing" and "Nursing care organisation and development". In addition evidence of known-group validity for the NPC Scale was obtained.
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  • Blennow, Mats, et al. (författare)
  • One-Year Survival of Extremely Preterm Infants After Active Perinatal Care in Sweden
  • 2009
  • Ingår i: JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. - 0098-7484. ; 301:21, s. 2225-2233
  • Tidskriftsartikel (refereegranskat)abstract
    • Context Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling. Objective To determine the 1-year survival in all infants born before 27 gestational weeks in Sweden during 2004-2007. Design, Setting, and Patients Population-based prospective observational study of extremely preterm infants (707 live-born and 304 stillbirths) born to 887 mothers in 904 deliveries (102 multiple births) in all obstetric and neonatal units in Sweden from April 1, 2004, to March 31, 2007. Main Outcome Measures Infant survival to 365 days and survival without major neonatal morbidity (intraventricular hemorrhage grade andgt; 2, retinopathy of prematurity stage andgt; 2, periventricular leukomalacia, necrotizing enterocolitis, severe bronchopulmonary dysplasia). Associations between perinatal interventions and survival. Results The incidence of extreme prematurity was 3.3 per 1000 infants. Overall perinatal mortality was 45% (from 93% at 22 weeks to 24% at 26 weeks), with 30% stillbirths, including 6.5% intrapartum deaths. Of live-born infants, 91% were admitted to neonatal intensive care and 70% survived to 1 year of age (95% confidence interval [CI], 67%-73%). The Kaplan-Meier survival estimates for 22, 23, 24, 25, and 26 weeks were 9.8% (95% CI, 4%-23%), 53% ( 95% CI, 44%-63%), 67% (95% CI, 59%-75%), 82% (95% CI, 76%-87%), and 85% ( 95% CI, 81%-90%), respectively. Lower risk of infant death was associated with tocolytic treatment (adjusted for gestational age odds ratio [ OR], 0.43; 95% CI, 0.36-0.52), antenatal corticosteroids (OR, 0.44; 95% CI, 0.24-0.81), surfactant treatment within 2 hours after birth ( OR, 0.47; 95% CI, 0.32-0.71), and birth at a level III hospital (OR, 0.49; 95% CI, 0.32-0.75). Among 1-year survivors, 45% had no major neonatal morbidity. Conclusion During 2004 to 2007, 1-year survival of infants born alive at 22 to 26 weeks of gestation in Sweden was 70% and ranged from 9.8% at 22 weeks to 85% at 26 weeks.
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  • Hägglund, Gunnar, et al. (författare)
  • [In process citation].
  • 2013
  • Ingår i: Läkartidningen. - 0023-7205. ; 110:38, s. 1665-7
  • Tidskriftsartikel (refereegranskat)
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8.
  • Gunnarson, BE, et al. (författare)
  • Legacies of pre-industrial land use can bias modern tree-ring climate calibrations
  • 2012
  • Ingår i: Climate Research. - 0936-577X. ; 53:1, s. 63-76
  • Tidskriftsartikel (refereegranskat)abstract
    • In Scandinavia, dendrochronological reconstructions of past climate have mostly been based on tree-ring data from forests in which there has been, supposedly, very little or no human impact. However, human land use in sub-alpine forests has a substantially longer history and more profound effects on the forest ecosystems than previously acknowledged. Therefore, to assess human influence on tree-ring patterns over the last 500 yr, we have analyzed tree-ring patterns using trees from 2 abandoned Sami settlements and a reference site with no human impact-all situated in the Tjeggelvas Nature Reserve in north-west Sweden. The hypothesis was that land use legacies have affected tree-ring patterns, and in turn, the resulting palaeoclimate inferences that have been made from these patterns. Our results show that climate signals are strongest at the reference site and weakest at one of the settlement sites. From the 1940s to the present, tree growth at this settlement site has been significantly lower than at the reference site. Lower tree growth at old settlements may have resulted from rapid changes in the traditional land use, or following the abrupt change when the settlements were abandoned. Without site-specific know ledge of past land use, there is a high risk of accidently sampling trees that have been affected by human-induced disturbances in the past. This may create bias in the climate signals inferred from such trees, and hence bias the outcome of climate reconstructions. We therefore recommend sampling several separate sites in study areas to improve the robustness of inferences.
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9.
  • Bang, P., et al. (författare)
  • A comparison of different definitions of growth response in short prepubertal children treated with growth hormone.
  • 2011
  • Ingår i: Hormone research in pædiatrics. - 1663-2826. ; 75:5, s. 335-45
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: How to define poor growth response in the management of short growth hormone (GH)-treated children is controversial. Aim: Assess various criteria of poor response. Subjects and Methods: Short GH-treated prepubertal children [n = 456; height (Ht) SD score (SDS) <=-2] with idiopathic GH deficiency (IGHD, n = 173), idiopathic short stature (ISS, n = 37), small for gestational age (SGA, n = 54), organic GHD (OGHD, n = 40), Turner syndrome (TS, n = 43), skeletal dysplasia (n = 15), other diseases (n = 46) or syndromes (n = 48) were evaluated in this retrospective multicenter study. Median age at GH start was 6.3 years and Ht SDS -3.2. Results: Median [25-75 percentile] first-year gain in Ht SDS was 0.65 (0.40-0.90) and height velocity (HtV) 8.67 (7.51-9.90) cm/year. Almost 50% of IGHD children fulfilled at least one criterion for poor responders. In 28% of IGHD children, Ht SDS gain was <0.5 and they had lower increases in median IGF-I SDS than those with Ht SDS >0.5. Only IGHD patients with peak stimulated growth hormone level <3 mu g/l responded better than those with ISS. A higher proportion of children with TS, skeletal dysplasia or born SGA had Ht SDS gain <0.5. Conclusion: Many children respond poorly to GH therapy. Recommendations defining a criterion may help in managing short stature patients.
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10.
  • Bengtsson, Ulrika, et al. (författare)
  • Development of a mobile phone self-report system for persons with hypertension: focus group interviews with patients and providers
  • 2013
  • Ingår i: Kardiovaskulära Vårmötet 2013.
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Hypertension is a risk factor for cardiovascular disease for which poor adherence to therapy becomes a substantial threat to health. Major efforts have been made to explore reasons for poor adherence but few successful interventions have been designed. There is a need for effective strategies designed to facilitate an increased understanding for the complexity of hypertension and treatment by strengthening of patient participation as well as patient empowerment. Purpose / Methods: The aim of this study was to explore and describe relevant aspects of hypertension and hypertension treatment, from the perspective of persons with hypertension and health care providers. Focus group interviews were performed with 15 persons with hypertension and 12 health care providers and analysed according to thematic analysis. Results: Persons with hypertension perceived trust, relationship to providers, well-being and prevention of complications as important aspects of hypertension care. Further they sought to understand the interplay between symptoms and variation of blood pressure. The providers emphasised accessibility, clear and consistent counselling, prevention of complications and educational efforts but doubted patients’ ability to be participating partners in care. Conclusion: The study presents aspects that persons with hypertension and health care providers deem important in hypertension management. Our finding provides input for future outcome measures, such as self-reports and may serve as a foundation for the development of a self-report system for persons with hypertension. They may further facilitate patient empowerment by increasing the understanding of hypertension and its’ treatment, from a person-centred perspective.
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