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Identifying Flowing Change and Learning Towards Healthy Ageing : An Action Research Study
No full textThis article identifies change and learning within a complex ecosystem aiming for healthy ageing through action research. Learning, innovation and progress are all referred to as change. Reflecting on a surprisingly good outcome within a collaborative project between dental care and municipal healthcare, fearing that change and learning from a predetermined outcome could overshadow elements that enabled change, a theoretical flow approach was used as an entrance to perspectives of change and learning. Flow approach made it possible to sense movement, focusing on timing, attentionality and undergoing. A research question was formulated: What change and learning outcomes can be identified through the lens of a flow approach? By looking beyond the project, focusing on what enabled change, actions could be traced that might have been overlooked in the absence of a flow approach. Although oral health is important for health, interprofessional collaborative projects have, to our knowledge, never been explored using a flow approach. This article contributes to theory by broadening perspectives on change and learning. Long-term interprofessional collaboration became evident as an enabling factor when mapping the emergence of change through a flow approach aiming for healthy ageing.CC BYThis research was funded by the Local Research and Development Board of Fyrbodal, Region Västra Götaland, Sweden, the Health Promotion Research Funding, Region Västra Götaland, Sweden and the Swedish Order of Freemasons, Grand Lodge of Sweden.</p
Navigating Landscapes for Digital Innovation : A Nordic Government Agency Case
No full textNordic public sector organizations offer a rich context to understand activities related to digital innovation. In this paper, we report on a recent qualitative case study carried out in a Nordic government agency. We focus on the early-stage innovation activities at a case organization that investigates blockchain-related technology. We show how a concept of navigating landscapes can help to understand and theorize these dynamics. Our findings distill organizational activities into three types: 1) navigating need-solutions landscapes, 2) navigating organizational landscape, and 3) navigating competence landscape. These findings are of interest to IS scholars as well as practitioners interested in public sector innovation involving emerging decentralized technologies (EDTs). © 2024 IEEE Computer Society. All rights reserved.CC BY-NC-ND 4.0</p
Chain conditions for rings with enough idempotents with applications to category graded rings
No full textWe obtain criteria for when a ring with enough idempotents is left/right artinian or noetherian in terms of local criteria defined by the associated complete set of idempotents for the ring. We apply these criteria to object unital category graded rings in general and, in particular, to the class of skew category algebras. Thereby, we generalize results by Nastasescu-van Oystaeyen, Bell, Park, and Zelmanov from the group graded case to groupoid, and in some cases category, gradings. CC-BY 4.0</p
Decisional needs for older adults, home health care nurses and dental hygienists during team-based oral health assessments in ordinary home settings : a qualitative study
No full textBACKGROUND: Participation by all actors involved in health planning is a prerequisite for person-centred care and healthy ageing. Understanding the multiple knowledge needs and the values that shape oral health assessments in home settings is important both to enable participation in oral health planning and to contribute to healthy ageing. OBJECTIVE: The aim of this study was to investigate decisional needs during oral health assessments in ordinary home settings from the perspectives of older adults, home health care nurses and dental hygienists. METHODS: Data was collected in ordinary home settings through 24 team-based oral assessments and 39 brief, semi-structured interviews including older adults (n = 24), home health care nurses (n = 8) and dental hygienists (n = 7). Data was analysed using content analysis with a deductive approach. The analysis was guided by the Ottawa Decision Support Guide. RESULTS: The analysis revealed that all participants considered participation in decision-making important but until now, older adults might not have participated in making decisions regarding oral health issues. The older adults considered participation important because the decisions had a strong impact on their lives, affecting their health. The professionals considered decision-making important for knowing what step to take next and to be able to follow up and evaluate previous goals and treatments. Organizational and personal barriers for shared decision-making among home health care nurses and dental hygienists were identified. Of the 24 older adults, 20 had different oral health conditions that objectively indicated the need for treatment. An initial important decision concerned whether the older adult wanted to make an appointment for dental care, and if so, how. Another decisional conflict concerned whether and how assisted oral care should be carried out. CONCLUSION: It is important for key participants in ordinary home settings to participate in interprofessional teams in home health care. To further anchor this in theory, conceptual models for professionals from different care organizations (municipal care, dental care) need to be developed that also involve older adults as participants. Future research could bridge theory and practice by including theories of learning while exploring interorganizational oral health planning in home settings.Open AccessThis research was funded by the Health Promotion Research Funding (VGFOUREG-937918, VGFOUREG-966932), Region Västra Götaland, Sweden and the Local Research and Development Board of Göteborg and Södra Bohuslän (VGFOUGSB-942302), Region Västra Götaland, Sweden</p
It´s not written in the text? : A study about students’ ability to make inferences
No full textBakgrund: Föreliggande studie utgör en kartläggning som förberedelse inför ett kommande utvecklingsarbete inom undervisning av elevers inferensläsning. Behovet av att stärka elevers inferensförmåga har uppmärksammats både av oss och våra kollegor samt i internationella tester av elevers läsförståelse. Detta påvisar ett tydligt behov av ett sådant utvecklingsområde. Syfte: Vår studie syftar till att undersöka och belysa elevers förmåga att göra textbaserade och kunskapsbaserade inferenser. Som stöd i att analysera elevernas inferensförmåga kommer vi att använda oss av PIRLS fyra förståelseprocesser. Dessa fyra förståelseprocesser utgör det som kallas för reading literacy. Dessa fyra förståelseprocesser är; Förståelseprocess 1; Fokusera och återge explicit uttryckt information Förståelseprocess 2; Dra enkla slutsatser Förståelseprocess 3; Tolka och integrera tankar, idéer och information Förståelseprocess 4; Granska och bedöma innehåll, språk och olika textelement. Vår problemformulering lyder; ”Hur väl kan eleverna göra inferenser baserat på textens explicita innehåll och textens implicita information?” Metod: Föreliggande studie är en kvalitativ studie med en deduktiv ansats. Vi har låtit elever i årskurs fyra genomföra ett av PIRLS (Progress in International Reading Literay Study) läsförståelsetest, där 15 elevers svar har analyserats. Vi har samlat både kvantitativa data, i form av antal rätt på PIRLS läsförståelseprov och kvalitativa data, genom att analysera olika kvalitéer i elevernas svar. Resultat: Sammanställningen av resultaten visar att eleverna har god förmåga att hämta och återge explicit information. Resultatet visar också att eleverna kan göra textbaserade inferenser. Eleverna kan alltså utan större svårighet koppla samman information som ligger nära varandra i texten. Däremot har eleverna svårigheter med att göra mer avancerade inferenser, såsom kunskapsbaserade inferenser. Av PIRLS fyra förståelseprocesser är det därför förståelseprocess 1; Fokusera och återge explicit uttryckt information och förståelseprocess 2; dra enkla slutsatser som eleverna behärskar bäst. Medan förståelseprocess 3; ”tolka och integrera tankar, idéer och information” och förståelseprocess 4;”granska och bedöma innehåll, språk och olika testelement” är mer utmanande för dem. Kartläggningen av elevernas inferensförmåga kommer att ligga till grund för vårt kommande utvecklingsarbete
Nurses strategies for dealing with ethical dilemmas in palliative care : An integrated compilation of qualitative research
No full textBackground Ethical dilemmas in palliative care is a common issue for nurses to handle. Nurses have the responsibility to provide care that is in the best interest for the patient and to enhance the quality of life in the end-of-life stage. Dilemmas occur when differing opinions exist about what is in the best interest for the patient. Previous research indicates that nurses play a significant and crucial role in managing ethical dilemmas in palliative care, many of them experience conflicts when their sense of what is right clashes with their perceived duties. Aim The aim of this study was to describe strategies that nurses use for dealing with ethical dilemmas in palliative care. Method A literature-based study where eleven articles have been analyzed according to Friberg's five-step model. Results The findings of this study indicates that the primary strategies nurses use for addressing ethical dilemmas in palliative care was to establishing trusting relationship with the patients and also with their relatives. Collaboration with colleagues is also crucial and fostering effective teamwork, creating an environment for collective reflection to exchange experiences and knowledge. Conclusion Effective teamwork and strong patient relationships are essential in palliative care, leadong to an increased well-being for the patient and the ability to tailor care needs individually. Nurses in palliative care require ongoing professional development to feel secure in their professional roles and to foster confident healthcare relationships.I strävan att uppnå optimal vård för patienter i palliativ vård står sjuksköterskor inte sällan inför komplexa etiska dilemman. Syftet med denna studie var att beskriva de strategier sjuksköterskor använder för att hantera etiska dilemman inom palliativ vård. Resultatet visar att genom att mötas i samtal och att lyssna noggrant uppstår tillitsfulla relationer till både patienter och närstående. Hanteringen av etiska dilemman underlättas när sjuksköterskorna skapar en personcentrerad vårdmiljö utifrån patienters och närståendes önskemål. En annan strategi var samarbete i det tvärvetenskapliga vårdteamet. Ett teams olika kompetenser behövs för att tillgodose patienters vårdbehov. Etiska dilemman har ingen enkel lösning och för att skapa en gemensam förståelse och strategi krävs att teamet kan diskutera samt reflektera tillsammans och dela med sig av erfarenheter. Studien identifierade behovet av kontinuerlig kompetensutveckling inom etik för sjuksköterskor inom palliativ vård. Att vara rustad med djupare kunskap inom etiska teorier och metoder gav sjuksköterskorna större trygghet att fatta svåra beslut och att agera som patientadvokater. Slutligen framkom det att tid för reflektion var viktigt när sjuksköterskor stod inför etiska dilemman. Regelbundna reflektioner ökade medvetenheten hos sjuksköterskor, hur deras egna etiska värderingar påverkade deras beslut i vården av patienter i palliativt skede. Studiens resultat grundades på en sökning av elva vetenskapliga artiklar från databaserna Pubmed och Cinahl. Efter noggrann granskning och analys av artiklarna sammanställdes resultatet i två huvudteman och sex subteman. Dessutom diskuterades personcentrerat förhållningssätt, samtalets betydelse, sjuksköterskors ansvar att hålla sig uppdaterade, teamarbetets betydelse och normmedvetet och hållbarhet. Slutsatsen indikerar att genom tillämpning av dessa strategier kan sjuksköterskor hantera etiska dilemman och därigenom öka välbefinnandet för patienter inom palliativ vård
Nurses´ experiences of caring for patients in end-of-life care at home : A literature-based study
No full textBackground: Every year in Sweden, approximately 90,000 people die. Some die due to trauma or terminal illness, while others die from natural causes. When patients are in a terminal condition, they can receive support and nursing care from nurses in their own homes. Patients' homes provide a safe environment for both the patient and their family, and many individuals express a desire to spend their final days at home. Previous research indicates that there is a significant amount of data available regarding nurses' experiences in providing end-of-life care in hospitals, but there is comparatively less data and research concerning nurses' care for patients in their own homes. Aim: The aim of this study was to describe nurses´ experiences of caring for patients in end-of-life care at home. Method: A method to contribute to evidence-based nursing with ground in analysis of qualitative research was performed to get a better understanding of nurses´ experiences. Results: Three main themes were discovered; Competence and teamwork makes a difference, need to dare to get close and assets and limitations of work while working in the patient's home. Nurses experienced many emotions, challenges and obstacles when working with patients in end-of-life care in their home. Collaboration was important with both physicians and with the family care providers to enable good care for the patients. Conclusion: When nurses worked closely with the patients in their home, they felt emotionally affected and the experience overall was both positive and negative. This study showed that nurses in home care need experience and self-confidence to give good and safe care for the patients in end-of-life care.Denna litteraturbaserade studie beskriver sjuksköterskors erfarenheter av att vårda patienter i livets slutskede i hemmet. Resultatet grundas på analys av tio vetenskapliga artiklar med kvalitativ metod. Från analysen av datamaterialet framkom tre teman; kompetens och samarbetegör skillnad, behöver våga komma nära samt tillgångar och begränsningar med att vårda i patienternas hem. Sjuksköterskor inom palliativ vård i livets slutskede behöver ständigt hålla sig à jour om ny kunskap inom palliativ omvårdnad och palliativ medicin. Sjuksköterskorna behöver ha ett följsamt och lyhört förhållningsätt när de arbetar i patienternas hem. I hemmet träffar de även närstående som de behöver etablera en god relation med. Närstående har en nyckelroll inom vård i livets slutskede i hemmet. Utan närstående blir det svårt för sjuksköterskorna att planera omvårdnaden. Det kan uppstå situationer där sjuksköterskor upplever mycket känslor i samband med att patienterna avlider vilket de genom erfarenhet lär sig att hantera. Sjuksköterskorna upplevde jobbet som givande och utmanande
The experience of recovery after surviving a cardiac-arrest
No full textBackground: A cardiac arrest is a traumatic experience. During the dramatic event of a cardiac arrest the focus is to keep the person alive with minimal brain damage. Statistics shows that more people are surviving cardiac arrest and 90 % of the survivors return home without major brain-damage. However previous research shows that survivors struggle with anxiety and depression post-arrest. This leads to a gap in knowledge concerning what makes a good recovery. Nurses have a responsibility to promote physical and mental wellbeing. Therefore, it is important for nurses to carry the knowledge of the experience of recovering from a cardiac arrest. Aim: The aim of this study was to explore the experience of recovery after surviving cardiac arrest. Method: This study was performed using a literature-based method. Articles were searched using databases CINAHL and PubMed and resulting in 9 qualitative articles analysed according to Friberg´s 5-step model. Results: Three themes emerged: lifestyle changes after cardiac arrest, need for support after cardiac arrest and the meaning of life after cardiac arrest. Based on the themes, eight sub-themes were identified: new routines in everyday life, to get to know a new self, to get an understanding for the event, to increase insecurity in oneself and family, access to good coping strategies, to return to work, to be around loved ones and to perform their dreams. Conclusion: Changes in everyday life and existential questions are hard to handle alone after cardiac arrest. To ease the recovery after cardiac arrest persons need support from healthcare systems and family
(Over)crowded house: exploring asylum seekers’ experiences of the COVID-19 pandemic while living at accommodation centers in Sweden
No full textBackground The COVID-19 pandemic has made visible the scale of health disparities in society, highlighting how the distribution of infection and deaths differs between population subgroups within countries. Asylum seekers represent a potentially vulnerable group; early in the pandemic, concerns were raised about their housing situation, usually involving overcrowded, camp-like accommodations, and the effects of COVID-19 in relation to this. Hence, this study aimed to explore asylum seekers’ experiences of the COVID-19 pandemic while living at accommodation centers. Methods In this qualitative study, 14 semi-structured interviews were conducted with asylum seekers at two accommodation centers in Sweden. Participants represented a diverse group of asylum seekers in regard to age, educational background, and gender. Data were analyzed using qualitative content analysis. Results Experiences related to COVID-19 were highly dependent on the living situation at the accommodation centers and the experience of feeling unsafe in shared spaces. This was enhanced by the experiences of a challenging mix of COVID-19 messages where different understandings of COVID-19 and related measures existed, together with a feeling of loss of control and safety in shared rooms. Additionally, participants felt more isolated from the outside society and missed prior social activities. Adding to this experience of isolation was an increasing mistrust regarding the authorities’ pandemic response. Conclusion This study highlights the importance of understanding the specific challenges and vulnerabilities of asylum seekers at accommodation centers during the pandemic, shaped by their housing situation and legal status. The findings underscore the need for context-specific support, holistic disease prevention approaches, and tailored health communication strategies using diverse formats. Additionally, the findings emphasize the crucial need to identify and mobilize existing community resources in planning and implementing pandemic control measures. Furthermore, the study emphasizes governmental responsibility in providing secure housing, and to address long-term vulnerabilities beyond pandemics.CC-BY 4.0Open access funding provided by Karolinska Institute. The project of which this study is a part was funded by the Swedish Red Cross University.</p
How adolescents' lives were disrupted over the course of the COVID-19 pandemic : A longitudinal investigation in 12 cultural groups in 9 nations from March 2020 to July 2022.
No full textIt is unclear how much adolescents' lives were disrupted throughout the COVID-19 pandemic or what risk factors predicted such disruption. To answer these questions, 1,080 adolescents in 9 nations were surveyed 5 times from March 2020 to July 2022. Rates of adolescent COVID-19 life disruption were stable and high. Adolescents who, compared to their peers, lived in nations with higher national COVID-19 death rates, lived in nations with less stringent COVID-19 mitigation strategies, had less confidence in their government's response to COVID-19, complied at higher rates with COVID-19 control measures, experienced the death of someone they knew due to COVID-19, or experienced more internalizing, externalizing, and smoking problems reported more life disruption due to COVID-19 during part or all of the pandemic. Additionally, when, compared to their typical levels of functioning, adolescents experienced spikes in national death rates, experienced less stringent COVID-19 mitigation measures, experienced less confidence in government response to the COVID-19 pandemic, complied at higher rates with COVID-19 control measures, experienced more internalizing problems, or smoked more at various periods during the pandemic, they also experienced more COVID-19 life disruption. Collectively, these findings provide new insights that policymakers can use to prevent the disruption of adolescents' lives in future pandemics.CC-BY 4.0This research has been funded by NICHD grant RO1-HD054805 and Fogarty International Center grant RO3-TW008141. This research also was supported by the Intramural Research Program of the NIH/NICHD, USA, and the Centre for the Evaluation of Development Policies at the Institute for Fiscal Studies, London, UK, funded by the European Research Council (ERC) under the Horizon 2020 research and innovation program (grant agreement No 695300-HKADeC-ERC-2015-AdG). </p