Bakgrund: Konfusion är ett övergående akut förvirringstillstånd som många patienter med höftfraktur drabbas av varje år efter att de genomgått en operation. De främsta orsakerna är det kirurgiska traumat, anestesin, smärta, sömnbrist, läkemedel och stress. Kvinnor är mest drabbade av konfusion men det kan vara en skrämmande upplevelse oavsett vem som drabbas. Syfte: Syftet med studien var att studera hur patienter som genomgått höftoperation kan undgå att drabbas av konfusion, genom att studera vad sjuksköterskor behöver för att uppnå god beredskap att förebygga eller lindra konfusion. Metod: Detta arbete är en litteraturöversikt som grundar sig på 11 kvantitativa vetenskapliga originalartiklar. Litteratursökningen genomfördes på databaserna PubMed, PsycInfo samt CINAHL. Samtliga studier kvalitetsgranskades med Fribergs (2017) granskningsmall för kvantitativa studier. Resultat: Artiklarnas resultat sammanställdes i två tabeller, en för vardera av de frågeställningar som kompletterade litteraturöversiktens syfte. I resultatet framkom det att sjuksköterskor saknade kompetensen att i kliniken identifiera tecken på konfusion hos patienterna. Sjuksköterskor utbildade i konfusion hade lägre konfusionsincidenter bland sina patienter. Hade patienten haft konfusion tidigare var detta viktig information för personal som sköter vården postoperativt. Det var också en fördel om kompletterande kompetenser, till exempel i form av geriatriksjuksköterskor, fysioterapeuter och arbetsterapeuter, kunde finnas tillgängliga vid behov. Patienter som fick lyssna på lugn klassisk musik fick en bättre utveckling på den kognitiva funktionen. Slutsats: Studiens resultat visar att det behövs mer kunskap, instrument och verktyg för sjuksköterskor för att förebygga, identifiera och behandla konfusion tidigt. En god kompetens, snabb identifiering och information till patientens andra vårdgivare kan leda till bättre vård för patienten och en bättre arbetsmiljö för sjuksköterskan. / Background: Delirium is a transient acute state of confusion that thousands of hip fracture patients suffer from each year after undergoing surgery. The main causes are surgical trauma, anesthesia, pain, lack of sleep, medication and stress. Women are most affected by delirium but it can be a scary experience no matter who is affected. Aim: The aim of the study was to study how patients who have undergone hip surgery can avoid being affected by delirium, by studying what nurses need to achieve good readiness to prevent or alleviate delirium. Method: This work is a literature review based on 11 quantitative scientific original articles. The literature search was performed on the databases PubMed, PsycInfo and CINAHL. All studies were quality reviewed with Friberg’s (2017) review template for quantitative studies. Result: The results of the articles were compiled in two tables, one for each of the questions that complemented the purpose of the literature review. The results showed that nurses lacked the competence to identify signs of delirium in the patients in the clinic. Nurses trained in delirium had lower delirium incidents among their patients. If the patient had had delirium before, this was important information for staff who provide care postoperatively. It was also an advantage if complementary competencies, for example in the form of geriatric nurses, physiotherapists and occupational therapists, could be available if needed. Patients who were allowed to listen to calm classical music had a better development of cognitive function. Conclusion: The results of the study show that more knowledge, instruments and tools are needed for nurses to prevent, identify and treat delirium early. Good competence, quick identification and information to the patient's other care providers can lead to better care for the patient and a better working environment for the nurse.

Bakgrund: Antalet katastrofer i världen och Sverige ökar och därmed ökar även behovet av katastrofmedicinsk beredskap. Akutmottagningen utgör ofta den första kontakten med sjukvården och därför har akutsjuksköterskorna en mycket central roll vid en allvarlig händelse. Sjuksköterskor är den största arbetsstyrkan vid en katastrof och sjukvården är helt beroende av deras kompetens. Forskning visar att bristfällig omvårdnad, triagering eller oförmåga till att finna den kritiskt dåliga patienten i ett tidigt skede, ökar mortaliteten. Dock visar forskningen även att sjuksköterskor inte känner sig tillräckligt förberedda. Sjuksköterskor som har arbetat i samband med allvarliga händelser beskriver starka och motstridiga känslor. Utbildning, övning och tidigare erfarenheter inom katastrofmedicin har uppgetts förbättra sjuksköterskornas beredskap. Trots vetskapen om sjuksköterskornas nyckelroll är forskningen angående sjuksköterskors uppfattningar om den katastrofmedicinska beredskapen begränsad. Fler studier inom området vore av värde med tanke på att behovet av katastrofmedicinsk beredskap ökar. Syfte: Syftet var att beskriva sjuksköterskors uppfattningar om den katastrofmedicinska beredskapen på akutmottagningar i Storstockholm. Metod: Studien utfördes med en kvalitativ metod och en induktiv ansats. Tio semistrukturerade intervjuer med sjuksköterskor från fyra akutmottagningar inom Storstockholm utfördes. Intervjuerna analyserades med hjälp av innehållsanalys. Resultat: Fyra teman kunde urskiljas: ”oro för organisationens begränsningar”, ”behov av struktur”, ”erfarenhet och övning skapar trygghet i nya situationer” samt ”motstridiga känslor och tankar om copingstrategier”. Inom det första temat beskrev deltagarna en stark oro för att akutsjukvården redan är högt belastad och att detta skulle äventyra patientsäkerheten ännu mer vid en allvarlig händelse. I ”behov av struktur” beskrev sjuksköterskorna att de uppfattade sin roll som central vid allvarliga händelser och att de hade behov av en tydlig struktur. Tema nummer tre, ”erfarenhet och övning”, förklarade sjuksköterskornas önskan om mer övning och att erfarenhet gynnar dem i deras arbete. Motstridiga känslor såsom skräck blandad med nyfikenhet inför arbete vid en allvarlig händelse belystes i tema fyra, liksom arbetsgruppens viktiga, stöttande funktion. Slutsats: Den katastrofmedicinska beredskapen behöver förankras bättre i akutsjukvårdens hektiska vardag. Sjuksköterskornas uppfattning var att en allvarlig händelse skulle kunna orsaka ett kaos som fordrar starka copingstrategier. Behov av ett nytt, strukturerat arbetssätt uppdagades. Realistiska övningar skulle kunna kompensera för bristen på erfarenhet från allvarliga händelser. Ett strukturerat arbetssätt och en stark arbetsgrupp är måsten för att kunna upprätthålla patientsäkerheten vid en allvarlig händelse. / Background: As the number of disasters increases in the world the need for an adequate disaster preparedness develops. Registered nurses in emergency departments have a significant role since they often constitute the first encounter with the healthcare after a disaster. Healthcare is dependent on the nurses' ability to effectively respond to an event of disaster. Studies have shown that a deficient triage, nursing and inability to identify a critically ill patient increase patient mortality. However, previous research reveal that nurses don’t feel properly prepared. Registered nurses with experience from disaster response describe strong and conflicting emotions. Experience, education and disaster-related training have been shown to improve registered nurses’ self-reported disaster preparedness. Despite the fact that there is knowledge about registered nurses’ key role in disaster response, research is limited regarding their perceptions of disaster preparedness. Since the need for disaster preparedness increases, more studies within the area would be worthwhile. Aim: The aim was to describe registered nurses’ perceptions of disaster preparedness in emergency departments. Methods: A qualitative interview study was carried out and ten interviews with registered nurses from four emergency departments were performed. During the interviews a semi structured method was used. The interviews were analyzed through content analysis. Results: Four themes emerged: “concern for organizational insufficiency”, “need for structure”, “experience and training create a feeling of security in new situations” and “conflicting emotions and thoughts about coping strategies”. Within the first theme the participants described a strong concern for the already existing high pressure in emergency care and that this could jeopardize patient safety in an event of a disaster. The second theme illustrates the registered nurse’s perception of having a central role and their need for a clear structure while working in an event of disaster. “Experience and training”, theme three, is about the registered nurses’ wish for more disaster-related training and the importance of experience in their work. The thought of disaster response generated conflicting emotions, such as fear mixed with curiosity, was highlighted in theme four, as well as the importance of a supportive work group. Conclusion: The disaster preparedness needs to be better anchored in reality’s crowded care situation within the emergency care. Registered nurses believed a disaster would result in a chaotic work environment with the need for coping strategies. A new and structured way of working was seen as necessary. Realistic disaster-related training might compensate for the lack of experience. To be able to withhold patient safety during a disaster structure and stability within the workforce is essential.

Världen har i nuläget ett sämre säkerhetsläge än på länge, där Sverige kan behöva förbereda sig för en eventuell samhällskris. Hemberedskap är därmed ett begrepp som blir alltmer relevant i vardagen. Forskning inom området har belyst hur beteenden samt attityder som utövas under samhällskriser relaterar till femfaktormodellens personlighetsdimensioner, med varierande resultat. Denna studie undersökte relationen mellan hemberedskap och femfaktormodellen, demografiska variabler och attityd till egen hemberedskap samt skillnaden mellan attityd till egen hemberedskap och aktuell hemberedskap. I studien deltog 124 studenter som besvarade en enkät bestående av demografiska frågor, en skala för hemberedskap samt en skala för femfaktormodellens personlighetsdimensioner. Materialet undersöktes med korrelationer, regressionsanalys samt variansanalys. Resultatet visade ej på signifikanta relationer mellan personlighetsdimensioner och hemberedskap utan enbart tendenser. Däremot föreligger signifikanta samband mellan hemberedskap och variablerna ålder och boendestatus. Ålder, kön samt boendestatus visade sig vara signifikanta för att predicera hemberedskap.  Slutsatsen i studien blev att demografiska variabler är bättre både för att se samband med och för att predicera hemberedskap. En signifikant skillnad existerade även mellan attityd till egen hemberedskap och aktuell hemberedskap hos universitetsstudenter vilket innebär att de tenderar att överskatta sin förmåga till hemberedskap.

The purpose of this quantitative research study was to explore dual enrollment as a college readiness strategy and the effects of dual enrollment programs on persistence and achievement within a post-secondary institution. This study examined documented institutional data of former dual enrollment students and their direct entry peers who were 1st-time college students at a community college in South Mississippi. Community colleges in Mississippi have maintained dual enrollment programs for over a decade, but few empirical-based research studies have been conducted to determine whether or not student achievement and persistence rates differed for students with prior dual enrollment experience. Therefore, more empirically-based research is needed to determine whether research findings are generalizable. Further research will contribute to the body of literature regarding the impact and effectiveness of dual enrollment and how it relates to college persistence. The sample included all students who graduated from local service area high schools in the spring of 2012 and matriculated to the community college in the fall of 2012. The study analyzed measures of achievement and indicators of persistence for all students over 2 academic years. The study used an independent sample t-test to compare whether prior dual enrollment students had different rates of persistence and achievement than direct entry students. A factorial analysis of variance was used to test for significance among independent variables of enrollment type with the dependent variables of persistence and achievement among categorical variables of race to determine if there was a difference in proportion of students in dual enrollment versus direct entry. Persistence is defined as the continuous full-time enrollment from the first year to the second year. Achievement was measured using ACT scores and grade point average (GPA). Findings revealed that no significant difference existed in measures of persistence between students with prior dual credit and direct entry students. Significant differences existed in measures of achievement by students with prior dual credit and by direct entry students in two areas: Act scores and cumulative GPA. Other findings indicated differences did not exist for persistence by enrollment type and race or for achievement by enrollment type and race.

Curriculum assessment has been an important tool in measuring the effectiveness of the curriculum to evaluate student learning and preparedness. This study develops a conceptual framework, based on course offerings and descriptions of the Hospitality and Tourism Management Program at the University of Massachusetts Amherst, to evaluate how the curriculum contributes to students’ preparedness for their future career. Using an online field survey, this study examines the skills that contribute to students’ preparedness. Besides putting forward the strengths and weaknesses of the program, and identifying the significant skill areas that contribute significantly to students’ preparedness, findings of this study indicate that students are quite well prepared and overall satisfied with the program. Results also highlight the importance of work experience as an integral part of the curriculum in affecting students’ preparedness.

“College Readiness” has been a phrase discussed across higher education and the workforce in most recent years. However, the perception of College Readiness has been debated throughout history as there is not a universal agreement on the philosophy of what it means to be College Ready. In Mississippi, the state has not even defined this phrase so there is not a way to measure the success of College Readiness. Because of this lack of universal philosophy, the purpose of this study is to understand the philosophy of college readiness programs in the state of Mississippi. The research question guiding this study will include: How do different stakeholders assigned to align college readiness programs between P-12 and postsecondary systems understand the philosophy of college readiness? Moreover, what influences the beliefs that shape philosophies about college readiness held by these stakeholders? Leaning on research from Thelin (2004), Conley (2007), and the Ecological Model of College Readiness as designed by Arnold et al. (2012), the literature review synthesizes research on the history of college readiness in American Higher Education, the definitions of College Readiness, and the most widely accepted conceptual framework to explain the factors that influence College Readiness among students. The design of this study included a qualitative comparative analysis and used focus groups to collect data from the perspectives of 16 directors or coordinators who are responsible for organizing or implementing college readiness programs across the state of Mississippi. As a result, the theme from the participant responses supported the consensus that college readiness is a complex and undefined phrase. However, each participant agreed that to be college ready, students need to have more than academic readiness. Instead, students must also have individual characteristics that yearn for a plan after high school. Another conclusion made was that college readiness is influenced by the students’ surroundings including people and politics. While the most current conceptual framework helps identify factors that influence college readiness, it does not precisely identify the relationships among the different layers or help explain when a student becomes college ready. Therefore, additional research should be conducted to determine the stages by which students pass through to become college ready.

Food provision in times of environmental and social crises has become a hot topic over recent years. The covid-19 pandemic and the Russian war on Ukraine have led to a re-evaluation of Swedish food preparedness. One proposed way of addressing food preparedness is to increase the resilience of the food system, so that it is better able to withstand disturbances. Additionally, one way of increasing food preparedness can be by increasing domestic production and reduce the dependency on imported food and fertilisers. Swedish municipalities have the power to decide to build on or protect agricultural land. Additionally, Swedish municipalities are responsible for providing food to schools, hospitals and care facilities even during crises. Hence, the aim of this study is to investigate how Swedish municipalities are working with food preparedness and protection of agricultural land through policies, plans and in practice. Case studies were conducted on Haninge and Heby municipalities through text analysis of governing documents and semi-structured qualitative interviews with municipality officials. Neither municipalities have policies in place for food preparedness nor protection of agricultural land. However, some efforts are being made in terms of food preparedness in public meals and encouraging locally produced food through procurement. Furthermore, limited practices outside of procurement and meal service could be identified, but some interesting ideas and potential innovative practices were mentioned in the interviews. Building housing or providing jobs within the municipality was prioritised over protecting agricultural land in certain cases. The results from the case study were analysed from a resilience thinking perspective, using the seven principles of resilience defined by Biggs et al. (2012). Resilience was not explicitly mentioned in the reviewed documents nor in interviews. However, some resilience thinking and practices were displayed by some of the officials during the interviews in terms of collaborations and connectivity, the encouragement of a diversity of actors at different scales and the enablement of participation and learning. As the municipalities are in the early stages of addressing food preparedness, they have the opportunity to include resilience thinking in the shaping of their governance and management policies. Ideally the inclusion of resilience thinking could aid in creating municipal food systems that are resilient to disturbances and sustainable in the long term. / Livsmedelsförsörjning i tider av miljömässiga och sociala kriser har blivit ett hett ämne under de senaste åren. Covid-19-pandemin och det ryska kriget mot Ukraina har lett till en omvärdering av den svenska livsmedelsberedskapen. Ett föreslaget sätt att hantera livsmedelsberedskap är att öka livsmedelssystemets resiliens, så att det bättre kan motstå störningar. Vidare kan ett sätt att öka livsmedelsberedskapen vara att öka den inhemska produktionen och minska beroendet av importerade livsmedel och gödningsmedel. Svenska kommuner har befogenhet att besluta om att bygga på eller skydda jordbruksmark. Dessutom är svenska kommuner ansvariga för att tillhandahålla mat till skolor, sjukhus och vårdinrättningar även under kriser. Syftet med denna studie är därför att undersöka hur svenska kommuner arbetar med livsmedelsberedskap och skydd av jordbruksmark genom policyer, planer och i praktiken. Fallstudier genomfördes på Haninge och Heby kommuner genom textanalys av styrdokument och semistrukturerade kvalitativa intervjuer med kommuntjänstemän. Ingen av kommunerna har någon policy för livsmedelsberedskap eller skydd av jordbruksmark. Vissa ansträngningar görs dock när det gäller livsmedelsberedskap i offentliga måltider och uppmuntran av lokalt producerade livsmedel genom upphandling. Dessutom kunde begränsade metoder utanför upphandling och måltidsservice identifieras, men några intressanta idéer och potentiella innovativa metoder nämndes i intervjuerna. Att bygga bostäder eller skapa arbetstillfällen inom kommunen prioriterades i vissa fall framför att skydda jordbruksmark. Resultaten från fallstudien analyserades utifrån ett resiliensperspektiv, med hjälp av de sju principerna för resiliens som definierats av Biggs et al (2012). Resiliens nämndes inte explicit i de granskade dokumenten eller i intervjuerna. Några av tjänstemännen visade dock prov på resilienstänk och -metoder under intervjuerna när det gäller samarbete och anslutningsmöjligheter, uppmuntran av en mångfald av aktörer på olika nivåer och möjliggörande av deltagande och lärande. Eftersom kommunerna befinner sig i ett tidigt skede av att ta itu med livsmedelsberedskap har de möjlighet att inkludera resilienstänk i utformningen av sina styrnings- och förvaltningspolicyer. I bästa fall kan införandet av resilienstänk bidra till att skapa kommunala livsmedelssystem som är motståndskraftiga mot störningar och hållbara på lång sikt.

This bachelor thesis aims to investigate household electricity supply and demand during a crisis. Both quantitative and qualitative aspects of crisis preparedness and household electricity demand are considered. In this thesis, the subject is studied by conducting simulations of electricity consumption as well as retrieving theoretical framework and concepts from literature and interviews. Emphasis will be on how the cost of a lithium-ion battery storage, that supplies households with electricity during power outages, is affected by households’ behavioural patterns regarding electricity use. To estimate household electricity demand, data are utilized from a stochastic model which simulates household members electricity usage patterns. Three different scenarios are modelled, representing varying household electricity reliance, across different lengths of power outages. The first scenario illustrates households’ normal electricity demand. The second scenario represents a changed behaviour pattern leading to a reduced electricity demand. The third and last scenario concerns a case where households with adequate crisis preparedness are taken into account, resulting in a linearly scaled down electricity demand. Gaps in the distribution of responsibility between municipalities and households concerning crisis preparedness are brought up and discussed. The thesis highlights households with unique needs that risk not getting the support needed from the municipality in case of a crisis. The result shows that meeting the electricity demand for Knivsta urban area during a power outage by utilizing a battery storage would be very costly for the municipality. Despite the cost reduction from decreased electricity consumption, large investments are still required. A battery storage system on that scale might not be the only nor most optimal solution for crisis preparedness. Instead, opportunities are found by challenging prevailing norms of constant electricity supply and increased resilience among households. Lastly, possible solutions less costly for the municipality are presented.

No description available.

The purpose of this quantitative study was to determine if a relationship existed between the quality of school-community partnerships and the average score of each ACT subtest for rural Tennessee high school students. Specifically, the researcher examined the following school-community partnerships: business partnerships, university partnerships, service learning partnerships, school-linked service integration, and faith-based partnerships (Sanders, 2006). Administrators from 62 rural Tennessee high schools rated the partnerships present in their schools using the Improving Community Partnership Quality rating scale developed by Sanders (2006). Each of these ratings was compared to the participating school’s mean score for each ACT benchmark to determine whether these partnerships could be linked to success on the ACT. Pearson correlation coefficients were calculated for each partnership type and each ACT subtest. The results revealed that a statistically significant relationship did not exist between school-community partnerships and ACT subtest scores.