| 1. |
- Bolin, Malin, 1974-
(författare)
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The importance of organizational characteristics for psychosocial working conditions and health
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The importance of organizations for understanding differences in the working conditions and health of employees is often emphasized but rarely explored empirically. The general aim of this thesis is to describe organizational characteristics of workplaces, and to assess their impact on the psychosocial working conditions and health of employees. In modern working life, it is assumed that employees' working conditions and health are affected by a general transformation of workplaces from bureaucracy to post-bureaucracy. The organizational data used are based on structured interviews with managers at workplaces in different types of operations in mid-Sweden, whereas the individual data consist of a questionnaire to all employees working in the participating workplaces, resulting in a dataset of 90 workplaces and 4306 individuals. Descriptive analysis was carried out for comparison of organizational characteristics in different types of operations, while multilevel analysis was applied to investigate the magnitude of the organizational impact on psychosocial working conditions, and to analyze associations between organizational characteristics, psychosocial working conditions and health. The results showed that the workplaces were mainly displayed by a combination of bureaucratic and post-bureaucratic characteristics, and these were unequally distributed between types of operations. A systematic variation in the psychosocial working conditions and health of employees was found between workplaces, and the variation in psychosocial working conditions was attributed to several organizational levels. The variation between workplaces was explained by both organizational characteristics of the workplaces and individual characteristics of the employees. Formalization, centralization, job enrichment, individual responsibility, soft control systems, and performance control were associated with psychosocial working conditions when controlled for occupational class, gender and age of employees, and a high degree of customer adaptation was associated with increased sickness absence of employees. It is concluded that bureaucracy and post-bureaucracy should not be regarded as dichotomies. Organizational characteristics of workplaces have an impact on the psychosocial working conditions and health of employees beyond occupational class. This has implications for both the theory and the practice of occupational health research.
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| 2. |
- Crommert, Martin Eriksson, 1974-
(författare)
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On the role of transversus abdominis in trunk motor control
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- All trunk muscles are important contributors to spine stability. However, the deepest abdominal muscle, transversus abdominis (TrA), with its characteristically horizontal fibre orientation seems to serve a unique function in trunk motor control. The main mechanical role of TrA is believed to be to contribute to vertebral alignment during imposed moments on the trunk, executed mainly via either regulating the pressure level within the abdominal cavity and/or transmit forces to the spine via the thoracolumbar fascia. However, the complete function of TrA and what factors affect its activation are still not fully understood. The purpose of the present thesis was to investigate the role of TrA in trunk motor control, specifically in relation to the presence or absence of postural demand on the trunk.The timing and magnitude of TrA activation were investigated, in relation to other trunk muscles, with intramuscular fine-wire electrodes in different loading situations and body positions with varying postural demand.In a side-lying position, with no postural demand of keeping the trunk upright, the activation of TrA was delayed relative the superficial abdominal muscles compared to previous experiments performed in a standing position. The timing and magnitude of activation of TrA did not depend upon the direction of perturbation. In the standing position, different static arm positions revealed that the activation of TrA co-varied with variations in the degree of postural demand on the trunk and also the imposed moments, regardless of moment direction. Finally, a study on rapid arm flexion movements confirmed that TrA is part of the pre-programmed anticipatory response in advance of known perturbations. The activation magnitude of TrA was the same regardless if the arm movement induced flexion or extension moments on the trunk.In conclusion, the activation of TrA is associated with the upright postural demand on the trunk and with balancing imposed moments acting on the spine, regardless their direction. The findings are in support of the beliefs that TrA act as a general, direction non specific, stabilizer of the lumbar spine.
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| 3. |
- Eriksson, Irene, 1965-
(författare)
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Urinary tract infection : a serious health problem in old women
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Urinary tract infection (UTI) is a common bacterial infection in women of all ages but the incidence and prevalence increase with age. Despite the high incidence of UTI, little is known about its impact on morale or subjective wellbeing and daily life in old women. UTI in older people can be a complex problem in terms of approach to diagnosis, treatment and prevention because in these patients it frequently presents with a range of atypical symptoms such as delirium, gastrointestinal signs and falls. Even if UTI has been shown to be associated with delirium it has frequently been questioned whether UTI can cause delirium or if it is only accidentally detected when people with delirium are assessed. The main purpose of this thesis was to describe the prevalence of UTI, to identify factors associated with UTI among very old women and to illuminate the impact of a UTI on old women’s health and wellbeing. This thesis is based on two main studies, the GErontological Regional DAtabase (GERDA) a cross-sectional, population-based study carried out in the northern parts of Sweden and Finland during 2005-2007 and a qualitative interview study in western Sweden 2008-2009. Data were collected from structured interviews and assessments made during home visits, from medical records, care givers and relatives. UTI was diagnosed if the person had a documented symptomatic UTI, with either short- or long-term ongoing treatment with antibiotics, or symptoms and laboratory tests judged to indicate the presence of UTI by the responsible physician or the assessor. One hundred and seventeen out of 395 women (29.6%) were diagnosed as having suffered from at least one UTI during the preceding year and 233 of these 395 (60%) had had at least one diagnosed UTI during the preceding 5 years. These old women with UTI were more dependent in their activities of daily living, and had poorer cognition and nutrition. In these women, UTI during the preceding year was associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia. Eighty-seven of 504 women (17.3%), were diagnosed as having a UTI with or without ongoing treatment when they were assessed, and almost half (44.8%) were diagnosed as delirious or having had episodes of delirium during the past month. In all, 137 of the 504 women (27.2%) were delirious or had had episodes of delirium during the past month and 39 (28.5%) of them were diagnosed as having a UTI. Delirium was associated with Alzheimer’s disease, multi-infarct dementia, depression, heart failure and UTI. Forty-six out of 319 women (14.4%) were diagnosed as having had a UTI with or without ongoing treatment and these had a significantly lower score on the Philadelphia Geriatric Center Morale Scale (PGCMS), (10.4 vs 11.9, p=0.003) than those without UTI, indicating a significant impact on morale or subjective wellbeing among very old women. The medical diagnoses significantly and independently associated with low morale were depression, UTI and constipation. The experience of suffering from repeated UTI was described in interviews conducted with 20 old women. The interviews were analysed using qualitative content analysis. The participants described living with repeated UTI as being in a state of manageable suffering and being dependent on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological inconveniences, struggling to deal with the illness and being restricted regarding daily life. Being dependent on alleviation was illustrated in terms of having access to relief but also experiencing receiving inadequate care. In conclusion, UTI is very common among old and very old women and is a serious health problem. UTI seems to be associated with delirium and to have a significant impact on the morale or subjective wellbeing of old women and those affected suffer both physically and psychologically and their social life is limited. UTI was also associated with vertebral fractures, urinary incontinence, inflammatory rheumatic disease and multi-infarct dementia which might raise the suspicion that UTI can have serious medical effects on health in old women.
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| 4. |
- Eriksson, Marie, 1970-
(författare)
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Aspects on stroke outcome : survival, functional status, depression and sex differences in Riks-Stroke, the National Quality Register for Stroke Care
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Stroke is a major cause of death and disability worldwide. In Sweden, about 30 000 strokes occur each year. The aim of this thesis was to analyse survival, functional outcome and self-reported depression after stroke, and to explore possible differences between men and women in stroke care and outcome. These studies were based on Riks-Stroke, the Swedish national quality register for stroke care. Information on background variables and treatment were collected during the hospital stay. The patient’s situation and outcome after stroke were followed-up after 3 months. Long term survival was retrieved from the Swedish Population Register (Folkbokföringen). Possible sex-differences in stroke care and outcome 3 months after stroke were explored in 24 633 strokes, registered during 2006. In conscious patients, the proportions treated at stroke units were similar for men and women. Men and women had equal chance to receive thrombolytic therapy or secondary prevention with oral anticoagulants. Compared to men, women were less likely to develop pneumonia, but more likely to experience deep venous thromboses and fractures during hospital stay. Women had worse 3-month survival and functional outcome, differences that were explained by their higher age and impaired level of consciousness on admission. Women felt more depressed and perceived their health as worse than men did. Women were also less satisfied with the care they had received in the hospital. The agreement between self-reported functional outcome 3 months after stroke and the commonly used modified Rankin Scale (mRS) was explored in 555 stroke survivors from 4 hospitals during May-September 2005. Riks-Stroke’s self-reported questions classified 76% of the patients into correct mRS grade. The association between functional outcome 3 months after stroke and 3-year survival was assessed in 15 959 men and women who had had a stroke during 2001-2002. Patients with estimated mRS grades 3, 4 and 5 had hazard ratios for death of 1.7, 2.5 and 3.8, respectively, as compared with patients with lower grades, 0-2. Depressed mood, male sex, high age, diabetes, smoking, antihypertensive therapy at onset and atrial fibrillation were also identified as predictors of poor survival. Self-reported depression 3 months after stroke and use of antidepressants were analysed in 15 747 stroke survivors from 2002. Fourteen percent felt depressed 3 months after stroke. Female sex, age <65, previous stroke, living alone or in institution, or being dependent in activities of daily living (ADL) were factors associated with self-reported depression. At the follow-up, 22% of the men and 28% of the women were using antidepressant medication, which were approximately twice as many as in the general population. Still, 8% of all patients in Riks-Stroke reported depressive mood but no treatment with antidepressants. In conclusion, men and women with stroke in Sweden experience similar treatment and outcome in most aspects. Patient-reported functional outcome can be reliably transformed to a standard disability scale. Impaired functional outcome three months after stroke is an independent predictor of poor long-term survival. Depressive mood is common after stroke and is associated with poor survival and impaired functional outcome.
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| 5. |
- Hammarström-Lewenhagen, Birgitta, 1951-
(författare)
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Den unika möjligheten - en studie av den svenska förskolemodellen 1968-1998
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Swedish preschool-model interlaces care, nurturing and learning and is organised to solve twin functions; providing children a playbased learning-environment and enabling parents to combine parenthood with work.The model was developed within the social sector then incorporated into the educational system 1998. This shift and the model´s “unique characteristics” praised by OECD formed the point of departure for this study.The aim of the thesis is to describe and analyse the discussions and negotiations shaping the Swedish preschool-model during 1968-1998. The research questions address: discursive themes; actors involved; governmental intentions; claims about the preschool´s task, pedagogical content and the preschool´s institutional identity and relationship to the institutions: social service, school and family. The study utilized abductive textual analysis inspired by discourse analysis and narrative approaches. Main text sources are: official reports, bills, steering documents, the preschool teachers´ periodical 1968 -1998 and a media debate.The results illuminate preschool-teachers´ struggle for a pedagogical identity and the construction of the educareconcept as a flexible and pragmatic solution to several societal interests and values.Governmental intentions concerning equality, emancipation and democratization have had great influence on the process in combination with a recurring theme about a revised preschool pedagogy with a strengthened focus on children´s learning. Political efforts to foster a preschool for all in a future are identified and described as one of the main discursive themes. Different standpoints about earlier school start are analyzed. The overall result is that the framework and core features of the model laid down by the National Commission on Child care still has a great impact on the launched syllabus (Lpfö) in the end of the period as on the curriculum in a broader sense.
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| 6. |
- Riestola, Päivi
(författare)
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Chef i en högpresterande kultur : Implementering av ett globalt managementkoncept i lokala organisationskulturella kontexter
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The subject matter of this thesis is governance principles in global management concepts and the application of such principles by managers at a local level. The thesis includes a case study on a foreign-owned Swedish group of companies that has introduced the management concept of High Performance Culture in all of its consolidated group countries. Global management concepts usually originate from the United States and make use of neo-rational governance principles. High Performance Culture is a management concept that puts increased performance and individualisation in the foreground. In addition, the concept advocates co-determination and self-development. The governance principles further promote employee autonomy orientation and self-development in addition to a leader-centric approach. The case study results indicate a discrepancy in the requirements of the governance principles of the management concept, highlighting the various dimensions of cultural layers and values to which managers in the same organisation are subject. The same values had an effect in different ways on the managers’ interpretation and handling of the management concept. This interpretation and handling of the management concept tools led to an implementation that partially opposed what the French management team and management concept advocated. The managers choosing to oppose the governance principles of the management concept can be seen as an example of modern individualism, according to which people are increasingly questioning rigid and hierarchic authority while showing initiative and assessing one’s own personal work. Hence, the values of modern individualism can act as a counterforce to neo-rational governance principles.
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| 7. |
- Svensson, Birgitta, 1974-
(författare)
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Barn som riskerar att fara illa i sin hemmiljö : Utmaningar i ett förebyggande perspektiv
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BaksidestextBarnmisshandel är ett omfattande folkhälsoproblem med långsiktiga negativa konsekvenser för den enskilda individen och för samhället i stort. Förebyggande insatser kan vara livsavgörande för de utsatta barnen. Denna avhandlings övergripande syfte var att öka kunskapen om barn som riskerar att fara illa i sin hemmiljö samt att identifiera utmaningar i ett förebyggande perspektiv. Två områden har studerats:(1) Våld mot barn med långvarig sjukdom/funktionsnedsättning(2) Förskolan som upptäckande och stödjande arenaGemensamt för inriktningarna är att barn med långvarig sjukdom/funktionsnedsättning och barn i förskoleåldern utgör särskilt sårbara grupper, som löper ökad risk att fara illa i sin hemmiljö. De har också unik kontakt med professionella med möjlighet att upptäcka och agera vid oro.Avhandlingen bygger på fyra delstudier; en nationell kartläggning riktad till skolelever, en intervjustudie med föräldrar samt två förskolestudier. Resultaten från studierna diskuteras utifrån identifierade utmaningar i ett förebyggande perspektiv. Utmaningarna inkluderar emotionella hinder samt behov av ett mer nyanserat och proaktivt förhållningssätt för att kunna utveckla tidiga insatser till barn och föräldrar.
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| 8. |
- Hobbins, Jennifer
(författare)
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Samhälle, individ och ansvar : En studie om synen på arbetslöshet
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the thesis is to highlight and to problematize conceptions of unemployment in Swedish society. The questions guiding my work have been: Which conceptions of unemployment emerge in society? How are these dealt with by the unemployed? Work on the thesis has been guided by a social constructionist approach. The empirical findings are constituted by four publications which, in various ways, are linked to overarching aim of the thesis. These publications consist of an analysis of the legal regulation surrounding the unemployed, a study of the activities of civil society organisations working with unemployed and two publications based on interviews with long-term unemployed young adults.The thesis provides increased knowledge of conceptions of unemployment in Swedish society. It shows that there is a widespread societal discourse concerning the individual being responsible for her/his unemployment, and that this conception has historically been well-grounded in Swedish labour market and social policy, as well as in people’s understandings. Among representatives of civil society organisations and unemployed individuals, there is also both a questioning of and a resistance to this understanding, indicating a possible change in the discourse. The thesis further shows that the individualisation of responsibility greatly affects individuals’ approaches in social contexts, as well as in their contacts with government agencies, but also when it comes to relationships with politics and political involvement. These insights are significant, for example during both policy formulation and efforts for the unemployed, bearing in mind that consideration needs to be paid to individual prerequisites in order for the individual’s strengths and abilities to be utilized. This is particulary important when it comes to those in an exposed position.
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| 9. |
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| 10. |
- Jansson, Ulrika
(författare)
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Den paradoxalt nödvändiga kvinnan : Könsdiskurser i Svenskt Näringsliv - ett nyliberalt drama
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- – Det är självklart att det ska råda jämställdhet mellan kvinnor och män. Ingen ska behöva behandlas sämre på grund av vilket kön man tillhör. Men är det lika självklart att det alltid – och överallt – ska råda könsjämvikt? Frågan diskuteras av organisationen Svenskt Näringsliv som en del i deras opinionsbildande verksamhet. Jämställdhet framställs som en självklarhet men samtidigt förefaller det finnas vissa reservationer för vad som kan betraktas vara jämställdhetens mål. Könsjämvikt, det vill säga en jämställd fördelning mellan kvinnor och män, antas som exemplet visar inte vara helt självklart. Med hänvisningar till marknadsekonomi förklarar Svenskt Näringsliv att politiska initiativ för ökad jämställdhet inte kan utgöra grund för näringslivets jämställdhetsarbete. Det måste istället utgå från näringslivets egna behov för att inte riskera företagens roll som producenter och organisatörer av värde och välfärd. I den här avhandlingen undersöks vad som händer när marknadsekonomiska principer möter politiska krav på förändring. Hur begripliggörs krav på jämlikhet mellan könen i en nyliberal kontext? Med utgångspunkt i en närgången läsning av Svenskt Näringslivs opinionsbildande material om jämställdhet diskuteras hur kön diskursivt konstrueras. Studien visar hur kvinnor på olika sätt införlivas både i en föreställningsvärld om marknaden som alldeles nödvändig och i en värld som domineras av män och manliga normer.
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