University of Borås

Review of: Dialogues: Fashion beyond the Wearable , curated by Andrea Hasselrot Gothenburg Museum of Art, Gothenburg, 12 May 2023–7 January 2024

Synthesis gas (syngas) fermentation represents a promising biological method for converting industrial waste gases, particularly carbon monoxide (CO) and carbon dioxide (CO₂) from industrial sources (e.g. steel production or municipal waste gasification), into high-value products such as biofuels, chemicals, and animal feed using acetogenic bacteria. This review identifies and addresses key challenges that hinder the large-scale adoption of this technology, including limitations in gas mass transfer, an incomplete understanding of microbial metabolic pathways, and suboptimal bioprocess conditions. Our findings emphasize the critical role of microbial strain selection and bioprocess optimization to enhance productivity and scalability, with a focus on utilizing diverse microbial consortia and efficient reactor systems. By examining recent advancements in microbial conditioning, operational parameters, and reactor design, this study provides actionable insights to improve syngas fermentation efficiency, suggesting pathways towards overcoming current technical barriers for its broader industrial application beyond the production of bulk chemicals.

This article is about the pedagogical potentials and challenges of co-drawing in science education. It builds on video data from three primary school classrooms where students worked in pairs to draw some science content on a shared paper. Grounded in a sociomaterialist approach, we analyse how students, drawing tools, paper templates, visual resources, and science concepts collaborate during drawing activities. Our findings reveal that even though two students share a paper they do not necessarily negotiate their understandings of the science content they are asked to draw. For example, one student may shape a verbal and visual narrative about the science content with little input from the other, or negotiations may focus more on drawing techniques and composition than on understanding the science content. However, the article identifies a promising scenario in terms of science learning opportunities, when both students draw within a confined space on the paper. In such cases, it seems that science learning emerge while drawing and that both students are involved in a joint learning process.

Process mining holds promise for analysing longitudinal data in clinical epidemiology, yet its application remains limited. The objective of this study was to propose and evaluate a methodology for applying process mining techniques in observational clinical epidemiology. We propose a methodology that integrates a cohort study design with data-driven process mining, with an eight-step approach, including data collection, data extraction and curation, event-log generation, process discovery, process abstraction, hypothesis generation, statistical testing, and prediction. These steps facilitate the discovery of disease progression patterns. We implemented our proposed methodology in a cohort study comparing new users of proton pump inhibitors (PPI) and H2 blockers (H2B). PPI usage was associated with a higher risk of disease progression compared to H2B usage, including a greater than 30% decline in estimated Glomerular Filtration Rate (eGFR) (Hazard Ratio [HR] 1.6, 95% Confidence Interval [CI] 1.4–1.8), as well as increased all-cause mortality (HR 3.0, 95% CI 2.1–4.4). Furthermore, we investigated the associations between each transition and covariates such as age, gender, and comorbidities, offering deeper insights into disease progression dynamics. Additionally, a risk prediction tool was developed to estimate the transition probability for an individual at a future time. The proposed methodology bridges the gap between process mining and epidemiological studies, providing a useful approach to investigating disease progression and risk factors. The synergy between these fields enhances the depth of study findings and fosters the discovery of new insights and ideas.

Background The emergency medical service (EMS) addresses all chief complaints across all ages in various contexts. Children in EMS present a particular challenge due to their unique anatomical and physical properties, which require specific training that EMS clinicians often report lacking. This combination exposes children to incidents threatening patient safety. The most common method to highlight incidents is the incident reporting system. Studies have shown underreporting of such incidents, highlighting the need for multiple methods to measure and enhance patient safety in EMS for children. Thus, the aim of this study was to modify and adapt the current Ambulance TT for road-based EMS (ATT) to a pediatric version (pATT) with a guide containing definitions of triggers. Methods The adaption of the ambulance trigger tool to a version suitable for children followed a stepwise manner, including (1) a review of previous literature to pinpoint areas of risk regarding patient safety among children in EMS. (2) Three sessions of expert panel discussions via video meetings were held to evaluate each trigger of the ATT in terms of clinical relevance, comprehensibility, language and areas of risk regarding patient safety among children in EMS. (3) Clinical use of the pATT along with Retrospective Record Review (RRR). (4) Calculation of Item-level validity index and positive predictive value (PPV) for each trigger. (5) calculate inter-rater reliability between two independent record reviewers. Results The literature search revealed 422 respective 561 articles in Cinahl and Medline where headlines and abstracts were read to identify areas posing risks to patient safety in EMS for children. During the structured discussions, one trigger was added to the existing 19 derived from the ATT, and the trigger definitions were modified to suit children. The three most common triggers identified in the 900 randomly selected records were deviation from treatment guidelines (63.9%), incomplete documentation (48.3%), and the patient is non conveyed after EMS assessment (41.1%). The positive triggers were categorized into near miss (54.6%), no harm incident (5.8%), and harmful incident (0.4%). Inter-rater reliability testing showed excellent agreement. Conclusion This study demonstrates the adaptation of an existing trigger tool (ATT) to one suitable for children. It also shows that the trigger tool, along with retrospective record review, is a feasible method to evaluate patient safety in EMS, thus complementing existing methods.

The study compared two simulation environments for training of Swedish naval Command and Control teams by using indirect measures, including workload, combat readiness, and situation awareness. The literature explains simulation-based training as providing a safe avenue to practice relevant scenarios. Fidelity, the degree of realism in the simulation, and workload, the equilibrium between demands and assigned tasks, are crucial factors examined in this study of low- and high-fidelity naval simulations. This study was conducted to better understand the effects of various training methods. An experimental design with repeated measures was used with three consecutive escalating parts. The subjective, multidimensional assessment tool, NASA-Task Load Index was used to rate perceived workload. Combat readiness of the ship and mental demand yielded significant results. For combat readiness of the ship, there was a difference between the low and the high-fidelity setting, for the initial part of the scenario p = 0.037 and for the second part p = 0.028. Mental demand was experienced as higher in the low-fidelity setting, p = 0.036. Notably, the simulated internal battle training for onboard command teams in a low-fidelity setting was found to induce a level of stress comparable with that experienced in a high-fidelity setting. The results indicate that low-fidelity training results in a workload not distinguishable from high-fidelity training and has practical implications for increased use of low-fidelity training as part of (naval) command team training programmes.

Aim To explore the healthcare experiences and needs of older adults living with HIV in Sweden. Design A phenomenological study using qualitative thematic analysis. Methods Data were gathered through semistructured qualitative interviews and analysed using thematic analysis. A purposive sample of individuals ageing and living with HIV was recruited for this study. Results A total of 22 participants aged 65 years and older, with a mean age of 75 years, participated in the study. Living with HIV meant a need to rely on consistent healthcare and treatment over the course of one's lifetime. The experiences of older adults were described under four themes: relying on access to health care, desiring involvement and shared decision‐making, the importance of trust and confidentiality and experiences of stigma in healthcare visits. Conclusion Living and ageing with HIV involved recurring exposure and vulnerability in healthcare encounters, and experiences of being exposed to HIV‐related stigma, especially outside HIV clinics. Continuity and being seen as a person in healthcare encounters were important. Enhancing HIV knowledge alongside fostering supportive attitudes and approaches of healthcare professionals is critical for ensuring high‐quality and nondiscriminating health care. Implications for the Profession and/or Patient Care Meeting the needs of older adults living with HIV requires a person‐centred approach, including active involvement and shared decision‐making between patients and healthcare providers. Impact This study describes the healthcare experiences and needs of older adults, aged 65 years and older, living with HIV, a population that is not typically investigated in qualitative research. Living and ageing with HIV means a vulnerability where the attitudes of professionals and the active involvement of the patient become significant for quality care. The findings can help with the implementation of policies and practices for the care of older adults living with HIV. Reporting Method The Consolidated Criteria for Reporting Qualitative Studies (COREQ) was used. Patient and Public Contribution Patient representatives were involved in discussions on data collection and the development of the interview guide.

We consider a tight-binding model recently introduced by Timmel and Mele (Phys Rev Lett 125:166803, 2020) for strained moiré heterostructures. We consider two honeycomb lattices to which layer antisymmetric shear strain is applied to periodically modulate the tunneling between the lattices in one distinguished direction. This effectively reduces the model to one spatial dimension and makes it amenable to the theory of matrix-valued quasi-periodic operators. We then study the charge transport and spectral properties of this system, explaining the appearance of a Hofstadter-type butterfly and the occurrence of metal/insulator transitions that have recently been experimentally verified for non-interacting moiré systems (Wang et al. in Nature 577:42–46, 2020). For sufficiently incommensurable moiré lengths, described by a diophantine condition, as well as strong coupling between the lattices, which can be tuned by applying physical pressure, this leads to the occurrence of localization phenomena.

Background It has been suggested that the university environment, to improve students’ health status and educational outcomes, should be based on a health promoting approach. More knowledge is needed about health promoting resources and lifestyle factors that may be of value for students in higher education and their future work-life balance. The aim of this study was to explore health-promoting resources, general health and wellbeing, and health promoting lifestyle factors among fourth and final semester students in higher education in healthcare and social work. Methods This longitudinal study is based on self-reported data collected through a web-based questionnaire that included questions about general health, wellbeing, and healthy lifestyle factors and made use of instruments: the Sense of Coherence (SOC) scale, the Salutogenic Health Indicator Scale (SHIS), and five questions from the General Nordic Questionnaire (QPS Nordic). The questionnaire was distributed among students enrolled in seven different healthcare and social work programmes at six universities in Sweden. Data was collected when students were in their fourth (2019/2020) and final (2020/2021) semesters analysed with multiple linear and logistic regressions. Results The survey included responses from students during the fourth (n = 498) and the final (n = 343) semester of higher education programmes in health and social work. Total SOC scores decreased between the fourth semester and the final semester. The prevalence of the health promoting lifestyle factor of physical exercise decreased between the fourth and final semesters. Students in their final semester reported valuing group work more highly than did students in their fourth semester. Despite this, students in both the fourth and the final semester reported high SOC, low levels of good general health and perceived wellbeing, and sleeping problems. Conclusions Students’ report of good general health were associated with wellbeing, high-intensity physical training, and no sleeping problems A high SOC level was associated with good general health, perceived wellbeing, and no sleeping problems. A higher SHIS level was also associated with wellbeing and no sleeping problems. Therefore, we suggest further research focusing on how to prepare students in healthcare and social work during higher education for a future work-life in balance targeting effects on sleep quality.

Evolutionary history is embedded in the deep and imperceptible past with traces left in fossils and in the genetic makeup of living organisms. Deep Evolutionary Time (DET) – the time living organisms have existed – is a demanding topic for students and the general public. Visual communication through various static, dynamic, interactive, and immersive visualisation forms is pivotal for interpreting and learning about DET and its implications. Nevertheless, both challenges and opportunities are associated with the interpretation of visualised DET. This review paper illuminates how visualisation of DET has developed, its integration in biology education and outreach, and potential future research avenues concerning visualised DET. We first show that the communication of DET has developed from views of a very young Earth to scientifically grounded concepts, with visual representations like ladders, timelines, tree diagrams, and palaeoimagery significantly shaping perceptions of evolution. We then synthesise research on interpreting DET visual representations, addressing static, animated and interactive forms, palaeoimagery, currently available digital interfaces, and the benefits of combining multiple representations in biology education and outreach. We close by advocating for integrating a historical perspective, critical visual literacy, and emerging interactive visualisations in communicating DET in formal and informal biology education.

Background To effectively utilize available healthcare resources, integrated care models are recommended. According to such model’s, registered nurses have the potential to increase patient access to health care services and alleviate organizational workload. Studies on acute home consultation assessments by registered nurses are sparse. The aim was to describe the reasons and actions for unscheduled same-day face-to-face registered nurse consultation at home offered to patients calling the national telephone helpline for healthcare in Sweden (SHD 1177), according to the integrated Collaborative Health Care model. Methods A descriptive cross-sectional study was designed. Data from registered nurses (n = 259) working within the Collaborative Health Care model, who performed unscheduled consultations at home (n = 615) using a data collection tool from 2017 to 2018 were collected. Results Among the 615 unscheduled home consultations performed by registered nurses, > 50% of the patients were managed at home as their health problems were not deemed as requiring a same-day referral to a clinic when assessed by the registered nurses. The most frequent health problems and reasons for contact were urinary tract problems, followed by medical and surgical conditions. Social factors, including living alone, impacted referral. Those living with a partner received care at home to a greater extent than those who lived alone. Conclusion An integrated model for healthcare involving registered nurses direct assessment, action and accountability seems to be an efficient option for providing integrated care at home and reducing acute clinic visits.

The growing global instability has increased the demand for healthcare and disaster response skills among registered nurses (RNs). However, research shows that RNs are not sufficiently prepared for disaster situations. Although RNs are responsible for managing injuries during armed conflicts in accordance with International Humanitarian Law (IHL), nursing education lacks specific training in this area. A national survey revealed that only two universities in Sweden offer IHL-related education for nursing students. These findings highlight the urgent need to revise nursing education in Sweden to better prepare RNs for the challenges posed by global crises, including armed conflicts.

Purpose Patients with exudative and nonexudative age‐related macular degeneration (AMD) can experience physical, mental, social, administrative or financial burden that are associated with the treatment of this progressive chronic disease. The role of healthcare providers in supporting patients who experience high treatment burden can be important, especially when it comes to effective communication. Despite previous research underlining the need to improve patient‐provider communication in AMD care, patient experiences with communication, and how these are related to perceived treatment burden, remain underexplored. Methods A survey was distributed among Dutch patients with AMD, which contained questions on several aspects of communication with the patient's ophthalmologist, such as the Quality Of communication Through the patients' Eyes (QUOTE‐COMM, including task‐, affect‐ and therapy‐oriented communication) questionnaire. Patients were primarily enlisted through a patient association. Results A total of 162 patients completed the questionnaire, of which 133 provided fully completed responses. While patients reported positive experiences with affect‐oriented communication of their ophthalmologist, they rated task‐ and therapy‐oriented communication as below their expectations. Most patients wished to receive (additional) information on AMD‐related costs (71%), future perspectives (71%) and coping with negative emotions pertaining to the disease (68%). Both lower experience scores on task‐ and affect‐oriented communication and lower self‐efficacy were associated with higher administrative burden and mental burden among patients. Conclusion Our study shows that current communication, information provision and decision‐making do not fully meet patients' needs and preferences. Enhancing patient‐provider communication seems important, as effective dialogue is likely to diminish patients' perceived treatment burden.

Background The estimated prognos of a patient might influence the expected benefit/risk ratio of different interventions. The main purpose of this study was to investigate the Clinical Frailty Scale (CFS) score as an independent predictor of short-, mid- and long-term mortality in critically ill older adults (aged ≥ 70) admitted to the emergency department (ED). Methods This is a retrospective, single-center, observational study, involving critically ill older adults, recruited consecutively in an ED. All patients were followed for 6.5–7.5 years. The effect of CFS score on mortality was adjusted for the following confounders: age, sex, Charlson’s Comorbidity Index, individual comorbidities and vital parameters. All patients (n = 402) were included in the short- and mid-term analyses, while patients discharged alive (n = 302) were included in the long-term analysis. Short-term mortality was analysed with logistic regression, mid- and long-term mortality with log rank test and Cox proportional hazard models. The CFS was treated as a continuous variable in the primary analyses, and as a categorical variable in completing analyses. Results There was a significant association between mortality at 30 days after ED admission and CFS score, adjusted OR (95% CI) 2.07 (1.64–2.62), p < 0.0001. There was a significant association between mortality at one year after ED admission and CFS score, adjusted HR (95% CI) 1.75 (1.53–2.01), p < 0.0001. There was a significant association between mortality 6.5–7.5 years after discharge and CFS score, adjusted HR (95% CI) 1.66 (1.46–1.89), p < 0.0001. Adjusted HRs are also reported for long-term mortality, when the CFS was treated as a categorical variable: CFS-score 5 versus 1–4: HR (95% CI) 1.98 (1.27–3.08); 6 versus 1–4: HR (95% CI) 3.60 (2.39–5.44); 7 versus 1–4: HR (95% CI) 3.95 (2.38–6.55); 8–9 versus 1–4: HR (95% CI) 20.08 (9.30–43.38). The completing analyses for short- and mid-term mortality indicated a similar risk-predictive value of the CFS. Conclusions Clinical frailty scale score was independently associated with all-cause short-, mid- and long-term mortality. A nearly doubled risk of death was observed in frail patients. This information is clinically relevant, since individualised treatment and care planning for older adults should consider risk of death in different time perspectives.

The aim of this study is to investigate the feasibility of an alternative Fenton-based advanced oxidation process for the discoloration of reactive-dyed waste cotton as a pre-treatment for textile recycling. For that, pre-wetted dark-colored (black and blue) knitted samples of 300 cm² are treated in 1200mL Fenton-solution containing 14 mM Fe²⁺ and 280mM H2O2 at 40 °C. Characterization of the textiles before and after the treatments are performed by UV VIS-spectrophotometry measuring color strength, microscopy, FTIR spectroscopy, thermal analysis and tensile testing measuring tenacity and elongation. Afterwards, the cotton is mechanically shredded for qualitative analysis of the recyclability. The color-strength measurements of the black and blue cotton led to discoloration-efficiencies of respectively 61.5 and 72.9%. Microscopic analysis of discolored textile fabric also showed significant fading of the colored textiles. Mechanical analysis resulted in reduced tensile strength after treatment, indicating oxidation of the cellulosic structure besides the degradation of the dye-molecules, also confirmed by reductions in thermal stability found after thermal analysis. Shredding of the fabric resulted in enhanced opening, but shorter remaining fibers after treatment. The findings of this study provide a proof-of-concept for an alternative color-stripping treatment concerning a Fenton-based advanced oxidation process as a pre-treatment for textile recycling.

Introduction: Ethical competence in professional practice can be considered essential among nurses and nurses in ambulance care encounter ethical dilemmas frequently. To enhance ethical competence among students in the ambulance specialist nursing program, high-fidelity simulation scenarios including ethical dilemmas were introduced as a learning activity. Research aim: The research aim was to investigate the usefulness of high-fidelity simulation in ambulance specialist nurse education to teach ethical reasoning when caring for children. Research design: This study was conducted as a qualitative interview study, complemented with observations and using field notes and qualitative interviews for data collection. Data was analysed using deductive qualitative content analysis based on a care ethical model. Participants and research context: Participants (n = 35) were recruited from an ambulance nurse educational program at a Swedish university. Data was collected after the students took part in two high-fidelity simulations involving children in an ambulance care setting. Ethical considerations: The study has been vetted and approved by the ethical council at the University of Borås, Sweden. The study follows the Helsinki Declaration's advice on ethical principles. Results: The results showed that most of the students expressed some form of ethical reasoning during the simulation sessions, which were elaborated and reflected upon during the debriefing part of the sessions. The simulation design seemed to have a great impact on the outcome of the student's ethical reasoning, where increased immersion led to deeper emotional engagement among the students which increased awareness of their personal preconceptions. Conclusions: This study aimed to investigate whether high-fidelity simulations could be useful to stimulate ethical reflections and contribute to increased ethical competence among students. In conclusion, a well-designed high-fidelity simulation can be useful as an educational tool to learn and enhance ethical competence among specialist ambulance nursing students.

Background: Occupational therapists have long been recognized for their expertise in welfare technology use, particularly in the context of dementia care. Despite this advanced training, however, there is often a gap between their knowledge of available technologies and the frequency with which they recommend these tools to individuals with dementia. Aims/objectives: This study explores the perspectives of occupational therapists on the recommendations of welfare technologies for individuals with dementia. Materials and methods: A survey was created with the assistance of an expert group in a Swedish municipality. The survey consisted of 26 questions (demographics, background/workload, perceptions of welfare technologies, accessibility/information and knowledge on how and when to use, and initiation of contact and recommendation frequency) and was distributed to 60 occupational therapists within the selected municipality. We received a total of 29 responses. The responses were then analyzed qualitatively for meaningful insights across various themes. Using an encoding scheme, a statistical analysis of the responses was performed to uncover potential trends in the distribution of the responses. Results: Results indicate positive perceptions of welfare technologies by occupational therapists, but a low frequency of recommendations for individuals with dementia. Conclusions and significance: Based on the results, we find it important to advocate for more educational opportunities for occupational therapists regarding welfare technologies and improved organizational structures that promote their understanding and ultimately benefits of recommending welfare technologies to individuals with dementia.