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Sökning: WFRF:(Köhler Anna Lena)

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  • Birkeland, Anna-Lena, 1955- (författare)
  • Psychosocial aspects of living with congenital heart disease : child, family, and professional perspectives
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Background: The vast majority of infants born with congenital heart disease (CHD) reach adulthood because of the developments in cardiology in recent decades. This thesis aims to describe the psychosocial situation of child/adolescent cardiac patients and their families, investigate the situation faced by parents and siblings initially and over time, investigate the approaches paediatric cardiologists use in encountering the family, and describe the teamwork occurring in paediatric cardiology teams (PCTs) in Sweden.Theoretical framework: The theoretical framework was based on a quality of life model applied to children, a stress-coping model, and a psychosocial approach including support, profession, and teamwork.Methods: The research combines quantitative data collection/analysis and qualitative research interviews/content analysis.Results: Complexity: The three grades of medical complexity differed regarding the number and severity of psychosocial symptoms, the children with the most complex CHD having the most severe symptoms. The most frequent symptoms in the whole patient group regarding various spheres were: healthcare and treatment-related needs in the external sphere, family symptoms in the interpersonal sphere, and mental/psychosomatic symptoms in the personal sphere.Coping: Being informed of a child’s/sibling’s heart disease has emotional consequences, so information, communication, and support are essential. Breaking the news of a child’s disease can be described as a turning point still significant after ten years. The professionalism of the doctor’s approach in breaking the news is crucial.Profession: Among paediatric cardiologists, how to break bad news to a family is an important concern, evident in findings regarding the significance of trust and confidence and the use of various emotional positions. Paediatric cardiologists commonly wish to be skilled at handling this situation, and attaining the needed skills calls for reflection, education, and sharing experience.Team: PCTs in Sweden aim and try to work in a structured way. In PCTs, there is a need for leadership, resource coordination, coaching, and a forum for joint reflection. Dependence on the physician on the team was identified in all PCTs. The challenge of managing increasing complexity at both the family and system levels requires interprofessional teams.Conclusions: These studies illustrate the psychosocial complexity and the need of psychosocial support. Emotional consequences, communication, information and support are essential both for the children, parents/families and for the professionals. To manage this complexity organizational alteration action plans are required. There is a need for a forum to stimulate dialogue and common reflection in the local PCT and at the regional and national centres.
  • Karlsson, MariAnne, 1956, et al. (författare)
  • D1.1. Integrated Framework. Deliverable to the MeBeSafe project
  • 2018
  • Ingår i: MeBeSafe – Measures for Behaving Safely in Traffic.
  • Rapport (övrigt vetenskapligt)abstract
    • The MeBeSafe project intends to develop, implement and validate interventions that direct road users (drivers and cyclists) towards safer behaviour in common traffic situations which carry an elevated risk. More specifically, the aim is to change habitual traffic behaviour using different nudging interventions, i.e. subconsciously pushing road users in a desired direction without being prohibitive against alternative choices of action. The project will also compare different ways of coaching and evaluate the effect of a combination of nudging and coaching. This deliverable, D1.1 Integrated Framework, describes the work completed within WP1 of the MeBeSafe project. Based on literature reviews, interviews with academic and non-academic experts, discussions and workshops, the deliverable: (i) describes the key characteristics of nudging and coaching respectively; (ii) presents a framework that integrates the two, taking into consideration (in particular) time and frequency; (iii) describes underlying theories and models of relevance for understanding road user behaviour; (iii) explains road user profiles or characteristics of relevance to consider in the design of the interventions (i.e., in WP2, WP3, and WP4), as well as the design and interpretation of the outcome of the field trials (in WP5); and (iv) presents design considerations, i.e. factors that should be observed when improving on the initial ideas and further develop the design of the nudging and coaching interventions. More detailed design guidelines must be developed as part of the work to be completed in WP2, WP3, and WP4.
  • Rehrl, Anna-Lena, et al. (författare)
  • Spatial and seasonal trends of organic micropollutants in Sweden's most important drinking water reservoir
  • 2020
  • Ingår i: Chemosphere. - : Elsevier. - 0045-6535 .- 1879-1298. ; 249
  • Tidskriftsartikel (refereegranskat)abstract
    • The main objective of this study was to comprehensively investigate the occurrence of organic micropollutants (OMPs) in the surface water in Lake Mälaren over a period of one year and assess the spatial (horizontal and vertical) distribution and seasonal trends of OMPs. The applied multi-residue method comprised 111 OMPs covering compounds with wide range of physicalal–chemical properties. In total, 46 OMPs were detected at least once above limit of quantification (LOQ). DEET (diethyltoluamide), lamotrigine, bicalutamide, tolyltriazole, caffeine, carbamazepine, metoprolol, oxazepam, cetirizine, fexofenadine, lidocaine and tramadol were detected in more than 75% of the sampling points. The highest detected concentration was found for lamotrigine with 140 ng/L. The locations Ekoln and Västeråsfjärden were identified to be most affected by OMPs pollution. In the surface water (0.5 m depth) most highest concentrations of OMPs were observed in spring and lower concentrations in summer. Antihistamine demonstrated a seasonal trend that can be related to seasonal consumption patterns. The investigation of the vertical distribution of OMPs demonstrated that thermal lake stratification can lead to different concentrations within the water column. For instance, in February the highest concentration for most OMPs was observed in the deepest sampled water depth (30 m). Two industrial chemicals, tolyltriazole and tris(2-butoxylethyl)phosphate were detected frequently and it is recommended to incorporate these compounds more regularly in future analysis. To the best of our knowledge, this study is the first one to report the occurrence and distribution of OMPs representing such wide physico-chemical properties, including industrial chemicals, in a Swedish lake. © 2020 Elsevier Ltd
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