Bakgrund: Specialistsjuksköterskor inom psykiatrisk hälso- och sjukvård möter dagligen patienter med suicidproblematik. Suicid ses som ett folkhälsoproblem och är ett komplext område att arbeta med. Syfte: var att beskriva specialistsjuksköterskors erfarenheter av omvårdnad vid suicidproblematik inom psykiatrisk hälso- och sjukvård. Metod: Kvalitativ design med induktiv ansats. Tolv semistrukturerade intervjuer analyserades enligt kvalitativ innehållsanalys. Resultat: I studien framkom tre kategorier “Behovet av kontinuerliga och enhetliga bedömningar för patientsäkerhet”, “Vikten av kollegial samverkan som grund för delaktighet” samt "Betydelsen av kompetens för att skapa trygghet”. I resultatet beskrevs specialistsjuksköterskans erfarenheter av att stundtals känna sig ensamma vid suicidriskbedömningar och därav betonades betydelsen av kollegialt samarbete. Specialistsjuksköterskornas erfarenheter var att kompetensen att möta patienter med suicidproblematik samt tiden att handleda kollegor var betydande för att omvårdnaden skulle vara trygg och säker. Specialistsjuksköterskor har en betydelsefull roll i mötet med patienter med suicidproblematik samt att förmedla kunskap till kollegor inom andra verksamheter. Konklusion: Tiden att finnas till för patienterna belystes som betydelsefull och vikten av utbildning och handledning beskrevs som betydande insatser i arbetet med patienter med suicidproblematik. / Background: Specialist nurses in psychiatric health care meet patients with suicide problems on a daily basis. Suicide is seen as a public health problem and is a complex area to work with. Aim: was to describe specialist nurses' experiences of nursing in suicide problems in psychiatric health care. Method: Qualitative design with inductiveapproach. Twelve semistructured interviews were analyzed according to qualitative content analysis. Results: The study revealed three categories "The need for continuous and uniform assessments for patient safety","The importance of collegial collaboration as a basis for participation" and "The importance of competence in creating security". The results described the specialist nurse's experience of sometimes feeling alone in suicide risk assessments and thus emphasized the importance of collegial cooperation. Specialist nurses have an important role in meeting patients with suicide problems and in conveying knowledge to colleagues in other organisations. Conclusion: The time to be there for the patients was highlighted as important and the importance of education and supervision was described as significant efforts in the work with patients with suicide problems.

Bakgrund: Specialistsjuksköterskor har en central roll i vården och kommunikationen inom professionen är av yttersta vikt för både patientsäkerhet och organisationens effektivitet. Kommunikation och sjuksköterskors teamarbete stärker varandra och tillsammans skapas förutsättningar för god och säker vård. Patienter aktualiseras ofta inom båda vårdformerna vilket kräver en god kommunikation mellan enheterna. Syfte: Syftet med studien var att beskriva specialistsjuksköterskors erfarenheter av kommunikation inom professionen mellan psykiatrisk öppen- och slutenvård. Metod: En intervjustudie med induktiv ansats som omfattade tolv specialistsjuksköterskor genomfördes. Data från intervjuerna analyserades enligt kvalitativ innehållsanalys och utmynnade i fyra kategorier. Resultat och konklusion: Kontaktvägar med olika funktion var en huvudkategori som framkom och beskriver specialistsjuksköterskornas erfarenheter av hur den nuvarande kommunikationen sker. Resultatet visar att specialistsjuksköterskorna efterlyser en personlig kontakt mellan sjuksköterskor. Kategorin Erfarenheter av ”vi och dem” innehåller resultat kring specialistsjuksköterskornas beskrivning av det relationella samspelet. Resultatet tyder på att specialistsjuksköterskorna saknar personlig kännedom om sina kollegor vilket påverkar samarbetet negativt. Resultatet under kategorin Upplevda hinder visar att specialistsjuksköterskorna har erfarenhet av att inte förstå varandras förutsättningar fullt ut. Kategorin Behov av fler kontaktytor berör önskemålet om utökade mötesplatser och hospitering, vilket kan ses som det centrala budskapet i resultatet av denna studie. / Background: Specialist nurses have a central role in healthcare and communication within the profession is of the utmost importance for both patient safety and the efficiency of the organization. Communication and nurses' teamwork strengthen each other and together the conditions are created for good and safe care. Patients are often brought up to date in both forms of care, which requires good communication between the units. Aim: The purpose of the study was to describe specialist nurses' experiences of communication within the profession between psychiatric outpatient and inpatient care. Method: An inductive interview study involving twelve specialist nurses was conducted. The material was analyzed with qualitative content analysis and resulted in four categories. Results and conclusion: Contact routes with different functions were a main category that emerged and describes the specialist nurses' experiences of how the current communication takes place. The results show that the specialist nurses call for a personal contact between nurses. The category Experiences of "us and them" contains results on the specialist nurses' description of the relational interaction. The results indicate that the specialist nurses lack personal knowledge of their colleagues, which negatively affects the collaboration. Ther esults under the category Perceived obstacles show that the specialist nurses have experience of not fully understanding each other's conditions. The category Need for more contact areas concerns the desire for expanded meeting places and hospitation, which can be seen as the central message in the results of this study.

The diet of an animal plays a fundamental role in its ecology, and the consequence of a specific diet may be more pronounced in mammals with a specialised diet that are more reliant on a specific food type. This can have a dramatic effect on its activity patterns, home range size and the interaction with heterospecifics. Investigating the diet of specialist mammals and the subsequent effects it will have on their ecology is thus vital to the management and subsequent conservation of the species, and crucial to our understanding of how the animal can survive and reproduce. In this thesis I investigate the effect that the diet of the aardwolf, a highly specialised myrmecophage, has on its ecology. Aardwolves feed predominantly on one genus of termite, Trinervoides spp., and are thus extremely dependent on the abundance and distribution of this arthropod. I firstly investigated the effect of temperature and rainfall on arthropod abundance and diversity, and further investigated the variation of arthropod abundance and diversity across the four habitat types at study site. This is one of a few studies that have been conducted on arthropod abundance and diversity in an arid environment and the findings show that in an arid environment arthropods are mainly influenced by temperature rather than rainfall. This is in contrast to studies in temperate and forest habitats where rainfall is the most important abiotic factor determining the abundance and diversity of arthropod assemblages. Habitat type still plays a major role in the abundance and diversity of arthropods, and habitat types that are more complex and diverse have both a higher diversity, and abundance of arthropods than other habitats. Due to the absence of prey items during the colder months of the year I investigated the diet of aardwolves to see if they display a switch in diet. This included an investigation into the seasonal variation of diet from a detailed scat analysis, using a newly developed method to assess scat content. The analysis of scats revealed that, contrary to previous studies, aardwolves showed no switch in diet and continued to feed on Trinervitermes. Using the data from the scat analyses and the information from the abundance and diversity of arthropods at the study site I expanded the study to investigate the functional responses of the aardwolf to change in prey abundance at the locality. Aardwolves demonstrate a Type I functional response to changes in prey abundance, a response that is normally found in plankton feeders. The expected functional response for specialist animals would be Type II response, and I propose that the Type I response seen in aardwolves is probably as a result of a limited handling time which reduces time spent foraging. The abundance of termites thus had a clear effect on the diet of aardwolves, showing that they feed on fewer when they are unavailable, and as such I investigated the effect of termite densities on home range sizes. The number of termite mounds in a home range influenced the size of the home range, and aardwolves with larger home ranges had a lower density of termite mounds. In contrast to previous studies, large overlaps between neighbouring individuals were recorded and indeed three male aardwolves shared a common den. I propose that the reason behind the overlap of home ranges is that a higher prey abundance during my study period occurred and as a consequence aardwolves did not need to defend an area to protect this resource. T. trinervoides has thus played a keystone role in driving the biology of the aardwolf and shaping many aspects of its ecology. / Thesis (PhD)--University of Pretoria, 2021. / South African Research Chair Initiative chair of Mammal Behavioural Ecology and Physiology / Zoology and Entomology / PhD / Unrestricted

Bakgrund: Beroende är ett globalt problem vilket kan fortsätta i generationer om cirkeln inte bryts. Det finns en erkänd koppling mellan trauma och beroende, vilket specialistsjuksköterskan kan upptäcka och identifiera med sin hälsofrämjande roll i beroendevården. Syfte: Beskriva vilka formulär som använts för att identifiera trauma och hur trauma beskrivs hos individer med beroende. Metod: En fristående beskrivande systematisk litteraturstudie. Huvudresultat: Tjugotvå etablerade formulär, fem intervjuformulär och sjutton självrapporterande, användes för identifiering av trauma vid beroende. Oavsett formulär beskrevs att fler än 50% hade med sig minst ett trauma medan ungdomar hade minst 62%. Genomsnittet var 63% och flest fanns inom slutenvården. Våld var det vanligaste traumat med störst spännvidd inom gruppen drog och alkohol hade flest. Sexuellt våld från barndomen beskrevs i de flesta artiklar. Slutsats: Trauma kan identifieras hos individer med beroende med stöd av etablerade formulär. Oavsett vård eller ej, beskriver fler än hälften minst ett trauma och av de ungdomar som har vård för beroende beskriver sex av tio att de har med sig minst ett trauma. Det mest förekommande traumat var våldsutsatthet, vilket återfanns i samtliga artiklar. Specialistsjuksköterskan kan i sin hälsofrämjande roll identifiera trauma vilket möjliggör att individen får adekvat behandling och återhämtning kan påbörjas. / Background: Addiction is a global problem that can continue for generations if the circle is not broken. There is a recognized link between trauma and addiction, which the specialist nurse can discover and identify with her health-promoting role in addiction care. Aim: Describe the forms used to identify trauma and how trauma is described in individuals with addiction. Method: An independent descriptive systematic literature study. Main results: Twenty-two established forms, five interview forms and seventeen self-reports, were used to identify trauma in addiction. Regardless of the form, it was described that more than 50% had at least one trauma with them, while young people had at least 62%. The average was 63% and most were in inpatient care. Violence was the most common trauma with the greatest range within the drug group and alcohol had the most. Childhood sexual violence was described in most articles. Conclusion: Trauma can be identified in individuals with addiction based on established forms. Regardless of care or not, more than half describe at least one trauma and of the young people who have care for addiction, six out of ten describe that they have at least one trauma. The most common trauma was exposure to violence, which was found in all articles. The specialist nurse can, in her role in promoting health, identify trauma, which enables the individual to receive adequate treatment and recovery can begin.

Bakgrund: Operationsteamet består av olika professioner som innehar unika kompetenser och kunskaper som behövs för en patientsäker vård. Operationssjuksköterskan har en viktig roll i teamet och bör använda sin kunskap och värna om sin yrkesroll för att kunna upprätthålla patientsäkerheten. Kommunikationsbrist, dålig arbetsmiljö och stor personalomsättning är de vanligaste orsaker till icke fungerande samverkan i teamet internationellt.   Syfte: Syftet var att beskriva operationssjuksköterskors upplevelser av teamarbete i en operationssal.    Metod: Studien är en systematisk litteraturstudie med induktiv ansats. Artikelsökningen genomfördes i databaserna Cinahl och PubMed. Sökorden togs fram med hjälp av PEO-modellen. Dataanalysen genomfördes utifrån Bettany-Saltikov & McSherry’s 9-stegs modell, som baseras på en metasyntes.     Resultat: Studiens resultat grundar sig i analyser av 19 vetenskapliga artiklar. Faktorer som påverkar teamarbetet, enligt operationssjuksköterskorna presenteras i tre huvudteman. Första huvudtemat är Teamets funktion med subteman Samarbete och beteenden i teamet och Ledarroll i teamet. Andra temat är Kommunikation med subteman Teamets kommunikationsförmåga, Informationsutbyte inom teamet och Kommunikationsverktyg. Tredje huvudtemat är Arbetsmiljö med subteman Organisationens ansvar och Öppet arbetsklimat.   Slutsats: Teamets samverkan är viktig då operationsmiljön är komplex. Resultatet visar att god kommunikation och respekt för varandras yrkeskompetenser främjar teamarbetet och därmed ökar patientsäkerheten. / Background: In an operating room, the surgical team is made up of a variety of professionals with specialized knowledge. The theatre nurse has an important role in the team and should use her knowledge and protect her professional role to maintain patient safety. On an international level, high staff turnover, lack of communication and poor working environment is the most common reasons of non-functioning collaboration in the team.    Aim: The aim was to describe the theatre nurse’s experiences of teamwork in the operating room.   Methods: The study is a systematic review with an inductive approach. The article search was performed in the databases Cinahl and PubMed. The keywords were generated using the PEO-model. Bettany- Saltikov & McSherry’s 9-step model, which is based on a meta-synthesis, was used to analyze the data.     Results: The study's findings are based on a review of 19 research literature. The factors that affecting teamwork, according to theatre nurses, is presented in three themes. The first main theme is the Team's function with subthemes Collaboration and behaviors in the team and Leadership role in the team. The second theme is Communication with subthemes The team's communication ability, Information exchange within the team and Communication tools Third theme is. Work environment with subthemes Organization responsibility and Open work climate.   Conclusions: The collaboration in the team is important as the operating environment is complex. The results shows that good communication, respect for each other’s professional competencies promotes teamwork and thereby increases patient safety.

Bakgrund: Operationssjuksköterskan har ansvar för patientsäkerheten och aseptiken på operationssalen. Långa operationsköer och brist på operationssjuksköterskor gör att behovet av operationssjuksköterskor och handledare är stort. Det ställs stora krav på operationssjuksköterskan som handledare att tillgodose studenternas, operationsavdelningens och framförallt patienternas behov i den perioperativa vården. Syfte: Syftet är att beskriva operationssjuksköterskors erfarenheter av att handleda operationssjuksköterskestudenter och nyutexaminerade operationssjuksköterskor in i det nya yrket. Metod: Kvalitativ studie där datainsamling och analys skedde via frågeformulär med grund i Critical incident technique. Deltagarnas erfarenheter och upplevelser analyserades. Resultat: Resultatet redovisas i form av huvudområdet; Tillit, tre kategorier; Skapa förutsättningar för handledning, Relationen samt Personlig utveckling med tillhörande subkategorier. Varje kategori presenteras i löpande text med ett antal belysande citat. Operationssjuksköterskan beskriver både positiva och negativa erfarenheter av handledning som innefattar tid, kommunikation, motivation och utveckling. Handledarutbildning och stöd från ledningen var några faktorer som påverkade handledningen. Slutsats: Att vara handledare är komplext, utmanande och givande. Med rätt förutsättningar blir handledning positivt för både handledare och student och bidrar till en kvalitativ och säker operationssjukvård. / Background: The operating room nurse is responsible for patient safety and aseptics in the operating room. The long wait for an operation and lack of operating room nurses creates a great need for operating room nurses and their preceptors. It’s demanding for mentors to fulfill the needs of student nurses, the operating department and foremost patient needs in perioperative care. Aim: The aim of this study was to describe operating room nurses’ experiences from mentoring operating room student nurses and newly qualified operating room nurses on their path into a new profession. Method: A qualitative study in which collection of data and analysis was carried out through a questionnaire taken shape from Critical incident technique. The result is shown in the form of a main theme and three categories with attached subcategories. Each category contains analyzing text with a series of quotes. Result: Operating room nurses describing both positive and negative experiences from mentoring including time, communication, motivation and development. Conclusion: Acting as a mentor is complex, challenging and rewarding. Under the right circumstances mentoring has a positive impact on both mentor and student and contributes to safe and high quality surgical care.

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Vid omhändertagande av en svårt sjuk eller allvarligt skadad människa är det essentiellt att samarbetet mellan den prehospitala personalen på plats fungerar. Frågor så som vem som har högst medicinsk kompetens och vem som leder arbetet spelar också en stor roll för att ett bra teamarbete skall komma till stånd. I en sådan situation i Stockholms Läns Landsting möts två sjuksköterskekompetenser, specialistsjuksköterskan i ambulanssjukvård och specialistsjuksköterskan i anestesisjukvård. Den ena i ambulans och den andra i förstärkningsenhet så som akutbil eller helikopter. I de medicinska riktlinjerna för ambulanssjukvården i Stockholm står att högst formell medicinsk kompetens innehar det medicinska ansvaret. I de fall då två specialistsjuksköterskor med olika specialistutbildning men med samma formella medicinska kompetens samverkar kring patienten innehas det medicinska ansvaret av sjuksköterskan med mest lämpad kompetens. Detta ger utrymme för tolkningar och kan ge upphov till oklarheter om vem som har det medicinska ansvaret baserat på olika kompetensfokus. Syftet med studien var att beskriva ambulanssjuksköterskans och anestesisjuksköterskans upplevelse av samarbetet vid prio1-larm avseende vem som innehar det medicinska ansvaret och identifiera faktorer som påverkar samarbetet. Som metod användes en kvalitativ intervjustudie med innehållsanalys. Utifrån en intervjuguide baserad på Critical Incident Technique (CIT) genomfördes tre fokusgruppsintervjuer. Sex ambulanssjuksköterskor och fyra anestesisjuksköterskor deltog i studien vilket resulterade i att 31 kritiska incidenter beskrevs. Insamlat material analyserades genom en kvalitativ innehållsanalys med en induktiv ansats. Ur resultatet framkommer två huvudområden av betydelse för specialistsjuksköterskornas upplevelse av samarbetet. Hantering genom situationsanpassning utifrån kategorierna uppfattning om kompetensnivå, uppfattning om ansvarsfördelning och uppfattning om trygghetsgenererande faktorer samt Hantering genom resursoptimering utifrån kategorierna att leda och samarbete. De slutsatser som kan dras från resultatet är att specialistsjuksköterskorna genom att visa kollegial respekt för varandras kompetens, anpassa sig utifrån förutsättningar och använda befintliga resurser på rätt sätt skapar ett fungerande samarbete kring patienten. Genom detta undviker de att hamna i en konflikt med kollegan orsakad av oenighet om vilken specialistkompetens som är mest lämpad att inneha det medicinska ansvaret under det aktuella omhändertagandet. / When assessing and caring for a critically ill or injured patient, it is essential that the cooperation and interaction within the group of pre-hospital providers functions at its best. Questions about competencies and who will be medically in charge of the case plays an important role. In Stockholm County Council (SCC) emergency medical services (EMS) two specialist nurse competencies meet, the nurse anesthetist in the rapid response unit and the ambulance nurse in the ambulance. Both specialist nurses are formally equal concerning the highest medical competence. The medical guidelines in SCC states that the highest formal medical competence is also in charge of the case. When two formally equal, but clinically different nurse competencies collaborate, the nurse most suited for the task is also considered to be in charge. There is room for interpretation, which can lead to unclarity in who should be in charge, based on different competencies. The aim of the study was to describe the experiences of the two specialist nurse competencies on cooperation and interaction when attending the same priority 1 case, concerning who is in charge and to identify factors influencing the cooperation and interaction. The method used was qualitative interview. Using an interview guide based on critical incident technique (CIT) three focus group interviews were conducted. Six ambulance nurses and four nurse anesthetists participated. The interviews resulted in 31 critical incidents. The data were analyzed with qualitative inductive content analysis. In the results two themes emerged. Situational management from the categories; perception of competence, perception of the division of responsibility and the perception of confidence generating factors. Also, management by resource optimization from the categories leadership and cooperation. The conclusions that can be drawn from the results are that the specialist nurses can create a functioning cooperation and interaction through collegial respect for each other’s competencies, situational adaption and the use of resources available at the time being. This way a conflict is avoided in the question on who should be in charge.

The purpose of this study was to explore and document the various roles of Virginia's Reading First reading coaches. The goal of Reading First is to ensure that all students learn to read at grade level or above by the end of third grade. Because of No Child Left Behind legislation and the mandates set forth by Reading First, reading coaches are in demand. In order to gain an understanding of the roles and responsibilities of reading coaches, this study was based on qualitative methodology. Specifically, the data collection consisted of a self-administered survey sent to Virginia's 95 Reading First reading coaches. The data revealed that the majority of Virginia's Reading First reading coaches had K-3 teaching experience and reading specialist certification. Reading coaches perceived that they are impacting reading teachers' practices. Furthermore, reading coaches indicated they are supported by the principal, LEA, and state level Reading First reading specialists. As a result of this study, it is recommended that additional studies involving the effect of reading coaches on school-wide reading achievement be conducted. Similarly, additional research concerning the best type of professional development to assist reading coaches in their positions is warranted. Additional research is needed to determine if there is a difference in reading coaches' effectiveness on teacher practice when they have support from state-level reading experts compared to those without such support