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Sökning: WFRF:(Berg Christina) > Doktorsavhandling

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1.
  • Berg, Christina, 1963 (författare)
  • Influences on schoolchildren's dietary selection : focus on fat and fibre at breakfast
  • 2002
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • One important aim of the Swedish Action Programme for Nutrition is to increase the consumption of dietary fibre and decrease fat intake. The currently available extensive range of fat-reduced and fibre-enriched foods makes these dietary practices possible, but also makes the selection of a health promoting diet more complex. This thesis aims to contribute to the understanding of psychosocial influences on schoolchildren?s food choice, with specific attention to fat and fibre content. The focus was on breakfast because typical Swedish breakfast foods are important sources of fat and fibre. The Theory of Planned Behaviour formed the theoretical basis of the studies. All pupils in the 5th, 7th and 9th grades in M?lndal municipality (N=1730) were asked to complete a questionnaire and a 7-day food record. Interviews were performed with 181 of those subjects. A picture-sort interview technique, the ?stacking box methodology?, was employed to describe perceptions and habitual choices. Assessing diets of children and adolescents is not an easy task. As in all dietary surveys, reporting and participation biases may exist. The present study using food records illustrates several such biases, which should be taken into consideration in the design, analysis and interpretation of future studies. The ?stacking box methodology? seems promising, and appeared to have some advantages compared to traditional methods. However, the two dietary assessment methods generally yielded similar results. Reduced-fat choices of milk and margarine were common, although a considerable number of subjects consumed full-fat products. When it comes to the consumption of bread and cereals, the low-fibre alternatives dominated. At the age of 11 as well as 15, children?s own attitudes and underlying beliefs were of importance for breakfast food choices, as was parental influence. Parents influenced food choice by controlling food availability, acting as models and encouraging the child to consume. The perceived parental norms supported dietary changes towards products with more fibre but not towards fat-reduced products. However, the perception of parents? own consumption seemed to favour consumption of fat-reduced milk. Participants? attitudes were associated with health beliefs as well as taste perceptions. In general, the results suggest that taste may be a barrier to the consumption of high-fibre products, while consumption of low-fat products appears to be impeded by health beliefs. Contrary to several other studies, the present results suggest that some aspects of young people?s dietary behaviour are related to their knowledge. Specifically, the choice of high-fibre products was associated with knowledge of fibre sources and the choice of fat-reduced milk products was associated with a positive attitude towards limited fat intake.
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2.
  • Billmayer, Jakob, 1983- (författare)
  • Ska dörren vara öppen? : Disciplin i klassrummet i Sverige och Tyskland
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this study is to investigate discipline in German and Swedish classrooms and describe its cultural contexts. In countries with compulsory education, it must be assumed that not all students voluntarily attend classes. The mandatory presence of students combined with the ban on corporal punishment in schools means that classroom interaction has to be organized according to certain manners and rules (Luhmann, 2002a:108a). These rules are understood here as discipline meaning the organization and control of individuals and their actions over space and time (Foucault, 1987/1975). This study assumes similarities in the fundamental disciplinary mechanisms, although different contexts (here Germany and Sweden) will create different concrete manifestations of the phenomenon. Since the observation of cultural contexts is not as self-evident and direct as the observation of classroom interactions of teachers and students, the theoretical considerations here include a detailed discussion of methodology for observing culture. Starting with Alfred Schütz’ concept of ideal types and Niklas Luhmann’s theory on massmedia, it is argued that culture can be observed through the products of mass media. The empirical data for this study consists of field studies in the form of observations in German and Swedish classrooms as well as the examination of Germanand Swedish films and television series about teachers and students. The classroom observations were used to create ideal typical descriptions of different implementations of disciplinary procedure. Based on the analysis of teacher figures in various German and Swedish films and television series, several “good” and “bad” teacher types were initially identified. Combining the two results allowed conclusions tobe made about correlations between disciplinary order and whether a teacher is considered “good” or “bad”. This review of the various types of order is the basis for the description of cultural contexts. The results of classroom observations and film studies and their discussion in relation to prior Swedish research, gives the picture of a cultural context in which various forms of classroom order are avail-able, in which they are critically discussed and also can exist in parallel to each other. On the other hand, the German context seems to allow only one form of classroom order, both in actual school operations as well as in the mass media representation and scientific reflection.
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3.
  • Dahlgren, Inger, 1942- (författare)
  • Analys av en utvärderingsmodell för förebyggande arbete inom socialpedagogiskt hälsoarbete
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The main purpose of this thesis is to find, test and develop a method/model for evaluating socio-educational work in mental health. The intention is not to do a complete evaluation but rather to illustrate how a model can be applied.The starting point is a model of self-assessment that shares many similarities with both programme-evaluation and evaluation with the use of stakeholders. The arguments used for evaluation in this study are based mainly on the aims to ‘promote and improve’ and ‘develop and critically analyse’. The arguments used to support a user-orientation are the service-adaptation argument and the bottom-up perspective.A self-assessment model i.e. an institutional and professional model was utilized for this evaluation because the service studied was a collaborative, preventive effort between Social Services and Primary Care focused on families with children. The model for self-assessment is combined with ‘SWOT-thinking’ which will assist planning, implementation and evaluation of a complex service.This model takes both the target group/target groups, the staff and the organisation into consideration. The frame factors, the process and the achievements are analysed for each of the included components. This model facilitates studying the relationships between the various parts of the model and further allows for a bottom-up and top-down perspective and for shifting between the various perspectives.This study is important because it demonstrates that several aspects of complex services can be studied with the aid of a self-assessment model. The model can be applied to planning, development, quality assurance and evaluation. By studying relationships within the model it is possible to proceed from any one segment in the model and follow how it influences every other segment. Thus it is possible to some extent predict later complications or highlight areas requiring further attention.
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4.
  • Johansson, Margareta (författare)
  • Becoming a father : Sources of information, birth preference, and experiences of childbirth and postnatal care
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The period of pregnancy and childbirth is an important and sensitive time for men’s upcoming parenthood. Research into fathers’ experiences of childbearing has received less attention compared to maternal experiences. The purpose of this thesis was to study the sources fathers use to obtain information about pregnancy and childbirth, fathers’ preference for the mode of birth of their baby, and fathers’ childbirth experience and their perception of postnatal care quality.In 2007, 1105 expectant fathers were enrolled in the study when their partner had reached the middle of pregnancy. The fathers were followed until one year after the birth of their baby. The fathers were living in the county of Västernorrland in Sweden and their babies were born in one of the three hospitals in the county. Data was analysed using descriptive and inferential statistics, and content analysis. An index was created from a combination of fathers’ experiences of postnatal care quality.iiiCommon sources of information about pregnancy and childbirth used by prospective fathers were the Internet, their partners and the midwife. Fathers who were expecting their first baby (OR 1.4; 1.2-1.7), had a high level of education (OR 1.3; 1.2-1.5) and fathers with previous experience of caesarean section (OR 1.3; 1.1-1.6) were the greatest users of the Internet. Of the prospective fathers 71 (6.4%) desired caesarean section for the birth of their baby. Previous negative birth experience (PR 8.6; 2.6-28.3) and the experience of caesarean section (PR 5.7; 2.8-11.9) were factors associated with the wish that the baby would be born by caesarean section. A desire to plan the day of the baby’s birth (PR 6.0; 1.5-24.1) was associated with a preference for caesarean section for the men who were expecting their first baby. Two months after the birth of the baby 604 (74%) of the fathers in this group had had a positive birth experience. A correlation with a less-positive birth experience was with emergency caesarean section (OR 7.5; 4.1-13.6), instrumental vaginal birth (OR 4.2; 2.3-8.0) and if the man was unhappy with the medical care which the partner received (OR; 4.6; 2.7-7.8). Positive experience of healthcare professionals’ knowledge and attitudes was related to a satisfactory birth experience. The deficiencies in the postnatal care were mainly related to deficiencies in the information on the baby’s care and needs, and fathers’ experiences of their partners’ inadequate check-ups and medical care. A year after the birth 488 (79%) of the fathers were satisfied with the overall postnatal care, although they had pointed to deficiencies in the provision. Deficiencies in the attitude of the staff (OR 5.01; 2.80-8.98) and the medical care and check-ups their partner received were associated with fathers’ dissatisfaction with the overall postnatal care (OR 2.13; 1.25-3.62).ivMost fathers in this study had a positive birth experience and were happy with the postnatal care. The thesis highlights, however, opportunities for improvements in intrapartum and postnatal care. Healthcare professionals should be informed regarding the information provided via the web and to discuss the information that expectant fathers receive about pregnancy and childbirth. Prospective fathers should be given the opportunity to discuss their preferences and attitudes to the mode of birth. In addition, professionals should provide supportive information and be present in the delivery room. The information about the newborn baby’s care and needs can be strengthened, both before and after birth.
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5.
  • Jonsson, Yvonne, 1974- (författare)
  • Cytokines and immune balance in preeclampsia : a survey of some immunological variables and methods in the study of preeclampsia
  • 2005
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Preeclampsia is one of the most feared pregnancy complications, with a risk of maternal and fetal death and with no ideal therapy readily available. The cause of this strictly pregnancyrelated disease is still unknown and is therefore a great challenge to all researchers in the field of pregnancy-related pathophysiology.Today, the dominating theory of the origin of preeclampsia is defective initial placentation with insufficient penetration of the trophoblasts, leading to impaired maternal blood flow through narrow spiral arteries. However, the cause of this defective trophoblast behavior is not known. The maternal immune system has been proposed to have an influence on both the placentation and the subsequent systemic reactions. Therefore, it is very interesting to study the maternal immune system during preeclampsia, in hope of achieving a better understanding of this puzzling disease.Earlier studies have suggested that normal pregnancy requires a shift to a Th2/antiinflammatory type of immunity, at least directed towards the fetus and placenta, while some pregnancy complications, such as preeclampsia, could be due to a skewed Th1/proinflammatory type of immunity. However, the results from earlier studies designed to test the Th1/Th2 hypothesis in preeclampsia have not been consistent. Therefore, the aim of this thesis was to examine if established preeclampsia is associated with increased innate inflammatory responses and a deviation of adaptive responses towards Th1 when compared with normal pregnancy.Enumerations of cytokine-producing cells from peripheral blood did not show any difference in the production of IFN-γ, IL-4, IL-10 and IL-12 between women with preeclampsia and normal pregnancies. However, a decrease in the spontaneously produced levels of IL-5 was detected in cell cultures on peripheral blood mononuclear cells in women with preeclampsia. Furthermore, a decreased production of IL-10 in response to paternal antigens, believed to represent the fetus, was also detected for the preeclamptic women.Serum analysis showed increased levels of the pro-inflammatory mediators IL-6 and IL-8 during preeclampsia. Also, preeclamptic women displayed increased serum levels of the soluble IL-4 receptor, but no difference in the levels of IL-4 compared to normal pregnant women. This was an elusive finding, since the receptor was originally thought to reflect the levels of IL-4, but has recently been shown to have both agonistic and antagonistic properties on the IL-4 levels. Further studies of the local immune responses in the placenta showed no difference in the immunohistochemical staining of IL-4 and TNF-α between women with preeclampsia and women with normal pregnancies. In general, there were no hallmarks of abnormal morphology in the placental sections examined, regardless of diagnosis.In conclusion, the decreased levels of IL-10 in response to paternal antigens and the systemically increased levels of IL-6 and IL-8 suggest a specific decrease in antiinflammatory responses towards fetal antigens, together with a systemic activation of proinflammatory mediators during preeclampsia. Furthermore, the decreased production of IL-5 also indicates, at least partly, decreased Th2 responses in the established preeclampsia.
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6.
  • Kautto, Ethel, 1966- (författare)
  • Is it the gluten-free diet that matters the most? : Food, gender and celiac disease
  • 2014
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The only treatment for celiac disease consists of excluding gluten. Gluten is a protein complex found in wheat, rye, and barley, which are cereals commonly used in bread, pasta, pizza, etc. The overall aims of this thesis were to study; what happens with food choices and nutrient intakes when individuals are prescribed a gluten-free diet and what consequences this has on the everyday lives of young women and young men dealing with this disease.Methods: A food frequency questionnaire (FFQ) was used to study nutrient intake and how food choices were affected after a change to a gluten-free diet. The FFQ was sent to 12-13 years-old adolescents who took part in a large Swedish celiac screening study. The following three groups were studied: previously diagnosed with celiac disease, screening-diagnosed and non-celiac controls. The first FFQ was sent out before the screening-diagnosed adolescents had been told they had celiac disease, and the second was sent 12-18 months after they had been prescribed the gluten-free treatment. Semi-structured interviews were performed five years later in order to study how everyday life was affected by celiac disease in seven young women and seven young men. The interviews were analyzed by content analysis.Results: The previously diagnosed celiac disease group reported a nutrient intake in line with the non-celiac control group. Most of the participants reported nutrient intakes above the estimated average requirements. A diagnosis of celiac disease altered the intake of some foods, and this was shown by comparing the results from the baseline FFQ before the diagnosis and the follow-up FFQ after. The young women and young men reported similar experiences of the gluten-free food, but the perceived consequences of living with celiac disease differed between genders.Conclusion: This thesis shows that after a diagnosis of celiac disease food changes are necessary in order to be compliant with the gluten-free diet. One common effect is that food options will be reduced. However, as long the food intake is gluten-free, varied, and in sufficient quantity there is no reason to worry more about the nutritional intake of adolescents diagnosed with celiac disease than there is for their non-celiac peers. The findings in this thesis also show that society’s gender order has a great impact on how young women and young men experience their everyday lives, with celiac disease, and with the gluten-free diet.
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7.
  • Persson, Marie (författare)
  • Immune regulation during pregnancy in relation to allergy and in women undergoing in vitro fertilization
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • During pregnancy, the fetus expresses both maternal and paternal antigens. To the mother, the paternal antigens are foreign, providing her immune system with an interesting challenge. The fact that the fetus is not normally attacked and rejected implies that mechanisms of tolerance must exist. Pregnancy has long been considered to cause a redirection of the maternal immune responses towards a less aggressive type. Allergic disease has also been associated with that same redirection of immune responses, suggesting that this deviation may be more pronounced in allergic women during pregnancy. Several observations support the concept of a role of the immune system in the etiology of unexplained infertility, associating a redirection of the immune responses towards a more aggressive type with pregnancy loss and pregnancy failure.The aim of this thesis was to investigate the immune responses during pregnancy in allergic and non-allergic women, and in infertile women undergoing IVF treatment. We hypothesized that allergic women would have a more pronounced Th2-deviation than non-allergic women towards paternal antigens during pregnancy and that an unsuccessful outcome of IVF treatment would be associated with aberrations in circulating leukocyte populations and a paternal antigen-specific Th1 and Th17 bias.An increased number of both spontaneous and paternal antigen-induced Th2-like cytokine-secreting cells in peripheral blood was associated with pregnancy in 54 women with pregnancies defined as normal. The allergic pregnant women did not have a more pronounced Th2-deviation than the non-allergic women, as measured by numbers of cytokine-secreting cells. However, when analyzing cytokine levels in cell supernatants, we did observe lower Th1 responses towards paternal antigens in the allergic compared with non-allergic women. Additionally, allergy was associated with a reduced capacity to induce anti-inflammatory IL-10 responses towards paternal antigens.In 25 infertile women undergoing IVF, the peak levels of the majority of paternal antigen-induced cytokines and leukocyte populations investigated coincided with the maximal levels of gonadotropins administered during IVF treatment, suggesting that controlled ovarian hyper-stimulation has a general stimulatory effect on the immune system and that it may be regarded as an inflammatory state. During the treatment, no differences were found regarding cytokine responses to paternal antigens in peripheral blood or the numbers or proportions of circulating leukocyte populations between women with a successful or unsuccessful outcome of IVF. We did see higher numbers of Th2-associated cytokine secreting cells and a lower proportion of lymphocytes in the pregnant compared with the non-pregnant women four weeks after embryo transfer, however, in line with previous findings of immune modulation during pregnancy.In conclusion, normal pregnancy seems to be characterized by a less aggressive type of immune responses, possibly more pronounced in allergic women. This may be of importance for the in utero influences on childhood allergy development. An unsuccessful outcome of IVF does not appear to be associated with a more aggressive type of immune responses towards paternal antigens or aberrations in circulating leukocyte populations, although this should be confirmed in a larger study. The results in this thesis also indicate that the hormonal therapy during IVF treatment has a stimulatory effect on the immune system, generating an inflammatory state.
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