| 1. |
- Agerström, Jens, 1976-, et al.
(författare)
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Discriminatory cardiac arrest care? : Patients with low socioeconomic status receive delayed cardiopulmonary resuscitation and are less likely to survive an in-hospital cardiac arrest
- 2021
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 42:8, s. 861-869
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Individuals with low socioeconomic status (SES) face widespread prejudice in society. Whether SES disparities exist in treatment and survival following in-hospital cardiac arrest (IHCA) is unclear. The aim of the current retrospective registry study was to examine SES disparities in IHCA treatment and survival, assessing SES at the patient level, and adjusting for major demographic, clinical, and contextual factors.Methods and results: In total, 24 217 IHCAs from the Swedish Register of Cardiopulmonary Resuscitation were analysed. Education and income constituted SES proxies. Controlling for age, gender, ethnicity, comorbidity, heart rhythm, aetiology, hospital, and year, primary analyses showed that high (vs. low) SES patients were significantly less likely to receive delayed cardiopulmonary resuscitation (CPR) (highly educated: OR = 0.89, and high income: OR = 0.98). Furthermore, patients with high SES were significantly more likely to survive CPR (high income: OR = 1.02), to survive to hospital discharge with good neurological outcome (highly educated: OR = 1.27; high income: OR = 1.06), and to survive to 30 days (highly educated: OR = 1.21; and high income: OR = 1.05). Secondary analyses showed that patients with high SES were also significantly more likely to receive prophylactic heart rhythm monitoring (highly educated: OR = 1.16; high income: OR = 1.02), and this seems to partially explain the observed SES differences in CPR delay.Conclusion: There are clear SES differences in IHCA treatment and survival, even when controlling for major sociodemographic, clinical, and contextual factors. This suggests that patients with low SES could be subject to discrimination when suffering IHCA.
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| 2. |
- Agerström, Jens, 1976-, et al.
(författare)
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Treatment and survival following in-hospital cardiac arrest : does patient ethnicity matter?
- 2021
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953.
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Tidskriftsartikel (refereegranskat)abstract
- AIMS : Previous research on racial/ethnic disparities in relation to cardiac arrest has mainly focused on black vs. white disparities in the USA. The great majority of these studies concerns out-of-hospital cardiac arrest (OHCA). The current nationwide registry study aims to explore whether there are ethnic differences in treatment and survival following in-hospital cardiac arrest (IHCA), examining possible disparities towards Middle Eastern and African minorities in a European context.METHODS AND RESULTS: In this retrospective registry study, 24 217 patients from the IHCA part of the Swedish Registry of Cardiopulmonary Resuscitation were included. Data on patient ethnicity were obtained from Statistics Sweden. Regression analysis was performed to assess the impact of ethnicity on cardiopulmonary resuscitation (CPR) delay, CPR duration, survival immediately after CPR, and the medical team's reported satisfaction with the treatment. Middle Eastern and African patients were not treated significantly different compared to Nordic patients when controlling for hospital, year, age, sex, socioeconomic status, comorbidity, aetiology, and initial heart rhythm. Interestingly, we find that Middle Eastern patients were more likely to survive than Nordic patients (odds ratio = 1.52).CONCLUSION: Overall, hospital staff do not appear to treat IHCA patients differently based on their ethnicity. Nevertheless, Middle Eastern patients are more likely to survive IHCA.
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| 3. |
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| 4. |
- Egonsdotter, Gunilla, 1961-, et al.
(författare)
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Child protection and cultural awareness : Simulation-based learning
- 2020
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Ingår i: Journal of Ethnic & Cultural Diversity in Social Work. - : Informa UK Limited. - 1531-3204 .- 1531-3212. ; 29:5, s. 362-376
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Tidskriftsartikel (refereegranskat)abstract
- Social work educators have long struggled with the challenge of finding appropriate strategies for fostering cultural awareness among their students. The purpose of this study is to illustrate how a computer-based simulation, SimChild, can be used in teaching about child protection to enhance cultural awareness among students and expand their insight into how personal biases can affect professional practice. In SimChild, individual students can assume the role of social worker and then collectively discuss the patterns emerging after their individual assessments have been aggregated. This study, based primarily on focus group data, reflects testing conducted at three Swedish universities.
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| 5. |
- Egonsdotter, Gunilla, et al.
(författare)
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Computer-based simulations in social work education : A scoping review
- 2024
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Ingår i: Research on social work practice. - : Sage Publications. - 1049-7315 .- 1552-7581. ; 34:1, s. 41-53
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Forskningsöversikt (refereegranskat)abstract
- Simulation-based learning is important in social work education. Most common is human-based simulations. In recent years, computer-based simulations have emerged as alternative. A question is if computer-based simulations differ from human-based, are similar abilities, that is, competence, trained when the simulation is computer-based?Purpose: Survey the international experiences of using computer-based simulations in social work education.Method: A five step scoping review. Databases focused on educational issues and social work was searched (Eric, Sociological Abstracts, Web of Science, Scopus). Sixteen publications were included.Results: Five different didactic categories of computer-based simulations were identified. The most common use of computer-based simulations is to practice student's procedural competence, and in lesser extent to enhance students’ meta-competence. Feedback and reflection are central for computer-based simulation, as for human-based simulations.Conclusion: The study shows a didactic field under development and that computer-based simulations provide opportunities to train self-reflection and critical thinking in social work education.
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| 6. |
- Egonsdotter, Gunilla
(författare)
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Datorbaserade simuleringar i socionomutbildningen : reflektion och social barnavård
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Socionomutbildningen i Sverige syftar till att ge blivande socialarbetare såväl vetenskaplig som praktisk professionell kunskap. En för utbildningen central fråga handlar dock om hur teori och praktik bäst kan integreras. Risken, menar kritiker, är att teori och praktik separeras: teori blir något som förmedlas i klassrummet och praktik något som studenterna ges tillgång till genom fältförlagda studier i olika professionella miljöer. Mot bakgrund av denna utmaning har olika didaktiska tillvägagångssätt prövats för att koppla samman teori med praktik. Ett sådant tillvägagångssätt är simuleringar, vilket innebär att professionella utmaningar i socialt arbete på olika sätt efterliknas i klassrummet, det vill säga i en miljö där sårbara klienter inte riskerar att komma till skada.Med denna avhandling fokuseras en specifik form av simuleringar, nämligen datorbaserade simuleringar.Avhandlingens syfte är att undersöka om en datorbaserad simulering som didaktiskt verktyg i undervisning av socionomstudenter främjar studenters reflektionsförmåga i sociala barnavårdsärenden. Vidare inbegriper syftet att ge en bild av den internationella omfattningen av liknande didaktiska utvecklingsarbeten samt diskutera möjligheterna av att använda datorbaserade simuleringar också i forskningssyfte.Avhandlingsarbetet bestod av två delar: dels en konstruktionsfas, dels en undersökningsfas.Under konstruktionsfasen utformades den datorbaserade simuleringen SimChild, vars avsikt är att utveckla svenska socionomstudenters förmåga att reflektera inom ett av det sociala arbetets viktigaste och svåraste verksamhetsfält, den sociala barnavården. Under övningar med SimChild antar studenter rollen som yrkesutövande socionomer och ställs inför uppgiften att individuellt göra bedömningar och fatta beslut i ett barnavårdsärende. Den skriftliga information som studenterna successivt får tillgång till är, som ofta är fallet i faktiska ärenden, knapphändig och motstridig. Deltagarna i simuleringen får tillgång till samma ärendebeskrivning men med den viktiga skillnaden att bakgrundsinformation om till exempel barnets etnicitet alternativt kön varieras slumpmässigt. Efter den individuella delen av övningen samlas deltagarna i lärarledda seminarier och får då tillgång till aggregerade data om hur skillnader i bakgrundsvariabler påverkat bedömningar och beslut. Från dessa utgångspunkter ges de möjligheter att reflektera över hur stereotypa uppfattningar om till exempel kön eller etnicitet kan påverka professionellt socialt arbete.Med undersökningsfasen fokuserades den betydelse etnicitet kan ha för bedömningar och beslut genom att barnets namn varierades på ett sätt som skulle kunna indikera olika etniciteter. Studier av sådana SimChild-övningar genomfördes vid tre lärosäten med totalt 176 socionomstudenter. Efter individuella bedömningar och beslut samlades undersökningens respondenter i fokusgrupper som för dem fick ersätta de seminarier som annars följer det individuella arbetet i SimChild. Aggregerade sammanställningar av individuella bedömningar och beslut för respektive lärosäte presenterades och låg till grund för fokusgruppsdiskussionerna. Tre fokusgrupper bestående av vardera åtta studenter, totalt 24 studenter, organiserades i direkt anslutning till de avslutade individuella bedömningen. Fokusgruppsdiskussionerna indikerade att denna typ av datorsimulering kan främja studenters reflektion och självinsikter (artikel I). Studie II illustrerar hur studenterna kunde bli medvetna om hur stereotypa föreställningar kan påverka bedömning i ett barnavårdsärende.Utöver de båda studierna av socionomstudenters upplevelser av SimChild ingår i avhandlingen ytterligare två studier som på olika sätt syftar till att fördjupa diskussionen om användningen av datorbaserade simuleringar i socialt arbete. En scoping review av internationell forskning, med 16 ingående publikationer, visar att datorbaserade simuleringar i utbildning av socialarbetare fortfarande är i en prövande, preliminär fas. Av översikten framgår att datorbaserade simuleringar främst används för att främja specifika färdigheter men också förmåga till reflektion eftersträvas. I den sista artikeln (IV) diskuteras huruvida utvecklingen av datorbaserade simuleringar för undervisningsbruk kan bidra till utvecklingen också av forskningsmetoder i socialt arbete. Diskussionen illustreras med data från en pilotstudie med 63 studenter och flera forskningsfördelar med simuleringar framhålls: studiers externa validitet främjas av realismen i simuleringen medan den interna validiteten främjas genom möjligheter till kontroll.Reflektion utgör en viktig teoretisk ram för avhandlingen och kan förstås som länken mellan socialarbetarens teoretiska kunskaper och praktiska färdigheter. För att förstå studenternas bedömningar och tolkningar i samband med den datorbaserade simuleringen utgår analysen från begreppen reflektion i handling, reflektion över handling och reflektion inför handling. Utöver dessa begrepp tar analysen även avstamp i kritisk reflektion, vilket bland annat innebär att synliggöra studenters förgivettagna föreställningar.En central slutsats i avhandlingen är att simuleringar av SimChilds typ gör det möjligt för socionomstudenter att se skillnader i beslut och bedömningar, reflektera över varför dessa skillnader uppstår och reflektera över den betydelse sådana skillnader kan få för klienter.
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| 7. |
- Israelsson, Charlotte, et al.
(författare)
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Appearance of Cxcl10-expressing cell clusters is common for traumatic brain injury and neurodegenerative disorders
- 2010
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Ingår i: European Journal of Neuroscience. - : Wiley. - 0953-816X .- 1460-9568. ; 31:5, s. 852-863
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Tidskriftsartikel (refereegranskat)abstract
- Traumatic brain injury (TBI) in the mouse results in the rapid appearance of scattered clusters of cells expressing the chemokine Cxcl10 in cortical and subcortical areas. To extend the observation of this unique pattern, we used neuropathological mouse models using quantitative reverse transcriptase-polymerase chain reaction, gene array analysis, in-situ hybridization and flow cytometry. As for TBI, cell clusters of 150–200 μm expressing Cxcl10 characterize the cerebral cortex of mice carrying a transgene encoding the Swedish mutation of amyloid precursor protein, a model of amyloid Alzheimer pathology. The same pattern was found in experimental autoimmune encephalomyelitis in mice modelling multiple sclerosis. In contrast, mice carrying a SOD1G93A mutant mimicking amyotrophic lateral sclerosis pathology lacked such cell clusters in the cerebral cortex, whereas clusters appeared in the brainstem and spinal cord. Mice homozygous for a null mutation of the Cxcl10 gene did not show detectable levels of Cxcl10 transcript after TBI, confirming the quantitative reverse transcriptase-polymerase chain reaction and in-situ hybridization signals. Moreover, unbiased microarray expression analysis showed that Cxcl10 was among 112 transcripts in the neocortex upregulated at least threefold in both TBI and ageing TgSwe mice, many of them involved in inflammation. The identity of the Cxcl10+ cells remains unclear but flow cytometry showed increased numbers of activated microglia/macrophages as well as myeloid dendritic cells in the TBI and experimental autoimmune encephalomyelitis models. It is concluded that the Cxcl10+ cells appear in the inflamed central nervous system and may represent a novel population of cells that it may be possible to target pharmacologically in a broad range of neurodegenerative conditions.
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| 8. |
- Israelsson, Johan, et al.
(författare)
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A more conservative test of sex differences in the treatment and outcome of in-hospital cardiac arrest
- 2023
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 58, s. 191-197
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies investigating sex disparities related to treatment and outcome of in-hospital cardiac arrest (IHCA) have produced divergent findings and have typically been unable to adjust for outstanding confounding variables.Objectives: The aim was to examine sex differences in treatment and survival following IHCA, using a comprehensive set of control variables including e.g., age, comorbidity, and patient-level socioeconomic status. Methods: This retrospective study was based on data from the Swedish Register of Cardiopulmonary Resuscitation and Statistics Sweden. In the primary analyses, logistic regression models and ordinary least square regressions were estimated.Results: The study included 24,217 patients and the majority (70.4%) were men. In the unadjusted analyses, women had a lower chance of survival after cardiopulmonary resuscitation (CPR) attempt, at hospital discharge (with good neurological function) and at 30 days (p<0.01). In the adjusted regression models, female sex was associated with a higher chance of survival after the CPR attempt (B = 1.09, p<0.01) and at 30-days (B = 1.09, p<0.05). In contrast, there was no significant association between sex and survival to discharge with good neurological outcome. Except for treatment duration (B=-0.07, p<0.01), no significant associations between sex and treatment were identified.Conclusions: No signs of treatment disparities or discrimination related to sex were identified. However, women had a better chance of surviving IHCA compared to men. The finding that women went from having a survival disadvantage (unadjusted analysis) to a survival advantage (adjusted analysis) attests to the importance of including a comprehensive set of control variables, when examining sex differences.
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| 9. |
- Israelsson, Jezzica, 1982-
(författare)
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Making themselves heard : Women’s and men’s voice through the regional petitioning process in Sweden, 1758–1880
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the eighteenth and nineteenth centuries, thousands of women and men contacted the Governor’s Administration of Västmanland (Länsstyrelsen i Västmanlands län), handing in petitions concerning a wide range of matters. This thesis studies these cases to deepen our understanding of women's and men's ability and need to make themselves heard through the regional petitioning process. It also elucidates how this practice was intertwined with people's endeavours to make a living by focusing on the participation’s connection to resources. By studying petition registers and a corpus of nearly 3,000 surviving petition files, it contributes to existing scholarship in three important ways.First, the thesis introduces an extended theoretical conceptualisation of the regional petitioning process, where the relationship between petitioner and respondent is integral to the petitioning itself. This inclusion shows that the commonest reason why people needed to make themselves heard, thus establishing a relationship with the governor and his administration in the first place, was because of interactions and conflicts with other people over some resource, primarily credit, land or working roles. Everyday interactions led people to use the regional administration in legally regulated disputes, which ultimately had political implications. Second, by comparing the participation of women and men as well as that of labouring people to other groups, the thesis sheds light on how the ability and need to make yourself heard varied with gender, marital status and socioeconomic status. To participate in this manner was expensive, which undoubtedly affected poor people’s ability to do so. Nevertheless, we find people from the lowest rungs of society who vehemently protected their rights, sometimes as petitioners but more often as respondents. Women's participation at the administration, as in almost all official contexts at this time, was lower than men’s, sometimes only a fraction. Despite their low levels of participation, it nevertheless took many forms, a variety that continued into the nineteenth century.Third, the investigation studies how the ways people made themselves heard through the regional petitioning process evolved over time, making it one of few Swedish studies of petitioners and respondents beyond the beginning of the nineteenth century. Its temporal setting has yielded previously unknown insights into how the development of voice through the petitioning process was connected to administrative bureaucratisation, aspects of the judicial revolution, the gradual but non-linear disappearance of household culture and the emergence of a civil citizen.
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| 10. |
- Israelsson, Karin, et al.
(författare)
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Building heat demand characteristics in a planned city district withlow-temperature district heating supply
- 2023
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Ingår i: Proceedings of the 64th International Conference of Scandinavian Simulation Society, SIMS 2023. - : Scandinavian Simulation Society. - 9789180753487
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Konferensbidrag (refereegranskat)abstract
- Due to desirable emission reductions and population growth, increasing energy demand is identified as a dire issue for energy systems. The introduction of low-energy building districts enables increased energy system efficiency. This study’s aim is twofold. Firstly, an extensive urban building energy model is used to simulate the hourly use and geographic distribution of the heat demand for residential and commercial buildings that are to be supplied by a low-temperature district heating system. The simulated buildings are a part of a planned city district, located in Gävle, Sweden. Two building energy performance cases are studied; one where all buildings are assumed to be of Passive House standard, and one where the building energy performance is in line with conventional new-building regulations in Sweden. Secondly, one specific building is modeled in detail and simulated in the building energy simulation software IDA ICE to investigate what building heating system is best suited for low-temperature heat supply. The temperature demands of floor heating and ventilation with heat recovery are investigated and compared to conventional water-based radiators. The building’s temperature demand results can be used when designing a lowtempered district heating system which will provide the supply temperature to identify a compatible heating system technique. Varying supply temperature demand will enable optimization for choosing building heating systems and consequently, possible cost reductions. The results could be used as an example for future city district planning as well as presenting relevant heating systems for low-temperature district heating.
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