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- Vogt, Hartmut
(författare)
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Early life factors and the long-term development of asthma
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Asthma, a huge burden on millions of individuals worldwide, is one of the most important public health issues in many countries. As genetic and environmental factors interact, asthma may be programmed very early in life, perhaps even in utero.The aim of this thesis was to assess the impact of gestational age, cord blood immunoglobulin E (IgE), a family history of asthma, migration, and pertussis immunization in early life on the development of asthma in child and adult populations.As a proxy for asthma disease, dispensed asthma medication was used as the main outcome variable based on data from the Swedish Prescribed Drug Register. Data from other national registers were used to control for confounders. Three of our studies were based on national cohorts, and one on a local birth cohort that was initiated in 1974–75.Gestational age had an inverse dose-response relationship with dispensed asthma medication in 6– to 19-year-olds. Odds ratios for dispensed asthma medication increased with degree of prematurity compared with children born in term. Furthermore, asthma medication was more likely to be dispensed among children and adolescents born early term after 37–38 weeks’ gestation than among those at the same age who were born in term.Elevated cord blood IgE and a family history of asthma in infancy were associated with a two- to threefold increased likelihood of dispensed asthma medication and self-reported allergen-induced respiratory symptoms at the age of 32–34 years, but the predictive power was poor.Age at migration had an inverse dose-response relationship with dispensed asthma medication at the age of 6–25 years in adoptees and foreign-born children with foreign-born parents. International adoptees and children born in Sweden to foreign-born parents had three- to fourfold higher rates of asthma medication compared with foreign-born children who were raised by their foreign-born birth parents.No association was found between pertussis immunization in early infancy and dispensed asthma medication in 15-year-olds. The type of vaccine or vaccine schedule did not affect the outcome.Fetal life is a vulnerable period. This thesis strengthens the evidence that every week of gestation is important for lung maturation. Cord blood IgE, however, did not predict the risk of asthma in adults. Furthermore, the study of migrating populations demonstrated that environmental changes at any age during childhood may affect the risk of asthma. Another, important public health message from this thesis is that vaccination against pertussis in early childhood can be considered safe with respect to the long-term development of asthma.
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| 2. |
- Andersson, Stefan
(författare)
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Information and Communication Technology : mediated support for working carers of older people
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Despite a growing awareness of the importance of support for carers who combine paid work with care of an older relative, so called ‘working carers’, there remains a lack of empirical knowledge about more innovative ways to support this largest group of carers of older people. Information and Communication Technologies (ICTs) are becoming more readily available. As a result, ICTs have made it feasible to offer working carers more targeted forms of support.This thesis aimed to gain an understanding about support for working carers of older people via the use of ICT.An integrative literature review was conducted to explore and evaluate the current evidence base concerning the use of ICT-mediated support for working carers (I). Content analysis of qualitative data was used to describe nursing and support staff’s experiences of using web-based ICTs for information, e-learning and support of working carers (II). Content analysis was also used to describe working carers’ experiences of having access to a web-based family care support network provided by the municipality (III). Descriptive statistical methods were used to analyse survey data which focused on the types of support received and how they were valued by working carers, with a focus on ICT support (IV).Findings highlighted that ICT mediated support provided working carers with the means to manage their caring situation, via the provision of information, e-learning and education, in addition to practical assistance and emotional and/or physical respite from caregiving. In this way, working carers felt empowered in their caring situation by feeling more competent and prepared in their caring role and by strengthening their self-efficacy and positive self-appraisal of their situation. Carers were provided channels to share their frustrations and burdens via forums for emotional and social support between working carers, caring professionals, and other peer carers. This led to working carers feeling less burdened by their caregiving role and it helped promote their wellbeing. Further, carers were helped in some instances to balance work and care. As a result caregiving activities conflicting with work obligations were then lessened.In contrast, when ICT mediated support was neither provided in a timely fashion or in accordance with individual carers’ needs and preferences, then it was perceived by them to be unimportant. Cross-sectional data revealed that take-up of support services was low suggesting that unmet support needs may be inflated by work-care conflicts. For carers with lower digital skills, the additional time needed to learn to use ICTs was a further barrier.Overall, ICT mediated support acted as a complementary form of support for working carers. Measures to overcome dis-empowering aspects of this innovative from of support are needed to avoid working carers’ deprioritizing their own support needs and also to avoid possible digital exclusion from the current information society.
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| 3. |
- Andréasson, Frida
(författare)
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Doing informal care : Identity, couplehood, social health and information and communication technologies in older people’s everyday lives
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis has been a) to analyse how informal care influences the identity of carers and care recipients, their sense of couplehood and social health, and b) to explore the use of Information and Communication Technology (ICT) in the context of informal care and the everyday lives of older people. Study I focused on how older carers conceptualised their identity as carers on a Swedish online social forum, using a netnographic methodology. The findings indicated a change in self-perception as the carer role was acquired. Carers’ capacities were filtered through the needs of the care recipient, making their carer identities into invisible selves. The findings revealed that online communication had the potential to create a virtual space of social recognition. Study II aimed to reflect on carers’ experiences of participation in a co-design process consisting of user group sessions with carers and researchers. The goal was to develop a web-based support programme for carers. The findings emphasised a need to consider carers’ lifeworlds and to develop flexible human-centred design methodologies, that are able to balance carers’ needs and ideas with proposed research outcomes. Studies III and IV utilised an ethnographic methodology. In study III, the notion of couplehood in informal care was analysed. The findings showed that in the process of becoming a carer and a care recipient previous (often gendered) responsibilities were re- negotiated and new practicalities emerged. Although these changes were understood as a natural part of family life, they nevertheless led to changes in the (power) balance between spouses, expressed in terms of a professionalised relationship and a sense of social isolation. ICT was used as a means to get a respite from caring and uphold a social connection with others. In study IV, the social implications and consequences of spousal informal care and carers and care recipients’ experiences of illness and the ill body was explored. The findings showed that the participants experienced barriers to living life as before. Thoughts about or the presence of ill and “leaking” bodies thus lead to “self-chosen” social isolation or social distancing by others. The thesis highlights that informal care needs to be understood as an identity forming practice, having a significant impact on involved parties’ sense of couplehood, their social health and that ICT can contribute to ease carers’ and care recipients’ daily life.
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| 4. |
- Hamreby, Kerstin, 1950-
(författare)
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Flickor och pojkar i den sociala barnavården : Föreställningar om kön och sociala problem under 1900-talet
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The topic of this study is girls and boys in the field of child welfare. The aim has been to trace and describe conceptions of gender, delinquency and social problems in child welfare from the end of the nineteenth century until the middle of the twentieth century. The sources of data in the study consist of legislative documents, journals and other historical literature representing the professional discourse. Two analytical approaches have been used. First, the sources were employed for descriptions of legislation and the legislative processes in child welfare. Second, the material was analyzed with a discursive approach to elucidate conceptions of gender and their importance in the legislative process and thus in the construction of social problems. Three main periods with different currants of ideas have been identified. In the first period moralism dominated. Thoughts about social problems were based in normative assumptions and scientific influences were rare. Child welfare legislation was deeply influenced by ideas of social control. Young people were to be controlled and disciplined especially through work: Girls through household work and care and boys through paid work. In the second period hygienism, ideas based in hygiene discourses, were the main trend. Genetically based arguments together with discussions about morality and poverty were used to explain social problems, and scientific methods were to be used to discipline and control young people. Proposals for measures take against social problems corresponded to two main lines, a hygienic-medical line and a social pedagogic line. The hygienic-medical line had a considerable influence on actions taken to prevent and deal with social problems. One example was the compulsory care and sterilization of certain young women to prevent them from reproducing. The social pedagogic line comprised parents’ education, the role of the family and sexual education. An increased use of psychological explanations for experiences and behaviour among individuals and groups was seen in the 1930’s; this marked the beginning of the third period, psychologism. During the period of psychologism, science, mainly represented by psychology and psychiatry, gradually achieved a greater impact in those processes where young people were categorized as social problems. If in the previous period external discipline was the means of control, in this period internalized self-discipline was to be the means of adjustment. The study showed that conceptions of girls and boys in child welfare were gendered throughout the first half of the twentieth century. This bias has had an impact on how girls and boys were treated in child welfare services. Discussions about social problems concerning girls were often about sexuality and sexual actions, and discussions concerning boys were about violence and criminality. Social problems among girls were seen above all as moral transgressions and social problems among boys as juridical transgressions. These differing conceptions are of great importance when considering how girls and boys were judged and treated according to the child welfare Acts in existence during the first part of the twentieth century.
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