| 1. |
- Heiwe, Susanne, et al.
(author)
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Evidence-based practice : attitudes, knowledge and behaviour among allied health care professionals
- 2011
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In: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 23:2, s. 198-209
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Journal article (peer-reviewed)abstract
- Objective: To explore dieticians', occupational therapists' and physical therapists' attitudes, beliefs, knowledge and behaviour concerning evidence-based practice within a university hospital setting. Design: Cross-sectional survey. Setting. University hospital. Participants: All dieticians, occupational therapists and physical therapists employed at a Swedish university hospital (n = 306) of whom 227 (74%) responded. Main Outcome Measures: Attitudes towards, perceived benefits and limitations of evidence-based practice, use and understanding of clinical practice guidelines, availability of resources to access information and skills in using these resources. Results: Findings showed positive attitudes towards evidence-based practice and the use of evidence to support clinical decision-making. It was seen as necessary. Literature and research findings were perceived as useful in clinical practice. The majority indicated having the necessary skills to be able to interpret and understand the evidence, and that clinical practice guidelines were available and used. Evidence-based practice was not perceived as taking into account the patient preferences. Lack of time was perceived as the major barrier to evidence-based practice. Conclusions: The prerequisites for evidence-based practice were assessed as good, but ways to make evidence-based practice time efficient, easy to access and relevant to clinical practice need to be continuously supported at the management level, so that research evidence becomes linked to work-flow in a way that does not adversely affect productivity and the flow of patients. © The Author 2011. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
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| 2. |
- Andersson, Erik, 1979-, et al.
(author)
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Delaktighet som pedagogik och demokratiskt värde för fullföljandet av studier – kunskapsbidrag från ett utvecklingsprojekt
- 2015
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In: Utbildning och Lärande / Education and Learning. - Skövde : Högskolan i Skövde. - 2001-4554. ; 9:1, s. 80-100
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Journal article (peer-reviewed)abstract
- Participation as a pedagogy and democratic value turns out to be a critical element in students’ completion of school. Completed education is a regional development project in which a survey has been conducted in order to identify successful strategies to promote completed education in school. In an analysis, in the context of the survey, with an emphasis on school and participation as a pedagogy and democratic value, several findings are shown. It turns out that the importance of participation manifests itself through an emphasis on the societal and democratic mission of school; school ethos; the value praxis of school; pedagogical approach; and viewing the pupil as capable. It is, in more detail, shown that it is particularly crucial to understand the completion of school as a pedagogical problem; create sustainable institutional structures not bound to one person; and to make sure that students are participants in their own studies.
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| 3. |
- Andersson, Susanne, 1957-, et al.
(author)
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Experiences of a Novel Structured Foot Examination Form for Patients With Diabetes From the Perspective of Health Care Professionals : Qualitative Study
- 2023
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In: JMIR nursing. - : JMIR Publications. - 2562-7600. ; 6
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Journal article (peer-reviewed)abstract
- BACKGROUND: Diabetes is a growing threat to public health, and secondary diseases like foot complications are common. Foot ulcers affect the individual's quality of life and are a great cost to society. Regular foot examinations prevent foot ulcers and are a recommended approach both in Sweden and worldwide. Despite existing guidelines, there are differences in the execution of the foot examination, which results in care inequality. A structured foot examination form based on current guidelines was developed in this study as the first step toward digitalized support in the daily routine, and was validated by diabetes health care professionals.OBJECTIVE: The study aimed to validate a structured foot examination form by assessing health care professionals' experiences of working with it "foot side" when examining patients with diabetes.METHODS: Semistructured interviews were held in a focus group and individually with 8 informants from different diabetes professions, who were interviewed regarding their experiences of working with the form in clinical practice. The users' data were analyzed inductively using qualitative content analysis. The study is part of a larger project entitled "Optimised care of persons with diabetes and foot complications," with Västra Götaland Region as the responsible health care authority, where the results will be further developed.RESULTS: Experiences of working with the form were that it simplified the foot examination by giving it an overview and a clear structure. Using the form made differences in work routines between individuals apparent. It was believed that implementing the form routinely would contribute to a more uniform execution. When patients had foot ulcers, the risk categories (established in guidelines) were perceived as contradictory. For example, there was uncertainty about the definition of chronic ulcers and callosities. The expectations were that the future digital format would simplify documentation and elucidate the foot examination, as well as contribute to the accessibility of updated and relevant data for all individuals concerned.CONCLUSIONS: The foot examination form works well as a support tool during preventive foot examination, creates a basis for decision-making, and could contribute to a uniform and safer foot examination with more care equality in agreement with current guidelines.TRIAL REGISTRATION: ClinicalTrials.gov NCT05692778; https://clinicaltrials.gov/ct2/show/NCT05692778.
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| 4. |
- Andersson, Susanne, et al.
(author)
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From glass ceiling to firewalls : Detecting and changing gendered organizational norms
- 2022
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In: NORA. - : Routledge. - 0803-8740 .- 1502-394X. ; 30:2, s. 140-153
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Journal article (peer-reviewed)abstract
- This article is based on an empirical case study with an interactive research approach focusing on gendered norms in a Swedish truck Company. It discusses the combined value of using the metaphor of a firewall for (1) analysing how organizational constraining gendered norms are done in everyday organizational life, and (2) as a practical tool to facilitate the processes aimed at improving norm awareness. The metaphor embodies an understanding that makes it possible to visualize relational ongoing organizational processes and power dimensions. In addition, the firewall is useful for emphasizing variations and complexity. Variations and dynamics are manifested in the ways that employees need to fulfil varying “codes” in order to be accepted. The possession of certain codes (norms) that are required to pass through the first layer of the firewall (employment), and give access to some networks, does not automatically ensure acceptance and integration into more influential networks (referred to as the informal and inner layers of the firewall). The results furthermore show that the firewall metaphor is fruitful when facilitating reflection processes amongst employees to improve norma wareness and to discuss strategies for change. The conclusion is that the firewall metaphor facilitates an analysis of the relational and complex doing of constraining norms, and that it also can be used to initiate change.
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| 5. |
- Andersson, Susanne, et al.
(author)
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Moving with(in) normative firewalls : a dynamic approach to study gendered careers and innovation processes in the truck industry
- 2018
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Conference paper (peer-reviewed)abstract
- In this paper we explore how existing work place culture and gendered norms impact on the possibilities to work with so called ”norm-critical” innovation processes in an organisation. Norm-critical reflexivity in the context of innovation processes implies to pay attention to invisible and implicit norms that may result in that certain privileged perspectives is being prevailed (over others) (Balkmar & Lykke 2015). The empirical findings emanates from a two year interactive research project, in which gender researchers in collaboration with participants at Volvo Group, Sweden, have explored the ways that the company can increase its capacity to work with norm-critical perspectives in the innovation process. Volvo is a highly gender segregated organisation. At the same time the trucking industry in itself is highly masculinized in terms of different professions; ranging from truck drivers to sales personnel to technical engineers involved in the design and manufacturing of trucks. In later years the shortage of truck drivers, in combination with more women drivers entering trucking academies and haulage contractors, has led to a questioning of male norms in the transport business. This includes reports of difficult working conditions for female truckers, including how the design of the truck itself takes the male body as the implicit norm, to the assumption that it is a man that is the presumed driver of trucks.This paper focus on the part of the project that seeks to better understand how existing work-place culture and norms structure who is considered the ideal employee (Acker 1992) and its implications for innovation. This includes studying its impacts on both the possibility for different categories of employees to take part in the innovation work on equal terms, and the ability to reflect upon the impact of implicit norms in the innovation process itself. In total, 17 semi-structured interviews were conducted with co-workers and managers (13 women and 5 men). The main questions concerned whether there existed ideals that formed implicit ”codes” (Bendl and Schmidt 2010) in the organization and its impact on ideas of preferred professional qualifications, behaviors, personal qualities and its links to career possibilities and innovation. The underlying theoretical assumption is that gender is a fundamental element of organisational structure and work life; “present in [its] processes, practices, images and ideologies, and distribution of power” (Acker 1992, p. 567). The way that gender plays out in the daily life in a workplace is understood as not being a static barrier prohibiting women in general, rather, it is considered fluid, relational and may vary depending on the context (Meyerson & Fletcher 2001, Bendl and Schmidt 2010). It is argued that the concept ”fire wall” (Bendl and Schmidt 2010 ), offers a fruitful way to highlight the elasticity and permeability that we believe characterize the forms of discrimination, inclusion and exclusion that takes place in these processes.ReferencesAcker, J. 1992. Gendering Organisational Theory. In Mills, A. and Tancered, P. (eds.). Gendering Organisational Analysis. London: SAGE.Acker, J. 2006. Inequality Regimes: Gender, Class, and Race in Organisations. Gender and Society 20(4):441-464.Balkmar, D. & Lykke, N. 2015. Developing disruptive norm-critical innovation at Volvo: FINAL REPORT. Linköping: Tema Genus Report Series No. 23: 2015.Bendl, R. & Schmidt. 2012. From 'Glass Ceilings' to 'Firewalls' - Different Metaphors for Describing Discrimination. Gender, Work and Organization. Vol. 17. No 5:612-635.Meyerson, D. & Fletcher J.K. 2001. A Modest Manifesto for Shattering the Glass Ceiling. Boston: Harvard Business Review.
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| 6. |
- Balkmar, Dag, 1974-, et al.
(author)
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Women truck drivers and (future) mobile work : Towards gender equal transport futures?
- 2021
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In: Gender and Equality in Transport. - Dublin : TU Dublin. ; , s. 161-165
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Conference paper (other academic/artistic)abstract
- This paper focuses gender and gender equality in contemporary and future haulage business, arguing for a need for norm-critical approaches to build more gender equal transport futures. Currently, there is a general demand for more drivers internationally and in Sweden. Following the current driver shortage in occupational road freight, transport companies in Europe and Sweden recognise the need to recruit more women chauffeurs. Part of the problem is how transport is gendered, strongly intertwined with masculine norms that prevents nonnormative bodies to identify themselves as drivers. In Sweden, a country with a world reputation as champions in gender equality, men still make up more than 90 % of the work force in the Swedish transport business. While recruiting more women would contribute to solve the urgent problem of driver shortage, women drivers typically face gendered problems, concerning their personal safety, harassments, hygiene, and work/life (im)balance. From the perspective of the haulage business, addressing these gendered problems can increase the ability hire more women drivers, but would also need to develop transport innovations that suit not only today’s male users but also those of tomorrow.Future road freight and transport innovations such as more autonomous vehicles are often imagined to ‘solve’ some of the current problems that transport companies struggle with, including driver shortage. With the advent of autonomous, electrified and connected mobilities, we may anticipate both a gendered re-segregation and that fewer drivers would be needed (Balkmar and Mellström 2018). Nevertheless, problems of road transportation and the lack of gender equality in the haulage business can’t be solved following the “old logics of a technological fix”, gendered social and cultural issues need to be part of the solution (Kröger and Weber, 2018). Against this background, the aim of this paper is to explore how normcritical perspectives can offer ways forward with regards to gender and (lack of) gender equality in the haulage business. This includes to consider how technological innovations may change what it entails to be a truck driver and open new opportunities for the profession with regards to gender equality.
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| 7. |
- Hatschek, Thomas, et al.
(author)
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Neoadjuvant Trastuzumab, Pertuzumab, and Docetaxel vs Trastuzumab Emtansine in Patients With ERBB2-Positive Breast Cancer A Phase 2 Randomized Clinical Trial
- 2021
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In: JAMA Oncology. - : American Medical Association. - 2374-2437 .- 2374-2445. ; 7:9, s. 1360-1367
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Journal article (peer-reviewed)abstract
- IMPORTANCE: Trastuzumab emtansine (T-DM1) is presently approved for treatment of advanced breast cancer and after incomplete response to neoadjuvant therapy, but the potential of T-DM1 as monotherapy is so far unknown.OBJECTIVE: To assess pathologic complete response (pCR) to standard neoadjuvant therapy of combination docetaxel, trastuzumab, and pertuzumab (DTP) vs T-DM1 monotherapy in patients with ERBB2 (formerly HER2)-positive breast cancer.DESIGN, SETTING, AND PARTICIPANTS: This randomized phase 2 trial, conducted at 9 sites in Sweden, enrolled 202 patients between December 1, 2014, and October 31, 2018. Participants were 18 years or older, with ERBB2-positive tumors larger than 20 mm and/or verified lymph node metastases. Analysis was performed on an intention-to-treat basis.INTERVENTIONS: Patients were randomized to receive 6 cycles of DTP (standard group) or T-DM1 (investigational group). Crossover was recommended at lack of response or occurrence of intolerable toxic effects. Assessment with fluorine 18-labeled fluorodeoxyglucose (F-18-FDG) positron emission tomography combined with computed tomography (PET-CT) was performed at baseline and after 2 and 6 treatment cycles.MAIN OUTCOME AND MEASURES: Pathologic complete response, defined as ypT0 or Tis ypN0. Secondary end points were clinical and radiologic objective response; event-free survival, invasive disease-free survival, distant disease-free survival, and overall survival; safety; health-related quality of life (HRQoL); functional and biological tumor characteristics; and frequency of breast-conserving surgery.RESULTS: Overall, 202 patients were randomized; 197 (99 women in the standard group [median age, 51 years (range, 26-73 years)] and 98 women in the investigational group [median age, 53 years (range, 28-74 years)]) were evaluable for the primary end point. Pathologic complete response was achieved in 45 patients in the standard group (45.5%; 95% CI 35.4%-55.8%) and 43 patients in the investigational group (43.9%; 95% CI 33.9%-54.3%). The difference was not statistically significant (P = .82). In a subgroup analysis, the pCR rate was higher in hormone receptor-negative tumors than in hormone receptor-positive tumors in both treatment groups (45 of 72 [62.5%] vs 45 of 125 [36.0%]). Three patients in the T-DM1 group experienced progression during therapy. In an exploratory analysis, tumor-infiltrating lymphocytes at 10% or more (median) estimated pCR significantly (odds ratio, 2.76; 95% CI, 1.42-5.36; P = .003). Response evaluation with F-18-FDG PET-CT revealed a relative decrease of maximum standardized uptake value by more than 31.3% (median) was associated with pCR (odds ratio, 6.67, 95% CI, 2.38-20.00; P < .001).CONCLUSIONS AND RELEVANCE: In this study, treatment with standard neoadjuvant combination DTP was equal to T-DM1.
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| 8. |
- Holländare, Fredrik, 1972-, et al.
(author)
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Two-year outcome of internet-based relapse prevention for partially remitted depression
- 2013
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In: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 51:11, s. 719-722
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Journal article (peer-reviewed)abstract
- The objective of the study was to investigate the long-term effects of internet-based relapse prevention for sufferers of partially remitted depression. Eighty-four individuals with partially remitted unipolar depression were randomized to either internet-based CBT (iCBT) or to a control group. After the ten week intervention period the participants were followed for 24 months and diagnostic interviews conducted to detect relapse. The intervention and monthly self-ratings of depressive symptoms were administered via an internet-based platform that ensured secure communication with all participants. Significantly fewer participants in the iCBT group had experienced a relapse compared with those in the control group two years after the internet-based intervention. The relapse rate in the iCBT group was 13.7% (CI 95% = 2.5–24.9) and in the control group it was 60.9% (CI 95% = 44.8–77). Furthermore, a significantly larger proportion of the iCBT group experienced remission two years after the intervention compared with the control group. Internet-based CBT seems promising for preventing relapse in sufferers of partially remitted depression.
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| 9. |
- Hägglund, Patricia, et al.
(author)
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Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
- 2017
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 17
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Journal article (peer-reviewed)abstract
- Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.
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| 10. |
- Karlsson, Jens, et al.
(author)
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Novel hypercapsulation RNA thermosensor variants in Neisseria meningitidis and their association with invasive meningococcal disease : a genetic and phenotypic investigation and molecular epidemiological study
- 2020
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In: The Lancet Microbe. - : Elsevier. - 2666-5247. ; 1:8, s. E319-E327
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Journal article (peer-reviewed)abstract
- Background: Neisseria meningitidis is the causative agent of invasive meningococcal disease and the polysaccharide capsule is one of its major virulence factors. Biosynthesis of the meningococcal capsule is controlled by an RNA thermosensor (RNAT) in the 5'-untranslated region (5'-UTR) of the cssA gene. The function of the RNAT depends on an 8-bp tandem repeat configuration. We aimed to identify and characterise novel RNATs in meningococcal isolates responsible for regulating capsule production.Methods: We investigated the allele igr_up_NEIS0055, containing the 5'-UTR of the cssA gene, in clinical meningococcal isolates for which whole-genome sequences are available on the Neisseria PubMLST database and that were isolated in Europe between Jan 1, 2010, and Dec 31, 2018. Eight isolates with different RNAT tandem repeat configurations were selected for genetic and phenotypic studies. The thermosensing capability of the RNAT and capsule production was tested with immunoblots. Bacterial survival by capsule protection was assessed with a human serum stress assay and capsule interference with bacterial cell adhesion was evaluated with a bacterial adhesion assay. The dataset of RNAT configurations was analysed for an association with invasive meningococcal disease, and was stratified to visualise the distribution of RNAT configurations within the meningococcal population.Findings: Our search of PubMLST identified 112 alleles for the igr_up_NEIS0055 locus and 7013 N meningitidis isolates. Five novel RNAT tandem repeat configurations were identified and eight RNAT tandem repeat configurations, ranging from 1 x 8-bp up to 8 x 8-bp, were characterised. The disrupted RNATs (1 x 8-bp and 3 x 8-bp to 8 x 8-bp) confer upregulated CssA expression and increased capsule production compared with the native 2 x 8-bp configuration, resulting in a hypercapsulation phenotype. Increased capsule production was associated with higher survival rates in up to 25% human serum. The prevalence of a disrupted RNAT resulting in hypercapsulation was almost twice as high in invasive meningococcal disease isolates compared with carrier isolates. Disrupted RNATs were especially attributed to isolates of capsule group B and C, and clonal complexes 23, 32, 213, and 269. Hypercapsulation in one isolate led to lower adhesion onto pharyngeal cells compared with a similar isolate with low capsule production.Interpretation: Six non-canonical RNAT tandem repeat variants (3 x 8-bp to 8 x 8-bp) were identified in the igr_up_NEIS0055 locus of N meningitidis that induce a hypercapsulation phenotype, thus providing the meningococci with better protection against host complement-mediated killing than does the native RNAT (2 x 8-bp). Further research is warranted to strengthen the association between hypercapsulation and the progression of invasive meningococcal disease, and to investigate the role of regulatory RNAs in meningococcal virulence and as potential markers for disease progression.
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