| 1. |
- Arvidsson, Lisa
(författare)
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Healthcare personnel's working conditions relationship to risk behaviours for organism transmission
- 2021
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Healthcare personnel (HCP) often experience undesirable working conditions. Risk behaviours for organism transmission can lead to healthcare associated infections and risk behaviours has been described to be influenced by working conditions. Research is lacking regarding HCPs working conditions and its relation to risk behaviours for organism transmission which this thesis aims to investigate. Methods: Study I had a mixed-methods convergent design. Observations and interviews were performed with 79 HCP, i.e., registered nurses (RNs) and assistant nurses (ANs). First-line managers were interviewed about the unit´s overall working conditions. The qualitative and quantitative data were analysed separately and then merged. Study II was a cross-sectional study with 417 RNs and ANs. The questionnaire included: self-efficacy to aseptic care, structural empowerment (SE), work engagement (WE) and work-related stress (WRS). Correlational analysis and group comparisons were performed. Results: In Study I risk behaviours frequently occurred regardless of measurable and perceived working conditions. The HCP described e.g. staffing levels and interruptions to influence risk behaviours. In the statistical analyses, risk behaviours were more frequent in interrupted activities and when the HCP worked together. In Study II the HCP rated high levels of self-efficacy to aseptic care. Differences were found between self-efficacy and some of the grouped working condition variables and definite but small relationships were found between self-efficacy to aseptic care and SE/WE/WRS. Conclusion: The HCP rated high levels of self-efficacy to aseptic care, but on the other hand, risk behaviours frequently occurred irrespective of working conditions. Healthcare managers are responsible for HCPs work environment and should continuously work to promote sufficient working conditions and to increase HCPs understanding of risk behaviours, which consequently also promote patient safety.
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| 2. |
- Buraczewska, Izabela, 1976-
(författare)
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Skin barrier responses to moisturizers
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Moisturizers are used in various types of dry skin disorders, but also by people with healthy skin. It is not unusual that use of moisturizers is continued for weeks, months, or even years. A number of moisturizers have been shown to improve the skin barrier function, while others to deteriorate it, but the reason for observed effects remains unknown. Further understanding of the mechanism by which long-term treatment with moisturizers influences the skin barrier would have clinical implications, as barrier-deteriorating creams may enhance penetration of allergens or irritants and predispose to dry skin and eczema, while barrier-improving ones could reduce many problems. The present research combined non-invasive techniques with analyses of skin biopsies, allowing studies of the epidermis at molecular and cellular level. Test moisturizers were examined on healthy human volunteers for their effect on the skin barrier, with regard to such factors as pH, lipid type, and presence of a humectant, as well as complexity of the product. After a 7-week treatment with the moisturizers, changes in transepidermal water loss, skin capacitance, and susceptibility to an irritant indicated a modified skin barrier function. Moreover, the mRNA expression of several genes involved in the assembly, differentiation and desquamation of the stratum corneum, as well as lipid metabolism, was altered in the skin treated with one of the moisturizers, while the other moisturizer induced fewer changes. In conclusion, long-term use of moisturizers may strengthen the barrier function of the skin, but also deteriorate it and induce skin dryness. Moisturizers have also a significant impact on the skin biochemistry, detectable at molecular level. Since the type of influence is determined by the composition of a moisturizer, more careful selection of ingredients could help to design moisturizers generating a desired clinical effect, and to avoid ingredients with a negative impact on the skin.
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| 3. |
- Lindberg, Magnus, 1973-
(författare)
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Excessive Fluid Overload Among Haemodialysis Patients : Prevalence, Individual Characteristics and Self-regulation of Fluid Intake
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is comprised of four studies and concerns haemodialysis patients’ confidence in being able to manage fluid intake between treatment sessions, and whether the fluid intake is influenced by certain modifiable characteristics of the persons in question. The overall aim was to study aspects of excessive fluid overload and haemodialysis patients’ self-regulation of fluid allotment from a bio-psychosocial and behavioural medicine perspective. The extent of non-adherence to fluid allotment was described in Study I. National registry data were used. Three out of ten Swedish haemodialysis patients had excessive fluid overload and one out of five was at risk for treatment related complications due to too rapid ultrafiltration rate. The objective in Study II was to develop and psychometrically evaluate a self-administered scale to measure situation-specific self-efficacy to low fluid intake. The measure (the Fluid Intake Appraisal Inventory) was found to be reliable and valid in haemodialysis settings. Subgroups based on individual profiles of self-efficacy, attentional style and depressive symptoms were explored in Study III using a cluster analytic approach. Three distinct subgroups were found and the subgroup structure was validated for clinical relevance. The individuals’ profile concerning self-efficacy, attentional style and depressive symptoms has to be taken into account in nursing interventions designed to reduce haemodialysis patients’ fluid intake. In Study IV, an intervention designed to reduce haemodialysis patients’ fluid intake was introduced and its acceptability, feasibility and efficacy were evaluated and discussed. Acceptability of such an intervention was confirmed. Addressing beliefs, behaviours, emotions and physical feelings is clinically feasible and may reduce haemodialysis patient’s excessive fluid overload. This thesis indicates that there is a potential for improvement in the fluid management care of haemodialysis patients. Behavioural nursing strategies that aim to assist patients to achieve fluid control should be applied more extensively. Cognitive profiles of the patients should be taken into account when targeted nursing intervention aiming to encourage and maintain the patient’s fluid control is introduced.
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| 4. |
- Lindberg, Susanne, 1987-
(författare)
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Ethics of User Involvement in Sensitive Design Situations
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- While this era of digital technology brings great possibilities for improving the lives of many people with digital healthcare services, the design of these services in turn present challenges that are ethical in nature. Participatory Design (PD) values user involvement in design from a democratic, empowerment and ethical perspective. However, the design of digital healthcare services constitutes sensitive design situations, that is, situations that have the potential to negatively impact the participants. As a consequence, participation in these design situations involves risks, causing ethical dilemmas. The ethical dilemmas that designers face in sensitive design situations are situated, dynamic, diverse, unpredictable, and occur in-action. Yet, it is a complex field with little in situ support for designers who intend to involve users in sensitive design situations, and high complexity and risk increase the need to understand ethics in these situations. Consequently, this thesis intends to answer the question: How can users be involved in sensitive design situations?The research question has emerged from the study of two design projects and is addressed through a Design Research (DR) approach. Both projects aimed at designing Digital Peer Support (DPS); one designs DPS for children between 8-12 cured from cancer, and the other designs DPS for people diagnosed with schizophrenia. The DR approach enables the study of de facto design situations in the two design projects. The thesis consists of a collection of five papers and a cover paper.The results show that, in sensitive design situations it can be challenging to uphold the fundamental ethical commitments of PD: that participation is a democratic right, the user is the expert, design should enhance, and design is situated. Based on the empirical study, I propose four principles for ethics in sensitive design situations that aim to support the upholding of these ethical commitments: (I) the principle of enhancement; (II) the principle of acknowledgement; (III) the principle of advocacy; and (IV) the principle of accommodation.The research contributes to the discourse on ethics in PD by expanding the understanding of ethical values of user involvement. Ethical guidelines must be dynamic and responsive, and participation should be carried out using methods for continuous critical reflection. The research contributes to practice by providing practical guidance for those who intend to involve users in sensitive design situations, ethical review boards who review PD, and for training of future PD researchers.
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| 5. |
- Stenberg, Jenny, 1976-
(författare)
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Fluid Management in Haemodialysis : Studies on current practices and new methods
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic fluid overload has been identified as an independent predictor of mortality in haemodialysis patients, and 30% remain fluid overloaded at dry weight. The use of bioimpedance spectroscopy (BIS) in fluid management may improve blood pressure control and cardiovascular status. However, the importance of regular and careful clinical assessment of fluid balance is repeatedly emphasised.This thesis is based on five papers and the overall aim was to investigate current practices and new methods for fluid management in haemodialysis, and to develop a management tool for dry weight determination, based on multiple complementary methods. The purpose was to contribute to reduced prevalence of fluid overload and intradialytic symptoms in haemodialysis patients, by providing the healthcare team and the patient with a tool, that facilitates communication and enables informed decision-making in dry weight determination.In the initial, cross-sectional study, clinical praxis for dry weight assessment in Sweden and Denmark was investigated. A wide variation in routines was found. Despite high access, BIS was sparsely used. Instead, nurses’ authorisation to adjust haemodialysis patients’ dry weight was associated with improved fluid status. The second study had a qualitative approach. Focus group interviews, with healthcare professionals, were carried out to achieve a deeper understanding of the factors preventing or facilitating the use of BIS. In the third study, the usefulness of a biomarker, brain natriuretic peptide (BNP), for assessing fluid status in haemodialysis patients, was investigated. An association between BNP and fluid overload was established. The between-individual variation in BNP levels was greater than the within-individual variation over time. Therefore, if BNP is to be used as a marker for fluid overload, repeated measurements are required. In the fourth study, we developed and validated a multifactorial decision aid, Recova®, that incorporates BIS in dry weight determination. Recova® is based on physiological parameters routinely measured in haemodialysis and provides guidance on when and how to respond to recognised fluid alterations. In the fifth study, the decision aid’s effect on volume status was tested in a cohort of haemodialysis patients. Implementation of Recova® had effect on fluid status symptoms, BIS-measured hydration status and NT-proBNP levels.
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| 6. |
- Lindberg, Ylva, et al.
(författare)
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Culture on the move : Language and literature as vectors for cultural empowerment in Swedish education
- 2024
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Ingår i: Educare. - : Malmö universitet. - 1653-1868 .- 2004-5190. ; :1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- This special issue consists of five position papers, four articles and two essays covering diverse aspects of the theme Culture on the Move that foregrounds language and literature both as pedagogical tools and disciplinary fields necessary for learning to live and work in a culturally diverse world. The contributions stem from the initial activities within the graduate school “Culturally Empowering Education through Language and Literature” (CuEEd-LL). Centre-staging teaching and learning in Swedish education, the texts in this issue present a range of inroads into how language and literature can be used to support cultural diversity among pupils, students and teachers since cultural diversity is steadily gaining attention both as a resource and a challenge in education and society.
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| 7. |
- Lindberg, Ylva, et al.
(författare)
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Letter from the guest editors
- 2024
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Ingår i: Educare. - : Malmö University Press. - 1653-1868 .- 2004-5190. ; :1, s. i-ii
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This special issue consists of five position papers, four articles and two essays covering diverse aspects of the theme Culture on the Move that foregrounds language and literature both as pedagogical tools and disciplinary fields necessary for learning to live and work in a culturally diverse world. The contributions stem from the initial activities within the graduate school “Culturally Empowering Education through Language and Literature” (CuEEd-LL). Centre-staging teaching and learning in Swedish education, the texts in this issue present a range of inroads into how language and literature can be used to support cultural diversity among pupils, students and teachers since cultural diversity is steadily gaining attention both as a resource and a challenge in education and society.
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