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- Hjelte, Jan, 1965-
(författare)
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Samarbete i gränsland : Om relation och kommunikation i samarbete mellan skola och barnomsorg
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is a case study about the forms of appearance and the consequences of relations and communication in collaborative work between school and child-care providers. The empirical data consists mainly of interviews, but include also a number of written documents.The aims of the study are:• First, to review how relations and communication appear in collaborations between school and child-care.• Second, to examine the consequences of relations and these communica-tions for cooperation between different professions in school and child-care.• Third, to review how these relations and communications between child-care and school are influenced by organizational conditions.The theoretical frame of reference has four sections. The first comprises some comprehensive assumptions for the thesis. The second deals with perspectives on relation and communication. The third discusses cooperation as organizing of social processes. The fourth examines, from a neo-institutional standpoint, how organizational conditions influence professional relations and communication in these collaborations.Regarding relations, the analysis shows that there was regular face-to-face-contact between different professional groups but variations in frequency of contact. One contributing cause to the variations was geographical distance. Another cause was the extent to which the groups shared common interests. It also became evident that there were variations in the distribution of power partly caused by systemic, structural, conditions and partly by episodic and temporary aspects.The analysis also shows that communication has four content types. First, work communication, refers to the everyday communication in cooperation. News- and status communication concerns actors, at different levels, informing other actors about their status. Management communication, partly concerned the coordination of areas of responsibility on the management level. It also con-cerned the managers’ direction of the operative level. Value and culture communication, included discussions about the underlying assumptions of different programs.Relations and communication affected those areas of knowledge and those programs that would be a part of the cooperation. If the actors did not agree with one another they had to negotiate to reach an agreement that both parties accepted. Communication also influenced the opportunity to organize cooperation around children’s needs. For example communication influenced flexibility in the cooperation. To make this possible continuous communication was necessary as was the opportunities to create similar knowledge about each other’s competence and how it was manifested in the practical work.Regarding the organizational conditions, institutional rules affected the actors opinions about whom they should cooperate, and therefore communicate, with. In spite of that, the actors on the operative level had a space to act strategically. Therefore the implementation of cooperation, to a great extent, was formed in communication between actors who were involved in the every day work.
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| 3. |
- Mani, Maria, et al.
(författare)
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Objective Assessment of Nasal Airway in Unilateral Cleft Lip and Palate : a Long-term Study
- 2010
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 47:3, s. 217-224
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To objectively evaluate the nasal function in adults operated on for unilateral cleft lip and palate with one-stage or two-stage palate closure. DESIGN: The population consists of all unilateral cleft lip and palate patients born from 1960 to 1987 and treated at the Cleft Lip and Palate Center, Uppsala University Hospital, Sweden. The patients were treated according to the same protocol except for palate closure, which was performed in one stage until 1977 and in two stages thereafter. Eighty-three patients participated. Mean follow-up time after primary surgery was 32 years. An age-matched control group underwent the same examinations. MAIN OUTCOME MEASURES: Nasal minimum cross-sectional area (cm(2)) and volume (cm(3)) were assessed (acoustic rhinometry). Airflow resistance (Pa s/cm(3)) (rhinomanometry), peak inspiratory flow (L/min) (peak nasal inspiratory flow), and number of identified odors (Scandinavian Odor Identification Test) were determined. RESULTS: The cleft side of unilateral cleft lip and palate patients had significantly lower values for all parameters compared with controls (p < .001). No difference was found between one-stage and two-stage procedures in values for the cleft side. However, the nasal area and volume of the noncleft side were significantly larger in patients who underwent one-stage as compared with two-stage procedures (p < .05). CONCLUSION: The nasal airway of unilateral cleft lip and palate patients demonstrates a wide range of impairments that can be quantified by objective measurements. However, the measurements used did not differentiate between patients operated on with the one-stage and two-stage procedures except for values of the noncleft side.
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| 4. |
- Moren, Staffan, et al.
(författare)
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Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate
- 2013
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X .- 2000-6764. ; 47:5, s. 383-389
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.
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| 5. |
- Morén, Staffan, et al.
(författare)
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Speech in Adults Treated for Unilateral Cleft Lip and Palate : Long-Term Follow-Up After One- or Two-Stage Palate Repair
- 2017
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 54:6, s. 639-649
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate speech in adults treated for unilateral cleft lip and palate with one-stage or two-stage palate closure and compare the speech of the patients with that of a noncleft control group.DESIGN: Cross-sectional study with long-term follow-up.PARTICIPANTS/SETTING: All unilateral cleft lip and palate patients born from 1960 to 1987 and treated at Uppsala University Hospital, Sweden, were invited (n = 109). Participation rate was 67% (n = 73) at a mean of 35 years after primary surgery. Forty-seven had been treated according to one-stage palate closure and 26 according to two-stage palate closure. Pharyngeal flap surgery had been performed in 11 of the 73 patients (15%). The noncleft control group consisted of 63 age-matched volunteers.MAIN OUTCOME MEASURE(S): Speech-language pathologists rated perceptual speech characteristics from blinded audio recordings.RESULTS: Among patients, seven (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one (2%) had reduced intelligibility. Controls had no audible signs of velopharyngeal insufficiency and no quantifiable problems with the other speech production variables. No significant differences were identified between patients treated with one-stage and two-stage palate closure for any of the variables.CONCLUSIONS: The prevalence of speech outcome indicative of velopharyngeal insufficiency among adult patients treated for unilateral cleft lip and palate was low but higher compared with individuals without cleft. Whether palatal closure is performed in one or two stages does not seem to affect the speech outcome at a mean age of 35 years.
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| 6. |
- Morén, Staffan, et al.
(författare)
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Speech in Adults Treated for Unilateral Cleft Lip and Palate as Rated by Naïve Listeners, Speech-Language Pathologists and Patients
- 2022
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Ingår i: Journal of Plastic, Reconstructive & Aesthetic Surgery. - : Elsevier. - 1748-6815 .- 1878-0539. ; 75:10
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Tidskriftsartikel (refereegranskat)abstract
- Speech may be affected in patients with cleft lip and palate (CLP). Professional listeners, naïve listeners, and patients may perceive speech differently. The aim of the study was to assess speech among adults treated for unilateral CLP (UCLP) as rated by naïve listeners, speech-language pathologists (SLPs), and self-assessment and to evaluate how well these ratings correlate.All patients with complete UCLP treated at the Uppsala University Hospital, Uppsala, Sweden, in 1960–1987 were invited. A total of 73 of 109 patients (67%) participated, with a mean of 35 years since the initiation of treatment. The noncleft control group consisted of 55 volunteers. All participants answered questionnaires for self-rating of speech, and their speech was audio-recorded digitally. Fourteen naïve listeners and four SLPs rated the speech individually from blinded recordings.There were more speech abnormalities among patients compared to controls according to the ratings of naïve listeners and SLPs. In controls and patients, there were positive correlations between the speech ratings by naïve listeners and SLPs r = 0.44 to 0.71, p < 0.001, Spearman). The patients were less satisfied and rated to have more speech abnormalities than controls (p < 0.001).Although adults treated for UCLP considered their speech as fairly good, they were less satisfied than noncleft controls. The agreement between ratings by naïve listeners and SLPs were good, while the agreement between these ratings and self-assessment varied widely. When assessing speech in adults treated for UCLP, differences in perception of speech abnormalities by professionals, laymen, and patients should be considered.
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| 7. |
- Morén, Staffan
(författare)
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Unilateral Cleft Lip and Palate : Speech, Voice and Nasal Function in Adults
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cleft lip and palate (CLP) is the most common craniofacial malformation. Even after repair of the cleft there may be persistent symptoms affecting speech, voice, nasal breathing, dentition, appearance and quality of life. The aims of the thesis were to: (I) investigate subjective nasal function and nasal airway at clinical examination, (II) evaluate speech by perceptual evaluation, (III) assess voice quality by perceptual evaluation and acoustic analysis and (IV) compare ratings of speech by naïve listeners, speech-language pathologists (SLPs) and patients.All consecutive patients with complete unilateral CLP, born 1960-1987, and treated at Uppsala University Hospital were invited. A total of 83 (76%) (I) and 73 (67%) (II, III, IV) of the 109 eligible patients and non-cleft controls (n=63) participated. Patients had been treated in childhood with one- or two-stage palate closure. The participants underwent clinical examination, recording of speech and filled in questionnaires.The results showed that: (I) Patients earlier treated for UCLP suffer from more nasal symptoms than controls. However, nasal symptoms were not associated with clinical findings or method of palate closure. (II) Seven patients (10%) presented with hypernasality, 12 (16%) had audible nasal emission and/or nasal turbulence, five (7%) had consonant production errors, one (2%) had glottal reinforcements/substitutions, and one had reduced intelligibility. Controls had no quantifiable problems with speech. (III) Among patients, the mean values for the 12 perceptual voice variables on a visual analogue scale (0 = no abnormality, 100 = maximal abnormality) ranged between 1 and 22 and the mean for all was 6 mm. Voice variables were similar between patients and controls except “vocal fry”; this and total mean of all the perceptual voice variables were slightly lower among patients (p = 0.009 and p = 0.018 ). No clear association was found between velopharyngeal insufficiency and dysphonia. (IV). There were positive correlations between speech ratings by naïve listeners and SLPs (r =0.44 to 0.69, p always < 0.001, Spearman). The correlations between ratings of any of these groups and the patients’ self-ratings were weaker (r < 0.40). The patients were less satisfied with their speech and rated themselves to have more speech abnormalities than controls (p < 0.001). There were no statistically significant differences in any of the variables regarding speech, voice or nose between patients treated with one-stage and two-stage palate closure in any of the studies.This thesis shows that adults treated for unilateral CLP have more nasal symptoms and cleft related speech abnormalities compared to the controls, however the prevalence of speech abnormalities are relatively low. Voice quality is not affected. Speech quality is rated differently by naïve listeners, SLPs and patients.
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| 8. |
- Morén, Staffan, et al.
(författare)
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Voice quality in adults treated for unilateral cleft lip and palate : Long-Term Follow-Up After One- or Two-Stage Palate Repair
- 2018
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Ingår i: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 55:8, s. 1103-1114
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the current study was to assess voice quality among adults treated for unilateral cleft lip and palate (UCLP), after 1- or 2-stage palate closure, and compare it to a noncleft control group.Study Design: Cross-sectional study in UCLP patients with long-term follow-up and noncleft controls.Participants: UCLP patients born 1960-1987, treated at Uppsala University Hospital, Sweden, were examined (n = 73) at a mean of 35 years after primary surgery. Forty-seven patients (64%) had been treated with 1-stage palate closure and 26 with 2-stage closure (36%). The noncleft control group consisted of 63 age-matched volunteers.Main Outcome Measure(s): Ratings of perceptual voice characteristics from blinded voice recordings with Swedish Voice Evaluation Approach (SVEA) method. Acoustic voice analysis including pitch and spectral measures.Results: Among the patients, the mean values for the 12 evaluated variables on a VAS scale (0 = no abnormality, 100 = maximal abnormality) ranged between 1 and 22 and the mean for all was 6 mm. Voice variables were similar between patients and controls except the total mean of all the perceptual voice variables, as well as “vocal fry”—both slightly lower among patients (P = .018 and P = .009). There was no difference in any variable between patients treated with 1-stage and 2-stage palate closure. No clear relationship was found between VPI and dysphonia.Conclusion: The voice characteristics among adults treated for UCLP in childhood are not different from those of individuals without cleft.
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| 10. |
- Nordlander, Lars, 1967-
(författare)
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Mellan kunskap och handling : Socialsekreterares kunskapsanvändning i utredningsarbetet
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study is about how social workers use knowledge in their investigation work. The study includes 16 social workers documentation of their knowledge use in 21 investigations in three personal social services in Västerbotten, Sweden. The three research-questions that the study aims to answer are: what knowledge do they use, how do they use their knowledge and on what grounds do they choose these knowledge’s?The studies empirical findings are a result of a systematic documentation instrument SPP (Systematic Planned Practice). The instrument consists of seven different forms that together correspond to the whole investigation process, from the first meeting with the client to a complete investigation. The SPP-instrument was designed by Professor Aaron Rosen from Washington University in St. Louis, USA. The SPP-instrument was used in this study as tool to gather information on what knowledge social workers use in the investigation work. The seven forms that the instrument consists of were sent to the social workers electronically. In each step of the investigation work the social workers filled out each form and send them back to the researcher for analyse.The results from the study shows that social workers use a variety of different types of knowledge as a base for their decisions in the investigation work. In the majority of these knowledge’s the social workers relates them to actual client situations. When the social workers describe how they use their knowledge the result shows that they use different strategies to express their use of knowledge in relation to specific decisions in the investigation work. How they use these knowledge’s seams not to correspond with what kind of knowledge they have used. The social workers claims that their choice of knowledge as roughly has to do with two different set of circumstances: 1) circumstances that limits their choice of knowledge and 2) circumstances that they intellectual know that they can influence ones they reflect upon their choices, but not during the actual choice of knowledge.All together the study shows that the social workers use of knowledge is partly a hidden process that they have trouble to express in writing. However this do not mean that they are short of relevant knowledge for their profession. Instead it shows that social workers use of knowledge is highly situational and that their use of knowledge is a cognitive process that is difficult to describe or conceptualise.
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