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Sökning: swepub > Umeå universitet > Högskolan i Borås

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1.
  • Bratt, Ewa-Lena, 1970, et al. (författare)
  • Effectiveness of the STEPSTONES Transition Program for Adolescents With Congenital Heart Disease : A Randomized Controlled Trial
  • 2023
  • Ingår i: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972.
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Adolescents with congenital heart disease transition from childhood to adulthood and transfer from pediatric-oriented to adult-oriented care. High-level empirical evidence on the effectiveness of transitional care is scarce. This study investigated the empowering effect (primary outcome) of a structured person-centered transition program for adolescents with congenital heart disease and studied its effectiveness on transition readiness, patient-reported health, quality of life, health behaviors, disease-related knowledge, and parental outcomes e.g., parental uncertainty, readiness for transition as perceived by the parents (secondary outcomes). Methods: The STEPSTONES-trial comprised a hybrid experimental design whereby a randomized controlled trial was embedded in a longitudinal observational study. The trial was conducted in seven centers in Sweden. Two centers were allocated to the randomized controlled trial-arm, randomizing participants to intervention or control group. The other five centers were intervention-naïve centers and served as contamination check control group. Outcomes were measured at the age of 16 years (baseline), 17 years, and 18.5 years. Results: The change in empowerment from 16 years to 18.5 years differed significantly between the intervention group and control group (mean difference = 3.44; 95% confidence interval = 0.27–6.65; p = .036) in favor of intervention group. For the secondary outcomes, significant differences in change over time were found in parental involvement (p = .008), disease-related knowledge (p = .0002), and satisfaction with physical appearance (p = .039). No differences in primary or secondary outcomes were detected between the control group and contamination check control group, indicating that there was no contamination in the control group. Discussion: The STEPSTONES transition program was effective in increasing patient empowerment, reducing parental involvement, improving satisfaction with physical appearance, and increasing disease-related knowledge. © 2023 Society for Adolescent Health and Medicine
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2.
  • Beach, Dennis, 1956-, et al. (författare)
  • Rurality and education relations : metro-centricity and local values in rural communities and rural schools
  • 2019
  • Ingår i: European Educational Research Journal. - : Sage Publications. - 1474-9041. ; 18:1, s. 19-33
  • Tidskriftsartikel (refereegranskat)abstract
    • Based on ethnographic fieldwork in six different types of rural area and their schools in different parts of Sweden, this article identifies how rural schools relate to the local place and discusses some of the educational implications from this. Recurrent references to the local community were present in some schools and people there explicitly positioned themselves in the local rural context and valorised rurality positively in education exchanges, content and interactions, with positive effects on young people's experiences of participation and inclusion. These factors tended to occur in sparsely populated areas. An emphasis on nature and its value as materially vital in people's lives was present as was a critique of middle-class metrocentricity. Such values and critique seemed to be absent in other areas, where rurality was instead often represented along the metrocentric lines of a residual space in modernizing societies.
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3.
  • Benouar, Sara, et al. (författare)
  • Classification of impedance cardiography dZ/dt complex subtypes using pattern recognition artificial neural networks
  • 2021
  • Ingår i: Biomedizinische Technik (Berlin. Zeitschrift). - : Walter de Gruyter. - 1862-278X .- 0013-5585. ; 66:5, s. 515-527
  • Tidskriftsartikel (refereegranskat)abstract
    • In impedance cardiography (ICG), the detection of dZ/dt signal (ICG) characteristic points, especially the X point, is a crucial step for the calculation of hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Unfortunately, for beat-to-beat calculations, the accuracy of the detection is affected by the variability of the ICG complex subtypes. Thus, in this work, automated classification of ICG complexes is proposed to support the detection of ICG characteristic points and the extraction of hemodynamic parameters according to several existing subtypes. A novel pattern recognition artificial neural network (PRANN) approach was implemented, and a divide-and-conquer strategy was used to identify the five different waveforms of the ICG complex waveform with output nodes no greater than 3. The PRANN was trained, tested and validated using a dataset from four volunteers from a measurement of eight electrodes. Once the training was satisfactory, the deployed network was validated on two other datasets that were completely different from the training dataset. As an additional performance validation of the PRANN, each dataset included four volunteers for a total of eight volunteers. The results show an average accuracy of 96% in classifying ICG complex subtypes with only a decrease in the accuracy to 83 and 80% on the validation datasets. This work indicates that the PRANN is a promising method for automated classification of ICG subtypes, facilitating the investigation of the extraction of hemodynamic parameters from beat-to-beat dZ/dt complexes.
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4.
  • Benouar, Sara, et al. (författare)
  • Time-series NARX feedback neural network for forecasting impedance cardiography ICG missing points : a predictive model
  • 2023
  • Ingår i: Frontiers in Physiology. - : Frontiers Media S.A.. - 1664-042X. ; 14
  • Tidskriftsartikel (refereegranskat)abstract
    • One of the crucial steps in assessing hemodynamic parameters using impedance cardiography (ICG) is the detection of the characteristic points in the dZ/dt ICG complex, especially the X point. The most often estimated parameters from the ICG complex are stroke volume and cardiac output, for which is required the left ventricular pre-ejection time. Unfortunately, for beat-to-beat calculations, the accuracy of detection is affected by the variability of the ICG complex subtypes. Thus, in this work, we aim to create a predictive model that can predict the missing points and decrease the previous work percentages of missing points to support the detection of ICG characteristic points and the extraction of hemodynamic parameters according to several existing subtypes. Thus, a time-series non-linear autoregressive model with exogenous inputs (NARX) feedback neural network approach was implemented to forecast the missing ICG points according to the different existing subtypes. The NARX was trained on two different datasets with an open-loop mode to ensure that the network is fed with correct feedback inputs. Once the training is satisfactory, the loop can be closed for multi-step prediction tests and simulation. The results show that we can predict the missing characteristic points in all the complexes with a success rate ranging between 75% and 88% in the evaluated datasets. Previously, without the NARX predictive model, the successful detection rate was 21%–30% for the same datasets. Thus, this work indicates a promising method and an accuracy increase in the detection of X, Y, O, and Z points for both datasets.
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5.
  • Bray, Lucy, et al. (författare)
  • Developing rights-based standards for children having tests, treatments, examinations and interventions : using a collaborative, multi-phased, multi-method and multi-stakeholder approach to build consensus
  • 2023
  • Ingår i: European Journal of Pediatrics. - : Springer Nature. - 0340-6199 .- 1432-1076.
  • Tidskriftsartikel (refereegranskat)abstract
    • Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020–2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child.What is Known:• Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care.• Professionals report uncertainty and tensions in applying evidence-based practice to children’s procedural care. What is New:• This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives.• The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.
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6.
  • Hilli, Yvonne, 1959-, et al. (författare)
  • Perspectives on preceptorship:A matter of ethics
  • 2014
  • Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 21:5, s. 565-575
  • Tidskriftsartikel (refereegranskat)abstract
    • Clinical education is an essential part of the Bachelor’s program in Nursing and a keystone of professional nursing education. Through clinical experiences, the student nurses acquire nursing knowledge and essential skills for professional practice. The preceptor plays a vital role in the development of student nurses becoming professional nurses. Aim: The aim of this Nordic qualitative study was to explore the experiences of good preceptorship in relation to undergraduate student nurses in clinical education from the perspective of the preceptors themselves. Method: Data were collected by narrative interviews with 27 preceptors in Finland and Sweden and analyzed using a hermeneutical approach. Findings: A caring relationship, based on caring ethics, is seen as the foundation for learning and development. Moreover, a mutual respect is a prerequisite for fellowship and a good atmosphere. As such, encounters are characterized by reciprocity and mutuality. The preceptors have a deep sense of responsibility toward the students and the profession. Furthermore, the preceptors have an inner responsibility to guide the students into working life and to share their knowledge by acting as role models. Conclusion: The findings suggest that preceptorship should be examined through new lenses. Moreover, preceptorship is an ethical issue that should be recognized by all stakeholders.
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8.
  • Lindahl, Berit, et al. (författare)
  • On being dependent on home mechanical ventilation : depictions of patients' experiences over time.
  • 2006
  • Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 16:7, s. 881-901
  • Tidskriftsartikel (refereegranskat)abstract
    • In this study, the authors describe the meanings of experiences of being dependent on a ventilator (HMV) and living at home as narrated by 13 people who had been using a ventilator via a mask or tracheostomy for half a year. The analyses revealed various movements across time toward the goal of using the ventilator successfully, and some narratives depicted suffering caused by care. The analyses also yielded different representations of embodiment. These findings were abstracted into two contrasting meanings of the experience of using HMV over time: a closing in or an opening up of the lived body, oneself, to other people and to the world. The authors illustrate this interpretation with two images. Ignorance and negative attitudes on the part of professionals working and/or managing care in the patients' homes are interpreted as causing suffering and intensifying a closed-in mode of being.
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9.
  • Angervall, Petra, 1970-, et al. (författare)
  • Academic Career : On institutions, social capital and gender
  • 2018
  • Ingår i: Higher Education Research and Development. - : Informa UK Limited. - 0729-4360 .- 1469-8366. ; 37:6, s. 1095-1108
  • Tidskriftsartikel (refereegranskat)abstract
    • During decades of change in the Western higher education sector, new ways of understanding academic work have reinforced notions of the impact of social capital. The present study investigates researchers’ experiences of their own career making within two areas of Education Sciences in Swedish higher education: Childhood Studies (CS) and Science Education (SE). The structure at the CS departments is collaborative and integrated; teaching and research are seen as an entity. This structure creates a coherent career path where members of the collective group jointly produce and accumulate social capital; it also appears to be related to discourses of femininity. In the SE departments, the career structure is strategic and differentiated; the two career paths work in parallel through a differentiation between teaching and research. This appears to be related to discourses of masculinity. In conclusion, our analysis shows how social capital and gender mutually create different ways of doing an academic career.
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10.
  • Angervall, Petra, 1970-, et al. (författare)
  • Assembling lines in research education : Challenges, choices and resistance among Swedish doctoral students
  • 2019
  • Ingår i: Studies in Graduate and Postdoctoral Education. - : Emerald Group Publishing Limited. - 2398-4686 .- 2398-4694. ; 10:2, s. 142-154
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose – The higher education sector in Sweden has, over decades, faced increasing demands in terms of efficiency rates in research, as well as increasing demands in the international competition for external revenue. These demands have influenced academic career trajectories and postdoctoral tracks as well as the everyday work of doctoral students. The purpose of this paper is to investigate how doctoral students express and challenge subjectivity in the present context of research education.Design/methodology/approach – The authors depart from the overall understanding that doctoral students’ lines of actions in research education depend on and form assemblages and, thus, define an academic institution. By re-analysing eight in-depth interviews, they illustrate how doctoral students from different milieus not only comply but also challenge, use border-crossings and change directions in research education.Findings – The results show that some of these doctoral students try to act as loyal and satisfied, especially in regard to their supervisors, whereas others use coping strategies and resistance. It is illustrated that when some of the students use “unsecure” molecular lines, they appear more open to redefining possibilities and change, in comparison with those on more stable molar lines. Those acting on molar lines sometimes express a lack of emotional (productive) engagement, even though this particular group tend to more often get access to rewarded assemblages. These patterns are partly gender-related.Social implications – The tension between finding more stable lines and spaces for change is apparent in doctoral students’ subjectivity, but also how this tension is related to gender. The women doctoral students appear not only more mobile but also in a sense more alert than their men peers. This offers insights in how actions define and redefine not only academic institutions but also different subjectivities.Originality/value – In the present, given the manifold demands on academic institutions, new insights and methodological approaches are necessary to illustrate how contemporary changes affect research education and the everyday life of doctoral students.
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