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- Högberg, Karin, 1982-
(författare)
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Persistent Digital Service Encounters : Challenges of organizational use of social media in a hotel chain
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The emergence of social media has in many ways changed how individuals interact, communicate and also consume online. Due to the massive, world wide use of social media, organizations are starting to use social media in order to be present where their customers are. Earlier research has studied social media from different, rather fragmented perspectives such as social media use for marketingor for internal communication. However, research on the organizational implications and challenges from a more general organizational social media use is lacking. This thesis explores organizational implications and challenges of social media use over time. Hence the focus lies on both internal and external organizational activities related to social media use. The consequences of social media have been particularly striking in service industries, e.g. banks, restaurants and travel agencies. Social media has fundamentally changed how we (can) buy services, and also how service is provided. For example, we can ask a question or make a complaint directly on a specific social media platform. Hence, social media have had implications for the relationship between service organizations and their customers and thus changed the context in which service is delivered and experienced. The service encounter, i.e., the actual meeting between the customer and employees, has come to take place on social media platforms. The expansion of social media has affected the hotel industry in several ways. Hotel guests are using social media platforms in order to review and share experiences about hotels, and hotel organizations use social media to keep up with competitors and customer demands. The aim of this thesis is to describe and understand the challenges social media use brings to organizations in the service industry, inparticular hotel organizations. The following research question is addressed:Why and how does the use of social media platforms represent organizational challenges? The empirical data focuses on the introduction and use of social media in one international hotel chain over a four-year period. Furthermore, data was collected from other, independent hotels. The empirical data was collected through interviews, online observations, workplace observations and written documents. VIIIA multifaceted theoretical framework was used, including the Technology-Organization-Environment framework, the concept of technological frames, andthe concepts of functional simplification and closure. These theoretical frameworks capture the drivers behind organizational social media use and how individual employees interpret and use social media, but also how social media attributes create the need for new organizational routines and management of social media content created outside organizational boundaries.The analysis illustrates how social media use creates challenges for the studied organizations. Five main organizational challenges have been identified: the nature of social media versus organizational structure: how organizations and individuals make sense of social media over time; how private use of social mediahas implications for professional use; how social media creates stretched service encounters; and pseudo-relationships and roboticization of service
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- Kivling, Anna, et al.
(författare)
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Diverging immune responses when allergy, type 1 diabetes and celiac disease coexist
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- An imbalance between different immune cells, among them T-cells and inflammatory cells, has been proposed to be part of the disease process in type 1 diabetes (T1D), celiac disease and allergy. T-cells and inflammatory cells exert their actions through cytokines and chemokines, and the secretion of those can be used to describe the cell milieu during an immune response. This study included seventy-two children, diagnosed with T1D, celiac disease, allergy, or a combination of two of these diseases and compared to reference children. The study aimed to evaluate the secretion of 27 different cytokines and chemokines in cell culture supernatant after in vitro stimulation with disease-associated antigens (birch, gluten, insulin) detected by Luminex technique. Combination of allergy with either T1D or celiac disease gave diverging results. Children with combination of T1D and allergy showed an increased secretion of several cytokines (IL-2, IL-4, IL-5, IL-7, IL-9, IL-10, IL-12, IL-15, IL-17 and CCL11), in comparison to almost all groups from birch stimulation. In contrast, when allergy was combined with celiac disease, the spontaneous secretion of IL-1β, IL-5, IL-6, IL-9, IL-10, IL-12 and CCL3 was decreased compared to children with T1D or allergy, as well as children with celiac disease alone, children with combination of T1D and allergy and reference children. In conclusion, our results shed some light on the immune responses in children with common immunological diseases. Our study indicates diverging immune responses when allergy, type 1 diabetes and celiac disease coexist.
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- Petersson, Christina, et al.
(författare)
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Children's experiences about a structured assessment of health-related quality of life during a patient encounter
- 2016
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Ingår i: Child Care Health and Development. - : Wiley. - 0305-1862 .- 1365-2214. ; 42:3, s. 424-432
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIt has been stated that care for children with chronic health conditions tends to focus on condition-specific issues rather than how these children experience their health and everyday life functioning.AimThe aim of this study was to explore children's experiences about a structured assessment of health-related quality of life applied during a patient encounter.MethodsPrior to the start of the study, a clinical intervention based on the questionnaire DISABKIDS Chronic Generic Measure (DCGM-37) was performed. A qualitative explorative design was chosen, and 25 children between 10–17 years of age were interviewed after the consultation at four different paediatric outpatient clinics. Data were analysed according to qualitative content analysis.ResultsThe results were twofold: children experienced that the assessment was providing them with insights about their health, which motivated them to make lifestyle changes. When outcomes were discussed and requested, the children felt encouraged.ConclusionsThe use of an assessment of health-related quality of life may promote insights about health and encourage children with chronic health conditions to discuss their outcomes with healthcare professionals.
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- Petersson, Christina, et al.
(författare)
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Impact of type 1 diabetes on health-related quality of life among 8–18-year-old children
- 2016
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Ingår i: Comprehensive Child and Adolescent Nursing. - : Taylor & Francis. - 2469-4207 .- 2469-4193. ; 39:4, s. 245-255
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Tidskriftsartikel (refereegranskat)abstract
- Measuring the health-related quality of life (HRQOL) is one way to understand an individual’s perspective on health, and, more specifically, how type 1 diabetes (T1D) affects a child’s everyday life. Early detection of poor HRQOL is considered a crucial factor for identifying children who are at risk of psychosocial problems. The aim of this study was to describe the differences in the HRQOL of children with T1D according to age, gender, and metabolic control (HbA1c). Cross-sectional data were collected from children with T1D using the DISABKIDS Chronic Generic Measure-37 (DCGM-37) and the diabetes specific module (DM-10). Non-parametric tests were used to investigate differences. There were differences between girls and boys, and girls reported lower HRQOL than boys (HRQOL total score: mean 74 and 67 respectively; p = .005). Adolescents described more worries and fears about the future compared with younger children. Children with poor metabolic control reported a lower HRQOL than those with better metabolic control (HRQOL total score:mean 68 and 76 respectively; p = .006), but the social dimensions were not affected. The findings of the present study elucidate the importance for paediatric nurses to explore potential problems in children with T1D and use this knowledge in clinical practice. Assessment of the HRQOL can provide the patient’s perspective on the quality of diabetes care. The HRQOL is correlated with HbA1c, gender, and age, and the HRQOL as well as HbA1c levels should be regularly assessed to establish a comprehensive care for children with T1D.
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- Petersson, Christina, et al.
(författare)
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To promote child involvement – healthcare professionals' use of a health-related quality of life assessment tool during paediatric encounters
- 2017
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Ingår i: European Journal for Person Centered Healthcare. - : University of Buckingham Press. - 2052-5648 .- 2052-5656. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children and healthcare professionals should be provided with easy-to-use tools which could lead to actionable results.Objectives: There is increasing interest in the use of patient reported outcomes to aid management of individual care; therefore, the use of health-related qualityof life (HRQOL) assessments during consultations need to be studied. The aim of this study was to explore how healthcare professionals use a HRQOL assessment tool during paediatric encounters.Design: A descriptive, explorative design with a qualitative approach based on video recordings was chosen.Methods: Twenty-one video recordings, from nine different healthcare professionals’ consultations where an assessment tool of HRQOL were used were analysed by content analysis.Results: The healthcare professionals were using different strategies and when they combined these strategies three approaches emerged. The instructing approach was characterized by healthcare professionals giving a summary of the results, leading to children becoming passive bystanders in the encounter. Based on an inviting approach, the children’s perceptions of their situation were requested while the items were explored. This resulted in involving the children in the conversations. In the engaging approach, an open dialogue and a common interpretation were sought to guide further care which was interpreted as children becoming actively involved.Conclusions: The child’s involvement could be facilitated depending on which approach is being used. When an inviting and engaging approach is used, actions in a non-linear set of interactions is co-produced with the child.Relevance to practice: The use of an HRQOL assessment tool change the management during consultations and could promote child involvement dependent on which approach the healthcare professionals are using.
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| 8. |
- Petersson, Christina
(författare)
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Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments.Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system.Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings.Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations.Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.
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- Samuelsson, John, 1981-, et al.
(författare)
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Autoimmune comorbidity in type 1 diabetes and its association with metabolic control and mortality risk in young people: a population-based study
- 2024
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Ingår i: Diabetologia. - : SPRINGER. - 0012-186X .- 1432-0428.
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis: This register-based study aimed to describe autoimmune comorbidity in children and young adults from type 1 diabetes onset, and to investigate whether such comorbidity was associated with a difference in HbA1c or mortality risk compared with children/young adults with type 1 diabetes without autoimmune comorbidity. Methods: A total of 15,188 individuals from the Swedish National Diabetes Register, registered with type 1 diabetes before 18 years of age between 2000 and 2019, were included. Five randomly selected control individuals from the Swedish population (Statistics Sweden) were matched to each individual with type 1 diabetes (n=74,210 [346 individuals with type 1 diabetes were not found in the Statistics Sweden register at the date of type 1 diabetes diagnosis, so could not be matched to control individuals]). The National Patient Register was used to attain ICD-10 codes on autoimmune diseases and the Cause of Death Register was used to identify deceased individuals. Results: In the total type 1 diabetes cohort, mean±SD age at onset of type 1 diabetes was 9.5±4.4 years and mean disease duration at end of follow-up was 8.8±5.7 years. Of the individuals with type 1 diabetes, 19.2% were diagnosed with at least one autoimmune disease vs 4.0% of the control group. The HRs for comorbidities within 19 years from onset of type 1 diabetes were 11.6 (95% CI 10.6, 12.6) for coeliac disease, 10.6 (95% CI 9.6, 11.8) for thyroid disease, 1.3 (95% CI 1.1, 1.6) for psoriasis, 4.1 (95% CI 3.2, 5.3) for vitiligo, 1.7 (95% CI 1.4, 2.2) for rheumatic joint disease, 1.0 (95% CI 0.8, 1.3) for inflammatory bowel disease, 1.0 (95% CI 0.7, 1.2) for systemic connective tissue disorder, 1.4 (95% CI 1.1, 1.9) for uveitis, 18.3 (95% CI 8.4, 40.0) for Addison’s disease, 1.8 (95% CI 0.9, 3.6) for multiple sclerosis, 3.7 (95% CI 1.6, 8.7) for inflammatory liver disease and 19.6 (95% CI 4.2, 92.3) for atrophic gastritis. Autoimmune disease in addition to type 1 diabetes had no statistically significant effect on HbA1c or mortality risk. Conclusions/interpretation: To our knowledge, this is the first comprehensive study where young individuals with type 1 diabetes were followed regarding development of a wide spectrum of autoimmune diseases, from onset of type 1 diabetes. In this nationwide and population-based study, there was already a high prevalence of autoimmune diseases in childhood, especially coeliac and thyroid disease. The presence of autoimmune comorbidity did not have a statistically significant effect on metabolic control or mortality risk. Graphical Abstract: [Figure not available: see fulltext.]
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- Thacher, Jesse D., et al.
(författare)
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Exposure to long-term source-specific transportation noise and incident breast cancer : A pooled study of eight Nordic cohorts
- 2023
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 178
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Tidskriftsartikel (refereegranskat)abstract
- Background: Environmental noise is an important environmental exposure that can affect health. An association between transportation noise and breast cancer incidence has been suggested, although current evidence is limited. We investigated the pooled association between long-term exposure to transportation noise and breast cancer incidence.Methods: Pooled data from eight Nordic cohorts provided a study population of 111,492 women. Road, railway, and aircraft noise were modelled at residential addresses. Breast cancer incidence (all, estrogen receptor (ER) positive, and ER negative) was derived from cancer registries. Hazard ratios (HR) were estimated using Cox Proportional Hazards Models, adjusting main models for sociodemographic and lifestyle variables together with long-term exposure to air pollution.Results: A total of 93,859 women were included in the analyses, of whom 5,875 developed breast cancer. The median (5th–95th percentile) 5-year residential road traffic noise was 54.8 (40.0–67.8) dB Lden, and among those exposed, the median railway noise was 51.0 (41.2–65.8) dB Lden. We observed a pooled HR for breast cancer (95 % confidence interval (CI)) of 1.03 (0.99–1.06) per 10 dB increase in 5-year mean exposure to road traffic noise, and 1.03 (95 % CI: 0.96–1.11) for railway noise, after adjustment for lifestyle and sociodemographic covariates. HRs remained unchanged in analyses with further adjustment for PM2.5 and attenuated when adjusted for NO2 (HRs from 1.02 to 1.01), in analyses using the same sample. For aircraft noise, no association was observed. The associations did not vary by ER status for any noise source. In analyses using <60 dB as a cutoff, we found HRs of 1.08 (0.99–1.18) for road traffic and 1.19 (0.95–1.49) for railway noise.Conclusions: We found weak associations between road and railway noise and breast cancer risk. More high-quality prospective studies are needed, particularly among those exposed to railway and aircraft noise before conclusions regarding noise as a risk factor for breast cancer can be made.
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