| 1. |
- Ludvigsson, Johnny, 1943-, et al.
(författare)
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GAD treatment and insulin secretion in recent-onset type 1 diabetes
- 2008
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Ingår i: New England Journal of Medicine. - Boston, Mass : Massachusetts medical society. - 0028-4793 .- 1533-4406. ; 359:18, s. 1909-1920
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Tidskriftsartikel (refereegranskat)abstract
- Background The 65-kD isoform of glutamic acid decarboxylase (GAD) is a major autoantigen in patients with type 1 diabetes mellitus. This trial assessed the ability of alum-formulated GAD (GAD-alum) to reverse recent-onset type 1 diabetes in patients 10 to 18 years of age. Methods We randomly assigned 70 patients with type 1 diabetes who had fasting C-peptide levels above 0.1 nmol per liter (0.3 ng per milliliter) and GAD autoantibodies, recruited within 18 months after receiving the diagnosis of diabetes, to receive subcutaneous injections of 20 μg of GAD-alum (35 patients) or placebo (alum alone, 35 patients) on study days 1 and 30. At day 1 and months 3, 9, 15, 21, and 30, patients underwent a mixed-meal tolerance test to stimulate residual insulin secretion (measured as the C-peptide level). The effect of GAD-alum on the immune system was also studied. Results Insulin secretion gradually decreased in both study groups. The study treatment had no significant effect on change in fasting C-peptide level after 15 months (the primary end point). Fasting C-peptide levels declined from baseline levels significantly less over 30 months in the GAD-alum group than in the placebo group (−0.21 vs. −0.27 nmol per liter [−0.62 vs. −0.81 ng per milliliter], P = 0.045), as did stimulated secretion measured as the area under the curve (−0.72 vs. −1.02 nmol per liter per 2 hours [−2.20 vs. −3.08 ng per milliliter per 2 hours], P = 0.04). No protective effect was seen in patients treated 6 months or more after receiving the diagnosis. Adverse events appeared to be mild and similar in frequency between the two groups. The GAD-alum treatment induced a GAD-specific immune response. Conclusions GAD-alum may contribute to the preservation of residual insulin secretion in patients with recent-onset type 1 diabetes, although it did not change the insulin requirement. (ClinicalTrials.gov number, NCT00435981.)
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| 2. |
- Nilsson, Maria, et al.
(författare)
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Investigating human-computer interaction issues in information-fusion-based decision support
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Information fusion is a research area which focuses on how to combine information from many different sources to support decision making. Commonly used information fusion systems are often complex and used in military and crises management domains. The focus of information fusion research so far has been mainly on the technological aspects. There is still a lack of understanding relevant user aspects that affect the information fusion systems as a whole. This paper presents a framework of HCI issues which considers users as embedded in the context of information fusion systems. The framework aims at providing insights regarding factors that affect user interaction to inform the development of future information fusion systems. Design considerations are presented together with a heuristic evaluation of an information fusion prototype.
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| 3. |
- Nogéus, Maria, et al.
(författare)
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Pediatric Nurses’ Person-Centered Approach to Nausea Management in Children With Cancer
- 2023
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Ingår i: Journal of Pediatric Hematology/Oncology Nursing. - : Sage Publications. - 2752-7530 .- 2752-7549. ; 40:2, s. 91-99
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nausea is a problematic side effect of childhood cancer treatment. However, it is not clear what interventions and assessments pediatric oncology nurses make when caring for a child with nausea. A person-centered approach can illuminate nausea management in pediatric care. The aim was to investigate how pediatric nurses retrieve the patient's narrative, establish partnership, and document nausea in hospitalized children with cancer.Methods: Individual interviews with nurses were conducted and analyzed using deductive content analysis with the framework of person-centered care.Results: The pediatric nurses described retrieving the patient's narrative regarding their nausea by listening to and observing the child. The pediatric nurses tried to establish a partnership with the child by allowing previous knowledge and the child's own preferences guide the interventions that focus on decreasing the child's nausea. The pediatric nurses also documented the effect of the given interventions and described the child's nausea using subjective words. When planning for the child's care it was rare for the nurses to have a documented care plan, but they did review documentation of previously administered interventions to plan for future care.Discussion: The results highlight the pediatric nurses’ willingness to listen to the child, but also emphasize the need to further include the child and the parents in the partnership and documentation of nausea management. Collaboration with the child and the parents contributes to higher quality care and a partnership with trust.
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| 4. |
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| 5. |
- Brahm, Carl-Otto, et al.
(författare)
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Patients with head and neck cancer treated with radiotherapy : Their experiences after 6 months of prophylactic tooth extractions and temporary removable dentures
- 2021
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Ingår i: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 7:5, s. 894-902
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The impact of dental occlusion on the experiences of head and neck cancer patients and their oral, social and psychological functioning has been sparsely investigated. There is a lack of knowledge regarding the experience of tooth loss and dentures among patients treated for head and neck cancer. The aim of this study was to describe the experiences of head and neck cancer patients of prophylactic tooth extractions and temporary removable dentures, 6 months after radiotherapy treatment. Material and methods: An individual interview with 25 patients 6 months after radiotherapy was subjected to a qualitative content analysis. Results: Two categories, Impaired oral function and Belief in the future, and seven subcategories described the patients' experiences of temporary removable dentures during the first 6 months after prophylactic tooth extractions. The temporary removable dentures affected the patients' ability to chew, swallow and speak, caused pain, and were experienced as an enemy. Despite that, the patients were hopeful and had a wish for recovery, which gave them the energy to live. Conclusion: Prophylactic tooth extractions and temporary removable dentures 6 months after radiotherapy treatment affect head and neck cancer patients' recovery and everyday life. However, they have the will to take on these challenges, pertaining not only to themselves, but also to relatives and health professionals. At the individual level, the patient needs individualized professional support to get through the arduous procedure, from the acute situation until the end of the rehabilitation phase.
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| 6. |
- Castor, C, et al.
(författare)
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Psychometric evaluation of the electronic faces thermometer scale for pain assessment in children 8–17 years old : A study protocol
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2637-3807 .- 2379-5824. ; 5:4, s. 99-109
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Tidskriftsartikel (refereegranskat)abstract
- It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8?17?years of age. A multi-site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish-speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think-aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8?17?years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well-validated tool to strengthen the child's voice within healthcare.
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| 7. |
- Fischl, Caroline, 1974-
(författare)
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Ageing in a digital society : an occupational perspective on social participation
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: For older adults to continue being healthy and active participants in an evolving digitalized society, there is a need to support their social participation through engagement in occupations that they need, want, or are expected to do in accordance to the roles that they assume. Occupational therapists together with other professionals face emerging challenges to promote older adults’ engagement in occupations mediated by digital technology. It is therefore relevant to acquire an understanding about how older adults continue to participate in their daily lives and engage in the occupations within their particular contexts. It is also relevant to explore ways to tailor supports for engaging in contemporary occupations and to measure the outcomes of such supports. Aim: The overall aim of this thesis was to develop knowledge to support older adults’ social participation through engagement in occupations mediated by digital technology. Developing knowledge entailed an exploration of older adults’ engagement in occupations mediated by digital technology (Study I), their contexts surrounding social participation (Study II), and tailoring supports for engagement (Study III). Additionally, part of developing knowledge also entailed an investigation of how outcomes of tailoring – specifically ability to perform occupation mediated by digital technology and ability to manage technology – could be measured and related (Study IV).Methods: Study participants were selected from rural and urban municipalities in Northern Sweden. In Study I, data was gathered through concurrent think aloud protocol and observations of ten older adults, aged 66-79 years, while they engaged in occupations that involved digital technology. Narrative inquiry was used to illuminate features in their occupational engagement and participation in daily life. In Study II, focus group interviews of eighteen older adults, aged 66-81 years, were conducted and analyzed using qualitative content analysis. Study III used a multiple case study methodology that included nine cases. Each case involved one adult who participated in a collaborative process to tailor supports for engagement in occupations mediated by digital technology. Data was gathered through questionnaires, observations, fieldnotes, memos for tailoring, and interviews, and then analyzed through cross-case synthesis. Nine older adults, aged 74-95 years, participated. In Study IV, twenty-five older adults, aged 71-93 years, were observed in their performances of digital technology-mediated occupations and scored on the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. Data was analyzed using Rasch analysis and Spearman correlation test. Results: Findings in Study I were presented as three stories reflecting facets of participation – Being alone, Belonging together, and Being alone together. The stories illuminated older adults’ participation involving digital technology as a negotiation of needs and values, refinement of identities, and experience of meaning during interactions with technological and social environments. Findings in Study II were sorted in three categories – Experiencing conditions for social participation in a state of flux, Perceiving drawbacks of urbanization on social participation, and Welcoming digital technology that facilitates daily and community living – and encapsulated in the theme The juxtaposition of narrowing offline social networks and expanding digital opportunities for social participation. The findings suggested that facilitating satisfactory use of digital technologies and co-creating usable digitalized services could support older adults’ social participation through occupations that they find relevant in their lives, and subsequently, might enable them to live longer at home. Study III resulted in a proposed scheme for tailoring to support older adults’ engagement in digital technology-mediated occupations. The scheme included various intervention strategies tailored to persons in their contexts, such as adapting visual settings on the device and forming instructional materials based on the older adults' needs and preferences. Tailoring interventions require collaboration with other professionals. Results in Study IV indicated preliminary evidence of internal validity and reliability in two aforementioned instruments on a small sample of older adults. Results also showed that there is a significant and strong positive correlation between the ability to engage in digital technology-mediated occupations and the ability to manage digital technology. It implies that an older person who is more able to engage in digital technology-mediated occupations will likely have more ability to manage digital technology and vice versa. In the same manner, an older person who is less able to engage in digital technology-mediated occupations will likely have less ability to manage digital technology and vice versa.Conclusions: In the contexts of ageing, narrowing social networks, and expanding digital possibilities, participation through satisfactory digital technology use can provide older adults opportunities to continue being active members of society. A scheme has been proposed to tailor supports for older adults’ occupational engagement, which needs further testing in various practice settings. Instruments for measuring outcomes of tailored supports have also been identified but need further validation in studies with older people.
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| 8. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Preconditions for nurses' perceived organizational support in healthcare : a qualitative explorative study
- 2021
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 35:9, s. 281-297
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to inductively explore the context-specific preconditions for nurses' perceived organizational support (POS) in healthcare organizations. Design/methodology/approach: A qualitative interview study was performed, based on the critical incident technique (CIT), with 24 registered nurses in different specialities of hospital care. Findings: The nurses perceived three actors as essential for their POS: the first-line manager, the overarching organization and their college. The preconditions affecting the nurses’ perceptions of organizational support were supportive structuring and structures at work, as well as individual recognition and professional acknowledgement. Originality/value: Previous studies of POS have mostly had a quantitative outset. In this paper, context-specific preconditions for nurses' POS are described in depth, enabled by the qualitative approach of the study. The findings may be used to guide healthcare organizations and managers aiming to foster nurses' POS, and thereby, benefit nurses' well-being and retention, as well as healthcare quality and efficiency.
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| 9. |
- Garcia-Ptacek, Sara, et al.
(författare)
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Differences in diagnostic process, treatment and social Support for Alzheimer's dementia between primary and specialist care : resultss from the Swedish Dementia Registry
- 2017
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Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 46:2, s. 314-319
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Tidskriftsartikel (refereegranskat)abstract
- Background: the increasing prevalence of Alzheimer's dementia (AD) has shifted the burden of management towards primary care (PC). Our aim is to compare diagnostic process and management of AD in PC and specialist care (SC). Design: cross-sectional study. Subjects: a total of, 9,625 patients diagnosed with AD registered 2011-14 in SveDem, the Swedish Dementia Registry. Methods: descriptive statistics are shown. Odds ratios are presented for test performance and treatment in PC compared to SC, adjusted for age, sex, Mini-Mental State Examination (MMSE) and number of medication. Results: a total of, 5,734 (60%) AD patients from SC and 3,891 (40%) from PC. In both, 64% of patients were women. PC patients were older (mean age 81 vs. 76; P < 0.001), had lower MMSE (median 21 vs. 22; P < 0.001) and more likely to receive home care (31% vs. 20%; P < 0.001) or day care (5% vs. 3%; P < 0.001). Fewer diagnostic tests were performed in PC and diagnostic time was shorter. Basic testing was less likely to be complete in PC. The greatest differences were found for neuroimaging (82% in PC vs. 98% in SC) and clock tests (84% vs. 93%). These differences remained statistically significant after adjusting for MMSE and demographic characteristics. PC patients received less antipsychotic medication and more anxiolytics and hypnotics, but there were no significant differences in use of cholinesterase inhibitors between PC and SC. Conclusion: primary and specialist AD patients differ in background characteristics, and this can influence diagnostic work-up and treatment. PC excels in restriction of antipsychotic use. Use of head CT and clock test in PC are areas for improvement in Sweden.
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| 10. |
- Hammarsten, Maria
(författare)
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Marias pedagogiska lådor gör succé [radiosändning]
- 2021
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Annan publikation (ljud/tal) (populärvet., debatt m.m.)abstract
- Fler barn och elever ska få komma ut ur klassrummen och få undervisning utomhus. Det är målet för Maria Hammarsten.Maria Hammarsten är doktorand vid Högskolan för lärande och kommunikation.I ett projekt tillsammans med Jönköpings naturskola på Upptech har hon tagit fram särskilda lådor med pedagogiskt material för matte- och språkundervisning utomhus, något som väckt stort intresse i hela landet.– När man är ute i spännande miljöer väcks barnens kreativitet. Det ökar intresset för närmiljön och dessutom är det bra för hälsan och välmåendet, säger Maria Hammarsten.
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