Data fusion is a multidisciplinary research area that involves different domains.It is used to attain minimum detection error probability and maximum reliability with the help of data retrieved from multiple healthcar...Data fusion is a multidisciplinary research area that involves different domains.It is used to attain minimum detection error probability and maximum reliability with the help of data retrieved from multiple healthcare sources.The generation of huge quantity of data from medical devices resulted in the formation of big data during which data fusion techniques become essential.Securing medical data is a crucial issue of exponentially-pacing computing world and can be achieved by Intrusion Detection Systems(IDS).In this regard,since singularmodality is not adequate to attain high detection rate,there is a need exists to merge diverse techniques using decision-based multimodal fusion process.In this view,this research article presents a new multimodal fusion-based IDS to secure the healthcare data using Spark.The proposed model involves decision-based fusion model which has different processes such as initialization,pre-processing,Feature Selection(FS)and multimodal classification for effective detection of intrusions.In FS process,a chaotic Butterfly Optimization(BO)algorithmcalled CBOA is introduced.Though the classic BO algorithm offers effective exploration,it fails in achieving faster convergence.In order to overcome this,i.e.,to improve the convergence rate,this research work modifies the required parameters of BO algorithm using chaos theory.Finally,to detect intrusions,multimodal classifier is applied by incorporating three Deep Learning(DL)-based classification models.Besides,the concepts like Hadoop MapReduce and Spark were also utilized in this study to achieve faster computation of big data in parallel computation platform.To validate the outcome of the presented model,a series of experimentations was performed using the benchmark NSLKDDCup99 Dataset repository.The proposed model demonstrated its effective results on the applied dataset by offering the maximum accuracy of 99.21%,precision of 98.93%and detection rate of 99.59%.The results assured the betterment of the proposed model.展开更多
Diabetic Retinopathy(DR)is a significant blinding disease that poses serious threat to human vision rapidly.Classification and severity grading of DR are difficult processes to accomplish.Traditionally,it depends on o...Diabetic Retinopathy(DR)is a significant blinding disease that poses serious threat to human vision rapidly.Classification and severity grading of DR are difficult processes to accomplish.Traditionally,it depends on ophthalmoscopically-visible symptoms of growing severity,which is then ranked in a stepwise scale from no retinopathy to various levels of DR severity.This paper presents an ensemble of Orthogonal Learning Particle Swarm Optimization(OPSO)algorithm-based Convolutional Neural Network(CNN)Model EOPSO-CNN in order to perform DR detection and grading.The proposed EOPSO-CNN model involves three main processes such as preprocessing,feature extraction,and classification.The proposed model initially involves preprocessing stage which removes the presence of noise in the input image.Then,the watershed algorithm is applied to segment the preprocessed images.Followed by,feature extraction takes place by leveraging EOPSO-CNN model.Finally,the extracted feature vectors are provided to a Decision Tree(DT)classifier to classify the DR images.The study experiments were carried out using Messidor DR Dataset and the results showed an extraordinary performance by the proposed method over compared methods in a considerable way.The simulation outcome offered the maximum classification with accuracy,sensitivity,and specificity values being 98.47%,96.43%,and 99.02%respectively.展开更多
Background: Regular physical activity(PA) has documented effects in prevention and treatment of many non-communicable diseases(NCDs).Physical inactivity is recognized as the fourth leading risk factor for premature de...Background: Regular physical activity(PA) has documented effects in prevention and treatment of many non-communicable diseases(NCDs).Physical inactivity is recognized as the fourth leading risk factor for premature death, worldwide. Despite these facts, physical inactivity is increasing,not only in high-income, but also in middle-and low-income countries. To address this negative trend, evidence-based methods to increase PA are needed. The purpose of this paper is to describe the implementation and assessment of 4 strategies designed to increase PA in Vietnam.Methods: Four strategies were used: i) introduction and evaluation of an education and training program on the Swedish method of Physical Activity on Prescription(PAP) among health care professionals, ii) translation of the PAP evidence-based handbook, Physical Activity in the Prevention and Treatment of Disease(called FYSS in Swedish) into Vietnamese, iii) launch of a mass-media campaign to promote PA, and iv)advocacy to support development of PA guidelines in Vietnam.Results: The evaluation indicated that the participating health care professionals had a positive attitude to PAP. However, they also reported uncertainty in prescribing PA. FYSS was translated and disseminated successfully to health care professionals. A mass-media campaign identified the beneficial effects of PA to health care professionals, journalists, policy makers, and the public. Last, the process of developing national guidelines on PA was initiated.Conclusion: This project led to enhanced awareness and appreciation of PA in the prevention and treatment of NCDs among health care professionals as well as initiation of national PA guidelines. Important lessons also were learned in the presentation of PAP, which will be considered when designing similar projects in the future.展开更多
Background: Patients and clinicians report pain and fatigue as key outcome measures in rheumatoid arthritis. Fatigue and pain are a major concern to patients. Aim: The objective of this study was to examine fatigue an...Background: Patients and clinicians report pain and fatigue as key outcome measures in rheumatoid arthritis. Fatigue and pain are a major concern to patients. Aim: The objective of this study was to examine fatigue and pain in adult patients with rheumatoid arthritis (RA) and to investigate the association between pain and fatigue with body awareness, demographic, disease-related, emotional and psychosocial factors. Method: Data were collected from a sample of patients with RA (n = 120) recruited from a Rheumatology clinic in a large university hospital in Stockholm, Sweden. Eligible for inclusion were patients between 20 -80 years of age and with a confirmed diagnosis of RA. Fatigue was measured using the Multidimensional Assessment of Fatigue (MAF) scale, while the Visual Analogue Scale (VAS) was used to assess components of pain. A multiple stepwise regression analysis was performed to evaluate factors related to fatigue and pain. In the first step a univariate analysis of variance (ANOVA) was used for all relevant independent factors. In the next step backwards stepwise regression was applied. Result: Fatigue was significantly associated with the Disease Activity Score 28-joints (DAS 28) (p = 0.049), the Body Awareness Questionnaire (BAQ) (p = 0.006), the Positive Affect (PA) scale (p = 0.008) and no smoking (p = 0.021). Pain was significantly associated with the EuroQol EQ-5D (p = 0.008) and the DAS 28 (p = 0.001). The adjusted R-square was 28.6% for fatigue and 50.0% for pain. Conclusion: This study clearly demonstrates that fatigue and pain in patients with RA appear to be associated with disease-related factors. Furthermore, fatigue was related to body awareness and emotional factors, and pain was related to health related quality of life.展开更多
Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arriv...Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arrived refugees. With the aim of paying attention to such symptoms, a revised culturally-tailored clinical health promotion model developed at Harvard Program in Refugee Trauma was used for invited groups of new-coming adult refugees in a town south of the Swedish capital. Methods: A coordinator administered the five-weekly sessions, 2 hours/week, with a professional interpreter. It covered major topics from Western and Arabic worldviews: 1) introduction;2) health care: organisation and access to;3) exercises;4) stress management and coping, 5) medical doctor-patient communication. Each topic was led by a nurse, a physiotherapist, a psychologist and a physician with experience of encounters with this target group in health care. Data cover results from 70 participants attending six groups;39 participants with pre-course findings and, post-course and six-month follow-ups. There were no significant differences in background factors between the participants and the drop-outs. Results: Participants’ perceptions of their health, measured by EQ-5D, changed positively over time, above all immediately after the course, with no significant differences between the two follow-ups. In the follow-ups, female participants perceived their health as significantly worse than males. Qualitative data at the six-month follow-up assessed the course as useful but expressed a wish to continue a similar course with a focus on post- migration stress. Conclusion: The results sup- port earlier findings. A course, administered to a small group in a dialogue setting, has value for the participants’ empowerment and perception of health. It is recommended that reception be more adapted to coping of post-migration stress of new-coming refugees. Practical Implications: The results have implications for education in clinical health promotion, intercultural communication and inter-professional collaboration in refugee reception.展开更多
Background: Correlations between CRP and serum lipids are weak, and there are conflicting and incomplete results in the literature. The aim of the present study was to clarify the strength and independence of relation...Background: Correlations between CRP and serum lipids are weak, and there are conflicting and incomplete results in the literature. The aim of the present study was to clarify the strength and independence of relationships between CRP and serum lipids in outpatients. Methods: Inclusion criteria were outpatients where all the following analyses were requested in clinical routine: high sensitivity CRP, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, ApoB, ApoA-1 and Lp(a). Data for patients meeting the above criteria during a period of six years (2004-2010) were copied from Aleris Medilab’s Laboratory Information System to the software Statistica. Basic statistics and correlations were calculated for 2771 patients. In patients with two (n = 959) or more sampling times changes over time were calculated. The study was a quality assurance project without access to patient files. Results: Median age was 59 years and median serum CRP concentration was 1.5 mg/L. The strongest correlations (Spearman R) were seen between CRP and triglycerides (0.25), ApoB/ApoA-1 ratio (0.21) and HDL-cholesterol (−0.18). Stepwise regression analysis showed that ApoB, total cholesterol, log triglycerides and log Lp(a) together explained 8% of the variation in log CRP. Unfavourable time trends for CRP and triglycerides counteracted a significant decrease in LDL-cholesterol and total cholesterol. Conclusion: In a large cohort of outpatients CRP showed stronger correlation with triglycerides and ApoB/ApoA-1 ratio than with LDL-cholesterol and Lp(a). LDL-cholesterol concentrations changed favorably over time whereas CRP and triglycerides did not.展开更多
Studies aimed to capture the effects of IT-innovations in health and social care have shown that there is a gap between expected and factual outcomes. Many decision makers feel the need to articulate an ideal end-stat...Studies aimed to capture the effects of IT-innovations in health and social care have shown that there is a gap between expected and factual outcomes. Many decision makers feel the need to articulate an ideal end-state for their organiza-tions. Striking the balance between novelty and believability of such an ideal end-state is often tricky and they become neither satisfied with the ideal not the visioning. In this study, we explore the contribution of IT-innovations to health and social care. The results showed that coherence between context and IT-innovation is important to capture effects and outcomes. Being coherent rather than visionary contributes to identify where you are, as an organization, and to capture effects and outcomes that “make sense” in the context in question. The paper makes an exposition from the model building, algorithm design to performance analysis and contributes to the academic prosperity in Intelligent In-formation Management The knowledge generated is expected to provide input when identifying goals that IT-investments are supposed to achieve.展开更多
Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family memb...Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family member, this often means sharing life with a changing person in a changing relationship, disrupting both individual identity and family identity. Our aim was to deepen the understanding of individual experiences that are important in constructing family identity close to death at home. We performed a secondary analysis of qualitative data collected through 40 interviews with persons with life-threatening illness and the family members who shared everyday life with them. The analysis resulted in interpretive descriptions which provided three patterns important for creating family identity, which we here call “we-ness” close to death. The patterns were: being an existential person, being an extension of the other, and being together in existential loneliness. Together, these three patterns seemed to play a part in the construction of family identity;we-ness, close to death. One important finding was the tension between the search for togetherness in “we-ness” while dealing with an existential loneliness, which seemed to capture an essential aspect of being a family of which one member is dying.展开更多
Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences...Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas—“Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were living alone, not having children or other commitments in relation to family, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.展开更多
The recognition of the importance of leadership education and training has come late to medicine,especially aca demic medicine.Long adopted by military academies and Master of Business Administration programs of all t...The recognition of the importance of leadership education and training has come late to medicine,especially aca demic medicine.Long adopted by military academies and Master of Business Administration programs of all types,leadership training in medicine has instead reflected a“just in time”approach.Academic faculty are often appointed to leadership roles having had little to no formal training in leadership,and they often have never considered themselves as leaders.The time has come to recognize that leadership is a core pillar of medicine,including subspecialty medicine.展开更多
This paper presents a qualitative study of immigrant Chinese teachers’professional identity and beliefs about the teacher-student relationship in an intercultural context.Theoretically,this study takes its departure ...This paper presents a qualitative study of immigrant Chinese teachers’professional identity and beliefs about the teacher-student relationship in an intercultural context.Theoretically,this study takes its departure from a sociocultural perspective on understanding professional identity.The empirical analysis in the study drew mainly upon ethnographic interviews with a group of Chinese language teachers in Denmark concerning their life experiences,perceptions,and beliefs.The results of this study suggest that teachers’beliefs about their roles as teachers and about student-teacher relationships are shaped by both their prior experiences and backgrounds and the current social and cultural contexts in which they are situated.Changes of context(e.g.,from China to Denmark)often lead to a transformation of their professional identity and beliefs.Being a teacher in an intercultural context often exposes them to the confrontation of diverse challenges and dilemmas.On one hand,teachers in this study generally experienced a transformation from being a moral role model,subject expert,authority and parental role to being a learning facilitator and culture worker.On the other hand,they developed diverse individualized coping strategies to handle student-teacher interactions and other aspects of teachers’professional identity.展开更多
文摘Data fusion is a multidisciplinary research area that involves different domains.It is used to attain minimum detection error probability and maximum reliability with the help of data retrieved from multiple healthcare sources.The generation of huge quantity of data from medical devices resulted in the formation of big data during which data fusion techniques become essential.Securing medical data is a crucial issue of exponentially-pacing computing world and can be achieved by Intrusion Detection Systems(IDS).In this regard,since singularmodality is not adequate to attain high detection rate,there is a need exists to merge diverse techniques using decision-based multimodal fusion process.In this view,this research article presents a new multimodal fusion-based IDS to secure the healthcare data using Spark.The proposed model involves decision-based fusion model which has different processes such as initialization,pre-processing,Feature Selection(FS)and multimodal classification for effective detection of intrusions.In FS process,a chaotic Butterfly Optimization(BO)algorithmcalled CBOA is introduced.Though the classic BO algorithm offers effective exploration,it fails in achieving faster convergence.In order to overcome this,i.e.,to improve the convergence rate,this research work modifies the required parameters of BO algorithm using chaos theory.Finally,to detect intrusions,multimodal classifier is applied by incorporating three Deep Learning(DL)-based classification models.Besides,the concepts like Hadoop MapReduce and Spark were also utilized in this study to achieve faster computation of big data in parallel computation platform.To validate the outcome of the presented model,a series of experimentations was performed using the benchmark NSLKDDCup99 Dataset repository.The proposed model demonstrated its effective results on the applied dataset by offering the maximum accuracy of 99.21%,precision of 98.93%and detection rate of 99.59%.The results assured the betterment of the proposed model.
文摘Diabetic Retinopathy(DR)is a significant blinding disease that poses serious threat to human vision rapidly.Classification and severity grading of DR are difficult processes to accomplish.Traditionally,it depends on ophthalmoscopically-visible symptoms of growing severity,which is then ranked in a stepwise scale from no retinopathy to various levels of DR severity.This paper presents an ensemble of Orthogonal Learning Particle Swarm Optimization(OPSO)algorithm-based Convolutional Neural Network(CNN)Model EOPSO-CNN in order to perform DR detection and grading.The proposed EOPSO-CNN model involves three main processes such as preprocessing,feature extraction,and classification.The proposed model initially involves preprocessing stage which removes the presence of noise in the input image.Then,the watershed algorithm is applied to segment the preprocessed images.Followed by,feature extraction takes place by leveraging EOPSO-CNN model.Finally,the extracted feature vectors are provided to a Decision Tree(DT)classifier to classify the DR images.The study experiments were carried out using Messidor DR Dataset and the results showed an extraordinary performance by the proposed method over compared methods in a considerable way.The simulation outcome offered the maximum classification with accuracy,sensitivity,and specificity values being 98.47%,96.43%,and 99.02%respectively.
基金funded by the Swedish International Development Cooperation Agency (Sida), Department for Development Partnership (No. AKT-2010-045)
文摘Background: Regular physical activity(PA) has documented effects in prevention and treatment of many non-communicable diseases(NCDs).Physical inactivity is recognized as the fourth leading risk factor for premature death, worldwide. Despite these facts, physical inactivity is increasing,not only in high-income, but also in middle-and low-income countries. To address this negative trend, evidence-based methods to increase PA are needed. The purpose of this paper is to describe the implementation and assessment of 4 strategies designed to increase PA in Vietnam.Methods: Four strategies were used: i) introduction and evaluation of an education and training program on the Swedish method of Physical Activity on Prescription(PAP) among health care professionals, ii) translation of the PAP evidence-based handbook, Physical Activity in the Prevention and Treatment of Disease(called FYSS in Swedish) into Vietnamese, iii) launch of a mass-media campaign to promote PA, and iv)advocacy to support development of PA guidelines in Vietnam.Results: The evaluation indicated that the participating health care professionals had a positive attitude to PAP. However, they also reported uncertainty in prescribing PA. FYSS was translated and disseminated successfully to health care professionals. A mass-media campaign identified the beneficial effects of PA to health care professionals, journalists, policy makers, and the public. Last, the process of developing national guidelines on PA was initiated.Conclusion: This project led to enhanced awareness and appreciation of PA in the prevention and treatment of NCDs among health care professionals as well as initiation of national PA guidelines. Important lessons also were learned in the presentation of PAP, which will be considered when designing similar projects in the future.
文摘Background: Patients and clinicians report pain and fatigue as key outcome measures in rheumatoid arthritis. Fatigue and pain are a major concern to patients. Aim: The objective of this study was to examine fatigue and pain in adult patients with rheumatoid arthritis (RA) and to investigate the association between pain and fatigue with body awareness, demographic, disease-related, emotional and psychosocial factors. Method: Data were collected from a sample of patients with RA (n = 120) recruited from a Rheumatology clinic in a large university hospital in Stockholm, Sweden. Eligible for inclusion were patients between 20 -80 years of age and with a confirmed diagnosis of RA. Fatigue was measured using the Multidimensional Assessment of Fatigue (MAF) scale, while the Visual Analogue Scale (VAS) was used to assess components of pain. A multiple stepwise regression analysis was performed to evaluate factors related to fatigue and pain. In the first step a univariate analysis of variance (ANOVA) was used for all relevant independent factors. In the next step backwards stepwise regression was applied. Result: Fatigue was significantly associated with the Disease Activity Score 28-joints (DAS 28) (p = 0.049), the Body Awareness Questionnaire (BAQ) (p = 0.006), the Positive Affect (PA) scale (p = 0.008) and no smoking (p = 0.021). Pain was significantly associated with the EuroQol EQ-5D (p = 0.008) and the DAS 28 (p = 0.001). The adjusted R-square was 28.6% for fatigue and 50.0% for pain. Conclusion: This study clearly demonstrates that fatigue and pain in patients with RA appear to be associated with disease-related factors. Furthermore, fatigue was related to body awareness and emotional factors, and pain was related to health related quality of life.
文摘Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arrived refugees. With the aim of paying attention to such symptoms, a revised culturally-tailored clinical health promotion model developed at Harvard Program in Refugee Trauma was used for invited groups of new-coming adult refugees in a town south of the Swedish capital. Methods: A coordinator administered the five-weekly sessions, 2 hours/week, with a professional interpreter. It covered major topics from Western and Arabic worldviews: 1) introduction;2) health care: organisation and access to;3) exercises;4) stress management and coping, 5) medical doctor-patient communication. Each topic was led by a nurse, a physiotherapist, a psychologist and a physician with experience of encounters with this target group in health care. Data cover results from 70 participants attending six groups;39 participants with pre-course findings and, post-course and six-month follow-ups. There were no significant differences in background factors between the participants and the drop-outs. Results: Participants’ perceptions of their health, measured by EQ-5D, changed positively over time, above all immediately after the course, with no significant differences between the two follow-ups. In the follow-ups, female participants perceived their health as significantly worse than males. Qualitative data at the six-month follow-up assessed the course as useful but expressed a wish to continue a similar course with a focus on post- migration stress. Conclusion: The results sup- port earlier findings. A course, administered to a small group in a dialogue setting, has value for the participants’ empowerment and perception of health. It is recommended that reception be more adapted to coping of post-migration stress of new-coming refugees. Practical Implications: The results have implications for education in clinical health promotion, intercultural communication and inter-professional collaboration in refugee reception.
文摘Background: Correlations between CRP and serum lipids are weak, and there are conflicting and incomplete results in the literature. The aim of the present study was to clarify the strength and independence of relationships between CRP and serum lipids in outpatients. Methods: Inclusion criteria were outpatients where all the following analyses were requested in clinical routine: high sensitivity CRP, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, ApoB, ApoA-1 and Lp(a). Data for patients meeting the above criteria during a period of six years (2004-2010) were copied from Aleris Medilab’s Laboratory Information System to the software Statistica. Basic statistics and correlations were calculated for 2771 patients. In patients with two (n = 959) or more sampling times changes over time were calculated. The study was a quality assurance project without access to patient files. Results: Median age was 59 years and median serum CRP concentration was 1.5 mg/L. The strongest correlations (Spearman R) were seen between CRP and triglycerides (0.25), ApoB/ApoA-1 ratio (0.21) and HDL-cholesterol (−0.18). Stepwise regression analysis showed that ApoB, total cholesterol, log triglycerides and log Lp(a) together explained 8% of the variation in log CRP. Unfavourable time trends for CRP and triglycerides counteracted a significant decrease in LDL-cholesterol and total cholesterol. Conclusion: In a large cohort of outpatients CRP showed stronger correlation with triglycerides and ApoB/ApoA-1 ratio than with LDL-cholesterol and Lp(a). LDL-cholesterol concentrations changed favorably over time whereas CRP and triglycerides did not.
基金supported by The Swedish Associa-tion of Local Authorities and Regions,Center for eHealth(CeHis)in Sweden.
文摘Studies aimed to capture the effects of IT-innovations in health and social care have shown that there is a gap between expected and factual outcomes. Many decision makers feel the need to articulate an ideal end-state for their organiza-tions. Striking the balance between novelty and believability of such an ideal end-state is often tricky and they become neither satisfied with the ideal not the visioning. In this study, we explore the contribution of IT-innovations to health and social care. The results showed that coherence between context and IT-innovation is important to capture effects and outcomes. Being coherent rather than visionary contributes to identify where you are, as an organization, and to capture effects and outcomes that “make sense” in the context in question. The paper makes an exposition from the model building, algorithm design to performance analysis and contributes to the academic prosperity in Intelligent In-formation Management The knowledge generated is expected to provide input when identifying goals that IT-investments are supposed to achieve.
基金The Erling-Persson Family Foundation the Signhild Engkvist Foundation.
文摘Daily life close to death involves physical, psychological, and social strain, exposing patients and their family members to major transitions affecting relational patterns and identity. For the individual family member, this often means sharing life with a changing person in a changing relationship, disrupting both individual identity and family identity. Our aim was to deepen the understanding of individual experiences that are important in constructing family identity close to death at home. We performed a secondary analysis of qualitative data collected through 40 interviews with persons with life-threatening illness and the family members who shared everyday life with them. The analysis resulted in interpretive descriptions which provided three patterns important for creating family identity, which we here call “we-ness” close to death. The patterns were: being an existential person, being an extension of the other, and being together in existential loneliness. Together, these three patterns seemed to play a part in the construction of family identity;we-ness, close to death. One important finding was the tension between the search for togetherness in “we-ness” while dealing with an existential loneliness, which seemed to capture an essential aspect of being a family of which one member is dying.
文摘Due to globalization, there is a need for nurses with skills and competence in providing safe, competent and culturally appropriate care. The aim of the study was to investigate whether International Study Experiences (ISE) in other countries during basic nursing education had an impact on newly graduated nurses as regards to self-reported competence. Moreover, a second aim was to explore what background factors that facilitated or constituted a hindrance for nursing students to choose to conduct part of their basic nursing education abroad. At 11 Universities/University Colleges (henceforth called Higher Education Institutions [HEIs]) in Sweden, 565 nursing students responded to the Nurse Professional Competence (NPC) Scale. Students with ISE rated their competence significantly higher on three NPC competence areas—“Legislation in nursing and safety planning”, “Leadership and development of nursing” and “Education and supervision of staff/students”. Background factors that significantly seemed to enhance ISE were living alone, not having children or other commitments in relation to family, international focus at the HEI and previous international experience. Lack of financial means was reported to prevent students from choosing ISE. The study implies that several background factors are of importance whether students choose ISE or not. ISE during basic nursing education might result in better self-reported competence in leading and developing nursing care, including education of future nurses, and in providing safe care.
文摘The recognition of the importance of leadership education and training has come late to medicine,especially aca demic medicine.Long adopted by military academies and Master of Business Administration programs of all types,leadership training in medicine has instead reflected a“just in time”approach.Academic faculty are often appointed to leadership roles having had little to no formal training in leadership,and they often have never considered themselves as leaders.The time has come to recognize that leadership is a core pillar of medicine,including subspecialty medicine.
文摘This paper presents a qualitative study of immigrant Chinese teachers’professional identity and beliefs about the teacher-student relationship in an intercultural context.Theoretically,this study takes its departure from a sociocultural perspective on understanding professional identity.The empirical analysis in the study drew mainly upon ethnographic interviews with a group of Chinese language teachers in Denmark concerning their life experiences,perceptions,and beliefs.The results of this study suggest that teachers’beliefs about their roles as teachers and about student-teacher relationships are shaped by both their prior experiences and backgrounds and the current social and cultural contexts in which they are situated.Changes of context(e.g.,from China to Denmark)often lead to a transformation of their professional identity and beliefs.Being a teacher in an intercultural context often exposes them to the confrontation of diverse challenges and dilemmas.On one hand,teachers in this study generally experienced a transformation from being a moral role model,subject expert,authority and parental role to being a learning facilitator and culture worker.On the other hand,they developed diverse individualized coping strategies to handle student-teacher interactions and other aspects of teachers’professional identity.
