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- Serenius, Fredrik, et al.
(författare)
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Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden
- 2013
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Ingår i: Obstetrical and Gynecological Survey. - : Lippincott Williams & Wilkins. - 0029-7828 .- 1533-9866. ; 68:12, s. 781-783
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- A proactive approach to the care of extremely preterm infants has increased survival and lowered the gestational age of viability, but these improvements may be associated with later neurodevelopmental disability. EXPRESS is a national population-based prospective study of all infants born alive or stillborn at less than 27 weeks’ gestation between 2004 and 2007 in Sweden. This prospective follow-up study was undertaken to assess neurologic and developmental outcome of the EXPRESS cohort at 2.5 years corrected age compared with a matched control group born at term.Of 707 live-born infants, 497 (70%) survived to corrected age 2.5 years; the final cohort included 491 children. Each preterm child was matched with 2 control subjects at 2.5 years chronological age. Cognitive, language, and motor development were assessed with the Bayley Scales of Infant and Toddler Development (Bayley III). Cerebral palsy (CP), visual and hearing disability, and a composite outcome of overall disabilities were assessed. The overall outcome was characterized as no, mild, moderate, and severe disability.Of 415 infants assessed with clinical examinations, 399, 393, and 382, respectively, completed the Bayley III cognitive, language, and motor scales; 366 control children were assessed with Bayley III. The mean composite cognitive, language, and motor scores for children in the preterm and control groups were 94 ± 12 and 104 ± 11, respectively (P < 0.001), 98 ± 17 and 109 ± 12 (P < 0.001), respectively, and 94 ± 16 and 107 ± 14 (P < 0.001), respectively. Normal cognitive development or mild cognitive disability was found in 354 preterm children (88.8%) and 364 control children (99.5%). Moderate or severe cognitive disability was present in 20 preterm children (5.0%) and 1 control child (0.3%) (P < 0.001) and in 25 (6.3%) and 1 (0.3%), respectively (P < 0.001). Normal language development or mild language disability was found in 330 children (83.9%) in the preterm group and with 351 (97.5%) in the control group (all group comparisons, P < 0.001). Normal motor development or mild motor disability occurred in 324 (84.8%) and 348 (98.6%) of children in the preterm and control groups, respectively. Moderate or severe mental developmental delay was seen in 88 and 10 children (20% and 2.8%), respectively (P < 0.001).In the preterm group, Bayley III cognitive, language, and motor scores increased with advancing gestational age at birth by 2.5 points (99% confidence interval [CI], 1.0–4.0) per week (P < 0.001), by 3.6 points (99% CI, 1.6–5.6) per week (P < 0.001), and by 2.5 points (99% CI, 0.5–4.5) per week scores (P = 0.001), respectively. Cerebral palsy was present in 32 preterm children (7.0%; 99% CI, 3.9–10.1%). Of 456 preterm children, 42.1% were classified as normal, 30.7% as having mild disabilities, and 27.2% as having moderate or severe disabilities (vs 78.1%, 18.6%, 3.3% of control subjects, respectively; P < 0.001 for all comparisons). The proportion of children with mild or no disabilities increased from 40% at 22 weeks to 83% at 26 weeks (P < 0.001 for trend). Moderate or severe disabilities decreased from 60% at 22 weeks to 17% at 26 weeks (P < 0.001 for trend).The impact of prematurity on neurodevelopmental outcome indicates that further improvements in neonatal care are necessary. Although preterm children had poorer neurodevelopmental outcomes than those born at term, 73% had no or mild disability, and neurodevelopmental outcome improved with each week of gestational age. These results are relevant for clinicians counseling couples facing extremely preterm birth of their infant
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När förvaltning blir business : marknadiseringens utmaningar för demokratin och välfärdsstaten
- 2013
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Att företag bedriver vård, omsorg och andra verksamheter på det offentligas uppdrag är idag en del av vår vardag. Den svenska förvaltningen har förändrats och blivit alltmer business.I den här boken väcker forskare från flera lärosäten frågor och uppmuntrar till fortsatt diskussion på detta tema. Vi tar upp vad marknadisering, konkurrensutsättning och privatisering betyder för den svenska demokratin och förvaltningsmodellen. Hur står det till med politikens möjligheter till styrning? Vad händer med synen på medborgarskapet? Finns det till exempel vinnare och förlorare? Finns det en framtid för förvaltningen som business?
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- Farstad, Britt Johanne, 1961-
(författare)
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Glaspärlespelaren : Nya världar, etik och androcentrism i Peter Nilsons science fiction-romaner
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on Peter Nilson’s (1937-1998) science fiction texts, and particularly on how narrative themes and structures in these texts are related to science as well as to the literary tradition of science fiction (SF). The primary texts are the novels Arken (The Ark, 1982), Äventyret (The Adventure, 1989), Rymdväktaren (The Space Guard, 1995), Nyaga (1996) as well as the short story “Kvinnan som ville ha barn med döden” (The Woman Who Wanted a Child With Death, 1987). Nilson was an established astronomer before publishing fiction, and in both novels and essays he joins “the two worlds” of the natural sciences and the humanities. My study of the reception of his work shows that his symbolic capital, his authority as a scientist, was transferred from one field of knowledge to another, thus increasing the value of his SF texts in critics’ eyes. Central to my analyses are the authorial strategies Nilson used when building bridges between natural science and the humanities, in a move evoking the Glass Bead Players in Herman Hesse’s novel The Glass Bead Game. My study shows that, unlike Hesse’s protagonists, the Glass Bead Players in Nilson’s texts accept, or even welcome, extreme consequences of scientific developments, such as the extinction of life as we know it.SF texts are traditionally categorized as either dystopic or utopic depending on the level of pessimism or optimism in their depictions of technology. I suggest instead that dystopic or utopic outcomes in modern SF novels depend on whether the texts build on an aleatoric or a teleological worldview. In aleatoric narratives, humankind is depicted as alone in the universe and thereby responsible for its own destiny. Teleological narratives feature superior, god-like forces from other worlds, which interfere with life on Earth and may elevate humans to higher levels of consciousness. The latter perspective, which is favoured in Nilson’s SF texts, entails that responsibility is removed from humankind since what happens is presented as meant to be. The tropes of the void and of creatio ex nihilo are recurrent in the examined texts, for instance through the use of myths and archetypes containing images of emptiness such as the “creation out of nothing”. Further, Nilson’s characters are often situated in a mental or physical “void” where their knowledge is of no use to them. My readings show that these voids are not empty but contain mythical and archetypal elements which activate obsolete religious ideas and gender models, such as the Logos vision: the creative power of words. This conservative tendency seems all the more surprising and problematic considering that the SF-genre is based on explorations of possible new worlds and beings.
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- Bohman, Anna, 1975-
(författare)
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Framing the water and sanitation challenge : A history of urban water supply and sanitation in Ghana 1909 - 2005
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis analyses the development of urban water supply and sanitation services in Ghana from 1909 to 2005. Special focus is put on institutional arrangements with regard to networked, large scale and centrally managed water and sewerage services. The national and international historical context is highlighted as a way to understand policy redirections in the sector. Further on, the concept of frames is used as an analytical tool in order to put light on the assumptions, arguments and reasons behind institutional reforms. The thesis finds that it was not until the water and sanitation challenge was framed from a productivity perspective, as opposed to a pure humanitarian “health frame”, that funds were released for investments in WSS infrastructure. To begin with, development strategies were largely focussed on “filling the gaps” in terms of manpower, technical and financial resources. As the water challenge was increasingly framed as a matter of managing scarcity, a new thinking gradually emerged which emphasized entrepreneurship, business mindedness and management skills as a way to achieve more efficiency within the sector. This development was also paralleled by a shift in the favoured organisational structure from an extremely centralised state utility model to a gradual focus on decentralisation and unbundling of the sector. Here a strong focus was put on private sector participation in urban water supply whereas the non-commercially viable task of sewerage development was decentralised to local authorities. The study finds that formal institutional change in the sector has been largely donor driven. However, the privatisation element of the recent urban water sector reform did not go unquestioned and a strong opposition movement concerned with the possible negative effects of privatisation was formed. Eventually the initial lease arrangement was transformed into a management contract where its signing was brought to closure in 2005. Besides changing frames strong elements of continuity in the urban water supply and sanitation sector development in Ghana are identified. Historical evidence demonstrate that urban water delivery was a highly political issue in Ghana already during colonial times which, just as today, was closely connected to the framing of water as independence and national integrity. The issue of finance and pricing has remained a constant concern and so the debate cannot be categorized as a novel issue that solely emanates from neo-liberal political trends during the 1980’s and 1990’s. The thesis argues that a legacy of a colonial frame tends to continue normalising inequalities in access and consumption. Continuity can also be found in a neglect of the issue of sanitation which persistently lags behind the development of water distribution. The dissertation concludes that the perceived space for policy alternatives in Ghanaian WSS sector development has been largely constrained by the historical context and contemporary development theories. Therefore, to constantly strive towards a frame reflective policy dialogue is strongly encouraged as a way for policy planners and decision makers to make well informed decisions for the future.
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| 9. |
- Levi, Richard, et al.
(författare)
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Spinalishandboken : ny kraft för skadad ryggmärg
- 2011. - 1
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- En ryggmärgsskada ställer hela livet på ända. Man måste lära sig kroppens nya signaler, hur man hanterar alla tankar och känslor och hur man nu ska leva sitt liv. Spinalishandboken tar upp dels vad som händer i kroppen och hur rehabilitering går till, dels tankar om existentiella frågor, vikten av att sörja och hur man kan leva ett gott liv trots skadan.
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