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Vad är ‘normen’ inom sjuksköterskeutbildning? : Att navigera normkritik i en campusbaserad klinisk lärmiljö för ett arbetsintegrerat sjuksköterskeprogram
No full textBackground: In nursing education, perspectives on social justice and health equity have increasingly been highlighted, mainly within the theoretical aspects of education. Various strategies have been used to integrate these concepts into practice-oriented learning activities. The strategy of norm-criticism aims to elevate the perspectives of equity and social justice in education. There is a need to integrate health equity into the practical aspects of education. This dissertation has thus explored a clinical learning environment (CBCLE) with norm-criticism and work-integrated learning (WIL) as parts of its educational structure. Aims: To explore the integration of and encounters with norm-criticism in a campus-based clinical learning environment for a work-integrated nursing education program. Methods: Study I was a scoping review of 16 peer-reviewed articles, with data that was thematically charted and analyzed to map out the existing research. Study II combined document analysis of 64 academic records with qualitative interviews of seven faculty members/stakeholders. This data was analyzed using reflexive thematic analysis. Study III involved participatory observation at a CBCLE, with field notes analyzed through reflexive thematic analysis. Study IV drew on narrative accounts from 14 undergraduate nursing students, which were analyzed through a narrative analysis and a theoretical analysis. Results: In Study I norm-critical research in nursing education was found to be predominantly qualitative and Western-oriented. Norm-criticism involved modifying curricula and learning environments to challenge norms and foster health equity. Teachers were encouraged to undergo a personal relearning process to teach more inclusively. In Study II the CBCLE was constructed to educate nursing students beyond the scope of traditional education and in partnership with societal elements. The WIL approach framed the incorporation of norm-criticism, allowing norm-criticism to be integrated and elevated to practical use. However, its inclusion caused institutional hesitation because of its political connotation. In Study III norm-critical dialogues were seldom initiated by the teachers, and only brief norm-critical moments were observed. Technical nursing skills were emphasized, which reinforced a theory-practice gap. In Study IV students’ gradual engagement with norm-criticism evolved from confusion to meaning making, which called for deeper integration of norm-criticism. Through WIL, norm-criticism was operationalized, bridging theory and practice while shaping professional identity and critical consciousness. Conclusion: Norm-criticism at the CBCLE was interpreted across three layers. These included a structural pedagogical norm aligned with the WIL approach, a disruptive personal experience fostering reflection and professional formation, and a theoretical-practical tool to support health equity. These layers collectively redefined teaching and learning practices in nursing education, thus constituting a new normal for the field.Bakgrund: Inom sjuksköterskeutbildning har rättvis och jämlik hälsa fått allt större uppmärksamhet, främst inom utbildningarnas teoretiska delar. Olika lärstrategier har använts för att integrera dessa perspektiv i utbildningens praktiska delar. Genom en normkritisk strategi kan normer synliggöras och frågor om social rättvisa lyftas fram. Det finns ett behov att integrera rättvis och jämlik hälsa i sjuksköterskeutbildningars praktiska delar. Denna avhandling har utforskat en campusbaserad klinisk lärandemiljö (KLC) där normkritik och arbetsintegrerat lärande (AIL) utgör en del av den pedagogiska strukturen. Syfte: Att utforska möten med och integrering av normkritik i en campusbaserad klinisk lärandemiljö i ett arbetsintegrerat sjuksköterskeutbildningsprogram. Metod: Studie I granskade 16 peer-reviewade artiklar, där data tematiskt strukturerades och analyserades för att få en överblick över befintlig forskning. Studie II kombinerade dokumentanalys av 64 dokument med kvalitativa intervjuer med sju aktörer bestående av fakultetsmedarbetare och partners från civilsamhället. Data analyserades med reflexiv tematisk analys. Studie III utgjordes av deltagande observationer vid ett KLC, där fältanteckningar analyserades med reflexiv tematisk analys. Studie IV bestod av berättelser från 14 sjuksköterskestudenter på grundnivå, berättelserna tolkades med hjälp av narrativ analys samt genom ett teoretiskt raster. Resultat: I studie I framkom att normkritisk forskning inom sjuksköterskeutbildning främst är kvalitativ och västerländskt präglad. Normkritik medförde förändringar i läroplaner och lärandemiljöer för att kunna utmana normer och främja rättvis och jämlik hälsa. Lärare uppmuntrades att genomgå en personlig omlärningsprocess för att undervisa mer inkluderande. I studie II framkom att KLC konstruerades i samverkan med civilsamhället med målet att utbilda sjuksköterskestudenter på ett annat sätt än traditionell sjuksköterskeutbildning. AIL-ansatsen utgjorde en ram för att integrera och möjliggöra att normkritik kunde omsättas till praktisk tillämpning. Dock medförde implementeringen en institutionell tveksamhet till normkritiken på grund av dess politiska laddning. Studie III uppmärksammar att normkritiska dialoger sällan initierades av lärarna och endast korta normkritiska inslag i undervisningen observerades. Medicintekniska färdigheter i relation till omvårdnad betonades, vilket förstärkte klyftan mellan teori och praktik. I studie IV utvecklades studenternas gradvisa engagemang i normkritik från förvirring till meningsskapande, vilket tydliggjorde vikten av att införliva normkritik på en djupare nivå på KLC. Genom AIL kunde normkritik konkretiseras och förena teori och praktik samtidigt som kritisk medvetenhet och professionell identitet formades. Slutsats: Normkritik vid KLC representerade tre lager: en strukturell pedagogisk norm i linje med AIL-ansatsen, en utmanande personlig erfarenhet som främjade reflektion och professionell utveckling, samt ett teoretisk-praktiskt verktyg för att stödja rättvis och jämlik hälsa. Dessa nivåer omformade undervisningen och lärandet och utgjorde därmed det nya normala inom sjuksköterskeutbildningen.Paper I and IV are to be submitted and not included in the electronic thesis.</p
Hur påverkar en lågkonjunktur bostadspriserna på småhus? : En regional studie
No full textThis thesis analyzes how a recession affect house prices in Sweden, focusing on three regions: Värmland, Norrbotten and Västra Götaland over the period from January 2020 to January 2025. Following the COVID-19 pandemic in 2020, Sweden entered a deep recession leading to a sharp rise in unemployment and reduced economic activity. The relationship between the independent variables unemployment, GDP-indicator, CPI, lending rate, the number of bought houses and dependent variable detached house prices is investigated using econometric techniques such as Augmented Dickey-Fuller test, Engle-Granger cointegration test and regression analysis. The results show that the model fits best in Västra Götaland with several significant variables. In Norrbotten there were only a few significant variables and in Värmland no variables were significant. Unexpectedly, positive relationships between unemployment and price levels was found. Overall the findings suggest that the effect of a recession is that the price level on houses increase in all regions but due to different driving forces
Occupational self-efficacy, job satisfaction and learning potential of the workplace in a sample of diabetes specialist nurses : A structural equation modeling analysis
No full textBackground: Diabetes mellitus is a chronic condition, cases of which are expected to continue rising worldwide. Diabetes specialist nurses play an essential role by assisting patients with preventing or delaying disease complications. Research has suggested an association between occupational self-efficacy and job satisfaction among professionals. However, the relationship between these factors among diabetes specialist nurses, as well as the learning potential of the workplace in this context, remains unexplored. Objective: This study aimed to explore the relationships between occupational self-efficacy, the learning potential of the workplace and job satisfaction. Design: A cross-sectional study design was used. Setting: The study data were collected through a national online survey conducted in Sweden. Participants: A total of 157 registered nurses who provide diabetes care to patients were included. Methods: Data were obtained through an online survey with a response rate of 28%. All variables were measured using Swedish-translated standardised instruments. The model was constructed and tested using structural equation modeling analysis with the hypothesis that perceived occupational self-efficacy has both direct and indirect effects on diabetes specialist nurses’ job satisfaction and is mediated by the learning potential of the workplace. Results: The findings supported the hypothesised model. The total effect of the relationship between occupational self-efficacy and job satisfaction was 0.547 ( p &lt; .001), comprising both the direct effect (β = 0.359, p &lt; .0001) between these constructs and the indirect effect (0.188, p &lt; .001). The indirect pathways included occupational self-efficacy, which was statistically significantly associated with all three dimensions of the Learning Potential of the Workplace scale: Opportunity to reflect (β = 0.480, p &lt; .0001), Support in learning (β = 0.226, p &lt; .01), and Time for exploration (β = 0.330, p &lt; .0001). Both Support in learning and Time for exploration were also statistically significantly associated with job satisfaction (β = 0.236 and β = 0.266, respectively, p &lt; .01), thereby contributing to the sum of the indirect effect (0.188, p &lt; .001). One dimension, Time for exploration , was identified as a mediator between occupational self-efficacy and job satisfaction, which explained 9% ( p &lt; .01) of the variance in job satisfaction. Conclusions: These results demonstrated the association between occupational self-efficacy and job satisfaction among diabetes specialist nurses. The mediation effect of the Time for exploration dimension underscores the importance of providing sufficient time for workplace learning. This finding suggests that fostering a supportive learning environment could be associated with job satisfaction. CC-BY 4.0 </p
Automatic Calibration and Update of a Digital Twin for Plug & Produce
No full textThis article presents a system for automatically updating a digital twin model, used for automated path planning of an industrial robot. The digital twin needs to be accurately calibrated in relation to the resource locations due to the physical limitations of placing resources out precisely. The process considered is a surface roughness measurement of aerospace metal parts that requires high positional accuracy. The scenario takes place in a robot cell that is a Plug & Produce system, where resources can be added and removed in minutes, allowing fast reconfiguration of the production resources. This means that an automated path planner is required for the robot to adapt to new locations of these resources automatically. A digital twin is proposed, consisting of a robot path planner and a simulation model that is updated when resources are added to the system. The resources should automatically appear in the simulation and be placed at an accurate location. The purpose of automating these steps is to make the update of the digital twin faster during production and remove the requirement for expert knowledge.CC BY 4.0</p
Discretionary Authority Coping and Stress in Human Service Organizations
No full textIn this paper we analyze coping during public service delivery and stress among workers in human service organizations whose discretion is protected by the authority of their jobs within the police, healthcare psychiatry, and social work. The data come from a survey sent to 990 frontline workers in Sweden. In line with recent neuroscience and psychology research, our findings suggest that the discretionary worker interacts through two families/forms with ways of coping: 1) approaching clients–through instrumental action, bending/breaking rules, using personal resources, or prioritizing motivated clients and 2) avoiding clients–through rationing, routinizing, or aggression. Statistically significant and systematic differences between policy sectors suggest that coping depends on institutionalized moral practices: prioritization and aggression are most common within the police; instrumental action is most common within healthcare; and bending/breaking rules and routinizing are most common within social work. Lower levels of stress are identified in relation to avoidant coping strategies.CC BY 4.0</p
Adaptive laser beam shaping with a deformable mirror for gap bridging in autogenous butt joint welding
No full textOne challenge in laser beam welding is the variability in joint gaps encountered during autogenous welding of butt joints. This study therefore develops and evaluates an adaptive laser beam shaping technique that utilizes a deformable mirror. By integrating image processing and an adaptive Kalman filter, the proposed method provides real-time estimation of the gap width which varies from point to point along the joint. This capability allows for dynamic adjustments of the beam shape during processing through feed-forward control. Proof of concept was performed in welding sheet metal plates with stepwise changes in gap widths, up to 0.55 mm. The distortion of the welded parts and the topology of the weld seam were assessed both qualitatively and quantitatively using data from a laser line scanner. The data analysis revealed a reduction above 80% in workpiece residual distortion compared to conventional welding with a static circular beam shape. Additionally, welding quality at a 0.55 mm gap width met the laser welding standard (ISO 13919-1) level D. In contrast, approximately 10% of the measured points using a static circular beam did not meet the level D of this standard. The seamlessly integration of real-time gap measurement with adaptive beam shaping thus offers a promising solution to mitigate gap variability in laser beam welding of butt joints. This approach also highlights the broader potential of adaptive beam shaping in high-power metal processing. CC-BY 4.0This research work received generous support from the Swedish Knowledge Foundation project DEDICATE, Sweden (reference number 20210094) and the Vinnova project TANDEM, Sweden (reference number 2021-03145) under the SMART EUREKA cluster on advanced manufacturing</p
Development of real time positional tracking for automated welding
No full textTypical systems for automated welding, or automated manufacturing processes in general, are only able to follow predefined motions, which makes them inflexible and puts a lot of importance on proper joint preparation. The use of sensors can be implemented to modify the machine’s path, but there are limitations for which procedures they can be applied to, and a predefine motion is still required. The system that is developed here will be capable of generating a path for the machine to follow in real-time, to be implemented in welding systems to account for imperfections on the workpiece and sudden movements during welding. This system is comprised of two parts; a PLC program that manages the movement produced by two servo motors and a client program that calculates the path the machine should follow and supplies the PLC with coordinates to follow. Due to the complexity caused by the need to synchronize the PLC program to the client, we had to develop a methodology for writing the PLC program that could simplify the implementation of the logic. The PLC program was made by implementing a state machine in structured text with an object oriented approach. This system was tested with a pair of servo motors, by having the client generate a path in the shape of a sinusoidal wave for the motors to follow while reading the motor’s positions. After running the test, it was found that this system is capable of following the path it is given with a good degree of accuracy. This system is capable of following a path with less than 2% deviation. This may get worse as the velocityof the system increases, or if the path becomes irregular
Language barriers in healthcare : what facilitates and complicates communication?
No full textBackground Communication is fundamental in healthcare, but language barriers present significant challenges. With the rise in migration and linguistic diversity, nurses often face difficulties communicating with patients who speak different languages. These barriers can compromise patient safety, care quality, and the overall healthcare experience. Aim This study aimed to explore nurses' experiences in managing language barriers in healthcare and the strategies they use in these situations. Method A literature review focused on qualitative studies published between 2014 and 2024. The search was carried out in databases like CINAHL and PubMed using terms such as “language barriers” and “nurses’ experiences.” Eight relevant articles were analyzed, providing insight into nurses’ experiences with language barriers. Results Language barriers often cause communication breakdowns that affect patient care and participation. Nurses reported difficulties in accessing professional interpreters, often relying on family members or non-professionals, which raised concerns about confidentiality and accuracy. Conclusion Addressing language barriers is crucial forproviding safe, effective, and person-centered care. Increasing access to professional interpreters and providing more training in cross-cultural communication can improve care outcomes. I dagens samhälle, som är alltmer präglat av mångkultur, uppstår utmaningar inom sjukvården där språkbarriärer kan påverka kommunikationen mellan patienter och vårdpersonal. Dessa barriärer kan ha en negativ inverkan på både kvaliteten på vården och patientsäkerheten. Syftet med denna studie var att undersöka hur sjuksköterskor upplever och hanterar språkbarriärer, samt hur dessa påverkar deras möjlighet att tillhandahålla god vård. Resultaten visar att språkbarriärer kan försvåra kommunikationen och minska patientens möjlighet att vara delaktig i sin vård. När det inte finns tillgång till professionella tolkar tvingas sjuksköterskor ofta använda familjemedlemmar för att översätta, vilket kan leda till missförstånd och påverka patientens integritet. Vidare uppger många sjuksköterskor att de saknar tillräcklig utbildning för att hantera dessa situationer på ett effektivt sätt. Studien pekar på behovet av förbättrad tillgång till tolktjänster samt ökad utbildning för sjuksköterskor om hur man arbetar med kulturell och språklig mångfald. Genom att stärka dessa områden kan vården bli mer inkluderande och säker för alla patienter, oavsett språklig bakgrund. Resultatet indikerar att sjuksköterskor behöver bättre resurser och utbildning för att hantera språkbarriärer på ett säkert och effektivt sätt, vilket skulle bidra till en mer rättvis och anpassad vård i ett mångkulturellt samhälle
In Situ Neutron Diffraction Study of Strain Evolution and Load Partitioning During Elevated Temperature Tensile Test in HIP-Treated Electron Beam Powder Bed Fusion Manufactured Ti-6Al-4V
No full textActive glide and twinning systems have been studied by transmission electron microscopy (TEM) in samples of three Ti-alloys, T40 (Ti+1000 ppm O), T60 (Ti+2000 ppm O) and TiAl6V4 deformed up to 5% by uniaxial or biaxial tension. The aim of the work was to understand more clearly which glide systems are activated during deformation of polycrystalline material and how they are related to the formation of the cold rolling textures. In order to estimate the stresses necessary for the activation of the observed glide systems, the resolved shear stresses for the different deformation systems were calculated from measured crystal orientations. The main results are: in TiAl6V4 〈a〉, basal slip has a lower critical resolved shear stress, τc, than prismatic slip. 〈c+a〉 pyramidal glide shows a very low τc, which is up to two times larger than that for prismatic slip. Nevertheless, 〈c+a〉 glide systems were only rarely activated and twinning systems were never activated. Therefore, deformation with c-components may be accommodated by β-phase deformation or grain boundary sliding. The observed c-type texture is due to the strong basal glide. In T40, τc for 〈c+a〉 glide is up to 13 times higher than that for prismatic glide. However, 〈c+a〉 glide and twinning were strongly activated, leading to the observed t-type texture. In T60, the high oxygen content completely suppressed twinning and strongly reduced 〈c+a〉 glide. The less developed t-type texture is due to the combination of 〈c+a〉 and basal glide.CC BY 4.0</p
Enhancing duplex stainless steel additive manufacturing with DED-LB/w : microstructural analysis and process optimization
No full textThe applicability of additive manufacturing (AM) of duplex stainless steels has been limited by the complex thermal history causing an imbalance of ferrite and austenite in the as-deposited material. Laser-beam directed energy deposition with wire (DED-LB/w) presents a promising solution when combined with solution annealing. This study utilizes a specially developed 3Dprint AM 2205 and a conventional ER2209 wire to continuously build cylindrical components. Metallographic examination was conducted using light optical microscopy (LOM), scanning electron microscopy (SEM) with energy dis- persive spectroscopy (EDS), electron backscatter diffraction (EBSD), and electron microprobe analysis (EPMA). While high deposition rates were achievable, excessively high wire feeding rates led to continuous areas of fine grains in the deposited beads. These regions, identified as partially molten wire, were sometimes associated with lack-of-fusion, porosity, and solidification cracking. Optimized parameter settings enabled efficient melting of the wire, producing defect-free deposits, and eliminating partially molten wire residues. Solution annealing effectively dissolved intermetallics and homogenized the microstructure, resulting in a more uniform phase distribution.CC BY 4.0</p