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1.	Bendtsen, Preben, et al. (författare) Referral to an electronic screening and brief alcohol intervention in primary health care in Sweden : Impact of staff referral to the computer 2011 Ingår i: International Journal of Telemedicine and Applications. - : Hindawi Limited. - 1687-6415 .- 1687-6423. ; 918763 Tidskriftsartikel (refereegranskat)abstract The aim of this paper was to evaluate whether primary health care staff's referral of patients to perform an electronic screening and brief intervention (e-SBI) for alcohol use had a greater impact on change in alcohol consumption after 3 month, compared to patients who performed the test on their own initiative. Staff-referred responders reported reduced weekly alcohol consumption with an average decrease of 8.4 grams. In contrast, self-referred responders reported an average increase in weekly alcohol consumption of 2.4 grams. Staff-referred responders reported a 49 reduction of average number of heavy episodic drinking (HED) occasions per month. The corresponding reduction for self-referred responders was 62. The differences between staff- and self-referred patient groups in the number who moved from risky drinking to nonrisky drinking at the followup were not statistically significant. Our results indicate that standalone computers with touchscreens that provide e-SBIs for risky drinking have the same effect on drinking behaviour in both staff-referred patients and self-referred patients. Copyright Â© 2011 Preben Bendtsen et al.
2.	Sundler, Annelie Johansson, 1973-, et al. (författare) Incidents reported by nurse anesthetists in the operating room 2018 Ingår i: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 32:6, s. 699-705 Tidskriftsartikel (refereegranskat)abstract The quality of health care and patient safety in the operating room is a major concern for nurse anaesthetists. However, few studies have focused on the experiences of nurse anaesthetists’ and their contributions to safety in this setting. Therefore, this study aims to explore the content and frequency of incidents reported by nurse anaesthetists in the operating room and the risks involved in these incidents. A retrospective study with a descriptive design was conduct. Data were gathered concerning 220 incidents reported by nurse anaesthetists from 2012 to 2015 in operating rooms at a middle-sized hospital in Sweden. These were analysed with a method for qualitative and quantitative content analysis. The findings are presented in five categories: communication and teamwork; routines and guidelines; patient care; nurses’ work environment; devices, materials and technologies. In 184 (73%) of the incidents, there was either a risk of harm or there was an actual harm to patients or nurses. Of all incidents only 23 (10%) had harmed patients or nurses. Few of these incidents involved patient harm (n = 6), while a greater number involved harm to nurses (n = 17). The findings reveal lack of communication and interprofessional teamwork as the two most common areas for the reported incidents, followed by problems related to lack of compliance with guidelines and routines. The findings suggest that strategies are needed to improve these areas. Patient safety reporting systems may be important to identify risk in preventing patients and health care professionals from being harmed. In addition, the findings indicate that the nurses sought to prevent harm to patients rather than to themselves. Consequently, increased attention to the work environments of nurses, and most likely other professionals, in the operating room may be needed to prevent health care professionals from being harmed.
3.	Arkkukangas, Marina, et al. (författare) Older persons' experiences of a home-based exercise program with behavioral change support 2017 Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 33:12, s. 905-913 Tidskriftsartikel (refereegranskat)abstract Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.Purpose: This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change.Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75years or older, and a qualitative content analysis was performed.Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.
4.	Henoch, Ingela, 1956, et al. (författare) The Swedish Version of the Frommelt Attitude Toward Care of the Dying Scale : Aspects of Validity and Factors Influencing Nurses' and Nursing Students' Attitudes. 2014 Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 37:1, s. E1-E11 Tidskriftsartikel (refereegranskat)abstract BACKGROUND:: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language. OBJECTIVES:: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients. METHODS:: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used. RESULTS:: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients. CONCLUSIONS:: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients. IMPLICATION FOR PRACTICE:: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.
5.	Henoch, Ingela, et al. (författare) The Swedish version of the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) : Aspects of validity and factors influencing nurses' and nursing students' attitudes 2014 Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 37:1 Tidskriftsartikel (refereegranskat)abstract Background: Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.Objectives: The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.Methods: A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.Results: The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach [alpha]'s. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.Conclusions: Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.Implication for Practice: Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.
6.	Johansson, Annelie, et al. (författare) Twenty-Year Benefit From Adjuvant Goserelin and Tamoxifen in Premenopausal Patients With Breast Cancer in a Controlled Randomized Clinical Trial 2022 Ingår i: Journal of Clinical Oncology. - : Lippincott, Williams & Wilkins. - 0732-183X .- 1527-7755. ; 40:35, s. 4071-4082 Tidskriftsartikel (refereegranskat)abstract PURPOSETo assess the long-term (20-year) endocrine therapy benefit in premenopausal patients with breast cancer.METHODSSecondary analysis of the Stockholm trial (STO-5, 1990-1997) randomly assigning 924 premenopausal patients to 2 years of goserelin (3.6 mg subcutaneously once every 28 days), tamoxifen (40 mg orally once daily), combined goserelin and tamoxifen, or no adjuvant endocrine therapy (control) is performed. Random assignment was stratified by lymph node status; lymph node-positive patients (n = 459) were allocated to standard chemotherapy (cyclophosphamide, methotrexate, and fluorouracil). Primary tumor immunohistochemistry (n = 731) and gene expression profiling (n = 586) were conducted in 2020. The 70-gene signature identified genomic low-risk and high-risk patients. Kaplan-Meier analysis, multivariable Cox proportional hazard regression, and multivariable time-varying flexible parametric modeling assessed the long-term distant recurrence-free interval (DRFI). Swedish high-quality registries allowed a complete follow-up of 20 years.RESULTSIn estrogen receptor-positive patients (n = 584, median age 47 years), goserelin, tamoxifen, and the combination significantly improved long-term distant recurrence-free interval compared with control (multivariable hazard ratio [HR], 0.49; 95% CI, 0.32 to 0.75, HR, 0.57; 95% CI, 0.38 to 0.87, and HR, 0.63; 95% CI, 0.42 to 0.94, respectively). Significant goserelin-tamoxifen interaction was observed (P = .016). Genomic low-risk patients (n = 305) significantly benefitted from tamoxifen (HR, 0.24; 95% CI, 0.10 to 0.60), and genomic high-risk patients (n = 158) from goserelin (HR, 0.24; 95% CI, 0.10 to 0.54). Increased risk from the addition of tamoxifen to goserelin was seen in genomic high-risk patients (HR, 3.36; 95% CI, 1.39 to 8.07). Moreover, long-lasting 20-year tamoxifen benefit was seen in genomic low-risk patients, whereas genomic high-risk patients had early goserelin benefit.CONCLUSIONThis study shows 20-year benefit from 2 years of adjuvant endocrine therapy in estrogen receptor-positive premenopausal patients and suggests differential treatment benefit on the basis of tumor genomic characteristics. Combined goserelin and tamoxifen therapy showed no benefit over single treatment. Long-term follow-up to assess treatment benefit is critical.
7.	Midttun, Øivind, et al. (författare) A cross-sectional study of inflammatory markers as determinants of circulating kynurenines in the Lung Cancer Cohort Consortium 2023 Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1 Tidskriftsartikel (refereegranskat)abstract Circulating concentrations of metabolites (collectively called kynurenines) in the kynurenine pathway of tryptophan metabolism increase during inflammation, particularly in response to interferon-gamma (IFN-γ). Neopterin and the kynurenine/tryptophan ratio (KTR) are IFN-γ induced inflammatory markers, and together with C-reactive protein (CRP) and kynurenines they are associated with various diseases, but comprehensive data on the strength of associations of inflammatory markers with circulating concentrations of kynurenines are lacking. We measured circulating concentrations of neopterin, CRP, tryptophan and seven kynurenines in 5314 controls from 20 cohorts in the Lung Cancer Cohort Consortium (LC3). The associations of neopterin, KTR and CRP with kynurenines were investigated using regression models. In mixed models, one standard deviation (SD) higher KTR was associated with a 0.46 SD higher quinolinic acid (QA), and 0.31 SD higher 3-hydroxykynurenine (HK). One SD higher neopterin was associated with 0.48, 0.44, 0.36 and 0.28 SD higher KTR, QA, kynurenine and HK, respectively. KTR and neopterin respectively explained 24.1% and 16.7% of the variation in QA, and 11.4% and 7.5% of HK. CRP was only weakly associated with kynurenines in regression models. In summary, QA was the metabolite that was most strongly associated with the inflammatory markers. In general, the inflammatory markers were most strongly related to metabolites located along the tryptophan-NAD axis, which may support suggestions of increased production of NAD from tryptophan during inflammation.
8.	Wang, Xinan, et al. (författare) Impact of individual level uncertainty of lung cancer polygenic risk score (PRS) on risk stratification 2024 Ingår i: Genome Medicine. - : BioMed Central (BMC). - 1756-994X. ; 16:1 Tidskriftsartikel (refereegranskat)abstract Background: Although polygenic risk score (PRS) has emerged as a promising tool for predicting cancer risk from genome-wide association studies (GWAS), the individual-level accuracy of lung cancer PRS and the extent to which its impact on subsequent clinical applications remains largely unexplored.Methods: Lung cancer PRSs and confidence/credible interval (CI) were constructed using two statistical approaches for each individual: (1) the weighted sum of 16 GWAS-derived significant SNP loci and the CI through the bootstrapping method (PRS-16-CV) and (2) LDpred2 and the CI through posteriors sampling (PRS-Bayes), among 17,166 lung cancer cases and 12,894 controls with European ancestry from the International Lung Cancer Consortium. Individuals were classified into different genetic risk subgroups based on the relationship between their own PRS mean/PRS CI and the population level threshold.Results: Considerable variances in PRS point estimates at the individual level were observed for both methods, with an average standard deviation (s.d.) of 0.12 for PRS-16-CV and a much larger s.d. of 0.88 for PRS-Bayes. Using PRS-16-CV, only 25.0% of individuals with PRS point estimates in the lowest decile of PRS and 16.8% in the highest decile have their entire 95% CI fully contained in the lowest and highest decile, respectively, while PRS-Bayes was unable to find any eligible individuals. Only 19% of the individuals were concordantly identified as having high genetic risk (> 90th percentile) using the two PRS estimators. An increased relative risk of lung cancer comparing the highest PRS percentile to the lowest was observed when taking the CI into account (OR = 2.73, 95% CI: 2.12–3.50, P-value = 4.13 × 10−15) compared to using PRS-16-CV mean (OR = 2.23, 95% CI: 1.99–2.49, P-value = 5.70 × 10−46). Improved risk prediction performance with higher AUC was consistently observed in individuals identified by PRS-16-CV CI, and the best performance was achieved by incorporating age, gender, and detailed smoking pack-years (AUC: 0.73, 95% CI = 0.72–0.74). Conclusions: Lung cancer PRS estimates using different methods have modest correlations at the individual level, highlighting the importance of considering individual-level uncertainty when evaluating the practical utility of PRS.
9.	Zhang, Ruyang, et al. (författare) A Large-Scale Genome-Wide Gene-Gene Interaction Study of Lung Cancer Susceptibility in Europeans With a Trans-Ethnic Validation in Asians 2022 Ingår i: Journal of Thoracic Oncology. - : Elsevier. - 1556-0864 .- 1556-1380. ; 17:8, s. 974-990 Tidskriftsartikel (refereegranskat)abstract Introduction: Although genome-wide association studies have been conducted to investigate genetic variation of lung tumorigenesis, little is known about gene-gene (G × G) interactions that may influence the risk of non-small cell lung cancer (NSCLC).Methods: Leveraging a total of 445,221 European-descent participants from the International Lung Cancer Consortium OncoArray project, Transdisciplinary Research in Cancer of the Lung and UK Biobank, we performed a large-scale genome-wide G × G interaction study on European NSCLC risk by a series of analyses. First, we used BiForce to evaluate and rank more than 58 billion G × G interactions from 340,958 single-nucleotide polymorphisms (SNPs). Then, the top interactions were further tested by demographically adjusted logistic regression models. Finally, we used the selected interactions to build lung cancer screening models of NSCLC, separately, for never and ever smokers.Results: With the Bonferroni correction, we identified eight statistically significant pairs of SNPs, which predominantly appeared in the 6p21.32 and 5p15.33 regions (e.g., rs521828C6orf10 and rs204999PRRT1, ORinteraction = 1.17, p = 6.57 × 10−13; rs3135369BTNL2 and rs2858859HLA-DQA1, ORinteraction = 1.17, p = 2.43 × 10−13; rs2858859HLA-DQA1 and rs9275572HLA-DQA2, ORinteraction = 1.15, p = 2.84 × 10−13; rs2853668TERT and rs62329694CLPTM1L, ORinteraction = 0.73, p = 2.70 × 10−13). Notably, even with much genetic heterogeneity across ethnicities, three pairs of SNPs in the 6p21.32 region identified from the European-ancestry population remained significant among an Asian population from the Nanjing Medical University Global Screening Array project (rs521828C6orf10 and rs204999PRRT1, ORinteraction = 1.13, p = 0.008; rs3135369BTNL2 and rs2858859HLA-DQA1, ORinteraction = 1.11, p = 5.23 × 10−4; rs3135369BTNL2 and rs9271300HLA-DQA1, ORinteraction = 0.89, p = 0.006). The interaction-empowered polygenetic risk score that integrated classical polygenetic risk score and G × G information score was remarkable in lung cancer risk stratification.Conclusions: Important G × G interactions were identified and enriched in the 5p15.33 and 6p21.32 regions, which may enhance lung cancer screening models.
10.	Ahlstrand, Inger, et al. (författare) Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study 2022 Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1 Tidskriftsartikel (refereegranskat)abstract Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
11.	Andersson, Elin, et al. (författare) Prehospital Identification of Patients with a Final Hospital Diagnosis of Stroke. 2018 Ingår i: Prehospital and Disaster Medicine. - 1049-023X .- 1945-1938. ; , s. 63-70 Tidskriftsartikel (refereegranskat)abstract Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke.METHODS: The study had a retrospective observational design. Data were collected from reports on patients who were transported by the EMS and had a final diagnosis of stroke at a single hospital in western Sweden (630 beds) in 2015. The data sources were hospital and prehospital medical journals.RESULTS: In total, 454 patients were included. Among them, the EMS clinician suspected stroke in 52%. The findings and documentation on patients with a suspected stroke differed from the remaining patients as follows: a) More frequently documented symptoms from the face, legs/arms, and speech; b) More frequently assessments of neurology, face, arms/legs, speech, and eyes; c) More frequently addressed the major complaint with regard to time and place of onset, duration, localization, and radiation; d) Less frequently documented symptoms of headache, vertigo, and nausea; and e) More frequently had an electrocardiogram (ECG) recorded and plasma glucose sampled. In addition to the 52% of patients who had a documented initial suspicion of stroke, seven percent of the patients had an initial suspicion of transitory ischemic attack (TIA) by the EMS clinician, and a neurologist was approached in another 10%.CONCLUSION: Among 454 patients with a final diagnosis of stroke who were transported by the EMS, an initial suspicion of stroke was not documented in one-half of the cases. These patients differed from those in whom a suspicion of stroke was documented in terms of limited clinical signs of stroke, a less extensive clinical assessment, and fewer clinical investigations. Andersson E , Bohlin L , Herlitz J , Sundler AJ , Fekete Z , Andersson Hagiwara M . Prehospital identification of patients with a final hospital diagnosis of stroke.
12.	Bergh, Ingrid H. E., et al. (författare) Assessment and documentation of women's labour pain : A cross-sectional study in Swedish delivery wards 2015 Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 28:2, s. E14-E18 Tidskriftsartikel (refereegranskat)abstract Background: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. Methods: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. Results and conclusion: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
13.	Berglund, Mia, et al. (författare) Suffering caused by care - Patients' experiences from hospital settings 2012 Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 7, s. Article number 18688- Tidskriftsartikel (refereegranskat)abstract Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients’ experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one’s healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.
14.	Bertrand, Yann, et al. (författare) First Dating of a Recombination Event in Mammalian Tick-borne Flaviviruses 2012 Ingår i: PLoS ONE. - San Francisco : Public Library of Science (PLoS). - 1932-6203. ; 7:2 Tidskriftsartikel (refereegranskat)abstract The mammalian tick-borne flavivirus group (MTBFG) contains viruses associated with important human and animal diseases such as encephalitis and hemorrhagic fever. In contrast to mosquito-borne flaviviruses where recombination events are frequent, the evolutionary dynamic within the MTBFG was believed to be essentially clonal. This assumption was challenged with the recent report of several homologous recombinations within the Tick-borne encephalitis virus (TBEV). We performed a thorough analysis of publicly available genomes in this group and found no compelling evidence for the previously identified recombinations. However, our results show for the first time that demonstrable recombination (i.e., with large statistical support and strong phylogenetic evidences) has occurred in the MTBFG, more specifically within the Louping ill virus lineage. Putative parents, recombinant strains and breakpoints were further tested for statistical significance using phylogenetic methods. We investigated the time of divergence between the recombinant and parental strains in a Bayesian framework. The recombination was estimated to have occurred during a window of 282 to 76 years before the present. By unravelling the temporal setting of the event, we adduce hypotheses about the ecological conditions that could account for the observed recombination.
15.	Bisholt, Birgitta, 1963-, et al. (författare) Nursing students' assessment of the learning environment in different clinical settings 2014 Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 14:3, s. 304-310 Tidskriftsartikel (refereegranskat)abstract INTRODUCTION: Nursing students perform their clinical practice in different types of clinical settings. The clinical learning environment is important for students to be able to achieve desired learning outcomes. Knowledge is lacking about the learning environment in different clinical settings.AIM: The aim was to compare the learning environment in different clinical settings from the perspective of the nursing students.DESIGN: A cross-sectional study with comparative design was conducted.METHOD: Data was collected from 185 nursing students at three universities by means of a questionnaire involving the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) evaluation scale. An open-ended question was added in order to ascertain reasons for dissatisfaction with the clinical placement.RESULTS: The nursing students' satisfaction with the placement did not differ between clinical settings. However, those with clinical placement in hospital departments agreed more strongly that sufficient meaningful learning situations occurred and that learning situations were multi-dimensional. Some students reported that the character of the clinical setting made it difficult to achieve the learning objectives.CONCLUSION: In the planning of the clinical placement, attention must be paid to whether the setting offers the student a meaningful learning situation where the appropriate learning outcome may be achieved.
16.	Bisholt, Birgitta, et al. (författare) Vårdorganisation och sjuksköterskestudenters värdering av lärandemiljö 2012 Ingår i: Verksamhetsförlagd utbildning i högskolans vårdutbildningar – möjligheter och utmaningar. Konferensbidrag (övrigt vetenskapligt/konstnärligt)
17.	Björk, Maria, et al. (författare) Living an everyday life shaded with traces from the cancer trajectory – families' lived experiences in a six year follow up 2012 Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 59:6, s. 1130-1130 Tidskriftsartikel (refereegranskat)
18.	Blom, Helen, et al. (författare) Participation and support in intensive care as experienced by close relatives of patients : A phenomenological study 2013 Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 29:1, s. 1-8 Tidskriftsartikel (refereegranskat)abstract Aim: The aim of this study was to explore participation and support as experienced by close relatives of patients at an intensive care unit (ICU).Method: This study used the phenomenological approach as developed by Dahlberg et al. (2008) as a method for reflective lifeworld research. Seven close relatives of critically ill patients cared for at an ICU were interviewed. The data were analysed with a focus on meanings.Results: Being allowed to participate in the care of critically ill patients at an ICU is impor-tant for close relatives to the patients. Their experiences can be described as having four constituents: participation in the care of and being close to the patient; confidence in the care the patient receives; support needed for involvement in caregiving; and vulnerability. Conclusion: Participation with and support from health-care professionals are important for the relatives’ well-being and their ability to contribute to the patients’ care. Health-care profes-sionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.
19.	Blomberg, Karin, 1970-, et al. (författare) Clinical group supervision in nursing education for integrate ethical reasoning : students and supervisors’ view 2012 Konferensbidrag (refereegranskat)
20.	Blomberg, Karin, 1970-, et al. (författare) Riskfaktorer för stress hos sjuksköterskestudenter i verksamhetsförlagd utbildning 2012 Ingår i: Verksamhetsförlagd utbildning i högskolans vårdutbildningar. Konferensbidrag (övrigt vetenskapligt/konstnärligt)
21.	Blomberg, Karin, 1970-, et al. (författare) Work stress among newly graduated nurses in relation to workplace and clinical group supervision 2016 Ingår i: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 24:1, s. 80-87 Tidskriftsartikel (refereegranskat)abstract The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.
22.	Carlsbecker, Annelie, et al. (författare) The DAL10 gene from Norway spruce (Picea abies) belongs to a potentially gymnosperm-specific subclass of MADS-box genes and is specifically active in seed cones and pollen cones. 2003 Ingår i: Evolution & Development. - : Blackwell publishing, INC. ; 5:6, s. 551-561 Tidskriftsartikel (refereegranskat)
23.	Carlsson, Gunilla, et al. (författare) Det nakna vårdandet 2008 Rapport (övrigt vetenskapligt/konstnärligt)
24.	Colzani, Edoardo, et al. (författare) Risk of hospitalization and death due to bone fractures after breast cancer: a registry-based cohort study 2016 Ingår i: British Journal of Cancer. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0007-0920 .- 1532-1827. Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Bone fractures may have an impact on prognosis of breast cancer. The long-term risks of bone fracture in breast cancer patients have not been thoroughly studied. METHODS: Poisson regression was used to investigate the incidence of hospitalisation due to bone fracture comparing women with and without breast cancer based on Swedish National registers. Cox regression was used to investigate the risk of being hospitalised with bone fracture, and subsequent risk of death, in a regional cohort of breast cancer patients. RESULTS: For breast cancer patients, the 5-year risk of bone fracture hospitalisation was 4.8% and the 30-day risk of death following a bone fracture hospitalisation was 2.0%. Compared with the general population, breast cancer patients had incidence rate ratios of 1.25 (95% CI: 1.23-1.28) and 1.18 (95% CI: 1.14-1.22) for hospitalisation due to any bone fracture and hip fracture, respectively. These ratios remained significantly increased for 10 years. Comorbidities (Charlson Comorbidity Index 1) were associated with the risk of being hospitalised with bone fracture. Women taking aromatase inhibitors were at an increased risk as compared with women taking tamoxifen (HR=1.48; 95% CI: 0.98-2.22). Breast cancer patients hospitalised for a bone fracture showed a higher risk of death (HR=1.83; 95% CI: 1.50-2.22) compared with those without bone fracture. CONCLUSIONS: Women with a previous breast cancer diagnosis are at an increased risk of hospitalisation due to a bone fracture, particularly if they have other comorbidities.
25.	Cromsigt, Joris, et al. (författare) Adaptiv sam- och flerartsförvaltning av klövvilt 2023 Rapport (övrigt vetenskapligt/konstnärligt)
26.	Dar, Huma, et al. (författare) Assessment of 25-Year Survival of Women With Estrogen Receptor-Positive/ERBB2-Negative Breast Cancer Treated With and Without Tamoxifen Therapy A Secondary Analysis of Data From the Stockholm Tamoxifen Randomized Clinical Trial 2021 Ingår i: JAMA Network Open. - : American Medical Association. - 2574-3805. ; 4:6 Tidskriftsartikel (refereegranskat)abstract IMPORTANCE Clinically used breast cancer markers, such as tumor size, tumor grade, progesterone receptor (PR) status, and Ki-67 status, are known to be associated with short-term survival, but the association of these markers with long-term (25-year) survival is unclear. OBJECTIVE To assess the association of clinically used breast cancer markers with long-term survival and treatment benefit among postmenopausal women with lymph node-negative, estrogen receptor [ER]-positive and ERBB2-negative breast cancer who received tamoxifen therapy. DESIGN, SETTING, AND PARTICIPANTS This study was a secondary analysis of data from a subset of 565 women with ER-positive/ERBB2-negative breast cancer who participated in the Stockholm tamoxifen (STO-3) randomized clinical trial. The STO-3 clinical trial was conducted from 1976 to 1990 and comprised 1780 postmenopausal women with lymph node-negative breast cancer who were randomized to receive adjuvant tamoxifen therapy or no endocrine therapy. Complete 25-year follow-up data through December 31, 2016, were obtained from Swedish national registers. Immunohistochemical markers were reannotated in 2014. Data were analyzed from April to December 2020. INTERVENTIONS Patients in the original STO-3 clinical trial were randomized to receive 2 years of tamoxifen therapy vs no endocrine therapy. In 1983, patients who received tamoxifen therapy without cancer recurrence during the 2-year treatment and who consented to continued participation in the STO-3 study were further randomized to receive 3 additional years of tamoxifen therapy or no endocrine therapy. MAIN OUTCOMES AND MEASURES Distant recurrence-free interval (DRFI) by clinically used breast cancer markers was assessed using Kaplan-Meier and multivariable Cox proportional hazards analyses adjusted for age, period of primary diagnosis, tumor size (T1a and T1b [T1a/b], T1c, and T2), tumor grade (1-3), PR status (positive vs negative), Ki-67 status (low vs medium to high), and STO-3 clinical trial arm (tamoxifen treatment vs no adjuvant treatment). A recursive partitioning analysis was performed to evaluate which markers were able to best estimate long-term DRFI. RESULTS The study population comprised 565 postmenopausal women (mean [SD] age, 62.0 [5.3] years) with lymph node-negative, ER-positive/ERBB2-negative breast cancer. A statistically significant difference in long-term DRFI was observed by tumor size (88% for T1a/b vs 76% for T1c vs 63% for T2 tumors; log-rank P <.001) and tumor grade (81% for grade 1 vs 77% for grade 2 vs 65% for grade 3 tumors; log-rank P =.02) but not by PR status or Ki-67 status. Patients with smaller tumors (hazard ratio [HR], 0.31 [95% CI, 0.17-0.55] for T1a/b tumors and 0.58 [95% CI, 0.38-0.88] for T1c tumors) and grade 1 tumors (HR, 0.48; 95% CI, 0.24-0.95) experienced a significant reduction in the long-term risk of distant recurrence compared with patients with larger (T2) tumors and grade 3 tumors, respectively. A significant tamoxifen treatment benefitwas observed among patients with larger tumors (HR, 0.53 [95% CI, 0.32-0.89] for T1c tumors and 0.34 [95% CI, 0.16-0.73] for T2 tumors), lower tumor grades (HR, 0.24 [95% CI, 0.07-0.82] for grade 1 tumors and 0.50 [95% CI, 0.31-0.80] for grade 2 tumors), and PR-positive status (HR, 0.38; 95% CI, 0.24-0.62). The recursive partitioning analysis revealed that tumor sizewas the most important characteristic associated with long-term survival, followed by clinical trial arm among patients with larger tumors. CONCLUSIONS AND RELEVANCE This secondary analysis of data from the STO-3 clinical trial indicated that, among the selected subgroup of patients, tumor size followed by tumor grade were the markers most significantly associated with long-term survival. Furthermore, a significant long-term tamoxifen treatment benefit was observed among patients with larger tumors, lower tumor grades, and PR-positive tumors.
27.	Darcy, Laura, 1967-, et al. (författare) A qualitative analysis of child and family complaints related to child mental health services 2023 Ingår i: Journal of Child and Adolescent Psychiatric Nursing. - : John Wiley & Sons. - 1073-6077 .- 1744-6171. Tidskriftsartikel (refereegranskat)abstract Problem: Little is known about issues of patient-reported problems, in particular within psychiatric services for children with mental ill health. Child and family complaints related to child mental health services can be analyzed and discussed in light of the universal human right to health and healthcare. Therefore, the aim of this study was to analyze child and family complaints related to child mental health services. Methods: A retrospective, descriptive design was used. Child and family complaints were analyzed with a qualitative thematic analysis. Findings: The findings were described in three themes describing lack of access to care, inadequate communication between services and children with mental ill health and their families, and lack of clarity of who is responsible for care, leading to neglect of children's needs. These issues place a huge responsibility on parents or relatives. Conclusion: Better communication within mental health services, and better collaboration with other services such as school and social services, could limit children's suffering. Healthcare services with named professionals who specialize in child mental health and provide continuity in care, are required. General human rights principles should guide planning and care of children.
28.	Dressel, Sabrina, et al. (författare) Achieving Social and Ecological Outcomes in Collaborative Environmental Governance : Good Examples from Swedish Moose Management 2021 Ingår i: Sustainability. - : MDPI. - 2071-1050. ; 13:4 Tidskriftsartikel (refereegranskat)abstract Collaborative governance approaches have been suggested as strategies to handle wicked environmental problems. Evaluations have found promising examples of effective natural resource governance, but also highlighted the importance of social-ecological context and institutional design. The aim of this study was to identify factors that contribute to the achievement of social and ecological sustainability within Swedish moose (Alces alces) management. In 2012, a multi-level collaborative governance regime was implemented to decrease conflicts among stakeholders. We carried out semi-structured interviews with six ‘good examples’ (i.e., Moose Management Groups that showed positive social and ecological outcomes). We found that ‘good examples’ collectively identified existing knowledge gaps and management challenges and used their discretionary power to develop procedural arrangements that are adapted to the social-ecological context, their theory of change, and attributes of local actors. This contributed to the creation of bridging social capital and principled engagement across governance levels. Thus, our results indicate the existence of higher-order social learning as well as a positive feedback from within-level collaboration dynamics to between-level collaboration. Furthermore, our study illustrates the importance of institutional flexibility to utilize the existing knowledge across stakeholder groups and to allow for adaptations based on the social learning process.
29.	Duek, Susanne, 1968-, et al. (författare) Den tibetanska argumentationstekniken – en alternativ retorik 2018 Ingår i: Kapet (elektronisk). - Karlstad : Karlstads universitet. - 2002-3979. ; 1, s. 7-19 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Tibetanska buddhistiska munkar har i tusentals år ägnat sig åt att fördjupa sitt vetande och sin visdom i sitt sökande att befria sig från oönskade tankar och handlingar. En aktivitet som de, i tät kontakt med indisk, hinduisk logik, har utvecklat under århundradena, är att, enligt ett visst mönster, föra filosofiska debatter med varandra. Denna debatt är också en del av undervisningen i skolor för tibetanska barn och unga och kan ses som ett sätt att bevara kulturella och språkliga traditioner. I vår artikel utvecklar vi aspekter av denna argumentationsteknik som har relevans för vår svenska utbildningskontext och kontrasterar den mot den antika retorik, som fått ny aktualitet i västerländsk skola och samhälle de senaste decennierna. Syftet med denna artikel är därför att belysa den tibetanska argumentationstekniken i relation till klassisk retorik och ett svenskt utbildningssammanhang. Vi diskuterar också i vilken mån den tibetanska argumentationstekniken kan inspirera i ett arbete för ökad respekt och ömsesidig förståelse – inte polarisering – i både klassrum och samhälle i dagens Sverige. Det empiriska materialet till artikeln består av observationer och intervjuer med studenter och lärare i Dharamsala, observationer i klassrum i Dharamsala, analys av läroplanen och fältanteckningar. Våra resultat pekar på att debatterna tycks engagera eleverna och en del debatter blir inte bara levande utan också känslomässigt engagerande. Resultaten visar också att debatternas avsikt är att skärpa tanken och kräver att man är kunnig, påläst på sitt ämne, och nyttjar källorna som argument.
30.	Ek, Susann, et al. (författare) Intervju med biblioteksveteran Halvar Olsson från Stavre 1984 Annan publikation (populärvet., debatt m.m.)abstract Interview with Halvar Olsson, born in 1908. The interview was conducted by Susann Ek, Olle Johansson and Anneli Paganus, students of the Swedish School of Library and Information Science in Borås in 1984.
31.	Elväng, Annelie, et al. (författare) Sequencing of a Tick-Borne Encephalitis Virus from Ixodes ricinus Reveals a Thermosensitive RNA Switch Significant for Virus Propagation in Ectothermic Arthropods 2011 Ingår i: Vector Borne and Zoonotic Diseases. - : Mary Ann Liebert Inc. - 1530-3667 .- 1557-7759. ; 11:6, s. 649-658 Tidskriftsartikel (refereegranskat)abstract Tick-borne encephalitis virus (TBEV) is a flavivirus with major impact on global health. The geographical TBEV distribution is expanding, thus making it pivotal to further characterize the natural virus populations. In this study, we completed the earlier partial sequencing of a TBEV pulled out of a pool of RNA extracted from 115 ticks collected on Torö in the Stockholm archipelago. The total RNA was sufficient for all sequencing of a TBEV genome (Torö-2003), without conventional enrichment procedures such as cell culturing or suckling mice amplification. To our knowledge, this is the first time that the genome of TBEV has been sequenced directly from an arthropod reservoir. The Torö-2003 sequence has been characterized and compared with other TBE viruses. In silico analyses of secondary RNA structures formed by the two untranslated regions revealed a temperature-sensitive structural shift between a closed replicative form and an open AUG accessible form, analogous to a recently described bacterial thermoswitch. Additionally, novel phylogenetic conserved structures were identified in the variable part of the 3′-untranslated region, and their sequence and structure similarity when compared with earlier identified structures suggests an enhancing function on virus replication and translation. We propose that the thermo-switch mechanism may explain the low TBEV prevalence often observed in environmentally sampled ticks. Finally, we were able to detect variations that help in the understanding of virus adaptations to varied environmental temperatures and mammalian hosts through a comparative approach that compares RNA folding dynamics between strains with different mammalian cell passage histories.
32.	Eneqvist, Erica, et al. (författare) Vem är förorenare? : Allokering av utsläpp från energiåtrevinning 2017 Rapport (övrigt vetenskapligt/konstnärligt)abstract De intervjuade aktörerna ser avfallsminskning som en viktig men relativt ”ny” fråga. Tidigare har den dominerande frågan inom avfallsområdet varit sortering. Aktörerna är också intresserade av nyckeltal och statistik som visar såväl mängder av avfall som klimatpåverkan och ser att detta kan vara relevant att arbeta med.Målet med projektet har varit att undersöka attityder hos prioriterade målgrupper avseende på: Avfallslämnarens roll och möjligheter att påverka mängden avfall. Behovet och nyttan av att visualisera avfallslämnarens klimatpåverkan genom ett mätetal.Möjligheter kopplat till att fördela klimatutsläppen från energiåtervinning av avfall mellan energiprodukterna och avfallstjänsten.Syftet med arbetet har varit att undersöka attityder kring ovanstående frågor för att skapa en bättre förståelse för hur Avfall Sverige och Energiföretagen kan kommunicera kring omallokeringsfrågan till aktörer och intressenter inom prioriterade sektorer. Arbetet skall ligga till grund för en fortsatt diskussion kring avfallets klimatpåverkan och en eventuell förändring av fördelningen av klimatpåverkan mellan avfall och fjärrvärme. Arbetet har genomförts genom ett antal intervjuer med huvudaktörer: avfallslämnare i form av civilsamhälle (kommuner, fastighetsägare), avfallslämnare i form av industri samt myndigheter och intresseorganisationer. När det gäller en förändring av hur klimatpåverkan allokeras, från värme- och elkunden till avfallslämnaren är det en större skepticism som råder bland respondenterna. Det är flera aktörer som lyfter frågetecken kring en allokering av klimatpåverkan till avfallslämnaren. Argumenten rör att man inte tror att det har effekt för avfallsminskning utan att det är en krånglig väg för att uppnå en kommunikation kring avfallets klimatpåverkan. Det finns också farhågor kring allokering av klimatpåverkan till avfallslämnaren i form av att det är ett försök att göra fjärrvärmens klimatpåverkan lägre. Frågetecken lyfts kring huruvida det verkligen är avfallsminimering som är det yttersta syftet. Det finns bland flera aktörer en önskan om att fjärrvärmeanläggningarna ska ställa större krav på avfallet som bränsle. Att anläggningarna genom kravställning sätter press på kommuner och andra avfallslämnare att sortera bättre och på så sätt minska avfallsmängderna. Det finns också en skepticism mot att allokera klimatpåverkan till hushållen. Man menar att det inte är de som har påverkan på de stora utsläppen, och att de inte riktigt kan styra över avfallet. Att det snarare är till produktionsledet som klimatpåverkan bör räknas, och att det här är möjligt att påverka de stora mängderna. Det är flera respondenter som återkommer till industrins roll, och de som styr över exempelvis förpackningarna som sedan når hushållen. Avfallsminimering och energiåtervinning är komplexa frågor och för att komma vidare i diskussionen kring avfallslämnarens roll, visualisering av klimatpåverkan från avfall samt en eventuell omfördelning av klimatutsläppen mellan energiprodukterna och avfallstjänsten föreslås två övergripande kommunikationsstrategier: Höja kunskapsnivånÖka diskussionen om en förändring av klimatallokeringen
33.	Eriksson, Jessica, 1975-, et al. (författare) Grammatik i teori och lärande praktik : Från förskoleklass till åk 3 2013. - 1 Bok (populärvet., debatt m.m.)
34.	Eriksson, Jessica, 1975-, et al. (författare) Kreativ grammatikundervisning: från förskoleklass till åk 6 2017. - 2 Bok (övrigt vetenskapligt/konstnärligt)abstract Huvudsyftet med Kreativ Grammatikundervisning är att både ge studenter på förskollärar- och lärarprogrammen (F-6) samt verksamma pedagoger nödvändiga ämneskunskaper och samtidigt visa hur man kan arbeta med grammatik på ett kreativt och inspirerande sätt.
35.	Fritz, Johanna, et al. (författare) Determinants of Implementing an Information and Communication Technology Tool for Social Interaction Among Older People : Qualitative Content Analysis of Social Services Personnel Perspectives 2024 Ingår i: JMIR Aging. - : JMIR Publications Inc.. - 2561-7605. ; 7:1 Tidskriftsartikel (refereegranskat)abstract Background: Older people are particularly vulnerable to social isolation and loneliness, which can lead to ill-health, both mentally and physically. Information and communication technology (ICT) can supplement health and social care and improve health among the vulnerable, older adult population. When ICT is used specifically for communication with others, it is associated with reduced loneliness in older populations. Research is sparse on how the implementation of ICT, used specifically for communication among older people in social services, can be performed. It is recommended to consider the determinants of implementation, that is, barriers to and facilitators of implementation. Determinants related to older people using ICT tools are reported in several studies. To the best of our knowledge, studies investigating the determinants related to the social services perspective are lacking. Objective: This study aims to explore the determinants of implementing the Fik@ room, a new, co-designed, and research-based ICT tool for social interaction among older people, from a social services personnel perspective. Methods: This study used an exploratory, qualitative design. An ICT tool called the Fik@ room was tested in an intervention study conducted in 2021 in 2 medium-sized municipalities in Sweden. Informants in this study were municipal social services personnel with experience of implementing this specific ICT tool in social services. We conducted a participatory workshop consisting of 2 parts, with 9 informants divided into 2 groups. We analyzed the data using qualitative content analysis with an inductive approach. Results: The results included 7 categories of determinants for implementing the ICT tool. Being able to introduce the ICT tool in an appropriate manner concerns the personnel’s options for introducing and supporting the ICT tool, including their competencies in using digital equipment. Organizational structure concerns a structure for communication within the organization. Leadership concerns engagement and enthusiasm as driving forces for implementation. The digital maturity of the social services personnel concerns the personnel’s skills and attitudes toward using digital equipment. Resources concern time and money. IT support concerns accessibility, and legal liability concerns possibilities to fulfill legal responsibilities. Conclusions: The results show that implementation involves an entire organization at varying degrees. Regardless of how much each level within the organization comes into direct contact with the ICT tool, all levels need to be involved to create the necessary conditions for successful implementation. The prerequisites for the implementation of an ICT tool will probably change depending on the digital maturity of future generations. As this study only included 9 informants, the results should be handled with care. The study was performed during the COVID-19 pandemic, which has probably affected the results.
36.	Grönvall Fransson, Camilla, 1972-, et al. (författare) Kreativ grammatikundervisning och skrivutvecklande arbete i skolans tidigare år 2020 Ingår i: Skrivundervisningens grunder. - Malmö : Gleerups Utbildning AB. - 9789151102788 ; , s. 169-194 Bokkapitel (övrigt vetenskapligt/konstnärligt)
37.	Gusdal, Annelie K, 1963-, et al. (författare) Older Adults’ Use of a Research-Based Web Platform for Social Interaction 2023 Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 11:3 Tidskriftsartikel (refereegranskat)abstract Loneliness and social isolation are triggers for unfavorable changes in older adults’ health and well-being. Information and communication technology (ICT) can be used by older adults to mitigate the negative effects of loneliness and social isolation. However, ICT needs to be customized to the specific needs and conditions of older adults. The aim of this study was to explore older adults’ use of a new, co-designed and research-based web platform for social interaction from the perspectives of older adults, researchers, and social services personnel. The study is an intervention study with a multimethod approach in which 20 older adults used the web platform for social interaction “the Fik@ room” for eight weeks. Quantitative and qualitative data were collected pretest, during the test, and posttest. The Fik@ room met the expectations of those older adults who completed the study. It enabled them to expand their social network and develop new friendships, but their experiences of loneliness were not reduced. The involvement of social services personnel in recruitment and support was important in facilitating older adults’ use of the Fik@ room. Our study contributes knowledge about a new, co-designed and research-based web platform, customized specifically for older adults, which is valuable in guiding the design and delivery of future web platforms for social interaction among older adults.
38.	Gusdal, Annelie K, 1963-, et al. (författare) Prerequisites for a healthy and independent life among older people : a Delphi study 2021 Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 41:9, s. 2171-2187 Tidskriftsartikel (refereegranskat)abstract The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65-79, older persons aged >= 80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.
39.	Gusdal, Annelie K, 1963-, et al. (författare) Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden : A Registry Study 2021 Ingår i: Sage Open Nursing. - : SAGE Publications Inc.. - 2377-9608. ; 7 Tidskriftsartikel (refereegranskat)abstract Introduction: Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives: The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods: A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results: Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions: This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.
40.	Gustafsson, Margareta, 1952-, et al. (författare) Different nurse teacher models in the clinical practice of nursing students 2013 Ingår i: NET2013 24th International Networking for Healthcare Education Conference. Konferensbidrag (refereegranskat)
41.	Gustafsson, Margareta, 1952-, et al. (författare) Nurse teacher models in clinical education from the perspective of student nurses : A mixed method study 2015 Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 35:12, s. 1289-1294 Tidskriftsartikel (refereegranskat)abstract Objectives: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses. Design and Settings: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design. Participants: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study. Methods: A questionnaire including the CLES + T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception. Results: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor. Conclusions: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students. (C) 2015 Elsevier Ltd. All rights reserved.
42.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) ACTION: A Person-centred Communication Intervention Targeting Nurse Assistants in Home Care for Older Persons 2019 Konferensbidrag (refereegranskat)abstract Background: The aging population and the number of older persons living at home are increasing. Some have extensive needs for care, which leads to increased demands on professionals in home care settings. Professionals’ need to have sufficient competency to promote health and wellbeing among older persons. For sustainable care, there is a need for efficient educational efforts in the home care context. Person-centred communication may increase the quality of care and improve older persons independence.Aim: To develop, test and evaluate a web based educational intervention on person-centred communication targeting nurse assistants (NA) in home care setting.Method: A stepwise web based education, consisting of eight modules, was developed and tested. The education was evaluated using both quantitative and qualitative data.Results: In all, 23 NAs participated in the education. The majority of the NAs (n=21) participated in five or more modules. Overall, the education was experienced as feasible and accessible. Challenges emerged during the time of the intervention, such as time constrains, technical problems, and participants´ engagement.Conclusion: The web-based education was found to be a feasible way to offer education to home care staff, although successful implementation requires adaptations to the current context. Engagement from managers, especially considering the NAs motivation to complete the education is important for accomplishment by participants.Implications: This study can contribute to the knowledge regarding how to develop, test and evaluate an educational intervention, and considerations found to be important during the implementation process for success.
43.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) An educational intervention to improve communication skills in home care – a feasibility study 2022 Konferensbidrag (refereegranskat)abstract An educational intervention to improve communication skills in home care – a feasibility studyBackgroundAn educational intervention focused on person-centred communication with older persons in home care was developed. Twenty-three nursing assistants (NAs) from two home care units were offered the intervention. This feasibility study was conducted to capture benefits and pit falls with study processes before large scale interventions, such as acceptability and appropriateness of evaluation methods.AimTo explore the feasibility of proposed methods for evaluating a novel educational intervention on person-centered communication for NAs in home care.MethodFeasibility study with pre- and post-assessments, including evaluation of data collection procedures, completion rates, and missing data for two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction. Descriptive and statistical analysis was conducted. ResultsThe results showed a completion rate of 83% and 61% in pre- and post-assessment respectively, and a low proportion of missing data. The questionnaires were feasible and acceptable for NAs to complete and understand. Stress due to staff shortages and high workload negatively affected NAs’ participation in data collection. Overall, NAs rated their communication skills as high with a tendency towards higher communication self-efficacy after the intervention, however, this difference was not statistically significant. Job satisfaction remained unchanged pre- and post-intervention.ConclusionLow follow-up rates suggest that the data collection procedures need refinement. Although the outcomes are preliminary at this point, they indicate a ceiling effect in NAs’ self-efficacy ratings. The ceiling effect limits possibilities for improvement and suggests that studies with a larger sample is needed.Implications for caring in a changing worldIn a changing world, where a rapid aging population challenges home care services, there is a need for innovative interventions that support and strengthen health care professionals’ communication skills, aiming at improving older persons’ well-being This study contributes with knowledge to the complexity of developing and evaluating complex interventions on communication in home care.
44.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction 2023 Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:3, s. 1375-1382 Tidskriftsartikel (refereegranskat)abstract AimTo explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.DesignA feasibility study with pre- and post-assessments.MethodsFeasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.ResultsThe questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.
45.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Development and process evaluation of an educational intervention on communication targeting nurse assistants in home care 2019 Konferensbidrag (refereegranskat)abstract BackgroundPerson-centred communication is important to assure the quality of home care services and to promote older persons´ independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context.AimThe aim was to describe the development and process evaluation of a web-based education intervention in person-centred communication for nurse assistants (NA) in home care.MethodThe intervention consisted of a step-wise education, with eight modules that included short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research on health care communication and person-centred care. Data were collected from multiple sources before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.ResultsA complex intervention was conducted to improve the communication competency wanted for person-centred care. The intervention was offered to 23 nurse assistants (NA). Of those, 91% (n=21) participated, in total or in parts, in five or more modules. The findings address participants’ experiences of expectations and worries before the intervention, experiences from the implementation process, and their experiences from taking part of the intervention. During the implementation changes were made according to local circumstances. Overall, the education was experienced as feasible. The web-based design was found to be accessible and the content relevant.ConclusionFrom this study, it can be concluded that the key features for successful implementation of the intervention was the format, educational content, and technical facilities provided. In addition to this, participant involvement, resources and constructive practical circumstances for NAs to participate in the intervention are crucial.
46.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Development and process evaluation of an educational intervention on person-centred communication targeting nurse assistants in home care 2020 Konferensbidrag (refereegranskat)abstract BACKGROUNDPerson-centred communication is important to assure the quality of home care services and to promote older persons´ independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context.AIMThe aim was to describe the development and process evaluation of a web-based education intervention in person-centred communication for nurse assistants (NA) in home care.METHODSThe intervention consisted of a step-wise education, with eight modules that included short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research on health care communication and person-centred care. Data were collected from multiple sources before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.RESULTSA complex intervention was conducted to improve the communication competency wanted for person-centred care. The intervention was offered to 23 nurse assistants (NA). Of those, 91% (n=21) participated, in total or in parts, in five or more modules. The findings address participants’ experiences of expectations and worries before the intervention, experiences from the implementation process, and their experiences from taking part of the intervention. During the implementation changes were made according to local circumstances. Overall, the education was experienced as feasible. The web-based design was found to be accessible and the content relevant. CONCLUSIONOur findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.
47.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Nurse assistants´ perceptions of developing person-centred communication 2021 Konferensbidrag (refereegranskat)abstract Background: Communication is important for nurse assistants (NAs) when caring for older persons. There is limited research about how to improve the communication competence of NAs in home care. The aim was to describe NAs perception on learning in relation to an educational intervention on person-centred communication.Methods: A qualitative descriptive study was conducted. Data consisted of four group interviews, five individual in-depth interviews and written reflection assignments from participants gathered during the web-based intervention. In total 23 NAs at two home care units participated. The data were analysed using a phenomenographic approach. This is a qualitative method for analysis developed from Nordic traditions of phenomenology. Phenomenography aims to describe individual perceptions of a certain phenomenon.Preliminary findings points to the nurse assistants perceiving that the education supported their development of person-centred communication. They pointed out self-reflections as important for their learning as well as to get confirmation on what was already known. The NAs described that the intervention added to their knowledge and skills. Even though, there was more to learn and challenges that remained regarding communication in challenging situations such as caring for persons in end-of-life and supporting their relatives, caring for persons being aggressive or violent.Preliminary implications of research: This study can provide knowledge on participants’ perspective on their learning process, which may be important to consider when conducting educational interventions in home care as well as other health care contexts.
48.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) Process evaluation of the ACTION programme : a strategy for implementing person‐centred communication in home care 2021 Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 20:1 Tidskriftsartikel (refereegranskat)abstract Background: There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods: A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results: The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions: The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration: This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary (). © 2021, The Author(s).
49.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) ‘Sometimes you need an eye-opener’: A qualitative study on nursing assistants' experiences of developing communication skills through an educational intervention on person-centred communication 2023 Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. Tidskriftsartikel (refereegranskat)abstract AimTo explore nursing assistants' (NAs') experiences of developing communication skills while participating in an educational intervention on person-centred communication.DesignA descriptive qualitative study was conducted.MethodsData were collected from interviews and written assignments before, during and after an educational intervention on person-centred communication targeting NAs in home care services. The data were analysed using a phenomenological approach. A total of 25 NAs participated in the study.ResultsThe findings describe NAs' experiences concerning the communication skills needed for building relationships with older persons and handling emotionally challenging situations. The educational intervention increased their knowledge and awareness of the importance of communication skills and how such skills are developed and refined.
50.	Gustafsson, Tanja, PhD student, 1980-, et al. (författare) The Development and Process Evaluation of the ACTION Study. A Person-centred Communication Intervention Targeting Nursing Staff in Home Care for Older Persons 2019 Konferensbidrag (refereegranskat)abstract Background: Person-centred communication is important to assure the quality of home care services and to promote older persons independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context. Hitherto, research on design and implementation of this type of intervention is scarce.Aims and objectives: To describe the development and process evaluation of an education intervention in person-centred communication for nursing staff (NS) in home care.Method: The web-based education consisted of eight modules, including short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research of health care communication and person-centred care. Data was collected from multiple sources (web analytics, interviews, evaluation forms, and field notes), before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.Results: In all, 23 NS participated in the education. Initial analysis indicate that a majority of the participants completed six or more modules. Overall, the content was experienced as relevant and interesting. The flexibility and accessibility of the web-based format was appreciated, as well as the mix of lectures, short movies, reflective assignments and group supervision. Challenges included developing content relevant to work teams with diverse competence levels and individual differences (e.g. age, language, motivation). Furthermore, time constrains and structure of work emerged as barriers for implementing the education, in some cases adding stress and fragmentation to NS´ work.Conclusions: This type of intervention seems to be a feasible approach for flexible educations in person-centred communication for NS. Engagement and commitment from managers and team leaders may be key factors in succeeding, with impact on participants´ motivation to fulfil the education.

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