Background: There is limited research on how web-based, point-of-care, evidence-based medicine (EBM) tools, such as evidence summaries, are being implemented and used in developing countries. Objectives: To investigate accessibility, use, and impact of an online EBM knowledge dissemination portal in orthopaedic surgery. To explore whether receiving daily targeted evidence summaries results in more frequent use of an EBM tool compared with receiving general weekly reports. To identify and explain the barriers and benefits of a point-of-care resource in the Indian context. Methods: Forty-four orthopaedic surgeons in Pune, India, were provided free access to OrthoEvidence (OE), a for-profit, online EBM knowledge dissemination portal. Participants were subsequently randomized to an Intervention group receiving daily targeted evidence summaries or a Control group receiving general weekly summaries. This study employed an explanatory sequential mixed methods design that incorporated two questionnaires, OE usage data, and semi-structured interviews to gain insight into the surgeons’ usage, perceptions and impact of OE. Results: There were no observable differences in OE usage between the Intervention and Control groups. OE was deemed to be comprehensive, practical, useful, and applicable to clinical practice by the majority of surgeons. The exit survey data revealed no differences between groups’ perceptions of the OE tool. Semi-structured interviews revealed barriers to keeping up with evidence that included limited access to relevant medical literature (limited internet connection, lack of time, minimal access to medical journals) and limited incentive to keep up with it (limited decision-making powers for residents, textbook-based residency curriculum, lack of research methods knowledge, limited context-specific research). Changing trauma practices at the hospital were noted following the intervention. Recommendations: The practice of EBM and the use of point-of-care tools in India can be promoted by investing in adequate electronic infrastructure (improvements to internet access) and by integrating EBM into training programs and surgical cultures. / Thesis / Master of Science (MSc)

The aim of this study is to understand how co-branding can be strategically implemented and its relevance in small business customer relationships. The study serves as a guide for small businesses striving to strengthen their brand and improve their customer relationships through strategic utilization of co-branding. By enhancing knowledge about co-branding as a strategy, businesses can identify opportunities and challenges of successfully implementing the strategy in their operations. The theoretical foundations of the study include areas of brand equity, co-branding and relationship marketing. Using a qualitative method and across-sectional study design, we conducted semi-structured interviews with five companies and seven consumers to obtain multiple valuable perspectives and viewpoints on the research topic. Based on the empirical research, the findings indicate that consumers value quality, company values, long-term relationships, personalized offers, and trust in brands. Consumers also view brand collaborations positively but emphasize the importance of clear objectives and beneficial partnerships. The companies reported that collaborations can provide broader reach, expand the target audience, increase market share and sales, and facilitate insights sharing and trust building. The prospects for successful collaborations highlights long-term commitment and strong relationships as key components for successful partnerships. Based on the previous mentioned information and the study’s results, the conclusion is that the establishment and management of brand equity play a central role in creating a stable customer base, requiring strategic implementation of the brand process early on to effectively communicate the brand and its identity. Small businesses have several advantages that gives them opportunities to implement co-branding as a strategy, where they can contribute with significant resources to other larger businesses with an interest in exchange through exposure. In relation to their customers, the importance of quality, long-term commitment, trust and strong values is emphasized as factors that need to remain stable in the implementation of a co-branding strategy.

No description available.

No description available.

Syfte: Att studera hur personer som blivit utsatta för sexuella övergrepp som barn, upplever sin munhälsa.Material och metod: Elva informanter (10 kvinnor), 19 - 56 år gamla som blivit utsatta för sexuella övergrepp som barn valdes ut strategiskt och djupintervjuades. Informanterna uppmanades att med egna ord berätta om hur de upplevde att de sexuella övergreppen påverkat deras munhälsa. Intervjuerna spelades in digitalt för att sedan transkriberas ordagrant. Det insamlade materialet analyserades enligt kvalitativ innehållsanalys. Resultat: Resultatet åskådliggjorde temat ”Utmanade förutsättningar för oral hälsa”, som grundar sig på tre kategorier; Emotionell påverkan med tillhörande subkategorier negativa -och positiva känslor; Munvård med subkategorierna tandläkarbesök med svårighet, genväg och egenvård med komplikationer; Heligt tempel med tillhörande subkategorier munhälsan har betydelse och munhälsans påverkan. Slutsats: Oral hälsa associerades med starka känslor som skam, skuld, ångest och till viss del stolthet. Alla deltagare rapporterade tandvårdsrädsla i varierande grad, som hade hindrat dem från att besöka tandvården regelbundet. Det fanns en önskan om nyttjande av olika genvägar, som behandling under olika typer av sedering och att bli kallad av tandvården. Det uttrycktes svårigheter med att utföra daglig oral egenvård. Generellt fanns en önskan om en förbättrad oral hälsa.Nyckelord: kvalitativ studie, munvård, skam, smärta, tandvårdsrädsla. / Aim: To study how victims of child sexual abuse experience their oral health. Methods: Eleven participants (10 women), 19-56 years of age, who experienced sexual abuse as a child were purposively selected and in-depth interviewed. The participants were encouraged to talk about how they experienced that the sexual abuse had affected their oral health. The interviews were recorded digitally and transcribed verbatim. The collected material was analyzed according to Qualitative Content Analysis.Results: The result in this study illustrated the theme “Challenged prerequisites for oral health”, which ground on three categories and associated subcategories; Emotional impact with associated subcategories negative- and positive feelings; Oral Care with subcategories dentistry visits with difficulties, shortcut and self-care with complications; Holy Temple with subcategories oral health is of importance and the oral health impact.Conclusion: Oral health is associated with strong feelings such as shame, blame, anxiety and partially pride. All participants reported dental fear in varied degree which had prevented them to visit dentistry on regular basis. There was a desire for using different shortcuts, such as treatment under sedation and to be recalled by the dentistry. There was expression for difficulties in providing daily oral care. There was generally a desire for an improved oral health. Keywords: dental fear, oral care, pain, qualitative study, shame.

Bakgrund: Nollseparation är en ny metod som syftar till att inte separera mamma och barn efter förlossningen. Användningen av nollseparation ökar och bidrar till hälsovinster samt att barnets rättigheter och anknytning stärks. Trots fördelarna med nollseparation separeras mammor och barn ibland efter förlossning, särskilt om barnet är i behov av neonatalvård. Motiv: Få studier lyfter fram möjligheter och hinder med nollseparation, ur sjuksköterskans perspektiv. En sådan studie kommer sannolikt att förbättra följsamheten av metoden och därmed förbättra barnets rätt till båda föräldrarna. Syfte: Belysa sjuksköterskors erfarenheter av möjligheter och hinder vid nollseparation efter förlossning. Metod: En kvalitativ studie genomfördes med hjälp av semistrukturerade intervjuer med sjuksköterskor (n=7) från en neonatalavdelning i södra Sverige. En intervjuguide användes som stöd vid de semistrukturerade intervjuerna som transkriberades ordagrant. Transkripten bearbetades med kvalitativ innehållsanalys och resulterade i sex underkategorier och tre kategorier. Resultat: Sjuksköterskornas erfarenheter handlade om att skapa förutsättningar för nollseparation, att samverka inom och mellan personalgrupper och att vårda familjen som en enhet. Genom rätt förutsättningar i form av personaltäthet utifrån arbetsbelastning, samt anpassad yttre miljö och tillgängligt material, underlättades genomförandet av nollseparation efter förlossning. God samverkan mellan involverad personal med klinisk erfarenhet, som använde god kommunikation samt hade en positiv inställning och attityd, ökade möjligheten för lyckad nollseparation. Om mammans och barnets hälsa tillät att nollseparation genomfördes kunde familjen vårdas som en enhet, dessutom upplevde sjuksköterskorna att föräldrarna blev mer delaktiga och att deras bindning till barnet stärktes. Konklusion: Studien klargör att nollseparation alltid bör vara vårdpersonalens målsättning. Barnets rättigheter tycks stärkas då nollseparation tillämpas, vilket antagligen påverkar hela familjen positivt. / Background: Zero separation is a new method aiming at not separate mother and child after delivery. The use of zero separation is constantly increasing. Through zero separation health benefits, children's rights and attachment will be achieved. However, despite the benefits of zero separation, mother and child are sometimes separated after delivery, especially if the child needs neonatal care. Motive: From nurses’ perspectives, few studies have highlighted opportunities and obstacles to zero separation, such a study will probably improve compliance with the method and thus, improve children's right to both parents. Aim: To illuminate nurses' experiences of opportunities and obstacles using zero separation after childbirth. Methods: A qualitative study was conducted using semi-structured interviews with nurses (n = 7) from a neonatal ward in southern Sweden. A tested interview guide supported the interviews. The interviews were transcribed verbatim. The transcripts were analysed using qualitative content analysis and resulted in six subcategories and three categories. Result: The nurses' experiences were about creating conditions for zero separation, collaborating within and between staff groups and caring for the family as a unit. Through the right conditions in form of workload and staff density as well as adapted external environment and available material, the implementation of zero separation after childbirth was facilitated. A well-functioning collaboration between staff with clinical experience, who used a clear communication and had a positive attitude increased the possibility of successful zero separation. If mothers’ and children's health allowed, the family could be cared for as a unit, the nurses also experienced that parents became more involved and their bond to the child was strengthened. Conclusion: The study clarifies that zero separation should always be the goal of healthcare professionals. Children's rights seem to be strengthened by zero separation, which probably has a positive effect on the family.

Bakgrund: Den psykiska ohälsan ökar och den vuxenpsykiatriska heldygnsvården har stor press på sig, både utifrån personalbrist, ökat behov och efterfrågan av personcentrerad vård samt med ett ansvar att behandla och möta ett brett spektrum av komplicerade psykiatriska diagnoser och tillstånd. Sjuksköterskor inom psykiatrisk vård besitter ofta stor kunskap och erfarenhet och kan bidra till att stärka vården men får inte alltid utrymme att kliva fram och ta det ansvar som professionen representerar. Rebellsjuksköterskor kan genom sitt driv, patientfokuserade och ledande egenskaper bana väg för andra sjuksköterskor att våga kliva fram och ta sitt professionella ansvar, samt bidra till en positiv utveckling av en säker, personcentrerad vård. Denna studie vill öka kunskapen kring erfarenheter av rebelledarskap för att skapa större förståelse för hur detta kan främjas och användas för att bidra till utvecklingen av vården. Syfte: Syftet med studien var att beskriva sjuksköterskors erfarenheter av rebelledarskap i vuxenpsykiatrisk heldygnsvård. Metod: Studien har genomförts med deskriptiv design och kvalitativ ansats. Datainsamlingen har skett genom semistrukturerade intervjuer med åtta sjuksköterskor med erfarenhet av rebelledarskap inom vuxenpsykiatrisk heldygnsvård i Sverige och har analyserats med en induktiv, kvalitativ innehållsanalys. Resultat: Analysen mynnade ut i tre huvudkategorier: att rebelledarskap kan vara en ensam resa på en väg kantad av utmaningar, att rebelledarskap kan driva verksamheten framåt och stärka en personcentrerad vård, samt att rebelledarskap är en inre drivkraft som utgår från profession och kompetens. Slutsats: Genom sitt driv att förbättra vården och hitta mer individanpassade lösningar utifrån patientens unika omvårdnadsbehov kan rebellsjuksköterskan utgöra en viktig resurs för utvecklandet av en mer personcentrerad psykiatrisk heldygnsvård. Mer forskning behövs för att klargöra hur rebellsjuksköterskans insatser påverkar patienternas återhämtning, samt för att potentiellt kunna bidra till en tydligare arbetsbeskrivning för sjuksköterskor inom vuxenpsykiatrisk heldygnsvård.

Yes / Objectives To assess the long-term effect on health and well-being of the Lifestyle Matters programme. Design Qualitative study of a subset of intervention arm participants who participated in the Lifestyle Matters randomised controlled trial (RCT). Setting The intervention took place at community venues within two sites in the UK. Participants A purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed at 24 months post randomisation. Interviews aimed to understand how participants had used their time in the preceding 2 years and whether the intervention had any impact on their lifestyle choices, participation in meaningful activities and well-being. Intervention Lifestyle Matters is a 4-month occupational therapy intervention, consisting of group and individual sessions, designed to enable community living older people to make positive lifestyle choices and participate in new or neglected activities through increasing self-efficacy. Results Interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants raised some form of benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, but there were significant and lasting benefits for 2 of 13 intervention participants interviewed. Conclusion The majority of those who experienced the Lifestyle Matters intervention reported minor benefits and increases in self-efficacy, but they did not perceive that it significantly improved their health and well-being. The two participants who had experienced major benefits also reported having had life-changing events, suggesting that this intervention is most effective at the time when lifestyle has to be reconsidered if mental well-being is to be sustained. / Medical Research Council grant number (G1001406).

Yes / Adolescent sexual and reproductive health (SRH) remains a challenge globally. High school youths without comprehensive sexuality education (CSE) are more likely to engage in high risk sexual behaviors than their peers in schools with CSE. Fiji continues to have very poor adolescents SRH indicators. This study aimed to gauge the perceptions of students towards the delivery of SRH education in schools in Fiji. A qualitative study design was used to collect data from students in year 11-13 in public secondary schools in Suva, Fiji in 2018. Schools with equal ethnic mix were selected. A semi-structured open-ended questionnaire was used to guide Focus Group Discussions (FGDs). A male research facilitator conducted FGD with males while a female research facilitator facilitated that amongst the females. Data collected was analyzed thematically. Seven FGDs were conducted. A total of 46 students (29 males) participated with the age range from 17-19 years old. Eight themes emerged: current SRH education; students' knowledge on adverse consequences of SRH; sources of SRH information; need for sex education; provision of SRH education in schools; characteristics of teachers of SRH education; age-appropriate incremental sex education; and ideal version of SRH. The study shows that Fijian students desired a lot more from sex education than what is currently offered for sexual decision-making. There is a need for mandatory and comprehensive sex education for young people.

Introduktion: Avslutad intensivvård leder ofta till efterföljande vård på en allmän vårdavdelning. Patienter som vårdats på en intensivvårdsavdelning efter utskrivning till vårdavdelning bör få en uppföljning av en intensivvårdssjuksköterska för att kunna upprätthålla hög patientsäkerhet och en god vård. Det är därför av betydelse att beskriva hur sjuksköterskor på vårdavdelning upplever denna uppföljning efter avslutad intensivvård. Syfte: Syftet var att beskriva grundutbildade sjuksköterskors upplevelse av att delta i uppföljning av utskriven intensivvårdspatient - Post intensivvårdsgrupp (PIG). Metod: En intervjustudie med ändamålsenligt urval och kvalitativ innehållsanalys genomfördes. Resultat: Resultatet bildade tre kategorier; Att utmanas i en dynamisk vårdmiljö där teamarbete är betydelsefullt, att få stöd bidrar till ett lärande som ger en känsla av trygghet och att utgå från patientens nuvarande status och individuella behov. Slutsats: PIG-uppföljning kan ge stöd och nytta till både patienter och vårdpersonal. PIG-uppföljning kan fungera som ett känslomässigt och pedagogiskt stöd för grundutbildade sjuksköterskor på vårdavdelning, med målet att hjälpa patienter vidare i sin fortsatta återhämning efter avslutad intensivvård. PIG-uppföljning kan bidra till ett fördjupat samarbete mellan IVA och vårdavdelning som ger möjlighet till kunskapsutbyte med syfte att öka kompetensen på vårdavdelning och därmed öka patientsäkerheten.