| 1. |
- Agélii Genlott, Annika, 1968-
(författare)
-
Designing for Transformational Change in School : Digitalizing the Digitized
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Digital technologies have gained a prominent role in education and schools, but research concerning how digital technologies can create better conditions for improved teaching and enhanced learning for students is scarce and inconclusive. Successful use of digital technologies requires a complex combination of interacting factors, including integrating technology and pedagogy as well as organizing and leading a structured transformation process. The capability of school organizations to lead and support the digitalization process is an under-researched field compared to the well-established focus on individual stakeholders.This thesis examines how experimentation and innovation processes in school can be designed and pursued to support and enhance digitalization across an entire school organization by using a Design Science Research (DSR) approach to answer the question: How can a school organization at municipal level lead digital transformation through the digitalization of teaching and learning processes in an organized, professional, and, as far as possible, scientifically based way?The findings show that the design and use of the Information System Artifact model (ISA) together with a DSR development method can support both improved teaching and enhanced learning within and across a school organization. Effective use of digital technologies to improve teaching and learning across the school organization requires fundamental changes of ordinary practices and engagement as well as commitment from school authorities and school leaders.This thesis contributes with empirically and theoretically based insights from leading (digital) transformational change in school through the iterative design of IS artifacts used as a driver and quality control for the shift from digitization towards digitalization aiming at improved teaching and enhanced learning.
|
|
| 2. |
- Agélii Genlott, Annika, 1968-, et al.
(författare)
-
Leading dissemination of digital, science-based innovation in school–a case study
- 2021
-
Ingår i: Interactive Learning Environments. - : Informa UK Limited. - 1049-4820 .- 1744-5191. ; , s. 1-11
-
Tidskriftsartikel (refereegranskat)abstract
- Digitalizing school is a process that comes with challenges. It requires strategic leadership and transformational change to work processes. Nevertheless, some succeed, and it is useful to understand what makes for success. This paper studies the challenges of leading digitalization of education in a city which decided to implement an IT-supported method for teaching literacy in primary schools. The method required transformational change; teachers not only had to learn to use technologies, they also had to review their pedagogy. This study is guided by the Diffusion of Innovation theory and draws on interviews with school principals. We find that the critical factors relate to the communication channel, the social system within and across schools, and the time perspective.
|
|
| 3. |
- Kriit, Hedi Katre, et al.
(författare)
-
Using Distributed Lag Non-Linear Models to Estimate Exposure Lag-Response Associations between Long-Term Air Pollution Exposure and Incidence of Cardiovascular Disease
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:5
-
Tidskriftsartikel (refereegranskat)abstract
- Long-term air pollution exposure increases the risk for cardiovascular disease, but little is known about the temporal relationships between exposure and health outcomes. This study aims to estimate the exposure-lag response between air pollution exposure and risk for ischemic heart disease (IHD) and stroke incidence by applying distributed lag non-linear models (DLNMs). Annual mean concentrations of particles with aerodynamic diameter less than 2.5 µm (PM2.5 ) and black carbon (BC) were estimated for participants in five Swedish cohorts using dispersion models. Simultaneous estimates of exposure lags 1–10 years using DLNMs were compared with separate year specific (single lag) estimates and estimates for lag 1–5-and 6–10-years using moving average exposure. The DLNM estimated no exposure lag-response between PM2.5 total, BC, and IHD. However, for PM2.5 from local sources, a 20% risk increase per 1 µg/m3 for 1-year lag was estimated. A risk increase for stroke was suggested in relation to lags 2–4-year PM2.5 and BC, and also lags 8–9-years BC. No associations were shown in single lag models. Increased risk estimates for stroke in relation to lag 1–5-and 6–10-years BC moving averages were observed. Estimates generally supported a greater contribution to increased risk from exposure windows closer in time to incident IHD and incident stroke. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
|
|
| 4. |
- Nilsson Sommar, Johan, et al.
(författare)
-
Long-term exposure to particulate air pollution and black carbon in relation to natural and cause-specific mortality: a multicohort study in Sweden
- 2021
-
Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 11:9
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To estimate concentration-response relationships for particulate matter (PM) and black carbon (BC) in relation to mortality in cohorts from three Swedish cities with comparatively low pollutant levels. Setting Cohorts from Gothenburg, Stockholm and Umea, Sweden. Design High-resolution dispersion models were used to estimate annual mean concentrations of PM with aerodynamic diameter <= 10 mu m (PM10) and <= 2.5 mu m (PM2.5), and BC, at individual addresses during each year of follow-up, 1990-2011. Moving averages were calculated for the time windows 1-5 years (lag1-5) and 6-10 years (lag6-10) preceding the outcome. Cause-specific mortality data were obtained from the national cause of death registry. Cohort-specific HRs were estimated using Cox regression models and then meta-analysed including a random effect of cohort. Participants During the study period, 7 340 cases of natural mortality, 2 755 cases of cardiovascular disease (CVD) mortality and 817 cases of respiratory and lung cancer mortality were observed among in total 68 679 individuals and 689 813 person-years of follow-up. Results Both PM10 (range: 6.3-41.9 mu g/m(3)) and BC (range: 0.2-6.8 mu g/m(3)) were associated with natural mortality showing 17% (95% CI 6% to 31%) and 9% (95% CI 0% to 18%) increased risks per 10 mu g/m(3) and 1 mu g/m(3) of lag1-5 exposure, respectively. For PM2.5 (range: 4.0-22.4 mu g/m(3)), the estimated increase was 13% per 5 mu g/m(3), but less precise (95% CI -9% to 40%). Estimates for CVD mortality appeared higher for both PM10 and PM2.5. No association was observed with respiratory mortality. Conclusion The results support an effect of long-term air pollution on natural mortality and mortality in CVD with high relative risks also at low exposure levels. These findings are relevant for future decisions concerning air quality policies.
|
|
| 5. |
- Nordin, Annika, et al.
(författare)
-
Emergent programme theories of a national quality register - a longitudinal study in Swedish elderly care
- 2017
-
Ingår i: Journal of Evaluation In Clinical Practice. - : John Wiley & Sons. - 1356-1294 .- 1365-2753. ; 23:6, s. 1329-1335
-
Tidskriftsartikel (refereegranskat)abstract
- Rationale, aim, and objective: This study aimed to explore programme theories of a national quality register. A programme theory is a bundle of assumptions underpinning how and why an improvement initiative functions. The purpose was to examine and establish programme theories of a national quality register widely used in Sweden: Senior alert. The paper reports on how programme theories among change recipients emerge in relation to the established programme theory of the initiator.Methods: A qualitative approach and a longitudinal research design were used. To develop programme theories among change recipients, individual semistructured interviews were conducted. Three sets of interviews were conducted in the period of 2011 to 2013, totalling 22 interviews. In addition, 4 participant observations were made. To develop the initiator's programme theory, an iterative multistage collaboration process between the researchers and the initiator was used. A directed content analysis was used to analyse data.Findings: The initiator and change recipients described similar programme logics, but differing programme theories. With time, change recipients' programme theories emerged. Their programme theories converged and became more like the programme theory of the initiator.Conclusions: This study has demonstrated the importance of making both the initiator's and change recipients' programme theories explicit. To learn about conditions for improvement initiatives, comparisons between their programme theories are valuable. Differences in programme theories provide information on how initiators can customize support for their improvement initiatives. Similar programme logics can be underpinned by different programme theories, which can be deceptive. Programme theories emerge over time and need to be understood as dynamic phenomena.
|
|
| 6. |
- Nordin, Annika
(författare)
-
Expressions of shared interpretations - Intangible outcomes of continuous quality improvement efforts in health- and elderly care
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is anchored in improvement science, the research field of improvement. Improvement science describes and explores improvement in real-life contexts and “system of profound knowledge” (Deming, 2000) is a cornerstone. Performance measures, including their variation over time, are fundamental in the research and evaluation of outcomes of continuous quality improvement efforts (CQI efforts). However, the strong emphasis on operationalisations and measurements risks overshadowing other kinds of outcomes to which CQI efforts can lead.Research has shown that it is advantageous that those performing change have some kind of “sharedness”, e.g. shared cognitions, understanding, knowledge, interpretations or frame of reference. Despite the diversity of concepts and scientific studies, “sharedness” is mainly described as a prerequisite for change.This thesis addresses the call to broaden the scientific approach in improvement science and to take advantage of knowledge developed since Deming's time. It has a point of departure in the presumption that CQI efforts also lead to intangible outcomes; qualitative effects that are not easily captured with traditional performance measures. The concept “Expressions of shared interpretations” is used to study “sharedness” as intangible outcomes.The overall aim with this thesis is to explore Expressions of shared interpretations as intangible outcomes of CQI efforts from the perspective of clinical microsystems and healthcare professionals. The specific aims are to examine and establish how Expressions of shared interpretations develop, influence CQI efforts and change over time.Using a qualitative approach, this thesis comprises four papers, based on three studies. The empirical context is healthcare and welfare organizations providing care: hospital clinics in county councils/regions and nursing homes in municipalities. The studies include time periods from one to three and a half years, totalling six years. Expressions of shared interpretations inherently mean that the methods for data analysis need to be based on commonalities or patterns in the data. In this thesis three methods are used: qualitative content analysis, thematic analysis and directed content analysis. To examine time-related changes, year-to-year comparative analyses of themes and categories are done.To explore Expressions of shared interpretations, different theoretical frameworks are used: team cognitions (Paper 1), sensemaking theory (Paper 2), cognitive shifts (Paper 3) and programme theories (Paper 4).A directed content analysis is applied in a meta-analysis of the results presented in the four papers. The results indicate that Expressions of shared interpretations develop as intangible outcomes of CQI efforts and a general programme theory of CQI efforts in health- and elderly care is developed, illuminating how Expressions of shared interpretations change and influence CQI efforts. The general programme theory incorporates the PDSA cycle and describes the complex, interconnected and continuous development of Expressions of shared interpretations. It also illuminates how Expressions of shared interpretations provide change performers with momentum to engage in forthcoming PDSA cycles and how sensemaking is a central activity.CQI efforts in health- and elderly care are characterised by a “just get on with it” attitude, while in this thesis, thoughtfulness is emphasized. Existing improvement tools support collaboration, creativity and analysis of critical aspects of the operations, yet none of the improvement tools help change performers gain understanding of the CQI effort as such. To address this, this thesis suggests that change performers complement the use of improvement tools with an inquiring mind, that they collaborate in thoughtful dialogues and that leaders function as inquirers. To support this posture, the widely used Model for improvement is complemented with a fourth question: What are our assumptions? The question pinpoints the need to be thoughtful in every step of the CQI effort, not just in the analysis of the problem at hand.
|
|
| 7. |
- Nordin, Annika, et al.
(författare)
-
Prospective sensemaking of a national quality register in health care and elderly care
- 2018
-
Ingår i: Leadership in Health Services. - : Emerald Group Publishing Limited. - 1751-1879 .- 1751-1887. ; 31:4, s. 398-408
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this paper is to examine how external change agents (ECAs) engaged to disseminate a national quality register (NQR) called Senior alert nationwide in the Swedish health care and elderly care sectors interpret their work. To study this, sensemaking theories are used.Design/methodology/approachThis is a qualitative inductive interview study including eight ECAs. To analyze the data, a thematic analysis is carried out.FindingsWell-disseminated NQRs support health care organizations’ possibility to work with quality improvement and to improve care for patient groups. NQRs function as artifacts that can influence how health care professionals make sense of their work. In this paper, a typology depicting how the ECAs make sense of their dissemination work has been developed. The ECAs are engaged in prospective sensemaking. They describe their work as being about creating future good results, both for patients and affiliated organizations, and they can balance different quality aspects.Originality/valueThe number of NQRs increased markedly in Sweden and elsewhere, but there are few reports on how health care professionals working with the registers interpret their work. The use of ECAs to disseminate NQRs is a novel approach. This paper describes how the ECAs are engaged in prospective sensemaking – an under-researched perspective of the sensemaking theory.
|
|
| 8. |
- Nordin, Annika, et al.
(författare)
-
Sensemaking and cognitive shifts – learning from dissemination of a National Quality Register in health care and elderly care
- 2018
-
Ingår i: Leadership in Health Services. - : Emerald Group Publishing Limited. - 1751-1879 .- 1751-1887. ; 31:4, s. 371-383
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe purpose of this study is to examine and establish how sensemaking develops among a group of external change agents (ECAs) engaged to disseminate a national quality register nationwide in Swedish health care and elderly care. To study the emergent sensemaking, the theoretical concept of cognitive shift has been used.Design/methodology/approachThe data collection method included individual semi-structured interviews, and two sets of interviews (initial sensemaking and renewed sensemaking) have been conducted. Based on a typology describing how ECAs interpret their work, structural analyses and comparisons of initial and renewed sensemaking are made and illuminated in spider diagrams. The data are then analyzed to search for cognitive shifts.FindingsThe ECAs’ sensemaking develops. Three cognitive shifts are identified, and a new kind of issue-related cognitive shift, the outcome-related cognitive shift, is suggested. For the ECAs to customize their work, they need to be aware of how they interpret their own work and how these interpretations develop over time.Originality/valueThe study takes a novel view of the interrelated concepts of sensemaking and sensegivers and points out the cognitive shifts as a helpful theoretical concept to study how sensemaking develops.
|
|
| 9. |
- Stockfelt, Leo, 1981, et al.
(författare)
-
Long-Term Exposure to Particulate Air Pollution, Black Carbon, and Their Source Components in Relation to Ischemic Heart Disease and Stroke
- 2019
-
Ingår i: Journal of Environmental Health Perspectives. - Durham : National Institute of Environmental Health Sciences. - 0091-6765 .- 1552-9924. ; 127:10
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Long-term exposure to particulate matter (PM) in ambient air has been associated with cardiovascular mortality, but few studies have considered incident disease in relation to PM from different sources.OBJECTIVES: We aimed to study associations between long-term exposure to different types of PM and sources, and incident ischemic heart disease (IHD) and stroke in three Swedish cities.METHODS: ), and black carbon (BC) from road wear, traffic exhaust, residential heating, and other sources in Gothenburg, Stockholm, and Umeå. Registry data for participants from four cohorts were used to obtain incidence of IHD and stroke for first hospitalization or death. We constructed time windows of exposure for same-year, 1- to 5-y, and 6- to 10-y averages preceding incidence from annual averages at residential addresses. Risk estimates were based on random effects meta-analyses of cohort-specific Cox proportional hazard models.RESULTS: exposure from residential heating.DISCUSSION: Few consistent associations were observed between different particulate components and IHD or stroke. However, long-term residential exposure to locally emitted BC from traffic exhaust was associated with stroke incidence. The comparatively low exposure levels may have contributed to the paucity of associations.
|
|
| 10. |
- Viberg, Olga, 1982-, et al.
(författare)
-
Integrating digital technology in mathematics education : A Swedish case study
- 2023
-
Ingår i: Interactive Learning Environments. - : Routledge. - 1049-4820 .- 1744-5191. ; 31:1, s. 232-243
-
Tidskriftsartikel (refereegranskat)abstract
- Integrating digital technology in education is challenging. This study reports on three high school mathematics classes where teachers attempted to improve their teaching and student learning by using a digital tool. For analysis we use the Information System Artifact model Lee et al. (2015) which distinguishes between three integrated sub-artifacts, the technological, the informational and the social and the Structurational Practice Lens to educational technology Halperin (2017). Using interviews and observations we find the major obstacle for student learning is a less developed social artifact. Students have difficulties using the tool effectively when teachers do not work to develop shared practices in technology use. When teachers do not themselves use the tool actively, they do not fully understand how students can learn from it, neither can they help them in synthesizing teacher- and tool instructions. Students end up having "two masters" competing rather than integrated teacher instruction and technology assistance.
|
|
