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  • 1.
    Andersson, John
    et al.
    Göteborgs Universitet, Scandinavian Surgical Outcomes Research Group, Department of Surgery, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy.
    Abis, G
    Alingsås Hospital, Department of Surgery.
    Gellerstedt, Martin
    University West, Department of Economics and IT.
    Angenete, Eva
    Göteborgs Universitet, Scandinavian Surgical Outcomes Research Group, Department of Surgery, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy.
    Angerås, Ulf
    Göteborgs Universitet, Scandinavian Surgical Outcomes Research Group, Department of Surgery, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy.
    Cuesta, M A
    VU University Medical Centre, Department of Surgery, Amsterdam.
    Jess, P
    Roskilde Hospital, Department of Surgery, Roskilde, Denmark.
    Rosenberg, Jakob
    Copenhagen University, Department of Surgery, Herlev Hospital, Copenhagen, Denmark.
    Bonjer, H J
    VU University Medical Centre, Department of Surgery, Amsterdam.
    Haglind, Eva
    Göteborgs Universitet, Scandinavian Surgical Outcomes Research Group, Department of Surgery, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy.
    Patient-reported genitourinary dysfunction after laparoscopic and open rectal cancer surgery in a randomized trial (COLOR II).2014In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, no 10, p. 1272-1279Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This article reports on patient-reported sexual dysfunction and micturition symptoms following a randomized trial of laparoscopic and open surgery for rectal cancer.

    METHODS: Patients in the COLOR II randomized trial, comparing laparoscopic and open surgery for rectal cancer, completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CR38 questionnaire before surgery, and after 4 weeks, 6, 12 and 24 months. Adjusted mean differences on a 100-point scale were calculated using changes from baseline value at the various time points in the domains of sexual functioning, sexual enjoyment, male and female sexual problems, and micturition symptoms.

    RESULTS: Of 617 randomized patients, 385 completed this phase of the trial. Their mean age was 67·1 years. Surgery caused an anticipated reduction in genitourinary function after 4 weeks, with no significant differences between laparoscopic and open approaches. An improvement in sexual dysfunction was seen in the first year, but some male sexual problems persisted. Before operation 64·5 per cent of men in the laparoscopic group and 55·6 per cent in the open group reported some degree of erectile dysfunction. This increased to 81·1 and 80·5 per cent respectively 4 weeks after surgery, and 76·3 versus 75·5 per cent at 12 months, with no significant differences between groups. Micturition symptoms were less affected than sexual function and gradually improved to preoperative levels by 6 months. Adjusting for confounders, including radiotherapy, did not change these results.

    CONCLUSION: Sexual dysfunction is common in patients with rectal cancer, and treatment (including surgery) increases the proportion of patients affected. A laparoscopic approach does not change this.

  • 2.
    Andersson, John
    et al.
    Sahlgrenska University Hospital/Östra,Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery, .
    Angenete, Eva
    Sahlgrenska University Hospital/Östra,Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery, .
    Gellerstedt, Martin
    Angerås, Ulf
    Sahlgrenska University Hospital/Östra,Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery.
    Jess, Peter
    Roskilde Hospital, Department of Surgery, Roskilde.
    Rosenberg, Jacob
    Herlev Hospital, University of Copenhagen, Department of Surgery.
    Fürst, A
    Caritas Clinic St Josef, Department of Surgery, Regensburg, Germany,.
    Bonjer, J
    VUmc University Medical Center, Amsterdam.
    Haglind, Eva
    Sahlgrenska University Hospital/Östra,Scandinavian Surgical Outcomes Research Group (SSORG), Department of Surgery, .
    Health-related quality of life after laparoscopic and open surgery for rectal cancer in a randomized trial2013In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 100, no 07, p. 941-949Article in journal (Refereed)
  • 3.
    Andersson, Ulf
    et al.
    University West, Department of Economics and IT, Division of Media and Design.
    Arvemo, Tobias
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Can Measurements of Online Behavior Predict Course Performance?2016In: Proceedings of the 7th International Multi-Conference on Complexity, Informatics and Cybernetics: IMCIC 2016 and the 7th International Multi-Conference onSociety and Information Technologies: ICSIT 2016: Volume II (Post-Conference Edition), 2016, p. 4-9Conference paper (Refereed)
    Abstract [en]

    This article is a pilot study on the relationship between performance in online classes and behavior in online discussion forums. Measuring student activity on the discussion forum, the collected data is then analyzed and mapped to the performance of the students on the course. The student activity was dividedinto a number of parameters, and during the study these parameters were compared to the performance of the students.The significance of each parameter was also analyzed through a Kruskall-Wallis-test Overall there was a strong tendency thatstudents with more activity and engagement received higher grades. This is in the future useful for developing some kind of monitoring to identify and support students on the verge of failing the course.

  • 4.
    Andersson, Ulf
    et al.
    University West, Department of Economics and IT, Division of Media and Design.
    Arvemo, Tobias
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    How well can completion of online courses be predicted using binary logistic regression?2016In: Proceedings of IRIS39, Information Systems Research Seminar in Scandinavia, Ljungskile, August 7-10, 2016 / [ed] Pareto, Lena, Svensson, Lars, Lundin, Johan, Lundh Snis, Ulrika Lundh Snis, 2016, p. 1-12Conference paper (Other academic)
    Abstract [en]

    This article uses binary logistic regression to create models for predicting course performance. The data used is the data-trail left by students activities on a discussion forum while attending an online course. The purpose of the study is to evalute how well models based on binary logistic regression can be used to predict course completion.Three sets of data was used for this. One set collected at the end of the course, one collected after 75% of the course and one set collected after half the course. The result of the study says that it's possible to design models with an accuracy of between 70% and 80% using these methods, regardless of what time is used.

  • 5.
    Angenete, Eva
    et al.
    Sahlgrenska Academy at University of Gothenburg, Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg.
    Angerås, U.
    Sahlgrenska Academy at University of Gothenburg, Department of Surgery, Institute of Clinical Sciences, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
    Börjesson, M.
    Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Ekelund, J.
    Sahlgrenska Academy at University of Gothenburg, Department of Surgery, Institute of Clinical Sciences, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Thorsteinsdottir, T.
    University of Iceland, Faculty of Nursing, School of Health Sciences, Reykjavik, Iceland.
    Steineck, Gunnar
    Sahlgrenska Academy at the University of Gothenburg, Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, Gothenburg, Sweden.
    Haglind, Eva
    Sahlgrenska Academy at University of Gothenburg, Department of Surgery, Institute of Clinical Sciences, SSORG, Sahlgrenska University Hospital/Östra, SE-416 85, Gothenburg, Sweden.
    Physical activity before radical prostatectomy reduces sick leave after surgery: results from a prospective, non-randomized controlled clinical trial (LAPPRO)2016In: BMC Urology, ISSN 1471-2490, E-ISSN 1471-2490, Vol. 16, no 1, p. 50-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Studies have reported that early physical rehabilitation after surgical procedures is associated with improved outcome measured as shorter hospital stay and enhanced recovery. The aim of this study was to explore the relationship between the preoperative physical activity level and subsequent postoperative complications, sick-leave and hospital stay after radical prostatectomy for prostate cancer in the setting of the LAPPRO trial (LAParoscopic Prostatectomy Robot Open). METHODS: LAPPRO is a prospective controlled trial, comparing robot-assisted laparoscopic and open surgery for localized prostate cancer between 2008 and 2011. 1569 patients aged 64 or less with an occupation were included in this sub-study. The Gleason score was <7 in 52 % of the patients. Demographics and the level of self-assessed preoperative physical activity, length of hospital stay, complications, quality of life, recovery and sick-leave were extracted from clinical record forms and questionnaires. Multivariable logistic regression, with log-link and logit-link functions, was used to adjust for potential confounding variables. RESULTS: The patients were divided into four groups based on their level of activity. As the group with lowest engagement of physical activity was found to be significantly different in base line characteristics from the other groups they were excluded from further analysis. Among patients that were physically active preoperativelly (n = 1467) there was no significant difference between the physical activity-groups regarding hospital stay, recovery or complications. However, in the group with the highest self-assessed level of physical activity, 5-7 times per week, 13 % required no sick leave, compared to 6.3 % in the group with a physical activity level of 1-2 times per week only (p < 0.0001). CONCLUSIONS: In our study of med operated with radical prostatectomy, a high level of physical activity preoperatively was associated with reduced need for sick leave after radical prostatectomy compared to men with lower physical activity. TRIAL REGISTRATION: The trial is registered at the ISCRTN register. ISRCTN06393679 .

  • 6.
    Angenete, Eva
    et al.
    University of Gothenburg, Department of Surgery, Sahlgrenska University Hospital/Östra.
    Jacobsson, Anders
    Swedish National Board of Health and Welfare, Stockholm.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Haglind, Eva
    University of Gothenburg, Department of Surgery, Sahlgrenska University Hospital/Östra.
    Laparoscopy on the Risk of Small-Bowel Obstruction: A Population-Based Register Study2012In: Archives of surgery (Chicago. 1960), ISSN 0004-0010, E-ISSN 1538-3644, ISSN 0004-0010, Vol. 147, no 4, p. 359-365Article in journal (Refereed)
    Abstract [en]

    Objective  To investigate the incidence and risk factors for small-bowel obstruction (SBO) after certain surgical procedures. Design A population-based retrospective register study. Setting Small-bowel obstruction causes considerable patient suffering. Risk factors for SBO have been identified, but the effect of surgical technique (open vs laparoscopic) on the incidence of SBO has not been fully elucidated. Patients The Inpatient Register held by the Swedish National Board of Health and Welfare was used. The hospital discharge diagnoses and registered performed surgical procedures identified data for cholecystectomy, hysterectomy, salpingo-oophorectomy, bowel resection, anterior resection, abdominoperineal resection, rectopexy, appendectomy, and bariatric surgery performed from January 1, 2002, through December 31, 2004. Data on demographic characteristics, comorbidity, previous abdominal surgery, and death were collected. Main Outcome Measures Episodes of hospital stay and surgery for SBO within 5 years after the index surgery. Results A total of 108 141 patients were included. The incidence of SBO ranged from 0.4% to 13.9%. Multivariate analysis revealed age, previous surgery, comorbidity, and surgical technique to be risk factors for SBO. Laparoscopy exceeded other risk factors in reduction of the risk of SBO for most of the surgical procedures.

    Conclusions Open surgery seems to increase the risk of SBO at least 4 times compared with laparoscopy for most of the abdominal surgical procedures studied. Other factors such as age, previous abdominal surgery, and comorbidity are also of importance

  • 7.
    Axelsson, Christer
    et al.
    University of Borås, Faculty of Caring Science,Working Life and Social Welfare,The Prehospital Research Centre of Western Sweden,Borås,Sweden.
    Herlitz, Johan
    University of Borås, Faculty of Caring Science,Working Life and Social Welfare,The Prehospital Research Centre of Western Sweden,Borås,Sweden.
    Karlsson, Anders
    Ambulance Service Sothern,Älvsborg Hospital,Borås,Sweden..
    Sjöberg, Henrik
    Ambulance Service Sothern,Älvsborg Hospital,Borås,Sweden..
    Jiménez-Herrera, Maria
    Nursing Department,Universitat Rovira I Virgili,Tarragona,Spain.
    Bång, Angela
    University of Borås, Faculty of Caring Science,Working Life and Social Welfare,The Prehospital Research Centre of Western Sweden,Borås,Sweden.
    Jonsson, Anders
    University of Borås, Faculty of Caring Science,Working Life and Social Welfare,The Prehospital Research Centre of Western Sweden,Borås,Sweden.
    Bremer, Anders
    University of Borås, Faculty of Caring Science,Working Life and Social Welfare,The Prehospital Research Centre of Western Sweden,Borås,Sweden.
    Andersson, Henrik
    University of Borås, Faculty of Caring Science,Working Life and Social Welfare,The Prehospital Research Centre of Western Sweden,Borås,Sweden.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Ljungström, Lars
    Infektion Disease Department,Skaraborg Hospital,Skövde,Sweden.
    The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting.2016In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 31, no 3, p. 272-277Article in journal (Refereed)
    Abstract [en]

    Purpose There is a lack of knowledge about the early phase of severe infection. This report describes the early chain of care in bacteraemia as follows: (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start of intravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter. Basic Procedures All patients in the Municipality of Gothenburg (Sweden) with a positive blood culture, when assessed at the Laboratory of Bacteriology in the Municipality of Gothenburg, from February 1 through April 30, 2012 took part in the survey. Main Findings/Results In all, 696 patients fulfilled the inclusion criteria. Their mean age was 76 years and 52% were men. Of all patients, 308 (44%) had been in contact with the EMS and/or the emergency department (ED). Of these 308 patients, 232 (75%) were transported by the EMS and 188 (61%) had "true pathogens" in blood cultures. Patients who were transported by the EMS were older, included more men, and suffered from more severe symptoms and signs. The EMS nurse suspected sepsis in only six percent of the cases. These patients had a delay from arrival at hospital until the start of antibiotics of one hour and 19 minutes versus three hours and 21 minutes among the remaining patients (P =.0006). The corresponding figures for cases with "true pathogens" were one hour and 19 minutes versus three hours and 15 minutes (P =.009).

    CONCLUSION: Among patients with bacteraemia, 75% used the EMS, and these patients were older, included more men, and suffered from more severe symptoms and signs. The EMS nurse suspected sepsis in six percent of cases. Regardless of whether or not patients with true pathogens were isolated, a suspicion of sepsis by the EMS clinician at the scene was associated with a shorter delay to the start of antibiotic treatment. Axelsson C , Herlitz J , Karlsson A , Sjöberg H , Jiménez-Herrera M , Bång A , Jonsson A , Bremer A , Andersson H , Gellerstedt M , Ljungström L . The early chain of care in patients with bacteraemia with the emphasis on the prehospital setting. Prehosp Disaster Med. 2016;31(3):1-6.

  • 8.
    Bernhard, Irène
    et al.
    University West, Department of Economics and IT, Division of Media and Design.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Gråsjö, Urban
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    The Role of Local E-government for Satisfied Citizens: Towards Sustainable Development?2015In: Uddevalla Symposium 2015. Regional Development in an International Context. Regional, National, Cross Border and International Factors for Growth and Development: Revised papers presented at the 18th Uddevalla Symposium, 11-13 June, Sönderborg, Denmark / [ed] Iréne Bernhard, Trollhättan: University West , 2015, p. 141-153Conference paper (Refereed)
    Abstract [en]

    The objective of this paper is to study the role of local e-government regarding citizens view of municipality service, information and accessibility to municipality service. The main hypothesis was that municipalities with high degree of pro-activity regarding e-government are municipalities with high degree of satisfied citizens. Satisfaction among citizens was studied by using a national survey which is performed twice ever year. The survey normally includes roughly 130 municipalities out of the 290 municipalities in Sweden. The number of randomly selected individuals per municipality is usually 600 in smaller municipalities and 1200 in larger municipalities. In this study we focus on the following dimensions: Overall satisfaction, Satisfaction with response and accessibility and Satisfaction with influence and confidence.The results implies that e-government and satisfied citizens are correlated. The correlations between the e-variables: e-proactivity, e-strategy, e-information/transparency, e-interaction were all significantly correlated to the satisfaction indices. The correlations were generally of medium strength, i.e. around 0.2-0.4. There were no significant correlations between in real life interactions, strategy for democracy and the satisfaction indices.

  • 9.
    Bernhard, Iréne
    et al.
    University West, School of Business, Economics and IT, Division of Media and Design.
    Lundh Snis, Ulrika
    University West, School of Business, Economics and IT, Divison of Informatics.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics.
    Svensson, Lars
    University West, School of Business, Economics and IT, Divison of Informatics.
    Collaboration Model for Work-Integrated Learning in Higher Education 3rd Cycle2018In: INTED 2018: Proceedings / [ed] L. Gómez Chova, A. López Martínez, I. Candel Torres, 2018, Vol. 1, p. 5509-5515Conference paper (Refereed)
    Abstract [en]

    Universities need to constantly accommodate new forms of collaboration with society. Interaction with and impacts on society and practice are of crucial importance. University West (UW) in Sweden has a profile area in work-integrated learning (WIL), which generally aims to address issues on integrating theory and practice in a coherent and sustainable way. In this paper we base our arguments on a research education (3rd cycle) in informatics with specialization in work-integrated learning. The aim with the paper is to evaluate UW’s research education and research environment from a WIL perspective. We will adopt an informing science model in order to conduct a current state analysis, in which we identify and visualize collaboration activities within and between the research education/environment and the UWs key stakeholders; society/practices, research community and PhD students. Concrete implications show how collaboration and informing flows are connected and how they can be improved. General reflections are given on the model as a useful means for quality development and assurance beyond learning outcomes, including aspects of collaboration and interaction that can be regarded as paths of societal and practical impacts.

  • 10.
    Bernhardsson, Lennarth
    et al.
    University West, School of Business, Economics and IT, Division of Media and Design.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics.
    Svensson, Lars
    University West, School of Business, Economics and IT, Divison of Informatics.
    An eye for an I: a framework with focus on the integration of work and learning in higher education2018In: INTED 2018: Proceedings, 2018Conference paper (Refereed)
    Abstract [en]

    Higher education plays a new role in the society and the highly specialized labor market, and higher education institutes are expected to interact with and contribute to the surrounding society. University West in Sweden is since 2002 commissioned by the government to develop the pedagogical strategy called work-integrated learning (WIL) and WIL is the “trade mark” for the University. This means that pedagogical methods are based on WIL and that the faculty is working on further refinement and development in order to maximize the pedagogical gain offered by using the synergy between theory and practice.

    Work-integrated-learning activities are often implemented in a course as methods aligned to the learning outcomes regarding knowledge in the specific subject. However, another perspective is that the capacity to reflect and understand the integration of theory and practice could actually be a learning outcome in itself. From this perspective, it is vital to theoretically frame and formulate stringent learnings outcomes. To have a clear framework for this is important for curriculum design, course delivery and assessment, as well.

    In a self-evaluation conducted at the University, including focus groups with, both undergraduate and post graduate students, teachers, researchers and managers, a call for a framework has been expressed.

    In this conceptual paper, we propose a framework to support, design, delivery and assessment of work-integrated-learning progression, i.e. understanding of the integration between theory and practice. This framework is inspired by theories regarding constructive alignment [3], the SOLO taxonomy, agentic learning, SAMR-model and the RAT-model. RAT means Replacement, Amplifying and Replacement [4] while SAMR is the acronym for Substitution, Augmentation, Modification and Redefinition [5]. Our WIL-4U has also been inspired by SOLO taxonomy [6]

    In short, the framework for progression includes a progression from being descriptive regarding the observed practice, skills for comparing and evaluating practices, to be agentic in how theory and practice could be used in synergy for evolving, new theory and development of practice. Thereby, putting on eye on the “i” in WiL.

    Ultimately such a framework could support the progression of “WiL-understanding” through an educational program, and that students after graduation have developed readiness for “life-long-learning” and could be agentic at workplaces in the sense that practice and theory are used in synergy.

  • 11.
    Bernhardsson, Lennarth
    et al.
    University West, School of Business, Economics and IT, Division of Media and Design.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics.
    Winman, Thomas
    University West, School of Business, Economics and IT, Divison of Informatics.
    Work-integrated-learning: So what?: A framework for describing the level of integration between work and learning2017In: ICERI2017 Proceedings, 2017, p. 443-451Conference paper (Refereed)
    Abstract [en]

    The knowledge society of today is characterized by a continuously ongoing technological development and digitalization that steadily calls for new competencies and transforms existing professions. For being able to provide up-to-date competence in a fast-changing labor market there is, perhaps more than ever, a need for extensive cooperation between Universities and surrounding society. A number of different models supporting the civic university has been established, e.g. “entrepreneurial university”, the triple-helix model and the increasingly popular adoption of “work-integrated learning” (WIL). 

    Work-integrated learning offer students authentic learning experiences and create synergy between theory and practice, e.g. by cooperative educational programs, internship, sandwich programs and case based teaching. Beyond the pedagogical benefits with experiential learning, WIL also supports the transfer between higher education and work, i.e. increases readiness, employability and also encourage a more agentic engagement. Furthermore, research results show that WIL-students have career benefits regarding salary in early career and job advancement. Even though, WIL and similar strategies for combining theory and practice seems to have promising pedagogical and career advantages, the theoretical underpinning is still underdeveloped. For instance, the methodology for how learning is promoted and which role external partners could play is vague. 

    At University West with more than 25 years’ experience of WIL a holistic approach to WIL have been adopted and WIL permeates all the Universities activities: education, research and extensive collaboration with the surrounding society. Over the years our efforts have been formalized and a taxonomy for will-activities have been developed. In sum, we know that WIL have promising potential, and we know what to do. But, in a recently performed study at this University, based on focus groups interviews and consolidation of our experiences we identified that even if the question “what?” is responded to, there is an important sub-question to be addressed, namely: “so what?”. When adopting different WIL activities, both small and large scale activities, e.g. a guest lecture or an internship, it is reasonable to reflect on whether these activities are used in an optimal way? What kind of impact does the WIL-activity imply? What could be achieved by successful integration between theory and practice? Could it be visualized?

    Inspired by models used for integrating technique in education (RAT, SAMR and TPCK-models), we have developed a framework for the progression of work-integrated learning in education. The framework is in a sense a model for “Wil-value”. This framework could be used on different levels and in different context: in a single course, educational program, in research projects, cooperation with surrounding society, mentorship and on partner workplaces.

  • 12.
    Bernhardsson, Lennarth
    et al.
    University West, Department of Economics and IT, Division of Media and Design.
    Vallo Hult, Helena
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Combining pedagogical strategies and ICT support for fostering the digitalized agentic learner2017In: INTED2017 Proceedings, 2017, p. 1433-1441Conference paper (Refereed)
    Abstract [en]

    Higher education is facing exceptional challenges due to an increased complexity on the labour market. The work life of today is highly specialized and demands continuous education, i.e. lifelong learning. Higher education must focus on developing competencies for work life, beyond traditional theoretical knowledge [1]. To cater for these demands, higher education must adopt more application-oriented and trans-disciplinary research [2]. Moreover, colleges and universities could more systematically take responsibility for career development and adjust curricula for both traditional and non-traditional students [3]. A crucial question to address is how higher education could foster a student to become a “lifelong learner”? From a pedagogical perspective, it is of course vital to teach a student how to learn [4], aiming at achieving the skill to become a self-directed learner. Interestingly, it is argued that the qualities for being a proactive and agentic learner in higher education are the very same abilities required for effective professional practice [5]. We need to use educational strategies, e.g. work-integrated learning (WiL), as a part of the preparation of becoming an agentic learner, that permit them to successfully negotiate, engage and learn from what they are afforded, for both personal and professional outcomes [6]. Furthermore, we need to adopt important key factors that support fostering agentic learners [7]. 

    In parallel to pedagogical strategies and key factors, Information and Communication Technology (ICT) could play an important role for continuous learning [8-10]. Research shows that over the recent years, social media has been pointed out as a tool, not only for external communication, but also for informal learning within organizations [11-14]. 

    In this paper we wish to suggest a combination where important pedagogical strategies are combined with ICT-support. Moreover, we wish to suggest a strategy for how this combination could be practiced in higher education, making the transfer to work life smoother. 

    We acknowledge that students of today most often have good knowledge of the use of various digital tools such as Facebook, Youtube etc. This is however often constrained to the use of various platforms and tools for entertainment and social contacts. How these tools can be used for learning portfolios, both during their studies and for lifelong learning, is less known and used. We suggest that students during their education choose digital tools based on individual preferences and build a personal learning environment (PLE) [15]. The PLE should include “open tools”, such tools are available outside closed systems within organizations, in order to be useful also after graduation. The student has the possible to develop and re-use knowledge of tools and platforms to work in the new context, working life. However, the use of a PLE will not in itself do the trick. 

    Portfolio is one of many tools to assess learning. When the digital development progressed and applications on the Internet has expanded, the portfolio characteristics can be changed to the e-portfolio [16]. We advocate that both teachers and student need support for developing pedagogical strategies that optimize the use of ICT and aims at fostering agentic learners. We suggest that an e-portfolio may constitute such a joint support. 

    In this paper we will show that an e-portfolio and PLE can support important factors for fostering agentic learners who in an efficient way take advantage of modern ICT. In sum, we suggest an approach for fostering “digitalized agentic learners”. 

  • 13.
    Emilsson, Maria
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Skyvell Nilsson, Maria
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Berndtsson, Ina
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Johansson, Kristina
    University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences.
    Pennbrant, Sandra
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Pedagogical challenges in nurse education: a case study focusing on the completion rate in theoretical education at a Swedish University2014In: Empirical Research in Vocational Education and Training, ISSN 1877-6345, Vol. 6, no 11, p. 14 s.-Article in journal (Refereed)
    Abstract [en]

    Background: The purpose of this survey was to relate completion rate and results on national clinical final examinations to student’s admission background and examination results for nursing and medical courses.

    Methods: The research data were based on a quantitative case study, with 286 nursing students, using statistical analysis.

    Results: The programme's overall completion rate was 76%, i.e. almost one out of four students did not complete the programme. The higher students' upper secondary/high school grades, the fewer attempts they needed to pass the nursing and medical courses exams (p<0.001). The average examination attempts needed to pass courses in medical science was significantly greater than the number needed to pass courses in nursing science (p<0.001). In a multivariate analysis both upper secondary/high school grades and average examination attempts needed to pass were significant predictors for national clinical final examination score.

    Conclusion: In sum, upper secondary/high school grades and examination attempts needed, especially for courses in medical science, may be regarded as important indicators of achieved knowledge and skills which are tested in the national final examination.

  • 14.
    Emilsson, Maria
    et al.
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics.
    Skyvell Nilsson, Maria
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Johansson, Kristina
    University West, Department of Social and Behavioural Studies, Division of Psychology, Pedagogy and Sociology.
    Berndtsson, Ina
    University West, Department of Health Sciences, Section for nursing - graduate level.
    Pennbrant, Sandra
    University West, Department of Health Sciences, Section for nursing - undergraduate level.
    Pedagogical challenges in nurse education: A Case Study Focusing on the Completion Rate in Theoretical Education at a Swedish University2014Conference paper (Refereed)
  • 15.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Engineering.
    A Course Designed for "Non-Traditional Students": Who that Might Be?2015In: Proceedings of the 6th International Multi-Conference onComplexity, Informatics and Cybernetics: IMCIC 2015: and the 6th International Multi-Conference on Society and Information Technologies: ICSIT 2015 / [ed] Callaos, N., Hsing-Wei, C., Sánchez, B. & Tremante, A., International Institute of Informatics and Systemics, 2015, Vol. II, p. 177-181Conference paper (Refereed)
    Abstract [en]

    The digital era and online education offers new possibilities for distributing higher education to non-traditional students, for instance full-working participants. This article describes experiences based on six years’ experience from an online course designed for non-traditional students. An on-line course in statistics, designed for attracting non-traditional students is used as a case. It is shown that the characteristics of the participants are completely different in comparison to traditional campus students. These differences may be rewarding for teachers and may offer interesting pedagogical opportunities.

  • 16.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    M12: Medicinsk statistik 2004 (ed. 1)Book (Other academic)
  • 17.
    Gellerstedt, Martin
    University West, Department of Economics and Informatics, Divison of Informatics.
    Partitioning reference values of several Gaussian subpopulations with unequal prevalence - A procedure with computer program support2006In: Clinical Chemistry and Laboratory Medicine, Vol. 44, no 10, p. 1258-1263Article in journal (Refereed)
    Abstract [en]

    Background: To be able to interpret laboratory values, it is essential to develop population-based reference intervals. A crucial consideration is whether a reference interval should be divided into subpopulations or not, so-called partitioning. There are established methods for deciding whether partitioning should be done or not. However, these methods are only applicable when partitioning into two subpopulations is considered. The primary aim of this study was to suggest a procedure that was also valid for several subpopulations. The method assumes that these subpopulations are Gaussian. Furthermore, a secondary aim was to provide a tailor-made computer program to support calculations. Methods: The fundamental idea is to partition reference intervals if the proportions of the distributions of the subpopulations outside the combined reference limit deviate from the nominal value of 0.025. This is made possible by finding the combined reference interval using an equation solver algorithm. Results: It was found that an equation solver algorithm could easily identify the combined reference interval when combining two or more subpopulations, even if these subpopulations had unequal prevalences. It was also found that this could be done even if the ratio between samples does not reflect the ratio between prevalences. Using this algorithm, it was possible to study whether the proportion outside the combined reference limits in any of several subpopulations deviated from the nominal 0.025 by such a magnitude that partitioning was recommended. When similar figures to those found in earlier studies with other methods were tested, the procedure showed consistent results with these methods. The procedure was also found to be applicable when several subpopulations were considered. As a practical result of the study, a tailor-made computer program was developed and is now provided over the Internet. Conclusions: The suggested procedure could serve as an alternative or complement to existing methods. The procedure provides calculations of the combined reference interval, even if sample fractions do not reflect prevalence fractions. The important advantage with the suggested procedure is the generalisation to the situation when several Gaussian subpopulations, possibly with unequal prevalences, are considered. Finally, since a tailor-made computer program is provided, the procedure is simple to use. © 2006 by Walter de Gruyter.

  • 18.
    Gellerstedt, Martin
    University West, Department of Studies of Work, Economics and Health.
    Statistical issues: significantly important in medical research.2002In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 57, no 2, p. 76-82Article, review/survey (Other academic)
  • 19.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Statistiska metoder för kvalitetsutveckling1997 (ed. 1)Book (Other academic)
  • 20.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    The Digitalization of Health Care Paves the Way for Improved Quality of Life?2016In: Journal of Systemics, Cybernetics and Informatics, ISSN 1690-4524, E-ISSN 1690-4524, Vol. 14, no 5, p. 1-10Article in journal (Refereed)
    Abstract [en]

    The digitalization of health care is really a game changer for developing health care. This article gives an, overview, discuss opportunities and reflects on methodological issues in this new era. Important issues discussed include: Could digitalization offer the right chemistry between evidence based medicine and individualization of health care. Does Big Data imply long tail health care? How could patients be co-creators of health care? And, methodological pros and cons with different sources of "evidence".

  • 21.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Vad betyder referensintervallet för den enskilde individen?: Individens risk för falskt positiv2006In: Laboratoriet : Svenska laboratrisföreningens tidskrift, ISSN 0345-696X, no 5, p. 16-18Article in journal (Other (popular science, discussion, etc.))
  • 22.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Engineering.
    Work integrated learning and learning integrated work: a love story between academia and working life?2015In: The 21st International Conference on Information Systems Analysis and Synthesis: General Framework and Plenary, Keynote Speakers of the Spring 2015, 2015, Vol. 13 March, p. 5-Conference paper (Refereed)
    Abstract [en]

    Higher education is perhaps facing the most unprecedented challenges ever. Financial turbulence, high unemployment rates, demographical changes, technological development and increased demands for high competence certainly implies the importance of putting cooperation between academia and working life on top of the agenda.

    The aim with work integrated learning is to enhance learning and prepare for working life by letting knowledge from research go hand in hand with experience based knowledge. This is often discussed in the view of how working life could cross the border into academia. However, a challenge for higher education is to discuss how to cross the border in the opposite direction. How could academia support learning integrated work? How could we foster a new generation of professionals to become boundary crossers, reflective practitioners and be a part of a continuously improved community of practice?

  • 23.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Arvemo, Tobias
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Work-integrated learning with work-integrated learners2014In: Proceedings of the international conferences on educational technologies (ICEduTech 2014), 2014, p. 1-8Conference paper (Refereed)
  • 24.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Bengtsson, U
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Niggemann, B
    University Children’s Hospital Charité, Berlin, Germany.
    Methodological issues in the diagnostic work-up of food allergy: a real challenge.2007In: Journal of investigational allergology & clinical immunology, ISSN 1018-9068, E-ISSN 1698-0808, Vol. 17, no 6, p. 350-356Article in journal (Refereed)
    Abstract [en]

    The standard of reporting in diagnostic studies has generally been low. Fortunately, this issue has begun to be addressed in recent years through the discussion of important methodological issues in educational series, textbooks, and checklists. Double-blind, placebo-controlled, oral food challenges (DBPCFC) are considered to be the gold standard for diagnosis of food allergy. However, there is no consensus regarding how to interpret the outcome and how to define positive and negative provocations in DBPCFC. Furthermore, since most theories on the diagnosis of food allergy rely on the assumption that the DBPCFC has a high accuracy, this accuracy must be formally statistically evaluated. In this review, we discuss essential methodological issues for diagnostic accuracy studies in general and for oral food challenges in particular and discuss the importance of methodological issues as a guide for forthcoming studies of diagnostic procedures.

  • 25.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Bengtsson, U
    The Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergy,Sahlgrenska University Hospital, Gothenburg, Sweden.
    Niggemann, B
    Department of Pneumology and Immunology, University Children’s Hospital Charité, Berlin, Germany.
    Methodological issues in the methodological issues in the diagnostic work-up of food allergy: a real challenge2007In: Journal of investigational allergology & clinical immunology, ISSN 1018-9068, E-ISSN 1698-0808, Vol. 17, no 6, p. 350-356Article in journal (Refereed)
    Abstract [en]

    The standard of reporting in diagnostic studies has generally been low. Fortunately, this issue has begun to be addressed in recent years through the discussion of important methodological issues in educational series, textbooks, and checklists. Double-blind, placebocontrolled, oral food challenges (DBPCFC) are considered to be the gold standard for diagnosis of food allergy. However, there is no consensus regarding how to interpret the outcome and how to defi ne positive and negative provocations in DBPCFC. Furthermore, since most theories on the diagnosis of food allergy rely on the assumption that the DBPCFC has a high accuracy, this accuracy must be formally statistically evaluated. In this review, we discuss essential methodological issues for diagnostic accuracy studies in general and for oral food challenges in particular and discuss the importance of methodological issues as a guide for forthcoming studies of diagnostic procedures.

  • 26.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Bång, Angela
    University College of Borås, Prehospital Research Centre of Western Sweden.
    Andréasson, Emma
    University West.
    Johansson, Anna
    University West.
    Herlitz, Johan
    Sahlgrenska University Hospital,, The Prehospital Research Centre of Western Sweden, Institute of Medicine, Department of Molecular and Clinical Medicine,.
    Does sex influence the allocation of life support level by dispatchers in acute chest pain?2010In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 28, no 8, p. 922-7Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to evaluate (a) the differences between men and women in symptom profile, allocated life support level (LSL), and presence of acute myocardial infarction (AMI), life-threatening condition (LTC), or death and (b) whether a computer-based decision support system could improve the allocation of LSL. PATIENTS: All patients in Göteborg, Sweden, who called the dispatch center because of chest pain during 3 months (n = 503) were included in this study. METHODS: Age, sex, and symptom profile were background variables. Based on these, we studied allocation of LSL by the dispatchers and its relationship to AMI, LTC, and death. All evaluations were made from a sex perspective. Finally, we studied the potential benefit of using a statistical model for allocating LSL. RESULTS: The advanced life support level (ALSL) was used equally frequently for men and women. There was no difference in age or symptom profile between men and women in relation to allocation. However, the allocation of ALSL was predictive of AMI and LTC only in men. The sensitivity was far lower for women than for men. When a statistical model was used for allocation, the ALSL was predictive for both men and women. Using a separate model for men and women respectively, sensitivity increased, especially for women, and specificity was kept at the same level. CONCLUSION: This exploratory study indicates that women would benefit most from the allocation of LSL using a statistical model and computer-based decision support among patients who call for an ambulance because of acute chest pain. This needs further evaluation.

  • 27.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Bång, Angela
    Herlitz, Johan
    Could a computer based system including a prevalence function support emergency medical system and improve allocation of life support level?2006In: European Journal of Emerging Medicine, ISSN 0969-9546, Vol. 13, no 5, p. 290-294Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate whether a computer-based decision support system could be useful for the emergency medical system when identifying patients with acute myocardial infarction (AMI) or life-threatening conditions and thereby improve the allocation of life support level.

    Methods: Patients in the Municipality of Goteborg who dialled the dispatch centre due to chest pain during a period of 3 months. To analyse the relationship between patient characteristics (according to a case record form used during an interview) and the response variables (AMI or life-threatening condition), multivariate logistic regression was used. For each patient, the probability of AMI/life-threatening condition was estimated by the model. We used these probabilities retrospectively to allocate advanced life support or basic life support. This model allocation was then compared with the true allocation made by the dispatchers.

    Results: The sensitivity, that is, the percentage of AMI patients allocated to advanced life support, was 85.7% in relation to the true allocation made by the dispatchers. The corresponding sensitivity regarding allocation made by the model was 92.4% (P=0.17). The specificity was also slightly higher for the model allocation than the dispatcher allocation. Among the 15 patients with AMI who were allocated to basic life support by the dispatchers, nine died (eight during and one after hospitalization). Among the eight patients with AMI allocated to basic life support by the model, only one patient died (in hospital) (P=0.02).

    Conclusion: A computer-based decision support system including a prevalence function could be a valuable tool for allocating the level of life support. The case record form, however, used for the interview can be refined and a model based on a larger sample and confirmed in a prospective study is recommended.

  • 28.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Furberg, Bengt
    D¹²: diagnostik - en tolkningsfråga?2007Book (Other academic)
  • 29.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT.
    Gråsjö, Urban
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Operationalizing the performance of a tourism network: A case study of Network Limfjorden, Denmark2014In: The 23rd Nordic Symposium on Tourism and Hospitality Research: THE VALUES of TOURISM / [ed] Budeanu, Adriana; Möckel, Marie & Gyimóthy, Szilvia, 2014, p. 56-58Conference paper (Refereed)
    Abstract [en]

    Partnership arrangements in order to achieve sustainable economic growth is nowadays a more and more common feature of developing strategies in different sectors of modern society. This is also the case in the tourism sector, where value of tourism for destination development is highlighted. Many of these partnership arrangements are formalized through the concept of the "network". Although there are usually several aims, the declared purpose of collaboration in a network or partnership is almost always to create synergy or added value. The members of the network are realizing that they have a common goal, which cannot be reached if they act individually. Instead, if the members pool their resources and act together the probability to reach the goal increases. Sometimes situations arise when actors take advantage of what others give, but do not themselves contribute equally (network problems arise in the form of "free riders"). This can then create an attitude in the network where members are reluctant to communicate experience and information to other members and then the mutual exchange of experience that is so important for successful networks can be lost. Hence, it is important to acknowledge that a network beside cooperation also may include a competitive dimension.

    Even if scholars have studied tourism networks in general, methods of how to evaluate tourism networks have been relatively neglected as an area of academic study. In this respect, the objective of the present paper was to study performance of a tourism network. The case of our study is a partnership called Network Limfjorden, which is a cooperation with the aim to develop the tourism around Limfjorden in Denmark. The network was established in 1995 and consists of two regions, eight municipalities and tourist offices around Limfjorden. The tourism activities in the Limfjorden region can be characterized as "slow" activities. In spring 2010 Network Limfjorden, adopted a new action plan "Towards 2015". The action plan states that the Limfjorden continues to be a strong brand. This will be achieved through:

    • Development of coherent useful products and activities
    • Launch projects and develop until they can run on their own
    • Marketing of products and activities under the common brand
    • A concerted effort to promote network development

    These goals are conventional for most networks. In order to study if the different network partners are committed to use and express the common branding one can study either what is said or written. We have chosen to study written material and in this case the traditional tourism brochures. Because branding, beyond its own operations, is about describing the common; common values, specific joint projects developed etc. Our study includes five tourism brochures from five municipalities around Limfjorden. We operationalized the study of brochures with the following measures:

    • The portion of sentences with a "network umbrella description". Such a sentence includes for instance a description of an area or an activity outside their own municipal but within the network area Limfjorden.
    • Yes/No whether or not the brochure include: the network logo, the address to the network website, map over the Limfjorden area, common launched network activities (old sail ship regatta, storytelling, etc.)

    In this way we examined to what extent a network member (municipality) in its own brochure promotes i) their own activities, and ii) other members' activities.  The results of the study indicate that it is more common to promote the own specific activity or location even if similar activities can be found also in other municipalities around Limfjorden. Several partners did not include network logo, link to website or common network activities. Consequently, the opportunity to create positive synergy effects among the network partners is not fully exploited. The macro perspective found among the aims with the network, was simply not adopted by several partners. Perhaps this may be explained by a lack of understanding and handling the balance between cooperation and competition. In conclusion, even though the network were ambitious and had well thought-thrown aims, our findings indicate that these ambitions were not successfully adopted by partners. This might well be the reason for why it was decided to discontinue the network. 

  • 30.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Johansson, Kristina
    University West, Department of Social and Behavioural Studies, Division of Psychology and Organisation Studies.
    Winman, Thomas
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Work Integrated Learning: a Marriage Between Academia and Working Life2015In: Journal of Systemics, Cybernetics and Informatics, ISSN 1690-4524, E-ISSN 1690-4524, Vol. 13, no 6, p. 38-46Article in journal (Refereed)
    Abstract [en]

    There is a demand for increased cooperation between higher education institutes and surrounding society, and different frameworks for such cooperation have been developed. University West in Sweden has a profile calledwork-integrated learning which could be regarded as a systematical approach for combining theory and practice.Actually work-integrated learning has become an ideologyfor the University which permeates all activities, i.e. education, research and cooperation with surrounding society. This article is a review, explaining and exemplifying our approach. We will also discuss strategies and challenges for bringing the relationship between theory and practice into a prospering marriage.

  • 31.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT.
    Magnusson, J
    Sahlgrenska University Hospital, Department of Respiratory Medicine and Allergy.
    Gråjö, Urban
    University West, Department of Economics and Informatics.
    Ahlstedt, S
    Karolinska Institute, Institute of Environmental Medicine.
    Bengtsson, U
    Sahlgrenska University Hospital, Department of Respiratory Medicine and Allergy.
    Interpretation of subjective symptoms in double-blind placebo-controlled food challenges - interobserver reliability2004In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 59, no 3, p. 354-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Subjective symptoms after food challenges are difficult to interpret and no standard is available. We discuss a strategy for how to interpret a diary. Furthermore, the interobserver reliability is evaluated. METHODS: Diaries for 32 patients with subjective symptoms were used. The diaries were re-evaluated with a predefined strategy by three independent observers. RESULTS: The proportion of positives was 21.9% among the old diagnoses, according to the new approach 34.4% (observers I and II) and 37.5% (observer III) were positive. The new approach had high interobserver reliability (97 and 100%). CONCLUSIONS: The proportion of positives depends on how subjective symptoms are interpreted. Interpretations of subjective symptoms in diaries could be made with high interobserver reliability.

  • 32.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Magnusson, J.
    Sahlgrenska University Hospital, Göteborg.
    Gråsjö, Urban
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Ahlstedt, S
    Karolinska institutet, Stockholm.
    Bengtsson, U
    Sahlgrenska University Hospital, Göteborg.
    Interpretation of subjective symptoms in double-blind placebo-controlled food challenges: interobserver reliability2004In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 59, no 3, p. 354-356Article in journal (Refereed)
    Abstract [en]

    Background: Subjective symptoms after food challenges are difficult to interpret and no standard is available. We discuss a strategy for how to interpret a diary. Furthermore, the interobserver reliability is evaluated.

    Methods: Diaries for 32 patients with subjective symptoms were used. The diaries were re-evaluated with a predefined strategy by three independent observers.

    Results: The proportion of positives was 21.9% among the old diagnoses, according to the new approach 34.4% (observers I and II) and 37.5% (observer III) were positive. The new approach had high interobserver reliability (97 and 100%).

    Conclusions: The proportion of positives depends on how subjective symptoms are interpreted. Interpretations of subjective symptoms in diaries could be made with high interobserver reliability.

    The double-blind placebo-controlled food challenge (DBPCFC) is the gold standard for diagnosing food hypersensitivity (1–5). However, DBPCFC needs further standardization regarding essential issues, e.g. quantity of food, vehicles, blinding, dose titration and interpretation of symptoms (2, 3, 6–10). This study highlights the latter problem. For patients with several subjective symptoms that may occur in various degrees both on active and placebo provocations, a standardized strategy for interpretation would be valuable. Bindslev-Jensen et al. have theoretically illustrated that there may be great differences dependent on how placebo symptoms are treated (11, 12) and in a position paper (13) it is suggested that in situations when only subjective symptoms are present, several provocations must be used. The lack of an interpretation standard may be one reason for explaining the doubts regarding the value of subjective variables for making a diagnosis (9, 14). We discuss a strategy for how to interpret the symptom profile found in such a mixed sequence of active and placebo provocations. Furthermore, the interobserver reliability is evaluated.

  • 33.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Pareto, Lena
    University West, Department of Economics and IT, Division of Media and Design.
    Svensson, Lars
    University West, Department of Economics and IT, Divison of Informatics.
    The Goalkeeper: a tool for monitoring learning outcomes in PhD education2015In: ICERI2015 Proceedings, 2015Conference paper (Refereed)
    Abstract [en]

    The journey from being a new Ph. D.-candidate towards passing the doctorate grade is often a bumpy road with both unexpected and complex challenges that has to be turned in to learning experiences that adds to progression. In this paper we describe the development and use of a tool (the Goalkeeper) designed to support, structure and visualize this journey. It is a tool for supervisors, doctorate students as well as people responsible for quality assurance of a doctorate education. Based on our experiences of having utilised the tool we argue that it is important that the implementation of such a tool is firmly grounded in a quality culture where support of progression and formative assessment dominate over summative assessment and control.

  • 34.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Petersen, Per Hyltoft
    University of Bergen, NOKLUS, Norwegian Quality Improvement of Primary Care Laboratories, Division for General Practice.
    Partitioning reference values for several subpopulations using cluster analysis2007In: Clinical chemistry and laboratory medicine, ISSN 1434-6621, Vol. 45, no 8, p. 1026-1032Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A crucial question when developing reference intervals is whether different subpopulations need their own reference interval or if a single joint reference interval can be used. It is reasonable to use partitioned reference intervals in situations where a single interval results in considerable variation in sensitivity between subpopulations. The aim of partitioning is to harmonize the sensitivity of the reference intervals, i.e., to make the sensitivity similar for all patients, regardless of patient characteristics. Statistical criteria to identify when partitioning is adequate have been developed over the last two decades. These criteria are applicable when considering two subpopulations, but recently a procedure for considering several subpopulations has been developed. When several subpopulations are considered, there is a possibility that some subpopulations could form a group or cluster that could share a common reference interval. However, there is no formal systematic approach to indicate how to divide these subpopulations into clusters. The aim of this study was to suggest such a systematic approach for clustering. METHODS: A clustering technique was applied to data including several subpopulations. The technique is based on measuring the distance between separated reference limits and successively pooling subpopulations divided by short distances. A cluster is defined by a group of subpopulations that are close to each other and that differ from subpopulations in another cluster. A cluster recruits new subpopulations as long as the subpopulations can be pooled without violating a partitioning criterion. CONCLUSIONS: We have suggested a procedure for partitioning a number of Gaussian (or Gaussian-transformable) subpopulations into clusters. This is the only formalized procedure indicating how to analyze several subpopulations and identify a suitable number of groups and reference intervals. Using a computer program developed for partitioning issues, the approach was easy to adopt.

  • 35.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Petersen, Per Hyltoft
    University of Bergen, Bergen, Norway.
    Partitioning reference values for several subpopulations using cluster analysis.2007In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 45, no 8, p. 1026-32Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A crucial question when developing reference intervals is whether different subpopulations need their own reference interval or if a single joint reference interval can be used. It is reasonable to use partitioned reference intervals in situations where a single interval results in considerable variation in sensitivity between subpopulations. The aim of partitioning is to harmonize the sensitivity of the reference intervals, i.e., to make the sensitivity similar for all patients, regardless of patient characteristics. Statistical criteria to identify when partitioning is adequate have been developed over the last two decades. These criteria are applicable when considering two subpopulations, but recently a procedure for considering several subpopulations has been developed. When several subpopulations are considered, there is a possibility that some subpopulations could form a group or cluster that could share a common reference interval. However, there is no formal systematic approach to indicate how to divide these subpopulations into clusters. The aim of this study was to suggest such a systematic approach for clustering. METHODS: A clustering technique was applied to data including several subpopulations. The technique is based on measuring the distance between separated reference limits and successively pooling subpopulations divided by short distances. A cluster is defined by a group of subpopulations that are close to each other and that differ from subpopulations in another cluster. A cluster recruits new subpopulations as long as the subpopulations can be pooled without violating a partitioning criterion. CONCLUSIONS: We have suggested a procedure for partitioning a number of Gaussian (or Gaussian-transformable) subpopulations into clusters. This is the only formalized procedure indicating how to analyze several subpopulations and identify a suitable number of groups and reference intervals. Using a computer program developed for partitioning issues, the approach was easy to adopt.

  • 36.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Rawshani, Nina
    Department of Emergency Medicine, University of Gothenburg, Göteborg, Sweden.
    Herlitz, Johan
    The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden, Department of Medicine, University of Gothenburg, Göteborg, Sweden.
    Bång, Angela
    The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
    Gelang, Carita
    The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden, Department of Ambulance and Prehospital Emergency Care, University of Gothenburg, Göteborg, Sweden.
    Andersson, Jan-Otto
    Department of Ambulance and Prehospital Emergency Care, Skaraborg, Sweden.
    Larsson, Anna
    The Pre-hospital Research Centre of Western Sweden, Prehospen, University College of Borås, Borås, Sweden.
    Rawshani, Araz
    Department of Medicine, University of Gothenburg, Göteborg, Sweden.
    Could prioritisation by emergency medicine dispatchers be improved by using computer-based decision support?: A cohort of patients with chest pain2016In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 220, p. 734-738Article in journal (Refereed)
    Abstract [en]

    Background: To evaluate whether a computer-based decision support system could improve the allocation of patients with acute coronary syndrome (ACS) or a life-threatening condition (LTC). We hypothesised that a system of this kind would improve sensitivity without compromising specificity. Methods: A total of 2285 consecutive patients who dialed 112 due to chest pain were asked 10 specific questions and a prediction model was constructed based on the answers. We compared the sensitivity of the dispatchers' decisions with that of the model-based decision support model. Results: A total of 2048 patients answered all 10 questions. Among the 235 patients with ACS, 194 were allocated the highest prioritisation by dispatchers (sensitivity 82.6%) and 41 patients were given a lower prioritisation (17.4% false negatives). The allocation suggested by the model used the highest prioritisation in 212 of the patients with ACS (sensitivity of 90.2%), while 23 patients were underprioritised (9.8% false negatives). The results were similar when the two systems were compared with regard to LTC and 30-day mortality. This indicates that computer-based decision support could be used either for increasing sensitivity or for saving resources. Three questions proved to be most important in terms of predicting ACS/LTC, [1] the intensity of pain, [2] the localisation of pain and [3] a history of ACS. Conclusion: Among patients with acute chest pain, computer-based decision support with a model based on a few fundamental questions could improve sensitivity and reduce the number of cases with the highest prioritisation without endangering the patients.

  • 37.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Svensson, Lars
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Www means win win win in education: some experiences from online courses in applied statistics2010In: OZCOTS 2010 Proceedings of the 7th Australian Conferenceon Teaching Statistics / [ed] Helen MacGillivray & Brian Phillips, Statistical society of Australia , 2010, p. 51-56Conference paper (Refereed)
    Abstract [en]

    This paper reports on the experiences from online courses in applied statistics. The courses were designed with the ambition of making studies in statistics, fun, interesting, useful, not that difficult and directly supported the possibility to combine studies and work. When designing the courses we considered three dimensions: "pedagogies","community" and "structure". Experiences after giving a first-year course three times show that the online course succeeds in attracting new studen ts since 90% of the participants would not be able to follow an on-campus course and 62% worked full time.

    The pedagogies were highly appreciated because focusing on the interpretation of results and using computer analyses really changed the prejudices about statistics. Structure and prompt feedback was experienced as important factors. It was possible to combine online studies with employment, and the student completion rate was (84%, 55% and 61%), with a potential for further improvements.

  • 38.
    Gellerstedt, Martin
    et al.
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics.
    Svensson, Lars
    University West, Department of Economics and IT, Divison of Informatics.
    Östlund, Christian
    University West, Department of Economics and IT, Divison of Informatics.
    Navigating in a new pedagogical landscape with an introductory course in applied statistics.2014In: Topics from Australian Conferences on Teaching Statistics: OZCOTS 2008-2012 / [ed] MacGillivray, H., Martin, M., and Phillips, B, New York: Springer , 2014, p. 119-148Chapter in book (Refereed)
    Abstract [en]

    During the last few decades, a great deal of effort has been put into improving statistical education, focusing on how students learn statistics and how we as teachers can find effective ways to help them. At the same time the use of computers, the Internet, and learning management systems has grown rapidly, and offers new educational possibilities. In this chapter, we will discuss how these changes in the pedagogical landscape have affected our introductory course in applied statistics. The course and teaching context are presented in relation to guidelines for assessment and instruction in statistics and to seven principles for effective teaching. Teaching strategies, course content, and examples of course material are included. Furthermore, results from evaluations are discussed, especially focusing on diversity in student characteristics. These results indicate a variation in learning styles both between and within groups. Finally, we present some of our ideas for future development including strategies for individualization and the use of educational mining.

  • 39.
    Jansson, Nina
    et al.
    Sahlgrenska Academy at University of Gothenburg, Perinatal Center, Institute of Neuroscience and Physiology.
    Nisfelt, Anna
    Sahlgrenska Academy at University of Gothenburg, Perinatal Center, Institute of Neuroscience and Physiology.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Wennergren, Margareta
    Sahlgrenska Academy at University of Gothenburg, Department of Obstetrics and Gynecology.
    Rossander-Hulthén, Lena
    Sahlgrenska Academy at University of Gothenburg, Department of Clinical Nutrition.
    Powell, Theresa L.
    University of Cincinnati, Department of Obstetrics and Gynecology, Cincinnati, OH, United States.
    Jansson, Thomas
    Sahlgrenska Academy at University of Gothenburg, Perinatal Center, Institute of Neuroscience and Physiology.
    Maternal hormones linking maternal body mass index and dietary intake to birth weight2008In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 87, no 6, p. 1743-1749Article in journal (Refereed)
  • 40. Magnusson, J
    et al.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Ahlstedt, S
    Andersson, B
    Bengtsson, U
    Telemo, E
    Hansson, T
    Peterson, C G B
    A kinetic study in adults with food hypersensitivity assessed as eosinophil activation in fecal samples2003In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 33, no 8, p. 1052-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Immune-mediated food hypersensitivity affecting the gut is difficult to evaluate, and objective tools to diagnose local gastrointestinal (GI) inflammatory reactions are lacking. OBJECTIVES: To determine whether allergic manifestations in adults with a history of food-related GI symptoms could be assessed in feces during symptomatic and non-symptomatic periods, using the surrogate markers, eosinophil cationic protein (ECP), eosinophil protein X (EPX) and myeloperoxidase (MPO). METHODS: Thirteen subjects with food hypersensitivity-related GI symptoms, confirmed by a positive double-blind placebo-controlled food challenge (DBPCFC), were subjected to an open kinetic food challenge design for 6 weeks. Symptoms were recorded and scored during the 3-week study period and stool samples were obtained every day. The surrogate markers ECP, EPX and MPO were measured in the supernatants from feces samples. RESULTS: A significant increase in abdominal pain, distension and flatulence was observed during challenge, with a gradual decrease during elimination diet. Both between days and subjects, EPX levels were more frequently increased compared to ECP and MPO. Individuals with a history of a short duration of symptoms had significantly higher mean levels of EPX and MPO than those with a longer duration of symptoms. CONCLUSIONS: An overall increase in levels of eosinophil markers, in particular EPX, was observed in feces from patients with food-related GI symptoms. However, rather than being a tool to differentiate symptomatic from non-symptomatic periods, EPX might be used for detecting an ongoing clinical or subclinical chronic inflammation, that may have an impact on the patient's clinical course of GI symptoms.

  • 41.
    Monneret, D.
    et al.
    Department of Metabolic Biochemistry, La Pitié Salpêtrière-Charles Foix University Hospital, Paris, France.
    Gellerstedt, Martin
    University West, School of Business, Economics and IT, Divison of Informatics. Department of Surgery, Institute of Clinical Sciences, University of Gothenburg, Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Bonnefont-Rousselot, D.
    Paris Descartes University, Faculty of Pharmacy, Department of Biochemistry, Paris, France.
    Determination of age- and sex-specific 99th percentiles for high-sensitive troponin T from patients: An analytical imprecision- and partitioning-based approach2018In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331Article in journal (Other academic)
    Abstract [en]

    Detection of acute myocardial infarction (AMI) is mainly based on a rise of cardiac troponin with at least one value above the 99th percentile upper reference limit (99th URL). However, circulating high-sensitive cardiac troponin T (hs-cTnT) concentrations depend on age, sex and renal function. Using an analytical imprecision-based approach, we aimed to determine age- A nd sex-specific hs-cTnT 99th URLs for patients without chronic kidney disease (CKD). A 3.8-year retrospective analysis of a hospital laboratory database allowed the selection of adult patients with concomitant plasma hs-cTnT (<300 ng/L) and creatinine concentrations, both assayed twice within 72 h with at least 3 h between measurements. Absence of AMI was assumed when the variation between serial hs-cTnT values was below the adjusted-analytical change limit calculated according to the inverse polynomial regression of analytical imprecision. Specific URLs were determined using Clinical and Laboratory Standards Institute (CLSI) methods, and partitioning was tested using the proportion method, after adjustment for unequal prevalences. After outlier removal (men: 8.7%; women: 6.6%), 1414 men and 1082 women with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 were assumed as non-AMI. Partitioning into age groups of 18-50, 51-70 and 71-98 years, the hs-cTnT 99th URLs adjusted on French prevalence were 18, 33, 66 and 16, 30, 84 ng/L for men and women, respectively. Age-partitioning was clearly required. However, sex-partitioning was not justified for subjects aged 18-50 and 51-70 years for whom a common hs-cTnT 99th URLs of about 17 and 31 ng/L could be used. Based on a laboratory approach, this study supports the need for age-specific hs-cTnT 99th URLs. © 2017 Walter de Gruyter GmbH.

  • 42.
    Nilsson, Hanna
    et al.
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Angerås, Ulf
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Bock, David
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Börjesson, Mats
    Swedish School of Sport and Health Sciences and Karolinska University Hospital, Stockholm, Sweden.
    Onerup, Aron
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Fagevik Olsen, Monika
    3 Department of Gastrosurgical Research and Education, Gothenburg, Sweden.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Haglind, Eva
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Angenete, Eva
    Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG—Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Is preoperative physical activity related to post-surgery recovery?: A cohort study of patients with breast cancer2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 1, article id e007997Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of our study is to assess the association between preoperative level of activity and recovery after breast cancer surgery measured as hospital stay, length of sick leave and self-assessed physical and mental recovery. Design: A prospective cohort study. Setting: Patients included were those scheduled to undergo breast cancer surgery, between February and November 2013, at two participating hospitals in the Western Region of Sweden. Participants: Patients planned for breast cancer surgery filled out a questionnaire before, as well as at 3 and 6 weeks after the operation. The preoperative level of activity was self-assessed and categorised into four categories by the participants using the 4-level SaltinGrimby Physical Activity Level Scale (SGPALS). Main outcome measure: Our main outcome was postoperative recovery measured as length of sick leave, in-hospital stay and self-assessed physical and mental recovery. Results: 220 patients were included. Preoperatively, 14% (31/220) of participants assessed themselves to be physically inactive, 61% (135/220) to exert some light physical activity (PA) and 20% (43/220) to be more active (level 3+4). Patients operated with mastectomy versus partial mastectomy and axillary lymph node dissection versus sentinel node biopsy were less likely to have a short hospital stay, relative risk (RR) 0.88 (0.78 to 1.00) and 0.82 (0.70 to 0.96). More active participants (level 3 or 4) had an 85% increased chance of feeling physically recovered at 3 weeks after the operation, RR 1.85 (1.20 to 2.85). No difference was seen after 6 weeks. Conclusions: The above study shows that a higher preoperative level of PA is associated with a faster physical recovery as reported by the patients 3 weeks post breast cancer surgery. After 6 weeks, most patients felt physically recovered, diminishing the association above. No difference was seen in length of sick leave or self-assessed mental recovery between inactive or more active patients.

  • 43.
    Olofsson, Pia
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Triage på akutmottagning: en utvärdering av triage i Västra Götalandsregionen2008Report (Other academic)
    Abstract [sv]

    Triage är en systematiserad form av prioritering som utförs på de flesta akutmottagningar i Sverige och internationellt. Syftet med triage är att uppnå en medicinskt säkerställd turordning för patienter som söker vård. I Västra Götalandsregionen har akutmottagningarna de senaste två åren implementerat Manchester Triage (MTS). Modellen består av ett medicinskt beslutsstöd i form av ett flödesschema, samt fem triagekategorier, som var och en anger maximal väntetid. Patienterna som bedöms tillhöra kategori 1 behöver omedelbar läkarkontakt. De övriga fyra kategorierna bedöms kunna vänta mellan 10 minuter och upptill 240 minuter. Den här studien utvärderar överensstämmelsen i form av mellanbedömarreliabilitet, samt träffsäkerhet i triagebedömningar hos sjuksköterskor som arbetar med MTS. De 79 sjuksköterskor som deltog i studien var verksamma på sju olika akutmottagningar i Västra Götalandsregionen. Sjuksköterskorna bedömde 13 fiktiva patientfall vardera. Dessa patientfall hade tilldelats en förväntad triagekategori utifrån en expertgrupps samlade bedömning. Mellanbedömar-reliabiliteten för akutmottagningarna totalt var 0,61 i oviktat k-värde vilket innebär god överensstämmelse. Mellan akutmottagningarna varierade k-värdet från 0,56-0,65. Träffsäkerheten gentemot expertgruppens förväntade triagekategori var 73 % totalt. 14 % av patienterna tilldelades en högre triagekategori än den förväntade (övertriage) och 13 % en lägre (undertriage). Träffsäkerheten för MTS var hög i kategori 1 (92 %) och kategori 2 (91 %), men lägre i kategori 3 (66 %) och 4 (63 %). Slutsatsen är att mellanbedömar-reliabiliteten var god och träffsäkerheten hög. Triagekategori 1 och 2 redovisade högst värden, vilket tyder på att denna grupp av patienter bereds vård utan riskfyllda väntetider. De patienter som ges en lägre prioritet visar sig emellertid vara svåra att bedöma. Trots att dessa patienter är mest frekventa på akutmottagningarna var de svåra att särskilja. Detta pekar på ett behov av att ytterligare utveckla bedömningar av kategori 3 och 4 i triagemodellen MTS.

  • 44.
    Olofsson, Pia
    et al.
    Nu-sjukvården, Trollhättan, Department of Emergency Medicin.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Carlström, Eric. D.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Manchester Triage in Sweden: Interrater reliability and accuracy2009In: International Emergency Nursing, Vol. 17, no 3, p. 143-148Article in journal (Refereed)
    Abstract [en]

    This study investigates the interrater reliability and the accuracy of Manchester Triage (MTS) at emergency departments in Western Sweden. Methods: A group of 79 nurses from seven emergency departments assessed simulated patient cases and assigned triage categories using the same principles as in their daily work. K statistics, accuracy, over-triage and under-triage were then analyzed. The nurses performed 1027 triage assessments. Results: The result showed an unweighted κ value of 0.61, a linear weighted κ value of 0.71, and a quadratic weighted κ value of 0.81. The determined accuracy was 92% and 91% for the two most urgent categories, but significantly lower for the less urgent categories. Conclusions: Patients in need of urgent care were identified in more than nine out of 10 cases. The high level of over-triage and under-triage in the less urgent categories resulted in low agreement and accuracy. This may suggest that the resources of emergency departments can be overused for non-urgent patients.

  • 45.
    Olsson, Anna Karin
    et al.
    University West, Department of Economics and IT, Division of Business Administration.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Doing Good: an Exploration of Members' Motivations and Behaviours in Tourism SettingsManuscript (preprint) (Other academic)
  • 46.
    Olsson, Anna Karin
    et al.
    University West, Department of Economics and IT, Division of Business Administration.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Doing good at a nonprofit tourist attraction2014In: International Journal of Culture, Tourism and Hospitality, ISSN 1750-6182, E-ISSN 1750-6190, Vol. 8, no 1, p. 74-91Article in journal (Refereed)
    Abstract [en]

    PurposeThe purpose of this paper is to contribute to the growing field of membership research by applying a relationship marketing perspective on members in tourism settings. Focus is on exploring why consumers are members (motivational dimensions) and how motivations are related to member behaviours (retention, participation and co-creation), and to member demographics (gender, age, distance between the member’s home and the supported organization).

     

    Design/methodology/approach -   A survey was conducted among members of a nonprofit tourist attraction (N=755). Classical chi-square tests, t-tests and multivariate analysis using logistic regression were used to analyze data and to test eight hypotheses on member demographics, member motivations and member behaviours.

     

    Findings - Findings show that among the three motivational dimensions, altruism, i.e., doing good for others, was the strongest motive, followed by self-interest, i.e., doing good for yourself, and then the social motive, i.e., doing good with others, which scored lowest. Furthermore, findings show that gender, age and distance were significantly related to member motivations and member behaviours.  Member behaviours were significantly related to motivations.

     

    Research limitations/implications – This study was conducted at a single nonprofit tourist attraction. However, it provides insights into different motivational dimensions for why people pay to become members and what kind of member behaviour they demonstrate. This topic calls for further research to explore the complex membership phenomenon such as extending this study by identifying member motives and behaviour in other contexts.

     

    Practical implications – This explorative study of members of a nonprofit tourist attraction contributes insights into why consumers are members (motivational dimensions), how motivations are related to member behaviours in a membership relationship context, and how member demographics are related to motivations and behaviours. Findings have implications for membership managers and the development of memberships in terms of giving a deeper insight into members as consumers in order to develop memberships as strategic resources and hence use the full potential of memberships especially vital to non-profit organizations. Several aspects of memberships are discussed that may inspire the development of member offerings. The present study contributes to the developing field of membership research as it is a response to the calls for more empirical studies of members to develop an integrated understanding of motivations of memberships. Furthermore it contributes with research of co-creation in customer relationships linking the co-creation concept to research of members in tourism settings.

     

     

    Originality/value –   This study contributes to the developing field of membership research and furthermore gives insights into consumer motivations and behaviours that may inspire development of innovative and competitive membership offerings building membership relationships in tourism settings.

     

  • 47.
    Olsson, Anna Karin
    et al.
    University West, Department of Economics and IT, Division of Business Administration.
    Lindh, Kristina
    University West, Department of Economics and IT, Division of Business Administration.
    Berndtsson, Leif
    University West, Department of Economics and IT, Division of Business Administration.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Division of Computer Science and Informatics.
    Nehls, Eddy
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Driving forces for sustainable destination development: A Nordic study based on maritime culture and inland sea-regions2012In: Developing Tourism - Sustaining Regions: Book of Abstracts The 21st Nordic Symposium in Tourism and Hospitality Research / [ed] Ednarsson, M., Hoppstadius, F., Lundmark, L., Marjavaara, R., Müller, D., Pitkänen, K., Åkerlund, U., Umeå: Umeå universitet , 2012, p. 110-110Conference paper (Refereed)
    Abstract [en]

    This study focuses on sustainable destination development in a Nordic context. At most destinations stakeholders from private, public and voluntary sectors interact and there is a need for coordination and cooperation. An escalating competition among destinations has raised calls for innovative offerings that are well-coordinated. Studies of tourism destinations show that networks are crucial since successful destinations are based on interrelated stakeholders that understand the concept of the destination and are committed to cooperate in offering a holistic experience to visitors. 

     

    The aim of this paper is to discuss the driving forces of sustainable destination development. In particular the study focuses on stakeholder cooperation and sharing of knowledge and experiences among two Nordic regions based on maritime culture and inland sea-regions.

    The data collection includes a combination of different methods: interviews with main stakeholders, collection of existing documents related to the regions, observation of stakeholder meetings, and participant observations of attractions and events. 

    The project is ongoing but so far we have interviewed a few stakeholders in each destination and gained their insights into how to cooperate in order to develop tourism sustainable regions.

     

  • 48.
    Onerup, Aron
    et al.
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Angerås, Ulf
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Bock, David
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Börjesson, Mats
    Karolinska University Hospital, Swedish School of Sport and Health Sciences and Karolinska University Hospital,.
    Fagevik Olsén, Monika
    Sahlgrenska Academy at Gothenburg University, Department of Gastrosurgical Research and Education.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics. University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Haglind, Eva
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Nilsson, Hanna
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    Angenete, Eva
    University of Gothenburg, Sahlgrenska Academy, Department of Surgery, Institute of Clinical Sciences,.
    The preoperative level of physical activity is associated to the postoperative recovery after elective cholecystectomy: A cohort study2015In: International Journal of Surgery, ISSN 1743-9191, E-ISSN 1743-9159, Vol. 19, no July, p. 35-41Article in journal (Refereed)
    Abstract [en]

    Introduction There is an increasing interest in the role of preoperative physical activity for postoperative recovery. The effect of preoperative physical activity and recovery after cholecystectomy is unknown. The aim of this study was to evaluate the association of self-reported leisure-time preoperative physical activity with postoperative recovery and complications after elective cholecystectomy due to gallstone disease. Methods Prospective observational cohort study with 200 patients scheduled to undergo elective cholecystectomy. Level of self-assessed leisure-time physical activity was compared with recovery. Results Regular physical activity was associated with a higher degree of return to work within three weeks post-operatively (relative chance (RC) 1.26, p = 0.040); with a higher chance of leaving hospital within one day post-op (RC 1.23, p = 0.001), as well as with better mental recovery (RC 1.18, p = 0.049), compared to physically inactive. No statistically significant association was seen with return to work within one week or with self-assessed physical recovery. Discussion In clinical practice, evaluating the patients’ level of physical activity is feasible, and may potentially be used to identify patients being more suitable for same-day surgery. Given the study design, the results from this study cannot prove causality. Conclusion The present study shows that the preoperative leisure-time physical activity-level, is positively associated with less sick leave, a shorter hospital stay and with better mental recovery, three weeks post-elective cholecystectomy. We recommend assessing the physical activity-level preoperatively for prognostic reasons. If preoperative/postoperative physical training will increase recovery remains to be shown in a randomized controlled study.

  • 49.
    Onerup, Aron
    et al.
    University of Gothenburg, Department of Surgery, SSORG—Scandinavian Surgical Outcomes Research GroupInstitute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Gothenburg Sweden.
    Bock, David
    University of Gothenburg, Department of Surgery, SSORG—Scandinavian Surgical Outcomes Research GroupInstitute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Gothenburg Sweden.
    Börjesson, Mats
    Göteborg University and Sahlgrenska University Hospital/Östra, Institute of Neuroscience and Physiology, Institute of Food, Nutrition and Sport Science, Sahlgrenska Academy, Gothenburg Sweden.
    Fagevik Olsén, Monica
    Sahlgrenska Academy at Gothenburg University, Department of Physical Therapy and Department of Surgery, Gothenburg, Sweden.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Law, Economics, Statistics and Politics. University of Gothenburg, Department of Surgery, SSORG—Scandinavian Surgical Outcomes Research GroupInstitute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Gothenburg Sweden.
    Haglind, Eva
    University of Gothenburg, Department of Surgery, SSORG—Scandinavian Surgical Outcomes Research GroupInstitute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Gothenburg Sweden.
    Nilsson, Hanna
    University of Gothenburg, Department of Surgery, SSORG—Scandinavian Surgical Outcomes Research GroupInstitute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Gothenburg Sweden.
    Angenete, Eva
    University of Gothenburg, Department of Surgery, SSORG—Scandinavian Surgical Outcomes Research GroupInstitute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital/Östra Gothenburg Sweden.
    Is preoperative physical activity related to post-surgery recovery?: €”a cohort study of colorectal cancer patients2016In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 31, no 6, p. 1131-1140Article in journal (Refereed)
    Abstract [en]

    Introduction: An increasing interest is seen in the role of preoperative physical activity (PA) in enhancing postoperative recovery. The short-term effect of preoperative PA on recovery after colorectal cancer is unknown. The aim of this study was to evaluate the association of the preoperative level of PA with postoperative recovery after surgery due to colorectal cancer disease. Methods: This is a prospective observational cohort study, with 115 patients scheduled to undergo elective colorectal surgery. The self-reported level of preoperative PA was compared to measures of recovery. Results: Regular self-reported preoperative PA was associated with a higher chance of feeling highly physically recovered 3 weeks after surgery (relative chance 3.3, p = 0.038), compared to physical inactivity. No statistically significant associations were seen with length of hospital stay, self-assessed mental recovery, re-admittances or with re-operations. Discussion: In clinical practice, evaluating the patients’ level of PA is feasible and may potentially be used as a prognostic tool for patients undergoing colorectal cancer surgery. Given the study design, the results from this study cannot prove causality. Conclusion: The present study found that the preoperative level of PA was associated with a faster self-assessed physical recovery after colorectal cancer surgery. PA did not show any associations with the primary outcome measure length of hospital stay or any of the other secondary outcome measures. Assessment of PA level preoperatively could be used for prognostic reasons. If systematic preoperative/postoperative physical training will enhance recovery, this remains to be studied in a randomized controlled study. Highlights: We examined preoperative physical activity and the recovery after colorectal cancer surgery.Physically active individuals had faster self-assessed physical recovery.Assessment of preoperative physical activity may provide prognostic clinical information. © 2016, Springer-Verlag Berlin Heidelberg.

  • 50.
    Rawshani, Araz
    et al.
    University of Gothenburg, Department of Medicine, Sahlgrenska Academy.
    Larsson, Anna
    University College of Borås,The Pre-hospital Research Centre of Western Sweden, Prehospen.
    Gelang, Carita
    University College of Borås,The Pre-hospital Research Centre of Western Sweden, Prehospen.
    Lindqvist, Jonny
    University of Gothenburg, Department of Medicine, Sahlgrenska Academy.
    Gellerstedt, Martin
    University West, Department of Economics and IT, Divison of Informatics.
    Bång, Angela
    University College of Borås,The Pre-hospital Research Centre of Western Sweden, Prehospen.
    Herlitz, Johan
    University of Gothenburg, Department of Medicine, Sahlgrenska Academy.
    Characteristics and outcome among patients who dial for the EMS due to chest pain2014In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 176, no 3, p. 859-865Article in journal (Refereed)
    Abstract [en]

    Objectives: This study aims to describe patients who called for the emergency medical service (EMS) due to chest discomfort, in relation to gender and age. Methods: All patients who called the emergency dispatch centre of western Sweden due to chest discomfort, between May 2009 and February 2010, were included. Initial evaluation, aetiology and outcome are described as recorded in the databases at the dispatch centre, the EMS systems and hospitals. Patients were divided into the following age groups: ≀ 50, 51-64 and ≥ 65 years. Results: In all, 14,454 cases were enrolled. Equal proportions of men (64%) and women (63%) were given dispatch priority 1. The EMS clinicians gave priority 1 more frequently to men (16% versus 12%) and older individuals (10%, 15% and 14%, respective of age group). Men had a significantly higher frequency of central chest pain (83% versus 81%); circulatory compromise (34% versus 31%); ECG signs of ischaemia (17% versus 11%); a preliminary diagnosis of acute coronary syndrome (40% versus 34%); a final diagnosis of acute myocardial infarction (14% versus 9%) and any potentially life-threatening condition (18% versus 12%). Individuals aged ≥ 65 years were given a lower priority than individuals aged 51-64 years, despite poorer characteristics and outcome. In all, 78% of cases with a potentially life-threatening condition and 67% of cases that died within 30 days of enrolment received dispatch priority 1. Mortality at one year was 1%, 4% and 18% in each individual age group. Conclusion: Men and the elderly were given a disproportionately low priority by the EMS. 

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