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- von Schantz Lundgren, Inger, 1958-, et al.
(author)
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Det är enklare i teorin...Om skolutveckling i praktiken : En fallstudie av ett skolutvecklingsprojekt i en gymnasieskola
- 2008
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Doctoral thesis (other academic/artistic)abstract
- This dissertation is a case study dealing with a school development project that took place in an upper secondary school as a result of a merger of two schools with different cultures. The project used a method called “Frirumsmodellen” and was planned to be conducted in three steps. The first was to carry out a cultural analysis in order to map the preconditions to start a school development project. The second was to carry out concrete actions and finally study eventual effects from such activities by doing a second cultural analysis. My role was to be a supervisor in the school development work, but at the same time study how this work was conducted and its impact in the ordinary school day.The dissertation takes its departure in the fact that schools are political governed. The mission of schools is never neutral; it is always an expression of behind laying social forces, ideologies and ideals of the contemporary society. Of this reason, there is a close connection between the macro political level and the micro political level. Another point of departure is the transition from a modern to a post modern society that gives the character to the changes that take place in schools. Steering of schools has partly been treated as a technical implementation problem. Schools contain on going conflicts between different interest groups that, more or less regularly, end up in educational reforms. These reforms generate school development activities in the single school. Undoubtedly, this makes school development to a complex process.At a rather late stage of the study I decided not to fulfil my task to follow the original plan. I instead let the school development project as a model to be in focus. The over all purpose was formulated: How is it possible to understand what happened in the school development project in the Falkgymnasiet and why was it not possible to carry it out as it was said in the project plan? To interpret what took place during the project I did create an interpretation frame of implementation and complexity theory that also made it possible to critically scrutinise the “Frirumsmodellen”.Already in an early stage of the process it was obvious that the “Frirumsmodellen” did not supply any tools to use and it became disconnected from the project. The project in it selves was marginalised and made invisible. The headmaster used the situation to change things she thought were important to develop. As a result, things happened, but most of the involved people did not at first hand connect this to the project. It is, of course, difficult in detail to say what caused what. The complexity theory successively made the hidden patterns revealed, hidden unofficial potentates visible, as well as unpredictable conditions that generated reactions from the personnel in front of a development work. Together this was rather efficient obstacles for not changing this school.I also discuss school development and implementation problems on a general level, for example, the possibility to transform a top-down initiated project to be bottom-up driven and using project as a tool for school development work. It was obvious that headmasters and teachers must be prepared to handle the ideological dimensions of problems schools have to face. Consequently, development work is about making problems visible and to handle these in the intersection point between the intentions of educational policies, pedagogical researchers, school administrators, headmasters, teachers and pupils. The ideological dimension also contains an existential issue. Do I as a teacher share the intentions for the development work? If not, how must I act?
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- Aléx, Jonas, et al.
(author)
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Being cold when injured in a cold environment : patients' experiences
- 2013
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In: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 21:1, s. 42-49
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Journal article (peer-reviewed)abstract
- Background: Patients in prehospital care, irrespective of diseases or trauma might experience thermal discomfort because of a cold environment and are at risk for decreasing body temperature which can increase both morbidity and mortality.Objective: To explore patients' experiences of being cold when injured in a cold environment.Method: Twenty persons who had been injured in a cold environment in northern Sweden were interviewed. Active heat supply was given to 13 of them and seven had passive heat supply. The participants were asked to narrate their individual experience of cold and the pre- and post-injury event, until arrival at the emergency department. The interviews were transcribed verbatim, then analyzed with qualitative content analysis.Results: Patients described that they suffered more from the cold than because of the pain from the injury. Patients who received active heat supply experienced it in a positive way. Two categories were formulated: Enduring suffering and Relief of suffering.Conclusion: Thermal discomfort became the largest problem independent of the severity of the injuries. We recommend the use of active heat supply to reduce the negative experiences of thermal discomfort when a person is injured in a cold environment.
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- Brechter, Anna Bernhold, et al.
(author)
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Kinin B1 and B2 receptor expression in osteoblasts and fibroblasts is enhanced by interleukin-1 and tumour necrosis factor-alpha. Effects dependent on activation of NF-kappaB and MAP kinases.
- 2008
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In: Bone. - : Elsevier BV. - 8756-3282 .- 1873-2763. ; 43:1, s. 72-83
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Journal article (peer-reviewed)abstract
- Pro-inflammatory mediators formed by the kallikrein-kinin system can stimulate bone resorption and synergistically potentiate bone resorption induced by IL-1 and TNF-alpha. We have shown that the effect is associated with synergistically enhanced RANKL expression and enhanced prostaglandin biosynthesis, due to increased cyclooxygenase-2 expression. In the present study, the effects of osteotropic cytokines and different kinins on the expression of receptor subtypes for bradykinin (BK), des-Arg10-Lys-BK (DALBK), IL-1beta and TNF-alpha have been investigated. IL-1beta and TNF-alpha enhanced kinin B1 and B2 receptor binding in the human osteoblastic cell line MG-63 and the mRNA expression of B1 and B2 receptors in MG-63 cells, human gingival fibroblasts and intact mouse calvarial bones. Kinins did not affect mRNA expression of IL-1 or TNF receptors. EMSA showed that IL-1beta and TNF-alpha activated NF-kappaB and AP-1 in MG-63 cells. IL-1beta stimulated NF-kappaB via a non-canonical pathway (p52/p65) and TNF-alpha via the canonical pathway (p50/p65). Activation of AP-1 involved c-Jun in both IL-1beta and TNF-alpha stimulated cells, but c-Fos only in TNF-alpha stimulated cells. Phospho-ELISA and Western blots showed that IL-1beta activated JNK and p38, but not ERK 1/2 MAP kinase. Pharmacological inhibitors showed that NF-kappaB, p38 and JNK were important for IL-1beta induced stimulation of B1 receptors, and NF-kappaB and p38 for B2 receptors. p38 and JNK were important for TNF-alpha induced stimulation of B1 receptors, whereas NF-kappaB, p38 and JNK were involved in TNF-alpha induced expression of B2 receptors. These data show that IL-1beta and TNF-alpha upregulate B1 and B2 receptor expression by mechanisms involving activation of both NF-kappaB and MAP kinase pathways, but that signal transduction pathways are different for IL-1beta and TNF-alpha. The enhanced kinin receptor expression induced by the pro-inflammatory cytokines IL-1beta and TNF-alpha might be one important mechanism involved in the synergistic enhancement of prostaglandin formation caused by co-treatment with kinins and one of the two cytokines. These mechanisms might help to explain the enhanced bone resorption associated with inflammatory disorders, including periodontitis and rheumatoid arthritis.
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- Fors, Egil A, et al.
(author)
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Psychosocial interventions as part of breast cancer rehabilitation programs? Results from a systematic review
- 2011
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In: Psycho-Oncology. - : Wiley-Blackwell. - 1057-9249 .- 1099-1611. ; 20:9, s. 909-918
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Research review (peer-reviewed)abstract
- Objective: This systematic review aimed to determine the effectiveness of psychoeducation, cognitive behavioural therapy (CBT) and social support interventions used in the rehabilitation of breast cancer (BC) patients. less thanbrgreater than less thanbrgreater thanMethods: We conducted a systematic literature search to identify randomised controlled trials of female BC patients who underwent different psychosocial interventions during or after primary cancer treatment. The methodological quality of all studies was independently assessed by two reviewers. Studies with low quality, less than 20 participants in each group, patients with metastatic cancer, data not presented separately for BC and studies that included other cancer types were excluded. less thanbrgreater than less thanbrgreater thanResults: Among 9617 identified studies, only 18 RCTs published between 1999 and 2008, including 3272 patients were finally included in this systematic evaluation. Outcome measures were categorised into quality of life (QoL), fatigue, mood, health behaviour and social function. Six trials examined psychoeducation had inconsistent results, both during and after the primary treatment. Seven trials examined the effect of CBT, four of which given after primary treatment (range 6-12 weeks) demonstrated improvements in QoL; the other three CBT studies given during primary treatment (range 9-20 weeks) had inconsistencies. Five studies addressed social support and showed no conclusive impacts of this intervention. less thanbrgreater than less thanbrgreater thanConclusions: Limited documentation exists on the efficacy of psychosocial rehabilitation interventions among BC patients. However, we found that patients might have QoL benefits from CBT given after primary BC treatment. More documentation is needed regarding the effects of CBT during primary treatment and the effects of psychoeducation and social support.
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- Henriksson, Otto, et al.
(author)
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Protection against cold : a survey of available equipment in Swedish pre-hospital services
- 2017
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In: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 61:10, s. 1354-1360
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Journal article (peer-reviewed)abstract
- Background: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services.Methods: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers.Results: The response rate was 77% (n = 255). All units carried woollen or polyester blankets for basic insulation. Specific windproof insulation materials were common in the HEMS, SAR and RS units but only present in about half of the AS units. Active warming equipment was present in all the SAR units, but only in about two-thirds of the HEMS units and about one-third of the AS units. About half of the RS units had the ability to provide a heated tent or container. Low-reading thermometers were present in less than half of the AS and HEMS units and were non-existent in the SAR units. Pre-warmed intravenous fluids were carried by almost all of the AS units and half of the HEMS units but infusion heaters were absent in most units.Conclusion: Basic insulation capabilities are well established in the Swedish pre-hospital services. Specific wind and waterproof insulation materials, active warming devices, low-reading thermometers and IV fluid heating systems are less common. We suggest the development and implementation of national guidelines on accidental hypothermia that include basic recommendations on equipment requirements.
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- Johnsson, Inger W, 1973-, et al.
(author)
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Females with a high birth weight have increased risk of offspring macrosomia and obesity, but not of gestational diabetes
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Other publication (other academic/artistic)abstract
- Aim This study investigated how maternal birth weight was related to offspring birth weight, as well as to risk of obesity in pregnancy and gestational diabetes.Methods The cohort (N= 305 893) comprises females born term and singleton in Sweden 1973-1995, studied at the time of their first pregnancy. Information regarding their birth weight, BMI and complications during pregnancy was retrieved from the Swedish Medical Birth Register in addition to data on their mothers and offspring.Results A maternal birth weight between 2-3 SDS was associated with a more than threefold increased risk of having an offspring with a birth weight between 2-3 SDS, OR 3.83 (3.44-4.26), or >3 SDS, OR 3.55 (2.54-4.97). Corresponding ORs for a maternal birth weight >3 SDS were 5.38 (4.12-7.01) and 6.98 (3.57-13.65), respectively. Risk of obesity in pregnancy was also related to maternal birth weight with OR 1.52 (1.42-1.63) for a birth weight corresponding to 2-3 SDS and 2.06 (1.71-2.49) for a birth weight >3 SDS. The risk of gestational diabetes was increased in females with a low (<2 SDS) birth weight, OR 2.49 (2.00-3.12), but not in those with a high birth weight.Conclusion Being born with a high birth weight was associated with increased risk of offspring macrosomia and obesity during pregnancy. The risks were most pronounced for subjects with a very high birth weight. A low, but not a high birth weight was associated with increased risk of gestational diabetes.
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- Johnsson, Inger W, 1973-
(author)
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Long-term metabolic effects of a high birth weight
- 2019
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Doctoral thesis (other academic/artistic)abstract
- The intrauterine environment influences foetal growth as well as future response to risk factors for disease. This occurs partly through epigenetic mechanisms. Thus, birth weight is a possible risk marker of adult disease. Low birth weight is a well-known risk factor for adult disease, particularly when associated with obesity and a U-shaped relationship between birth weight and several metabolic diseases has been suggested.In this thesis we investigated associations between a high birth weight and risk of adult disease, e.g. obesity, cardiovascular disease, type 2 diabetes and gestational diabetes.By analyses of national register data on 759 999 subjects up to the age of 37 years, we could demonstrate an increased risk of type 2 diabetes in males, but not in females, with a high birth weight (>2 SDS). The increase was particularly pronounced in males with a birth weight >3 SDS. There was an association between high birth weight and obesity in males and females, but no such relation was seen for hypertension or serum lipid abnormalities.In a clinical study, 27 cases with a birth weight ≥4 500 grams were compared with 27 controls with normal birth weight, regarding risk factors for cardiovascular disease and diabetes. The cases had a greater radial artery intima thickness and intima:media ratio compared with the controls indicating early atherosclerotic changes. Body mass index, body composition, insulin sensitivity, lipid profiles, blood pressure, resting energy expenditure and respiratory quotient did not differ between cases and controls, but females with a high birth weight had a more disadvantageous distribution of body fat.In order to investigate associations between birth weight and pregnancy outcomes, register data on 305 893 females was analysed. The results demonstrated an association between the female´s own birth weight and offspring birth weight. A high maternal birth weight was associated with increased risk of obesity. The risk of gestational diabetes was increased in females with a low, but not a high birth weight.In conclusion, subjects with a moderately high birth weight did not differ substantially from those with a normal birth weight regarding risk factors for cardiovascular disease. However, differences in arterial wall dimensions were demonstrated in a clinical investigation, and there were differences in BMI and risk of type 2 diabetes on a population level. Since risks are most pronounced in subjects with a birth weight >3 SDS, this group is in particular need of follow up and disease preventive measures.
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