Dalarna University College Electronic Archive
Not a member yet
13986 research outputs found
Sort by
Day-to-day variability in activity levels detects transitions to depressive symptoms in bipolar disorder earlier than changes in sleep and mood
No full textAnticipating clinical transitions in bipolar disorder (BD) is essential for the development of clinically actionable predictions. Our aim was to determine what is the earliest indicator of the onset of depressive symptoms in BD. We hypothesized that changes in activity would be the earliest indicator of future depressive symptoms. The study was a prospective, observational, contactless study. Participants were 127 outpatients with a primary diagnosis of BD, followed up for 12.6 (5.7) [(mean (SD)] months. They wore a smart ring continuously, which monitored their daily activity and sleep parameters. Participants were also asked to complete weekly self-ratings using the Patient Health Questionnaire (PHQ-9) and Altman Self-Rating Mania Scale (ASRS) scales. Primary outcome measures were depressive symptom onset detection metrics (i.e., accuracy, sensitivity, and specificity); and detection delay (in days), compared between self-rating scales and wearable data. Depressive symptoms were labeled as two or more consecutive weeks of total PHQ-9 > 10, and data-driven symptom onsets were detected using time-frequency spectral derivative spike detection (TF-SD2). Our results showed that day-to-day variability in the number of steps anticipated the onset of depressive symptoms 7.0 (9.0) (median (IQR)) days before they occurred, significantly earlier than the early prediction window provided by deep sleep duration (median (IQR), 4.0 (5.0) days; p <.05). Taken together, our results demonstrate that changes in activity were the earliest indicator of depressive symptoms in participants with BD. Transition to dynamic representations of behavioral phenomena in psychiatry may facilitate episode forecasting and individualized preventive interventions
Causal effect of PM2.5 on the urban heat island
No full textThe planet is experiencing global warming, with an increasing number of heat waves worldwide. Cities are particularly affected by the high temperatures because of the urban heat island (UHI) effect. This phenomenon is mostly explained by the land cover changes, reduced green spaces, and the concentration of infrastructure in urban settings. However, the reasons for the UHI are complex and involve multiple factors still understudied. Air pollution is one of them. This work investigates the link between particulate matter ≤2.5 μm (PM2.5) and air temperature by convergent cross-mapping (CCM), a statistical method to infer causation in dynamic non-linear systems. A positive correlation between the concentration of fine particulate matter and urban temperature is observed. The causal relationship between PM2.5 and temperature is confirmed in the most urbanized areas of the study site (Quito, Ecuador). The results show that (i) the UHI is present even in the most elevated capital city of the world, and (ii) air quality is an important contributor to the higher temperatures in urban than outlying areas. This study supports the hypothesis of a non-linear threshold effect of pollution concentration on urban temperature
From drawing to grade : a qualitative study on students’ experiences with visual arts and assessment
No full textSyftet med denna studie var att i stöd av kvalitativa fokusgruppintervjuer finna svar på hur elever i årskurs 6 upplever bildämnet och betygssättning i ämnet. De frågeställningar studien ämnade att besvara var Hur resonerar elever i årskurs 6 kring sina uppfattningar och upplevelser av bildskapande? Hur upplever elever i årskurs 6 undervisningen i bildämnet? Samt Hur reflekterar elever i årskurs 6 över betygssättning och bedömning inom bildämnet? Genomförandet grundade sig i ett diskursanalytiskt perspektiv för att identifiera hur eleverna samtalade om bildundervisningen och betygssättning. Resultatet visade att eleverna upplevde bildundervisningen som bristfällig när det gällde transparens kring innehåll och betygskriterier samt en avsaknad av varierade bedömningsmetoder. Trots detta kände de ingen stress över betygssättningen i årskurs 6. Eleverna påpekade också att intresset för bildämnet sjönk när uppgifterna minskade i variation och av ökad tidspress. Sammanfattningsvis pekar studien på ett behov av ökad lärarkompetens, mer utrymme för bildämnet och större transparens i bedömningsprocessen
Hållbart arbetsmiljöarbete i praktiken – erfarenheter från två avslutade arbetsmiljöprojekt inom den svenska hästnäringen
No full textBakgrund: Det är väl känt att en hälsosam och säker arbetsmiljö med anständiga arbetsvillkor är avgörande för både individers hälsa och välbefinnande som för företags och organisationers framgång. Ett systematiskt arbetsmiljöarbete är tillsammans med delaktighet och inflytande två viktiga utgångspunkter för att skapa attraktiva, hälsosamma och hållbara arbetsmiljöer och för att främja verksamhetsutveckling. Dessutom är det en lagstadgad skyldighet genom arbetsmiljölagen (SFS 1977:1160) som bland annat föreskriver kraven på ett systematiskt arbetsmiljöarbete (AFS 2023:1). Forskning har dock visat på dålig efterlevnad och uppföljning vad gäller det systematiska arbetsmiljöarbetet. Vidare verkar införandet av lagar och regler inte vara tillräckligt för att påverka medarbetarnas aktiva deltagande i arbetsmiljöarbetet. Flera studier har i stället visat på att motivation har en avgörande roll för medarbetarnas följsamhet till rutiner och riktlinjer samt engagemang och deltagande i arbetsmiljöarbete. Arbetsmiljöproblemen som finns inom svensk hästnäring är förhållandevis välkända. Däremot var kunskapen om effektiva praktiska metoder och verktyg och tillämpningen av dessa för att uppnå ett framgångsrikt systematiskt arbetsmiljöarbete bristfällig. Resultatet bygger på erfarenheter från två avslutade forskningsprojekt; Förbättrad arbetsmiljö inom hästnäringen genom nya metoder och verktyg (2018–2022) och Säker hästnäringen (2020–2023). Syfte: Det övergripande syftet med projektet var att öka kunskapen om hur ett långsiktigt förebyggande och systematiskt arbetsmiljöarbete praktiskt kan integreras och vara kontinuerligt fungerande inom den svenska hästnäringen. Metod: En interventionsstudie på sex ridskolor och sex travstall med det specifika syftet att utveckla och utvärdera metoder och verktyg för systematiskt arbetsmiljöarbete anpassat för hästnäringens behov, med särskilt fokus på att främja motivation. Datan samlades in genom enkäter, observationer och semistrukturerade intervjuer både med medarbetare och chefer. Resultat: Projekten gav insikter om framgångsfaktorer för ett hållbart arbetsmiljöarbete, där de viktigare var medarbetarnas motivation och delaktighet, kunniga och intresserade chefer, en tillåtande kultur med en öppenhet till förändring samt tillräckliga resurser i form av personal, tid, ekonomi, och utrustning. Resultatet visade även på att det fanns ett signifikant samband mellan ett fungerande systematiskt arbetsmiljöarbete, enligt de bestämmelser som finns framskrivna i föreskriften, och en hög grad av motivation för arbetsmiljöarbete bland medarbetarna. Det kan förstås som att ett systematiskt arbetsmiljöarbete är ett användbart arbetssätt för att öka medarbetarnas engagemang och motivation för arbetsmiljöförbättrande åtgärder. Likväl är medarbetarnas delaktighet helt avgörande för utfallet av det systematiska arbetsmiljöarbetet. Projektet resulterade i några användbara och uppskattade metoder och arbetssätt för att öka motivation för och kunskaper om arbetsmiljöarbete, exempelvis Visit, SAM-pusslet och Ergonomiplanschen. Metoderna, som utgår från Arbetsmiljöverkets föreskrifter och allmänna råd om systematiskt arbetsmiljöarbete (AFS 2023:1) och Belastningsergonomi (AFS 2012:2), är lättillgängliga, enkla att använda för praktiken och anpassade till branschens förutsättningar. Ett intressant resultat var att de arbetsplatser som lyckats med sitt arbetsmiljöarbete inte exakt följde det som föreskrifterna kräver (exempelvis vad gäller dokumentation, skriftliga rutiner och riskbedömningar). De hittade andra arbetssätt som passade deras verksamheter. Framgångsfaktorer var istället att arbetsmiljöarbetet genomsyrade hela verksamheten och involverade alla medarbetare
From Arrival to Establishment : A Qualitative Study on Migrants’ Experiences of Reception in Sweden and Its Significance for Integration
No full textSverige har en lång historia av migration, som under den så kallade ”migrationskrisen” 2015 ställdes inför stora utmaningar. Sverige hade svårigheter med att upprätthålla den standard som tidigare funnits inom mottaggningsprocessen. Studien syftar till att undersöka hur personer som migrerade till Sverige under 2015 upplevde mottagningen samt vilka delar inom den som hämmande respektive främjade integrationen. Studien är kvalitativ och identifierade med hjälp av semi-strukturerade intervjuer och tematisk analys fyra huvudteman: att leva i osäkerhet, otillräckligt samhällsstöd gav upphov till eget driv, starkt formellt stöd för en bra start samt betydelsen av sociala kontakter. I resultatet framkommer bland annat egen vilja och sociala kontakter som tydligt främjande faktorer för integrering. Vidare tydliggörs hur de långa väntetiderna hos Migrationsverket skapade en hämmande effekt på integreringen. Utöver ovissheten som väntan skapade ser intervjupersonerna positivt på mottaggningsprocessen. Sweden has a long history of migration, which during the so-called “migrationcrisis” of 2015 faced significant challenges. Sweden had difficulties maintaining the standard that had previously existed within the reception process. The study aims to examine how individuals who migrated to Sweden in 2015 experienced the reception process and which aspects of it hindered or promoted integration. The study is qualitative, identified through semi-structured interviews and thematic analysis, revealing four main themes: living in uncertainty, insufficient social support gave rise to self-drive, strong formal support for a good start, and the significance of social contacts. The results reveal, among other things, personal motivation and social contacts as clearly facilitating factors for integration. Furthermore, it clarifies how the long waiting times at the Migration Agency created a hindering effect on integration. Beyond the uncertainty created by the waiting, the interviewees view the reception process positively
Passing-skill training vs. small-sided games for improvement of side-foot kick accuracy among youth female soccer players
No full textThis study compared the effectiveness of a passing-skill training (PST) concept (theory lectures, passing-skill training, and external- and internal-focus feedback) and three-a-side small-sided games (SSG) on improving side-foot kick accuracy among youth female soccer players. Seventeen youth female soccer players (age: 12.7 ± 0.8 years) completed the pre-post-intervention study, where the pre- and post-tests included three 10-m passing accuracy tests with increasing level of complexity: (1) stationary ball with a fixed target (SBFT), (2) rolling ball with a fixed target (RBFT), and (3) rolling ball with a moving target (RBMT). Based on the pre-tests, the participants were matched into the PST group or the SSG group. The training consisted of nine 30-min sessions for both groups during a period of 4.5 weeks. During the intervention, the PST group significantly improved the side-foot kick accuracy across all three tests. In contrast, the SSG group showed no significant change in passing accuracy in either the RBFT test or the RBMT test; however, their side-foot kick accuracy was significantly reduced in the SBFT test. There were significant between-group differences in side-foot kick accuracy across all three tests after the intervention, where the PST group had a greater side-foot kick accuracy than the SSG group. In conclusion, results indicate that the PST concept significantly enhances passing accuracy across all tested variables, unlike SSG, suggesting PST's superiority in technical skill development
Simulation as a foundation for experiential learning among ambulance nursing students : A qualitative observation study
No full textSimulation-based education is commonly used in undergraduate training but has gained increased utilization in postgraduate education. Ambulance nursing programs struggle to provide suitable simulations, as ambulance care can involve any possible situation. Simulation-based education in ambulance nursing programs commonly includes basic assessment and treatment of various conditions. However, there seems to be a lack of knowledge regarding students’ experience of simulating pediatric emergency care in an ambulance care setting. Thus, the aim of this study was to explore specialist nursing students’ experiences of simulating pediatric emergency care in an ambulance care setting. A qualitative design was deployed, utilizing field notes, individual and group interviews to capture the students’ experiences. The results show that students immerse themselves in the simulations when the environment and facilitators support this. The simulation can elicit both emotional and physical responses among the students. Students gain insights into their knowledge deficit regarding certain topics, such as pediatric emergency care, as well as the rules and regulations governing what they are allowed to do for a child’s safety and well-being. During simulation, students understand the importance of using adequate communication and recognize that there might be several aspects influencing this. Finally, the students gain insight into their emotional and behavioral responses when encountering patients and relatives in situations that conflict with their own views. In conclusion, simulation-based education can be a useful pedagogical tool if barriers to immersion are reduced. It can provide students with insights into their emotional and behavioral responses when encountering unexpected events. If properly discussed in debriefing sessions, these matters lead to increased learning that students can carry with them into their future careers. However, more research is needed on the feasibility of this kind of simulation in the ambulance nurse education setting
'All I Do Is Sit in a Chair Until the Pain Fades'-Experiences of Living With Gout
No full textBACKGROUND: Living with gout impacts most dimensions of life. However, there is a lack of studies exploring the trajectory of patients' experiences of living with and being treated for gout, beyond the experiences during a flare. This study aimed to explore how individuals with gout experience the disease, its effects on daily life and their encounters with healthcare. METHODS: A constructivist grounded theory was used, involving simultaneous data collection and analysis. Semi-structured individual interviews were conducted with 12 individuals living with gout and aged between 40 and 87 in Central Sweden. RESULTS: Navigating the uncertainty of living with gout was represented through two categories: 'a mismatch between individuals' needs and the provision of care' and 'a process of adaptation'. The mismatch involved unmet needs for pain relief, feeling dismissed as having a minor condition and a lack of personalised care. The adaptation process included seeking explanations, developing self-management strategies and adjusting to pain and functional limitations. CONCLUSIONS: Living with gout entails a significant degree of uncertainty. The process of adaptation is affected by a mismatch between individuals' needs and the care provided, in addition to the disease's 'roller coaster' nature and its slow progression. PATIENT AND PUBLIC CONTRIBUTION: This study is part of a research project aimed at gathering knowledge essential for developing an intervention in primary care. A patient, appointed by the Swedish Rheumatism Association, is actively participating in the project's research group. The results of this study have been discussed and analysed within the research group, including input from the patient participant
Exposure to distressing situations among registered nurses during the COVID-19 pandemic : a cross-sectional study
No full textBACKGROUND: The COVID-19 pandemic exacerbated distressing situations among healthcare professionals, due to resource limitations and complex patient care challenges. RESEARCH OBJECTIVES: The research aims to explore the frequency of RNs' exposure to distressing situations across various care settings during the pandemic and assess the association between this exposure and: (1) stress of conscience, (2) intentions to leave the profession, (3) job satisfaction, and (4) self-rated health in the late phase of the pandemic. In addition, the aim was to describe other common situations they encountered during the pandemic. RESEARCH DESIGN: A cross-sectional multi-method study was conducted with participants recruited from a national cohort of Registered Nurses (RNs) between October 2021 and January 2022. In total, 3,958 individuals met the eligibility criteria, with 2,237 participants (56.5%) responding to the survey. Among these respondents, 1,881 answered questions about distressing situations, and 239 shared open-ended responses about their experiences. RESULTS: The results showed that during the peak of the COVID-19 pandemic, between 24% and 70% of RNs encountered distressing situations on a weekly basis or more often. Over 70% reported difficulties in communication due to personal protective equipment. Additionally, just over 40% of RNs reported working in situations lacking clear guidelines and facing prioritization challenges. RNs exposed to these distressing situations were frequently nearly twice as likely to experience stress of conscience (44% vs. 21%, [OR] = 2.87) and showed a stronger intention to leave the profession (25% vs. 14%, [OR] = 1.98). Moreover, they reported lower job satisfaction (85% vs. 92%, [OR] = 0.50) and poorer self-rated health (34% vs. 50%, [OR] = 0.52) compared to their counterparts with less exposure. In addition, RNs experienced a lack of support, understaffing, and working beyond their expertise, leading to emotional and physical exhaustion. They felt inadequate due to overwhelming workloads and limited recovery time. CONCLUSION: The COVID-19 pandemic has significantly impacted RNs, underscoring the need for strong organizational support and leadership. Nurses require guidance from leaders and institutions to manage distress and ethical challenges effectively. Future strategies should prioritize adequate staffing, skill development, teamwork, mental health resources, and transparent communication to support nurses' wellbeing and recovery, ensuring the delivery of high-quality care
Patients´ experiences of the relationship to nurses in psychiatric care : a literature review
No full textBakgrund: Psykisk ohälsa är ett samlingsbegrepp för en variation på olika tillstånd inom psykiatrin. Psykisk ohälsa kan drabba alla åldrar och befolkningsgrupper. Individer med psykisk ohälsa upplever ofta stigmatisering vilket skapar barriärer och påverkar individens hälsa. Det är viktig att patientens delaktighet och autonomi eftersträvas i vården. Syfte: Syftet med denna litteraturöversikt var att beskriva sjuksköterske- och patientrelationen inom den psykiatriska vården utifrån patientens perspektiv. Metod: Examensarbetet genomförs som en strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikter. Litteraturöversiktens resultat baseras på 13 vetenskapliga artiklar, varav tio kvalitativa, två kvantitativa och en mixed-method. Resultat: I sammanställningen av resultatet framkom två huvudkategorier. Patientens upplevelse beskriver upplevelser av relationen, kommunikationen, främjande attityder hos sjuksköterskan och patientens upplevda känslor.Patientens önskemål beskriver önskemål på kommunikationen i relationen och egenskaper hos en sjuksköterska för att få en fungerande relation. Slutsats: Relationen mellan sjuksköterskor och patienter kan påverka patienters upplevelser av vården. Resultatet i litteraturöversikten visade patienters upplevelser inom vården samt patienters förväntningar. För en god upplevelse av vårdrelationen är det nödvändigt att sjuksköterskor är intresserade, lyhörda, engagerade och individanpassar vården efter patienters problem, behov och resurser.Background: Mental illness is a collective term for a variety of different conditions within psychiatry. It can affect individuals across all age groups and segments of the population. Individuals with mental illness often face stigmatization, which creates barriers to care and negatively impacts their overall health. Promoting patient participation and autonomy is essential in the delivery of psychiatric care. Aim: The aim of this literature review was to describe the nurse-patient relationship within psychiatric care from the patient´s perspective. Method: The study is conducted as a structured literature review, in corporating elements of the methodology used in systematic reviews. The findings of the literature review are based on 13 scientific articles, including ten qualitative studies, two quantitative studies, and one mixed-method study. Results: In the synthesis of the results, two main categories emerged. The patient's experience encompasses perceptions of the nurse–patient relationship, communication, the nurse’s supportive attitudes, and the patient’s emotional responses. The patient’s wishes refer to expectations regarding communication within the relationship and the desired qualities in a nurse that contribute to a functional and effective therapeutic relationship. Conclusions: The relationship between nurses and patients can affect patients´experiences of care. The results of the literature review showed patients´experiences within the care setting as well as their expectations. For a positive experience of the care relationship, it is essential that nurses are interested, attentive, engaged, and personalize the care according to the patients´ problem, needs, and resources.