Högskolebiblioteket i Halmstad Publikationer
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Deep Decision Forest
No full textThis thesis presents Deep Decision Forest (DDF), a novel hierarchicalensemble model that incorporates a feedback-based retraining mechanism into a tree-based layered framework inspired by Deep Forest.Deep Forest (Zhou & Feng, 2017) is an ensemble method that stackslayers of decision tree ensembles, where the output of one layer becomes the input to the next, enabling progressive feature transformation. While Deep Forests have proven effective for structured tabulardata, they typically rely on fixed-layer training without iterative refinement. To the best of our knowledge, integrating a feedback mechanism into such models has not been previously explored.The core objective of this work is to prototype and evaluate howfeedback-driven retraining, inspired by layer-wise correction mechanisms found in deep learning, can influence performance in treebased hierarchical models. DDF refines its internal representations byretraining selected trees in earlier layers based on the performance oflater layers, enabling a form of structural adjustment without relyingon traditional gradient-based optimisation (i.e., backpropagation).Experiments were conducted on a diverse set of tabular datasets, comparing DDF against classical models such as Decision Trees, RandomForests, and standard Deep Forests. DDF achieves competitive accuracy across multiple datasets. As expected, DDF showed stronger performance on certain datasets that appeared to contain overlapping orstructurally similar features. In the end, DDF achieved higher resultsthan all other models it was compared to in 3 out of 7 datasets.To better understand when feedback-driven retraining is most beneficial, this work introduces a redundancy scoring metric that quantifiesfeature overlap in datasets. Beyond this, the thesis contributes severalnovel mechanisms to the DDF: 1. A strategy for selecting which features to retrain, based on heuristics. 2. Layer-wise feedback that retrains earlier trees according to the performance of deeper layers. 3.An experimental evaluation across multiple datasets comparing DDFagainst standard decision trees, random forests, and Deep Forest baselines.Ultimately, this thesis contributes a new architectural variant of DeepForests and opens a direction for further research into feedback-basedlearning mechanisms in non-neural models
Shaping Interoperability through Blockchain : Exploring Actor-Driven Adoption of Blockchain Technology for Patient-Owned Health Data in Swedish Healthcare
No full textThis thesis investigates how actors shape the adoption of blockchain-based systems for patient-owned health data in the context of Swedish healthcare, with a particular focus on enabling interoperability. The study applies the Innovation Translation framework in a deductive, qualitative research design. Data were collected through semi-structured interviews and secondary sources, and analyzed across the four translation stages of problematization, interessement, enrolment, and mobilisation, allowing the dynamics of both human and non-human actors to be systematically traced. The findings show that adoption is not driven by technology alone but by the dynamic roles actors play in shaping its meaning and use. Patients articulate demands for control and transparency, clinicians weigh usability against workflow constraints, policymakers and regulators define compliance boundaries, while technical artefacts and standards act as non-human actors that enable or restrict possibilities. These roles are fluid and continuously renegotiated, influencing both opportunities and barriers in the move toward interoperability. The study concludes that blockchain’s capacity to advance interoperable, patient-owned health data can only be realized when innovation is embedded within participatory governance, inclusive design, and long-term institutional commitment
Participation in care decisions in ALS – focusing on patients´ experiences : A general literature study
No full textBakgrund: Amyotrofisk lateralskleros (ALS) är en dödlig neurologisk sjukdom som leder till progressiv förlust av livsnödvändiga funktioner. Vanliga symtom är nedsatt tal- och sväljförmåga och muskelförtvining som förvärras ju mer sjukdomen fortskrider. Omvårdnaden fokuserar på att lindra symtomen och sätta in livsuppehållande behandling. Beslutsprocessen är komplex på grund av sjukdomens snabba förlopp som leder till att patienten måste ta många vårdbeslut samtidigt. Det är därför viktigt att som sjuksköterska göra patienten delaktig i vårdbeslut. Syfte: Syftet med litteraturstudien var att beskriva upplevelser av delaktighet i vårdbeslut för patienter med amyotrofisk lateralskleros. Metod: Den allmänna litteraturstudien genomfördes med induktiv ansats. Tio kvalitativa artiklar från tre olika omvårdnadsfokuserade databaser inkluderades i litteraturstudien. Resultat: Fyra huvudkategorier framkom i litteraturstudiens resultat; delaktighet genom en kontinuerlig beslutsprocess, delaktighet genom kontroll och självbestämmande, delaktighet genom information samt delaktighet genom kommunikation och stöd. Konklusion: Delaktighet i vårdbeslut påverkades av flertalet faktorer. Patientens känsla av kontroll över sin egen vård upplevdes som betydelsefull. Patienterna upplevde även att information som ges fortlöpande, tidigt och på olika sätt var viktigt för att bibehålla delaktighet och kontroll i vårdbeslut. Anhörigas stöd, kommunikationshjälpmedel och att beslutsfattande sågs som en process upplevdes som betydelsefulla faktorer i stärkandet av patienters delaktighet i omvårdnaden.Background: Amyotrophic lateral sclerosis (ALS) is a deadly neurological disease that causes progressive loss of vital functions. Common symptoms include impaired speech and swallowing ability, muscle weakness, which gets worse as the disease progresses. Nursing care focuses on relieving symptoms and providing life-sustaining treatment. The decision-making process is complex because the disease progresses quickly, which forces patients to make several care decisions at the same time. Therefore, it is important for nurses to involve patients in care decisions. Aim: The aim was to describe experiences of participation in care decisions among patients with ALS. Method: A general literature review with an inductive approach was done. Ten qualitative articles from three nursing-focused databases were included. Results: Four main themes were found: participation through a continuous decision-making process, participation through control and autonomy, participation through information and participation through communication and support. Conclusion: Participation in care decisions is affected by several factors. Feeling in control of their own care was important for the patients. Patients also felt that receiving information early, continuously, and in different ways helped them stay involved and make informed decisions. Support from family, communication tools, and seeing decision-making as an ongoing process were important to strengthen their participation in care
Patients’ health literacy and its significance for shared decision-making in nursing care : A literature review
No full textBakgrund: Hälsolitteracitet, det vill säga individens förmåga att förstå, värdera och använda hälsoinformation, är en central förutsättning för att patienten ska kunna delta aktivt i sin egen vård. Inom omvårdnad är delat beslutsfattande en viktig del av den personcentrerade vården och förutsätter att patienten har tillräcklig kunskap för att fatta informerade beslut tillsammans med vårdpersonal. Syfte: Syftet var att beskriva vilken betydelse patientens hälsolitteracitet har för det delade beslutsfattandet inom omvårdnad. Metod: En litteraturöversikt utfördes genom systematiska sökningar i databaserna CINAHL, PubMed och PsycINFO. Datainsamlingen resulterade i 16 artiklar som analyserades enligt Popenoe et al. (2021). Resultat: Resultatet visade att hög hälsolitteracitet underlättar patientens förståelse av vårdinformation, stärker delaktigheten och förbättrar samarbetet mellan patient och vårdpersonal. Låg hälsolitteracitet utgjorde däremot ett hinder för delat beslutsfattande och ökade risken för missförstånd, passivitet och sämre vårdresultat. Sjuksköterskans kommunikativa kompetens och förmåga att anpassa information efter individens förutsättningar framstod som en avgörande faktor. Slutsats: Hälsolitteracitet framträdde som en betydande faktor som påverkade patienters upplevelse av delat beslutsfattandet. Hälsolitteracitet var inte en enskild faktor, eftersom den hade både en direkt och en indirekt påverkan på gemensamt beslutsfattande.Background: Health literacy is an individual's ability to understand, evaluate, and use health information. It is a key prerequisite for the patient to be able to actively participate in their own care. In nursing, shared decision-making is an important part of person-centered care and requires that the patient possesses sufficient knowledge to make informed decisions together with healthcare professionals. Aim: The aim was to describe the significance of the patient’s health literacy for shared decision-making in nursing. Method: A literature review was conducted through systematic searches in the databases CINAHL, PubMed, and PsycINFO. The data collection resulted in 16 articles that were analyzed according to Popenoe et al. (2021). Results: The results showed that high health literacy facilitates the patient’s understanding of healthcare information, strengthens participation, and improves collaboration between patients and healthcare professionals. Low health literacy, on the other hand, was identified as a barrier to shared decision-making and increased the risk of misunderstandings, passivity, and poorer care outcomes. The nurse’s communication skills and ability to adapt information to the individual’s conditions emerged as crucial factors. Conclusion: Health literacy appeared as a significant factor influencing patients’ experience of shared decision-making. Although health literacy was not an individual factor as it had a direct and indirect impact on shared decision making
Who benefits from the Industrial Agreement? Uncovering the trends and structures of wage inequality at play in the Swedish wage-setting model
No full textSweden’s Industrial Agreement (IA) has long been heralded as a cornerstone of the country’s balanced growth model – anchoring wage formation to export sector norms while also promoting wage equality across the labour market. This paper interrogates the IA’s distributive outcomes between 2014 and 2023, a period spanning both pre-pandemic stability and post-pandemic inflation. Using occupational wage data and multinomial regression analyses, we find a growing divergence between the IA’s intentions and its effects. While the manufacturing sector maintains its benchmark function, wage growth has become increasingly stratified by occupational hierarchy and wage level. High-status groups, such as those in advanced-education occupations, generally outperform others in wage growth, particularly during inflationary periods. In contrast, many low-wage and mid-tier occupations face poorer wage increases. These findings suggest an institutional drift in the IA model: though it retains formal coordination at the industry level, it fails to contain wage growth dispersion across occupational and income strata. As wage level and occupational hierarchy shape outcomes, the solidaristic underpinnings of Sweden’s wage-setting regime appear to erode – raising fundamental questions about the future of the balanced growth model and the legitimacy of IA as a mechanism for equitable wage development. © Australian Labour and Employment Relations Association (ALERA) 2025
Family caregivers’ experiences of involvement in home-based palliative care : A literature review
No full textBakgrund: Palliativ vård i hemmet blir allt vanligare i takt med att fler patienter önskarvårdas och dö i hemmet. För närstående innebär detta en förändrad livssituation däromsorgsansvar förenas med betydande emotionella påfrestningar. Distriktssköterskanintar en central position i att stödja både patient och närstående genom helavårdprocessen. Syfte: Syftet med denna litteraturstudie var att belysa vilka aspekter sompåverkar närståendes upplevelse av delaktighet i palliativ vård i hemmet. Metod: Studiengenomfördes som en allmän litteraturöversikt baserad på 15 kvalitativa vetenskapligaartiklar. Analysen följde Bettany-Saltikov och McSherrys niostegsmodell. Resultat: Närståendes delaktighet formas av ett komplext samspel mellankommunikation, relationer, stödstrukturer och individuella värderingar. En kontinuerlig,empatisk och tydlig kommunikation med distriktssköterskan främjar trygghet,begriplighet och samhörighet. Behovet av undervisning, emotionellt stöd och bekräftelseav närståenderollen framträder som centrala förutsättningar för att möjliggöra delaktighet.Vidare påverkar kulturella, etiska och existentiella perspektiv hur närstående tolkaransvar, mening och sina egna gränser i vårdandet. Slutsats: Distriktssköterskans närvaro,kommunikativa kompetens och förtroendefulla relation till familjen är avgörande för attstärka närståendes delaktighet och välbefinnande i palliativ hemsjukvård. Studienindikerar behov av fortsatt forskning om strategier för hur distriktssköterskan kan stödjanärståendes emotionella, existentiella och praktiska behov. Background: Palliative home care has become increasingly common as more patientswish to be cared for and die at home. For family caregivers, this entails a transformationof everyday life, combining responsibility, emotional strain, and close involvement in thepatient’s care. District nurses play a key role in supporting both patients and familymembers throughout the palliative process. Aim: The aim of this literature review was toexplore aspects that influence the involvement of family caregivers’ in palliative homecare. Method: This study is an integrative literature review based on 15 qualitativeresearch articles published between 2015 and 2025. The articles were analyzed usingBettany-Saltikov and McSherry´s nine steps model. Results: The findings reveal thatfamily caregivers’ sense of participation is shaped through a dynamic interplay betweencommunication, relationships, support, and personal values. Open and empatheticdialogue with the district nurse fosters trust, meaning, and connection. Furthermore,information, emotional support, and affirmation of the caregiving role are identified askey conditions for participation. Cultural, ethical, and existential factors also influencehow caregivers perceive responsibility and meaning in care. Conclusion: The districtnurse’s caring presence, communicative competence, and relational continuity areessential for strengthening family caregivers’ participation and well-being in palliativehome care. The study highlights the need for further research to explore how districtnurses can develop sustainable strategies to support family caregivers’ emotional,existential, and practical needs.
Patients’ experiences in physical activity following myocardial infarction : A general literature study
No full textBakgrund: Hjärtinfarkt utgör en vändpunkt för patienter att överväga förändring av levnadsvanor. Fysisk aktivitet rekommenderas som sekundärprevention till alla patienter som genomgått hjärtinfarkt. Sjuksköterskans ansvar är att identifiera varje patients individuella behov och förutsättningar till fysisk aktivitet. Syfte: Syftet var att belysa patienters upplevelser av fysisk aktivitet efter hjärtinfarkt. Metod: En allmän litteraturstudie genomfördes och inkluderade 10 kvalitativa resultatartiklar. Artiklarna bearbetades enligt Popenoes analysmetod. Resultat: Tre kategorier identifierades: en ny tillvaro, balansen mellan osäkerhet och handlingskraft och i gemenskapens trygghet. Patienter upplevde en förändrad tillvaro, vilket påverkade deras förutsättningar för fysisk aktivitet efter inträffad hjärtinfarkt till följd av att kropp och hjärta beskrevs förändrad. Patienter beskrev att fysisk aktivitet efter hjärtinfarkt kunde orsaka oro för att överbelasta hjärtmuskeln. Trygghet i gemenskapen av närstående, andra patienter och hälso- och sjukvårdspersonal gav upphov till ökat engagemang till fysisk aktivitet. Konklusion: Patienter uttrycker ett behov av vägledning och upplysning kring vad för fysisk aktivitet som bör tillämpas och vad som bör undvikas. Patienter som genomgått hjärtinfarkt upplever att fysisk aktivitet ger upphov till både hopp och oro. Det är viktigt att sjuksköterskans omvårdnad grundas i en humanistisk människosyn där patienten betraktas som unik.Background: Myocardial infarction represents a turning point for patients in considering changing their lifestyle habits. Physical activity is recommended as a secondary prevention for all patients who have had a myocardial infarction. The nurse’s responsibility is to identify each patient’s individual needs and conditions for physical activity. Aim: The literature review aimed to illustrate patients’ experiences of physical activity after a myocardial infarction. Method: A general literature review was conducted, including ten qualitative articles. The articles were processed according to Popenoe’s analytical method. Result: Three categories were identified: a new existence, the balance between uncertainty and agency, and the safety of the community. Patients experienced a changed existence, which affected their conditions for physical activity after a myocardial infarction, as both body and heart were perceived as changed. Patients described that physical activity after a myocardial infarction could cause concern about overstraining the heart muscle. A sense of security derived from close relatives, other patients, and healthcare professionals fostered increased commitment to physical activity. Conclusion: Patients express a need for guidance and information regarding which forms of physical activity are appropriate and which should be avoided. Patients who have had a myocardial infarction experience that physical activity evokes both hope and concern. It is important that the nursing care is grounded in a humanistic view of the person, acknowledging each patient as unique
Feasibility of district heating in a mild climate : A comparison of warm and cold temperature networks in Bilbao
No full textDistrict heating and cooling systems can aid in decarbonisation and the provision of efficient heating and cooling in Europe. However, whereas these systems have achieved high penetration rates in colder climates of Northern, Central and Eastern Europe, they remain marginal in milder climates of Southern Europe. In terms of network design, district heating and cooling systems can be configured in different ways. In so-called warm networks, the required temperature for all the consumers is attained city-wide, and in so-called cold systems, the necessary temperature is achieved at the consumers' premises by ancillary equipment. The most cost-effective heating and cooling solution for urban areas requires investigation. This research models and compares cold and warm district energy systems with other heating and cooling solutions through a comprehensive case study executed in the city of Bilbao, Spain. The city is characterised by a mild climate and a high population density which is characteristic of many Southern European cities. The results show that district energy systems are economically advantageous compared to other low-carbon solutions, such as air-source heat pumps. However, these systems are not able to outcompete natural gas under current cost and taxation levels. Warm networks provide a cheaper source of heat compared to cold networks, but both network types lead to similar expenditures for combined heating and cooling supply. This paper, presents the study context and its results, and is complemented by an exhaustive detailed methodology document and a separate supplementary material repository. © 2024 The Authors Decarb City Pipes 2050 - Transition roadmaps to energy efficient, zero-carbon urban heating and coolin
Hen och inga tjänstemän : En korpusstudie om könsneutralt språk i nyhetstexter före och efter #MeToo-rörelsens början
No full textSyftet med denna uppsats är att undersöka om förekomsten av könsneutralt språk har ökat i nyhetstexter i samband med #MeToo-rörelsens början. Studien fokuserar på tre språkliga fenomen: pronomenet hen, beskrivningarna kvinnlig och manlig, samt yrkesbeteckningar med efterledet -man och deras könsneutrala alternativ. Med en korpuslingvistisk metod besvaras forskningsfrågorna genom analyser av kvantitativa och kvalitativa data från korpusen SVT nyheter med texter publicerade mellan 2011 och 2023. Användningen av hen har ökat efter rörelsens början, medan äldre uttrycksformer som han eller hon har minskat. Kvinnlig och manlig används i olika kontexter, men kvinnlig dominerar under samtliga tidsperioder. Ett antal könsneutrala yrkesbeteckningar ökar i frekvens, men är fortfarande mindre vanliga än deras traditionella motsvarigheter. Detta resultat ger ett visst stöd för att könsneutralt språk har ökat efter rörelsens start, men det finns trots det spår av sexistiskt språkbruk i materialet
Källkritiskt förhållningssätt till digitala medier i undervisningen: : En litteraturstudie om elever och lärares kompetens
No full textAbstract The increase of the society's digitalization has led to higher requirements for source criticism in digital media for every individual. The aim of this study was to investigate how teachers in social studies education can develop pupil’s media literacy to digital media in grade 4-6. Previous research has shown that young children are daily exposed to social- and digital media and therefore the interest in this study was to search for further studies to apply this topic into the question at issue. To conduct this literature review, systematic searches in the databases SwePub and ERIC (EBSCO) were made, and 13 articles were included. The articles were analyzed in different stages and were included or excluded by criteria. In conclusion the search in this study found that useful strategies to increase pupil’s media literacy in digital media was project-based learning and education that contained activities focused on the pupil’s interest. Also, the teacher’s competence and attitude towards digital media and media literacy was shown to have a significant impact on their teaching. Sammanfattning Den ökade digitaliseringen i samhället har lett till att det idag ställs högre krav för kunskap inom området källkritik i yngre årskurser. Syftet med denna litteraturstudie var att ta reda på hur lärare i årskurs 4–6 kan utveckla elevers kunskap inom källkritik i förhållande till digitala medier i samhällskunskapsundervisningen. Tidigare forskning visade att allt yngre elever dagligen exponeras för sociala- och digitala medier vilket har lett till ett ökat intresse att vidare undersöka ämnet. Detta arbete är en kunskapsöversikt i form av en litteraturstudie. Studien utfördes genom systematiska sökningar i databaserna SwePub och ERIC (EBSCO), där totalt 13 artiklar inkluderades. Artiklarna analyserades i flera olika steg och inkluderades eller exkluderades utifrån kriterier. Slutsatsen för denna studie blev att användbara strategier för att öka elevernas mediekompetens i digitala medier är projektbaserat lärande och undervisning som innehöll aktiviteter som fokuserade på elevernas intressen. Även lärarnas kompetens och attityd gentemot digitala medier samt lärarnas mediekompetens visade sig ha en betydande påverkan på deras undervisning. Arbetet avslutas med implikationer för Examensarbete II där förslag på framtida forskning som är baserat på resultatet som framkommit i denna studie presenteras.