| 1. |
- Hägglund, Josefin
(författare)
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Demokratins stridslinjer : Carl Lindhagen och politikens omvandling, 1896–1923
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Carl Lindhagen was one of Sweden’s most well-known politicians at the beginning ofthe 20th century. He entered parliament as a Liberal in 1897 but joined the Social Democrats in 1909. In 1917 he became a key figure in forming the Left Socialist party,which became the Swedish Communist Party in 1921 – although it expelled him in that moment. He returned to the Social Democrats in 1923. During those years, Sweden gradually moved towards universal suffrage, including most men in 1909 and women in 1921. As an MP, Lindhagen was a central actor in debates concerning democracy, combining the roles of the visionary political thinker and the hands-on political practitioner, and doing so in ways that would spark both enthusiasm and controversy among his contemporaries. This dissertation examines how Lindhagen interpreted the transformation of politics 1896–1923, how he envisioned a future of “true” democracy and the steps he took to realize his ideals. In his perspective, the constitutional reforms of the 1910s and the 1920s only achieved “formal” democracy. From the early 1910s he preferred to label himself as a ”humanist”, seeing Liberalism and Socialism as temporary forces, contributing elements to a historical process approaching the universal values of “humanism”. In 1919 he also created a party transcending organization for “humanist politics”, gathering like-minded people among Left Socialists, Social Democrats, and Liberal leftists.This study concentrates on Lindhagen’s most active and influential years, finding its central sources in texts which he wrote, modified, used and reused, for many purposes within the parliament and in his party organizations, as well as in addressing a general public. Three chronological parts follow Lindhagen through his political affiliations, 1896–1909,1909–1917, and 1917–1923. The study shows a remarkable amount of continuity in Lindhagen’s attitudes and positions, although he elaborated them, as well as the language he used to express them, due to new experiences, situations, and political environments. This makes him a tellingly complex case in the historiography of Liberalism, Social Democracy, and Communism in Sweden. Adding to this telling complexity is also the way in which Lindhagen gradually focused more and more on political parties as a central political problem, stressing that a condition for “true democracy” was practical measures of democracy at alllevels in the political process, especially within the political parties which took theirmodern form during the era studied in the dissertation.
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| 2. |
- Bengtsson, Erik, et al.
(författare)
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Agrarian politics in Sweden, c. 1850-1950
- 2022
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Ingår i: Making Politics in the European Countryside: 1780s to 1930s. - 9782503595061 - 9782503595078 ; 19, s. 293-312
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 3. |
- Berner, Josefin, et al.
(författare)
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An experimental comparison of PID autotuners
- 2018
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Ingår i: Control Engineering Practice. - : Elsevier BV. - 0967-0661. ; 73, s. 124-133
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Tidskriftsartikel (refereegranskat)abstract
- In this paper two novel autotuners are compared with two industrially available ones. The aim is to see if the research frontline can improve the industry standard of today. Experiments are made on three laboratory processes with different characteristics. Two lag-dominated processes of which one is a level control problem with fast dynamics, and one a temperature control problem with slow dynamics, as well as one delay-dominated level control process. Both the experiments and the obtained controller performances are evaluated and discussed. The results show that the performance of the stateof-the-art industrial autotuners can be significantly improved.
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| 4. |
- Berner, Josefin, et al.
(författare)
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Asymmetric relay autotuning - Practical features for industrial use
- 2016
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Ingår i: Control Engineering Practice. - : Elsevier BV. - 0967-0661. ; 54, s. 231-245
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Tidskriftsartikel (refereegranskat)abstract
- The relay autotuner provides a simple way of finding PID controller parameters. Even though relay autotuning is much investigated in the literature, the practical aspects are not that well-documented. In this paper an asymmetric relay autotuner with features such as a startup procedure and adaptive relay amplitudes is proposed. Parameter choices and handling of noise, disturbances, start in non-steady state and other possible error sources are discussed. The autotuner is implemented and tested in an industrial air handling unit to show its use in practice. The experiments show good results, and prove that the proposed simple autotuner is well-suited for industrial use. But the experiments also enlighten possible error sources and remaining problems.
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| 5. |
- Berner, Josefin, et al.
(författare)
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Autotuner identification of TITO systems using a single relay feedback experiment
- 2017
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Ingår i: IFAC-PapersOnLine. - : Elsevier BV. - 2405-8963. ; 50:1, s. 6619-6623
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Tidskriftsartikel (refereegranskat)abstract
- Relay autotuning has proven very successful for single-input single-output systems. This paper proposes an identification method for relay autotuning of systems with two inputs and two outputs (TITO systems). The combination of asymmetric relay feedback and output error identification admits short tuning time, without the need for limit cycle convergence. The method is successfully demonstrated on relevant system models, including the Wood-Berry distillation column.
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| 6. |
- Berner, Josefin, et al.
(författare)
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Improved Relay Autotuning using Normalized Time Delay
- 2016
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Ingår i: American Control Conference (ACC), 2016.
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Konferensbidrag (refereegranskat)abstract
- The relay autotuner provides a simple way offinding PID controllers of sufficient performance. By usingan asymmetric relay function the excitation of the process isimproved. This gives better models, and hence a better tuning,without increasing the time consumption or complexity of theexperiment. Some processes demand more accurate modelingand tuning to obtain controllers of sufficient performance.These processes can be singled out by their normalized timedelays and be subject to further modeling efforts. The autotunerproposed in this paper provides a simple way of findingthe normalized time delay from the experiment, and uses itfor model and controller selection. The autotuner has beenimplemented and evaluated both in a simulation environmentand by industrial experiments.
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| 7. |
- Berner, Josefin, et al.
(författare)
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Practical Evaluation of a Novel Multivariable Relay Autotuner with Short and Efficient Excitation
- 2017
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Ingår i: IEEE Conference on Control Technology and Applications, CCTA 2017. ; , s. 1505-1510
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Konferensbidrag (refereegranskat)abstract
- In this paper we propose an autotuning method that combines a setup for decentralized relay autotuning of two-input two-output systems with an identification method that uses short experiments to estimate up to second-ordertime-delayed systems. A small modification of the experiment gives better low-frequency excitation and improved models. The method is successfully demonstrated in simulations and on a quadruple tank process.
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| 8. |
- Berner, Josefin, et al.
(författare)
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Towards a New Generation of Relay Autotuners
- 2014
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Ingår i: 19th IFAC World Congress, 2014.
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Konferensbidrag (refereegranskat)abstract
- The relay autotuner for PID control is based on the simple idea of investigating process dynamics by the oscillation obtained when the PID controller is replaced by a relay unction. In this paper an asymmetric relay function is used, which provides an equation for the static gain of the process. A method to find the normalized time delay is proposed and the benefits of this is discussed. Ways to find low-order models from the experiment are described. Considerations of how to choose the relay parameters are made and some examples are given.
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| 9. |
- Fagerlund, A. J., et al.
(författare)
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Experiences from patients in mental healthcare accessing their electronic health records : Results from a cross-national survey in Estonia, Finland, Norway, and Sweden
- 2024
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Ingår i: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients’ online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users’ overall experiences with national PAEHR services. Methods: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users’ experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. Results: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. Conclusions: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.
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| 10. |
- Fredriksson, Robert, et al.
(författare)
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The obesity gene, FTO, is of ancient origin, up-regulated during food deprivation and expressed in neurons of feeding-related nuclei of the brain
- 2008
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Ingår i: Endocrinology. - : The Endocrine Society. - 0013-7227 .- 1945-7170. ; 149:5, s. 2062-71
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Tidskriftsartikel (refereegranskat)abstract
- Gene variants of the FTO (fatso) gene have recently been strongly associated with body mass index and obesity. The FTO gene is well conserved and found in a single copy in vertebrate species including fish and chicken, suggesting that the ancestor of this gene was present 450 million years ago. Surprisingly, the FTO gene is present in two species of algae but not in any other invertebrate species. This could indicate that this gene has undergone a horizontal gene transfer. Quantitative real-time PCR showed that the gene is expressed in many peripheral and central rat tissues. Detailed in situ hybridization analysis in the mouse brain showed abundant expression in feeding-related nuclei of the brainstem and hypothalamus, such as the nucleus of the solitary tract, area postrema, and arcuate, paraventricular, and supraoptic nuclei as well as in the bed nucleus of the stria terminalis. Colabeling showed that the FTO gene is predominantly expressed in neurons, whereas it was virtually not found in astrocytes or glia cells. The FTO was significantly up-regulated (41%) in the hypothalamus of rats after 48-h food deprivation. We also found a strong negative correlation of the FTO expression level with the expression of orexigenic galanin-like peptide, which is mainly synthesized in the arcuate nucleus. These results are consistent with the hypothesis that FTO could participate in the central control of energy homeostasis.
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| 11. |
- Hagström, Josefin, et al.
(författare)
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Adolescents' and Young Adults' Experiences of Offense from Reading Their Health Records Online
- 2024
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Ingår i: Studies in Health Technology and Informatics. - : IOS Press. - 0926-9630 .- 1879-8365. ; 310, s. 1422-1423
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Tidskriftsartikel (refereegranskat)abstract
- Patients feeling offended by reading records online is a concern among healthcare professionals, however previously published work has focused on adult patients. Here, a survey was used to explore and compare experiences of offense among adolescents (15-19 years old) and young adults (20-24 years old). Findings indicated that while the ratio of those offended did not differ between adolescents and young adults, reasons for feeling offended did.
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| 12. |
- Hagström, Josefin, et al.
(författare)
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Adolescents Identifying Errors and Omissions in Their Electronic Health Records : A National Survey
- 2023
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Ingår i: Caring is Sharing. - : IOS Press. - 9781643683881 - 9781643683898 ; 302, s. 242-246
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Konferensbidrag (refereegranskat)abstract
- Patient accessible electronic health records (PAEHRs) have been proposed as a means to improve patient safety and documentation quality, as patients become an additional source to detect mistakes in the records. In pediatric care, healthcare professionals (HCP) have noted a benefit of parent proxy users correcting errors in their child's records. However, the potential of adolescents has so far been overlooked, despite reports of reading records to ensure accuracy. The present study examines errors and omissions identified by adolescents, and whether patients reported following up with HCPs. Survey data was collected during three weeks in January and February 2022 via the Swedish national PAEHR. Of 218 adolescent respondents, 60 reported having found an error (27.5%) and 44 (20.2%) had found missing information. Most adolescents did not take any action upon identifying an error or an omission (64.0%). Omissions were more often perceived as serious than errors. These findings call for development of policy and PAEHR design that facilitates reports of errors and omissions for adolescents, which could both improve trust and support the individual's transition into an involved and engaged adult patient.
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| 13. |
- Hagström, Josefin, et al.
(författare)
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Adolescents' reasons for accessing their health records online, perceived usefulness and experienced provider encouragement : a national survey in Sweden
- 2024
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Ingår i: BMJ Paediatrics Open. - : BMJ Publishing Group Ltd. - 2399-9772. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Having online access to electronic health records (EHRs) may help patients become engaged in their care at an early age. However, little is known about adolescents using patient portals. A national survey conducted within the Nordic eHealth project NORDeHEALTH provided an important opportunity to advance our understanding of adolescent users of patient portals. The present study explored reasons for reading the EHRs, the perceived usefulness of information and functions in a patient portal and the association between frequency of use and encouragement to read the EHR. Methods Data were collected in a survey using convenience sampling, available through the Swedish online health portal during 3 weeks in January and February 2022. This study included a subset of items and only respondents aged 15-19. Demographic factors and frequencies on Likert-style questions were reported with descriptive statistics, while Fisher's exact test was used to explore differences in use frequency based on having been encouraged to read by a healthcare professional (HCP). Results Of 13 008 users who completed the survey, 218 (1.7%) were unique users aged 15-19 (females: 77.1%). One-fifth (47/218, 21.6%) had been encouraged by HCPs to read their records, and having been encouraged by HCPs was related to higher use frequency (p=0.018). All types of information were rated high on usefulness, while some functions were rated low, such as blocking specific clinical notes from HCPs and managing services for family members. The main reason for reading their health records online was out of curiosity. Conclusions Adolescents who read their records online perceive it to be useful. Encouragement by HCPs can lead to increased use of patient portals among adolescents. Findings should be considered in the future design of patient portals for adolescents.
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| 14. |
- Hagström, Josefin, et al.
(författare)
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Minor and Parental Access to Electronic Health Records : Differences Across Four Countries
- 2022
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Ingår i: Challenges of Trustable AI and Added-Value on Health. - : IOS Press. - 9781643682846 - 9781643682853 ; 294, s. 495-499
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Konferensbidrag (refereegranskat)abstract
- An increasing number of countries are implementing patient access to electronic health records (EHR). However, EHR access for parents, children and adolescents presents ethical challenges of data integrity, and regulations vary across providers, regions, and countries. In the present study, we compare EHR access policy for parents, children and adolescents in four countries. Documentation from three areas: upper age limit of minors for which parents have access; age at which minors obtain access; and possibilities of access restriction and extension was collected from Sweden, Norway, Finland, and Estonia. Results showed that while all systems provided parents with automatic proxy access, age limits for its expiry differed. Furthermore, a lower minimum age than 18 for adolescent access was present in two of four countries. Differences between countries and potential implications for adolescents are discussed. We conclude that experiences of various approaches should be explored to promote the development of EHR regulations for parents, children and adolescents that increases safety, quality, and equality of care.
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| 15. |
- Hagström, Josefin, et al.
(författare)
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Minors' and guardian access to and use of a national patient portal : A retrospective comparative case study of Sweden and Finland.
- 2024
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Ingår i: International Journal of Medical Informatics. - 1386-5056 .- 1872-8243. ; 187
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Approaches to implementing online record access (ORA) via patient portals for minors and guardians vary internationally, as more countries continue to develop patient-accessible electronic health records (PAEHR) systems. Evidence of ORA usage and country-specific practices to allow or block minors' and guardians' access to minors' records during adolescence (i.e. access control practices) may provide a broader understanding of possible approaches and their implications for minors' confidentiality and guardian support.AIM: To describe and compare minors' and guardian proxy users' PAEHR usage in Sweden and Finland. Furthermore, to investigate the use of country-specific access control practices.METHODS: A retrospective, observational case study was conducted. Data were collected from PAEHR administration services in Sweden and Finland and proportional use was calculated based on population statistics. Descriptive statistics were used to analyze the results.RESULTS: In both Sweden and Finland, the proportion of adolescents accessing their PAEHR increased from younger to older age-groups reaching the proportion of 59.9 % in Sweden and 84.8 % in Finland in the age-group of 17-year-olds. The PAEHR access gap during early adolescence in Sweden may explain the lower proportion of users among those who enter adulthood. Around half of guardians in Finland accessed their minor children's records in 2022 (46.1 %), while Swedish guardian use was the highest in 2022 for newborn children (41.8 %), and decreased thereafter. Few, mainly guardians, applied for extended access in Sweden. In Finland, where a case-by-case approach to access control relies on healthcare professionals' (HCPs) consideration of a minor's maturity, 95.8 % of minors chose to disclose prescription information to their guardians.CONCLUSION: While age-based access control practices can hamper ORA for minors and guardians, case-by-case approach requires HCP resources and careful guidance to ensure equality between patients. Guardians primarily access minors' records during early childhood and adolescents show willingness to share their PAEHR with parents.
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| 16. |
- Hagström, Josefin, et al.
(författare)
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Security and Privacy of Online Record Access : A Survey of Adolescents' Views and Experiences in Sweden
- 2024
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Ingår i: Journal of Adolescent Health. - : Elsevier. - 1054-139X .- 1879-1972.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Ensuring security of online health records and patients' perceptions of security are concerns in adolescent healthcare. Little is known about adolescents' perceptions about healthcare's ability to protect online health records. This article explores adolescents' perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information. Methods: This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15–19 years. Gender and health status differences were calculated using the Kruskal-Wallis test. Results: Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%). Discussion: In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems.
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| 17. |
- Hagström, Josefin, et al.
(författare)
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Use of and Experiences With Online Access to Electronic Health Records for Parents, Children, and Adolescents : Protocol for a Scoping Review
- 2022
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Ingår i: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 11:6
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Forskningsöversikt (refereegranskat)abstract
- Background: As patient online access to electronic health records becomes the standard, implementation of access for adolescents and parents varies across providers, regions, and countries. There is currently no international compilation of evidence to guide policy decisions in matters such as age limit for access and the extent of parent proxy access.Objective: This paper presents the protocol for a scoping review of different stakeholders’ (including but not limited to end users) perspectives on use, opinions, and experiences pertaining to online access to electronic health records by parents, children, and adolescents.Methods: This scoping review will be conducted according to the Arksey and O’Malley framework. Several databases will be used to conduct a literature search (PubMed, CINAHL, and PsycInfo), in addition to literature found outside of these databases. All authors will participate in screening identified papers, following the research question: How do different stakeholders experience parents’, children’s, and adolescents’ online access to the electronic health records of children and adolescents? Data abstraction will include but will not be limited to publication type, publication year, country, sample characteristics, setting, study aim, research question, and conclusions. The data to be analyzed are from publicly available secondary sources, so this study does not require an ethics review.Results: The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. This scoping review protocol was first initiated by Uppsala University in June 2021 as part of the NordForsk-funded research project NORDeHEALTH. The results are expected to be presented in a scoping review in June 2022. The results will be disseminated through stakeholder meetings, scientific conference presentations, oral presentations to the public, and publication in a peer-reviewed journal.Conclusions: This is, to our knowledge, the first study to map the literature on the use and experiences of parents’ and adolescents’ online access to the electronic health records of children and adolescents. The findings will describe what benefits and risks have been experienced by different stakeholders so far in different countries. A mapping of studies could inform the design and implementation of future regulations around access to patient-accessible electronic health records.
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| 18. |
- Hagström, Josefin, et al.
(författare)
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Views, Use, and Experiences of Web-Based Access to Pediatric Electronic Health Records for Children, Adolescents, and Parents : Scoping Review
- 2022
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 24:11
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Forskningsöversikt (refereegranskat)abstract
- Background: Ongoing efforts worldwide to provide patients with patient-accessible electronic health records (PAEHRs) have led to variability in adolescent and parental access across providers, regions, and countries. There is no compilation of evidence to guide policy decisions in matters such as access age and the extent of parent proxy access. In this paper, we outline our scoping review of different stakeholders’ (including but not limited to end users) views, use, and experiences pertaining to web-based access to electronic health records (EHRs) by children, adolescents, and parents. Objective: The aim of this study was to identify, categorize, and summarize knowledge about different stakeholders’ (eg, children and adolescents, parents, health care professionals [HCPs], policy makers, and designers of patient portals or PAEHRs) views, use, and experiences of EHR access for children, adolescents, and parents. Methods: A scoping review was conducted according to the Arksey and O’Malley framework. A literature search identified eligible papers that focused on EHR access for children, adolescents, and parents that were published between 2007 and 2021. A number of databases were used to search for literature (PubMed, CINAHL, and PsycINFO). Results: The approach resulted in 4817 identified articles and 74 (1.54%) included articles. The papers were predominantly viewpoints based in the United States, and the number of studies on parents was larger than that on adolescents and HCPs combined. First, adolescents and parents without access anticipated low literacy and confidentiality issues; however, adolescents and parents who had accessed their records did not report such concerns. Second, the main issue for HCPs was maintaining adolescent confidentiality. This remained an issue after using PAEHRs for parents, HCPs, and other stakeholders but was not an experienced issue for adolescents. Third, the viewpoints of other stakeholders provided a number of suggestions to mitigate issues. Finally, education is needed for adolescents, parents, and HCPs. Conclusions: There is limited research on pediatric PAEHRs, particularly outside the United States, and on adolescents’ experiences with web-based access to their records. These findings could inform the design and implementation of future regulations regarding access to PAEHRs. Further examination is warranted on the experiences of adolescents, parents, and HCPs to improve usability and utility, inform universal principles reducing the current arbitrariness in the child’s age for own and parental access to EHRs among providers worldwide, and ensure that portals are equipped to safely and appropriately manage a wide variety of patient circumstances. International Registered Report Identifier (IRRID): RR2-10.2196/36158
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| 19. |
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| 20. |
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| 21. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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A Nordic Perspective on Patient Online Record Access and the European Health Data Space
- 2024
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 26:1
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Tidskriftsartikel (refereegranskat)abstract
- The Nordic countries are, together with the United States, forerunners in online record access (ORA), which has now become widespread. The importance of accessible and structured health data has also been highlighted by policy makers internationally. To ensure the full realization of ORA’s potential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, informed by our research in a Nordic-led project that carries out the first of its kind, large-scale international investigation of patients’ ORA—NORDeHEALTH (Nordic eHealth for Patients: Benchmarking and Developing for the Future). We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records. In our analysis of the proposal, we have identified five key principles for ORA: (1) the right to access, (2) proxy access, (3) patient input of their own data, (4) error and omission rectification, and (5) access control. ORA implementation today is fragmented throughout Europe, and the EHDS proposal aims to ensure all European citizens have equal online access to their health data. However, we argue that in order to implement the EHDS, we need more research evidence on the key ORA principles we have identified in our analysis. Results from the NORDeHEALTH project provide some of that evidence, but we have also identified important knowledge gaps that still need further exploration.
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| 22. |
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| 23. |
- Hägglund, Maria, et al.
(författare)
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NORDeHEALTH – Learning from the Nordic Experiences of Patient Online Record Access
- 2023
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The Nordic countries are forerunners in online record access (ORA) which has now become widespread. The importance of accessible and structured health data has also been highlighted by policymakers internationally. To ensure the full realization of ORA’spotential in the short and long term, there is a pressing need to study ORA from a cross-disciplinary, technical, clinical, humanistic, and social sciences perspective that looks beyond strictly technical aspects. In this viewpoint paper, we explore the policy changes in the European Health Data Space (EHDS) proposal to advance ORA across the European Union, and introduce a Nordic-led research project that carries out the first of its kind, large-scale international investigation of patients’ ORA; NORDeHEALTH. We argue that the EHDS proposal will pave the way for patients to access and control third-party access to their electronic health records (EHRs). This will have implications within Europe and globally as it will further extend the boundaries for accessing and using EHRs for primary and secondary data use. Research such as that led by the NORDeHEALTH project is essential in guiding the design and implementation of solutions to meet the requirements of the EHDS proposal. Further international collaboration and research are needed to ensure that socio-technical and contextual factors are considered to ensure successful and secure implementation.
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| 24. |
- Hägglund, Maria, Lektor, 1975-, et al.
(författare)
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The NORDeHEALTH 2022 Patient Survey : Cross-Sectional Study of National Patient Portal Users in Norway, Sweden, Finland, and Estonia
- 2023
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although many surveys have been conducted on patients accessing their own health records in recent years, there is a limited amount of nationwide cross-country data available on patients' views and preferences. To address this gap, an international survey of patient users was conducted in the Nordic eHealth project, NORDeHEALTH. OBJECTIVE: We aimed to investigate the sociodemographic characteristics and experiences of patients who accessed their electronic health records (EHRs) through national patient portals in Norway, Sweden, Finland, and Estonia. METHODS: A cross-sectional web-based survey was distributed using the national online health portals. The target participants were patients who accessed the national patient portals at the start of 2022 and who were aged ≥15 years. The survey included a mixture of close-ended and free-text questions about participant sociodemographics, usability experience, experiences with health care and the EHR, reasons for reading health records online, experience with errors, omissions and offense, opinions about security and privacy, and the usefulness of portal functions. In this paper, we summarized the data on participant demographics, past experience with health care, and the patient portal through descriptive statistics. RESULTS: In total, 29,334 users completed the survey, of which 9503 (32.40%) were from Norway, 13,008 (44.35%) from Sweden, 4713 (16.07%) from Finland, and 2104 (7.17%) from Estonia. National samples were comparable according to reported gender, with about two-thirds identifying as women (19,904/29,302, 67.93%). Age distributions were similar across the countries, but Finland had older users while Estonia had younger users. The highest attained education and presence of health care education varied among the national samples. In all 4 countries, patients most commonly rated their health as "fair" (11,279/29,302, 38.48%). In Estonia, participants were more often inclined to rate their health positively, whereas Norway and Sweden had the highest proportion of negative health ratings. Across the whole sample, most patients received some care in the last 2 years (25,318/29,254, 86.55%). Mental health care was more common (6214/29,254, 21.24%) than oncological care (3664/29,254, 12.52%). Overall, most patients had accessed their health record "2 to 9 times" (11,546/29,306, 39.4%), with the most frequent users residing in Sweden, where about one-third of patients accessed it "more than 20 times" (4571/13,008, 35.14%). CONCLUSIONS: This is the first large-scale international survey to compare patient users' sociodemographics and experiences with accessing their EHRs. Although the countries are in close geographic proximity and demonstrate similar advancements in giving their residents online records access, patient users in this survey differed. We will continue to investigate patients' experiences and opinions about national patient-accessible EHRs through focused analyses of the national and combined data sets from the NORDeHEALTH 2022 Patient Survey.
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| 25. |
- Jansson, Anton, 1983, et al.
(författare)
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Inledning: Politiskt aktörskap i en omvandlingstid
- 2024
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Ingår i: Politiskt aktörskap i en omvandlingstid: Sverige 1880–1930 (red. Anton Jansson, Josefin Hägglund & Erik Bengtsson). - Lund : Nordic Academic Press. - 2002-2131. - 9789189361782 ; , s. 7-26
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Bokkapitel (refereegranskat)
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| 26. |
- Jansson, Anton, 1983, et al.
(författare)
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Slutresonemang: Politiskt aktörskap i en omvandlingstid
- 2024
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Ingår i: Politiskt aktörskap i en omvandlingstid: Sverige 1880–1930 / Anton Jansson, Josefin Hägglund, Erik Bengtsson (eds.). - Lund : Nordic Academic Press. - 2002-2131. - 9789189361782 ; , s. 245-259
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Bokkapitel (refereegranskat)
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| 27. |
- Kujala, Sari, et al.
(författare)
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Benchmarking usability of patient portals in Estonia, Finland, Norway, and Sweden
- 2024
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Ingår i: International Journal of Medical Informatics. - : Elsevier. - 1386-5056 .- 1872-8243. ; 181
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Poor usability is a barrier to widespread adoption of electronic health records (EHR). Providing good usability is especially challenging in the health care context, as there is a wide variety of patient users. Usability benchmarking is an approach for improving usability by evaluating and comparing the strength and weaknesses of systems. The main purpose of this study is to benchmark usability of patient portals across countries. METHODS: A mixed-methods survey approach was applied to benchmark the national patient portals offering patient access to EHR in Estonia, Finland, Norway, and Sweden. These Nordic countries have similar public healthcare systems, and they are pioneers in offering patients access to EHR for several years. In a survey of 29,334 patients, both patients' quantitative ratings of usability and their qualitative descriptions of very positive and very negative peak experiences of portal use were collected. RESULTS: The usability scores ranged from good to fair level of usability. The narratives of very positive and very negative experiences included the benefits of the patient portals and experienced usability issues. The regression analysis of results showed that very positive and negative experiences of patient portal use explain 19-35% of the variation of usability scores in the four countries. The percentage of patients who reported very positive or very negative experiences in each country was unrelated to the usability scores across countries. CONCLUSIONS: The survey approach could be used to evaluate usability with a wide variety of users and it supported learning from comparison across the countries. The combination of quantitative and qualitative data provided an approximation of the level of the perceived usability, and identified usability issues to be improved and useful features that patients appreciate. Further work is needed to improve the comparability of the varied samples across countries.
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| 28. |
- Lindblom, Hanna, et al.
(författare)
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Implementation of the injury prevention exercise programme Knee Control plus : a cross-sectional study after dissemination efforts within a football district
- 2023
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Ingår i: Injury Prevention. - : BMJ PUBLISHING GROUP. - 1353-8047 .- 1475-5785. ; 29:5, s. 399-406
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework can be used for evaluation of implementation initiatives in sports injury prevention. The aim was to evaluate the implementation of the injury prevention exercise programme Knee Control+ among amateur clubs and coaches in one regional football district using all five dimensions of the RE-AIM framework. MethodsDissemination of Knee Control+ during the 2021 season with information and webinars within one regional football district. This was followed by a cross-sectional study with questionnaires to club personnel and coaches after the season. ResultsThe reach of Knee Control+ was fair to high, 83% of club personnel and 66% of coaches knew about the programme. 41% of club personnel and 51% of coaches had adopted it. Perceived programme effectiveness was high (6 on a 1-7 Likert scale) among coaches. Regarding implementation and maintenance, 27% of club personnel had informed coaches about Knee Control+ and 57% planned to inform coaches. The coaches had implemented the programme mainly as recommended, but half used the programme once per week or less. Intention to maintain use of the programme was high (7 on a 1-7 Likert scale) among coaches. ConclusionThe reach of Knee Control+ was fair to high, and adoption was fair in clubs, but there was a lack of policies for preventive training. Active strategies probably need to accompany dissemination of programme material. Reach, perceived effectiveness, adoption, implementation and planned maintenance were positive among coaches, but further studies are needed to analyse long-term maintenance.
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| 29. |
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| 30. |
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Politiskt aktörskap i en omvandlingstid: Sverige 1880–1930
- 2024
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- I antologin Politiskt aktörskap i en omvandlingstid möter läsaren tio personer som på ett eller annat vis agerade politiskt decennierna kring förra sekelskiftet. Riksdagsledamöter som Nelly Thüring och Carl Lindhagen studeras jämte mer eller mindre fria intellektuella som Anton Nyström, Adrian Molin och Elin Wägner, professorer som Pontus Fahlbeck, och aktivister som Martin Andersson, Karin Hollman-Adamsson och Nils Adamsson. Även mångsysslaren och feministen Anna Bugge Wicksell framträder här, främst som diplomat. Dessa personer tillhörde olika politiska läger och slogs för skilda ideal, men gemensamt har de att de försökte göra avtryck i en komplex och föränderlig politisk värld. Fokus för antologin är därmed tvåfaldig: dels ställs här själva förändringen i centrum, genom att det visas hur dessa individers position och situation skiftade, eller hur de reagerade på och tolkade samhällsomvandling. Dels finns också ett fokus på själva aktörskapet, vilken typ av handlande som personerna gjorde för att försöka vrida politiken i önskad riktning. Gällande aktörskapet framträder i antologin hur karaktäristiskt det var för politiskt aktiva under den här tiden att röra sig mellan olika handlingspositioner och sammanhang, som riksdagen, medievärlden, universiteten, affärsverksamhet, eller organisationer och samfund på gräsrotsnivå. Här tar antologin bland annat avstamp i Jan-Werner Müllers begrepp ”in-between figures” och biografiforskning. Vidare förs i bokens inledning och avslutning en diskussion kring forskningstraditionen politisk historia, med avstamp hos Max Weber och Susan Pedersen, samt relaterad till samtida svensk forskning.
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| 31. |
- Simola, Saija, et al.
(författare)
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Patients’ Experiences of a National Patient Portal and Its Usability : Cross-Sectional Survey Study
- 2023
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient portals not only provide patients with access to electronic health records (EHRs) and other digital health services, such as prescription renewals, but they can also improve patients’ self-management, engagement with health care professionals (HCPs), and care processes. However, these benefits depend on patients’ willingness to use patient portals and, ultimately, their experiences with the usefulness and ease of use of the portals. Objective: This study aimed to investigate the perceived usability of a national patient portal and the relationship of patients’ very positive and very negative experiences with perceived usability. The study was aimed to be the first step in developing an approach for benchmarking the usability of patient portals in different countries. Methods: Data were collected through a web-based survey of the My Kanta patient portal’s logged-in patient users in Finland from January 24, 2022, to February 14, 2022. Respondents were asked to rate the usability of the patient portal, and the ratings were used to calculate approximations of the System Usability Scale (SUS) score. Open-ended questions asked the patients about their positive and negative experiences with the patient portal. The statistical analysis included multivariate regression, and the experience narratives were analyzed using inductive content analysis. Results: Of the 1,262,708 logged-in patient users, 4719 responded to the survey, giving a response rate of 0.37%. The patient portal’s usability was rated as good, with a mean SUS score of 74.3 (SD 14.0). Reporting a very positive experience with the portal was positively associated with perceived usability (β=.51; P<.001), whereas reporting a very negative experience was negatively associated with perceived usability (β=−1.28; P<.001). These variables explained 23% of the variation in perceived usability. The information provided and a lack of information were the most common positive and negative experiences. Furthermore, specific functionalities, such as prescription renewal and the ease of using the patient portal, were often mentioned as very positive experiences. The patients also mentioned negative emotions, such as anger and frustration, as part of their very negative experiences. Conclusions: The study offers empirical evidence about the significant role of individual experiences when patients are evaluating the usability of patient portals. The results suggest that positive and negative experiences provide relevant information that can be used for improving the patient portal’s usability. Usability should be improved so that patients receive information efficiently, easily, and quickly. Respondents would also appreciate interactive features in the patient portal.
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