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  • Velders, Matthijs A
    et al.
    Calais, Fredrik
    Dahle, Nina
    Fall, Tove
    Hagström, Emil
    Leppert, Jerzy
    Nowak, Christoph
    Tenerz, Åke
    Ärnlöv, Johan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska institutet.
    Hedberg, Pär
    Cathepsin D improves the prediction of undetected diabetes in patients with myocardial infarction2019Inngår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, s. 1-6Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Newer therapeutic agents for type 2 diabetes mellitus can improve cardiovascular outcomes, but diabetes remains underdiagnosed in patients with myocardial infarction (MI). We sought to identify proteomic markers of undetected dysglycaemia (impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus) to improve the identification of patients at highest risk for diabetes. Materials and methods: In this prospective cohort, 626 patients without known diabetes underwent oral glucose tolerance testing (OGTT) during admission for MI. Proximity extension assay was used to measure 81 biomarkers. Multivariable logistic regression, adjusting for risk factors, was used to evaluate the association of biomarkers with dysglycaemia. Subsequently, lasso regression was performed in a 2/3 training set to identify proteomic biomarkers with prognostic value for dysglycaemia, when added to risk factors, fasting plasma glucose, and glycated haemoglobin A1c. Determination of discriminatory ability was performed in a 1/3 test set. Results: In total, 401/626 patients (64.1%) met the criteria for dysglycaemia. Using multivariable logistic regression, cathepsin D had the strongest association with dysglycaemia. Lasso regression selected seven markers, including cathepsin D, that improved prediction of dysglycaemia (area under the receiver operator curve [AUC] 0.848 increased to 0.863). In patients with normal fasting plasma glucose, only cathepsin D was selected (AUC 0.699 increased to 0.704). Conclusions: Newly detected dysglycaemia, including manifest diabetes, is common in patients with acute MI. Cathepsin D improved the prediction of dysglycaemia, which may be helpful in the a priori risk determination of diabetes as a motivation for confirmatory OGTT.

  • Gifford, Wendy
    et al.
    Lewis, Krystina B.
    Eldh, Ann Catrine
    Fiset, Val
    Abdul-Fatah, Tara
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Thavorn, Kednapa
    Graham, Ian D.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Feasibility and usefulness of a leadership intervention to implement evidence-based falls prevention practices in residential care in Canada2019Inngår i: Pilot and Feasibility Studies, ISSN 2055-5784, Vol. 5, artikkel-id 103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Leadership is critical to supporting and facilitating the implementation of evidence-based practices in health care. Yet, little is known about how to develop leadership capacity for this purpose. The aims of this study were to explore the (1) feasibility of delivering a leadership intervention to promote implementation, (2) usefulnessof the leadership intervention, and (3) participants’ engagement in leadership to implement evidence-based fall prevention practices in Canadian residential care.

    Methods: We conducted a mixed-method before-and-after feasibility study on two units in a Canadian residential care facility. The leadership intervention was based on the Ottawa model of implementation leadership (O-MILe) and consisted of two workshops and two individualized coaching sessions over 3 months to develop leadership capacity for implementing evidence-based fall prevention practices. Participants (n = 10) included both formal (e.g., managers) and informal (e.g., nurses and care aids leaders). Outcome measures were parameters of feasibility (e.g., number of eligible candidates who attended the workshops and coaching sessions) and usefulness of the leadership intervention (e.g., ratings, suggested modifications). We conducted semi-structured interviews guided by the Implementation Leadership Scale (ILS), a validated measure of 12-item in four subcategories (proactive, supportive, knowledgeable, and perseverant), to explore the leadership behaviors that participants used to implement fall prevention practices. We repeated the ILS in a focus group meeting to understand the collective leadership behaviors used by the intervention team. Barriers and facilitators to leading implementation were also explored.

    Results: Delivery of the leadership intervention was feasible. All participants (n = 10) attended the workshops and eight participated in at least one coaching session. Workshops and coaching were rated useful (≥ 3 on a 0–4 Likert scale where 4 = highly useful) by 71% and 86% of participants, respectively. Participants rated the O-MILe subcategories of supportive and perseverant leadership highest for individual leadership, whereas supportive and knowledgeable leadership were rated highest for team leadership.

    Conclusions: The leadership intervention was feasible to deliver, deemed useful by participants, and fostered engagement in implementation leadership activities. Study findings highlight the complexity of developing implementation leadership and modifications required to optimize impact. Future trials are now required to test the effectiveness of the leadership intervention on developing leadership for implementing evidence-based practices.

  • Disputas: 2019-09-06 13:00 Clas Ohlsson, Borlänge
    Paidi, Vijay
    Högskolan Dalarna, Akademin Industri och samhälle, Mikrodataanalys.
    Developing decision support systems for last mile transportation problems2019Licentiatavhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Last mile transportation is the most problematic phase of transportation needing additional research and effort. Longer waits or search times, lack of navigational directions and real-time information are some of the common problems associated with last mile transportation. Inefficient last mile transportation has an impact on the environment, fuel consumption, user satisfaction and business opportunities. Last mile problems exist in several transportation domains, such as: the landing of airplanes, docking of ships, parking of vehicles, attended home deliveries, etc. While there are dedicated inter-connected decision support systems available for ships and aircraft, similar systems are not widely utilized in parking or attended handover domains. Therefore, the scope of this thesis covers last mile transportation problems in parking and attended handover domains. One problem area for parking and attended handovers is due to lack of real-time information to the driver or consumer. The second problem area is dynamic scheduling where the handover vehicle must traverse additional distance to multiple handover locations due to lack of optimized routes. Similarly, during parking, lack of navigational directions to an empty parking space can lead to increased fuel consumption and CO2 emissions. Therefore, aim of this thesis is to design and develop decision support systems for last mile transportation problems by holistically addressing real time customer communication and dynamic scheduling problem areas. The problem areas discussed in this thesis consists of persistent issues even though they were widely discussed in the literature. In order to investigate the problem areas, microdata analysis approach was implemented in the thesis. The phases involved in Microdata analysis are: data collection, data processing, data storage, data analysis and decision-making. Other similar research domains, such as: computer science or statistics also involve phases such as data collection, processing, storage and analysis. These research domains also work in the fields of decision support systems or knowledge creation. However, knowledge creation or decision support systems is not a mandatory phase in these research domains, unlike Microdata analysis. Three papers are presented in this thesis, with two papers focusing on parking domains, while the third paper focuses on attended handover domains.

    The first paper identifies available smart parking tools, applications and discusses their uses and drawbacks in relation to open parking lots. The usage of cameras in identifying parking occupancy was recognized as one of the suitable tools in this paper. The second paper uses a thermal camera to collect the parking lot data, while deep learning methodologies were used to identify parking occupancy detection. Multiple deep learning networks were evaluated for identifying parking spaces and one method was considered suitable for acquiring real time parking occupancy. The acquired parking occupancy information can be communicated to the user to address real-time customer communication problems. However, the decision support system (DSS) to communicate parking occupancy information still needs to be developed. The third paper focuses on the attended handovers domain where a decision support system was reported which addresses real-time customer communication and dynamic scheduling problems holistically. Based on a survey, customers accepted the use of mobile devices for enabling a real-time information flow for improving customer satisfaction. A pilot test on vehicle routing was performed where the decision support system reduced the vehicle routing distance compared to the route taken by the driver. The three papers work in developing decision support systems for addressing major last mile transportation problems in parking and attended handover domains, thus improving customer satisfaction, and business opportunities, and reducing fuel costs, and pollution.

  • Diamant, Linda
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Pedagogiskt arbete.
    Digitaliserad undervisning med fokus på engelska i årskurs 7-9: Några lärares upplevelser kring implementeringen av ett digitaliserat läromedel.2019Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Detta arbete syftar till att undersöka vilka attityder fyra engelsklärare samt en lärare i samhällsorienterande ämnen i årskurs 7-9 har till digitalisering i skolan i allmänhet och ett specifikt digitalt läromedel i synnerhet i samma kommun. Arbetet syftar även till att översiktligt redogöra för de olika roller som krävs för förändring. Semistrukturerade intervjuer med fem lärare i samma kommun, samt med försteläraren i it har genomförts för att undersöka fördelar och nackdelar som kan finnas med ett digitalt läromedel med fokus på engelska. Forskningen som presenteras samt resultaten antyder att en förändring, som digitalisering i undervisningen innebär, kräver engagerade och positiva lärare som ser fördelar med förändringen tydligt. För att lärarna ska bli positivt inställda krävs en engagerad och positiv skolledning. I den aktuella kommunen ser inte lärarna vinsten med förändringen tydligt vilket kan vara en av orsakerna till att förändringsarbetet går tungt. I slutet av arbetet ges några förslag på hur en skolledning skulle kunna arbeta för att underlätta införandet av ett digitalt läromedel.  

  • Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. University of Gothenburg, Sahlgrenska Academy.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Johansson, Unn-Britt
    Borg, Sixten
    Palaszewski, Bo
    Franzén, Stefan
    Gudbjörnsdottir, Soffia
    Eeg-Olofsson, Katarina
    Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes: a nationwide cross-sectional study2019Inngår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, nr 1, artikkel-id 141Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting.

    Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18–80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36- item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes.

    Results: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures.

    Conclusions: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

  • Erlandsson, Kerstin
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Byrskog, Ulrika
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Osman, Fatumo
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Pedersen, Christina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Hatakka, Mathias
    Högskolan Dalarna, Akademin Industri och samhälle, Informatik.
    Klingberg-Allvin, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Evaluating a model for the capacity building of midwifery eduators in Bangladesh through a blended, web-based master's programme2019Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, nr 1, artikkel-id 1652022Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: While setting international standards for midwifery education has attracted considerable global attention, the education and training of midwifery educators has been relatively neglected, particularly in low-resource settings where capacity building is crucial. Objective: The aim of this study was to describe the expectations of midwifery educators in Bangladesh who took part in a blended web-based master's programme in SRHR and the extent to which these were realized after 12 months of part-time study. Methods: Both quantitative and qualitative methods have been used to collect data. A structured baseline questionnaire was distributed to all participants at the start of the first course (n = 30) and a second endpoint questionnaire was distributed after they (n = 29) had completed the core courses one year later. At the start of the first course, five focus group discussions (FGD) were held with the midwifery educators. Descriptive statistics and content analysis were used for the analyses. Results: Midwifery educators who took part in the study identified expectations that can be grouped into three distinct areas. They hoped to become more familiar with technology, anticipated they would learn pedagogical and other skills that would enable them to better support their students' learning and thought they might acquire skills to empower their students as human beings. Participants reported they realized these ambitions, attributing the master's programme with helping them take responsibility for their own teaching and learning, showing them how to enhance their students' learning and how to foster reflective and critical thinking among them. Conclusions: Midwifery educators have taken part in a creative learning environment which has developed their engagement in teaching and learning. They have done this using a blended learning model which combines online learning with face-to-face contact. This model can be scaled up in low resource and remote settings.

  • Hägglund, Patricia
    et al.
    Koistinen, Susanne
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Olai, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Ståhlnacke, Katri
    Wester, Per
    Levring Jäghagen, Eva
    Older people with swallowing dysfunction and poor oral health are at greater risk of early death2019Inngår i: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden.

    METHODS: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI).

    RESULTS: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02-2.75; P = .041 and aHR: 1.98, 95% CI 1.07-3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15-5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%).

    CONCLUSIONS: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.

  • Palmér, Lina
    et al.
    Ericson, Jenny
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Center for Clinical Research Dalarna; Falu hospital.
    A qualitative study on the breastfeeding experience of mothers of preterm infants in the first 12 months after birth2019Inngår i: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 14, artikkel-id 35Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Being a mother of a preterm infant (< 37 gestational weeks) puts the mother in a vulnerable and fragile situation wherein breastfeeding is an important part of becoming a mother and bonding with the infant. Nevertheless, the breastfeeding experience of mothers during the first year after a preterm birth has not been well studied. To develop professional caring and supporting relationships, it is important to address this knowledge gap. The aim of this study was to describe the breastfeeding experience of mothers of preterm infants from birth up until 12 months after birth.

    Methods: The data in this qualitative study are derived from a multicentre randomized controlled trial where 270 mothers of preterm infants provided 496 written comments through questionnaires containing open-ended questions. The questionnaires were sent to the mother three times during the first 12 months after birth. A thematic network analysis based on hermeneutical philosophy was used to analyse and interpret the resulting data to describe the mothers' experiences of breastfeeding.

    Results: Three organizing themes, namely, "navigating smoothly," "navigating with a struggle" and "navigating in ambiguity" were revealed in the mothers' narratives regarding their breastfeeding experiences during the first 12 months after birth. These organizing themes were further interpreted as one global theme that was deemed "A journey to finding one's unique way in breastfeeding."

    Conclusion: Mothers of preterm infants are in an exposed and vulnerable situation when initiating breastfeeding during the first year. This situation leads to a unique journey wherein each mother navigates through breastfeeding depending on her individual situation. An awareness of the diversity of breastfeeding experiences may contribute to the provision of professional caring and supportive relationships.

    Trial registration: www.clinicaltrial.gov NCT01806480 registered 7 March 2013.

  • Pirouznia, Pouyan
    et al.
    Högskolan Dalarna, Akademin Industri och samhälle, Materialteknik. KTH; Voestalpine Precis Strip AB, .
    Andersson, Nils Å. I
    KTH Royal Inst Technol, Dept Mat Sci & Engn, Div Proc, SE-10044 Stockholm, Sweden..
    Tilliander, Anders
    KTH Royal Inst Technol, Dept Mat Sci & Engn, Div Proc, SE-10044 Stockholm, Sweden..
    Jonsson, Par G.
    KTH Royal Inst Technol, Dept Mat Sci & Engn, Div Proc, SE-10044 Stockholm, Sweden..
    An investigation of the temperature distribution of a thin steel strip during the quenching step of a hardening process2019Inngår i: Metals, ISSN 2075-4701, Vol. 9, nr 6, s. 1-14Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The dimension quality of the strip within the hardening process is an essential parameter, which great attention needs to be paid. The flatness of the final product is influenced by the temperature distribution of the strip, specifically across the width direction. Therefore, based on physical theories, a numerical model was established. The temperature of the strip for the section before the martensitic transformation was objected in the predicted model by using a steady state approach. In addition an infrared thermal imaging camera was applied in the real process in order to validate the results and to improve the boundary conditions of the numerical model. The results revealed that the temperature of strip decreased up to 250 degrees C within the area between the furnace and the quenching bath. This, in turn, resulted in significant temperature difference across the width of the strip. This difference can be up to 69 degrees C and 41 degrees C according to the numerical results and thermal imaging data, respectively. Overall, this study gave a better insight into the cooling step in the hardening process. In addition, this investigation can be used to improve the hardening process as well as an input for future thermal stress investigations.

  • Thomson, Gill
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Balaam, Marie-Clare
    International insights into peer support in a neonatal context: a mixed-methods study2019Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 7, artikkel-id e0219743Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Peer support is a widely used intervention that offers information and emotional support to parents during their infant's admission to the neonatal unit and/or post-discharge. Despite its widespread use, there are no comprehensive insights into the nature and types of neonatal-related peer support, or the training and support offered to peer supporters. We aimed to bridge these knowledge gaps via an international study into neonatal peer support provision. A mixed-methods study comprising an online survey was issued to peer support services/organisations, and follow-up interviews held with a purposive sample of survey respondents. Survey/interview questions explored the funding, types of peer support and the recruitment, training and support for peer supporters. Descriptive and thematic analysis was undertaken. Thirty-one managers/coordinators/trainers and 77 peer supporters completed the survey from 48 peer support organisations/services in 16 different countries; with 26 interviews undertaken with 27 survey respondents. We integrated survey and interview findings into five themes: 'background and infrastructure of peer support services', 'timing, location and nature of peer support', 'recruitment and suitability of peer supporters', 'training provision' and 'professional and emotional support'. Findings highlight variations in the types of peer support provided, training and development opportunities, supervisory and mentoring arrangements and the methods of recruitment and support for peer supporters; with these differences largely related to the size, funding, multidisciplinary involvement, and level of integration of peer support within healthcare pathways and contexts. Despite challenges, promising strategies were reported across the different services to inform macro (e.g. to facilitate management and leadership support), meso (e.g. to help embed peer support in practice) and micro (e.g. to improve training, supervision and support of peer supporters) recommendations to underpin the operationalisation and delivery of PS provision.

  • Udo, Camilla
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete. Center for Clinical Research Dalarna.
    Svenningsson, Irene
    Björkelund, Cecilia
    Hange, Dominique
    Jerlock, Margareta
    Petersson, Eva-Lisa
    An interview study of the care manager function: Opening the door to continuity of care for patients with depression in primary care2019Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 3, s. 974-982Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To explore experiences among patients with depression of contact with a care manager at a primary care centre.

    Design: A qualitative explorative study.

    Methods: During spring and summer 2016, 20 individual face-to-face interviews were conducted with patients with experience of care manager contact. The material was analysed using systematic text condensation.

    Results: The participants described that having contact with a care manager was a support in their recovery process. Care became more available, and the structured continuous contact and the care manager's availability contributed to a trusting relationship. Having someone to share their burden with was a relief. However, it was described as negative when the care manager was perceived as inflexible and not open to issues that the participants felt a need to discuss. For the care manager contact to be successful, there is a need for flexibility and individually tailored contact.

  • Håkansson Eklund, Jakob
    et al.
    Holmström, Inger K
    Ollén Lindqvist, Anna
    Sundler, Annelie J
    Hochwälder, Jacek
    Marmstål Hammar, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Empathy levels among nursing students: a comparative cross-sectional study2019Inngår i: Nursing Open, E-ISSN 2054-1058, Vol. 6, nr 3, s. 983-989Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: Empathy is a crucial component of the nurse-patient relationship, but knowledge is lacking as to when empathy develops during nursing education. The aim of the present study was to compare empathy levels at different stages of undergraduate nursing education and different master's nursing programmes.

    Design: The design was a comparative cross-sectional study.

    Methods: A total of 329 participants in Sweden, comprised of nursing students in their second and sixth semesters in an undergraduate nursing programme as well as master's nursing students, rated their own empathy using the Jefferson Scale of Physician Empathy.

    Results: Students in their sixth semester in an undergraduate nursing programme expressed more empathy than did students in their second semester and master's nursing students. Among the five master's programmes, public-health nursing students expressed the most empathy and intensive-care nursing students the least.

  • Byrskog, Ulrika
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Ahrne, Malin
    Small, Rhonda
    Andersson, Ewa
    Essen, Birgitta
    Adan, Aisha
    Ahmed, Fardosa Hassen
    Tesser, Karin
    Åhman-Berndtsson, Anna
    Schytt, Erica
    Rationale, development and feasibility of group antenatal care for immigrant women in Sweden: a study protocol for the Hooyo Project2019Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 7, artikkel-id e030314Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes.

    OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study.

    METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group.

    ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenatal care units, national/international conferences, through publications in peer-reviewed journals, seminars involving stakeholders, practitioners, community and via the project website. Participating women will receive a summary of results in their language.

  • Saarijärvi, Markus
    et al.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Göteborgs universitet; Karolinska institutet.
    Moons, Philip
    Gyllensten, Hanna
    Bratt, Ewa-Lena
    Transition program for adolescents with congenital heart disease in transition to adulthood: protocol for a mixed-method process evaluation study (the STEPSTONES project)2019Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, nr 8, artikkel-id e028229Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Today, the majority of young persons living with chronic conditions in high-income countries survive into adulthood and will need life-long medical follow-up. Therefore, transition programmes have been developed to facilitate transfer to adult care, and to support self-management and independence during adulthood. The Swedish Transition Effects Project Supporting Teenagers with chrONic mEdical conditionS (STEPSTONES) project aims to evaluate the effectiveness of a person-centred transition programme for empowering adolescents with congenital heart disease in transition to adulthood. To understand how the transition programme causes change and how outcomes are created, process evaluation is imperative to assess implementation, context and mechanisms of impact. This protocol aims to describe the process evaluation of the STEPSTONES transition programme.

    METHODS AND DESIGN: Medical Research Council guidance for process evaluation of complex interventions will be the guiding framework for this mixed-method study. The combination of qualitative and quantitative data will capture different aspects of programme delivery. The sample will consist of participants in the STEPSTONES randomised controlled trial (RCT), persons implementing the programme and healthcare professionals. Quantitative data will consist of protocols and routine monitoring documents from the RCT, data collected from patient registries and sociodemographic data to assess the implementation of the intervention. This data will be analysed with quantitative content analysis, along with descriptive and inferential statistics. Qualitative data will consist of participatory observations, logbooks and interviews with persons implementing the programme, participants and healthcare professionals. Analyses will be performed using qualitative content analysis to investigate mechanism of impact, context and delivery. Quantitative and qualitative data will be integrated in the final stage by using a triangulation protocol according to mixed-method guidelines.

    ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be presented in open access, peer-reviewed journals and at international scientific conferences.

  • Svenningsson, I
    et al.
    Petersson, E-L
    Udo, Camilla
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Westman, J
    Björkelund, C
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Center for Clinical Research; Karolinska institutet, Göteborgs universitet.
    Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression.2019Inngår i: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 20, nr 1, artikkel-id 108Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been tested in Sweden in the PRIM-CARE RCT with successful results. The aim of the present study was to evaluate the process of implementing care managers in collaborative care for patients with depression in Swedish primary health care in the PRIM-CARE RCT.

    METHODS: The study followed UK Medical Research Council guidance for process evaluation. Field notes from the implementation of the PRIM - CARE RCT were used, as well as data collected from five focus group discussions with General Practitioners (n = 29) and three focus group discussions with care managers (n = 11). Data were analysed with content analysis.

    RESULTS: Training sessions, careful preparation and extensive initial support to the care manager and staff at the Primary Care Centres were important ingredients in the implementation. The close access to facilitators, the recurrent peer support meetings, and the weekly newsletter strengthened the care manager function.

    CONCLUSIONS: A complex intervention adapted to the Swedish primary care context focusing on a care manager function for patients with depression could be performed through a stepwise implementation process. Financial support from the health care regions included in the study helped to reduce the impact of identified barriers. This process evaluation has revealed new and important knowledge for primary care development concerning infrastructure and organization building, knowledge sharing, and facilitating factors and barriers.

    TRIAL REGISTRATION: NCT02378272 Care Manager - Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM - CARE). Registered March 4 2015. Retrospectively registered.

  • Jansson, Andreas
    et al.
    Högskolan Dalarna, Akademin Industri och samhälle, Informatik.
    Pernsjö, Jonna
    Högskolan Dalarna, Akademin Industri och samhälle, Informatik.
    Animationers inverkan på användarens förtroende för webbplatsen2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Syftet med denna studie var att ta reda på om animationer kan användas för att påverka en användares förtroende för en webbplats, vid situationer där förtroende har en stor betydelse. Som till exempel registrering av prenumerationstjänster eller sociala medier. Syftet är även att ta reda på vilka animationer som ger ett förtroendeingivande intryck. För att genomföra undersökningen har litteratursökning, visuell innehållsanalys och enkätundersökning använts. Resultatet visade på att animationer kan användas för att öka en användares förtroende för en webbplats. Resultatet visade även vilka animationer som kan användas för att öka förtroendet. Slutsatserna visar att webbplatser bör innehålla någon form av animation för att öka förtroendet, användaren vill få feedback när interaktion med webbplatsen sker. Feedbacken ska ske så snabbt som möjligt och med någon form av varaktighet. Animationerna bör öka kontrasten på elementet gentemot sin omgivning, oavsett vilken sorts animering det gäller. Dock bör inte kontrasten vara för påtaglig.

  • Matsdotter, Freja
    et al.
    Högskolan Dalarna, Akademin Industri och samhälle, Informatik.
    Turesson, Lellah Johanna
    Högskolan Dalarna, Akademin Industri och samhälle, Informatik.
    Typographical trust issues: The impact of font types on trust in the context of online banking websites2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [en]

    The purpose of this study was to examine if font choices affect how text and sender are perceived in the context of online banking websites. Large amounts of money are invested to produce effective design units; therefore, graphic designers need to be aware of how their font choices impact the readers’ perception of text. This study aimed to raise awareness around the impact of fonts and to create a helpful report that can guide designers in their font choices.

    Previous research on the subject argues that typography is a critical tool in visual communication, and that selecting an appropriate typeface is very important. Studies have shown how readers are aware of the difference in appropriateness between different font and text matches. Shaikh, Chaparro and Fox (2006) found serif and sans serif fonts to be the most appropriate in most situations while scripts were appropriate only for scrapbooking and e-greetings and modern display fonts were perceived as rude or coarse.

    The methods used in the present study were a Literature Study, two Focus Groups, a Quantitative Web Survey and two Visual Content Analyses. The results show that font choices do affect perception of the sender in this context. The most appropriate fonts were strict and structured, but not boring, non-decorative and had a medium x-height in relation to cap height.

  • Hodacs, Hanna
    et al.
    Högskolan Dalarna, Akademin Humaniora och medier, Historia.
    Mathias, Persson
    Uppsala university.
    Globalizing the savage: From stadial theory to a theory of luxury in late-18th-century Swedish discussions of Africa2019Inngår i: History of the Human Sciences, ISSN 0952-6951, E-ISSN 1461-720X, s. 1-15Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article examines the effects of globalization on changing notions of the ‘savage’. We compare discussions taking place in different contexts in the late 18th century concerning two Swedish scholars and travellers to Africa: Anders Sparrman (1748–1820), a naturalist and Linnaean disciple, and Carl Bernhard Wadstro¨m (1746–99), an engineer and economist. Both moved in Swedish Swedenborgian circles, and both became involved in the British abolitionist movement. Nevertheless, their images of African ‘Others’ diverged in crucial respects, reflecting differences in their ideological outlooks, institutional affiliations, and understandings of how the world was changing. More specifically, we argue that the perception of global change brought about by a new economic framework of production and consumption provides a key for reading and comparing Wadstro¨m’s and Sparrman’s texts. Comparing their divergent uses of ‘savagery’, the article also highlights the versatility of the savage as a tool for presenting distant parts of the world to a domestic audience.

  • Kylén, Maya
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Von Koch, Lena
    Pessah-Rasmussen, Hélène
    Marcheschi, Elizabeth
    Ytterberg, Charlotte
    Heylighen, Ann
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Chalmers University.
    The importance of the built environment in person-centred rehabilitation at home: study protocol2019Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, nr 13, artikkel-id E2409Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This-along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred-will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient's recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person-environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home.

  • Talman, L.
    et al.
    Wilder, J.
    Stier, Jonas
    Högskolan Dalarna, Akademin Humaniora och medier.
    Gustafsson, C.
    Staff’s and managers’ conceptions of participation for adults with profound intellectual disabilities or profound intellectual and multiple disabilities2019Inngår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 21, nr 1, s. 78-88Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    One goal of disability policies in Sweden and other countries is to ensure that people with disabilities are afforded an equal level of daily life participation as other citizens. However, few studies have examined this in adults with profound intellectual disabilities (PID) or profound intellectual and multiple disabilities (PIMD). This study used a phenomenographic approach to interview managers and staff at a social care organisation in a medium-sized Swedish municipality. It aimed to elucidate and describe conceptions of participation to highlight conceptual variations. Divergent conceptualisations were found, reflecting a lack of organisational consensus about the meaning of participation. Trying to fulfil policy goals of daily life participation for adults with PID or PIMD without a common understanding of the meaning of participation is difficult, so people at all levels of an organisation need to have a shared understanding and definition of it. © 2019 The Author(s).