| 1. |
- Ekström, Elin
(författare)
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From a place without speech : negotiations of othering among unaccompanied female minors in Sweden
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The study presented in this thesis focuses on unaccompanied female minors and their experiences as newly arrived migrants in Sweden. As a group, unaccompanied female minors have until recently been rather invisible in both academic research and media. However, according to previous research on migration and integration, they risk being constructed as ‘others’ both due to their status as unaccompanied minors, being female and in relation to general perceptions of what it means to be Swedish.This study is based on qualitative interviews with 11 girls, 13 to 18 years old, who arrived in Sweden as unaccompanied minors in the period between 2014 and 2017. The interviews were conducted in two phases, with nine months to one year between the first and second phases. Whereas the focus in the first phase was on getting to know the participants, the second phase provided an opportunity to delve deeper into discussions on recurring themes from the first phase. The interviews were transcribed using a denaturalised approach and thematically analysed through an abductive process.The thesis explores the girls’ narratives of everyday experiences and interprets them through a theoretical framework of othering. Without losing sight of the social structures that situates the girls’ experiences, othering is approached as a reciprocal, three-dimensional relationship, focusing on knowledge, values and conduct towards the other.The findings indicate that the girls participating in this study were often seen through the normative perception of an already othered context, and as a consequence, their own voices and agency were disregarded. They were, metaphorically, put in places without speech. However, by engaging a critical perspective on their everyday interactions, the girls were also able to recognise and resist othering by keeping true to their own experiences. The thesis concludes that by exploring the margins between their comfort zones and new contexts the girls engage in an epistemic merging of different horizons, which can be understood as a slow but insistent process of moving out from the place without speech.
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| 2. |
- Ekström, Elin, et al.
(författare)
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"I've Got Many Stories You Know" : Problematizing Silence Among Unaccompanied Migrant Girls
- 2022
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Ingår i: Journal of International Migration and Integration. - : Springer. - 1488-3473 .- 1874-6365. ; 23, s. 797-814
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents a study on inhabited silence among unaccompanied female minors in Sweden. Silence among unaccompanied minors has often been explained by experienced trauma. Conversely, research also explains silence as a natural way of establishing autonomy during adolescence. By analyzing the narratives of 11 unaccompanied female minors, we aim to problematize and broaden the understanding of silence as a lack of communication. By using Bourdieu's concept of linguistic capital, we analyze how hegemonic narratives on migration and integration influence how the girls in this study use silence in their everyday interactions. Our findings suggest that silence can be understood as both a rejection of these narratives and a strategy to preserve the girls' integrity. We also demonstrate how these girls negotiate their linguistic capital in relation to embodiment and othering, thereby pushing boundaries of identity and what it means to be seen as Swedish. The paper concludes that silence itself speaks and shows that what is often perceived as a lack of communication can also be understood as a failure to listen.
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| 3. |
- Johansson, Linda, 1978-, et al.
(författare)
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Using aggregated data from Swedish national quality registries as tools to describe health conditions of older adults with complex needs
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33:5, s. 1297-1306
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Tidskriftsartikel (refereegranskat)abstract
- Background: Combining National Quality Registries (NQRs) with existing National Health Registries (NHRs) might make it possible to get a wider picture of older adults health situation. The aim was to examine the feasibility of aggregating data across different NQRs and existing NHRs to explore the possibility to investigate trajectories and patterns of disease and care, specifically for the most ill older adults. Method: A Swedish twin population (N = 44,816) was linked to nine NQRs and four NHRs. A descriptive mixed-method study was performed. A manifest content analysis identified which health parameters were collected from each NQR. Factor analysis identified patterns in representation across NQRs. Two case studies illustrated individual trajectories of care by using NQRs and NHRs. Results: About 36% of the population was registered in one or more NQRs. NQRs included 1849 variables that were sorted into 13 categories with extensive overlap across the NQRs. Health and function variables were identified, but few social or cognitive variables. Even though most individuals demonstrated unique patterns of multi-morbidities, factor analysis identified three clusters of representation in the NQRs with sufficient sample sizes for future investigations. The two cases illustrated the possibility of following patterns of disease and trajectories of care. Conclusions: NQRs seem to be a significant source for collecting data about a population that may be underrepresented in most research on aging because of their age and poor health. However, NQRs are primarily disease related, and further development of the registries to maximize coverage and utility is needed.
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| 4. |
- Kekezi, Orsa
(författare)
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Labor mobility across jobs and space
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis consists of one introductory chapter and four independent papers. Each paper looks at different aspects of labor mobility, especially focusing on the transferability of specific human capital and the role of space for job matching.The focus of the first paper is to examine how diversity of previous work experience of employees in creative industries matters for labor productivity. I further distinguish between related vs. unrelated occupation and industry experience to better understand how they matter for knowledge flows within a firm. The results show that diversity, and especially relatedness of previous occupational experience, are positively related to labor productivity.In the second paper, I study how co-location of knowledge-intensive business services influences the innovative capacity of the sector. The results suggest that co-location facilitates labor mobility and thereby knowledge flows as well as innovation capacity across firms.In the third and fourth papers, the focus shifts from the firm to the individual. The third paper examines how regional characteristics, especially Marshallian labor market pooling, influence the type of employment obtained after job displacement. The results show that regional industrial and occupational structures are crucial for facilitating job matches and occupational upgrades of individuals. The fourth paper examines whether there are wage returns to migration after job displacement, after the job match is considered. The results indicate that returns to migration are positive only when combined with a re-employment that matches the skills of the worker.
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| 5. |
- Ludvigsson, Jonas F., 1969-, et al.
(författare)
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Swedish Inflammatory Bowel Disease Register (SWIBREG) : a nationwide quality register
- 2019
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Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 54:9, s. 1089-1101
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Forskningsöversikt (refereegranskat)abstract
- Background: Inflammatory bowel disease (IBD) is a chronic, inflammatory relapsing disease with increasing incidence. IBD research and long-term follow-up of patients have, however, been hampered by lack of detailed data on disease phenotype, patient-reported outcome measures, Physician Global Assessment, disease activity, and hospital-administered drugs.Aim: To review the Swedish IBD quality register (SWIBREG).Methods: Review of SWIBREG including questionnaire data from users and patients.Results: SWIBREG was launched in 2005, and as of April 2019, contains 46,400 patients with IBD (Crohn's disease: n = 15,705, ulcerative colitis: n = 21,540, IBD unclassified and other colitis (including e.g., microscopic colitis): n = 9155). Of these IBD patients, 7778 had been diagnosed in childhood (16.8%). Earlier research has shown that combining SWIBREG and the Swedish National Patient Register (NPR) yields a positive predictive value of 100% (95%CI = 95-100%) for having a diagnosis of IBD. Moreover, out of all patients in the NPR with a diagnosis of IBD plus either IBD-related surgery or immunomodulatory/biological treatment during the past 18 months, SWIBREG covers 59.0%. SWIBREG records not only information on conventional therapies but also on biological treatment, surgery, smoking, disease activity, patient-reported outcome measures (PROMs), and patient-experienced measures (PREMs). Data are presented through a graphical decision support system.Conclusion: SWIBREG benefits patients with IBD, and offers an ideal opportunity for healthcare personnel and researchers to examine disease phenotype and activity, PROMs/PREMs, and hospital-administered drugs in patients with IBD.
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| 6. |
- Mårild, Karl, 1982, et al.
(författare)
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Histologic activity in inflammatory bowel disease and risk of serious infections : A nationwide study
- 2024
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Ingår i: Clinical Gastroenterology and Hepatology. - : Elsevier. - 1542-3565 .- 1542-7714. ; 22:4, s. 831-846
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Individuals with inflammatory bowel disease (IBD) are at increased risk of serious infections, but whether this risk varies by histological disease activity is unclear.METHODS: A national population-based study of 55,626 individuals diagnosed with IBD in 1990-2016 with longitudinal data on ileo-colorectal biopsies followed through 2016. Serious infections were defined as having an inpatient infectious disease diagnosis in the Swedish National Patient Register. We used Cox regression to estimate hazard ratios (HRs) for serious infections in the 12 months following documentation of histologic inflammation (vs. histological remission), adjusting for social and demographic factors, chronic comorbidities, prior IBD-related surgery and hospitalization. We also adjusted for IBD-related medications in sensitivity analyses.RESULTS: With histological inflammation vs. remission, there was 4.62 (95%CI=4.46-4.78) and 2.53 (95%CI=2.36-2.70) serious infections per 100 person-years of follow-up, respectively (adjusted [a]HR=1.59; 95%CI=1.48-1.72). Histological inflammation (vs. remission) were associated with an increased risk of serious infections in ulcerative colitis (UC, aHR=1.68; 95%CI=1.51-1.87) and Crohn's disease (CD, aHR=1.59; 95%CI=1.40-1.80). The aHRs of sepsis and opportunistic infections were 1.66 (95%CI=1.28-2.15) and 1.71 (95%CI=1.22-2.41), respectively. Overall, results were consistent across age groups, sex and education level and remained largely unchanged after adjustment for IBD-related medications (aHR=1.47; 95%CI=1.34-1.61).CONCLUSION: Histological inflammation of IBD was an independent risk factor of serious infections, including sepsis, suggesting that achieving histological remission may reduce infections in IBD.
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| 7. |
- Oliva, Delmy, et al.
(författare)
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Single nucleotide polymorphism directed antiemetic treatment in women with breast cancer treated with neo- or adjuvant chemotherapy : a randomised multicentre phase II study. (EudraCT: 2015–000658-39)
- 2023
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Ingår i: Anticancer Research. - : International Institute of Anticancer Research. - 0250-7005 .- 1791-7530. ; 43:6, s. 2671-2681
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Tidskriftsartikel (refereegranskat)abstract
- Background/aim: The role of single nucleotide polymorphisms (SNPs) in the frequency and intensity of chemotherapy-induced nausea and vomiting (CINV) in women with breast cancer (BC) is unclear. The primary purpose of this study was to compare/evaluate the effect of SNP-guided antiemetic treatment versus standard CINV treatment.Patients and methods: A randomised, factorial, phase II multicentre study design was used. Women planned for neoadjuvant or adjuvant chemotherapy with epirubicin, cyclophosphamide and fluorouracil (FEC /EC, with or without fluorouracil) for BC were randomised to SNP-guided antiemetic treatment (based on the results of SNP analyses) versus standard CINV treatment. Blood samples were taken before the treatment was initiated. Patient-reported data on CINV (during 10 days from onset of cancer treatment) and health-related quality of life (HRQoL), were collected before and after the first cancer treatment.Results: A total of 188 women were included. Overall, nausea was reported by 86% (n=129) of the patients during the ten-day period from the start of cancer treatment. The SNP genotype studied varied. In FAS-CD95, the genotypes AG and GG were overrepresented; in RB1-LPAR6, GG was overrepresented, and in CCL2, both AA and GG were overrepresented. We found no statistically significant difference in CINV between SNP-guided antiemetic treatment versus standard CINV treatment.Conclusion: SNP-guided antiemetic treatment could be as effective as standard treatment. SNP-guided antiemetic treatment of CINV is possibly useful in detecting patients with a higher or lower risk for CINV and thus may help in avoiding over-treatment with toxic components. CINV negatively affects the HRQL.Keywords: Breast cancer; chemotherapy-induced nausea and vomiting; single nucleotide polymorphism.
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| 8. |
- Rantzow, Veronica, et al.
(författare)
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Occurrence of oral health problems and planned measures in dependent older people in nursing care
- 2018
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 27:23-24, s. 4381-4389
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVE:To describe oral health problems and planned measures in older people receiving nursing care.BACKGROUND:Poor oral health conditions have a negative impact on the quality of life of older people. Therefore, oral care is an important task in daily nursing activities.METHODS:Data were obtained from the web-based Swedish national quality register Senior Alert. Data regarding oral health status and planned measures in individuals ≥65 years from one county in Sweden between July 2014-June 2015 were included. The Revised Oral Assessment Guide-the Jönköping (ROAG-J) was used routinely by nursing staff in nursing care facilities to measure oral health status.RESULTS:Oral assessments were made on 2,567 individuals (65.7% women). The most common oral health problem was related to "Teeth" (43.0%), which indicates deficient oral hygiene and/or broken teeth. At least one measure was planned in all the participants. The most common planned measures were "Moistening of the mouth" (16.6%), followed by "Brushing - assistance or complete help" (13.5%).CONCLUSION:Oral health problems were common, and planned measures did not seem to be sufficient to address the identified problems. The results indicate that greater priority should be given to the oral health care of older people in nursing care.RELEVANCE TO CLINICAL PRACTICE:The study highlights the importance of not only identifying oral health problems but also having knowledge and strategies for oral health care. Collaboration is needed to support nurses in caring for the oral health care of older people in nursing homes.
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| 9. |
- Shrestha, Sarita, 1991-, et al.
(författare)
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The use of ICD codes to identify IBD subtypes and phenotypes of the Montreal classification in the Swedish National Patient Register
- 2020
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 55:4, s. 430-435
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Whether data on International Classification of Diseases (ICD)-codes from the Swedish National Patient Register (NPR) correctly correspond to subtypes of inflammatory bowel disease (IBD) and phenotypes of the Montreal classification scheme among patients with prevalent disease is unknown. Materials and methods: We obtained information on IBD subtypes and phenotypes from the medical records of 1403 patients with known IBD who underwent biological treatment at ten Swedish hospitals and retrieved information on their IBD-associated diagnostic codes from the NPR. We used previously described algorithms to define IBD subtypes and phenotypes. Finally, we compared these register-generated subtypes and phenotypes with the corresponding information from the medical records and calculated positive predictive values (PPV) with 95% confidence intervals. Results: Among patients with clinically confirmed disease and diagnostic listings of IBD in the NPR (N = 1401), the PPV was 97 (96-99)% for Crohn's disease, 98 (97-100)% for ulcerative colitis, and 8 (4-11)% for IBD-unclassified. The overall accuracy for age at diagnosis was 95% (when defined as A1, A2, or A3). Examining the validity of codes representing disease phenotype, the PPV was 36 (32-40)% for colonic Crohn's disease (L2), 61 (56-65)% for non-stricturing/non-penetrating Crohn's disease behaviour (B1) and 83 (78-87)% for perianal disease. Correspondingly, the PPV was 80 (71-89)% for proctitis (E1)/left-sided colitis (E2) in ulcerative colitis. Conclusions: Among people with known IBD, the NPR is a reliable source of data to classify most subtypes of prevalent IBD, even though misclassification commonly occurred in Crohn's disease location and behaviour and also among IBD-unclassified patients.
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