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  • Abarca-Gómez, Leandra, et al. (författare)
  • Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults
  • 2017
  • Ingår i: Lancet (London, England). - 1474-547X. ; 390:10113, s. 2627-2642
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m(2) per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m(2) per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m(2) per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m(2) per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m(2) per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.FUNDING: Wellcome Trust, AstraZeneca Young Health Programme.
  • Nilsson, Jan, et al. (författare)
  • Development and validation of a new tool measuring nursesself-reported professional competence—The nurse professionalcompetence (NPC) Scale
  • 2014
  • Ingår i: Nurse Education Today. - Midlothian, Scotland : Churchill Livingstone. - 0260-6917. ; 2014:34, s. 574-580
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To develop and validate a new tool intended for measuring self-reported professional competenceamong both nurse students prior to graduation and among practicing nurses. The new tool is based on formalcompetence requirements from the Swedish Board of Health and Welfare, which in turn are based on WHOguidelines.Design: A methodological study including construction of a new scale and evaluation of its psychometricproperties.Participants and settings: 1086 newly graduated nurse students from 11 universities/university colleges.Results: The analyses resulted in a scale named the NPC (Nurse Professional Competence) Scale, consisting of 88items and covering eight factors: “Nursing care”, “Value-based nursing care”, “Medical/technical care”, “Teaching/learning and support”, “Documentation and information technology”, “Legislation in nursing and safetyplanning”, “Leadership in 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 intwo main themes: “Patient-related nursing” and “Nursing care organisation and development”. In addition,evidence of known-group validity for the NPC Scale was obtained.
  • Tidskriftsartikel (refereegranskat)
  • Craftman, Åsa, et al. (författare)
  • Unlicensed personnel administering medications to older persons living at home a challenge for social and care services
  • 2015
  • Ingår i: International Journal of Older People Nursing. - 1748-3735. ; 10:3, s. 201-210
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.Aim. The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.Methods. Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.Results. According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.Conclusions. Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. Implications for practice. This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.
  • Gardulf, Ann, et al. (författare)
  • The Nurse Professional Competence (NPC) Scale Self-reported competence among nursing students on the point of graduation
  • 2016
  • Ingår i: Nurse Education Today. - 0260-6917. ; 36, s. 165-171
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. Objectives: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. Methods and participants; The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1[20-56] years, 87.3% women) from 11 universities/university colleges participated. Results: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27 years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (932% vs 875% of NSPGs). Summary and conclusion: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs. (C) 2015 Elsevier Ltd. All rights reserved.
  • Nilsson, Jan, et al. (författare)
  • Disaster nursing : Self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters
  • 2016
  • Ingår i: Nurse Education in Practice. - 1471-5953. ; 17, s. 102-108
  • Tidskriftsartikel (refereegranskat)abstract
    • The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events.
  • Göransson, Kerstin, et al. (författare)
  • Speciella yrken? Specialpedagogers och speciallärares arbete och utbildning En enkätstudie
  • 2015
  • Rapport (övrigt vetenskapligt)abstract
    • Forskningsprojektet ”Speciella yrken? Ett projekt om speciallärares och specialpedagogers arbete och utbildning” är finansierat av Vetenskapsrådet. I den här rapporten redovisas resultat från delprojekt 1. Syftet med rapporten är att ge en övergripande och representativ bild av specialpedagogers och speciallärares yrkesroll. Det empiriska materialet utgörs av data från en enkätundersökning som omfattar alla som tagit specialpedagog- eller speciallärarexamen från och med 2001 års examensordning (4252 personer, svarsfrekvens 75%). I rapporten redovisas vilka kunskaper och värderingar yrkesgrupperna bedömer att deras utbildning har resulterat i, vilka arbetsuppgifter de menar kännetecknar deras praktiserande av yrkesrollen, och även vilka förutsättningar yrkesgrupperna har att hävda en specifik expertis vad gäller att identifiera och arbeta med skolproblem. Rapporten riktar sig i främsta hand till praktiskt verksamma inom skolverksamheten på olika nivåer, lärarutbildare och blivande specialpedagoger och speciallärare.
  • Malm, Mari-Cristin, et al. (författare)
  • Development of a tool to evaluate fetal movements in full-term pregnancy
  • 2014
  • Ingår i: Sexual & Reproductive HealthCare. - 1877-5756. ; 5:1, s. 31-35
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To study women's description of fetal movements in full-term pregnancy. Further to investigate if their descriptions could be sorted with regard to intensity and type of movements, using a matrix under development to be a tool for evaluating fetal movements in clinical praxis. Methods: Data were collected by distributing questionnaires including an open question: "Please describe your perception of the baby's movements during this gestational week." A matrix listed seven categories of movements divided into powerful and non-powerful movements, was used for the content analysis. Results: 393 (78%) women responded to the open question. The movements were split into two domains: Powerful movements and Non-powerful movements. Altogether, 383 (96%) women perceived fetal movements that were sorted as powerful movement: firm, slow stretching, large and side to side. Ten (4%) women described movements exclusively, i.e. movements that did not include any of the movements in the powerful domain. Most women perceived movements that corresponded to more than one type of category, and all movements described by the women could be referred to at least one of the categories in the matrix. Conclusion: The matrix was useful for identification of the women's perceptions of fetal movements in full-term pregnancy. Further studies are needed in order to develop the tool and its potential to evaluate the well-being of the fetus before it is to be used in clinical praxis.
  • Malm, Mari-Cristin, et al. (författare)
  • Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy. A Crossover trial.
  • 2014
  • Ingår i: BMC Pregnancy and Childbirth. - 1471-2393. ; 14:1, s. Art. no. 349
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundLow maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women’s compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women’s experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method.MethodsData were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method.ResultsOf the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby.ConclusionsIn the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.
  • Craftman, Åsa, et al. (författare)
  • Older people's experience of utilisation and administration of medicines in a health- and social care context.
  • 2015
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 29:4, s. 760-768
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.DESIGN: A qualitative descriptive study.METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.
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