| 1. |
- Nilsen, Per, 1960-, et al.
(författare)
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Realizing the potential of artificial intelligence in healthcare : Learning from intervention, innovation, implementation and improvement sciences
- 2022
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Ingår i: Frontiers in Health Services. - Lausanne : Frontiers Media S.A.. - 2813-0146. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Artificial intelligence (AI) is widely seen as critical for tackling fundamental challenges faced by health systems. However, research is scant on the factors that influence the implementation and routine use of AI in healthcare, how AI may interact with the context in which it is implemented, and how it can contribute to wider health system goals. We propose that AI development can benefit from knowledge generated in four scientific fields: intervention, innovation, implementation and improvement sciences.Aim: The aim of this paper is to briefly describe the four fields and to identify potentially relevant knowledge from these fields that can be utilized for understanding and/or facilitating the use of AI in healthcare. The paper is based on the authors' experience and expertise in intervention, innovation, implementation, and improvement sciences, and a selective literature review.Utilizing knowledge from the four fields: The four fields have generated a wealth of often-overlapping knowledge, some of which we propose has considerable relevance for understanding and/or facilitating the use of AI in healthcare.Conclusion: Knowledge derived from intervention, innovation, implementation, and improvement sciences provides a head start for research on the use of AI in healthcare, yet the extent to which this knowledge can be repurposed in AI studies cannot be taken for granted. Thus, when taking advantage of insights in the four fields, it is important to also be explorative and use inductive research approaches to generate knowledge that can contribute toward realizing the potential of AI in healthcare. © 2022 Nilsen, Reed, Nair, Savage, Macrae, Barlow, Svedberg, Larsson, Lundgren and Nygren.
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| 2. |
- Savage, Mairi, et al.
(författare)
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Medical leadership : boon or barrier to organisational performance? A thematic synthesis of the literature
- 2020
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Ingår i: BMJ Open. - London : BMJ Publishing Group Ltd. - 2044-6055. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe influx of management ideas into healthcare has triggered considerable debate about if and how managerial and medical logics can coexist. Recent reviews suggest that clinician involvement in hospital management can lead to superior performance. We, therefore, sought to systematically explore conditions that can either facilitate or impede the influence of medical leadership on organisational performance.DesignSystematic review using thematic synthesis guided by the Enhancing Transparency in Reporting the synthesis of Qualitative research statement.Data sourcesWe searched PubMed, Web of Science and PsycINFO from 1 January 2006 to 21 January 2020.Eligibility criteriaWe included peer-reviewed, empirical, English language articles and literature reviews that focused on physicians in the leadership and management of healthcare.Data extraction and synthesisData extraction and thematic synthesis followed an inductive approach. The results sections of the included studies were subjected to line-by-line coding to identify relevant meaning units. These were organised into descriptive themes and further synthesised into analytic themes presented as a model.ResultsThe search yielded 2176 publications, of which 73 were included. The descriptive themes illustrated a movement from 1. medical protectionism to management through medicine; 2. command and control to participatory leadership practices; and 3. organisational practices that form either incidental or willing leaders. Based on the synthesis, the authors propose a model that describes a virtuous cycle of management through medicine or a vicious cycle of medical protectionism.ConclusionsThis review helps individuals, organisations, educators and trainers better understand how medical leadership can be both a boon and a barrier to organisational performance. In contrast to the conventional view of conflicting logics, medical leadership would benefit from a more integrative model of management and medicine. Nurturing medical engagement requires participatory leadership enabled through long-term investments at the individual, organisational and system levels.
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| 3. |
- Bergman, David, et al.
(författare)
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Teaching group dynamics - do we know what we are doing? : An approach to evaluation
- 2008
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Ingår i: Medical teacher. - : Informa UK Limited. - 0142-159X .- 1466-187X. ; 30:1, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research into the efficacy of programs of leadership and group dynamics in undergraduate medical education is sparse. Aims: The aim of this study was to apply and test a pre-post evaluation design of a one-week experiential learning based course of group dynamics. Methods: Two questionnaires were sent to 160 medical students, before and after the course. The response rate was acceptable (73%). Results: While there was a small change in attitudes towards openness in their professional role and group dynamics, there was a major change in two subgroups of students to these topics. The students who were least interested in collaborative constructivist learning and those students who mainly looked for practical value were the students who changed their attitudes most towards openness in their professional role. Conclusions: It appears that those students who would be least likely to voluntarily attend such a course were the ones who learned the most. This study does not allow for any generalizations regarding the outcome of experiential learning of group dynamics, but it is an argument for the use of systematic evaluations in order to identify students who can benefit from courses aimed at improving profound knowledge.
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| 4. |
- Dahlberg, Marie, et al.
(författare)
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Why publish? : An interview study exploring patient innovators’ reasons for and experiences of scientific publishing
- 2024
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Ingår i: Research Involvement and Engagement. - : BioMed Central (BMC). - 2056-7529. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Scientific publications featuring patient-driven innovations (i.e., innovations that are developed and driven by patients or informal caregivers) are increasing. By understanding patient innovators' experiences of research publication, the scientific community may be better prepared to support or partner with patient innovators. Thus, the aim of this study was to explore patient innovators' reasons for and experiences of authoring scientific publications about their innovations.Methods: Qualitative semi-structured interviews were conducted with 15 international patient innovators from three continents who had published in scientific journals. Participants were identified through a scoping review on patient-driven innovations and snowball sampling. Interviews were conducted from June to October 2022 and the data was analyzed using the Framework Method.Findings: Participants' reasons for publishing in scientific journals were to strengthen the roles and voices of patients and informal caregivers, and to get recognition for their innovations. Some published as a response to serendipitous opportunities. Several positive experiences were reported: collaborations defined by transparency, mutual respect, and meaningful participation; learning and competence development; and gained confidence regarding the value of lived experiences in research. Participants also reported negative experiences, such as cultural barriers manifested as conservatism in academia and power imbalances between participants and researchers, and structural barriers regarding academic affiliations and research funding.Conclusions: Despite progress in increasing patient and public involvement in research and publication, our study found that patient innovators still experience barriers. This suggests that continued efforts are needed to facilitate contributions from patient innovators and other public actors to the production of relevant and meaningful research.
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| 5. |
- Esmaily, Hamideh M, et al.
(författare)
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Does an outcome-based approach to continuing medical education improve physicians' competences in rational prescribing?
- 2009
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Ingår i: Medical teacher. - : Informa UK Limited. - 0142-159X .- 1466-187X. ; 31:11, s. E500-E506
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Tidskriftsartikel (refereegranskat)abstract
- Background: Continuing medical education (CME) is compulsory in Iran, and traditionally it is lecture-based, which is mostly not successful. Outcome-based education has been proposed for CME programs. Aim: To evaluate the effectiveness of an outcome-based educational intervention with a new approach based on outcomes and aligned teaching methods, on knowledge and skills of general physicians (GPs) working in primary care compared with a concurrent CME program in the field of "Rational prescribing". Method: The method used was cluster randomized controlled design. All GPs working in six cities in one province in Iran were invited to participate. The cities were matched and randomly divided into an intervention arm for education on rational prescribing with an outcome-based approach, and a control arm for a traditional program on the same topic. Knowledge and skills were assessed using a pre- and post-test, including case scenarios. Results: In total, 112 GPs participated. There were significant improvements in knowledge and prescribing skills after the training in the intervention arm as well as in comparison with the changes in the control arm. The overall intervention effect was 26 percentage units. Conclusion: The introduction of an outcome-based approach in CME appears to be effective when creating programs to improve GPs' knowledge and skills.
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| 6. |
- Esmaily, Hamideh M., et al.
(författare)
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Identifying outcome-based indicators and developing a curriculum for a continuing medical education programme on rational prescribing using a modified Delphi process.
- 2008
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 8, s. 33-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Continuing medical education (CME) is compulsory for physicians in Iran. Recent studies in Iran show that modifications of CME elements are necessary to improve the effectiveness of the educational programmes. Other studies point to an inappropriate, even irrational drug prescribing. Based on a needs assessment study regarding CME for general physicians in the East Azerbaijan province in Iran, rational prescribing practice was recognized as a high priority issue. Considering different educational methods, outcome-based education has been proposed as a suitable approach for CME. The purpose of the study was to obtain experts' consensus about appropriate educational outcomes of rational prescribing for general physicians in CME and developing curricular contents for this education. METHODS The study consisted of two phases: The first phase was conducted using a two-round Delphi consensus process to identify the outcome-based educational indicators regarding rational prescribing for general physicians in primary care (GPs). In the second phase the agreed indicators were submitted to panels of experts for assessment and determination of content for a CME program in the field. RESULTS Twenty one learning outcomes were identified through a modified Delphi process. The indicators were used by the panels of experts and six educational topics were determined for the CME programme and the curricular content of each was defined. The topics were 1) Principles of prescription writing, 2) Adverse drug reactions, 3) Drug interactions, 4) Injections, 5) Antibiotic therapy, and 6) Anti-inflammatory agents therapy. One of the topics was not directly related to any outcome, raising a question about the need for a discussion on constructive alignment. CONCLUSIONS Consensus on learning outcomes was achieved and an educational guideline was designed. Before suggesting widespread use in the country the educational package should be tested in the CME context.
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| 7. |
- Esteve, Romain, et al.
(författare)
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Toward 4H-SiC MISFETs Devices Based on ONO (SiO2-Si3N4-SiO2) Structures
- 2011
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Ingår i: Journal of the Electrochemical Society. - : The Electrochemical Society. - 0013-4651 .- 1945-7111. ; 5:158, s. 496-501
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Tidskriftsartikel (refereegranskat)abstract
- The electrical properties of metal-insulator-semiconductor (MIS) devices based on ONO (SiO2-Si3N4-SiO2) structures fabricatedon n-type 4H-SiC (0001) epilayers have been investigated. Three different combinations of low-pressure chemical vapordeposition (LPCVD), plasma-enhanced chemical vapor deposition (PECVD) and thermal oxidations (TO) in N2O and wet oxygenH2O:O2 were studied for the formation of the ONO stack. In addition, the influence of the thickness of SiO2and Si3N4 layers were considered and recommendations for optimal ONO structure are given. Oxide characterization tests and reliability investigations have been performed at room and high temperatures. This comparative study resulted in the development of ONO structuresdescribing low oxide/near interface/interface defects and high reliability of the devices even at high temperature.
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| 8. |
- Gustafsson, Oscar, et al.
(författare)
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A performance assessment of type-II interband In0.5Ga 0.5Sb QD photodetectors
- 2013
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Ingår i: Infrared physics & technology. - : Elsevier BV. - 1350-4495 .- 1879-0275. ; 61, s. 319-324
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Tidskriftsartikel (refereegranskat)abstract
- Self-assembled quantum-dot (QD) structures with type-II band alignment to the surrounding matrix material have been proposed as a III/V material approach to realize small-bandgap device structures suitable for photon detection and imaging in the long-wavelength infrared (LWIR) band. Here, we analyze the photoresponse of In0.5Ga0.5Sb/InAs QD photodiodes and estimate the system performance of type-II QD -based photodetectors. A review of alternative design approaches is presented and the choice of matrix material is discussed in terms of band alignment and its effect on the photoresponse. Photodiodes were fabricated consisting of 10 layers of In0.5Ga 0.5Sb QDs grown on InAs (0 0 1) substrates with metal-organic vapor-phase epitaxy (MOVPE). The photoresponse and dark current were measured in single pixel devices as a function of temperature in the range 20-230 K. The quantum efficiency shows an Arrhenius type behavior, which is attributed to hole trapping. This severely limits the detector performance at typical LWIR sensor operating temperatures (60-120 K). A device design with the matrix material InAs0.6Sb0.4 is proposed as a mean to improve the performance by reducing the barrier for hole transport. This can potentially allow type-II InGaSb QDs to be a competitive sensor material for LWIR detection.
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| 9. |
- Hazelzet, Jan A., et al.
(författare)
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Value-based healthcare's blind spots : call for a dialogue
- 2021
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Ingår i: F1000Research. - London : F1000 Research Ltd. - 2046-1402. ; 10:1314
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- The value-based healthcare (VBHC) concept was first proposed as a solution to many of the ills of healthcare. Since then, we have seen the term “value” defined, used, confused, and interpreted in multiple ways. While we may disagree that competition based on value will solve healthcare’s complex challenges, value is a concept integral to the future of healthcare. Before VBHC becomes consigned to the long list of quality improvement trends and management fads that have passed through healthcare, we call for a dialogue around the term value and the implications of its different interpretations. The intention is not just to critique, but to facilitate ongoing efforts to substantially improve healthcare in ways that are relevant and sustainable for society at large.
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| 10. |
- Hemmingsson, Carl, 1964-, et al.
(författare)
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Deep-Level Defects in Electron-irradiated 4H SiC Epitaxial Layers
- 1997
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Ingår i: Journal of Applied Physics. - : AIP Publishing. - 0021-8979 .- 1089-7550. ; 81:9, s. 6155-6159
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Tidskriftsartikel (refereegranskat)abstract
- Deep level defects in electron-irradiated 4H SiC epitaxial layers grown by chemical vapor deposition were studied using deep level transient spectroscopy. The measurements performed on electron-irradiated p+n junctions in the temperature range 100–750 K revealed several electron traps and one hole trap with thermal ionization energies ranging from 0.35 to 1.65 eV. Most of these defects were already observed at a dose of irradiation as low as ≈5×1013 cm-2. Dose dependence and annealing behavior of the defects were investigated. For two of these electron traps, the electron capture cross section was measured. From the temperature dependence studies, the capture cross section of these two defects are shown to be temperature independent. © 1997 American Institute of Physics.
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