| 1. |
- Almqvist, Jonas, 1968-, et al.
(författare)
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Pragmatiska studier av meningsskapande
- 2008
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Ingår i: Utbildning och Demokrati. - 1102-6472 .- 2001-7316. ; 17:3, s. 11-24
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Tidskriftsartikel (refereegranskat)abstract
- The overall aim of the article is to present a pragmatic approach for studies of meaning-making used in the articles of this issue. The approach, which is developed within the SMEDgroup (Studies of Meaning-making in Educational Discourses), mainly builds on the writings of John Dewey, Ludwig Wittgenstein and Michel Foucault. A common ambition for the researchers in SMED is to enable studies and discussions on questions concerning how meanings are made in people’s actions. Another ambition is to carry out these studies beyond assumptions of dualism, essentialism, causality and determinism. In this perspective learning and socialization are viewed in a communicative perspective. We argue in the article that our approach makes it possible, and important, to study meaning-making in action in different kinds of educational practices.
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| 2. |
- Barber, R. M., et al.
(författare)
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Healthcare access and quality index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015 : A novel analysis from the global burden of disease study 2015
- 2017
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 390:10091, s. 231-266
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Tidskriftsartikel (refereegranskat)abstract
- Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0-42·8) in 1990 to 53·7 (52·2-55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright © The Author(s). Published by Elsevier Ltd.
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| 3. |
- Carrington, Thomas, 1974-, et al.
(författare)
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An empirical test of the hierarchical construct of professionalism and managerialism in the accounting profession
- 2013
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Ingår i: Behavioral Research in Accounting. - : American Accounting Association. - 1050-4753 .- 1558-8009. ; 25:2, s. 1-20
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Tidskriftsartikel (refereegranskat)abstract
- Research into the tension between professionalism and commercialism in the accounting profession is inconclusive and warrants greater attention. How to conceptualize and measure these constructs are thus pressing concerns. Using questionnaire data from 1646 auditors in Sweden, and applying confirmatory factor analysis and structural regression models within a structural equation modeling framework to a measurement model developed by Suddaby et al. (2009), we find little empirical evidence for the existence of the two logics of professionalism and managerialism (i.e., commercialism) as two higher-order latent constructs shared by auditors. However, we find that two sub-elements of the proposed higher-order constructs do discriminate between each other in a way that could indicate two exclusive value statements in the accounting profession connected to the professionalism-commercialism tension: these are the respective emphases on independence enforcement and client commitment.
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| 4. |
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| 5. |
- Geibe, Christine, et al.
(författare)
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Comparison of soil solution chemistry sampled by centrifugation, two types of suction lysimeters and zero-tension lysimeters
- 2006
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Ingår i: Applied Geochemistry. - : Elsevier BV. - 0883-2927 .- 1872-9134. ; 21:12, s. 2096-2111
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Tidskriftsartikel (refereegranskat)abstract
- The choice of sampling method for soil solution is of great importance. In this paper soil solution chemistry sampled by centrifugation, two types of suction lysimeters and zero-tension lysimeters have been studied with the purpose of investigating systematic differences between them. The samples were taken at 4 depths from an acidified forest soil as well as from adjacent lime and ash treated soils. A centrifugation drainage method was compared with two types of suction lysimeters ('Rhizon' and 'Prenart') and zero-tension lysimeters. About half of the 27 variables measured showed a significant difference between the sampling methods used. Typically the centrifuged samples had lower pH (4.0 vs. 4.4), Ca (21 mu M vs. 30 mu M) and Mg (25 mu M vs. 34 mu M) concentrations and higher CI (330 mu M vs. 230 mu M) and DOC (4.4 mM vs. 3.2 mM) concentrations than the Rhizon lysimeters. Also the other lysimeters showed significant differences compared to the centrifuged samples for about half the number of analytes. Centrifuged samples had higher concentrations of all analytes except NO3 and PO4 compared to zero-tension lysimeters and also for all analytes except NO3 and Al compared to Prenart lysimeters. Among the environmental factors considered depth showed an influence to some extent, while sampling occasion had a great significant impact on the difference between the centrifugation method and the Rhizon lysimeters. Factors like individual pits or soil treatment did not show any influence on the difference between the methods. (c) 2006 Elsevier Ltd. All rights reserved.
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| 6. |
- Gustafsson, Sanna Aila, et al.
(författare)
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How to deal with sociocultural pressures in daily life : reflections of adolescent girls suffering from eating disorders
- 2011
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press Ltd. - 1178-2390. ; 4, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent girls with eating disorders experience unattainable and contradictory expectations in daily life, which create stress and negatively affect their self-evaluation. Disordered eating may function as a way of seeking control and consistency. In order to make progress in the understanding of eating disorders, the aim of this study was to describe how adolescent girls with eating disorders reflect upon ways of dealing with sociocultural pressures in daily life. Eighteen interviews with girls aged 15–19 years were analyzed using a phenomenographic approach. The results were summarized into three conceptions: ‘Striving to be oneself" (conception A) was described as the most desirable, but also the hardest. "Adapting to various situations’ (conception B) was used without much reflection, as long as it worked, but when this way of dealing with everyday expectations was unsuccessful it was evaluated negatively. "Presenting oneself in a positive light" (conception C) was described negatively even when it was successful. Within these conceptions, the participants described various strategies that could be used more or less effectively depending on the circumstances. A common theme was their difficulties in finding a balance between trying harder to live up to perceived expectations from others on one hand, and trying to accept the situation as it was, without trying to change themselves or the situation, on the other hand. The participants believed that their eating disorder was partly a result of being unable to deal with sociocultural pressures in an effective way, and they experienced a conflict between societal values of being assertive and values of being interpersonally oriented. Implications for treatment are discussed.
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| 7. |
- Gustafsson, Sanna Aila, 1972-, et al.
(författare)
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Perceived expectations in daily life among adolescent girls suffering from an eating disorder : A Phenomenographic Study
- 2010
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Ingår i: Eating Disorders. - Philadelphia : Routledge. - 1064-0266 .- 1532-530X. ; 18:1, s. 25-42
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the variation of perceived expectations in daily life of adolescent girls suffering from eating disorders. Eighteen interviews with girls between the age of 15 and 19 years were analyzed according to the phenomenographic approach. The results could be summarized into three categories: expectations from others, self-imposed expectations, and conflicting expectations. Each of these could be further subdivided into two conceptions. Conflicting and unattainable expectations were severe stressors in the informants’ lives. Many informants had problems identifying expectations that were not explicit. The informants internalized these expectations and interpreted them to be self-imposed. Clinical implications are suggested.
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| 8. |
- Hansson, Mats G, et al.
(författare)
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Concern for privacy in relation to age during physical examination of children : an exploratory study
- 2009
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell Publishing Inc.. - 0803-5253 .- 1651-2227. ; 98:8, s. 1349-1354
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore whether physicians behave differently regarding ethics and respect for privacy depending on children's age. We explored whether physician behaviours contributed to child uneasiness.Study design: Observational study of 21 children (0-12 years; 18 boys; mean age 3.2) undergoing evaluation for inguinal hernia. Specific physician-initiated verbal and nonverbal behaviours were coded from digital video discs of the consultations.Results: Physician intrusiveness (i.e. approaching the child suddenly or in an uninvited way) during the physical examination was related to concurrent child uneasiness (r = 0.42, p < 0.06) and lasted through the postexamination phase of the consultation (r = 0.52, p < 0.01). Child mood during the examination strongly predicted postexamination mood (r = 0.69, p < 0.0001). Neither the total number of physician-initiated positive behaviours or privacy-related behaviours was associated with child age. Negative physician behaviours were strongly related to negative mood in the child (r = 0.72, p < 0.0001) at the close of the consultation.Conclusion: Although physicians were more likely to provide information to older than younger children, their behaviours regarding privacy did not differ by child age. We found that intrusiveness was rather common and related to child uneasiness that has implications for the ethical practice and a child's willingness to be examined.
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| 9. |
- Hansson, Mats G, et al.
(författare)
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Ethics takes time, but not that long
- 2007
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Ingår i: BMC Medical Ethics. - : Springer Science and Business Media LLC. - 1472-6939. ; 8, s. 6-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Time and communication are important aspects of the medical consultation. Physician behavior in real-life pediatric consultations in relation to ethical practice, such as informed consent (provision of information, understanding), respect for integrity and patient autonomy (decision-making), has not been subjected to thorough empirical investigation. Such investigations are important tools in developing sound ethical praxis. METHODS: 21 consultations for inguinal hernia were video recorded and observers independently assessed global impressions of provision of information, understanding, respect for integrity, and participation in decision making. The consultations were analyzed for the occurrence of specific physician verbal and nonverbal behaviors and length of time in minutes. RESULTS: All of the consultations took less than 20 minutes, the majority consisting of 10 minutes or less. Despite this narrow time frame, we found strong and consistent association between increasing time and higher ratings on all components of ethical practice: information, (beta = .43), understanding (beta = .52), respect for integrity (beta = .60), and decision making (beta = .43). Positive nonverbal behaviors by physicians during the consultation were associated particularly with respect for integrity (beta =.36). Positive behaviors by physicians during the physical examination were related to respect for children's integrity. CONCLUSION: Time was of essence for the ethical encounter. Further, verbal and nonverbal positive behaviors by the physicians also contributed to higher ratings of ethical aspects. These results can help to improve quality of ethical practice in pediatric settings and are of relevance for teaching and policy makers.
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| 10. |
- Hay, S. I., et al.
(författare)
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Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016 : A systematic analysis for the Global Burden of Disease Study 2016
- 2017
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 390:10100, s. 1260-1344
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Tidskriftsartikel (refereegranskat)abstract
- Background: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). Methods: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE difered from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. Findings: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs ofset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the fve lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. Interpretation: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs ofset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention eforts, and development assistance for health, including fnancial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. © The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
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